WorldWideScience

Sample records for care universal service

  1. Uptake Of Eye Care Services In University Of Calabar Teaching ...

    African Journals Online (AJOL)

    This study was carried out to determine the importance of alternative sources of eye care services in delay in seeking ophthalmic treatment in University of Calabar teaching hospital (UCTH).Atotal of 580 patients who visited the hospital within 3 months of the study period October 2003 to December 2003, were examined ...

  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. 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 facilities.

  4. 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.

  5. Management of health care services for flood victims: the case of the shelter at Nakhon Pathom Rajabhat University Central Thailand.

    Science.gov (United States)

    Buajaroen, Hathaichanok

    2013-08-01

    In Central Thailand basic health care services were affected by a natural disaster in the form of a flood situation. Flood Relief Operations Centers were established from the crisis. Nakhon Pathom Rajabhat University and including the faculty of nursing volunteered to care for those affected and assist in re-establishing a functioning health care system. The aim of this study was to make explicit knowledge of concept, lesson learned, and the process of management for re-establishing a health care service system at a flood victims at Relief Operations Center, Nakhon Pathom Rajabhat University. We used a qualitative design with mixed methods. This involved in-depth interviews, focus group, observational participation and non-observational participation. Key informants included university administrators, instructors, leaders of flood victims and the flood victims. Data was collected during October-December, 2010. Data were analysed using content analysis and compared matrix. We found that the concept and principle of health care services management were community based and involved home care and field hospital services. We had prepared a management system that placed emphasise on a community based approach and holistic caring such as 24h Nursing Clinic Home, visits with family, a referral system, field hospital. The core of management was to achieve integrated instruction started from nursing students were practiced skills as Health promotion and nursing techniques practicum. Rules were established regarding the health care service system. The outcomes of Health Care Service at the Flood Relief Operations Center were direct and sincere help without conditions, administrations concerned and volunteer nursing students instructors, University Officer have sympathetic and charitable with flood victims and environment. Copyright © 2013 College of Emergency Nursing Australasia Ltd. Published by Elsevier Ltd. All rights reserved.

  6. Racial/Ethnic Differences in the Use of Primary Care Providers and Preventive Health Services at a Midwestern University.

    Science.gov (United States)

    Focella, Elizabeth S; Shaffer, Victoria A; Dannecker, Erin A; Clark, Mary J; Schopp, Laura H

    2016-06-01

    Many universities seek to improve the health and wellbeing of their faculty and staff through employer wellness programs but racial/ethnic disparities in health care use may still persist. The purpose of this research was to identify racial/ethnic disparities in the use of preventive health services at a Midwestern university. A record review was conducted of self-reported health data from University employees, examining the use of primary care and common screening procedures collected in a Personal Health Assessment conducted by the University's wellness program. Results show that there were significant racial/ethnic differences in the use of primary care and participation in screening. Notably, Asian employees in this sample were less likely to have a primary care provider and participate in routine cancer screenings. The observed racial/ethnic differences in screening behavior were mediated by the use of primary care. Together, these data show that despite equal access to care, racial and ethnic disparities in screening persist and that having a primary care provider is an important predictor of screening behavior. Results suggest that health communications designed to increase screening among specific racial/ethnic minority groups should target primary care use.

  7. Satisfaction With Medication Therapy Management Services at a University Ambulatory Care Clinic.

    Science.gov (United States)

    Kim, Shiyun; Martin, Michelle T; Pierce, Andrea L; Zueger, Patrick

    2016-06-01

    A survey was issued to patients enrolled in the Medication Therapy Management Clinic (MTMC) at University of Illinois Hospital and Health Sciences (June 2011-January 2012) in order to assess satisfaction with pharmacy services provided by pharmacists. A 23-item survey was offered to 65 patients in the MTMC program before or after clinic visits. Since there is a paucity of data indicating the level of satisfaction with MTM services provided by pharmacists, this survey may contribute to the process of building a greater collaboration between the pharmacist and patient. Sixty-two of 65 patients completed the survey; satisfaction with MTMC pharmacists was demonstrated to be significantly positively correlated with overall satisfaction with the MTMC. Patient satisfaction is not significantly different according to age, gender, ethnicity, or number of disease states. Satisfaction with the pillbox service is not significantly different between younger and older patients. It was also noted that patients taking a greater number of medications had higher levels of satisfaction. Most patients indicated that they were satisfied with the MTMC pharmacists and services; further study linking patient satisfaction with MTM services to improved patient outcomes may allow our MTMC to serve as a model for other pharmacist-managed MTMCs serving similar patient populations. © The Author(s) 2014.

  8. In Madagascar, Use Of Health Care Services Increased When Fees Were Removed: Lessons For Universal Health Coverage.

    Science.gov (United States)

    Garchitorena, Andres; Miller, Ann C; Cordier, Laura F; Ramananjato, Ranto; Rabeza, Victor R; Murray, Megan; Cripps, Amber; Hall, Laura; Farmer, Paul; Rich, Michael; Orlan, Arthur Velo; Rabemampionona, Alexandre; Rakotozafy, Germain; Randriantsimaniry, Damoela; Gikic, Djordje; Bonds, Matthew H

    2017-08-01

    Despite overwhelming burdens of disease, health care access in most developing countries is extremely low. As governments work toward achieving universal health coverage, evidence on appropriate interventions to expand access in rural populations is critical for informing policies. Using a combination of population and health system data, we evaluated the impact of two pilot fee exemption interventions in a rural area of Madagascar. We found that fewer than one-third of people in need of health care accessed treatment when point-of-service fees were in place. However, when fee exemptions were introduced for targeted medicines and services, the use of health care increased by 65 percent for all patients, 52 percent for children under age five, and over 25 percent for maternity consultations. These effects were sustained at an average direct cost of US$0.60 per patient. The pilot interventions can become a key element of universal health care in Madagascar with the support of external donors. Project HOPE—The People-to-People Health Foundation, Inc.

  9. Prevalence of thrombocytopenia among pregnant women attending antenatal care service at Gondar University Teaching Hospital in 2014, northwest Ethiopia.

    Science.gov (United States)

    Asrie, Fikir; Enawgaw, Bamlaku; Getaneh, Zegeye

    2017-01-01

    Thrombocytopenia is a common hematologic abnormality during pregnancy. Pregnant women with thrombocytopenia have a higher risk of bleeding excessively during or after childbirth, particularly if they need to have a cesarean section or other surgical intervention during pregnancy, labor or in the puerperium. The main aim of this study was to determine the prevalence of thrombocytopenia among pregnant women attending antenatal care service at Gondar University Hospital, northwest Ethiopia. A cross-sectional study was used to assess the prevalence of thrombocytopenia among pregnant women attending antenatal care service at Gondar University Hospital from January to April 2015. A total of 217 pregnant women were included in the study and a structured pretested questionnaire was used to obtain sociodemographic information, nutritional factors, obstetrics and gynecological factors, history and clinical condition. Blood samples were collected for platelet count and other platelet parameters, which were determined by using SysmexKX 21 automation. The data were entered to Epi info version 6 software and analyzed using SPSS version 20 software. Bivariable and multivariable statistical analyses were used to evaluate the effect of independent variable over the dependent variable. A p -value of women receiving antenatal care service at Gondar University Hospital participated in the study. Thrombocytopenia among 19 pregnant women showed a prevalence of 8.8%. The mean ± standard deviation platelet count was 238.85×10 9 /L (±74.57). Thrombocytopenia was significantly associated with patients who lived rurally (crude odds ratio =4.3, 95% confidence interval 1.48-12.76). The prevalence of thrombocytopenia was 8.8% predominantly with mild type of thrombocytopenia. Thrombocytopenia was higher among pregnant women who lived rurally. Therefore, health care providers should screen routinely for thrombocytopenia to avoid excessive bleeding during pregnancy, especially in women who live

  10. 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 ... are chronically ill, recovering from surgery, or disabled. Home care services include Personal care, such as help ...

  11. Telecommunications and Universal Service

    International Development Research Centre (IDRC) Digital Library (Canada)

    The book is intended to provide valuable input to the Universal Service Agency .... Figure 1 is not, of course, drawn to scale for South Africa. .... Such uneconomic customers and areas are mainly found in rural, peripheral, and less favoured regions. ... The United Kingdom is a good example of the enduring nature of this task.

  12. Health Care Services

    Science.gov (United States)

    Misuse and Addiction Prevention Finance & Management Services Health Care Services Juvenile Justice , 2017 Warning - A phone number that was once used for the Denali KidCare program is now being used to ask people for their credit card number in order to win a prize. The phone number related to this

  13. 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 Vietna...

  14. Pediatric dental care in a tertiary public hospital. Four years of experience in the Service of Stomatology of Valencia University General Hospital (Valencia, Spain).

    Science.gov (United States)

    Poveda, Rafael; Jiménez, Yolanda; Gavaldá, Carmen; Sanchís, José María; Carbonell, Enrique; Margaix, María; Sarrión, Gracia

    2008-05-01

    A study is made of the experience gained with the Child Oral Care Program (Plan de Atención Dental Infantil, PADI) in the Service of Stomatology of Valencia University General Hospital (Valencia, Spain) after four years in operation (July 2003 - July 2007). The sample comprised 2626 children between 5-14 years of age, pertaining to department 9 of the Valencian public health system. A clinical history was compiled in each case, a radiological study was made, and a treatment plan was elaborated including fillings, extractions, and control visits. Of the 2626 designated children, 2369 visited our Service - mostly referred from the Preventive Dental Care Units. A total of 5784 fillings were carried out (93.3% with silver amalgam, 5.6% with composites and the rest as provisional fillings). The permanent first molars were the teeth with the largest number of fillings (70.2% of the total). These were followed in order of frequency by the second molars (19.1%). As regards composite resin fillings, most involved the upper central incisors, followed by the upper lateral incisors. A total of 644 extractions were performed, corresponding to 110 permanent teeth and 534 temporary teeth. In the case of the permanent dentition, the first molars were the most commonly removed teeth. In the temporary dentition, the most frequently removed teeth were the second molars. The response of the population to this program has been very good, and reinforces the preventive measures already in place, with the provision of restorative treatments to improve the oral and dental health of the pediatric population, and yielding good results in terms of the program quality indicators. The Service of Stomatology (Valencia University General Hospital) is able to address the demand and offers the public health network integrated and continuous patient care.

  15. Decreased Risk of Preeclampsia After the Introduction of Universal Voucher Scheme for Antenatal Care and Birth Services in the Republic of Korea.

    Science.gov (United States)

    Choe, Seung-Ah; Min, Hye Sook; Cho, Sung-Il

    2017-01-01

    Objectives A number of interventions to reduce disparities in maternal health have been introduced and implemented without concrete evidence to support them. In Korea, a universal voucher scheme for antenatal care and birth services was initiated in December 2008 to improve Korea's fertility rate. This study explores the risk of preeclampsia after the introduction of a universal voucher scheme. Methods Population-based cohort data from the National Health Insurance Service-National Sample Cohort (NHIS-NSC) covering 2002-2013 were analysed. A generalized linear mixed model (GLMM) was used to estimate the relationship between the risk of preeclampsia and voucher scheme introduction. Results The annual age-adjusted incidence of preeclampsia showed no significant unidirectional change during the study period. In the GLMM analysis, the introduction of a voucher scheme was associated with a reduced risk of preeclampsia, controlling for potential confounding factors. The interaction between household income level and voucher scheme was not significant. Conclusions for Practice This finding suggests that the introduction of a voucher scheme for mothers is related to a reduced risk of preeclampsia even under universal health coverage.

  16. University Opinion Poll 9: Child Care, MPIRG, Lettuce. Preliminary Report.

    Science.gov (United States)

    Matross, Ronald; And Others

    The University Opinion Poll conducted a survey of student opinion on issues related to University-sponsored day care, the role of the Minnesota Public Interest Research Group (MPIRG) and the University's policy on buying lettuce for its food services. Four hundred fifty-two respondents, 76% of a random sample of University of Minnesota students,…

  17. Community care and social services.

    OpenAIRE

    Renwick, D.

    1996-01-01

    The aim of community care is to enable people with various types of disability to live in their own homes, rather than in institutions. This involves the provision of support and services at home by various agencies. After a critical report in 1986 identified problems with coordination and flexibility of community care services, the white paper Caring for People (1989) stated the government's aim to provide a "needs led," responsive range of services, promoting maximum independence of those w...

  18. Nasal Colonization rate of Staphylococcus aureus strains among Health Care Service Employee’s of Teaching University Hospitals in Yazd

    Directory of Open Access Journals (Sweden)

    Khalili Mohammad Bagher

    2009-10-01

    Full Text Available This study was carried out to find the extent of staphylococcal carriages including Methicillin resistant Staphylococcus aureus MRSA in employee's of teaching university hospitals in Yazd. Nasal swabs of 742 employees in four different medical teaching hospitals in Yazd were collected, and tested for detection of staphylococci strains. Out of 742 employees, 94 (12.7% were carrier of staphylococcus aurus and 57 (11.38% for methicillin resistant Staphylococcus aureus (MRSA respectively. Prevalence of Staphylococci aureus and MRSA in individual hospitals and wards were different. In general the highest carriers were personnel of dialysis ward and the lowest pediatrics wards. Resistance rate of MRSA against Ciprofloxacin, Vancomycin, and Rifampin were found to be as 28.1%, 10.5% and 35.1% respectively.

  19. 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.

  20. Information Services at the University of Calgary.

    Science.gov (United States)

    Norris, Douglas

    The University of Calgary was the first university in Canada to combine its library, computer center, and audiovisual services into one unit. For a period of three years the Division of Information Services administered and coordinated library services, computer services, and communications media. The organizational structure, objectives, and the…

  1. 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.

  2. Analysis of Eye Care Services in Yemen

    OpenAIRE

    Saleh A. Al-Akily; Mutahar Y. Al-Shaer; Mahfouth A. Bamashmus; Abdulmoghni O. Al-Barrag; Tawfik K. Alkhatib; Hisham A. Al-Akhlee

    2017-01-01

    Purpose: The objective of this study was to undertake an analysis of the eye care services situation in Yemen and to assess ophthalmic human resources, eye units’ ownership and ophthalmic equipments. Methods: Eye care providers were surveyed by a standardized questionnaire which was sent to the 184 eye units in governmental, university, military, private and charity clinics and hospitals in Yemen and covered the period between 01 January to 31 December 2012. The questionnaire determined l...

  3. 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…

  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. 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.

  6. Telecommunications and Universal Service: International ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    The services delivered over telecommunications networks can provide ... livestock vaccine development and production to benefit farmers across the Global South. ... OECD's Development Co-Operation Report highlights critical role of data to ...

  7. Home Care Services: Questions to Ask

    Science.gov (United States)

    Healthy Lifestyle Healthy aging Home care services range from medical care to help with daily household chores. If ... 12, 2017 Original article: http://www.mayoclinic.org/healthy-lifestyle/healthy-aging/in-depth/home-care-services/art- ...

  8. Telecommunications and Universal Service: International ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Out of print. 104 pages. e-ISBN : 1552503216. Téléchargez le PDF · Téléchargez le cyberlivre. The services delivered over telecommunications networks can provide enormous ... Amnisties pour la paix dans le delta du Niger - évaluation critique de la contribution à une paix durable du pardon de crimes du passé.

  9. Telecommunications and Universal Service : International ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Les services fournis au moyen de réseaux de télécommunications peuvent offrir des possibilités énormes dans les domaines suivants : éducation, soins de santé, production de revenu et accès à tous les paliers de gouvernement et communication avec eux. Pour en bénéficier, les pays doivent trouver des moyens d'offrir ...

  10. Child Health Care Services in Austria.

    Science.gov (United States)

    Kerbl, Reinhold; Ziniel, Georg; Winkler, Petra; Habl, Claudia; Püspök, Rudolf; Waldhauser, Franz

    2016-10-01

    We describe child health care in Austria, a small country in Central Europe with a population of about 9 million inhabitants of whom approximately 1.7 million are children and adolescents under the age of 20 years. For children and adolescents, few health care indicators are available. Pediatric and adolescent health provision, such as overall health provision, follows a complex system with responsibilities shared by the Ministry of Health, 19 social insurance funds, provinces, and other key players. Several institutions are affiliated with or cooperate with the Ministry of Health to assure quality control. The Austrian public health care system is financed through a combination of income-based social insurance payments and taxes. Pediatric primary health care in Austria involves the services of general pediatricians and general practitioners. Secondary care is mostly provided by the 43 children's hospitals; tertiary care is (particularly) provided in 4 state university hospitals and 1 private university hospital. The training program of residents takes 6 years and is completed by a final examination. Every year, this training program is completed by about 60 residents. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. [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.

  12. Universal service in Vietnam: An institutional approach

    DEFF Research Database (Denmark)

    Do Manh, Thai; Falch, Morten

    2018-01-01

    Applying institutional theory to look at the Program 74 (a universal service policy) in Vietnam, this paper concludes that the Vietnamese universal service policy was strongly affected by formal institutional factors (the international agreements and the directives of the Communist Party of Vietnam...... - CPV), in which the international agreements played a leading role and the CPV’s directives played a guarantee role. The formulation and implementation of the universal service policy in Vietnam were mainly concentrated on action at levels 2 and 3 (formal and informal institutional arrangement......, and formal institutional environment). The paper recommends that nations favouring a top-down approach not based on a market-oriented regime should deregulate and emphasize the role of provincial governments as well as encourage private sectors/social organizations and rural users to be more involved...

  13. Health care financing in Nigeria: Implications for achieving universal ...

    African Journals Online (AJOL)

    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.

  14. Home care services for sick children

    DEFF Research Database (Denmark)

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

    2017-01-01

    as challenging for healthcare professionals in home care services used to providing care predominately for adults. DESIGN: An inductive qualitative design. METHOD: Seven focus group interviews were performed with 36 healthcare professionals from multidisciplinary home care services. Data were analysed stepwise......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...... using a phenomenographic analysis. RESULTS: Three description categories emerged: "A challenging opportunity", "A child perspective", and "Re-organise in accordance with new prerequisites." Providing home care services for children was conceived to evoke both professional and personal challenges...

  15. The effect of restructuring of health care services on caesarean ...

    African Journals Online (AJOL)

    Nicky

    2005-06-24

    Jun 24, 2005 ... The effect of restructuring of health care services on caesarean section rates. ARTICLE. Medical Research Council/ University of KwaZulu-Natal, Pregnancy Hypertension Research. Unit and Department of Obstetrics and Gynaecology, Nelson R Mandela School of Health. Sciences, University of ...

  16. Long-Term Care Services for Veterans

    Science.gov (United States)

    2017-02-14

    includes but is not limited to home physical , occupational, or speech therapy ; wound care; and intravenous (IV) care. A VA physician determines that a...restoring/rehabilitating the veteran’s health, such as skilled nursing care, physical therapy , occupational therapy , and IV therapy Same as HBPC... geriatric evaluation,  palliative care,  adult day health care,  homemaker/home health aide care,  respite care, Long-Term Care Services for

  17. 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......, education, and integration. One lesson learned is that developing services for education is a cultural challenge as much as it is a technological one, and that the rate of adoption tends to be slower....

  18. 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...

  19. Home Health Care: Services and Cost

    Science.gov (United States)

    Widmer, Geraldine; And Others

    1978-01-01

    Findings from a study of home care services in one New York district document the value and relatively modest costs of home health care for the chronically ill and dependent elderly. Professional nurses coordinated the care, but most of the direct services were provided by home health aides and housekeepers. (MF)

  20. Home Care Services and the Rural Elderly.

    Science.gov (United States)

    Hayslip, Bert, Jr.; And Others

    1980-01-01

    Independent studies examined a needs v an agency perspective on home health care service needs within a rural county. Interviews with 299 elderly, aged 60-93, revealed there were substantial needs for home health care services and the desire for services varied with residence within the county. (Author)

  1. Universal access, cost recovery, and payment services

    OpenAIRE

    Sujit Chakravorti; Jeffery W. Gunther; Robert R. Moore

    2005-01-01

    We suggest a subtle, yet far- reaching, tension in the objectives specified by the Monetary Control Act of 1980 (MCA) for the Federal Reserve’s role in providing retail payment services, such as check processing. Specifically, we argue that the requirement of an overall cost-revenue match, coupled with the goal of ensuring equitable access on a universal basis, partially shifted the burden of cost recovery from high-cost to low-cost service points during the MCA’s early years, thereby allowin...

  2. Gender Inequality in University Administration and Services

    OpenAIRE

    Estelles Miguel, Sofia; NAVARRO GARCÍA, ANTONIO; Palmer Gato, Marta Elena; Albarracín Guillem, José Miguel

    2014-01-01

    This work is licensed under a Creative Commons Attribution 3.0 License. This article addresses inequalities between men and women at work. Inequalities in job access and career progression are addressed. The article reviews literature on equal opportunities at work. A case study of administrative and services staff at a public university in Valencia (Spain) is then presented. The case study assesses the current reality of gender inequality in Spanish public institutions. Spanish public uni...

  3. Managing Cancer Care - Finding Health Care Services

    Science.gov (United States)

    ... my condition? Has it been rated by state, consumer, or other groups for its quality of care? ... be both rewarding and demanding. It can change relationships and require families to cope with all aspects ...

  4. Nuclear Data Online Services at Peking University

    International Nuclear Information System (INIS)

    Fan, T.S.; Guo, Z.Y.; Ye, W.G.; Liu, W.L.; Chen, J.X.; Tang, G.Y.; Shi, Z.M.; Chen, J.E.; Liu, T.J.; Liu, C.X.; Huang, X.L.

    2005-01-01

    The Institute of Heavy Ion Physics at Peking University has developed a new nuclear data online services software package. Through the web site (http://ndos.nst.pku.edu.cn), it offers online access to main relational nuclear databases: five evaluated neutron libraries (BROND, CENDL, ENDF, JEF, JENDL), the ENSDF library, the EXFOR library, the IAEA photonuclear library and the charged particle data of the FENDL library. This software allows the comparison and graphic representations of the different data sets. The computer programs of this package are based on the Linux implementation of PHP and the MySQL software

  5. 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,

  6. Primary health care facility infrastructure and services and the ...

    African Journals Online (AJOL)

    ... Research Council ae Currently from Cape Peninsula University of Technology ... Keywords: primary health care facilities; nutritional status; children; caregivers' rural; South Africa ... underlying causes of malnutrition in children, while poor food quality, .... Information on PHC facility infrastructure and services was obtained.

  7. UNMET NEED IN TURKEY: HOME CARE SERVICE

    Directory of Open Access Journals (Sweden)

    Nuket SUBASI

    2006-02-01

    Full Text Available Home care services can be provided as an alternative to institutional care to people, in case of their demand, who need care because of aging and chronic diseases. Structured home care service in health system does not exist in Turkey. Relatives try to provide care at home to those people. In this cross-sectional study, household was selected as a sampling unit, determining prevalence of home care at the households and gathering some information about home care in Cankaya district of Ankara was intended. It was found that in one-month period before this study was carried out, home care services were provided at 8.7% of the households in Cankaya district. 62.5% of people who received home care service were women, 15.3% of them were belonging to 65-74 age group; 31.7% of those were illiterate and 12.5% had no social and health insurance. Among people, 15.4% were receiving home care after surgical operation, 15.4% were receiving care because of stroke and cerebrovascular diseases and 9.6% were cancer patients. 81.7% of adults who were taken care at home were found to be dependent at different levels while performing daily living activities, the most common treatment method was detected as oral medication (81.4%. These people were in need of preventive, curative and rehabilitative and supportive services. A home care service model, which takes into consideration the social characteristics of the country, should be developed at this district where there is a large elderly population. [TAF Prev Med Bull 2006; 5(1.000: 19-31

  8. Nursing care documentation practice: The unfinished task of nursing care in the University of Gondar Hospital.

    Science.gov (United States)

    Kebede, Mihiretu; Endris, Yesuf; Zegeye, Desalegn Tegabu

    2017-09-01

    Even though nursing care documentation is an important part of nursing practice, it is commonly left undone. The objective of this study was to assess nursing care documentation practice and the associated factors among nurses who are working at the University of Gondar Hospital. An institution-based cross-sectional study was conducted among 220 nurses working at the University of Gondar Hospital inpatient wards from March 20 to April 30, 2014. Data were collected using a structured and pre-tested self-administered questionnaire. Data were entered into Epi Info version 7 and analyzed with SPSS version 20. Descriptive statistics, bivariate, and multivariate logistic regression analyses were carried out. Two hundred and six nurses returned the questionnaire. Good nursing care documentation practice among nurses was 37.4%. A low nurse-to-patient ratio AOR = 2.15 (95%CI [1.155, 4.020]), in-service training on standard nursing process AOR = 2.6 (95%CI[1.326, 5.052]), good knowledge AOR = 2.156(95% CI [1.092, 4.254]), and good attitude toward nursing care documentation AOR = 2.22 (95% CI [1.105, 4.471] were significantly associated with nursing care documentation practice. Most of the nursing care provided remains undocumented. Nurse-to-patient ratio, in-service training, knowledge, and attitude of nurses toward nursing care documentation were factors associated with nursing care documentation practice.

  9. Nurses' Needs for Care Robots in Integrated Nursing Care Services.

    Science.gov (United States)

    Lee, Jai-Yon; Song, Young Ae; Jung, Ji Young; Kim, Hyun Jeong; Kim, Bo Ram; Do, Hyun-Kyung; Lim, Jae-Young

    2018-05-13

    To determine the need for care robots among nurses and to suggest how robotic care should be prioritized in an integrated nursing care services. Korea is expected to be a super-aged society by 2030. To solve care issues with elderly inpatient caused by informal caregivers, the government introduced 'integrated nursing care services'; these are comprehensive care systems staffed by professionally trained nurses. To assist them, a care robot development project has been launched. The study applied a cross-sectional survey. In 2016, we conducted a multi-center survey involving 302 registered nurses in five hospitals including three tertiary and two secondary hospitals in Korea. The questionnaire consisted of general characteristics of nurses and their views on and extents of agreement about issues associated with robotic care. Trial center nurses and those with ≥10 years of experience reported positively on the prospects for robotic care. The top three desired primary roles for care robots were 'measuring/monitoring', 'mobility/activity' and 'safety care'. 'Reduction in workload', especially in terms of 'other nursing services' which were categorized as non-value-added nursing activities, was the most valued feature. The nurses approved of the aid by care robots but were concerned about device malfunction and interruption of rapport with patients. Care robots are expected to be effective in integrated nursing care services, particularly in 'measuring/monitoring'. Such robots should decrease nurses' workload and minimize non-value-added nursing activities efficiently. No matter how excellent care robots are, they must co-operate with and be controlled by nurses. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  10. Improving the delivery of preventive care services.

    Science.gov (United States)

    Hung, Dorothy Y

    2007-05-01

    Performance of preventive services is an important indicator of high-quality health care, but many recommended services are not regularly offered in primary care practices. Health risk assessments, counseling, and referral to community-based programs help address risk behaviors, many of which are leading causes of preventable death and disability in the United States. This study examined various influences on the delivery of preventive services designed to address smoking, excessive consumption of alcohol, unhealthy diets, and sedentary lifestyles. More than 300 health care providers in 52 practices nationwide have contributed data to this study. Staff participation in quality improvement enhanced work relationships and also diminished the effect of practice size on the performance of preventive care. The use of nurse practitioners, allied health professionals, clinician reminders, and patient registries were positively associated with care delivery.

  11. 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...... 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...... 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...

  12. Competition in Telecoms-Implications for Universal Service and Employment

    OpenAIRE

    Petrazzini, Ben A.

    1996-01-01

    The author argues that competition in domestic telecommunications markets promotes both universal service and employment in developing countries. Thus, incumbent monopoly operators should be reformed. And since incumbents are subject to increasingly fierce international competition from callback services, Internet phone services, mobile satellite services, and global operators, this reform ...

  13. Factors affecting utilization of University health services in a tertiary ...

    African Journals Online (AJOL)

    2013-01-16

    Jan 16, 2013 ... Objective: To determine students' perception of health care services provided in a tertiary institution and ... evaluation of health services utilization among students in the .... African culture and health. ... Asian Am Pac Isl J.

  14. 77 FR 48453 - Connect America Fund; High-Cost Universal Service Support; Universal Service Reform-Mobility Fund

    Science.gov (United States)

    2012-08-14

    ... constitutes corporate welfare, as the average annual net income of such carriers purportedly demonstrates that... preferences here. Blooston cites the Universal Service principle of competitive neutrality, which it...

  15. Models of care and organization of services.

    Science.gov (United States)

    Markova, Alina; Xiong, Michael; Lester, Jenna; Burnside, Nancy J

    2012-01-01

    This article examines the overall organization of services and delivery of health care in the United States. Health maintenance organization, fee-for-service, preferred provider organizations, and the Veterans Health Administration are discussed, with a focus on structure, outcomes, and areas for improvement. An overview of wait times, malpractice, telemedicine, and the growing population of physician extenders in dermatology is also provided. Copyright © 2012 Elsevier Inc. All rights reserved.

  16. Creating Service Concepts for Finnish Elderly Care : Case: Virtual Interactive Care Service

    OpenAIRE

    Nwagu, Promise

    2016-01-01

    This thesis looks at creating service concept by evaluating the research project of Virtual Interactive Care Service. The research project was initiated and implemented by the author together with Hovi Group Oy and Suomen kotilääkäripalvelu Oy. The goal was to provide a virtual care service business that uses interactive and stimulating activities to improve the wellbeing of elderly people in Finland. The study employed qualitative research method by reviewing existing works particularly...

  17. 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.

  18. 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…

  19. 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…

  20. Identifying barriers to emergency care services.

    Science.gov (United States)

    Cannoodt, Luk; Mock, Charles; Bucagu, Maurice

    2012-01-01

    This paper aims to present a review of published evidence of barriers to emergency care, with attention towards both financial and other barriers. With the keywords (financial) accessibility, barriers and emergency care services, citations in PubMed were searched and further selected in the context of the objective of this article. Forty articles, published over a period of 15 years, showed evidence of significant barriers to emergency care. These barriers often tend to persist, despite the fact that the evidence was published many years ago. Several publications stressed the importance of the financial barriers in foregoing or delaying potentially life-saving emergency services, both in poor and rich countries. Other publications report non-financial barriers that prevent patients in need of emergency care (pre-hospital and in-patient care) from seeking care, from arriving in the proper emergency department without undue delay or from receiving proper treatment when they do arrive in these departments. It is clear that timely access to life-saving and disability-preventing emergency care is problematic in many settings. Yet, low-cost measures can likely be taken to significantly reduce these barriers. It is time to make an inventory of these measures and to implement the most cost-effective ones worldwide. Copyright © 2011 John Wiley & Sons, Ltd.

  1. Students' perspectives to health care services in lithuania

    OpenAIRE

    Brancevič, Jolita

    2016-01-01

    Students' Perspectives to Health Care Services in Lithuania Introduction. The Rights of Patients and Compensation for the Damage to Their Health Act defines health care services as safe and effective means to take care of health, identify, diagnose and treat diseases and provide nursing services. The aims set out in a policy of health care services are fairly broad and, among others, include the improvement of both the quality and the availability of health care services. The issues of increa...

  2. 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…

  3. 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…

  4. 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…

  5. Innovative and creative entrepreneurship support services at universities

    NARCIS (Netherlands)

    Arroyo-Vazquez, M.; van der Sijde, P.C.; Jimenez-Saes, F.

    2010-01-01

    In the context of entrepreneurial universities, new stakeholders and new roles for old ones have emerged. Accordingly, university entrepreneurship support services have to behave in a creative and innovative manner to actively support business creation at universities. This means that a common

  6. 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.

  7. Uniting Community and University through Service Learning

    Science.gov (United States)

    Arney, Janna B.; Jones, Irma

    2006-01-01

    At its core, service-learning is about creating opportunities for students to apply theory they learn in the classroom to real-world problems and real-world needs. A service-learning project was initiated with the CEO of the Brownsville Chamber of Commerce. The project required 2nd-year business communication students to interview community…

  8. 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 internal consistency (Cronbach's alpha = 0.87). SEQUenCE is a valid, reliable scale that is grounded in the 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.

  9. 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…

  10. Adolescent health care: improving access by school-based service.

    Science.gov (United States)

    Gonzales, C; Mulligan, D; Kaufman, A; Davis, S; Hunt, K; Kalishman, N; Wallerstein, N

    1985-10-01

    Participants in this discussion of the potential of school-based health care services for adolescents included family medicine physicians, school health coordinators, a school nurse, and a community worker. It was noted that health care for adolescents tends to be either inaccessible or underutilized, largely because of a lack of sensitivity to adolescent culture and values. An ideal service for adolescents would offer immediate services for crises, strict confidentiality, ready access to prescribed medications, a sliding-scale scheme, and a staff that is tolerant of divergent values and life-styles. School-based pilot adolescent clinics have been established by the University of New Mexico's Department of Family, Community, and Emergency Medicine to test the community-oriented health care model. On-site clinics provide urgent medical care, family planning, pregnancy testing, psychological counseling, alcohol and drug counseling, and classroom health education. Experience with these programs has demonstrated the necessity for an alliance among the health team and the school administration, parents, and students. Financial, ethical, and political factors can serve as constraints to school-based programs. In some cases, school administrators have been resistant to the provision of contraception to students on school grounds and parents have been unwilling to accept the adolescent's right to confidentiality. These problems in part stem from having 2 separate systems, each with its own values, orientation, and responsibilities, housed in 1 facility. In addition, there have been problems generating awareness of the school-based clinic among students. Health education theater groups, peer counseling, and student-run community services have been effective, however, in increasing student participation. It has been helpful to mold clinic services to meet the needs identified by teenagers themselves. There is an interest not only in curative services, but in services focused

  11. 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.

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

    Science.gov (United States)

    Prinja, Shankar; Bahuguna, Pankaj; Pinto, Andrew D; Sharma, Atul; Bharaj, Gursimer; Kumar, Vishal; Tripathy, Jaya Prasad; Kaur, Manmeet; Kumar, Rajesh

    2012-01-01

    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. 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. 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. 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.

  13. Prison hospice and pastoral care services in California.

    Science.gov (United States)

    Linder, John F; Knauf, Keith; Enders, Sheila R; Meyers, Frederick J

    2002-12-01

    Hospice at the California Medical Facility (CMF) Vacaville dates back to the mid-1980s, when the acquired immune deficiency syndrome (AIDS) epidemic began to be felt throughout California's Department of Corrections. Vacaville has served for decades as the principal location for delivering health services to California's incarcerated men. Informal hospice-like services were inspired by Elisabeth Kubler-Ross and through inmate and community calls for more humane care for dying inmates. By 1990, efforts to formally establish a hospice were under way. In 1996, a 17-bed, state-licensed hospice began caring for dying inmates. An interdisciplinary team plans and delivers the care, meeting weekly to admit and review patients. The Pastoral Care Services (PCS) inmate volunteer program, with more than 50 trained participants, provides care and comfort to dying patients in hospice and to ill patients on the general medicine service. PCS volunteers perform many duties, including sitting vigil with actively dying inmates. Inmates enrolling in hospice have to forgo further curative therapy, consent to the program in writing, and have a 6-month or less survival prognosis; patients are not required to have a do-not-resuscitate (DNR) order, but are encouraged to consider one. Training for physicians, staff and PCS volunteers is provided by the University of California, Davis faculty of the West Coast Center for Palliative Education. Bereavement services are provided for PCS volunteers, other inmate "family" and staff. Family and friends of the deceased in the free community are followed by phone, mail, and primarily through referral to resources in their local area.

  14. Adoption of Lean Thinking and Service Improvement for Care Home Service

    OpenAIRE

    Chuang-Chun Chiou

    2014-01-01

    Ageing population is a global trend; therefore the need of care service has been increasing dramatically. There are three basic forms of service delivered to the elderly: institution, community, and home. Particularly, the institutional service can be seen as an extension of medical service. The nursing home or so-called care home which is equipped with professional staff and facilities can provide a variety of service including rehabilitation service, short-term care, and long term care. Sim...

  15. Air ambulance services--integrated emergency care.

    Science.gov (United States)

    Ferdinand, M

    1994-10-01

    In the name of cost-conscious care, air ambulance program directors and service contractors are seeing the dawn of integrated networks as a boon to their business. As integrated networks form, facilities will become increasingly specialized in the types of services they provide. Patients will need to be moved around the system, resulting in more frequent patient transport and more points of transfer. Many programs are considering aircraft replacement and additions, rather than leasing. Financial benefits could come on depreciation and the high resale value of aircraft. Unless reimbursement levels increase, more program mergers and affiliations may take place to spread and reduce cost. Air ambulance services will increasingly become part of a facility's strategic plan.

  16. 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

  17. 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.

  18. 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…

  19. An Appraisal of Digital Reference Services in Nigerian University ...

    African Journals Online (AJOL)

    This study examined digital reference services in Nigeria university libraries. A descriptive research design of the ex-post facto was adopted in the study. The instrument used in collecting data for this study was the questionnaire. One hundred and twenty respondents were randomly selected from six Nigerian universities ...

  20. Service Users' Involvement and Engagement in Interprofessional Care.

    Science.gov (United States)

    Kaini, B K

    2016-01-01

    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.

  1. Modeling the mental health service utilization decisions of university undergraduates: A discrete choice conjoint experiment.

    Science.gov (United States)

    Cunningham, Charles E; Zipursky, Robert B; Christensen, Bruce K; Bieling, Peter J; Madsen, Victoria; Rimas, Heather; Mielko, Stephanie; Wilson, Fiona; Furimsky, Ivana; Jeffs, Lisa; Munn, Catharine

    2017-01-01

    We modeled design factors influencing the intent to use a university mental health service. Between November 2012 and October 2014, 909 undergraduates participated. Using a discrete choice experiment, participants chose between hypothetical campus mental health services. Latent class analysis identified three segments. A Psychological/Psychiatric Service segment (45.5%) was most likely to contact campus health services delivered by psychologists or psychiatrists. An Alternative Service segment (39.3%) preferred to talk to peer-counselors who had experienced mental health problems. A Hesitant segment (15.2%) reported greater distress but seemed less intent on seeking help. They preferred services delivered by psychologists or psychiatrists. Simulations predicted that, rather than waiting for standard counseling, the Alternative Service segment would prefer immediate access to E-Mental health. The Usual Care and Hesitant segments would wait 6 months for standard counseling. E-Mental Health options could engage students who may not wait for standard services.

  2. 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…

  3. 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.…

  4. Education Technology Services at Indiana University: A Case Study.

    Science.gov (United States)

    Bichelmeyer, B. A.; Hara, Noriko; Yi, Jessi; Dennen, Vanessa; Avers, Dale; Tzeng, Jeng-Yi

    1998-01-01

    This paper, based on a qualitative research study, describes the technology resources available in the Indiana University School of Education, explains the range of services provided by Education Technology Services (ETS), documents the organizational structure of ETS, and describes the key processes and culture of ETS. (Author/AEF)

  5. 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,…

  6. The Case of Roskilde University E-Services

    DEFF Research Database (Denmark)

    Heilesen, Simon

    2008-01-01

    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......, 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....

  7. Care pathways as boundary objects between primary and secondary care: Experiences from Norwegian home care services.

    Science.gov (United States)

    Håland, Erna; Røsstad, Tove; Osmundsen, Tonje C

    2015-11-01

    The need for integration of healthcare services and collaboration across organisational boundaries is highlighted as a major challenge within healthcare in many countries. Care pathways are often presented as a solution to this challenge. In this article, we study a project of developing, introducing and using a care pathway across healthcare levels focusing on older home-dwelling patients in need of home care services after hospital discharge. In so doing, we use the concept of boundary object, as described by Star and Griesemer, to explore how care pathways can act as tools for translation between specialist healthcare services and home care services. Based on interviews with participants in the project, we find that response to existing needs, local tailoring, involvement and commitment are all crucial for the care pathway to function as a boundary object in this setting. Furthermore, the care pathway, as we argue, can be used to push boundaries just as much as it can be used as a tool for bridging across them, thus potentially contributing to a more equal relationship between specialist healthcare services and home care services. © The Author(s) 2015.

  8. 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

  9. Medical universities educational and research online services: benchmarking universities' website towards e-government.

    Science.gov (United States)

    Farzandipour, Mehrdad; Meidani, Zahra

    2014-06-01

    Websites as one of the initial steps towards an e-government adoption do facilitate delivery of online and customer-oriented services. In this study we intended to investigate the role of the websites of medical universities in providing educational and research services following the E-government maturity model in the Iranian universities. This descriptive and cross- sectional study was conducted through content analysis and benchmarking the websites in 2012. The research population included the entire medical university website (37). Delivery of educational and research services through these university websites including information, interaction, transaction, and Integration were investigated using a checklist. The data were then analyzed by means of descriptive statistics and using SPSS software. Level of educational and research services by websites of the medical universities type I and II was evaluated medium as 1.99 and 1.89, respectively. All the universities gained a mean score of 1 out of 3 in terms of integration of educational and research services. Results of the study indicated that Iranian universities have passed information and interaction stages, but they have not made much progress in transaction and integration stages. Failure to adapt to e-government in Iranian medical universities in which limiting factors such as users' e-literacy, access to the internet and ICT infrastructure are not so crucial as in other organizations, suggest that e-government realization goes beyond technical challenges.

  10. Emergency mobile care service: trauma epidemiology in prehospital care

    Directory of Open Access Journals (Sweden)

    Mateus Kist Ibiapino

    2017-06-01

    Full Text Available Objective: to characterize trauma victims assisted by the Mobile Emergency Care Service (SAMU 192 in the city of Ilhéus, Bahia, Brazil. Method: this is a descriptive and retrospective study in which 1,588 records of traumatic events were analyzed from the following variables: sex, age, day of the week, period of the day, trauma mechanism, topography and type of injuries, revised trauma score, type of mobile unit used, professional responsible for care, time to hospital care, procedures performed and deaths. Results: there was a predominance of male victims (69.5% and age between 18 and 37 (46.5%. Occurrences were concentrated at weekends (37.8% and in the evening (52.0%. It revealed traffic accidents (41.3% as the main mechanism of trauma, among which prevailed the involvement of motorcycles (73.0%. Regarding the topographic distribution of lesions, the majority affected the limbs (58.2%. The most adopted conducts in prehospital care were immobilization (26.3% and compression dressing (25.9%. The deaths accounted for 2.7% of the total sample. Conclusion: The population most affected by traumatic events in Ilhéus shown to be composed of young men involved in traffic accidents, mainly motorcyclists, during the weekends.

  11. 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

  12. 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.

  13. Managed Care for Children: Effect on Access to Care and Utilization of Health Services.

    Science.gov (United States)

    Szilagyi, Peter G.

    1998-01-01

    Reviews what is known about the effect of managed care on access to health services, as well as utilization of hospital care, emergency department visits, primary care services, and specialty pediatric services. The effect of managed care appears dependent on several factors and, thus, is likely to vary according to the population served. (SLD)

  14. Factors affecting utilization of university health services in a tertiary institution in South-West Nigeria.

    Science.gov (United States)

    Obiechina, G O; Ekenedo, G O

    2013-01-01

    Most university health services have extensive health infrastructures, for the provision of effective and efficient health services to the students. In this study, we have tried to determine student's perception of factors affecting their utilization. To determine students' perception of health care services provided in a tertiary institution and assess students' attitude towards utilization. Simple random sampling technique was used to select 540 respondents, comprising of 390 males and 150 females. A structured and self-administered questionnaire was the instrument used to collect data for the study, while data collected was analyzed using descriptive statistics of frequency count and percentage. High cost of drugs (72.0%), non availability of essential drugs (54.8%), time spent waiting for treatment (67.2%), inadequate referral services (81.7%), and satisfaction with services (60.6%) were considered by the respondents as factors affecting the utilization of university health services. Students-medical staff relationship and accessibility to health facility (77.6% and 74.3% respectively) were, however, not considered as factors that affect utilization of university health services. It is recommended that to improve utilization and cost of care, government should make necessary efforts to incorporate tertiary institution into National Health Insurance scheme so that students above the age of 18 years can benefit from free treatment.

  15. Home health services in primary care: What can we do?

    Directory of Open Access Journals (Sweden)

    Yasemin Çayır

    2013-01-01

    Full Text Available Home health services is to give examination, diagnosis,treatment, and rehabilitation services to the patients whobedridden, have difficulties to access health facility due toa variety of chronic or malignant disease by professionalhealth care team. Family physicians that providing healthcare in primary care is responsible for to determine whowill need home health care services, and to make homevisit on a regular basis among registered patients in theirpopulations. It is seems that the biggest shortcoming thecontent and scope of this service is not yet a standard. Inthis article, how home health services should be given willbe discussed.Key words: Primary health care, home health care, bedriddenpatient

  16. Income Disparities in the Use of Health Screening Services Among University Students in Korea

    Science.gov (United States)

    Lee, Su Hyun; Joh, Hee-Kyung; Kim, Soojin; Oh, Seung-Won; Lee, Cheol Min; Kwon, Hyuktae

    2016-01-01

    Abstract Public health insurance coverage for preventive care in young adults is incomplete in Korea. Few studies have focused on young adults’ socioeconomic disparities in preventive care utilization. We aimed to explore household income disparities in the use of different types of health screening services among university students in Korea. This cross-sectional study used a web-based self-administered survey of students at a university in Korea from January to February 2013. To examine the associations between household income levels and health screening service use within the past 2 years, odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using logistic regression with adjustment for various covariables. Of 2479 participants, 45.5% reported using health screening services within 2 years (university-provided screening 32.9%, private sector screening 16.7%, and both 4.1%). Household income levels were not significantly associated with overall rates of health screening service use with a multivariable-adjusted OR (95% CI) in the lowest versus highest income group of 1.12 (0.87–1.45, Ptrend = 0.35). However, we found significantly different associations in specific types of utilized screening services by household income levels. The multivariable-adjusted OR (95% CI) of university-provided health screening service use in the lowest versus highest income level was 1.74 (1.30–2.34; Ptrend income level was 0.45 (0.31–0.66; Ptrend income groups among university students in Korea, although overall rates of health screening service use were similar across income levels. Low-income students were more likely to use university-provided health screening services, and less likely to use private sector screening services. To ensure appropriate preventive care delivery for young adults and to address disparities in disadvantaged groups, the expansion of medical insurance coverage for preventive health care, establishment of a usual source of

  17. The Need for a Comprehensive Care and Education Service for Pre-School Children.

    Science.gov (United States)

    Blackstone, Tessa

    An argument is presented for a comprehensive and universal system of care and education for preschool children outside the family. Current institutional arrangements in the United Kingdom for government provision of education and care for young children are discussed and proposals are made for alternative ways of providing this service. It is…

  18. 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.

  19. The Effect of Service Compact (SERVICOM on Service Delivery in Nnamdi Azikiwe University Teaching Hospital Nnewi, Nigeria

    Directory of Open Access Journals (Sweden)

    Jude Kennedy Emejulu

    2014-12-01

    Full Text Available This study examined the effect of service compact (Servicom Service delivery in Nnamdi Azikiwe University Teaching Hospital Nnewi. Questionnaire and face-to-face interviews were used in the collection of data. The hypotheses were tested using descriptive statistics. The study discovered among other things that with the inauguration of the SERVICOM Charter by the Federal Government of Nigeria, the Management of Nnamdi Azikiwe University Teaching Hospital Nnewi identified key areas that required re-evaluation and attention based on the submissions of every service unit and department, after an analysis of the Strengths, Weaknesses, Opportunities and Threats (SWOT of each of the service areas. A pre-SERVICOM Charter workshop which was supervised by the Federal Government was held in the various institutions nationwide to enable care providers enumerate their current service capacity and identify their impediments. In the light of the foregoing, some of the recommendations proffered are that the SERVICOM Charter project should be sustained and supervision and control of the SERVICOM Charter project should be intensified in order to ensure that the Nigerian factor of service-fatigue would not supervene in care delivery in the near future.

  20. Intensive care management of severe tetanus at the university of ...

    African Journals Online (AJOL)

    Intensive care management of severe tetanus at the university of Benin teaching ... Journal Home > Vol 14, No 1 (2015) > ... Open Access DOWNLOAD FULL TEXT ... protocol in the centre, in line with evidence-based medical principles.

  1. 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…

  2. Patient satisfaction with primary health-care services in Kuwait.

    Science.gov (United States)

    Alotaibi, Muhammad; Alazemi, Talal; Alazemi, Fahad; Bakir, Yusif

    2015-06-01

    The study aims to evaluate patient satisfaction with respect to primary health-care services in Kuwait.A total of 245 patients completed the General Practice Assessment Questionnaire postconsultation version 2.0. Two statistically significant differences of patients' satisfaction with sex and level of education were found. Overall satisfaction was higher among men than women (P = 0.002), and it was also higher among those with university degree of education than the other levels of education (P = 0.049). We also found statistically significant differences of patients' responses over sex for three themes, namely: satisfaction with receptionists, satisfaction with access and satisfaction with communication; and over the age for one theme: satisfaction with access. There was no statistically significant differences of patients' responses over nationality for all themes. Satisfaction is a multifactorial and no one factor alone could provide satisfaction with primary health services in Kuwait. © 2014 Wiley Publishing Asia Pty Ltd.

  3. 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...... 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....

  4. Building nursing capacity for palliative care at a Jesuit Catholic University: A model program

    Directory of Open Access Journals (Sweden)

    Eileen R. O’Shea

    2017-01-01

    Full Text Available The average life span is increasing, due to vast advancements in social conditions, public health, and medical care. Globally, those living with chronic and serious medical conditions can benefit from palliative care services. Yet, the workforce is insufficient to support the demand. This case study describes efforts made by one Jesuit Catholic University to build nursing capacity and to promote access to high quality, compassionate palliative healthcare.

  5. Integrating mental health services into primary HIV care for women: the Whole Life project.

    OpenAIRE

    Dodds, Sally; Nuehring, Elane M.; Blaney, Nancy T.; Blakley, Theresa; Lizzotte, Jean-Marie; Lopez, Myriam; Potter, JoNell E.; O'Sullivan, Mary J.

    2004-01-01

    The high rate of mental health problems in HIV-infected women jeopardizes the health of this vulnerable population, and constitutes a mandate for integrating mental health services into HIV primary care. The Whole Life project-a collaboration of the departments of Psychiatry and Obstetrics/Gynecology at the University of Miami School of Medicine-successfully integrated mental health services into primary HIV care for women. This article describes the conceptual framework of the integration, i...

  6. Estimating the Impact of Low-Income Universal Service Programs

    OpenAIRE

    Daniel A. Ackerberg; David R. DeRemer; Michael H. Riordan; Gregory L. Rosston; Bradley S. Wimmer

    2013-01-01

    This policy study uses U.S. Census microdata to evaluate how subsidies for universal telephone service vary in their impact across low-income racial groups, gender, age, and home ownership. Our demand specification includes both the subsidized monthly price (Lifeline program) and the subsidized initial connection price (Linkup program) for local telephone service. Our quasi-maximum likelihood estimation controls for location differences and instruments for price endogeneity. The microdata all...

  7. Experience with the Implementation of Clinical Pharmacy Services and Processes in a University Hospital in Belgium.

    Science.gov (United States)

    Somers, Annemie; Claus, Barbara; Vandewoude, Koen; Petrovic, Mirko

    2016-03-01

    This article summarizes the experience with the development of clinical pharmacy services in the Ghent University Hospital in Belgium. Implementation of clinical pharmacy services in Belgian hospitals has not been evident because these activities were initially not structurally financed. The aim is to describe the strengths and weaknesses of the clinical pharmacy development process, and the milestones that enhanced the progress. Furthermore, the organisation of clinical pharmacy in the Ghent University Hospital is explained, including back- and front-office activities, seamless pharmaceutical care and medication safety improvement. Some working methods, procedures and tools are explained for different clinical pharmacy services. In particular, the clinical pharmacy projects for geriatric patients as well as the preparation of clinical pharmacy services for the accreditation process are explained. We also reflect on the organisation model and the future development of clinical pharmacy, taking into consideration facilitators and potential barriers.

  8. Barriers to Accessing Eye Care Services in the Federal Capital ...

    African Journals Online (AJOL)

    This study was carried out to determine the barriers to accessing eye care services in the Federal ... 153(61.7%), others were high cost of services, lack of money, non-availability of eye care services, long ... Barrier studies are being conducted.

  9. University Students' Views of a Public Service Graduation Requirement

    Science.gov (United States)

    Moely, Barbara E.; Ilustre, Vincent

    2011-01-01

    As New Orleans began to rebuild after Hurricane Katrina, Tulane University also began its recovery process. A new initiative in the recovery was the establishment of a public service graduation requirement for undergraduate students. Attitudes toward the requirement were assessed for 290 first-year and 257 advanced students in fall 2006. The…

  10. User-Focused Strategic Services for Technological University Libraries.

    Science.gov (United States)

    Townley, Charles T.

    This paper describes the New Mexico State University (NMSU) Library's strategic plan to develop its services amid an atmosphere of change. A summary of the following components of the strategic plan is given: vision; mission; values; and goals. The revised organizational functions are then illustrated, as well as the role of the selector-liaison…

  11. 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…

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

    Science.gov (United States)

    Crossno, J E; Berkins, B; Gotcher, N; Hill, J L; McConoughey, M; Walters, M

    2001-04-01

    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. 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 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. 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.

  13. [Professional's expectations to improve quality of care and social services utilization in geriatric oncology].

    Science.gov (United States)

    Antoine, Valéry; de Wazières, Benoît; Houédé, Nadine

    2015-02-01

    Coordination of a multidisciplinary and multi-professional intervention is a key issue in the management of elderly cancer patients to improve health status and quality of life. Optimizing the links between professionals is needed to improve care planning, health and social services utilization. Descriptive study in a French University Hospital. A 6-item structured questionnaire was addressed to professionals involved in global and supportive cares of elderly cancer patients (name, location, effective health care and services offered, needs to improve the quality of their intervention). After the analysis of answers, definition of propositions to improve cares and services utilization. The 37 respondents identified a total of 166 needs to improve quality of care in geriatric oncology. Major expectations were concerning improvement of global/supportive cares and health care services utilization, a better coordination between geriatric teams and oncologists. Ten propositions, including a model of in-hospital health care planning, were defined to answer to professional's needs with the aim of optimizing cancer treatment and global cares. Identification of effective services and needs can represent a first step in a continuous program to improve quality of cares, according to the French national cancer plan 2014-2019. It allows federating professionals for a coordination effort, a better organization of the clinical activity in geriatric oncology, to optimize clinical practice and global cares. Copyright © 2014 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.

  14. Planning a regional palliative care services network.

    Science.gov (United States)

    Zalot, G N

    1989-03-01

    Table 1 summarizes the role of task force members and staff for each of the main tasks of the process of planning. The number of meetings required for each stage of the process is estimated in the last column. Planning for a regional palliative care services network is a process involving "hard" and "soft" elements. Hard elements involve the organizational structure, task force meetings, information/statistical data bases and the discrete tasks summarized in Table 1. These elements are well known, if nokt always well organized in practice. It is the "softer" elements that usually mean the difference between a dull bureaucratic exercise and a creative exchange of ideas and concepts with a vision for the future. Not to be underestimated is the critical role of group development in this process. The Task Force, supported by professional staff expertise and judgment, hopes to achieve a level of group development termed "synergy," that is, where the group outperforms (in terms of quality and quantity of work) its best individual member. Not a small feat, but critical to a successful planning exercise! Any regional planning implies a commitment to change. After all, new services will be added, some phased out, others revised, and others enhanced, resulting in changes in roles and responsibilities of providers. Change should not be greeted with disdain but viewed as a natural part of the environment in which we plan and provide services. A major advantage to the process of planning is that the level of support for change is already mobilized through the various stages of the process highlighted.(ABSTRACT TRUNCATED AT 250 WORDS)

  15. Service availability and readiness for diabetes care at health ...

    African Journals Online (AJOL)

    EPHA USER33

    2Addis Ababa University, College of Health Science, School of Medicine, Department of Internal Medicine, ... Results: Among all health facilities, 59% of health facilities offer services for .... provide good-quality client services for diabetes,.

  16. 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.

  17. 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.

  18. The influence of nursing care integration services on nurses' work satisfaction and quality of nursing care.

    Science.gov (United States)

    Ryu, Jeong-Im; Kim, Kisook

    2018-06-20

    To investigate differences in work satisfaction and quality of nursing services between nurses from the nursing care integration service and general nursing units in Korea. The nursing care integration service was recently introduced in Korea to improve patient health outcomes through the provision of high quality nursing services and to relieve the caregiving burden of patients' families. In this cross-sectional study, data were collected from a convenience sample of 116 and 156 nurses working in nursing care integration service and general units, respectively. The data were analysed using descriptive statistics, t tests and one-way analysis of variance. Regarding work satisfaction, nursing care integration service nurses scored higher than general unit nurses on professional status, autonomy and task requirements, but the overall scores showed no significant differences. Scores on overall quality of nursing services, responsiveness and assurance were higher for nursing care integration service nurses than for general unit nurses. Nursing care integration service nurses scored higher than general unit nurses on some aspects of work satisfaction and quality of nursing services. Further studies with larger sample sizes will contribute to improving the quality of nursing care integration service units. These findings can help to establish strategies for the implementation and efficient operation of the nursing care integration service system, for the improvement of the quality of nursing services, and for successfully implementing and expanding nursing care integration service services in other countries. © 2018 John Wiley & Sons Ltd.

  19. Combining service marketing and strategic alliances in health care.

    Science.gov (United States)

    Lazarus, I R

    1993-11-01

    With or without federal health care reform to impact the delivery of health care services in the U.S., hospitals must commit to service marketing and strategic alliances as a fundamental business strategy. Service marketing not only differentiates the provider, but with the proper programs in place, it may actually facilitate the formation of strategic alliances. The combination of these strategies will be particularly effective in preparing for any health care policy change.

  20. Economic analysis of an epilepsy outreach model of care in a university hospital setting.

    Science.gov (United States)

    Maloney, Eimer; McGinty, Ronan N; Costello, Daniel J

    2017-07-01

    The prevalence of epilepsy in people with intellectual disability is higher than in the general population and prevalence rates increase with increasing levels of disability. Prevalence rates of epilepsy are highest among those living in residential care. The healthcare needs of people with intellectual disability and epilepsy are complex and deserve special consideration in terms of healthcare provision and access to specialist epilepsy clinics, which are usually held in acute hospital campuses. This patient population is at risk of suboptimal care because of significant difficulties accessing specialist epilepsy care which is typically delivered in the environs of acute hospitals. In 2014, the epilepsy service at Cork University Hospital established an Epilepsy Outreach Service providing regular, ambulatory outpatient follow up at residential care facilities in Cork city and county in an effort to improve access to care, reduce the burden and expense of patient and carer travel to hospital outpatient appointments, and to provide a dedicated specialist phone service for epilepsy related queries in order to reduce emergency room visits when possible. We present the findings of an economic analysis of the outreach service model of care compared to the traditional hospital outpatient service and demonstrate significant cost savings and improved access to care with this model. Ideally these cost savings should be used to develop novel ways to enhance epilepsy care for persons with disability. We propose that this model of care can be more suitable for persons with disability living in residential care who are at risk of losing access to specialist epilepsy care. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Skilled antenatal care service utilization and its association with the ...

    African Journals Online (AJOL)

    Data were entered into EPI info version 7 statistical software and exported to STATA ... Conclusions: Skilled ANC service utilization is the joint effect of individual and ... analysis, skilled antenatal care service, women's health development team ...

  2. Scope of neonatal care services in major Nigerian hospitals

    African Journals Online (AJOL)

    2015-10-12

    Oct 12, 2015 ... Quality of newborn care by level of services offered is a critical determinant of ... natal unit capacity, personnel, trainings in newborn cardio-pulmonary ... The availability of surfactant replacement service was also solicited.

  3. 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.

  4. A model for ageing-home-care service process improvement

    OpenAIRE

    Yu, Shu-Yan; Shie, An-Jin

    2017-01-01

    The purpose of this study was to develop an integrated model to improve service processes in ageing-home-care. According to the literature, existing service processes have potential service failures that affect service quality and efficacy. However, most previous studies have only focused on conceptual model development using New Service Development (NSD) and fail to provide a systematic model to analyse potential service failures and facilitate managers developing solutions to improve the se...

  5. Relationship between home care service use and changes in the care needs level of Japanese elderly.

    Science.gov (United States)

    Kato, Gohei; Tamiya, Nanako; Kashiwagi, Masayo; Sato, Mikiya; Takahashi, Hideto

    2009-12-21

    With the introduction of long-term care insurance (LTCI) in Japan, more home care services are available for the community-dwelling elderly. To deliver effective home care services, it is important to know the effects of service use. In this study, as the first step to determine this, we sought to describe different home service use in the sustained/improved group and deteriorated group in their care needs levels, and to report the relationship between the use of home care services and changes in care needs levels. The participants included 624 of a total of 1,474 users of LTCI services in one city in Japan. Home care service users were stratified into a 'lower care needs level subgroup' and a 'higher care needs level subgroup' based on the baseline care needs level. Simple statistical comparison and multiple logistic regression analyses in which the change in care needs level was set as a dependent variable were performed. Gender, age, and baseline care needs level were designated as control variables. Home based services were treated as independent variables. In this study, home care services consisted of home help, home bathing services, a visiting nurse, home rehabilitation, nursing home daycare, health daycare, loan of medical devices, respite stay in a nursing home, respite stay in a health care facility, respite stay in a sanatorium-type medical care facility, and medical management by a physician. In the lower care needs level subgroup, age (OR = 1.04, CI, 1.01-1.08), use of respite stay in a nursing home (OR = 2.55; CI, 1.43-4.56), and the number of types of long-term care services (OR = 1.33; CI, 1.02-1.74) used during an 11 month period were significantly related to a deterioration of the user's care needs level. In the higher care needs level subgroup, use of medical management by a physician (OR = 6.99; CI, 1.42-41.25) was significantly related to a deterioration of the user's care needs level. There were no home based services significantly related to

  6. 38 CFR 17.111 - Copayments for extended care services.

    Science.gov (United States)

    2010-07-01

    ... therapeutic outpatient care program that provides medical services, rehabilitation, therapeutic activities... vehicle; food for veteran, veteran's spouse, and veteran's dependents; education for veteran, veteran's...

  7. Developing a culturally appropriate mental health care service for Samoa.

    Science.gov (United States)

    Enoka, Matamua Iokapeta Sina; Tenari, Aliilelei; Sili, Tupou; Peteru, Latama; Tago, Pisaina; Blignault, Ilse

    2013-06-01

    Mental Health Care Services are part of the National Health Services for Samoa. Their function is to provide mental health care services to the population of Samoa, which numbers 180,000 people. However, like many other countries in the Pacific region, mental health is considered a low priority. The mental health budget allocation barely covers the operation of mental health care services. More broadly, there is a lack of political awareness about mental health care services and mental health rarely becomes an issue of deliberation in the political arena. This article outlines the recent development of mental health care services in Samoa, including the Mental Health Policy 2006 and Mental Health Act 2007. It tells the story of the successful integration of aiga (family) as an active partner in the provision of care, and the development of the Aiga model utilizing Samoan cultural values to promote culturally appropriate family-focused community mental health care for Samoa. Mental Health Care Services today encompass both clinical and family-focused community mental health care services. The work is largely nurse-led. Much has been achieved over the past 25 years. Increased recognition by government and increased resourcing are necessary to meet the future health care needs of the Samoan people. Copyright © 2012 Wiley Publishing Asia Pty Ltd.

  8. 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

  9. Long term care needs and personal care services under Medicaid: a survey of administrators.

    Science.gov (United States)

    Palley, H A; Oktay, J S

    1991-01-01

    Home and community based care services constitute a public initiative in the development of a long term care service network. One such home based initiative is the personal care service program of Medicaid. The authors conducted a national survey of administrators of this program. They received a response from 16 administrators of such programs in 1987-1988. The responses raise significant issues regarding training, access to and equity of services, quality of services, administrative oversight and the coordination of home-based care in a network of available services. Based on administrator responses, the authors draw several conclusions.

  10. 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.

  11. 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.

  12. 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

  13. Influence of home care services on caregivers' burden and satisfaction.

    Science.gov (United States)

    Kim, Eun-Young; Yeom, Hyun-E

    2016-06-01

    To examine the factors affecting the burden and satisfaction of family caregivers, focusing on the beneficial impacts of home care service use. Long-term care for older patients is a multifaceted process that brings both burden and satisfaction to family caregivers. It is expected that home care services offered by the Korean long-term care insurance may contribute to decreasing the burden of family caregivers and enhancing their satisfaction by assisting with practical caregiving tasks. A cross-sectional study. A convenience sample of 157 family caregivers was recruited from five home care service agencies in South Korea. Information about the caregivers, caregiving history, older care recipients and use of home care services was assessed. The effects of home care service use on caregiving burden and satisfaction were tested using hierarchical multiple regression analyses after adjusting for the characteristics of the caregivers, caregiving history and older care recipients. There was no significant influence of home care service use on reducing caregiving burden or on increasing caregivers' satisfaction. Although several factors were associated with caregiving burden and satisfaction, family functioning was the most unique factor to significantly affect both caregiving burden and satisfaction. Home care services might not automatically have a positive impact on caregivers' burden and satisfaction, but maintaining healthy family functioning is an important issue for family caregivers. The findings highlight the important need to reconsider ways to provide home care services and to develop nursing interventions to reinforce supportive family functioning. Practical strategies for providing home care services should be developed through a concrete assessment of the family dynamics and the needs of family caregivers. Health professionals should play a pivotal role in performing the assessment and in developing interventions to strengthen supportive family functioning

  14. 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

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

    Directory of Open Access Journals (Sweden)

    Sven Streit

    Full Text Available 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.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.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%.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.

  16. Accuracy of Caregiver Proxy Reports of Home Care Service Use.

    Science.gov (United States)

    Chappell, Neena L; Kadlec, Helena

    2016-12-01

    Although much of the research on service use by older adults with dementia relies on proxy reports by informal caregivers, little research assesses the accuracy of these reports, and that which does exist, does not focus on home care services. This brief report compares proxy reports by family caregivers to those with dementia with provincial Ministry of Health records collected for payment and monitoring. The four home care services examined include home nursing care, adult day care, home support, and respite care. Data come from a province-wide study of caregivers in British Columbia, Canada. Caregiver reports are largely consistent with Ministry records, ranging from 81.0% agreement for home support to 96.6% for respite care. Spouses living with the care recipient (the vast majority of the sample) are the most accurate. Others, whether living with the care recipient or not, have only a 50-50 chance of being correct.

  17. 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.

  18. Heterogenous customer satisfaction index for evaluating university food service

    Science.gov (United States)

    Aziz, Nazrina; Zain, Zakiyah; Syarifi, Nadia Asyikin Mohammad; Klivon, Julia; Ap, Nurasiah Che; Zaki, Mahirah

    2017-11-01

    This paper aims to measure the performance of university food service based on students' perception. Two cafeterias were chosen for comparison: one located at student residential hall (Café 1) and another at the university administration centre (Café 2). By considering the components of importance and satisfaction, the Heterogeneous Customer Satisfaction Index-HCSI was computed to measure the performance of quality items in both cafeterias. Stratified sampling method was used to select 278 students and the DINESERVE instrument was used to assess customer perception on service quality. The findings show that the customer rate these two cafeterias as quite satisfied only, with the HCSI for Café 1 slightly higher than that for Café 2.

  19. Mobility through Location-based Services at University

    Directory of Open Access Journals (Sweden)

    S. Martín

    2008-07-01

    Full Text Available Location tracking systems are becoming morerelevant in many new environments, due to the fact they thecore of context aware applications. This new concept canimprove the way universities provide services and a widenumber of companies do business. Inside university area,users location (both students, teachers and staff gives rise toa new kind of services based on their profile and on the areain which the user is in each moment, allowing apersonalization of the offered contents. The present papershows how location-based applications can be developed formobile devices through a middleware that allows differentlocation methods, such as Wi-Fi and RFID. Finally somelocation-based applications are given showing possibleexamples in different environments.

  20. Home care: from adequate funding to integration of services.

    Science.gov (United States)

    Hébert, Réjean

    2009-01-01

    With the aging of the population, the healthcare system needs to shift from the actual hospital-centred system developed in the past century for dealing with acute diseases and a young population toward a home-centred system, more appropriate for serving older people with chronic diseases. Funding of home care should not only be significantly increased but also be managed differently. We propose the introduction of an autonomy support benefit (ASB) to cover costs related to disabilities, irrespective of living environment, and to set up a public universal autonomy insurance program that will cover the ASB. This insurance should be at least partly capitalized to provide for the aging of the population and to ensure intergenerational equity. Also, since the home is a much more complicated service-delivery environment than the hospital, these services must be coordinated and integrated. The Program of Research to Integrate the Services for the Maintenance of Autonomy (PRISMA) is a coordination-type model of integration that was implemented and evaluated in three areas (one urban and two rural) in and around Sherbrooke, Quebec. A four-year longitudinal quasi-experimental study with over 1,500 participants demonstrated its efficiency in improving system effectiveness at no extra cost.

  1. 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.…

  2. 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.

  3. Customer service: the key to remaining competitive in managed care.

    Science.gov (United States)

    Howard, J E

    2000-01-01

    The health care industry is undergoing a rapid transformation to meet the ever-increasing needs and demands of its patient population. Employers and managed care organizations are demanding better service and higher quality care, while providers are trying to tackle reimbursement cutbacks, streamlining of services, and serving a diverse population. Providers have begun to realize that to overcome these obstacles and meet the needs of their health plans and consumers, they must focus on the demands of their customers. Health care organizations have found they can meet the demands of both the consumer and the managed care industry through initiating and maintaining a customer service program. This essay explains the importance of customer service and its link to success in the managed care environment.

  4. Utilization of dental services in a population of Nigerian University ...

    African Journals Online (AJOL)

    Results: The results revealed only 14.1% of the subjects had utilised dental services in the past one year with a significant higher dental care use by the females than males (p<0.01). The major reasons for visiting dentist in the past 12 months among the subjects were pain from teeth (20.8%) and the need for cleaning of ...

  5. Science and Service at a University Research Reactor

    International Nuclear Information System (INIS)

    Bode, Peter

    2013-01-01

    Experiences of the Laboratory for Instrumental Neutron Activation Analysis (INAA) of the Reactor Institute Delft at the Delft University of Technology are presented on basis of more than 30 years experience with INAA services to others. Recommendations are given to neutron activation analysis groups starting as a service provider, but also pitfalls are identified. The importance of fitness for intended purpose is emphasized, so that analysis protocols should be optimized to answer the customer’s basic question, rather than to yield the highest number of elements and best level of precision. The absence of automation and no return of revenues are identified as highest threats of becoming a successful and reliable partner for providing services. (author)

  6. Commissioning of specialist palliative care services in England.

    Science.gov (United States)

    Lancaster, Harriet; Finlay, Ilora; Downman, Maxwell; Dumas, James

    2018-03-01

    Some failures in end-of-life care have been attributed to inconsistent provision of palliative care across England. We aimed to explore the variation in commissioning of services by Clinical Commissioning Groups (CCGs) using a data collection exercise. We sent a Freedom of Information request in the form of an open questionnaire to all 209 CCGs in England to assess their commissioning of palliative and end-of-life care services, mainly focused on the provision of specialist palliative care services. 29 CCGs provided information about the number of patients with some form of palliative care needs in their population. For specialist palliative care services, CCGs allocated budgets ranging from £51.83 to £2329.19 per patient per annum. 163 CCGs (77.90%) currently commission 7-day admission to their specialist palliative care beds. 82.84% of CCGs commission 7-day specialist palliative care services in patients' own homes and out-of-hours services rely heavily on hospice provision. 64 CCGs (31.37%) commission pain control teams, the majority of whom only operate in regular working hours. 68.14% of CCGs reported commissioning palliative care education of any sort for healthcare professionals and 44.85% of CCGs had no plans to update or review their palliative care services. The most important finding from this exercise is that the information CCGs hold about their population and services is not standardised. However, information based on data that are more objective, for example, population and total budget for palliative care, demonstrate wide variations in commissioning. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  7. 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…

  8. 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.

  9. 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 urged to... SpeakUP TM ... are more likely to get better faster. To help prevent health care mistakes, patients are urged to “ ...

  10. Medicaid Home Care Services and Survival in New York City

    Science.gov (United States)

    Albert, Steven M.; Simone, Bridget; Brassard, Andrea; Stern, Yaakov; Mayeux, Richard

    2005-01-01

    Purpose: New York City's Medicaid Home Care Services Program provides an integrated program of housekeeping and personal assistance care along with regular nursing assessments. We sought to determine if this program of supportive care offers a survival benefit to older adults. Design and Methods: Administrative data from New York City's Medicaid…

  11. Mothers' health services utilization and health care seeking ...

    African Journals Online (AJOL)

    Background: data from different studies showed health care behaviour and estimated per capita health care expenditure for the general population, but the specific data for infants at different levels of care are lacking. The objectives of this study were to describe mothers' health service utilization during pregnancy and ...

  12. Reimbursement for school nursing health care services: position statement.

    Science.gov (United States)

    Lowe, Janet; Cagginello, Joan; Compton, Linda

    2014-09-01

    Children come to school with a variety of health conditions, varying from moderate health issues to multiple, severe chronic health illnesses that have a profound and direct impact on their ability to learn. The registered professional school nurse (hereinafter referred to as school nurse) provides medically necessary services in the school setting to improve health outcomes and promote academic achievement. The nursing services provided are reimbursable services in other health care settings, such as hospitals, clinics, and home care settings. The National Association of School Nurses (NASN) believes that school nursing services that are reimbursable nursing services in other health care systems should also be reimbursable services in the school setting, while maintaining the same high quality care delivery standards. Traditionally, local and state tax revenues targeted to fund education programs have paid for school nursing health services. School nurses are in a strategic position to advocate for improving clinical processes to better fit with community health care providers and to align reimbursements with proposed changes. Restructuring reimbursement programs will enable health care funding streams to assist in paying for school nursing services delivered to students in the school setting. Developing new innovative health financing opportunities will help to increase access, improve quality, and reduce costs. The goal is to promote a comprehensive and cost-effective health care delivery model that integrates schools, families, providers, and communities.

  13. Integrated Specialized Early-Course Psychosis Treatment Services - University Psychiatric Hospital Vrapce Model.

    Science.gov (United States)

    Ostojić, DraŽenka; Čulo, Ilaria; Silić, Ante; Kos, Suzana; Savić, Aleksandar

    2018-06-01

    First episode of psychosis presents a critical period in terms of numerous associated risks, but also possibilities for effective therapeutic interventions. There is a continued focus on early interventions in prodromal states and early course of frank psychosis, aimed at ensuring faster remission, reducing relapses, achieving better long-term functioning, and preventing adverse outcomes linked to untreated psychosis and chronic psychotic disorders. A number of different specialized treatment models and services exist trying to close knowledge gaps and provide clinical interventions to first-episode psychosis (FEP) patients, but there is still no generally accepted standard of care informing our every-day practice. FEP and early-course psychosis specialized treatment model developed in 2004 in University Psychiatric Hospital Vrapce rests on integration of care across different organization units and clinical presentation acuity levels and patient needs (intensive care, FEP inpatient unit, FEP outpatient services including day hospital). Such integration of FEP services allows for flexible entry point on multiple levels, earlier structuring of therapeutic alliance for those requiring inpatient care, reduction of risks associated with FEP, quicker formation of long-term treatment plans, reduction of delay in accessing specialized services, and a more coordinated diagnostic process and recruitment of FEP patient population. Detailed evaluations of outcomes and comparisons with different treatment models are necessary in order to assess strengths and weaknesses of each specific model and inform modifications to current practice models.

  14. 32 CFR 728.71 - Ex-service maternity care.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 5 2010-07-01 2010-07-01 false Ex-service maternity care. 728.71 Section 728.71... FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES Other Persons § 728.71 Ex-service maternity... certified by medical authorities that the pregnancy existed prior to entry into service (EPTE), maternity...

  15. Patients' satisfaction with eye care services in a Nigerian Teaching ...

    African Journals Online (AJOL)

    ... will recommend the hospital to others strongly, 145 (47.2%) will do so hesitantly. Conclusion: Majority of the patients were satisfied with the services received. The major dissatisfaction points were cost of services and inadequate toilet facilities. Key words: Developing country, eye care services, patient satisfaction ...

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

    OpenAIRE

    Morgan, R; Ensor, T; Waters, H

    2016-01-01

    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. Combi...

  17. A qualitative description of service providers' experiences of ethical issues in HIV care.

    Science.gov (United States)

    Sabone, Motshedisi B; Mogobe, Keitshokile Dintle; Matshediso, Ellah; Shaibu, Sheila; Ntsayagae, Esther I; Corless, Inge B; Cuca, Yvette P; Holzemer, William L; Dawson-Rose, Carol; Baez, Solymar S Soliz; Rivero-Mendz, Marta; Webel, Allison R; Eller, Lucille Sanzero; Reid, Paula; Johnson, Mallory O; Kemppainen, Jeanne; Reyes, Darcel; Nokes, Kathleen; Wantland, Dean; Nicholas, Patrice K; Lingren, Teri; Portillo, Carmen J; Sefcik, Elizabeth; Long-Middleton, Ellen

    2018-01-01

    Managing HIV treatment is a complex multi-dimensional task because of a combination of factors such as stigma and discrimination of some populations who frequently get infected with HIV. In addition, patient-provider encounters have become increasingly multicultural, making effective communication and provision of ethically sound care a challenge. This article explores ethical issues that health service providers in the United States and Botswana encountered in their interaction with patients in HIV care. A descriptive qualitative design was used to collect data from health service providers and patients using focused group discussions. This article is based on responses from health service providers only. Participants and context: This article is based on 11 focused group discussions with a total sample of 71 service providers in seven US sites and one Botswana site. Ethical considerations: Ethical review boards at all the study sites reviewed the study protocol and approved it. Ethical review boards of the study's coordinating centers, Rutgers University and the University of California at San Francisco, also approved it. The study participants provided a written informed consent to participate. HIV service providers encountered ethical challenges in all the four Beauchamp and Childress' biomedical ethics of respect for patients' autonomy, beneficence, justice, and nonmaleficence. The finding that HIV service providers encounter ethical challenges in their interaction with patients is supported by prior studies. The ethical challenges are particularly prominent in multicultural care and resource-constrained care environments. Provision of HIV care is fraught with ethical challenges that tend to pose different issues depending on a given care environment. It is important that strong partnerships are developed among key stakeholders in HIV care. In addition, health service providers need to be provided with resources so they can provide quality and ethically sound

  18. Developing a costing framework for palliative care services.

    Science.gov (United States)

    Mosoiu, Daniela; Dumitrescu, Malina; Connor, Stephen R

    2014-10-01

    Palliative care services have been reported to be a less expensive alternative to traditional treatment; however, little is known about how to measure the cost of delivering quality palliative care. The purpose of this project was to develop a standardized method for measuring the cost of palliative care delivery that could potentially be replicated in multiple settings. The project was implemented in three stages. First, an interdisciplinary group of palliative care experts identified standards of quality palliative care delivery in the inpatient and home care services. Surveys were conducted of government agencies and palliative care providers to identify payment practices and budgets for palliative care services. In the second phase, unit costs were defined and a costing framework was designed to measure inpatient and home-based palliative care unit costs. The final phase was advocacy for inclusion of calculated costs into the national funding system. In this project, a reliable framework for determining the cost of inpatient and home-based palliative care services was developed. Inpatient palliative care cost in Romania was calculated at $96.58 per day. Home-based palliative care was calculated at $30.37 per visit, $723.60 per month, and $1367.71 per episode of care, which averaged 45 visits. A standardized methodology and framework for costing palliative care are presented. The framework allows a country or provider of care to substitute their own local costs to generate cost information relevant to the health-care system. In Romania, this allowed the palliative care provider community to advocate for a consistent payment system. Copyright © 2014 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  19. Obstetric critical care services in South Africa

    Directory of Open Access Journals (Sweden)

    Gladness Nethathe

    2015-01-01

    Full Text Available More than half of all global maternal deaths occur in Africa. A large percentage of these deaths are preventable, and lack of access to adequate critical care facilities is a contributing factor. There are limited published data on the clinical and management challenges presented by the critically ill obstetric patient admitted to the intensive care unit in our setting, and more data are required in order to better define the critical care needs of this group of patients.

  20. 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. Copyright © 2011 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

  1. A Web-Based Review of Sexual and Reproductive Health Services Available at Colleges and Universities in Georgia.

    Science.gov (United States)

    Cushing, Katherine F; Carson, Anna E; Short, Tyiesha D; Kot, Stefanie N; Tschokert, Merete; Sales, Jessica M

    2018-04-13

    Although two-thirds of graduating high school seniors attend college or university in the U.S., there is a paucity of national or state specific research regarding SRH services available on or near college and university campuses. A review of websites for all colleges and universities in Georgia was conducted to evaluate sexual health services available on campuses and evidence of referral to community providers. Of 96 colleges in Georgia, 44░had campus-located health centers, with only 3 at two-year colleges. Overall SRH service provision was low, with great variation between colleges. Distances between colleges and Title X clinics ranged from 0.33 to 35.45 miles. Many students lack access to campus health centers, and information on college websites regarding SRH service availability and referrals differs dramatically between campuses. In the absence of robust campus-located services, schools should highlight where students can obtain comprehensive SRH care in the community.

  2. Income Disparities in the Use of Health Screening Services Among University Students in Korea: A Cross-Sectional Study of 2479 Participants in a University.

    Science.gov (United States)

    Lee, Su Hyun; Joh, Hee-Kyung; Kim, Soojin; Oh, Seung-Won; Lee, Cheol Min; Kwon, Hyuktae

    2016-05-01

    Public health insurance coverage for preventive care in young adults is incomplete in Korea. Few studies have focused on young adults' socioeconomic disparities in preventive care utilization. We aimed to explore household income disparities in the use of different types of health screening services among university students in Korea.This cross-sectional study used a web-based self-administered survey of students at a university in Korea from January to February 2013. To examine the associations between household income levels and health screening service use within the past 2 years, odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using logistic regression with adjustment for various covariables.Of 2479 participants, 45.5% reported using health screening services within 2 years (university-provided screening 32.9%, private sector screening 16.7%, and both 4.1%). Household income levels were not significantly associated with overall rates of health screening service use with a multivariable-adjusted OR (95% CI) in the lowest versus highest income group of 1.12 (0.87-1.45, Ptrend = 0.35). However, we found significantly different associations in specific types of utilized screening services by household income levels. The multivariable-adjusted OR (95% CI) of university-provided health screening service use in the lowest versus highest income level was 1.74 (1.30-2.34; Ptrend income level was 0.45 (0.31-0.66; Ptrend income groups among university students in Korea, although overall rates of health screening service use were similar across income levels. Low-income students were more likely to use university-provided health screening services, and less likely to use private sector screening services. To ensure appropriate preventive care delivery for young adults and to address disparities in disadvantaged groups, the expansion of medical insurance coverage for preventive health care, establishment of a usual source of care, focusing on

  3. Maternity Care Services Provided by Family Physicians in Rural Hospitals.

    Science.gov (United States)

    Young, Richard A

    The purpose of this study was to describe how many rural family physicians (FPs) and other types of providers currently provide maternity care services, and the requirements to obtain privileges. Chief executive officers of rural hospitals were purposively sampled in 15 geographically diverse states with significant rural areas in 2013 to 2014. Questions were asked about the provision of maternity care services, the physicians who perform them, and qualifications required to obtain maternity care privileges. Analysis used descriptive statistics, with comparisons between the states, community rurality, and hospital size. The overall response rate was 51.2% (437/854). Among all identified hospitals, 44.9% provided maternity care services, which varied considerably by state (range, 17-83%; P maternity care, a mean of 271 babies were delivered per year, 27% by cesarean delivery. A mean of 7.0 FPs had privileges in these hospitals, of which 2.8 provided maternity care and 1.8 performed cesarean deliveries. The percentage of FPs who provide maternity care (mean, 48%; range, 10-69%; P maternity care who are FPs (mean, 63%; range, 10-88%; P maternity care services in US rural hospitals, including cesarean deliveries. Some family medicine residencies should continue to train their residents to provide these services to keep replenishing this valuable workforce. © Copyright 2017 by the American Board of Family Medicine.

  4. The role of university hospitals as centers of excellence for shared health-care-delivery of in- and outpatients

    International Nuclear Information System (INIS)

    Adelhard, K.; Matzko, M.; Bruening, R.; Holzknecht, N.; Stark, V.; Reiser, M.

    2002-01-01

    Problem. Health care delivery in Germany has to face severe challenges that will lead to a closer integration of services for in- and out-patients. University hospitals play an important role due to their activities in research, education and health care delivery. They are requested to promote and evaluate new means and ways for health care delivery. Methods. The Institute of Clinical Radiology at the University Hospital of the Ludwig-Maximilians-University started teleradiological services for hospitals and general practices in January 1999 in the framework of the ''Imaging services - teleradiological center of excellence''. Legal, technical and organizational prerequisites were analyzed. Results. Networks between university hospitals and general practices are not likely to solve all future problems. They will, however, increase the availability of the knowledge of experts even in rural areas and contribute to a quality ensured health care at the patients home. Future developments may lead to international co-operations and such services may be available to patients abroad. Conclusion. Legal, technical and organizational obstacles have to be overcome to create a framework for high quality telemedical applications. University hospitals will play an important role in promoting and evaluating teleradiological services. (orig.) [de

  5. Estimated time spent on preventive services by primary care physicians

    Directory of Open Access Journals (Sweden)

    Gradison Margaret

    2008-12-01

    Full Text Available Abstract Background Delivery of preventive health services in primary care is lacking. One of the main barriers is lack of time. We estimated the amount of time primary care physicians spend on important preventive health services. Methods We analyzed a large dataset of primary care (family and internal medicine visits using the National Ambulatory Medical Care Survey (2001–4; analyses were conducted 2007–8. Multiple linear regression was used to estimate the amount of time spent delivering each preventive service, controlling for demographic covariates. Results Preventive visits were longer than chronic care visits (M = 22.4, SD = 11.8, M = 18.9, SD = 9.2, respectively. New patients required more time from physicians. Services on which physicians spent relatively more time were prostate specific antigen (PSA, cholesterol, Papanicolaou (Pap smear, mammography, exercise counseling, and blood pressure. Physicians spent less time than recommended on two "A" rated ("good evidence" services, tobacco cessation and Pap smear (in preventive visits, and one "B" rated ("at least fair evidence" service, nutrition counseling. Physicians spent substantial time on two services that have an "I" rating ("inconclusive evidence of effectiveness", PSA and exercise counseling. Conclusion Even with limited time, physicians address many of the "A" rated services adequately. However, they may be spending less time than recommended for important services, especially smoking cessation, Pap smear, and nutrition counseling. Future research is needed to understand how physicians decide how to allocate their time to address preventive health.

  6. Service robots, care ethics, and design

    NARCIS (Netherlands)

    van Wynsberghe, Amy Louise

    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

  7. Barriers to formal emergency obstetric care services' utilization.

    Science.gov (United States)

    Essendi, Hildah; Mills, Samuel; Fotso, Jean-Christophe

    2011-06-01

    Access to appropriate health care including skilled birth attendance at delivery and timely referrals to emergency obstetric care services can greatly reduce maternal deaths and disabilities, yet women in sub-Saharan Africa continue to face limited access to skilled delivery services. This study relies on qualitative data collected from residents of two slums in Nairobi, Kenya in 2006 to investigate views surrounding barriers to the uptake of formal obstetric services. Data indicate that slum dwellers prefer formal to informal obstetric services. However, their efforts to utilize formal emergency obstetric care services are constrained by various factors including ineffective health decision making at the family level, inadequate transport facilities to formal care facilities and insecurity at night, high cost of health services, and inhospitable formal service providers and poorly equipped health facilities in the slums. As a result, a majority of slum dwellers opt for delivery services offered by traditional birth attendants (TBAs) who lack essential skills and equipment, thereby increasing the risk of death and disability. Based on these findings, we maintain that urban poor women face barriers to access of formal obstetric services at family, community, and health facility levels, and efforts to reduce maternal morbidity and mortality among the urban poor must tackle the barriers, which operate at these different levels to hinder women's access to formal obstetric care services. We recommend continuous community education on symptoms of complications related to pregnancy and timely referral. A focus on training of health personnel on "public relations" could also restore confidence in the health-care system with this populace. Further, we recommend improving the health facilities in the slums, improving the services provided by TBAs through capacity building as well as involving TBAs in referral processes to make access to services timely. Measures can also be

  8. Substitution of Formal and Informal Home Care Service Use and Nursing Home Service Use: Health Outcomes, Decision-Making Preferences, and Implications for a Public Health Policy.

    Science.gov (United States)

    Chen, Chia-Ching; Yamada, Tetsuji; Nakashima, Taeko; Chiu, I-Ming

    2017-01-01

    The purposes of this study are: (1) to empirically identify decision-making preferences of long-term health-care use, especially informal and formal home care (FHC) service use; (2) to evaluate outcomes vs. costs based on substitutability of informal and FHC service use; and (3) to investigate health outcome disparity based on substitutability. The methods of ordinary least squares, a logit model, and a bivariate probit model are used by controlling for socioeconomic, demographic, and physical/mental health factors to investigate outcomes and costs based substitutability of informal and formal health-care use. The data come from the 2013 Japanese Study of Aging and Retirement (JSTAR), which is designed by Keizai-Sangyo Kenkyu-jo, Hitotsubashi University, and the University of Tokyo. The JSTAR is a globally comparable data survey of the elderly. There exists a complement relationship between the informal home care (IHC) and community-based FHC services, and the elasticity's ranges from 0.18 to 0.22. These are reasonable results, which show that unobservable factors are positively related to IHC and community-based FHC, but negatively related to nursing home (NH) services based on our bivariate probit model. Regarding health-care outcome efficiency issue, the IHC is the best one among three types of elderly care: IHC, community-based FHC, and NH services. Health improvement/outcome of elderly with the IHC is heavier concentrated on IHC services than the elderly care services by community-based FHC and NH care services. Policy makers need to address a diversity of health outcomes and efficiency of services based on providing services to elderly through resource allocation to the different types of long-term care. A provision of partial or full compensation for elderly care at home is recommendable and a viable option to improve their quality of lives.

  9. Substitution of Formal and Informal Home Care Service Use and Nursing Home Service Use: Health Outcomes, Decision-Making Preferences, and Implications for a Public Health Policy

    Directory of Open Access Journals (Sweden)

    Chia-Ching Chen

    2017-11-01

    Full Text Available ObjectivesThe purposes of this study are: (1 to empirically identify decision-making preferences of long-term health-care use, especially informal and formal home care (FHC service use; (2 to evaluate outcomes vs. costs based on substitutability of informal and FHC service use; and (3 to investigate health outcome disparity based on substitutability.Methodology and dataThe methods of ordinary least squares, a logit model, and a bivariate probit model are used by controlling for socioeconomic, demographic, and physical/mental health factors to investigate outcomes and costs based substitutability of informal and formal health-care use. The data come from the 2013 Japanese Study of Aging and Retirement (JSTAR, which is designed by Keizai-Sangyo Kenkyu-jo, Hitotsubashi University, and the University of Tokyo. The JSTAR is a globally comparable data survey of the elderly.ResultsThere exists a complement relationship between the informal home care (IHC and community-based FHC services, and the elasticity’s ranges from 0.18 to 0.22. These are reasonable results, which show that unobservable factors are positively related to IHC and community-based FHC, but negatively related to nursing home (NH services based on our bivariate probit model. Regarding health-care outcome efficiency issue, the IHC is the best one among three types of elderly care: IHC, community-based FHC, and NH services. Health improvement/outcome of elderly with the IHC is heavier concentrated on IHC services than the elderly care services by community-based FHC and NH care services.ConclusionPolicy makers need to address a diversity of health outcomes and efficiency of services based on providing services to elderly through resource allocation to the different types of long-term care. A provision of partial or full compensation for elderly care at home is recommendable and a viable option to improve their quality of lives.

  10. Income-Related Inequalities in Access to Dental Care Services in Japan.

    Science.gov (United States)

    Nishide, Akemi; Fujita, Misuzu; Sato, Yasunori; Nagashima, Kengo; Takahashi, Sho; Hata, Akira

    2017-05-12

    Background : This study aimed to evaluate whether income-related inequalities in access to dental care services exist in Japan. Methods : The subjects included beneficiaries of the National Health Insurance (NHI) in Chiba City, Japan, who had been enrolled from 1 April 2014 to 31 March 2015. The presence or absence of dental visits and number of days spent on dental care services during the year were calculated using insurance claims submitted. Equivalent household income was calculated using individual income data from 1 January to 31 December 2013, declared for taxation. Results : Of the 216,211 enrolled subjects, 50.3% had dental care during the year. Among those with dental visits, the average number of days (standard deviation) spent on dental care services per year was 7.7 (7.1). Low income was associated with a decreased rate of dental care utilization regardless of age and sex. However, there was a significant inverse linear association between the number of days spent on dental care services and income levels for both sexes. Conclusions : There were income-related inequalities in access to dental care services, regardless of the age group or sex, within the Japanese universal health insurance system.

  11. 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.

  12. 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.

  13. Improving palliative care outcomes for Aboriginal Australians: service providers' perspectives.

    Science.gov (United States)

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

    2013-07-23

    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. In-depth, qualitative interviews with urban, rural and remote palliative care providers were undertaken in inpatient and community settings in Western Australia. Interviews were audio-recorded, transcribed verbatim and coded independently by two researchers with QSR NVivo 10 software used to help manage data. Data analysis was informed by multiple theoretical standpoints, including the social ecological model, critical cultural theories and the 'cultural security' framework. Thematic analysis was carried out that identified patterns within data. Fifteen palliative care providers were interviewed. Overall they reported lack of understanding of Aboriginal culture and being uncertain of the needs and priorities of Aboriginal people during end-of-life care. According to several participants, very few Aboriginal people had an understanding of palliative care. Managing issues such as anger, denial, the need for non-medical support due to socioeconomic disadvantage, and dealing with crises and conflicts over funeral arrangements were reported as some of the tensions between Aboriginal patients and families and the service providers. Early referral to palliative care is important in demonstrating and maintaining a caring therapeutic relationship. Paramount to meeting the needs for Aboriginal patients was access to appropriate information and logistical, psychological and emotional support. These were often seen as essential but additional to standard palliative care services. The broader context of Aboriginal history and historical distrust of mainstream services was seen to impinge on Aboriginal people's willingness and

  14. Care satisfaction among older people receiving public care and service at home or in special accommodation.

    Science.gov (United States)

    Karlsson, Staffan; Edberg, Anna-Karin; Jakobsson, Ulf; Hallberg, Ingalill R

    2013-02-01

    To explore care satisfaction in relation to place of living, health-related quality of life, functional dependency and health complaints among people 65 years or older, receiving public care and service. The concept public care and service concerns formal care from the municipality, including home help, home nursing care, rehabilitation and a special accommodation. To be able to provide care and service of high quality to older people, knowledge about factors influencing their experience of satisfaction with the care is essential. Cross-sectional, including comparison and correlation. One-hundred sixty-six people receiving public care and service from the municipality were interviewed regarding demography, functional ability, perceived health complaints and care. Health-related quality of life was measured with SF-12, and self-rated care satisfaction was measured with a questionnaire. Low self-rated care satisfaction was associated with dependency in Instrumental Activities of Daily Living, blindness, faeces incontinence and anxiety, while high self-rated care satisfaction was associated with dependency in Personal Activities of Daily Living. Those at home rated an overall higher care satisfaction and were more satisfied with care continuity and personal relations; they thought that the staff had more time and were more respectful and quiet, than the ratings by those in a special accommodation (equivalent to a nursing home). Care satisfaction and health-related quality of life among older people was more associated with functional impairment and health complaints than to whether care and service was received at home or in a special accommodation. An approach using intervention focused on functional ability and health complaints is important for development of improved care satisfaction for older people receiving public care and service. © 2013 Blackwell Publishing Ltd.

  15. Social inequalities in the organization of pregnancy care in a universally funded public health care system.

    Science.gov (United States)

    Sutherland, Georgina; Yelland, Jane; Brown, Stephanie

    2012-02-01

    To examine the social organization of pregnancy care and the extent to which socioeconomic factors affect women's experience of care. We consider these data in the global discussion on taking action to reduce health inequalities. This study draws on cross-sectional data from a large population-based survey of Australian women 6 months after giving birth. Only those women reporting to attend publically-funded models of antenatal care (i.e., public clinic, midwife clinic, shared care, primary medical care, primary midwife care) were included in analyses. Results showed a social patterning in the organization and experience of care with clear links between model of care attended in pregnancy and a number of individual-level indicators of social disadvantage. Our findings show model of care is a salient feature in how women view their care. How women from socially disadvantaged backgrounds navigate available care options are important considerations. Pregnancy care is recognized as an opportunity to intervene to give children 'the best start in life.' Our data show the current system of universally accessible pregnancy care in Australia is failing to support the most vulnerable women and families. This information can inform actions to reduce social disparities during this critical period.

  16. Quantifying the demand for hospital care services: a time and motion study.

    Science.gov (United States)

    van Oostveen, Catharina J; Gouma, Dirk J; Bakker, Piet J; Ubbink, Dirk T

    2015-01-22

    The actual amount of care hospitalised patients need is unclear. A model to quantify the demand for hospital care services among various clinical specialties would avail healthcare professionals and managers to anticipate the demand and costs for clinical care. Three medical specialties in a Dutch university hospital participated in this prospective time and motion study. To include a representative sample of patients admitted to clinical wards, the most common admission diagnoses were selected from the most recent update of the national medical registry (LMR) of ICD-10 admission diagnoses. The investigators recorded the time spent by physicians and nurses on patient care. Also the costs involved in medical and nursing care, (surgical) interventions, and diagnostic procedures as an estimate of the demand for hospital care services per hospitalised patient were calculated and cumulated. Linear regression analysis was applied to determine significant factors including patient and healthcare outcome characteristics. Fifty patients on the Surgery (19), Pediatrics (17), and Obstetrics & Gynecology (14) wards were monitored during their hospitalization. Characteristics significantly associated with the demand for healthcare were: polypharmacy during hospitalization, complication severity level, and whether a surgical intervention was performed. A set of predictors of the demand for hospital care services was found applicable to different clinical specialties. These factors can all be identified during hospitalization and be used as a managerial tool to monitor the patients' demand for hospital care services and to detect trends in time.

  17. Can home care services achieve cost savings in long-term care for older people?

    Science.gov (United States)

    Greene, V L; Ondrich, J; Laditka, S

    1998-07-01

    To determine whether efficient allocation of home care services can produce net long-term care cost savings. Hazard function analysis and nonlinear mathematical programming. Optimal allocation of home care services resulted in a 10% net reduction in overall long-term care costs for the frail older population served by the National Long-Term Care (Channeling) Demonstration, in contrast to the 12% net cost increase produced by the demonstration intervention itself. Our findings suggest that the long-sought goal of overall cost-neutrality or even cost-savings through reducing nursing home use sufficiently to more than offset home care costs is technically feasible, but requires tighter targeting of services and a more medically oriented service mix than major home care demonstrations have implemented to date.

  18. Obstetric critical care services in South Africa

    African Journals Online (AJOL)

    time of their first pregnancy, and assisted reproductive technology that has made it ... transport between levels of care, unavailability of blood and blood products ... 0.24%. Severe obstetric haemorrhage, hypertension and sepsis were the most ...

  19. Job strain: a cross-sectional survey of dementia care specialists and other staff in Swedish home care services

    Directory of Open Access Journals (Sweden)

    Sandberg L

    2018-05-01

    Full Text Available Linda Sandberg,1 Lena Borell,1 David Edvardsson,2,3 Lena Rosenberg,1 Anne-Marie Boström1,4,5 1Department of Neurobiology, Care Sciences and Society (NVS, Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden; 2School of Nursing and Midwifery, La Trobe University, Heidelberg, VIC, Australia; 3Department of Nursing, Umea University, Umea, Sweden; 4Theme Aging, Karolinska University Hospital, Stockholm, Sweden; 5Department of Nursing, Western Norway University of Applied Sciences, Haugesund, Norway Introduction: An increasing number of older persons worldwide live at home with various functional limitations such as dementia. So, home care staff meet older persons with extensive, complex needs. The staff’s well-being is crucial because it can affect the quality of their work, although literature on job strain among home care staff is limited. Aim: To describe perceived job strain among home care staff and to examine correlations between job strain, personal factors, and organizational factors. Methods: The study applied a cross-sectional survey design. Participants were dementia care specialists who work in home care (n=34 and other home care staff who are not specialized in dementia care (n=35. The Strain in Dementia Care Scale (SDCS and Creative Climate Questionnaire instruments and demographic variables were used. Descriptive and inferential statistics (including regression modeling were applied. The regional ethical review board approved the study. Results: Home care staff perceived job strain – particularly because they could not provide what they perceived to be necessary care. Dementia care specialists ranked job strain higher (m=5.71 than other staff members (m=4.71; p=0.04. Job strain (for total score and for all five SDCS factors correlated with being a dementia care specialist. Correlations also occurred between job strain for SDCS factor 2 (difficulties understanding and interpreting and not having Swedish as

  20. Development of a Behavior Change Intervention to Improve Sexual Health Service Use Among University Undergraduate Students: Mixed Methods Study Protocol.

    Science.gov (United States)

    Cassidy, Christine; Steenbeek, Audrey; Langille, Donald; Martin-Misener, Ruth; Curran, Janet

    2017-11-02

    University students are at risk for acquiring sexually transmitted infections and suffering other negative health outcomes. Sexual health services offer preventive and treatment interventions that aim to reduce these infections and associated health consequences. However, university students often delay or avoid seeking sexual health services. An in-depth understanding of the factors that influence student use of sexual health services is needed to underpin effective sexual health interventions. In this study, we aim to design a behavior change intervention to address university undergraduate students' use of sexual health services at two universities in Nova Scotia, Canada. This mixed methods study consists of three phases that follow a systematic approach to intervention design outlined in the Behaviour Change Wheel. In Phase 1, we examine patterns of sexual health service use among university students in Nova Scotia, Canada, using an existing dataset. In Phase 2, we identify the perceived barriers and enablers to students' use of sexual health services. This will include focus groups with university undergraduate students, health care providers, and university administrators using a semistructured guide, informed by the Capability, Opportunity, Motivation-Behaviour Model and Theoretical Domains Framework. In Phase 3, we identify behavior change techniques and intervention components to develop a theory-based intervention to improve students' use of sexual health services. This study will be completed in March 2018. Results from each phase and the finalized intervention design will be reported in 2018. Previous intervention research to improve university students' use of sexual health services lacks a theoretical assessment of barriers. This study will employ a mixed methods research design to examine university students' use of sexual health service and apply behavior change theory to design a theory- and evidence-based sexual health service intervention. Our

  1. Quantifying low-value services by using routine data from Austrian primary care.

    Science.gov (United States)

    Sprenger, Martin; Robausch, Martin; Moser, Adrian

    2016-12-01

    Open debates about the reduction of low-value services, unnecessary diagnostic tests and ineffective therapeutic procedures and initiatives like "Choosing Wisely "in the USA and Canada are still absent in Austria. The objectives of this study are: (i) to establish a list of ineffective or low-value services possibly provided in Austrian primary care, (ii) to explore how many of these services are quantifiable using routine data and (iii) to estimate the number of affected beneficiaries and avoidable costs arising from the provision of these services. In May 2014, we identified low-value care services relevant for primary care in Austria. For our analysis we used routine data sets from the Austrian health insurance. All analysis refer to the insured population of the Lower Austrian Sickness Fund (n = 1 168 433) in the year 2013. (i) We found 453 low-value services possibly offered in Austrian primary care. (ii) Only 34 (7.5%) services were quantifiable using routine data. (iii) In the year 2013, these 34 services were provided to at least 246 131 beneficiaries and the estimated avoidable costs arising were at least 11.38 million Euros. This accounts for 1.2% of overall spending of the Lower Austrian Sickness Fund for drugs and services provided by primary care doctors in the year 2013. The absence of a homogeneous, transparent and accessible coding system for diagnosis in Austrian primary care restrained our assessment. However, our study findings illustrate the potential utility and limitations of using claims-based measures to identify low-value care. © The Author 2016. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

  2. Providers of antenatal care services in Ghana: evidence from Ghana demographic and health surveys 1988-2014.

    Science.gov (United States)

    Dickson, Kwamena Sekyi; Darteh, Eugene Kofuor Maafo; Kumi-Kyereme, Akwasi

    2017-03-14

    Antenatal care is one of the three most essential care - antenatal, delivery and post-natal, given to women during pregnancy and has the potential to contribute towards the achievement of the Sustainable Development Goal (SDG) target 3.1- reducing the global maternal mortality ratio to less than 70 per 100,000 and target 3.8 - achieve universal health coverage. The main objective is to examine the contribution of the various providers of antenatal care services in Ghana from 1988 to 2014. The study uses data from all the six rounds of the Ghana Demographic and Health Survey (GDHS). Binary logistic regression models were applied to examine the association between background characteristics of respondents and providers of antenatal care services. The results show that majority of antenatal care services were provided by nurses over the period under review. The proportion of women who received antenatal care services from nurses improved over the period from 55% in 1988 to 89.5% in 2014. Moreover, there was a decline in antenatal care services provided by traditional birth attendants and women who did not receive antenatal care services from any service provider over the years under review. It was observed that women from rural areas were more likely to utilise antenatal care services provided by traditional birth attendants, whilst those from urban areas were more likely to utilise antenatal care from doctors and nurses. To further improve access to and utilisation of antenatal care services provided by nurses and doctors it is recommended that the Ghana Health Service and the Ministry of Health should put in place systems aimed at improving on the quality of care given such as regular training workshops for health personnel and assessment of patient's satisfaction with services provided. Also, they should encourage women in rural areas especially those from the savannah zone to utilise antenatal care services from skilled providers through social and behaviour

  3. Poverty, Access to Health Care Services and Human Capital ...

    African Journals Online (AJOL)

    FIRST LADY

    socio-economic development because it is essential for a virile labour force ... Poverty and access to health care services are major development problems ..... including preventive, curative and palliative intervention, whether directed to.

  4. 20 CFR 638.510 - Health care and services.

    Science.gov (United States)

    2010-04-01

    ... UNDER TITLE IV-B OF THE JOB TRAINING PARTNERSHIP ACT Center Operations § 638.510 Health care and services. The center operator shall provide a health program, including basic medical, dental, and mental...

  5. Assessment of Emergency Obstetric Care Services in Ibadan ...

    African Journals Online (AJOL)

    AJRH Managing Editor

    ORIGINAL RESEARCH ARTICLE ... Nigeria's high maternal mortality has been attributed to poor utilization of obstetric care services to handle ... Poor obstetric outcome in middle and low-income ... Evidence also showed that access to.

  6. Patterns of maternity care service utilization in Southern Ethiopia ...

    African Journals Online (AJOL)

    Patterns of maternity care service utilization in Southern Ethiopia: Evidence from a community ... PROMOTING ACCESS TO AFRICAN RESEARCH ... Result: The study revealed that only 26.1 % and 3.3% of the women received antenatal and ...

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

    Science.gov (United States)

    ... from the 2011–2012 National Health Interview Survey (NHIS), selected measures of preventive health care service use ... any gender and age. Data source and methods NHIS is a multipurpose health survey conducted continuously throughout ...

  8. 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...

  9. 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.

  10. 76 FR 64882 - Inquiry Into Disbursement Process for the Universal Service Fund Low Income Program

    Science.gov (United States)

    2011-10-19

    ...] Inquiry Into Disbursement Process for the Universal Service Fund Low Income Program AGENCY: Federal... payments would replace the current administrative process, under which the Universal Service Administrative... Wireline Competition Bureau (WCB) seeks comment on a proposal for disbursing Universal Service Fund low...

  11. 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.

  12. Mechanisms of Funding for Universal Service Obligations: the Electricity Case

    International Nuclear Information System (INIS)

    Mirabel, Francois; Poudou, Jean-Christophe

    2001-06-01

    The transition towards a more competitive regime in network industries (and specially in electricity sector) raises the relevant question of funding for the Universal Service Obligations (USOs). Our paper focuses on two ways of funding for universal service and equal treatment obligations (?Ubiquity and Non Discrimination constraints?): the funding through access charge (CS regime) or taxation (T regime). Using a network model including competition between an historical monopoly (in charge for the USOs) and an entrant, we obtain some results concerning gains and losses of social welfare due to those mechanisms. We show that most of the time it is socially better to let the historical monopoly be active whatever the type of funding for USOs applying, and whatever profitability of the firms is. However, when the entrant is active, we can highlight that the introduction of the T regime (compared to the CS one) implies either welfare deterioration or an entry prevention strategy by the historical firm. Therefore, the T regime could not be an argument for the regulator to promote vertical separation of the historical firm (according to the European community line). (authors)

  13. Mechanisms of funding for Universal Service Obligations. The electricity case

    International Nuclear Information System (INIS)

    Mirabel, Francois; Poudou, Jean-Christophe

    2004-01-01

    The transition towards a more competitive regime in network industries (and specially in electricity sector) raises the relevant question of funding for the Universal Service Obligations (USOs). Our paper focuses on two ways of funding for universal service and equal treatment obligations ('Ubiquity and Nondiscrimination constraints, UND'): the funding through access charge (CS regime) or taxation (T regime). Using a network model including competition between a historical monopoly (in charge for the USOs) and an entrant, we obtain some results concerning gains and losses of social welfare due to those mechanisms. We show that most of the time it is socially better to let the historical monopoly be active whatever the type of funding for USOs applying, and whatever profitability of the firms is. However, when the entrant is active, we can highlight that the introduction of the T regime (compared to the CS one) implies either welfare deterioration or an entry prevention strategy by the historical firm. Therefore, the T regime could not be an argument for the regulator to promote vertical separation of the historical firm (according to the European community line)

  14. Mechanisms of funding for Universal Service Obligations: the electricity case

    International Nuclear Information System (INIS)

    Mirabel, F.; Poudou, J.C.

    2004-01-01

    The transition towards a more competitive regime in network industries (and specially in electricity sector) raises the relevant question of funding for the Universal Service Obligations (USOs). Our paper focuses on two ways of funding for universal service and equal treatment obligations ''Ubiquity and Nondiscrimination constraints, UND'': the funding through access charge (CS regime) or taxation (T regime). Using a network model including competition between a historical monopoly (in charge for the USOs) and an entrant, we obtain some results concerning gains and losses of social welfare due to those mechanisms. We show that most of the time it is socially better to let the historical monopoly be active whatever the type of funding for USOs applying, and whatever profitability of the firms is. However, when the entrant is active, we can highlight that the introduction of the T regime (compared to the CS one) implies either welfare deterioration or an entry prevention strategy by the historical firm. Therefore, the T regime could not be an argument for the regulator to promote vertical separation of the historical firm (according to the European community line). (author)

  15. Patients' perception of the ambulance services at Hospital Universiti Sains Malaysia.

    Science.gov (United States)

    Anisah, A; Chew, K S; Mohd Shaharuddin Shah, C H; Nik Hisamuddin, N A R

    2008-08-01

    Little is known regarding public opinion of prehospital care in Malaysia. This study was conducted to find out the public's perception and expectations of the ambulance services in one of the university hospitals in Malaysia. A six-month prospective cross-sectional study to look at patients' perception of Hospital Universiti Sains Malaysia's (HUSM) ambulance service was conducted from February 2006 to July 2006. Upon arrival at the hospital, patients or their relatives (who used our hospital's ambulances) were interviewed with a set of questions regarding their perception of the ambulance services and were asked to rate the perception on a Likert Scale from 1 to 10. A convenient sampling method was applied. A total of 87 samples were obtained. Despite the many problems faced by the ambulance service in HUSM, the mean score for each of the questions on patient's perception ranged from 9.33 to 9.70 out of 10. The questions with the highest mean score, which were both 9.70 each, were related to staff attentiveness and staff gentleness. Patients' perceptions can be very subjective, but until further similar studies could be carried out in other parts of Malaysia, this set of data merely represents a numerical measure of public perception of the ambulance services from HUSM.

  16. Symptoms of burnout among staff of direct service care

    OpenAIRE

    ZICHOVÁ, Eliška

    2017-01-01

    This dissertation was focused on burnout syndrome among the staff of direct service care. The degree of burnout was estimated using Copenhagen Burnout Inventory questionnaire which was completed by the respondents from six Prague homes for seniors. The burnout incidence in this group was 30-45 %, whereas it was only 18-32 % among Czech Army employees who were studied for comparison. The staff of direct service care had significantly higher degree of personal, work-related, client-related and ...

  17. Universities' expectations of pastoral care: trends, stressors, resource gaps and support needs for teaching staff.

    Science.gov (United States)

    Laws, Thomas A; Fiedler, Brenton A

    2012-10-01

    Since the mid-90s, the university environment has challenged the motivation of academic staff to engage in pastoral care. A literature review revealed five themes that aligned with analysis of interview data from a previous study (Laws and Fiedler, 2010). The key themes were i) staff were often disturbed by unplanned intrusions of students who exhibited behavioural problems or sought emotional support, ii) the management of emotions in face-to-face encounters was stressful, iii) staff felt under-equipped for dealing with Mental Health (MH) issues, iv) standards and control needed updating and v) counselling and disability services did not meet academics' need to know about 'at risk' students. Having identified the incidence of mental health issues among Australian University students, this study aims to locate literature that describes how well current university policies/protocols are supported by Evidence Based Practice in the management of MH problems in the student population. Findings from a content analysis of the literature were triangulated with verbatim comments recorded during a previous study that utilised semi structured interviews with 34 academics at the School of Nursing and Midwifery and the School of Commerce at the University of South Australia (Laws and Fiedler, 2010). Lack of clarity on role boundaries around promotion of students' well-being was not clearly defined. The Higher Education (HE) institutions' slowness in responding to mental health needs of students combined with the increasing expectations of academics' performance monitoring has lead staff to avoid deep investment in their students' well-being. The literature indicates that students are in need of psychological support, but pastoral care remains ill-defined despite enduring expectations held by university administrators. Teacher motivation is diminished by time spent with students in need of emotional support which is not acknowledged in workloads. Staff stress is increased by

  18. The universal service in the future of network-type industries: telecommunications, electricity, postal services

    International Nuclear Information System (INIS)

    Bremond, Celine Clelia

    2003-01-01

    The notion of universal service emerged in the European regulation of the telecommunications sector, and can be applied to all network-type industries. Public monopolies have been put into question again. The introduction of deregulation and competitiveness were expected to improve the service provided to the end consumer, but this deregulation has been also put into question again for matters of universality and equity. Then the issue of financing of these services emerges. The aim of this research thesis is therefore to identify which funding modes can be optimal, and to identify a general methodology for all network-type industries. In the first part of this research thesis, the author studies the cost of universal service obligations. She explains the general methodology of calculation of this cost, and reports this calculation while taking indirect benefits of the operator into account. In a second part, she studies the modalities of financing thus calculated cost by describing the different possible modalities, their benefits and drawbacks, and by presenting a comparison between these methodologies according to three criteria: those set by the European Commission, welfare, and applicability. For these different topics, the author takes all experiments and recent developments into account. These experiments and developments are noticed in different countries: USA, Australia, UK, Sweden, Netherlands, Germany, Belgium, Italy, France

  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. Public health capacity in the provision of health care services.

    Science.gov (United States)

    Valdmanis, Vivian; DeNicola, Arianna; Bernet, Patrick

    2015-12-01

    In this paper, we assess the capacity of Florida's public health departments. We achieve this by using bootstrapped data envelopment analysis (DEA) applied to Johansen's definition of capacity utilization. Our purpose in this paper is to measure if there is, theoretically, enough excess capacity available to handle a possible surge in the demand for primary care services especially after the implementation of the Affordable Care Act that includes provisions for expanded public health services. We measure subunit service availability using a comprehensive data source available for all 67 county health departments in the provision of diagnostic care and primary health care. In this research we aim to address two related research questions. First, we structure our analysis so as to fix budgets. This is based on the assumption that State spending on social and health services could be limited, but patient needs are not. Our second research question is that, given the dearth of primary care providers in Florida if budgets are allowed to vary is there enough medical labor to provide care to clients. Using a non-parametric approach, we also apply bootstrapping to the concept of plant capacity which adds to the productivity research. To preview our findings, we report that there exists excess plant capacity for patient treatment and care, but question whether resources may be better suited for more traditional types of public health services.

  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. 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.

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

    Science.gov (United States)

    Agampodi, Suneth B; Agampodi, Thilini C; Ukd, Piyaseeli

    2008-05-03

    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. 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. 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. Adolescent health services are inadequate and available services

  4. 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

    2012-06-01

    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 hygiene program and two special education districts in rural southern Illinois. Senior dental hygiene students participated in a school-based service-learning project that provided dental examinations, preventive services, and education to children with special health care needs. Evidence-based behavioral interventions were used to teach children to comply with oral procedures. School nurses mentored dental hygiene students in behavior management of children. Dental exams were provided to 234 children from four special education schools with the majority receiving cleanings and fluoride.

  5. Service Line Management: A New Paradigm in Health Care System

    Directory of Open Access Journals (Sweden)

    Rafat Rezapour Nasrabad

    2016-12-01

    Full Text Available Health care organizations are required to implement modern management practices and approaches due to the importance of improving quality and increasing efficiency of health care services. Service line management of healthcare services is one of the new approaches that managers of health sectors are interested in. The “service line” approach will organize the management of inpatient and outpatient in clinical services focusing on patient diagnostic clusters. Services specific in each patient diagnostic cluster will be offered by a multidisciplinary team including nurses, physicians, and so no. Accordingly, the present study aims to evaluate the features, process and benefits of service line management approach in the provision of health services. In this descriptive study, internal and external scientific database have been reviewed and the necessary data have been extracted from the latest research projects and related scientific documents. The results showed that the new management approach is based on a paradigm shift from traditional health care system management to healthcare service line management with a focus on managers’ competencies. Four specific manager’s competencies in this new management model are: conceptual, collaborative, interpersonal, and leadership competencies. Theses competencies should be developed in health system managers so as to lead to organizational excellency and improvement of health service quality. The health sector managers should strengthen these four key competencies and act on them. Then they will become effective leaders and managers in the health system.

  6. 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

  7. 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.

  8. Megamarketing strategies for health care services.

    Science.gov (United States)

    Mobley, M F; Elkins, R L

    1990-01-01

    Megamarketing, as coined by Kotler (1968), is a strategic way of thinking which takes an enlarged view of the skills and resources needed to enter and operate in obstructed or protected markets. The concept of megamarketing emphasizes the mastering and coordination of economic, psychological, political, and public relation skills and suggest that organizations can take a proactive stance in shaping macroenvironmental conditions. As health care delivery is characterized by a highly regulated environment, this marketing approach has definite applications for the health care marketer.

  9. 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…

  10. Antenatal care service utilization and associated factors in Metekel ...

    African Journals Online (AJOL)

    socioeconomic and some obstetric factors have been stated by few studies in other areas, the factors associated with low utilization of Antenatal care in Metekel Zone are not well assed before. Therefore, the objective of this study was to assess the status of Antenatal care service utilization and associated factors among ...

  11. Patients‟ perceptions of primary health care services in the Eastern ...

    African Journals Online (AJOL)

    Seeking to understand patient perspectives is an important step in the efforts to improve the quality of health care. The purpose of this study was to examine patient satisfaction with primary health care (PHC) services. A purposive sample of 19136 patients aged 18 years and above was interviewed at 266 PHC clinics in ...

  12. Improving Services for Women with Depression in Primary Care Settings

    Science.gov (United States)

    Katon, Wayne J.; Ludman, Evette J.

    2003-01-01

    Women have a higher prevalence of depressive disorders compared to men. The current system of care for women with depressive disorders provides significant financial barriers for patients with lower incomes to access mental health services. Primary care systems are used extensively by women and have the potential to diagnose patients at early…

  13. Factors affecting maternal health care services utilization in rural ...

    African Journals Online (AJOL)

    Results: Mother's age at birth, mother's educational level, sex of head of household, household wealth status, employment/work status of mothers, region, religion, birth order and partner's/husband's level of educational were found to be predictors of utilization of delivery care and postnatal care services. Religion and sex of ...

  14. The Role of Quality Obstetric Care Services on Reducing Maternal ...

    African Journals Online (AJOL)

    The study recommends that, special initiative should be done to bring changes on reducing maternal mortality, such as ensure essential equipments and ... Enforcement in providing quality of obstetric care services in maternal health services especially in rural areas where majority of people in Tanzania reside is not an ...

  15. Antenatal care services utilization among women of reproductive ...

    African Journals Online (AJOL)

    Methods: A cross-sectional study was carried out between September and October 2013 among 425 women of reproductive age using a multi-stage sampling technique. Results: Almost all the respondents (93.9%) were aware of antenatal care services. A good proportion of the mothers (90.1%) used antenatal services, ...

  16. Social Support and the Receipt of Home Care Services.

    Science.gov (United States)

    Chappell, Neena L.

    1985-01-01

    Compares differences between elderly who use formal home care services and those who do not. Data revealed users as less healthy and less active and as receiving more assistance from both formal and informal sources. Suggests that formal and informal services complement rather than substitute for one another. (NRB)

  17. Pharmacist Advancement of Transitions of Care to Home (PATCH) Service.

    Science.gov (United States)

    Trang, Joseph; Martinez, Amanda; Aslam, Sadaf; Duong, Minh-Tri

    2015-11-01

    There is a paucity of literature on a well-defined role of a pharmacist in different aspects of transition of care service (TCS). Although health care institutions have specific details on the discharge process, there is a need for a sustainable TCS with a well-defined role of pharmacists. To describe the impact of a pharmacist-led TCS on acute health care utilization, clinic quality indicators, and identification and resolution of medication-related problems (MRPs). A pharmacist-managed TCS service, referred to as the Pharmacist Advancement of Transitions of Care to Home (PATCH) service, was established at an academic medical center, where high-risk patients received a postdischarge phone call from a pharmacist followed by a face-to-face meeting with the pharmacist and the patient's primary care provider (PCP). In a prospective transitions of care group (n = 74), outcomes of patients such as acute health care utilization (an emergency department visit or an inpatient readmission, within 30 days post discharge), clinic quality indicators, and identification and resolution of MRPs were compared to a retrospective control group (n = 87) who received the standard of care. Utilization of acute health care services was significantly lower in the prospective group compared to the retrospective control group (23% vs 41.4%; P = .013). A total of 49 MRPs were discovered in patients who received the TCS. Pharmacists play an integral role in improving the transitions of care to reduce acute health care utilization. In addition, they may improve care transitions by optimizing clinic quality indicators and by identifying and resolving MRPs.

  18. Exploring care for human service profession

    DEFF Research Database (Denmark)

    Høy, Bente

    2016-01-01

    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. Reimbursement for critical care services in India

    Science.gov (United States)

    Jayaram, Raja; Ramakrishnan, Nagarajan

    2013-01-01

    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. PMID:23833469

  20. Spending on Hospital Care and Pediatric Psychology Service Use Among Adolescents and Young Adults With Cancer.

    Science.gov (United States)

    McGrady, Meghan E; Peugh, James L; Brown, Gabriella A; Pai, Ahna L H

    2017-10-01

    To examine the relationship between need-based pediatric psychology service use and spending on hospital care among adolescents and young adults (AYAs) with cancer. Billing data were obtained from 48 AYAs with cancer receiving need-based pediatric psychology services and a comparison cohort of 48 AYAs with cancer not receiving services. A factorial analysis of covariance examined group differences in spending for hospital care. Pending significant findings, a multivariate analysis of covariance was planned to examine the relationship between need-based pediatric psychology service use and spending for inpatient admissions, emergency department (ED) visits, and outpatient visits. Spending for hospital care was higher among AYAs receiving need-based pediatric psychology services than in the comparison cohort (p psychology services. The behavioral and psychosocial difficulties warranting need-based pediatric psychology services may predict higher health care spending. © The Author 2017. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  1. The clients’ readiness to use mental health care services: Experiences and perceptions from Iranian context

    Science.gov (United States)

    Alavi, Mousa; Irajpour, Alireza

    2013-01-01

    Background: Underutilization of mental health care services has been a challenge for the health care providers for many years. This challenge could be met in part by improving the clients’ readiness to use such services. This study aimed to introduce the important aspects of the clients’ readiness to use mental health services in the Iranian context. Materials and Methods: A thematic analysis of in-depth interviews was undertaken using a constant comparative approach. Participants (11 health professionals consisting of 3 physicians, 7 nurses, 1 psychologist, and 5 patients/their family members) were recruited from educational hospitals affiliated with Isfahan University of Medical Sciences, Iran. The credibility and trustworthiness was grounded on four aspects: factual value, applicability, consistency, and neutrality. Results: The study findings uncovered two important aspects of the clients’ readiness for utilizing mental health care services. These are described through two themes and related sub-themes: “The clients’ awareness” implies the cognitive aspect of readiness and “the clients’ attitudes” implies the psychological aspect of readiness, both of which have perceived to cultivate a fertile context through which the clients could access and use the mental health services more easily. Conclusions: For the health care system in Isfahan, Iran to be successful in delivering mental health services, training programs directed to prepare service users should be considered. Improving the clients’ favorable attitudes and awareness should be considered. PMID:24554948

  2. The clients' readiness to use mental health care services: Experiences and perceptions from Iranian context.

    Science.gov (United States)

    Alavi, Mousa; Irajpour, Alireza

    2013-11-01

    Underutilization of mental health care services has been a challenge for the health care providers for many years. This challenge could be met in part by improving the clients' readiness to use such services. This study aimed to introduce the important aspects of the clients' readiness to use mental health services in the Iranian context. A thematic analysis of in-depth interviews was undertaken using a constant comparative approach. Participants (11 health professionals consisting of 3 physicians, 7 nurses, 1 psychologist, and 5 patients/their family members) were recruited from educational hospitals affiliated with Isfahan University of Medical Sciences, Iran. The credibility and trustworthiness was grounded on four aspects: factual value, applicability, consistency, and neutrality. The study findings uncovered two important aspects of the clients' readiness for utilizing mental health care services. These are described through two themes and related sub-themes: "The clients' awareness" implies the cognitive aspect of readiness and "the clients' attitudes" implies the psychological aspect of readiness, both of which have perceived to cultivate a fertile context through which the clients could access and use the mental health services more easily. For the health care system in Isfahan, Iran to be successful in delivering mental health services, training programs directed to prepare service users should be considered. Improving the clients' favorable attitudes and awareness should be considered.

  3. Assessing the market for long-term care services.

    Science.gov (United States)

    Rice, J A; Taylor, S

    1984-02-01

    Traditionally, long-term care services have been used by a diverse marketplace. The chronically ill, developmentally disabled, mentally ill and aging population has looked to long-term care support services as a means of physical and emotional support. Much of the time these services were housed together for the sake of efficiency. The enormous burden these services are creating on the economy, and the growing aging population, have forced the recognition that long-term care service delivery systems must change. Alternate programming for long-term care services that reach out into the community and into individual homes is becoming an attractive approach to meeting the growing demands of the marketplace. Home health, specialized housing and creative funding mechanisms such as HMOs, are examples of initiatives undertaken by healthcare organizations that view diversification as a vehicle for survival. Market research techniques that have been used in other industries are being adapted to the healthcare industry to ensure the proper mix of services that are demanded by older, more knowledgeable consumers. The programs of the future will be market driven, with the ability of the individual to pay for such services playing a significant role. The healthcare provider of today is in a position to serve the community in new ways. By becoming an integral link in the long-term care system and by developing new programs, the organization can serve as a catalyst for change. It is up to the governing bodies and managers of these facilities to become visionaries and to accept responsibility for assessing the market for long-term care services and to guide their organization into the future.

  4. Applying the International Classification of Functioning, Disability and Health to guide home health care services planning and delivery in Thailand.

    Science.gov (United States)

    Pimdee, Atipong; Nualnetr, Nomjit

    2017-01-01

    Home health care is an essential service for home-bound patients in Thailand. In this action research study, we used the International Classification of Functioning, Disability and Health (ICF) framework to modify home health care services provided by a university hospital. Staff responsible for delivering the services (physical therapist, nurses, and Thai traditional medicine practitioners) participated in the development of an ICF-based assessment tool and home health care service procedure. After an 8-month trial of implementing these changes, professional satisfaction and empowerment were high among the home health care team members. Patients and their caregivers were also satisfied with the services. In conclusion, the ICF is an effective means of guiding home health care.

  5. Diagnosis of the quality of service, in customer service, at the National University of Chimborazo- Ecuador

    OpenAIRE

    Salazar Yépez, Wilfrido; Cabrera Vallejo, Mario

    2016-01-01

    The purpose of this article is to determine the quality of service of improvements in the enrollment processes at the National University of Chimborazo- Ecuador. This cross-sectional research is the result of a field work, where an analysis of the collected information was carried out, through surveys applied to the students, through the SERVQUAL model, afterwards, comparing these found aspects and determining The gap between perceptions and expectations, thus determining the quality of servi...

  6. 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.

  7. Participative management in health care services

    Directory of Open Access Journals (Sweden)

    M. Muller

    1995-03-01

    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.

  8. P-1139 - Increased utilization of health care services after psychotherapy

    DEFF Research Database (Denmark)

    Fenger, Morten Munthe; Mortensen, Erik Lykke; Poulsen, Stig Bernt

    2012-01-01

    Background Psychotherapeutic treatment is associated with significant reduction of symptoms in patients, and it is generally assumed that treatment improves health and decreases the need for additional health care. The present study investigates the long-term changes in utilization of health care...... services for patients referred to psychotherapeutic treatment in 2004 and 2005. Method The study was a matched control study, which included 716 consecutive patients and 15,220 matched controls. Data from a comprehensive set of health care services were collected from central registries for an observation...... period of four years before intake and four years after ended treatment. Changes in utilization of health care services in eight health parameters were analyzed with t-test and with ANCOVA one and four year pre-post treatment. Results Of the 761 patients, 216 patients did not show up for treatment, while...

  9. [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.

  10. 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

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

    CERN Multimedia

    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...

  12. Distance education: Physics through the University of South Carolina for pre-service and in-service K-12 teachers

    Science.gov (United States)

    Safko, John L.; Edge, Ronald D.

    1997-03-01

    For the past several years (10 years for JLS, 3 years for RDE) we have been offering telecommunications-based distance education for K-12 teachers through our Office of Distance Education. In addition to practicing teachers and those majoring in science education, we also enroll students who are working on their Master's of Art in Teaching. These latter students often have an undergraduate degree in some science and are completing content and methods courses for state certification as a teacher. These courses are delivered by video cassette and written material. The courses offered are a two semester introductory physics course (by JLS) and a one semester course in physics demonstrations and experiments suitable for the elementary/middle/high school with little or no sources of equipment (by RDE). These courses will be described in the next two sections. First, a few comments on the services provided by the Office of Distance Education and Instructional Services. The University of South Carolina has been offering courses by telecommunications instruction since 1972. During that time it has developed excellent support services for the instructor. Currently the university offers courses live over satellite links and by video cassette to over 10,000 students. The office provides recording capabilities as well as taking care of distribution of video and print materials. They coordinate the receipt and return of any assignments and exams and provide student services for questions about enrollment, supplies, and other technical problems versus content questions. Keeping all of this organized is a full time job for many staff.

  13. Facilitators and Barriers for Successful Implementation of Interconception Care in Preventive Child Health Care Services in the Netherlands

    NARCIS (Netherlands)

    Sijpkens, M.K. (Meertien K.); E.A.P. Steegers (Eric); Rosman, A.N. (Ageeth N.)

    2016-01-01

    textabstractObjectives Successful implementation of preconception and interconception care contributes to optimizing pregnancy outcomes. While interconception care to new mothers could potentially be provided by Preventive Child Health Care services, this care is currently not routinely available in

  14. Participative management in health care services.

    Science.gov (United States)

    Muller, M

    1995-03-01

    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 operationalization 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. A continuum of interactive decision-making and problem-solving is described, the different role-players involved, as well as the levels of interactive decision-making and problem-solving. The most appropriate decision-making strategy should be employed in pro-active and reactive decision-making. Applicable principles and assumptions in each element of participative management is described. It is recommended that this proposed model for participative management be refined by means of a literature control, interactive dialogue with experts and a model case description or participative management, to ensure the trustworthiness of this research.

  15. Mental health care roles of non-medical primary health and social care services.

    Science.gov (United States)

    Mitchell, Penny

    2009-02-01

    Changes in patterns of delivery of mental health care over several decades are putting pressure on primary health and social care services to increase their involvement. Mental health policy in countries like the UK, Australia and New Zealand recognises the need for these services to make a greater contribution and calls for increased intersectoral collaboration. In Australia, most investment to date has focused on the development and integration of specialist mental health services and primary medical care, and evaluation research suggests some progress. Substantial inadequacies remain, however, in the comprehensiveness and continuity of care received by people affected by mental health problems, particularly in relation to social and psychosocial interventions. Very little research has examined the nature of the roles that non-medical primary health and social care services actually or potentially play in mental health care. Lack of information about these roles could have inhibited development of service improvement initiatives targeting these services. The present paper reports the results of an exploratory study that examined the mental health care roles of 41 diverse non-medical primary health and social care services in the state of Victoria, Australia. Data were collected in 2004 using a purposive sampling strategy. A novel method of surveying providers was employed whereby respondents within each agency worked as a group to complete a structured survey that collected quantitative and qualitative data simultaneously. This paper reports results of quantitative analyses including a tentative principal components analysis that examined the structure of roles. Non-medical primary health and social care services are currently performing a wide variety of mental health care roles and they aspire to increase their involvement in this work. However, these providers do not favour approaches involving selective targeting of clients with mental disorders.

  16. 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.

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

    Science.gov (United States)

    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 and community settings in Western Australia. Interviews were audio-recorded, transcribed verbatim and coded independently by two researchers with QSR NVivo 10 software used to help manage data. Data analysis was informed by multiple theoretical standpoints, including the social ecological model, critical cultural theories and the ‘cultural security’ framework. Thematic analysis was carried out that identified patterns within data. Results Fifteen palliative care providers were interviewed. Overall they reported lack of understanding of Aboriginal culture and being uncertain of the needs and priorities of Aboriginal people during end-of-life care. According to several participants, very few Aboriginal people had an understanding of palliative care. Managing issues such as anger, denial, the need for non-medical support due to socioeconomic disadvantage, and dealing with crises and conflicts over funeral arrangements were reported as some of the tensions between Aboriginal patients and families and the service providers. Conclusion Early referral to palliative care is important in demonstrating and maintaining a caring therapeutic relationship. Paramount to meeting the needs for Aboriginal patients was access to appropriate information and logistical, psychological and emotional support. These were often seen as essential but additional to standard palliative care services. The broader context of Aboriginal history and historical distrust of mainstream services was seen to

  18. Customer assessment of long-term care pharmacy provider services.

    Science.gov (United States)

    Clark, Thomas R

    2008-09-01

    Assess performance of long-term care pharmacy providers on key services offered to nursing facilities. Cross-sectional; nursing facility team. Random phone survey of nursing facility team members. 485 nursing facility team members (practicing in nursing facilities, interacting with > or = 1 consultant pharmacist); 46 members excluded, unable to identify facility's pharmacy provider. Directors of nursing, medical directors, and administrators were asked to rate long-term care pharmacy provider performance of eight commonly offered pharmacy services. All groups evaluated pharmacy provider performance of these services using a five-point scale. Results are broken down by employer type. Average rating for eight pharmacy services was 3.64. Top two services: "Labeling medications accurately" ranked in top 1-2 services for all groups (combined rating of 3.97) and "Provides medication administration system" ranked in top 1-3 services for all groups (combined rating of 3.95). One service, "Provides educational inservices," ranked lowest for all groups (combined rating of 3.54). In general, when looking at the eight services in combination for all providers, all services were ranked between Good and Very Good (average score of 3.64). Therefore, while the pharmacy provider is performing above average for these services, there is room for improvement in all of these services. These results can be used as a benchmark. Detailed data results and sample surveys are available online at www.ascp.com/supplements. These surveys can be used by the pharmacy provider to solicit assessments from their own facilities on these services.

  19. Occupational Health Services Integrated in Primary Health Care in Iran.

    Science.gov (United States)

    Rafiei, Masoud; Ezzatian, Reza; Farshad, Asghar; Sokooti, Maryam; Tabibi, Ramin; Colosio, Claudio

    2015-01-01

    A healthy workforce is vital for maintaining social and economic development on a global, national and local level. Around half of the world's people are economically active and spend at least one third of their time in their place of work while only 15% of workers have access to basic occupational health services. According to WHO report, since the early 1980s, health indicators in Iran have consistently improved, to the extent that it is comparable with those in developed countries. In this paper it was tried to briefly describe about Health care system and occupational Health Services as part of Primary Health care in Iran. To describe the health care system in the country and the status of occupational health services to the workers and employers, its integration into Primary Health Care (PHC) and outlining the challenges in provision of occupational health services to the all working population. Iran has fairly good health indicators. More than 85 percent of the population in rural and deprived regions, for instance, have access to primary healthcare services. The PHC centers provide essential healthcare and public-health services for the community. Providing, maintaining and improving of the workers' health are the main goals of occupational health services in Iran that are presented by different approaches and mostly through Workers' Houses in the PHC system. Iran has developed an extensive network of PHC facilities with good coverage in most rural areas, but there are still few remote areas that might suffer from inadequate services. It seems that there is still no transparent policy to collaborate with the private sector, train managers or provide a sustainable mechanism for improving the quality of services. Finally, strengthening national policies for health at work, promotion of healthy work and work environment, sharing healthy work practices, developing updated training curricula to improve human resource knowledge including occupational health

  20. 76 FR 59388 - Board of Regents of the Uniformed Services University of the Health Sciences

    Science.gov (United States)

    2011-09-26

    ... University of the Health Sciences AGENCY: Department of Defense, Uniformed Services University of the Health... Uniformed Services University of the Health Sciences. DATES: Tuesday, October 25, 2011, from 8:30 a.m. to 11... FURTHER INFORMATION CONTACT: Janet S. Taylor, Designated Federal Officer, 4301 Jones Bridge Road, Bethesda...

  1. Family-centred care delivery: comparing models of primary care service delivery in Ontario.

    Science.gov (United States)

    Mayo-Bruinsma, Liesha; Hogg, William; Taljaard, Monica; Dahrouge, Simone

    2013-11-01

    To determine whether models of primary care service delivery differ in their provision of family-centred care (FCC) and to identify practice characteristics associated with FCC. Cross-sectional study. Primary care practices in Ontario (ie, 35 salaried community health centres, 35 fee-for-service practices, 32 capitation-based health service organizations, and 35 blended remuneration family health networks) that belong to 4 models of primary care service delivery. A total of 137 practices, 363 providers, and 5144 patients. Measures of FCC in patient and provider surveys were based on the Primary Care Assessment Tool. Statistical analyses were conducted using linear mixed regression models and generalized estimating equations. Patient-reported FCC scores were high and did not vary significantly by primary care model. Larger panel size in a practice was associated with lower odds of patients reporting FCC. Provider-reported FCC scores were significantly higher in community health centres than in family health networks (P = .035). A larger number of nurse practitioners and clinical services on-site were both associated with higher FCC scores, while scores decreased as the number of family physicians in a practice increased and if practices were more rural. Based on provider and patient reports, primary care reform strategies that encourage larger practices and more patients per family physician might compromise the provision of FCC, while strategies that encourage multidisciplinary practices and a range of services might increase FCC.

  2. 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

  3. 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

  4. 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

  5. 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

  6. Quality of emergency rooms and urgent care services: user satisfaction.

    Science.gov (United States)

    Lima, Cássio de Almeida; Santos, Bruna Tatiane Prates dos; Andrade, Dina Luciana Batista; Barbosa, Francielle Alves; Costa, Fernanda Marques da; Carneiro, Jair Almeida

    2015-01-01

    To evaluate the quality of emergency rooms and urgent care services according to the satisfaction of their users. A cross-sectional descriptive study with a quantitative approach. The sample comprised 136 users and was drawn at random. Data collection took place between October and November 2012 using a structured questionnaire. Participants were mostly male (64.7%) aged less than 30 years (55.8%), and the predominant level of education was high school (54.4%). Among the items evaluated, those that were statistically associated with levels of satisfaction with care were waiting time, confidence in the service, model of care, and the reason for seeking care related to acute complaints, cleanliness, and comfortable environment. Accessibility, hospitality, and infrastructure were considered more relevant factors for patient satisfaction than the cure itself.

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

    OpenAIRE

    Akhil Abraham; Royston Pinto

    2014-01-01

    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 cu...

  8. 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.

  9. 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.

  10. Assessment of quality of care in family planning services in Jimma ...

    African Journals Online (AJOL)

    Background: Providing quality of care in family planning services is an important task for care providers so as to increase service utilization and coverage; however, little is known about the existing quality of care in such services. Objective: To assess quality of care in family planning services in Jimma Zone, southwest ...

  11. 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.

  12. The Bromhead Care Home Service: the impact of a service for care home residents with dementia on hospital admission and dying in preferred place of care.

    Science.gov (United States)

    Garden, Gill; Green, Suzanne; Pieniak, Susan; Gladman, John

    2016-04-01

    People with dementia have worse outcomes associated with hospital admission, are more likely to have interventions and are less likely to be offered palliative care than people without dementia. Advance care planning for care home residents has been shown to reduce hospital admissions without increasing mortality. Studies have shown that staff confidence in managing delirium, a common reason for admission, improves with training. A service combining education for care home staff and advance care planning for care home residents with dementia was introduced to care homes in Boston, UK. There were improvements in staff confidence in recognition, prevention, management and knowledge of factors associated with delirium and dysphagia. 92% of carers rated the service >9/10. Admissions fell by 37% from baseline in the first year and 55% in the second and third years. All but one resident died in the preferred place of care. © 2016 Royal College of Physicians.

  13. Re-engineering university services to manage ICT in education

    NARCIS (Netherlands)

    Fisser, Petra; van Geloven, M.P.; Franklin, Stephen D.; Strenski, Ellen

    2000-01-01

    Integrating ICT is a hot topic in higher education, in the Netherlands,especially at the University of Twente, the only residential university in the Netherlands. The University of Twente (UT) is profiling itself as a “Telematics University”, a university where telematics applications (or ICT)

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

    Science.gov (United States)

    Agampodi, Suneth B; Agampodi, Thilini C; UKD, Piyaseeli

    2008-01-01

    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. Conclusions and recommendations

  15. 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

  16. Equity in financing and use of health care in Ghana, South Africa, and Tanzania: implications for paths to universal coverage.

    Science.gov (United States)

    Mills, Anne; Ataguba, John E; Akazili, James; Borghi, Jo; Garshong, Bertha; Makawia, Suzan; Mtei, Gemini; Harris, Bronwyn; Macha, Jane; Meheus, Filip; McIntyre, Di

    2012-07-14

    Universal coverage of health care is now receiving substantial worldwide and national attention, but debate continues on the best mix of financing mechanisms, especially to protect people outside the formal employment sector. Crucial issues are the equity implications of different financing mechanisms, and patterns of service use. We report a whole-system analysis--integrating both public and private sectors--of the equity of health-system financing and service use in Ghana, South Africa, and Tanzania. We used primary and secondary data to calculate the progressivity of each health-care financing mechanism, catastrophic spending on health care, and the distribution of health-care benefits. We collected qualitative data to inform interpretation. Overall health-care financing was progressive in all three countries, as were direct taxes. Indirect taxes were regressive in South Africa but progressive in Ghana and Tanzania. Out-of-pocket payments were regressive in all three countries. Health-insurance contributions by those outside the formal sector were regressive in both Ghana and Tanzania. The overall distribution of service benefits in all three countries favoured richer people, although the burden of illness was greater for lower-income groups. Access to needed, appropriate services was the biggest challenge to universal coverage in all three countries. Analyses of the equity of financing and service use provide guidance on which financing mechanisms to expand, and especially raise questions over the appropriate financing mechanism for the health care of people outside the formal sector. Physical and financial barriers to service access must be addressed if universal coverage is to become a reality. European Union and International Development Research Centre. Copyright © 2012 Elsevier Ltd. All rights reserved.

  17. perception and satisfaction with quality of antenatal care services ...

    African Journals Online (AJOL)

    of this new focus, measurement of customer satisfaction has become equally important in assessing ... Objectives: This study evaluated clients' perception of antenatal care quality at the University College Hospital (UCH), ..... National Health Insurance Scheme (NHIS), waivers for staff of the UCH and for People Living with.

  18. Perspective of patients, patients' families, and healthcare providers towards designing and delivering hospice care services in a middle income Country.

    Science.gov (United States)

    Azami-Aghdash, Saber; Ghojazadeh, Morteza; Aghaei, Mir Hossein; Naghavi-Behzad, Mohammad; Asgarlo, Zoleikha

    2015-01-01

    In view of the recent surge in chronic disease rates and elderly population in the developing countries, there is an urgent felt need for palliative and hospice care services. The present study investigates the views and attitudes of patients and their families, physicians, nurses, healthcare administrators, and insurers regarding designing and delivering hospice care service in a middle income country. In this qualitative study, the required data was collected using semi structured interviews and was analyzed using thematic analysis. Totally 65 participants from hospitals and Tabriz University of Medical Sciences were selected purposively to achieve data saturation. Analyzing the data, five main themes (barriers, facilitators, strategies, attitudes, and service provider) were extracted. Barriers included financial issues, cultural-religious beliefs, patient and family-related obstacles, and barriers related to healthcare system. Facilitators included family-related issues, cultural-religious beliefs, as well as facilitators associated with patients, healthcare status, and benefits of hospice service. Most participants (79%) had positive attitude towards hospice care service. Participant suggested 10 ways to design and deliver effective and efficient hospice care service. They thought the presence of physicians, nurses, and psychologists and other specialists and clergy were necessary in the hospice care team. Due to lack of experience in hospice care in developing countries, research for identifying probable barriers and appropriate management for reducing unsuccessfulness in designing and delivering hospice care service seems necessary. Input from the facilitators and their suggested solutions can be useful in planning the policy for hospice care system.

  19. 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.

  20. Process value of care safety: women's willingness to pay for perinatal services.

    Science.gov (United States)

    Anezaki, Hisataka; Hashimoto, Hideki

    2017-08-01

    To evaluate the process value of care safety from the patient's view in perinatal services. Cross-sectional survey. Fifty two sites of mandated public neonatal health checkup in 6 urban cities in West Japan. Mothers who attended neonatal health checkups for their babies in 2011 (n = 1316, response rate = 27.4%). Willingness to pay (WTP) for physician-attended care compared with midwife care as the process-related value of care safety. WTP was estimated using conjoint analysis based on the participants' choice over possible alternatives that were randomly assigned from among eight scenarios considering attributes such as professional attendance, amenities, painless delivery, caesarean section rate, travel time and price. The WTP for physician-attended care over midwife care was estimated 1283 USD. Women who had experienced complications in prior deliveries had a 1.5 times larger WTP. We empirically evaluated the process value for safety practice in perinatal care that was larger than a previously reported accounting-based value. Our results indicate that measurement of process value from the patient's view is informative for the evaluation of safety care, and that it is sensitive to individual risk perception for the care process. © The Author 2017. Published by Oxford University Press in association with the International Society for Quality in Health Care.

  1. THE PERFORMANCE OF SERVQUAL TO MEASURE SERVICE QUALITY IN PRIVATE UNIVERSITY

    OpenAIRE

    Leonnard

    2018-01-01

    The increasing number of educational services has caused a high competition in this industry. In Indonesia, the number of private universities is the highest compared to state universities and other forms of higher education institutions. Ability to predict factors that are important in providing educational services to achieve student satisfaction and make them loyal to the university is highly necessary. In this study, we investigated the main factors of service quality that affect student ...

  2. Building evaluative culture in community services: Caring for evidence.

    Science.gov (United States)

    Mayne, John

    2017-05-25

    An organization with a strong evaluative culture engages in self-reflection, evidence-based learning and experimentation. It sees evidence as essential for managing well, but building such a culture is challenging. Community service organizations seek to provide effective services for their clients. To build an evaluative culture, they need to acquire basic monitoring and evaluation capabilities, be provided with opportunities for using these capabilities and be adequately motivated to care about evidence as a means to improve services to their clients. Leadership along with a phased in approach are key in bringing about these behaviour changes. Copyright © 2017. Published by Elsevier Ltd.

  3. Managed Care Approaches to Children's Services within Public Systems of Care.

    Science.gov (United States)

    Pumariega, Andres; Fallon, Theodore, Jr.

    This report presents two discussions of conceptual and infrastructure issues that state mental health systems serving children with emotional disturbances must consider to make an effective transition towards a managed care organization of services under Medicaid. The first discussion, "Clinical Experiences in Managed Care Implementation for…

  4. 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

  5. 75 FR 32692 - Schools and Libraries Universal Service Support Mechanism

    Science.gov (United States)

    2010-06-09

    ...-rate program--separately priced firewall services, anti-virus/anti-spam software, scheduling services.../anti-spam software, scheduling services, wireless Internet access applications, and web hosting should... that separately priced firewall services, anti-virus and anti-spam software, teleconferencing...

  6. Assessment of client satisfaction on emergency department services in Hawassa University Referral Hospital, Hawassa, Southern Ethiopia.

    Science.gov (United States)

    Worku, Mesfin; Loha, Eskindir

    2017-06-27

    Satisfaction refers to a state of pleasure or contentment with an action, event or service, especially one that was previously desired. Regarding to client, satisfaction is the level of happiness that clients experience having used a service. It therefore reflects the gap between the expected service and the experience of the service, from the client's point of view. Information was unavailable regarding the level of satisfaction of patients towards emergency health care servicesat Hawassa University Referral Hospital thatserve a huge catchment area; and this study addressed this gap. Cross-sectional study was conducted from March 13 to May 15/2014. Systematic sampling method was used to enroll study participants. The data was collected by trained data collectors using pre-structured questionnaire. A total 407 clients were enrolled under this study with respondent rate of 96.9%. Nearly two third of study participants were male, 270 (66.3%). 86.7% of study participants were satisfied by services provided in Emergency Out Patient Department (OPD). The percentage of study satisfaction with physical examination by Doctor, nursing, laboratory and pharmacy services were 95.6%, 89.9%, 84.7% and 67.6%, respectively. Only 31.9% were satisfied with availability of drugs in the pharmacy. Regarding to staff courtesy, 91.7% of study participants were satisfied by the manner shown by the staffs working in Emergency OPD. The vast majority of the participants (97%) were satisfied with the courtesy of Medical laboratory personnel and the least satisfaction (79.4%) was recorded for security guards. This study showed low level of patient satisfaction in pharmacy services specifically due to unavailability of drugs due to lack of sustained supply of drugs.

  7. 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.

  8. Factors Influencing Antenatal Care Service Utilization in Hadiya Zone

    African Journals Online (AJOL)

    Therefore, the objective of this study was to explore factors influencing antenatal care services utilization in Southern Ethiopia. METHODS: A community-based cross sectional study was conducted in Hadiya Zone of Southern Ethiopia from January to February 2009. A multi stage sampling technique was used to select the ...

  9. The Role of Pharmacist in Dental Care Services | Kalala | Tanzania ...

    African Journals Online (AJOL)

    The Role of Pharmacist in Dental Care Services. WM Kalala. Abstract. No Abstract. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL ...

  10. Quality of Antenatal care services in eastern Uganda: implications ...

    African Journals Online (AJOL)

    Good quality Antenatal Care (ANC) provides opportunity to detect and respond to risky maternal conditions. This study assessed quality of ANC services in eastern Uganda with a goal of benchmarking implications for interventions. Methods Data was collected from 15 health facilities in Eastern Uganda to establish capacity ...

  11. Utilization of antenatal care services among teenagers in Ethiopia: A ...

    African Journals Online (AJOL)

    Background: Teenaged women suffer from a disproportionate share of reproductive health problem. The purpose of this study was to estimate the utilization of antenatal care (ANC) services among teenagers (13-19 years) during delivery in Ethiopia. Methodology: Raw data collected from all part of the country on child ...

  12. Evaluation of Service Station Attendant-Auto Care Project.

    Science.gov (United States)

    Cress, Ronald J.

    The project described offers an approach to providing occupational skills to socially and educationally handicapped youth, specifically the skills necessary for a service station attendant in driveway salesmanship and auto care. The 10-page evaluation report presents project goals and objectives with evaluation data (represented graphically) and…

  13. Point of Care Testing Services Delivery: Policy Analysis using a ...

    African Journals Online (AJOL)

    Annals of Biomedical Sciences ... The service providers (hospital management) and the testing personnel are faced with the task of trying to explain these problems. Objective of the study: To critically do a policy analysis of the problems of point of care testing with the aim of identifying the causes of these problems and ...

  14. WORKING MOTHERS AND THE NEED FOR CHILD CARE SERVICES.

    Science.gov (United States)

    Women's Bureau (DOL), Washington, DC.

    DATA AND CHARTS DOCUMENT THE RISING NUMBER OF WORKING MOTHERS IN THE UNITED STATES TODAY AND THE INCREASING NEED FOR CHILD CARE SERVICES. DATA WERE OBTAINED FROM U.S. DEPARTMENTS OF LABOR, COMMERCE, AND HEALTH, EDUCATION, AND WELFARE. NEARLY 10 MILLION MOTHERS WITH CHILDREN UNDER 18 YEARS OF AGE WERE WORKERS IN MARCH 1966. MORE THAN ONE OF THREE…

  15. Poverty, Access to Health Care Services and Human Capital ...

    African Journals Online (AJOL)

    The paper is aimed at examining the poverty profile of Nigeria and its consequences on access to health care services and human capital development in the country. It is a startling paradox that about two – thirds of Nigerians are poor despite living in a country with vast potential wealth. Apart from looking at the theoretical ...

  16. Mobile health service for HIV screening and care in resource ...

    African Journals Online (AJOL)

    particularly those living in remote areas, to reduce loss-to-follow-up, and to improve patient outcomes. With a reduction in HIV-related stigma and associated discrimination by using these services, the mobile strategy may assist decentralisation of programs devoted to HIV screening, anti-retroviral treatment and HIV care.

  17. Clients satisfaction of antenatal care services in public and private ...

    African Journals Online (AJOL)

    Background: Antenatal care involves screening for health and socioeconomic conditions likely to increase the possibility of specific adverse pregnancy outcomes, providing therapeutic interventions known to be effective and educating pregnant women about planning for safe birth. Quality and customer service have been ...

  18. Paramedic-Initiated Home Care Referrals and Use of Home Care and Emergency Medical Services.

    Science.gov (United States)

    Verma, Amol A; Klich, John; Thurston, Adam; Scantlebury, Jordan; Kiss, Alex; Seddon, Gayle; Sinha, Samir K

    2018-01-01

    We examined the association between paramedic-initiated home care referrals and utilization of home care, 9-1-1, and Emergency Department (ED) services. This was a retrospective cohort study of individuals who received a paramedic-initiated home care referral after a 9-1-1 call between January 1, 2011 and December 31, 2012 in Toronto, Ontario, Canada. Home care, 9-1-1, and ED utilization were compared in the 6 months before and after home care referral. Nonparametric longitudinal regression was performed to assess changes in hours of home care service use and zero-inflated Poisson regression was performed to assess changes in the number of 9-1-1 calls and ambulance transports to ED. During the 24-month study period, 2,382 individuals received a paramedic-initiated home care referral. After excluding individuals who died, were hospitalized, or were admitted to a nursing home, the final study cohort was 1,851. The proportion of the study population receiving home care services increased from 18.2% to 42.5% after referral, representing 450 additional people receiving services. In longitudinal regression analysis, there was an increase of 17.4 hours in total services per person in the six months after referral (95% CI: 1.7-33.1, p = 0.03). The mean number of 9-1-1 calls per person was 1.44 (SD 9.58) before home care referral and 1.20 (SD 7.04) after home care referral in the overall study cohort. This represented a 10% reduction in 9-1-1 calls (95% CI: 7-13%, p home care referral and 0.79 (SD 6.27) after home care referral, representing a 7% reduction (95% CI: 3-11%, p home care records were included in the analysis, the reductions in 9-1-1 calls and ambulance transports to ED were attenuated but remained statistically significant. Paramedic-initiated home care referrals in Toronto were associated with improved access to and use of home care services and may have been associated with reduced 9-1-1 calls and ambulance transports to ED.

  19. Coordination of services for dual diagnosis clients in the interface between specialist and community care

    Directory of Open Access Journals (Sweden)

    Bjørkquist C

    2018-05-01

    Full Text Available Catharina Bjørkquist, Gunnar Vold Hansen Faculty of Health and Welfare, Østfold University College, Halden, Norway Purpose: The aim of this article is to study the coordination of comprehensive services for clients with concurrent substance abuse and mental health disorders (dual diagnosis, which is a very complex client group. In order to achieve comprehensive care and treatment, the service providers need to cooperate and coordinate, but the questions here, are how this is done and how appropriate the coordination is. Data and methods: Data were collected from group interviews during a 1-day workshop with clients, relatives, and employees from the various services involved. Results: Information exchange between the services was generally in writing. Coordination between substance abuse and mental health services was experienced as fragmented. ­Employees had an unclear perception of the work and expertise of the other service providers involved. There were examples of disparity between the services a municipality could offer and client needs. A coordinator, if available, was emphasized by both clients and service providers as serving an important function in coordination and relationship building. Conclusion: Predominantly written communication and unclear division of responsibilities and duties resulted in employees creating stereotypes of each other, both within specialist health services and between specialist and municipal health services. A coordinator was able to coordinate various inputs, often through informal contact, with a view to establishing appropriate services for individual clients. Coordination in interagency meeting points, such as “responsibility teams”, was the most successful solution, but this will involve a greater degree of networking than is common today. Keywords: addiction and mental health issues, collaboration, coordination, specialist health services, primary care

  20. Library and information services: impact on patient care quality.

    Science.gov (United States)

    Marshall, Joanne Gard; Morgan, Jennifer Craft; Thompson, Cheryl A; Wells, Amber L

    2014-01-01

    The purpose of this paper is to explore library and information service impact on patient care quality. A large-scale critical incident survey of physicians and residents at 56 library sites serving 118 hospitals in the USA and Canada. Respondents were asked to base their answers on a recent incident in which they had used library resources to search for information related to a specific clinical case. Of 4,520 respondents, 75 percent said that they definitely or probably handled patient care differently using information obtained through the library. In a multivariate analysis, three summary clinical outcome measures were used as value and impact indicators: first, time saved; second, patient care changes; and third, adverse events avoided. The outcomes were examined in relation to four information access methods: first, asking librarian for assistance; second, performing search in a physical library; third, searching library's web site; or fourth, searching library resources on an institutional intranet. All library access methods had consistently positive relationships with the clinical outcomes, providing evidence that library services have a positive impact on patient care quality. Electronic collections and services provided by the library and the librarian contribute to patient care quality.

  1. 75 FR 15495 - Agency Information Collection (Application for Furnishing Long-Term Care Services to...

    Science.gov (United States)

    2010-03-29

    ... (Application for Furnishing Long- Term Care Services to Beneficiaries of Veterans Affairs, and Residential Care... Furnishing Long-Term Care Services to Beneficiaries of Veterans Affairs, VA Form 10-1170. b. Residential Care... application used by a residential care facility or home that wishes to provide residential home care to...

  2. The Prevalence of Service Excellence and the Use of Business Process Improvement Methodologies in Australian Universities

    Science.gov (United States)

    Ciancio, Sharone

    2018-01-01

    Service transformation is an increasingly common pursuit in the higher education sector, with university strategic plans frequently featuring a "service excellence" objective and the adoption of leaner and more sustainable service models. Previous studies agree that service excellence is intentional not incidental, and systematic not…

  3. Improving Communication between Postgraduate Researchers and the University Library: A Case Study at De Montfort University Library and Learning Services

    Science.gov (United States)

    Petch, Melanie; Fraser, Katie; Rush, Nathan; Cope, Alan; Lowe, Julie

    2016-01-01

    A well-established postgraduate researcher development program has existed at De Montfort University for many years. Library and Learning Services include modules on literature searching skills and critical appraisal. However, we recognized that researchers seemed to be disengaged with the services on offer. This concern informed a research…

  4. A Home-Based Palliative Care Consult Service for Veterans.

    Science.gov (United States)

    Golden, Adam G; Antoni, Charles; Gammonley, Denise

    2016-11-01

    We describe the development and implementation of a home-based palliative care consult service for Veterans with advanced illness. A retrospective chart review was performed on 73 Veterans who received a home-based palliative care consult. Nearly one-third were 80 years of age or older, and nearly one-third had a palliative diagnosis of cancer. The most common interventions of the consult team included discussion of advance directives, completion of a "do not resuscitate" form, reduction/stoppage of at least 1 medication, explanation of diagnosis, referral to home-based primary care program, referral to hospice, and assessment/support for caregiver stress. The home-based consult service was therefore able to address clinical and psychosocial issues that can demonstrate a direct benefit to Veterans, families, and referring clinicians. © The Author(s) 2015.

  5. A retrospective evaluation of the Perfecting Patient Care University training program for health care organizations.

    Science.gov (United States)

    Morganti, Kristy Gonzalez; Lovejoy, Susan; Beckjord, Ellen Burke; Haviland, Amelia M; Haas, Ann C; Farley, Donna O

    2014-01-01

    This study evaluated how the Perfecting Patient Care (PPC) University, a quality improvement (QI) training program for health care leaders and clinicians, affected the ability of organizations to improve the health care they provide. This training program teaches improvement methods based on Lean concepts and principles of the Toyota Production System and is offered in several formats. A retrospective evaluation was performed that gathered data on training, other process factors, and outcomes after staff completed the PPC training. A majority of respondents reported gaining QI competencies and cultural achievements from the training. Organizations had high average scores for the success measures of "outcomes improved" and "sustainable monitoring" but lower scores for diffusion of QI efforts. Total training dosage was significantly associated with the measures of QI success. This evaluation provides evidence that organizations gained the PPC competencies and cultural achievements and that training dosage is a driver of QI success.

  6. 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.

  7. Mandatory universal drug plan, access to health care and health: Evidence from Canada.

    Science.gov (United States)

    Wang, Chao; Li, Qing; Sweetman, Arthur; Hurley, Jeremiah

    2015-12-01

    This paper examines the impacts of a mandatory, universal prescription drug insurance program on health care utilization and health outcomes in a public health care system with free physician and hospital services. Using the Canadian National Population Health Survey from 1994 to 2003 and implementing a difference-in-differences estimation strategy, we find that the mandatory program substantially increased drug coverage among the general population. The program also increased medication use and general practitioner visits but had little effect on specialist visits and hospitalization. Findings from quantile regressions suggest that there was a large improvement in the health status of less healthy individuals. Further analysis by pre-policy drug insurance status and the presence of chronic conditions reveals a marked increase in the probability of taking medication and visiting a general practitioner among the previously uninsured and those with a chronic condition. Copyright © 2015 Elsevier B.V. All rights reserved.

  8. 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

  9. 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.

  10. Health care inequities in north India: role of public sector in universalizing health care.

    Science.gov (United States)

    Prinja, Shankar; Kanavos, Panos; Kumar, Rajesh

    2012-09-01

    Income inequality is associated with poor health. Inequities exist in service utilization and financing for health care. Health care costs push high number of households into poverty in India. We undertook this study to ascertain inequities in health status, service utilization and out-of-pocket (OOP) health expenditures in two States in north India namely, Haryana and Punjab, and Union Territory of Chandigarh. Data from National Sample Survey 60 th Round on Morbidity and Health Care were analyzed by mean consumption expenditure quintiles. Indicators were devised to document inequities in the dimensions of horizontal and vertical inequity; and redistribution of public subsidy. Concentration index (CI), and equity ratio in conjunction with concentration curve were computed to measure inequity. Reporting of morbidity and hospitalization rate had a pro-rich distribution in all three States indicating poor utilization of health services by low income households. Nearly 57 and 60 per cent households from poorest income quintile in Haryana and Punjab, respectively faced catastrophic OOP hospitalization expenditure at 10 per cent threshold. Lower prevalence of catastrophic expenditure was recorded in higher income groups. Public sector also incurred high costs for hospitalization in selected three States. Medicines constituted 19 to 47 per cent of hospitalization expenditure and 59 to 86 per cent OPD expenditure borne OOP by households in public sector. Public sector hospitalizations had a pro-poor distribution in Haryana, Punjab and Chandigarh. Our analysis indicates that public sector health service utilization needs to be improved. OOP health care expenditures at public sector institutions should to be curtailed to improve utilization of poorer segments of population. Greater availability of medicines in public sector and regulation of their prices provide a unique opportunity to reduce public sector OOP expenditure.

  11. Incoherent policies on universal coverage of health insurance and promotion of international trade in health services in Thailand.

    Science.gov (United States)

    Pachanee, Cha-aim; Wibulpolprasert, Suwit

    2006-07-01

    The Thai government has implemented universal coverage of health insurance since October 2001. Universal access to antiretroviral (ARV) drugs has also been included since October 2003. These two policies have greatly increased the demand for health services and human resources for health, particularly among public health care providers. After the 1997 economic crisis, private health care providers, with the support of the government, embarked on new marketing strategies targeted at attracting foreign patients. Consequently, increasing numbers of foreign patients are visiting Thailand to seek medical care. In addition, the economic recovery since 2001 has greatly increased the demand for private health services among the Thai population. The increasing demand and much higher financial incentives from urban private providers have attracted health personnel, particularly medical doctors, from rural public health care facilities. Responding to this increasing demand and internal brain drain, in mid-2004 the Thai government approved the increased production of medical doctors by 10,678 in the following 15 years. Many additional financial incentives have also been applied. However, the immediate shortage of human resources needs to be addressed competently and urgently. Equity in health care access under this situation of competing demands from dual track policies is a challenge to policy makers and analysts. This paper summarizes the situation and trends as well as the responses by the Thai government. Both supply and demand side responses are described, and some solutions to restore equity in health care access are proposed.

  12. 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; pdiabetes 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.

  13. [Relationship of the effectiveness of care management services and burdens of primary family caregivers].

    Science.gov (United States)

    Lee, Chia-Ling; Liu, Li-Fan; Chen, Shuh-Sin; Lin, Hsiu-Chun

    2014-02-01

    In Taiwan, long-term care management centers hold primary responsibility for administering long-term care services, assisting with long-term care placements, and sharing the care burden with family caregivers in need. Research into the effectiveness of current care management services and the effectiveness of these services in reducing care burdens remains limited. This study investigates the relationship among care management center service effectiveness, care management personnel, and burdens in relation to the provision of care services from the prospective of caregivers. A purposive sampling method and structured questionnaire survey were used to conduct telephone interviews with 154 home caregivers who had been transferred from care management centers to homecare service centers. Participants expressed overall satisfaction with care management centers and with the services provided by these centers. Satisfaction toward the care managers' professional competence was associated with lower physical burden for caregivers. Participants' psychological and social burdens were associated with overall satisfaction with the care management centers and their satisfaction with the services provided by care managers. The implementation of care management services has improved satisfaction. However, center services remain inadequate to reduce the psychological and social burdens of caregivers. Greater focus on these two aspects will be critical to the successful implementation of the proposed intensive care management model and multiple services intervention in order to meet the complex care needs of home service recipients and their primary caregivers.

  14. The Flexible Care Service: a third-sector service for older people with mental health needs.

    Science.gov (United States)

    Ryder, Elaine

    2015-01-01

    Demographic patterns indicate that by 2030, one in five people in England will be over 65. Together with the fact that as people age they are more likely to suffer from comorbidities, it is of paramount importance that local services are designed to meet the needs of individual older people. The Flexible Care Service is a resource for older people with mental health problems. Through the use of client case studies, the Department of Health's 'six Cs' (care, compassion, competence, communication, courage and commitment) are used as a framework to demonstrate how a third-sector service such as Flexible Care can offer a person-centred approach in order to meet the diverse needs of individual clients. The framework is also used to demonstrate the high level of skills needed by flexible carers in order to provide this support.

  15. 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.

  16. 75 FR 17584 - Schools and Libraries Universal Service Support Mechanism

    Science.gov (United States)

    2010-04-07

    ..., wireless LAN controllers, VoIP-related services, and virtualization software. We also find that telephone... been designated as an eligible service, and the E-rate program pays for the software for a server-based... messaging is an ``add- on to voice mail'' service and not software for voice mail itself. Therefore, we find...

  17. Dental care as a vital service response for disaster victims.

    Science.gov (United States)

    Mosca, Nicholas G; Finn, Emanuel; Joskow, Renée

    2007-05-01

    Hurricane Katrina's impact on the infrastructure of public health and the health care system in the affected areas was unprecedented in the United States. Many dental offices were flood-bound in New Orleans and over 60% of dental practices were partially or completely damaged in affected counties in Mississippi. Most needs assessments conducted during the initial recovery operations did not include questions about access to oral health care. However, the extent of the destruction of the health care infrastructure demonstrated the need for significant state and federal support to make dental treatment accessible to survivors and evacuees. The Katrina response is one of the few times that state and federal government agencies responded to provide dental services to victims as part of disaster response and recovery. The purpose of this paper is to share our experiences in Mississippi and the District of Columbia providing urgent dental care to disaster victims as part of a crisis response.

  18. Developing library bioinformatics services in context: the Purdue University Libraries bioinformationist program.

    Science.gov (United States)

    Rein, Diane C

    2006-07-01

    Purdue University is a major agricultural, engineering, biomedical, and applied life science research institution with an increasing focus on bioinformatics research that spans multiple disciplines and campus academic units. The Purdue University Libraries (PUL) hired a molecular biosciences specialist to discover, engage, and support bioinformatics needs across the campus. After an extended period of information needs assessment and environmental scanning, the specialist developed a week of focused bioinformatics instruction (Bioinformatics Week) to launch system-wide, library-based bioinformatics services. The specialist employed a two-tiered approach to assess user information requirements and expectations. The first phase involved careful observation and collection of information needs in-context throughout the campus, attending laboratory meetings, interviewing department chairs and individual researchers, and engaging in strategic planning efforts. Based on the information gathered during the integration phase, several survey instruments were developed to facilitate more critical user assessment and the recovery of quantifiable data prior to planning. Given information gathered while working with clients and through formal needs assessments, as well as the success of instructional approaches used in Bioinformatics Week, the specialist is developing bioinformatics support services for the Purdue community. The specialist is also engaged in training PUL faculty librarians in bioinformatics to provide a sustaining culture of library-based bioinformatics support and understanding of Purdue's bioinformatics-related decision and policy making.

  19. The rise and fall of democratic universalism: health care reform in Italy, 1978-1994.

    Science.gov (United States)

    Ferrera, M

    1995-01-01

    In 1978, a sweeping reform created the first national health service of continental Europe: Italy's Servizio Sanitario Nazionale. This new scheme was based on the principle of "full democratic universalism": The state would provide free and equal benefits to every citizen and the organization of public health would subject to popular control, essentially through political parties. However, the severe problems encountered in implementing the reform design and rapidly increasing health expenditures soon eroded any consensus on this principle. Thus the 1980s and early 1990s witnessed a gradual shift to "conditional and well managed universalism." These latter principles stress the need to differentiate access to care according to some criterion to regulate demand and the need for efficient use of scarce resources through adequate valorization of managerial skills and the use of "market-type" incentives. An elaborated system of user copayments was introduced gradually, and in 1992 a "reform of the reform" profoundly changed the organizational framework of the Servizio Sanitario Nazionale. The new government elected in the spring of 1994 announced ambitious plans to partially dismantle public universal insurance. Although these plans may prove difficult, the potential to form an anti-universalistic coalition seems strong in the contemporary Italian health care arena.

  20. 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. © 2015 S. Karger AG, Basel.

  1. Temporary services for patients in need of chronic care

    DEFF Research Database (Denmark)

    Hesse, Morten

    2008-01-01

    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...

  2. Utilization of health care services by migrants in Europe

    DEFF Research Database (Denmark)

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

    2017-01-01

    : Compared with previous systematic reviews, the results indicate a clearer picture of the differences in health service utilization between migrants and non-migrants in Europe. Areas timely for developing research: A comprehensive comparison across European countries is impossible because the number......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...

  3. Billing third party payers for pharmaceutical care services.

    Science.gov (United States)

    Poirier, S; Buffington, D E; Memoli, G A

    1999-01-01

    To describe the steps pharmacists must complete when seeking compensation from third party payers for pharmaceutical care services. Government publications; professional publications, including manuals and newsletters; authors' personal experience. Pharmacists in increasing numbers are meeting with success in getting reimbursed by third party payers for patient care activities. However, many pharmacists remain reluctant to seek compensation because they do not understand the steps involved. Preparatory steps include obtaining a provider/supplier number, procuring appropriate claim forms, developing data collection and documentation systems, establishing professional fees, creating a marketing plan, and developing an accounting system. To bill for specific patient care services, pharmacists need to collect the patient's insurance information, obtain a statement of medical necessity from the patient's physician, complete the appropriate claim form accurately, and submit the claim with supporting documentation to the insurer. Although many claims from pharmacists are rejected initially, pharmacists who work with third party payers to understand the reasons for denial of payment often receive compensation when claims are resubmitted. Pharmacists who follow these guidelines for billing third party payers for pharmaceutical care services should notice an increase in the number of paid claims.

  4. 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

  5. [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.

  6. The Effect of Service Compact (SERVICOM) on Service Delivery in Nnamdi Azikiwe University Teaching Hospital Nnewi, Nigeria

    OpenAIRE

    Jude Kennedy Emejulu; M. C. Muo; E. E.O. Chukwuemeka

    2014-01-01

    This study examined the effect of service compact (Servicom Service delivery) in Nnamdi Azikiwe University Teaching Hospital Nnewi. Questionnaire and face-to-face interviews were used in the collection of data. The hypotheses were tested using descriptive statistics. The study discovered among other things that with the inauguration of the SERVICOM Charter by the Federal Government of Nigeria, the Management of Nnamdi Azikiwe University Teaching Hospital Nnewi identified key areas that requir...

  7. Quality Management and Innovation in Information Services - The case study of the Documentation Services of the University of Minho

    OpenAIRE

    Guedes, Susana

    2008-01-01

    [The present paper is based on a curricular traineeship, part of the Degree in Information Science, under the theme of the implementation of Quality Management Systems, occurred at the Documentation Services of the University of Minho (SDUM).] The SDUM have their main purpose in providing the best resources, services and easy access to all the community of the University of Minho (formed by students of several areas, teachers, collaborators and investigators). In or...

  8. 38 CFR 17.35 - Hospital care and medical services in foreign countries.

    Science.gov (United States)

    2010-07-01

    ... VETERANS AFFAIRS MEDICAL Hospital Or Nursing Home Care and Medical Services in Foreign Countries § 17.35 Hospital care and medical services in foreign countries. The Secretary may furnish hospital care and... associated with and held to be aggravating a service-connected disability; (b) If the care is furnished to a...

  9. 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…

  10. Publication Services at the University Library Graz: A New Venture, a New Role

    Science.gov (United States)

    Ginther, Clara; Lackner, Karin; Kaier, Christian

    2017-01-01

    Establishing Publication Services in the library at the University of Graz did more than broaden the service portfolio of the library. A convergence of expertise at the library, needs of researchers at the university, and ongoing changes in scholarly communication also contributed to the evolution of the library's role and profile. The new…

  11. 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.

  12. 75 FR 48235 - Rural Health Care Universal Service Support Mechanism

    Science.gov (United States)

    2010-08-09

    ... an e-mail to [email protected] or call the Consumer & Governmental Affairs Bureau at 202-418-0530 (voice...) standard terms and conditions; (6) sustainability plan; (7) excess capacity disclosures; (8) vendor cost... (whichever period is shorter). Participants should be able to demonstrate in their sustainability plans that...

  13. Administration of care to older patients in transition from hospital to home care services: home nursing leaders' experiences

    Directory of Open Access Journals (Sweden)

    Dale B

    2013-10-01

    Full Text Available Bjørg Dale,1 Sigrun Hvalvik21Centre for Caring Research – Southern Norway, Faculty of Health and Sport Sciences, University of Agder, Grimstad, 2Centre for Caring Research – Southern Norway, Faculty of Health and Social Studies, Telemark University College, Porsgrunn, NorwayBackground: Older persons in transition between hospital and home care services are in a particularly vulnerable situation and risk unfortunate consequences caused by organizational inefficiency. The purpose of the study reported here was to elucidate how home nursing leaders experience the administration of care to older people in transition from hospital to their own homes.Methods: A qualitative study design was used. Ten home nursing leaders in two municipalities in southern Norway participated in individual interviews. The interview texts were audio taped, transcribed verbatim and analyzed by use of a phenomenological-hermeneutic approach.Results: Three main themes and seven subthemes were deduced from the data. The first main theme was that the home nursing leaders felt challenged by the organization of home care services. Two subthemes were identified related to this. The first was that the leaders lacked involvement in the transitional process, and the second was that they were challenged by administration of care being decided at another level in the municipality. The second main theme found was that the leaders felt that they were acting in a shifting and unsettled context. Related to this, they had to adjust internal resources to external demands and expectations, and experienced lack of communication with significant others. The third main theme identified was that the leaders endeavored to deliver care in accordance with professional values. The two related subthemes were, first, that they provided for appropriate internal systems and routines, and, second, that they prioritized available professional competence, and made an effort to promote a professional

  14. Description of the Implementation of Home Care Servicer at RS Murni Teguh, Medan

    OpenAIRE

    Manalu, Ayu P Sary

    2014-01-01

    Home care service constitutes providing service and nurses’ equipment for patients and their families at home in order to keep their health, education, prevention from diseases, palliative therapy, and rehabilitation. Home care service at RS Murni Teguh, Medan, has its specification in management, compared with home care service in other places. The objective of the research was to find out the description of the implementation of home care service at RS Murni Teguh, Medan. The research used ...

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

    Science.gov (United States)

    Leichsenring, Kai

    2004-01-01

    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. 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. 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. 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. The cross-national overview shows that issues concerning co-ordination and integration of services are high on the agenda in most countries. Depending on the state of service development, various approaches and instruments can be

  16. Occupational Therapy experience in family care in a primary health care service

    Directory of Open Access Journals (Sweden)

    Gisele Baissi

    2013-08-01

    Full Text Available Occupational therapy is presented as the core knowledge involved in the remodeling and strengthening of Primary Health Care in the Brazilian Unified Health Care System (Sistema Único de Saúde – SUS. In this study, we aimed to describe the interventions in the process of occupational therapy in supervised family care in a primary health care service in the municipality of Várzea Paulista, São Paulo state. In this case study, the moments of care were described and analyzed in light of narratives on the supervised practice of occupational therapy with a family. The results showed forms of intervention that characterize the process of occupational therapy focused on family health needs in favor of creativity and the role for changes in health practices in everyday life. Through the accomplishment of occupational activities directed to self-care, Occupational Therapy can aid families to cope with daily life adversity.

  17. Behind the Appearance of Reference Services at the Library University

    Directory of Open Access Journals (Sweden)

    Lailatur Rahmi

    2016-12-01

    Full Text Available This study aims to describe the development of reference services at the Library of Universitas Indonesia. The research discussed about innovation in the development of new activities in the reference services. Analyzing reference services from librarians’ point of view concerning the new activities in reference services, including attitudes and policies toward activities. This research takes a descriptive qualitative approach and uses semiotic analysis refering to Semiology of Roland Bathes concerning significance from two stage,  denotation and connotation, for analyzing the result of interviews. The results showed that the Universitas Indonesia Library reference service provides some new activities. Librarians become more active, revealed to be closer  to users, and transformation of information technology is seen as one of the competitive need to accompany the development of knowledge. Transfer media eventually have implications not on technology but rather to communication of reference services in the Universitas Indonesia Library.

  18. Behind the Appearance of Reference Services at the Library University

    Directory of Open Access Journals (Sweden)

    Lailatur Rahmi

    2018-01-01

    Full Text Available This study aims to describe the development of reference services at the Library of Universitas Indonesia. The research discussed about innovation in the development of new activities in the reference services. Analyzing reference services from librarians’ point of view concerning the new activities in reference services, including attitudes and policies toward activities. This research takes a descriptive qualitative approach and uses semiotic analysis refering to Semiology of Roland Bathes concerning significance from two stage,  denotation and connotation, for analyzing the result of interviews. The results showed that the Universitas Indonesia Library reference service provides some new activities. Librarians become more active, revealed to be closer  to users, and transformation of information technology is seen as one of the competitive need to accompany the development of knowledge. Transfer media eventually have implications not on technology but rather to communication of reference services in the Universitas Indonesia Library.

  19. Consolidating the University Career Service System in Taiwan

    Science.gov (United States)

    Ho, Hsuan-Fu; Hu, Tien-Ling

    2017-01-01

    The university graduate unemployment rate reached a record high of 6% in 2009 in Taiwan; paradoxically, business managers complained that they could not find enough qualified employees. The mismatch between knowledge taught in universities and the requests of the job market has been criticized as the main reason for the escalation of the…

  20. Stakeholder Perception of Service Quality in Qatar Higher Education Institutions: An Application to Qatar University

    OpenAIRE

    Shurair, Amal S.

    2017-01-01

    Managing quality of services offered by institutions of higher education is important in any country due to the inherent aim of producing quality graduates from programs offered in the university. Qatar has made substantial investments in higher education. Qatar University, being the national university of the country, the perception of stakeholders on the service quality in education becomes an important factor for developing a quality education system. Therefore, the main goal of this thesi...

  1. How the Goethe-Institut Finland Promotes Its Services to Finnish University Students of German Language

    OpenAIRE

    Venho, Alexandra

    2013-01-01

    This study analyzes how the Goethe-Institut Finnland, a nonprofit cultural German institution, promotes its services to Finnish university students of German language, by focusing on the perspectives of students in HAAGA-HELIA University of Applied Sciences. The objective of the study is to identify the degree of familiarity of the Goethe-Institut Finnland among students of German language in HAAGA-HELIA University of Applied Sciences, to recognize the demand for its services for learners...

  2. 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…

  3. Where's the Justice in Service-Learning? Institutionalizing Service-Learning from a Social Justice Perspective at a Jesuit University

    Science.gov (United States)

    Cuban, Sondra; Anderson, Jeffrey B.

    2007-01-01

    We attempt to answer "where" the social justice is in service-learning by probing "what" it is, "how" it looks in the process of being institutionalized at a Jesuit university, and "why" it is important. We develop themes about institutionalizing service-learning from a social justice perspective. Our themes were developed through an analysis of…

  4. 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...

  5. Service innovations breaking institutionalized rules of health care

    DEFF Research Database (Denmark)

    Wallin, Arto; Fuglsang, Lars

    2017-01-01

    .e. regulations, normative rules, and cultural-cognitive beliefs) protecting the field by introducing digitally enabled service innovations into health care markets. Design/methodology/approach – The study is qualitative and interpretative in nature and utilizes case study as a research strategy. The paper...... is based on data that were collected through narrative interviews and document analysis from seven new ventures participating in a start-up accelerator program. Findings – Results indicate that service innovations that require a change in the institutional structures of the health care system are enacted...... through three highly iterative key processes: institutional sensemaking that creates an understanding of prevailing institutional arrangements and that constructs meaning for institutional change efforts, theorization of change through linguistic device, and modifications of institutions by building...

  6. Perceptions of the care received from Australian palliative care services: A caregiver perspective.

    Science.gov (United States)

    Pidgeon, Tanya M; Johnson, Claire E; Lester, Leanne; Currow, David; Yates, Patsy; Allingham, Samuel F; Bird, Sonia; Eagar, Kathy

    2018-04-01

    ABSTRACTBackground:Caregiver satisfaction and experience surveys help health professionals to understand, measure, and improve the quality of care provided for patients and their families. Our aim was to explore caregiver perceptions of the care received from Australian specialist palliative care services. Caregivers of patients receiving palliative care in services registered with Australia's Palliative Care Outcomes Collaboration were invited to participate in a caregiver survey. The survey included the FAMCARE-2 and four items from the Ongoing Needs Identification: Caregiver Profile questionnaire. Surveys were completed by 1,592 caregivers from 49 services. Most respondents reported high satisfaction and positive experiences. Caregivers receiving care from community-based palliative care teams were less satisfied with the management of physical symptoms and comfort (odds ratio [OR] = 0.29; 95% confidence interval [CI95%] = 0.14, 0.59), with patient psychological care (OR = 0.56; CI95% = 0.32, 0.98), and with family support (OR = 0.52; CI95% = 0.35, 0.77) than caregivers of patients in an inpatient setting. If aged over 60 years, caregivers were less likely to have their information needs met regarding available support services (OR = 0.98; CI95% = 0.97, 0.98) and carer payments (OR = 0.99; CI95% = 0.98, 1.00). Also, caregivers were less likely to receive adequate information about carer payments if located in an outer regional area (OR = 0.41; CI95% = 0.25, 0.64). With practical training, caregivers receiving care from community services reported inadequate information provision to support them in caring for patients (OR = 0.60; CI95% = 0.45, 0.81). While our study identified caregivers as having positive and satisfactory experiences across all domains of care, there is room for improvement in the delivery of palliative care across symptom management, as well as patient and caregiver support, especially in community settings. Caregiver surveys can facilitate the

  7. Need assessment of staffs' welfare services at tehran university of medical sciences: a cross-sectional study.

    Science.gov (United States)

    Dehghan, Reza; Mafimoradi, Shiva; Hadi, Mohammad

    2015-01-01

    Reviewing the human resources management literature shows an absence of attention given to the employee's benefits. Taking a look at functions of the Tehran University of Medical Sciences' wellbeing services system, it uncovers a gap between employees' real needs and what is delivered to meet their needs. So it requires an improved comprehensive system for delivering wellbeing services (financial, insurance, health care services, educational and training services, etc). Wellbeing need assessment can helps planners to identify vital needs of employee and response to them effectively. Moreover it can be used to evaluate the effectiveness of the current services which are delivered. Thus, the aim of this study is to assess wellbeing services of staffs working in TUMS to (1) evaluate the satisfactory rate of services which are delivered, and (2) exploring those wellbeing needs which were not fulfilled by the organization. Being a cross-sectional and analytic-descriptive survey including 98 responding participants, it is conducted by a questionnaire collecting employees' demographic information, their satisfactory rate of the implemented services, and determines unfulfilled wellbeing needs which were not already covered. Results indicated that services related to financial, educational, non-financial, insurance, occupational health and tourism/recreational services were the most satisfactory services successively. 'Staff's unwillingness to receive services' and 'poor announcement' (unawareness on the wellbeing services),' were found to be the most frequent reasons for not receiving the existing wellbeing services. To increase the satisfaction rate and responsiveness to the real needs of the staff, the current delivery system of wellbeing services in the TUMS should be redesigned by defining new wellbeing packages.

  8. Youth with special health care needs: transition to adult health care services.

    Science.gov (United States)

    Oswald, Donald P; Gilles, Donna L; Cannady, Mariel S; Wenzel, Donna B; Willis, Janet H; Bodurtha, Joann N

    2013-12-01

    Transition to adult services for children and youth with special health care needs (CYSHCN) has emerged as an important event in the life course of individuals with disabilities. Issues that interfere with efficient transition to adult health care include the perspectives of stakeholders, age limits on pediatric service, complexity of health conditions, a lack of experienced healthcare professionals in the adult arena, and health care financing for chronic and complex conditions. The purposes of this study were to develop a definition of successful transition and to identify determinants that were associated with a successful transition. The 2007 Survey of Adult Transition and Health dataset was used to select variables to be considered for defining success and for identifying predictors of success. The results showed that a small percentage of young adults who participated in the 2007 survey had experienced a successful transition from their pediatric care.

  9. Care services for older people in Europe - Challenges for Labour

    OpenAIRE

    Lethbridge, Jane

    2011-01-01

    This report is published (March 2011) at a time when Europe stands at a crossroads. The economic crisis, austerity measures and the proposed European economic governance package risk not only to increase poverty and social exclusion but to have a devastating impact on the potential to build a sustainable and cohesive Europe.\\ud \\ud As the report notes, there is growing demand for more and better care services to address the needs of an ageing population. Potentially, Europe has the capacity t...

  10. 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.

  11. Developing online accreditation education resources for health care services: An Australian Case Study.

    Science.gov (United States)

    Pereira-Salgado, Amanda; Boyd, Leanne; Johnson, Matthew

    2017-02-01

    In 2013, 'National Safety and Quality Health Service Standards' accreditation became mandatory for most health care services in Australia. Developing and maintaining accreditation education is challenging for health care services, particularly those in regional and rural settings. With accreditation imminent, there was a need to support health care services through the process. A needs analysis identified limited availability of open access online resources for national accreditation education. A standardized set of online accreditation education resources was the agreed solution to assist regional and rural health care services meet compulsory requirements. Education resources were developed over 3 months with project planning, implementation and assessment based on a program logic model. Resource evaluation was undertaken after the first 3 months of resource availability to establish initial usage and stakeholder perceptions. From 1 January 2015 to 31 March 2015, resource usage was 20 272, comprising 12 989 downloads, 3594 course completions and 3689 page views. Focus groups were conducted at two rural and one metropolitan hospital (n = 16), with rural hospitals reporting more benefits. Main user-based recommendations for future resource development were automatic access to customizable versions, ensuring suitability to intended audience, consistency between resource content and assessment tasks and availability of short and long length versions to meet differing users' needs. Further accreditation education resource development should continue to be collaborative, consider longer development timeframes and user-based recommendations. © The Author 2016. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

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

    OpenAIRE

    Soc?as, M. Eugenia; Shoveller, Jean; Bean, Chili; Nguyen, Paul; Montaner, Julio; Shannon, Kate

    2016-01-01

    Background 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. Methods Data was drawn from an ongoing community-based, prospective cohort of women sex worke...

  13. A panchayat level primary-care approach for adolescent services.

    Science.gov (United States)

    Nair, M K C; Leena, M L; George, Babu; Sunitha, R M; Prasanna, G L; Russell, P S

    2012-01-01

    To develop a model for providing community adolescent care services in the primary care setting Need assessment was done among adolescents and perceived problems of adolescents were studied using qualitative and quantitative methods. Based on the results of these studies, a Family Life Education (FLE) module was prepared. Awareness programs were organized for all stakeholders in the community on adolescent issues. All anganwadi workers in the panchayat were trained to take interactive sessions for all the adolescents in the panchayat using the FLE module. Ward based Teen Clubs were formed in all the 13 wards of the Panchayat separately for boys and girls and FLE classes were given to them through anganwadi workers. An Adolescent Clinic was set up to provide necessary medical and counseling facilities. Adolescent Health Card was distributed to all Teen Club members and those who attended the adolescent clinics. The present approach stresses the need and feasibility of adolescent-centered, community-based interventions. The authors' experience showed that before starting any adolescent program, community awareness generation about the need and content of the program is very important for its success. The experience of this model has made it possible to up-scale the program to seven districts of southern Kerala as a service model. The experiences of the program gave a realistic picture of the needs and problems of adolescents and a simple feasible model for providing services to adolescents in the primary care setting that can be easily replicated in other parts of India.

  14. 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…

  15. 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

  16. Person-centered care planning and service engagement: a study protocol for a randomized controlled trial.

    Science.gov (United States)

    Stanhope, Victoria; Tondora, Janis; Davidson, Larry; Choy-Brown, Mimi; Marcus, Steven C

    2015-04-22

    interpretation of outcomes. The aim of this study is to generate valuable guidance for state systems engaged in scale-up and transformation efforts. Targeted staff selection for training to support sustainability will serve to provide further insight into important intervention implementation strategies. Person-centered care planning has the potential to enhance the impact of all evidence-based and recovery-oriented practices and bring practice into line with the emerging national guidelines in health care reform. This trial was registered with ClinicalTrials.gov (Identifier: NCT02299492) on 21 November 2014 as New York University Protocol Record PCCP-13-9762, Person-Centered Care Planning and Service Engagement.

  17. 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

  18. Does integrated care lead to both improved service quality and lower care cost

    Science.gov (United States)

    Waldeyer, Regina; Siegel, Achim; Daul, Gisela; Gaiser, Karin; Hildebrandt, Helmut; Köster, Ingrid; Schubert, Ingrid; Stunder, Brigitte; Stützle, Yvonne

    2010-01-01

    Purpose and context ‘Gesundes Kinzigtal’ is one of the few population-based integrated care approaches in Germany, organising care across all health service sectors and indications. The management company and its contracting partners (the physicians’ network in the region and two statutory health insurers) strive to reach a higher quality of care at a lower overall cost as compared with the German standard. During its first two years of operation (2006–2007), the Kinzigtal project achieved surprisingly positive financial results compared with its reference value. To gain independent evidence on the quality aspects of the system, the management company and its partners provided a remarkable budget for its evaluation by independent scientific institutions. Case description and data sources We will present interim results of a population-based controlled cohort study. In this study, quality of care is checked by relying on health and service quality indicators that have been constructed from health insurers’ administrative data (claims data). Interim results are presented for the intervention region (Kinzigtal area) and the control region (the rest of Baden-Württemberg, i.e., Southwest Germany). Preliminary conclusions and discussion The evaluation of ‘Gesundes Kinzigtal’ is in full progress. Until now, there is no evidence that the surprisingly positive financial results of the Kinzigtal system have been achieved at the expense of care quality. Rather, Gesundes Kinzigtal Integrated Care seems to be about to increasingly realize comparative advantages regarding health service quality (in comparison to the control region).

  19. [The strategic purchasing of health services: a big opportunity for the National Universal Health System].

    Science.gov (United States)

    González-Block, Miguel Ángel; Alarcón Irigoyen, José; Figueroa Lara, Alejandro; Ibarra Espinosa, Ignacio; Cortés Llamas, Noemí

    2015-01-01

    proposed to establish a service packages, whether through a single obligatory list or through the definition of a flexible, high priority set to be offered to specific populations according to their economic possibilities. For the strategic purchasing of services, two alternatives are proposed: to assign the fund either to a single national manager or to each of the existing public provider institutions, with the expectation that they would contract across each other and with private providers to fulfill their complementary needs.The proposal does not consider the risks and alternatives to a single tax contribution fund, which could have been suggested given that it is not an essential part of a National Universal Health System. However, it is necessary to discuss in more detail the roles and strategies for a national single-payer, especially for the strategic purchasing of high-cost and specialized interventions in the context of public and private providers. The alternative of allocating funds directly to providers would undermine the incentives for competition and collaboration and the capacity to steer providers towards the provision of high quality health services.It is proposed to focus the discussion of the reform of the national health system around strategic purchasing and the functions and structure of a single-payer as well as of agencies to articulate integrated health service networks as tools to promote quality and efficiency of the National Universal Health System. The inclusion of economic incentives to providers will be vital for competition, but also for the cooperation of providers within integrated, multi-institutional health service networks.Health professionals and sector policy specialists coordinated by the Centro de Estudios Espinosa Yglesi as in Mexico propose a policy to anchor the health system in primary care centered on the individual. The vision includes effective stewardship,solid financing, and the provision of services by a

  20. Evaluating a Chat Reference Service at the University of South Alabama's Baugh Biomedical Library

    Science.gov (United States)

    Clanton, Clista C.; Staggs, Geneva B.; Williams, Thomas L.

    2006-01-01

    The University of South Alabama's Baugh Biomedical Library recently initiated a chat reference service targeted at distance education students in the biomedical sciences. After one year of service, the library conducted an evaluation of the chat reference to assess the success of this mode of reference service. Both traditional reference and…

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

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    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.

  2. Needs of home care services for the bedridden patient’s problems living in their home

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    Nuran Akdemir

    2011-03-01

    Full Text Available The study was carry out as an semi-experimental study to identify the difficulties confronted by bedridden patients with stroke to give them necessary counseling services and to improve models of home care service.Method: The research sample is composed of 38 patients discarged from Hacettepe University İbni Sina Hospital and Health Ministry Ankara Numune Hospital Neurology services following cerebro-vascular accident. The data derived from the research is evaluated through percentage usage. Patients included in the study were visited average 5 times during the research.Result: During the home visiting, it is found out that most of the patients were in need of information concerning insufficient hygienic care, other illnesses, use of medication, discharge system problems like constipation and diarhea and dietary/nutritional; it is also observed that they are experiencing psycho-social diffuculties. The study results put forward suggestions in realizing progression and to form model of systematic home care services.

  3. netCare, a new collaborative primary health care service based in Swiss community pharmacies.

    Science.gov (United States)

    Erni, Pina; von Overbeck, Jan; Reich, Oliver; Ruggli, Martine

    2016-01-01

    The Swiss Pharmacists Association has launched a new collaborative project, netCare. Community pharmacists provide a standard form with structured triage based on decision trees and document findings. As a backup, they can collaborate with physicians via video consultation. The aim of the study was to evaluate the impact of this service on the Swiss health care system. All pharmacists offering netCare completed two training courses, a course covering the most common medical conditions observed in primary health care and a specific course on all of the decision trees. The pharmacists were free to decide whether they would provide the usual care or offer netCare triage. The patient was also free to accept or refuse netCare. Pharmacists reported the type of ailment, procedure of the consultation, treatment, patient information and outcomes of the follow-up call on a standardized form submitted to the study center. Pharmacists from 162 pharmacies performed 4118 triages over a period of 21 months. A backup consultation was needed for 17% of the cases. In follow-up calls, 84% of the patients who were seen only by pharmacists reported complete relief or symptom reduction. netCare is a low-threshold service by which pharmacists can manage common medical conditions with physician backup, if needed. This study showed that a pharmacist could resolve a large proportion of the cases. However, to be efficient and sustainable, this service must be fully integrated into the health care system. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. 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.

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

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    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

  6. Management of pharmaceutical services in the Brazilian primary health care.

    Science.gov (United States)

    Gerlack, Letícia Farias; Karnikowski, Margô Gomes de Oliveira; Areda, Camila Alves; Galato, Dayani; Oliveira, Aline Gomes de; Álvares, Juliana; Leite, Silvana Nair; Costa, Ediná Alves; Guibu, Ione Aquemi; Soeiro, Orlando Mario; Costa, Karen Sarmento; Guerra, Augusto Afonso; Acurcio, Francisco de Assis

    2017-11-13

    To identify limiting factors in the management of pharmaceutical services in the primary health care provided by the Brazilian Unified Health System (SUS). This study was based on the data from the Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos no Brasil (PNAUM - National Survey on Access, Use and Promotion of Rational Use of Medicines), and it was conducted by interviews with professionals responsible for pharmaceutical services in Brazilian cities, in 2015. To identify the management limiting factors, we considered the organizational, operational, and sustainability indicators of the management. For the analyses, we included the weights and structure of analysis plan for complex samples. The results were expressed by frequencies and measures of central tendency with 95% confidence interval, considering the Brazilian geographic regions. We identified the following limiting factors: lack of pharmaceutical services in the Municipal Health Secretariat organization chart (24%) and in the health plan (18%); lack of participation of managers in the Health Board and the absence of reference to this topic in the agenda of meetings (58.4%); lack of financial autonomy (61.5%) and lack of knowledge on the available values (81.7%); lack of adoption of operational procedures (about 50%) for selection, scheduling, and acquisition; and the fact that most professionals evaluate the organization of pharmaceutical services as good and great (58.8%), despite the worrisome indicators. Pharmaceutical services management is currently supported by a legal and political framework that should guide and contribute to improve the pharmaceutical services in the Brazilian Unified Health System primary health care. However, there is a mismatch between the goals established by these guidelines and what is actually happening.

  7. Need Assessment of Staffs’ Welfare Services at Tehran University of Medical Sciences: A Cross-Sectional Study

    Science.gov (United States)

    Dehghan, Reza; Mafimoradi, Shiva; Hadi, Mohammad

    2015-01-01

    Background: Reviewing the human resources management literature shows an absence of attention given to the employee's benefits. Taking a look at functions of the Tehran University of Medical Sciences’ wellbeing services system, it uncovers a gap between employees’ real needs and what is delivered to meet their needs. So it requires an improved comprehensive system for delivering wellbeing services (financial, insurance, health care services, educational and training services, etc). Wellbeing need assessment can helps planners to identify vital needs of employee and response to them effectively. Moreover it can be used to evaluate the effectiveness of the current services which are delivered. Thus, the aim of this study is to assess wellbeing services of staffs working in TUMS to (1) evaluate the satisfactory rate of services which are delivered, and (2) exploring those wellbeing needs which were not fulfilled by the organization. Material and Methods: Being a cross-sectional and analytic-descriptive survey including 98 responding participants, it is conducted by a questionnaire collecting employees’ demographic information, their satisfactory rate of the implemented services, and determines unfulfilled wellbeing needs which were not already covered. Result: Results indicated that services related to financial, educational, non-financial, insurance, occupational health and tourism/recreational services were the most satisfactory services successively. ‘Staff's unwillingness to receive services’ and ‘poor announcement’ (unawareness on the wellbeing services),’ were found to be the most frequent reasons for not receiving the existing wellbeing services. Conclusion: To increase the satisfaction rate and responsiveness to the real needs of the staff, the current delivery system of wellbeing services in the TUMS should be redesigned by defining new wellbeing packages. PMID:25767818

  8. Knowledge, Awareness and Compliance with Universal Precautions among Health Care Workers at the University Hospital of the West Indies, Jamaica

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    K Vaz

    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.

  9. Knowledge, awareness and compliance with universal precautions among health care workers at the University Hospital of the West Indies, Jamaica.

    Science.gov (United States)

    Vaz, K; McGrowder, D; Alexander-Lindo, R; Gordon, L; Brown, P; Irving, R

    2010-10-01

    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. To assess knowledge, awareness and compliance of universal precautions among health care workers at the University Hospital of the West Indies, Jamaica. 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. 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). There was adequate knowledge and a fair level of awareness among medical doctors, medical technologists, and nurses towards universal precautions.

  10. [Service quality in health care: the application of the results of marketing research].

    Science.gov (United States)

    Verheggen, F W; Harteloh, P P

    1993-01-01

    This paper deals with quality assurance in health care and its relation to quality assurance in trade and industry. We present the service quality model--a model of quality from marketing research--and discuss how it can be applied to health care. Traditional quality assurance appears to have serious flaws. It lacks a general theory of the sources of hazards in the complex process of patient care and tends to stagnate, for no real improvement takes place. Departing from this criticism, modern quality assurance in health care is marked by: defining quality in a preferential sense as "fitness for use"; the use of theories and models of trade and industry (process-control); an emphasis on analyzing the process, instead of merely inspecting it; use of the Deming problem solving technique (plan, do, check, act); improvement of the process of care by altering perceptions of parties involved. We present an experience of application and utilization of this method in the University Hospital Maastricht, The Netherlands. The successful application of this model requires a favorable corporate culture and motivation of the health care workers. This model provides a useful framework to uplift the traditional approach to quality assurance in health care.

  11. Influence of ICT on Reference Services in Selected University ...

    African Journals Online (AJOL)

    Journal Home > Vol 14, No 1-2 (2014) > ... What are the challenges of ICT on reference collections and services in the selected academic libraries? ... incomplete automation, reduced patronage (because of the availability of search engines), ...

  12. Spatial analysis of elderly access to primary care services

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    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

  13. 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

    ... 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 of Day Care Homes for the Period July 1, 2011 Through June 30, 2012 Correction In notice document 2011-18257 appearin...

  14. Expectations of Health Care Professionals Regarding the Services

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    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.

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

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    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.

  16. Bowel management systems in critical care: a service evaluation.

    Science.gov (United States)

    Ritzema, Jennifer

    2017-01-25

    Aim Many patients who are critically ill develop faecal incontinence associated with diarrhoea, and require a bowel management system (BMS) to prevent skin excoriation. Following guidelines produced by the National Institute for Health and Care Excellence, early rehabilitation has resulted in a reduction in the number of days that patients receive mechanical ventilation. However, patients with a BMS are potentially mechanically ventilated for longer because they are cared for in bed. The aim of this evaluation was to investigate whether patients with a BMS are mechanically ventilated for longer than those without a BMS. Method This was a retrospective service evaluation, in which a database search was conducted to identify patients admitted to the critical care department in one healthcare organisation during 2013. The search was narrowed to identify patients admitted to the critical care department who had received advanced respiratory support (mechanical ventilation), to compare the mean number of mechanically ventilated days between patients with and without a BMS (n = 122). Data were analysed using the Mann-Whitney U test. Results There was a significant difference in the number of mechanically ventilated days (Pcritically ill patients with a BMS are placed in a sitting position for short periods of time. Further research should explore alternative bowel care options for patients who are critically ill.

  17. Patients' satisfaction towards radiological service and associated factors in Hawassa University Teaching and referral hospital, Southern Ethiopia.

    Science.gov (United States)

    Mulisa, Teshome; Tessema, Fasil; Merga, Hailu

    2017-06-26

    Patient satisfaction, one of the main components of quality of care, is a crucial phenomenon for the overall health care delivery system. Even though a number of studies have been conducted about patient satisfaction in different health services, studies in radiology services are flimsy in Ethiopia. This study aimed at assessing patient satisfaction towards radiological service and associated factors in Hawassa University Teaching and Referral hospital. An institution based cross-sectional study was conducted among 321 adult patients presented for radiological service in the study area using stratified sampling technique. Patient satisfaction was measured using SERVQUAL (Service Quality) tool that consisted of seven items: accessibility, quality of radiological service, courtesy of radiology staff, existence of good communication with service provider and desk worker, physical environment and privacy technique. Exit interviews of patients were conducted using a structured and pretested questionnaire. Data was collected by three grade ten completed trained data collectors from May 12 to May 28, 2016. Multiple logistic regressions were used to identify independent factors associated with patient satisfaction on radiological services using SPSS version 21. The overall patient satisfaction towards radiological service was 71.6%. Satisfaction to accessibility of the service was 84.5% while it was 80.6% to courtesy of the staff. Similarly, 81.6% reported satisfied with quality of the service and 59.4% and 71% of reported satisfied with physical environment and radiological service provider respectively. On the other hand, 99.7% of the respondents were dissatisfied with privacy of the service. The study revealed that patients who attended primary school (AOR = 0.317, 95% CI: 0.11-0.88), unemployed patients (AOR = 0.067, 95% CI: 0.007-0.622) and patients who had short waiting time to enter into examination room less than one hour (AOR = 4.12, 95% CI: 1.4-11.62) were

  18. Children With Special Health Care Needs: Child Health and Functioning Outcomes and Health Care Service Use.

    Science.gov (United States)

    Caicedo, Carmen

    This study describes health, functioning, and health care service use by medically complex technology-dependent children according to condition severity (moderately disabled, severely disabled, and vegetative state). Data were collected monthly for 5 months using the Pediatric Quality of Life Generic Core Module 4.0 Parent-Proxy Report. Health care service use measured the number of routine and acute care office visits (including primary and specialty physicians), emergency department visits, hospitalizations, nursing health care services, special therapies, medications, medical technology devices (MTDs), and assistive devices. Child physical health was different across the condition severity groups. The average age of the children was 10.1 years (SD, 6.2); the average number of medications used was 5.5 (SD, 3.7); the average number of MTDs used was 4.2 (SD, 2.9); and the average number of assistive devices used was 4.3 (SD, 2.7). Severely disabled and vegetative children were similar in age (older) and had a similar number of medications, MTDs, and assistive devices (greater) than moderately disabled children. The advanced practice nurse care coordinator role is necessary for the health and functioning of medically complex, technology-dependent children. Copyright © 2016 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.

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

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    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

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

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    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

  1. 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.

  2. Beware of Data Gaps in Home Care Research: The Streetlight Effect and Its Implications for Policy Making on Long-Term Services and Supports

    Science.gov (United States)

    Newquist, Deborah D.; DeLiema, Marguerite; Wilber, Kathleen H.

    2016-01-01

    Policy initiatives increasingly seek greater use of home- and community-based services for older persons and those with chronic care needs, yet large gaps persist in our knowledge of home care, an indispensable component of long-term services and supports. Unrecognized data gaps, including the scope of home care provided by private hire and nonmedical providers, can distort knowledge and poorly inform long-term services and supports policy. The purpose of this article is to examine these gaps by describing the universe of formal home care services and provider types in relationship to major national sources. Findings reveal four distinct home care sectors and that the majority of formal home care is provided in the sectors that are understudied. We discuss the policy implications of data gaps and conclude with recommendations on where to expand and refine home care research. PMID:26062611

  3. Beware of Data Gaps in Home Care Research: The Streetlight Effect and Its Implications for Policy Making on Long-Term Services and Supports.

    Science.gov (United States)

    Newquist, Deborah D; DeLiema, Marguerite; Wilber, Kathleen H

    2015-10-01

    Policy initiatives increasingly seek greater use of home- and community-based services for older persons and those with chronic care needs, yet large gaps persist in our knowledge of home care, an indispensable component of long-term services and supports. Unrecognized data gaps, including the scope of home care provided by private hire and nonmedical providers, can distort knowledge and poorly inform long-term services and supports policy. The purpose of this article is to examine these gaps by describing the universe of formal home care services and provider types in relationship to major national sources. Findings reveal four distinct home care sectors and that the majority of formal home care is provided in the sectors that are understudied. We discuss the policy implications of data gaps and conclude with recommendations on where to expand and refine home care research. © The Author(s) 2015.

  4. 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

  5. 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. Copyright © 2012 Elsevier B.V. All rights reserved.

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

    Science.gov (United States)

    2011-11-21

    ... concerning the billing 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... to ``RIN 2900-AN98--Payment for home health and services and hospice care by non-VA providers...

  7. 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

  8. Spatial Accessibility to Health Care Services: Identifying under-Serviced Neighbourhoods in Canadian Urban Areas.

    Directory of Open Access Journals (Sweden)

    Tayyab Ikram Shah

    Full Text Available Urban environments can influence many aspects of health and well-being and access to health care is one of them. Access to primary health care (PHC in urban settings is a pressing research and policy issue in Canada. Most research on access to healthcare is focused on national and provincial levels in Canada; there is a need to advance current understanding to local scales such as neighbourhoods.This study examines spatial accessibility to family physicians using the Three-Step Floating Catchment Area (3SFCA method to identify neighbourhoods with poor geographical access to PHC services and their spatial patterning across 14 Canadian urban settings. An index of spatial access to PHC services, representing an accessibility score (physicians-per-1000 population, was calculated for neighborhoods using a 3km road network distance. Information about primary health care providers (this definition does not include mobile services such as health buses or nurse practitioners or less distributed services such as emergency rooms used in this research was gathered from publicly available and routinely updated sources (i.e. provincial colleges of physicians and surgeons. An integrated geocoding approach was used to establish PHC locations.The results found that the three methods, Simple Ratio, Neighbourhood Simple Ratio, and 3SFCA that produce City level access scores are positively correlated with each other. Comparative analyses were performed both within and across urban settings to examine disparities in distributions of PHC services. It is found that neighbourhoods with poor accessibility scores in the main urban settings across Canada have further disadvantages in relation to population high health care needs.The results of this study show substantial variations in geographical accessibility to PHC services both within and among urban areas. This research enhances our understanding of spatial accessibility to health care services at the neighbourhood

  9. 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.

  10. THE PERFORMANCE OF SERVQUAL TO MEASURE SERVICE QUALITY IN PRIVATE UNIVERSITY

    Directory of Open Access Journals (Sweden)

    Leonnard

    2018-03-01

    Full Text Available The increasing number of educational services has caused a high competition in this industry. In Indonesia, the number of private universities is the highest compared to state universities and other forms of higher education institutions. Ability to predict factors that are important in providing educational services to achieve student satisfaction and make them loyal to the university is highly necessary. In this study, we investigated the main factors of service quality that affect student satisfaction and loyalty by collecting data from 319 students from London School of Public Relation in Jakarta. Structural equation modeling (SEM was employed to analyze the data through AMOS 24 statistical package. The findings indicated that the main factors influencing student satisfaction in private university are tangible and reliability consisting of: 1 comfortable lecture rooms, 2 adequate library facilities, 3 neat staff appearance, 4 non-discriminatory treatments provided by staff and lecturers, 5 high ability and knowledge provided by staffs and lecturers, and 6 appropriate academic services provided by the university. Student satisfaction with these factors would indirectly lead to loyalty to the university. Finally, service quality measurement through SERVQUAL was redundant as a model to measure the effect of service quality in educational service.

  11. Medical Universities Educational and Research Online Services: Benchmarking Universities’ Website Towards E-Government

    Science.gov (United States)

    Farzandipour, Mehrdad; Meidani, Zahra

    2014-01-01

    Background: Websites as one of the initial steps towards an e-government adoption do facilitate delivery of online and customer-oriented services. In this study we intended to investigate the role of the websites of medical universities in providing educational and research services following the E-government maturity model in the Iranian universities. Methods: This descriptive and cross- sectional study was conducted through content analysis and benchmarking the websites in 2012. The research population included the entire medical university website (37). Delivery of educational and research services through these university websites including information, interaction, transaction, and Integration were investigated using a checklist. The data were then analyzed by means of descriptive statistics and using SPSS software. Results: Level of educational and research services by websites of the medical universities type I and II was evaluated medium as 1.99 and 1.89, respectively. All the universities gained a mean score of 1 out of 3 in terms of integration of educational and research services. Conclusions: Results of the study indicated that Iranian universities have passed information and interaction stages, but they have not made much progress in transaction and integration stages. Failure to adapt to e-government in Iranian medical universities in which limiting factors such as users’ e-literacy, access to the internet and ICT infrastructure are not so crucial as in other organizations, suggest that e-government realization goes beyond technical challenges. PMID:25132713

  12. Development of indicators for patient care and monitoring standards for secondary health care services of Mumbai.

    Science.gov (United States)

    Malik, Seema S; D'Souza, Roshni Cynthia; Pashte, Pramod Mukund; Satoskar, Smita Manohar; D'Souza, Remilda Joyce

    2015-01-01

    The Qualitative aspect of health care delivery is one of the major factors in reducing morbidity and mortality in a health care setup. The expanding suburban secondary health care delivery facilities of the Municipal Corporation of Greater Mumbai are an important part of the healthcare backbone of Mumbai and therefore the quality of care delivered here needed standardization. The project was completed over a period of one year from Jan to Dec, 2013 and implemented in three phases. The framework with components and sub-components were developed and formats for data collection were standardized. The benchmarks were based on past performance in the same hospital and probability was used for development of normal range. An Excel spreadsheet was developed to facilitate data analysis. The indicators comprise of 3 components--Statutory Requirements, Patient care & Cure and Administrative efficiency. The measurements made, pointed to the broad areas needing attention. The Indicators for patient care and monitoring standards can be used as a self assessment tool for health care setups for standardization and improvement of delivery of health care services.

  13. 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.

  14. 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.

  15. Personal care services provided to children with special health care needs (CSHCN) and their subsequent use of physician services.

    Science.gov (United States)

    Miller, Thomas R; Elliott, Timothy R; McMaughan, Darcy M; Patnaik, Ashweeta; Naiser, Emily; Dyer, James A; Fournier, Constance J; Hawes, Catherine; Phillips, Charles D

    2013-10-01

    Medicaid Personal Care Services (PCS) help families meet children's needs for assistance with functional tasks. However, PCS may have other effects on a child's well-being, but research has not yet established the existence of such effects. To investigate the relationship between the number of PCS hours a child receives with subsequent visits to physicians for evaluation and management (E&M) services. Assessment data for 2058 CSHCN receiving PCS were collected in 2008 and 2009. Assessment data were matched with Medicaid claims data for the period of 1 year after the assessment. Zero-inflated negative binomial and generalized linear multivariate regression models were used in the analyses. These models included patient demographics, health status, household resources, and use of other medical services. For every 10 additional PCS hours authorized for a child, the odds of having an E&M physician visit in the next year were reduced by 25%. However, the number of PCS hours did not have a significant effect on the number of visits by those children who did have a subsequent E&M visit. A variety of demographic and health status measures also affect physician use. Medicaid PCS for CSHCN may be associated with reduced physician usage because of benefits realized by continuity of care, the early identification of potential health threats, or family and patient education. PCS services may contribute to a child's well-being by providing continuous relationships with the care team that promote good chronic disease management, education, and support for the family. Copyright © 2013 Elsevier Inc. All rights reserved.

  16. Children's Needs -- for Universal Food Service and Nutrition.

    Science.gov (United States)

    Briggs, George M.

    Good nutrition and adequate nutritious food are not only essential to good health but also represent the difference between life and death. Nutrition is the world's number one problem today, along with war and population control. Good nutrition means providing, with care and love, all 45 essential nutrients in adequate amounts to each child -- one…

  17. Meeting the mental health needs of today's college student: Reinventing services through Stepped Care 2.0.

    Science.gov (United States)

    Cornish, Peter A; Berry, Gillian; Benton, Sherry; Barros-Gomes, Patricia; Johnson, Dawn; Ginsburg, Rebecca; Whelan, Beth; Fawcett, Emily; Romano, Vera

    2017-11-01

    A new stepped care model developed in North America reimagines the original United Kingdom model for the modern university campus environment. It integrates a range of established and emerging online mental health programs systematically along dimensions of treatment intensity and associated student autonomy. Program intensity can be either stepped up or down depending on level of client need. Because monitoring is configured to give both provider and client feedback on progress, the model empowers clients to participate actively in care options, decisions, and delivery. Not only is stepped care designed to be more efficient than traditional counseling services, early observations suggest it improves outcomes and access, including the elimination of service waitlists. This paper describes the new model in detail and outlines implementation experiences at 3 North American universities. While the experiences implementing the model have been positive, there is a need for development of technology that would facilitate more thorough evaluation. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  18. 78 FR 17777 - Proposed Information Collection (Application for Furnishing Long-Term Care Service to...

    Science.gov (United States)

    2013-03-22

    ... (Application for Furnishing Long- Term Care Service to Beneficiaries of Veterans Affairs, and Residential Care.... Application for Furnishing Long-Term Care Services to Beneficiaries of Veterans Affairs, VA Form 10-1170. b. Residential Care Home Program--Sponsor Application, VA Form 2407. OMB Control Number: 2900-0616. Type of...

  19. 75 FR 2595 - Proposed Information Collection (Application for Furnishing Long-Term Care Services to...

    Science.gov (United States)

    2010-01-15

    ... (Application for Furnishing Long- Term Care Services to Beneficiaries of Veterans Affairs, and Residential Care... comments for information needed to determine non-Federal nursing home or residential care home... information technology. Titles: a. Application for Furnishing Long-Term Care Services to Beneficiaries of...

  20. Health care: a community concern? : developments in the organization of Canadian health services

    National Research Council Canada - National Science Library

    Crichton, Anne

    1997-01-01

    ... Canadian Health Care Organizational Policies 1967-86 IV Service Delivery Systems and Their Response to the Need for Change to a Collective Care Organization 9. Care in the Doctor's Office 10. Support Services for Physicians in General Practice 11. Medical Practice Organization: Alternative Medical Care Delivery Models 12. Evolution of Public H...

  1. 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. Copyright © 2016 Elsevier Ltd. All rights reserved.

  2. 75 FR 67060 - Universal Service Reform Mobility Fund

    Science.gov (United States)

    2010-11-01

    ... rulemaking. SUMMARY: In this document, the Federal Communication Commission proposes the creation of a new... U.S. Postal Service Express Mail and Priority Mail) must be sent to 9300 East Hampton Drive, Capitol... techniques or other forms of information technology. In addition, pursuant to the Small Business Paperwork...

  3. 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

  4. Home care clients in the last year of life: is material deprivation associated with service characteristics?

    Science.gov (United States)

    Goodridge, Donna; Buckley, Alan; Marko, Josh; Steeves, Megan; Turner, Hollie; Whitehead, Steve

    2011-09-01

    To compare demographic, social, medical, and health care characteristics of home care clients in the last year of life by quintile of deprivation and examine associations between material deprivation and service characteristics. This retrospective study used administrative data for 700 clients who died while receiving home care services. Outcome measures were the receipt of supportive or palliative home care. Associations were assessed using multiple logistic regression. Material deprivation was not associated with either the hours of home care received or the receipt of supportive home care services. Clients with dementia or stroke, those were older than 80 years and those who were single were less likely to receive palliative care services than other groups. Inequalities in allocation of home care services based on age, diagnosis, and marital status, but not material deprivation, suggest the need to carefully match service with need at the end of life.

  5. Implementing Information and Communication Technology to Support Community Aged Care Service Integration: Lessons from an Australian Aged Care Provider

    OpenAIRE

    Douglas, Heather E; Georgiou, Andrew; Tariq, Amina; Prgomet, Mirela; Warland, Andrew; Armour, Pauline; Westbrook, Johanna I

    2017-01-01

    Introduction: There is limited evidence of the benefits of information and communication technology (ICT) to support integrated aged care services. Objectives: We undertook a case study to describe carelink+, a centralised client service management ICT system implemented by a large aged and community care service provider, Uniting. We sought to explicate the care-related information exchange processes associated with carelink+ and identify lessons for organisations attempting to use ICT to su...

  6. Demographics and complaints of university students who sought help at a campus mental health service between 1987 and 2004.

    Science.gov (United States)

    Oliveira, Maria Lilian Coelho de; Dantas, Clarissa de Rosalmeida; Azevedo, Renata Cruz Soares de; Banzato, Cláudio Eduardo Muller

    2008-01-02

    Client characterization is an important step in evaluating the services offered by campus counseling and mental health centers and in their further planning and development. The objectives here were to describe reported complaints and demographics among students who sought counseling/mental healthcare at a Brazilian campus mental health service over a 17-year period and to compare these characteristics with those of the general university student body. Retrospective study at the Psychological and Psychiatric Service for Students (SAPPE), Universidade Estadual de Campinas (Unicamp). The participants were all of the 2,194 students who sought counseling/mental health care at SAPPE from 1987 to 2004. Information was obtained from clients clinical charts. Unicamps database was consulted for general information on its students. The findings indicated overrepresentation, among the clients, of undergraduates, female students, students from Brazilian states other than São Paulo, students living in the campus residence hall and those whose main source of income was a scholarship grant. We also found overrepresentation of Humanities and Arts students among the clients. The most frequently reported complaints were difficulties in interpersonal relationships, family conflicts and poor academic performance. Course level (undergraduate or postgraduate), study field, living in a university residential facility and reliance on a scholarship grant were found to influence the behavior of seeking mental health counseling among Brazilian university students in this study. Course level was found to influence the pattern of complaints reported at first contact with the mental health service.

  7. Increasing Registered Nurse Retention Using Mentors in Critical Care Services.

    Science.gov (United States)

    Schroyer, Coreena C; Zellers, Rebecca; Abraham, Sam

    2016-01-01

    Recruiting and training 1 newly hired registered nurse can cost thousands of dollars. With a high percentage of these newly hired nurses leaving their first place of employment within their first year, the financial implications may be enormous. It is imperative that health care facilities invest in recruiting and retention programs that retain high-quality nurses. Mentorship programs in retaining and easing the transition to practice for new graduate nurses, re-entry nurses, and nurses new to a specialty area are critical in nurse retention. Discussion in this study includes the effect of implementing a mentor program into the critical care services area of a 325-bed not-for-profit community hospital in northern Indiana. Based on this study, nurses with a mentor were retained at a 25% higher rate than those not mentored. Implementation of a mentor program reduced the training cost to the facility and increased retention and morale.

  8. 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.

  9. Club Ed: This University Is at Your Service

    Science.gov (United States)

    Bartlett, Thomas

    2008-01-01

    Lots of colleges treat students like customers. How many have an ice-cream truck? And valet parking? And a concierge desk? And an enormous hot tub in the middle of the campus? Not too many. Actually, only one: High Point University. This once-sleepy institution in the hills of North Carolina has undergone a revival in the last couple of years,…

  10. Pre-Service Teachers’ Attitudes Toward Teaching Science and Their Science Learning at Indonesia Open University

    OpenAIRE

    Nadi SUPRAPTO; Ali MURSID

    2017-01-01

    This study focuses on attitudes toward (teaching) science and the learning of science for primary school among pre-service teachers at the Open University of Indonesia. A three-year longitudinal survey was conducted, involving 379 students as pre-service teachers (PSTs) from the Open University in Surabaya regional office. Attitudes toward (teaching) science’ (ATS) instrument was used to portray PSTs’ preparation for becoming primary school teachers. Data analyses were used, including descrip...

  11. Pengaruh Service Quality Terhadap Competitive Advantage Melalui Student Loyalty Dan University Reputation Sebagai Variabel Intervening

    OpenAIRE

    Kevin, Kristianto

    2015-01-01

    This study is aims to examine the effect of service quality to competitive advantage with student loyalty and university reputation as intervening variables. Data that used in this study are primary data. This study use students from 6 private universities in Surabaya as samples with purposive sampling method. Hypotheses in this study is analyzed using structural equation model (SEM) with SmartPLS 2.0. The result revealed that, service quality significantly affect competitive advantage direct...

  12. 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.

  13. 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.…

  14. [Care quality in intensive care evaluated by the patients using a service quality scale (SERVQUAL)].

    Science.gov (United States)

    Regaira Martínez, E; Sola Iriarte, M; Goñi Viguria, R; Del Barrio Linares, M; Margall Coscojuela, M A; Asiain Erro, M C

    2010-01-01

    The evaluation made by the patients on the quality of service received is important to introduce improvement strategies in the care quality. 1. To evaluate the care quality through the analysis of the differences obtained between expectations and perceptions, that the patients have of the service received in the ICU. 2. To analyze if there is any relationship between care quality evaluated by the patients and the sociodemographic variables. A total of 86 patients who were conscious and oriented during their stay in the ICU were studied prospectively. At 24h of the discharge from the ICU, the SERVQUAL (Service Quality) scale, adapted for the hospital setting by Babakus and Mangold (1992), was applied. This scale measures the care quality based on the difference in scores obtained between expectations and perceptions of the patients. The positive scores indicate that the perceptions of the patients exceed their expectations. The scale has 5 dimensions: Tangibility, Reliability, Responsiveness, Assurances and Empathy. It includes 15 items for perceptions and the same for expectations, with 5 grades of response (1 totally disagree - 5 totally agree). The mean score of perceptions 66.92) exceeded that of the expectations (62.30). The mean score of the difference between perceptions and expectations for the total of the SERVQUAL scale was 4.62. It was also positive for each one of the dimensions: Tangibility=1.44, Reliability=0.53, Responsiveness=0.95, Assurances=0.99, Empathy=0.71. No statistically significant associations were found between care quality evaluated by the patients and the sociodemographic variables. The care quality perceived by the patients in the ICU exceeds their expectations, and had no relationship with the sociodemographic characteristics. Copyright 2009 Elsevier España, S.L. y SEEIUC. All rights reserved.

  15. Sustainability of University Technology Transfer: Mediating Effect of Inventor’s Technology Service

    Directory of Open Access Journals (Sweden)

    Fang Li

    2018-06-01

    Full Text Available Based on the perspective of knowledge transfer and the technology acceptance model (TAM, this paper constructs a university technology transfer sustainable development model that considers the inventor’s technology service from the perspective of the long-term cooperation of enterprise, and analyzes the mediating effect of the inventor’s technology service on university technology transfer sustainability. By using 270 questionnaires as survey data, it is found that the availability of an inventor’s technology service has a significant positive impact on the attitude tendency and practice tendency of enterprise long-term technological cooperation; enterprise technology absorption capacity and trust between a university and an enterprise also have significant influence on an inventor’s technical service availability. Therefore, the inventor’s technology service acts as a mediator in the relationship between university technology transfer sustainability and influence factors. Universities ought to establish the technology transfer model, which focuses on the inventor’s tacit knowledge transfer service, and promotes the sustainable development of the university.

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

    OpenAIRE

    Peng Qingchao

    2016-01-01

    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 explor...

  17. 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…

  18. 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…

  19. 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…

  20. The Nature of Choice and Value for Services and Amenities in Australian Universities

    Science.gov (United States)

    Yezdani, Omer

    2015-01-01

    In two decades, Australian university students have accumulated over $25 billion in debt, a figure that is expected to increase dramatically over the next few years. The literature has rarely considered students' attitudes about ancillary services and amenities, despite their importance to the character of university life and substantial…

  1. Which need characteristics influence healthcare service utilization in home care arrangements in Germany?

    Science.gov (United States)

    Dorin, Lena; Turner, Suzi C; Beckmann, Lea; große Schlarmann, Jörg; Faatz, Andreas; Metzing, Sabine; Büscher, Andreas

    2014-05-22

    We see a growing number of older adults receiving long-term care in industrialized countries. The Healthcare Utilization Model by Andersen suggests that individual need characteristics influence utilization. The purpose of this study is to analyze correlations between need characteristics and service utilization in home care arrangements. 1,152 respondents answered the questionnaire regarding their integration of services in their current and future care arrangements. Care recipients with high long-term care needs answered the questionnaire on their own, the family caregiver assisted the care recipient in answering the questions, or the family caregiver responded to the questionnaire on behalf of the care recipient. They were asked to rank specific needs according to their situation. We used descriptive statistics and regression analysis. Respondents are widely informed about services. Nursing services and counseling are the most used services. Short-term care and guidance and training have a high potential for future use. Day care, self-help groups, and mobile services were the most frequently rejected services in our survey. Women use more services than men and with rising age utilization increases. Long waiting times and bad health of the primary caregiver increases the chance of integrating services into the home care arrangements. The primary family caregiver has a high impact on service utilization. This indicates that the whole family should be approached when offering services. Professionals should react upon the specific needs of care dependents and their families.

  2. 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. Copyright © 2014 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

  3. Multi-stakeholder perspectives in defining health-services quality in cataract care.

    Science.gov (United States)

    Stolk-Vos, Aline C; van de Klundert, Joris J; Maijers, Niels; Zijlmans, Bart L M; Busschbach, Jan J V

    2017-08-01

    To develop a method to define a multi-stakeholder perspective on health-service quality that enables the expression of differences in systematically identified stakeholders' perspectives, and to pilot the approach for cataract care. Mixed-method study between 2014 and 2015. Cataract care in the Netherlands. Stakeholder representatives. We first identified and classified stakeholders using stakeholder theory. Participants established a multi-stakeholder perspective on quality of cataract care using concept mapping, this yielded a cluster map based on multivariate statistical analyses. Consensus-based quality dimensions were subsequently defined in a plenary stakeholder session. Stakeholders and multi-stakeholder perspective on health-service quality. Our analysis identified seven definitive stakeholders, as follows: the Dutch Ophthalmology Society, ophthalmologists, general practitioners, optometrists, health insurers, hospitals and private clinics. Patients, as dependent stakeholders, were considered to lack power by other stakeholders; hence, they were not classified as definitive stakeholders. Overall, 18 stakeholders representing ophthalmologists, general practitioners, optometrists, health insurers, hospitals, private clinics, patients, patient federations and the Dutch Healthcare Institute sorted 125 systematically collected indicators into the seven following clusters: patient centeredness and accessibility, interpersonal conduct and expectations, experienced outcome, clinical outcome, process and structure, medical technical acting and safety. Importance scores from stakeholders directly involved in the cataract service delivery process correlated strongly, as did scores from stakeholders not directly involved in this process. Using a case study on cataract care, the proposed methods enable different views among stakeholders concerning quality dimensions to be systematically revealed, and the stakeholders jointly agreed on these dimensions. The methods

  4. 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.

  5. [A glossary for health care promoting universities (an HPU glossary)].

    Science.gov (United States)

    Bravo-Valenzuela, Paulina; Cabieses, Báltica; Zuzulich, María S; Muñoz, Mónica; Ojeda, Minerva

    2013-01-01

    The health promotion in the university context emerges as an important initiative to facilitate the development of healthy lifestyle behaviors in this environment where students, faculty and university staff spend and share a significant part of their lives. The movement of Health Promoting Universities (HPU) has over 20 years of experience, but still lacks a common language that allows effective communication between those who are interested in its planning and implementation. The purpose of this paper is to develop the most relevant concepts in the context of the international movement of UPS. This document is organized into five anchor dimensions: [1]The university and health promotion, [2] The University and its social responsibility, [3] The University, inequality and inequity, [4] The University and evidence in health promotion, and [5] Strategies to develop a HPU. It is hoped that this glossary for HPU encourages the development of a common language between those who promote this initiative and come from different disciplines, and at the same time serve as a guide for practice.

  6. ONLINE SERVICES FOR 'OPEN' COOPERATION OF UNIVERSITY TEACHERS

    Directory of Open Access Journals (Sweden)

    A. Manzhula

    2013-08-01

    Full Text Available In this article the basic stages of creating open educational resources were defined (creation, storing, protection, publication, social assessment, search of creative partners, forming a culture of social exchange and collaboration, as well as analysis of tools for such type of creative activity was made, following free online service were described: Google docs, Google Drive, Yandex Disc, Creative Commons, Innovative Teachers Net. The intensity of ICT and open educational resources use, general attitude and position toward open educational resources among teachers were analyzed.

  7. Users' Satisfaction with Library Services: A Case Study of Delta State University Library

    Science.gov (United States)

    Ikolo, Violet E.

    2015-01-01

    The study focused on users' satisfaction with library services at the Delta State University main Library, Abraka, Delta State. The objective was to find out if users are satisfied with the services, facilities, the library environment, information sources and staff of the library. Using the descriptive survey design, the population for the study…

  8. Educational Service Quality in Zanjan University of Medical Sciences from Students' Point of View

    Science.gov (United States)

    Mohammadi, Ali; Mohammadi, Jamshid

    2014-01-01

    This study aims at evaluating perceived service quality in Zanjan University of Medical Sciences (ZUMS). This study was cross-sectional and authors surveyed educational services at ZUMS. Through stratified random sampling, 384 students were selected and an adapted SERVQUAL instrument was used for data collection. Data analysis was performed by…

  9. Breaking Ground on the University Garden: Service-Learning and Action Research

    Science.gov (United States)

    Davis, Bryce Collin

    2014-01-01

    The purpose of this dissertation was to document, analyze, understand, and describe how the environmental virtue ethics of undergraduate students were impacted after participating in a service-learning project designed to establish a new university garden. This service-learning project occurred during the fall semester of 2011, on the campus of…

  10. 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

  11. 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…

  12. 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…

  13. 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…

  14. 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…

  15. The student health services at the University of Pretoria from 2000 to 2005

    Directory of Open Access Journals (Sweden)

    D H van Papendorp

    2007-11-01

    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.

  16. Incorporating Service-Learning, Technology, and Research Supportive Teaching Techniques into the University Chemistry Classroom

    Science.gov (United States)

    Saitta, E. K. H.; Bowdon, M. A.; Geiger, C. L.

    2011-01-01

    Technology was integrated into service-learning activities to create an interactive teaching method for undergraduate students at a large research institution. Chemistry students at the University of Central Florida partnered with high school students at Crooms Academy of Information Technology in interactive service learning projects. The…

  17. Problems and Expectations of University Students Attending Higher Education in Turkey: Orientation Services

    Science.gov (United States)

    Kutlu, Mustafa

    2005-01-01

    The objective of this research is to find out the problems and expectations of the students in Inonu University (in Malatya, a city in east Turkey) concerning the orientation services. An additional objective is to ascertain whether students' expectations with regard to orientation services differ according to their sex, their place of origin, and…

  18. Academic Service Climate as a Source of Competitive Advantage: Leverage for University Administrators

    Science.gov (United States)

    Martin, Angela; Kennedy, Barbara; Stocks, Belinda

    2006-01-01

    The psychological climate literature examines links between facets of climate, such as service orientation and a range of individual and organisational outcomes including work attitudes and performance. This study investigated the relationship between the service climate of an Australian university and outcomes important to its key stakeholders. A…

  19. Service quality that improves customer satisfaction in a university: a case study in Institut Teknologi Indonesia

    Science.gov (United States)

    Theresia, L.; Bangun, R.

    2017-12-01

    Universities should provide better service quality to get more customers. The purpose of this study was to find service quality which has impact on the increasing of customer satisfaction in a university. This study is a case study in Institut Teknologi Indonesia (ITI). The result of the study will help ITI to improve its service quality to increase customer satisfaction. This study employs path analysis technique. The data were collected through questionnaires developed from the literature. Questionnaires have two parts namely 1) service quality and 2) customer satisfaction. Service quality is measured through 22 questions with five service quality dimensions: 1) Tangibles, 2) Reliability, 3) Responsiveness, 4) Assurance and 5) Empathy. Customer Satisfaction is measured through 4 questions. The data then are processed by SPSS. The results showed that the students preferred to tangible quality improvement than intangible aspect.

  20. Progress in the utilization of antenatal and delivery care services in Bangladesh: where does the equity gap lie?

    Science.gov (United States)

    Pulok, Mohammad Habibullah; Sabah, Md Nasim-Us; Uddin, Jalal; Enemark, Ulrika

    2016-07-29

    Universal access to health care services does not automatically guarantee equity in the health system. In the post Millennium Development Goals (MDGs) era, the progress towards universal access to maternal health care services in a developing country, like Bangladesh requires an evaluation in terms of equity lens. This study, therefore, analysed the trend in inequity and identified the equity gap in the utilization of antenatal care (ANC) and delivery care services in Bangladesh between 2004 and 2011. The data of this study came from the Bangladesh Demographic and Health Survey. We employed rate ratio, concentration curve and concentration index to examine the trend in inequity of ANC and delivery care services. We also used logistic regression models to analyse the relationship between socioeconomic factors and maternal health care services. The concentration index for 4+ ANC visits dropped from 0.42 in 2004 to 0.31 in 2011 with a greater decline in urban area. There was almost no change in the concentration index for ANC services from medically trained providers during this period. We also found a decreasing trend in inequity in the utilization of both health facility delivery and skilled birth assistance but this trend was again more pronounced in urban area compared to rural area. The concentration index for C-section delivery decreased by about 33 % over 2004-2011 with a similar rate in both urban and rural areas. Women from the richest households were about 3 times more likely to have 4+ ANC visits, delivery at a health facility and skilled birth assistance compared to women from the poorest households. Women's and their husbands' education were significantly associated with greater use of maternal health care services. In addition, women's exposure to mass media, their involvement in microcredit programs and autonomy in healthcare decision-making appeared as significant predictors of using some of these health care services. Bangladesh faces not only a

  1. Confronting the fear factor: the coverage/access disparity in universal health care.

    Science.gov (United States)

    Litow, Mark E

    2007-01-01

    Since their introduction following World War II, single-payer health care systems and universally mandated health care systems have stumbled, but in their pratfalls are many lessons that apply to the universal health care proposals currently on the table in the United States. The critical and often-over-looked point is that universal coverage does not guarantee that individuals will receive needed care--In many cases guaranteed access to care is a false promise or available only on a delayed timetable. A more feasible alternative lies in providing a safety net for citizens who truly need care and financial support with an appropriate system of checks and balances--without disrupting the economic and actuarial fundamental principles of supply and demand and risk classification.

  2. 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.

  3. 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.

  4. The role of nurses in commissioning services within primary care.

    Science.gov (United States)

    Leach, Katherine; Shepherd, Alison Burton

    2013-04-01

    This article is a critical reflection on the role of the nurse in commissioning a service within the primary care setting. It will use the fictitious example of commissioning a nurse-led crisis prevention service in the London borough of Lambeth as an exemplar to highlight the difficulties surrounding the commissioning process. In placing particular focus on the prevalence of smoking, it is suggested that designing services based around tackling 'clusters' of unhealthy risk factors such as smoking, diet and excessive alcohol consumption may be a more holistic approach to delivering better healthcare outcomes for more socioeconomically deprived populations as opposed to previous national siloed attempts (Buck and Forsini 2012;1). It will argue that despite multifaceted and evolving roles, community nurses are ideally placed to recognise compounding risk factors detrimental to health as they work at the interface between the individual and their environment. This awareness can be used to positively impact on the commissioning process but only if greater attention is paid towards enhancing leadership skills throughout nursing, and the rhetoric of effective collaboration across agencies is translated into practice (Ham et al, 2012; NHS Commissioning Board (NHS CB), 2012), NHS Alliance, 2011).

  5. Access to emergency care services: a transversal ecological study about Brazilian emergency health care network.

    Science.gov (United States)

    Rocha, T A H; da Silva, N C; Amaral, P V; Barbosa, A C Q; Rocha, J V M; Alvares, V; de Almeida, D G; Thumé, E; Thomaz, E B A F; de Sousa Queiroz, R C; de Souza, M R; Lein, A; Toomey, N; Staton, C A; Vissoci, J R N; Facchini, L A

    2017-12-01

    Studies of health geography are important in the planning and allocation of emergency health services. The geographical distribution of health facilities is an important factor in timely and quality access to emergency services; therefore, the present study analyzed the emergency health care network in Brazil, focusing the analysis at the roles of small hospitals (SHs). Cross-sectional ecological study. Data were collected from 9429 hospitals of which 3524 were SHs and 5905 were high-complexity centers (HCCs). For analytical purposes, we considered four specialties when examining the proxies of emergency care capability: adult, pediatrics, neonatal, and obstetric. We analyzed the spatial distribution of hospitals, identifying municipalities that rely exclusively on SHs and the distance of these cities from HCCs. More than 14 and 30 million people were at least 120 km away from HCCs with an adult intensive care unit (ICU) and pediatric ICU, respectively. For neonatal care distribution, 12% of the population was more than 120 km away from a health facility with a neonatal ICU. The maternities situation is different from other specialties, where 81% of the total Brazilian population was within 1 h or less from such health facilities. Our results highlighted a polarization in distribution of Brazilian health care facilities. There is a concentration of hospitals in urban areas more developed and access gaps in rural areas and the Amazon region. Our results demonstrate that the distribution of emergency services in Brazil is not facilitating access to the population due to geographical barriers associated with great distances. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  6. [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.

  7. 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.

  8. 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.

  9. Clients' perception of service quality of care in health facilities in ...

    African Journals Online (AJOL)

    Introduction: Clients perception of service quality is important for utilization of health services. Clients with positive perception are more likely to comply with treatment and to continue to use health care services. Assessing clients' perception of services offered is crucial for improving delivery and organization of the services.

  10. [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

  11. 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

  12. 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

    2013-01-01

    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.

  13. 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.

  14. 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.

  15. 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.

  16. Assessing Private Sector Involvement in Health Care and Universal Health Coverage in Light of the Right to Health

    Science.gov (United States)

    2016-01-01

    Abstract The goal of universal health coverage is to “ensure that all people obtain the health services they need without suffering financial hardship when paying for them.” There are many connections between this goal and the state’s legal obligation to realize the human right to health. In the context of this goal, it is important to assess private actors’ involvement in the health sector. For example, private actors may not always have the incentives to deal with externalities that affect the availability, accessibility, acceptability, and quality of health care services; they may not be in a position to provide “public goods”; or they may operate under imperfect information. This paper sets out to answer the question, what legal human rights obligations do states have in terms of regulating private sector involvement in health care? PMID:28559678

  17. Assessing Private Sector Involvement in Health Care and Universal Health Coverage in Light of the Right to Health.

    Science.gov (United States)

    Hallo De Wolf, Antenor; Toebes, Brigit

    2016-12-01

    The goal of universal health coverage is to "ensure that all people obtain the health services they need without suffering financial hardship when paying for them." There are many connections between this goal and the state's legal obligation to realize the human right to health. In the context of this goal, it is important to assess private actors' involvement in the health sector. For example, private actors may not always have the incentives to deal with externalities that affect the availability, accessibility, acceptability, and quality of health care services; they may not be in a position to provide "public goods"; or they may operate under imperfect information. This paper sets out to answer the question, what legal human rights obligations do states have in terms of regulating private sector involvement in health care?

  18. 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.

  19. Barriers to utilization of antenatal care services in Eastern Nepal

    Directory of Open Access Journals (Sweden)

    Krishna Kumar eDeo

    2015-08-01

    Full Text Available BackgroundWorld Health Organization (WHO recommends at least four pregnancy check-ups for normal pregnancies. Ministry of Health and Population (MOHP Nepal has introduced various strategies to promote prenatal care and institutional delivery to reduce maternal and child deaths. However, maternal health service utilization is low in some selected and socio-economic and ethnic groups. Hence, this study aims to assess barriers to the recommended four antenatal care (4ANC visits in eastern Nepal.MethodsA cross-sectional quantitative study was conducted in Sunsari district. A total of 372 randomly selected women who delivered in the last year preceding the survey were interviewed using a semi-structured questionnaire. Bivariate and multivariate logistic regression analysis was carried out to identify barriers associated with 4ANC visits.ResultsMore than two-third women (69% attended at least 4ANC visits. The study revealed that women exposed to media had higher chance of receiving four or more ANC visits with an adjusted Odds Ratio (aOR=3.5, 95% CI: 1.2-10.1 in comparison to women who did not. Women from an advantaged ethnic group had more chance of having 4ANC visits than respondents from a disadvantaged ethnic group (aOR=2.4, 95% CI: 2.1-6.9. Similarly, women having a higher level of autonomy were nearly three times more likely (aOR= 2.9, 95%CI: 1.5-5.6 and richer women were twice (aOR=2.3, 95% CI: 1.1-5.3 as likely to have at least 4ANC visits compared to women who had a lower level of autonomy and were economically poor.ConclusionBeing from disadvantaged ethnicity, lower women?s autonomy, poor knowledge of maternal health service and incentive upon completion of ANC, less media exposure related to maternal health service, and lower wealth rank were significantly associated with fewer than the recommended 4ANC visits. Thus, maternal health programs need to address such socio-cultural barriers for effective health care utilization.

  20. The role of affect in consumer evaluation of health care services.

    Science.gov (United States)

    Ng, Sandy; Russell-Bennett, Rebekah

    2015-01-01

    Health care services are typically consumed out of necessity, typically to recover from illness. While the consumption of health care services can be emotional given that consumers experience fear, hope, relief, and joy, surprisingly, there is little research on the role of consumer affect in health care consumption. We propose that consumer affect is a heuristic cue that drives evaluation of health care services. Drawing from cognitive appraisal theory and affect-as-information theory, this article tests a research model (N = 492) that investigates consumer affect resulting from service performance on subsequent service outcomes.

  1. Socioeconomic inequalities in the access to and quality of health care services

    Directory of Open Access Journals (Sweden)

    Bruno Pereira Nunes

    2014-12-01

    Full Text Available OBJECTIVE To assess the inequalities in access, utilization, and quality of health care services according to the socioeconomic status. METHODS This population-based cross-sectional study evaluated 2,927 individuals aged ≥ 20 years living in Pelotas, RS, Southern Brazil, in 2012. The associations between socioeconomic indicators and the following outcomes were evaluated: lack of access to health services, utilization of services, waiting period (in days for assistance, and waiting time (in hours in lines. We used Poisson regression for the crude and adjusted analyses. RESULTS The lack of access to health services was reported by 6.5% of the individuals who sought health care. The prevalence of use of health care services in the 30 days prior to the interview was 29.3%. Of these, 26.4% waited five days or more to receive care and 32.1% waited at least an hour in lines. Approximately 50.0% of the health care services were funded through the Unified Health System. The use of health care services was similar across socioeconomic groups. The lack of access to health care services and waiting time in lines were higher among individuals of lower economic status, even after adjusting for health care needs. The waiting period to receive care was higher among those with higher socioeconomic status. CONCLUSIONS Although no differences were observed in the use of health care services across socioeconomic groups, inequalities were evident in the access to and quality of these services.

  2. 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.

  3. 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...

  4. Variation in critical care services across North America and Western Europe

    NARCIS (Netherlands)

    Wunsch, Hannah; Angus, Derek C.; Harrison, David A.; Collange, Olivier; Fowler, Robert; Hoste, Eric A. J.; de Keizer, Nicolette F.; Kersten, Alexander; Linde-Zwirble, Walter T.; Sandiumenge, Alberto; Rowan, Kathryn M.

    2008-01-01

    Objective: Critical care represents a large percentage of healthcare spending in developed countries. Yet, little is known regarding international variation in critical care services. We sought to understand differences in critical care delivery by comparing data on the distribution of services in

  5. Transforming Data into Practical Information: Using Consumer Input to Improve Home-Care Services

    Science.gov (United States)

    Applebaum, Robert; Kunkel, Suzanne; Wilson, Ken

    2007-01-01

    Purpose: As funds have increased for the provision of in-home care, so too have concerns about the quality of services. In response, care management agencies and home-care providers have developed an array of monitoring activities designed to ensure the quality of services. In this article, we show how an area agency on aging both collected and…

  6. 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. Project HOPE—The People-to-People Health Foundation, Inc.

  7. Used and foregone health services among a cohort of 87,134 adult open university students residing throughout Thailand.

    Science.gov (United States)

    Yiengprugsawan, Vasoontara; Seubsman, Sam-Ang; Lim, Lynette L-Y; Sleigh, Adrian C

    2009-11-01

    There are limited data on the frequency of foregone health service use in defined populations. Here we describe Thai patterns of health service use, types of health insurance used and reports of foregone health services according to geo-demographic and socioeconomic characteristics. Data on those who considered they had needed but not received health care over the previous year were obtained from a national cohort of 87,134 students from the Sukhothai Thammathirat Open University (STOU). The cohort was enrolled in 2005 and was largely made up of young and middle-age adults living throughout Thailand. Among respondents, 21.0% reported use of health services during the past year. Provincial/governmental hospitals (33.4%) were the most attended health facilities in general, followed by private clinics (24.1%) and private hospitals (20.1%). Health centers and community hospitals were sought after in rural areas. The recently available government operated Universal Coverage Scheme (UCS) was popular among the lower income groups (13.6%), especially in rural areas. When asked, 42.1% reported having foregone health service use in the past year. Professionals and office workers frequently reported 'long waiting time' (17.1%) and 'could not get time off work' (13.7%) as reasons, whereas manual workers frequently noted it was 'difficult to travel' (11.6%). This information points to non-financial opportunity cost barriers common to a wide array of Thai adults who need to use health services. This issue is relevant for health and workplace policymakers and managers concerned about equitable access to health services.

  8. Reconstructing continuity of care in mental health services : a multilevel conceptual framework

    NARCIS (Netherlands)

    Wierdsma, Andre; Mulder, Cornelis; de Vries, Sanne; Sytema, Sjoerd

    Continuity of mental health care is a key issue in the organization and evaluation of services for patients with disabling chronic conditions. Over many years, health services researchers have been exploring the conceptual boundaries between continuity of care and other service characteristics. On

  9. 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

    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

  10. Improving Older Adults' Functional Ability through Service Use in a Home Care Program in Hong Kong

    Science.gov (United States)

    Cheung, Chau-kiu; Ngan, Raymond Man-hung

    2005-01-01

    Objective: Despite past findings about the contribution of home care services to older users' functional ability, the effective processes and components of the services are not transparent. Such processes appear to rely on the actual use of component services of the home care program. Method: The study gathered 116 observations during 2 years…

  11. Supply and Demand for Child Care Services in Turkey : A Mixed Methods Study

    OpenAIRE

    World Bank

    2015-01-01

    Despite increases in availability of center based child care and preschool services in Turkey over the last decade, both the supply of services and utilization remain low. There are regional disparities in availability and the majority of children and households remain unserved in terms of child care and preschool services. This report has collected and assessed information on the supply a...

  12. Collaboration in the provision of mental health care services

    DEFF Research Database (Denmark)

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

    2012-01-01

    collaboration with mental health teams were a lack of GPs'confidence in their communication skills and ability to diagnose the most frequent mental disorders, prompt referral to mental health team specialists, low estimation of the prevalence of non-managed mental disorders, and location of mental health team......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 mental health team members and determine predictors for better collaboration. Methods. In this cross-sectional study, a 41- item questionnaire was distributed to a random sample of 797 Lithuanian GPs. The purpose of this questionnaire was to obtain knowledge about current practices of GPs in providing...

  13. HEALTH SECTOR CORRUPTION AS THE ARCHENEMY OF UNIVERSAL HEALTH CARE IN INDONESIA

    OpenAIRE

    Juwita, Ratna

    2017-01-01

    AbstractThis article argues that health sector corruption is a direct threat towards universal health care in Indonesia. Three Indonesian legal cases of health sector corruption are selected to exemplify the reality of health sector corruption and it’s detrimental effect to the realization of the right to health. This article emphasizes that corruption causes misallocation and embezzlement of the fund that hampers the State party to optimally provide universal health care for the people. This...

  14. Professionalization and retention outcomes of a university-service mentoring program partnership.

    Science.gov (United States)

    Latham, Christine L; Ringl, Karen; Hogan, Mikel

    2011-01-01

    With the use of a university-service partnership to introduce mentoring and shared governance, the aim of this study was to evaluate the effect of these interventions on nurse perceptions of the supportive culture of the workplace environment, professional skill development, decisional involvement, and retention and vacancy rates. A nonequivalent pretest-posttest, noncontrol group design was used with mentors of newly hired mentees to evaluate their workplace perspectives following mentor classes, ongoing mentor support, and a formal mentor-management workforce governance board. A convenience sample of 89 RNs from two acute care facilities attended mentoring and professionalization classes and worked with 109 mentees over 1-3 years. Mentors reported improved teamwork and the ability to deal with conflict but wanted more administrative oversight of the quality and scope of practice of support staff and additional interdepartmental collaboration. One hospital's vacancy rate decreased by 80%, and the other facility's retention rate improved by 21%. The data suggest that a mentor program with comprehensive education and mentor-management alliances through formal workforce environment governance enhances professionalization of frontline nurses and helps sustain a positive, constructive workplace environment. Mentoring classes on communication and cultural sensitivity skills and other leadership concepts, followed by mentor support and mentor-administrative forums, have positive implications for sustained improvement of a supportive culture as perceived by hospital-based RNs and new nurse graduates. Copyright © 2011 Elsevier Inc. All rights reserved.

  15. Does service integration improve technical quality of care in low-resource settings? An evaluation of a model integrating HIV care into family planning services in Kenya.

    Science.gov (United States)

    Mutemwa, Richard; Mayhew, Susannah H; Warren, Charlotte E; Abuya, Timothy; Ndwiga, Charity; Kivunaga, Jackline

    2017-11-01

    The aim of this study was to investigate association between HIV and family planning integration and technical quality of care. The study focused on technical quality of client-provider consultation sessions. The cross-sectional study observed 366 client-provider consultation sessions and interviewed 37 health care providers in 12 public health facilities in Kenya. Multilevel random intercept and linear regression models were fitted to the matched data to investigate relationships between service integration and technical quality of care as well as associations between facility-level structural and provider factors and technical quality of care. A sensitivity analysis was performed to test for hidden bias. After adjusting for facility-level structural factors, HIV/family planning integration was found to have significant positive effect on technical quality of the consultation session, with average treatment effect 0.44 (95% CI: 0.63-0.82). Three of the 12 structural factors were significantly positively associated with technical quality of consultation session including: availability of family planning commodities (9.64; 95% CI: 5.07-14.21), adequate infrastructure (5.29; 95% CI: 2.89-7.69) and reagents (1.48; 95% CI: 1.02-1.93). Three of the nine provider factors were significantly positively associated with technical quality of consultation session: appropriate provider clinical knowledge (3.14; 95% CI: 1.92-4.36), job satisfaction (2.02; 95% CI: 1.21-2.83) and supervision (1.01; 95% CI: 0.35-1.68), while workload (-0.88; 95% CI: -1.75 to - 0.01) was negatively associated. Technical quality of the client-provider consultation session was also determined by duration of the consultation and type of clinic visit and appeared to depend on whether the clinic visit occurred early or later in the week. Integration of HIV care into family planning services can improve the technical quality of client-provider consultation sessions as measured by both health facility

  16. A Universal Design Approach to Government Service Delivery: The Case of ChileAtiende.

    Science.gov (United States)

    Sandoval, Leonardo

    2016-01-01

    A common challenge for government administrations that aim to improve the delivery of information and services to citizens is to go beyond a government-centred approach. By focusing on citizens and the needs of a wide range of citizens, Universal Design (UD) can help to increase the effectiveness, efficiency and satisfaction of government services. This paper examines the case of an internationally recognised Chilean government service delivery programme inspired by UD principles known as ChileAtiende ("ChileService"). A brief account of its creation and current status is provided.

  17. FROM ARCHITECTURE TO RELIGIOUS SERVICES: APPLYING “UNIVERSAL DESIGN” PRINCIPALS ON RELIGIOUS SERVICES

    OpenAIRE

    Gören, Ayşe Burcu

    2016-01-01

    Universal Design isa design concept of all products, environments and information systems whichaims to be accessed, understood and used by the broadest possible spectrum ofhuman ability regardless of their age, size, ability or disability. Universaldesign puts high value on both diversity and inclusiveness. The name father ofUniversal Design is Ronald Mace, who challenged the conventional approach ofdesigning for the average user and provided a design foundation for moreaccessible and usable ...

  18. Evaluation of headache service quality indicators: pilot implementation in two specialist-care centres.

    Science.gov (United States)

    Katsarava, Zaza; Gouveia, Raquel Gil; Jensen, Rigmor; Gaul, Charly; Schramm, Sara; Schoppe, Anja; Steiner, Timothy J

    2015-01-01

    Evaluating quality of health care is increasingly recognized as an important contributor to the advancement of health-care delivery. We recently developed a set of quality indicators for headache care, intended to be applicable across countries, cultures and settings so that deficiencies in headache care worldwide might be recognized and rectified. These indicators themselves require evaluation and proof of fitness for purpose. This pilot study begins this process. We tested the quality indicators in the tertiary headache centres of the University of Duisburg-Essen in Essen, Germany, and the Hospital da Luz in Lisbon, Portugal. Using seven previously-developed enquiry instruments, we interrogated health-care providers (HCPs), including doctors, nurses, psychologists and physiotherapists, as well as consecutive patients and their medical records. The questionnaires were easily understood by both HCPs and patients and were not unduly time-consuming. The results from the two headache centres were comparable despite their differences in structure, staffing and language. These findings met the purpose of the study. Diagnoses were made according to ICHD criteria and critically evaluated during follow-up. However, diagnostic diaries and instruments assessing burden and response to treatment were not always in place or routinely utilised. Triage systems adjusted waiting times to urgency of need. Treatment plans included pathways to other specialities. Patients felt welcomed, reassured and educated, and were mostly satisfied. Discussion points arose over inclusion of psychological therapies in treatment plans; over recording of outcomes; over indicators of efficiency and equitability (protocols to limit wastage of resources, systems to measure input costs and means of ensuring equal access to the services); and over protocols for reporting serious adverse events. This pilot study to assess feasibility of the methods and acceptability of the instruments of headache service

  19. Planning future care services: Analyses of investments in Norwegian municipalities.

    Science.gov (United States)

    Hagen, Terje P; Tingvold, Laila

    2018-06-01

    To analyse whether the Norwegian Central Government's goal of subsidizing 12,000 places in nursing homes or sheltered housing using an earmarked grant was reached and to determine towards which group of users the planned investments were targeted. Data from the investment plans at municipal level were provided by the Norwegian Housing Bank and linked to variables describing the municipalities' financial situation as well as variables describing the local needs for services provided by Statistics Norway. Using regression analyses we estimated the associations between municipal characteristics and planned investments in total and by type of care place. The Norwegian Central Government reached its goal of giving subsidies to 12,000 new or rebuilt places in nursing homes and sheltered housing. A total of 54% of the subsidies (6878 places) were given to places in nursing homes. About 7500 places were available by the end of the planning period and the rest were under construction. About 50% of the places were planned for user groups aged Investments in nursing homes were correlated with the share of the population older than 80 years and investments in sheltered houses were correlated with the share of users with intellectual disabilities. Earmarked grants to municipalities can be adequate measures to affect local resource allocation and thereby stimulate investments in future care. With the current institutional setup the municipalities adapt investments to local needs.

  20. Absenteeism and its implications for nursing care in emergency services

    Directory of Open Access Journals (Sweden)

    Ione Carvalho Pinto

    2017-11-01

    Full Text Available The aim of this study was to identify the frequency of absenteeism among nursing teams and its determinants in healthcare emergency services. A cross-sectional study was carried out by means of secondary data from records of a coordination of human resources. Occurrences with 208 nursing professionals were identified. Univariate analysis was carried out with frequency calculation of the variables age, gender, professional category, workplace, and days and reasons for absenteeism. Fisher’s exact test was applied, fixing the error type I in 5%. The mean age of the participants was 47.2 years, with a prevalence of the female gender (79.8%. A total of 5,778 occurrences of absenteeism were found (mean of 28 per professional, and illness was the main determinant for absenteeism (2,671 occurrences; 46.2%. There was a prevalence of short-term absenteeism (3,020 occurrences; 52.3%. The findings observed in emergency services were similar, with a potential impact on planning, workforce, and quality of care.

  1. Effectiveness of regionalization of trauma care services: a systematic review.

    Science.gov (United States)

    Vali, Y; Rashidian, A; Jalili, M; Omidvari, A H; Jeddian, A

    2017-05-01

    Improving trauma systems in various forms has always been an important aspect of health policy. While several papers have reported the implementation of a structured trauma system of care, research evidence on the effectiveness of such regionalization for improvement in trauma outcome is limited. Systematic review. Medline, EMbase, EconLit and Health Management Information Consortium were searched, using sensitive search terms, for interventional studies that reported a trauma regionalization system as their intervention, and compared important outcomes such as mortality and preventable deaths. At least two authors assessed eligibility for inclusion and risk of bias, and extracted data from the included studies. As meta-analysis was not possible for all studies, two controlled before-after studies were included in the meta-analysis, and a narrative analysis was conducted for the other studies. After title and abstract sifting, 66 papers were retrieved. After reading the full texts, a total of 24 studies from the USA, UK, Canada, Australia, and the Netherlands were included in this review. In spite of variation in study specifications, most were before-after studies with a high risk of bias. Although a reduction in mortality was shown in most studies, only two studies were eligible for meta-analysis, and the results showed a significant reduction in mortality after implementation of an organized trauma system (odds ratio 0.840, 95% confidence interval 0.756-0.924; P = 0.00). Correlation was found between a regionalized network of trauma care and a reduction in trauma-related mortality, based on studies that did not exclude the effects of other concurrent changes on observed reductions. It is recommended that more studies with robust research designs should be conducted in a more diverse range of countries to assess the effectiveness of regionalization. Despite this limitation, the present findings support the regionalization of trauma care services. Copyright

  2. A comparison of the home-care and healthcare service use and costs of older Australians randomised to receive a restorative or a conventional home-care service.

    Science.gov (United States)

    Lewin, Gill; Allan, Janine; Patterson, Candice; Knuiman, Matthew; Boldy, Duncan; Hendrie, Delia

    2014-05-01

    Restorative home-care services, or re-ablement home-care services as they are now known in the UK, aim to assist older individuals who are experiencing difficulties in everyday living to optimise their functioning and reduce their need for ongoing home care. Until recently, the effectiveness of restorative home-care services had only been investigated in terms of singular outcomes such as length of home-care episode, admission to hospital and quality of life. This paper reports on a more complex and perhaps more significant measure--the use and cost of the home-care and healthcare services received over the 2-year period following service commencement. Seven hundred and fifty older individuals referred for government-funded home care were randomly assigned to a restorative or standard service between June 2005 and August 2007. Health and aged care service data were sourced and linked via the Western Australian Data Linkage System. Restorative clients used fewer home-care hours (mean [SD], 117.3 [129.4] vs. 191.2 [230.4]), had lower total home-care costs (AU$5570 vs. AU$8541) and were less likely to be approved for a higher level of aged care (N [%], 171 [55.2] vs. 249 [63.0]) during follow-up. They were also less likely to have presented at an emergency department (OR = 0.69, 95% CI = 0.50-0.94) or have had an unplanned hospital admission [OR (95% CI), 0.69 (0.50-0.95)]. Additionally, the aggregated health and home-care costs of the restorative clients were lower by a factor of 0.83 (95% CI 0.72-0.96) over the 2-year follow-up (AU$19,090 vs. AU$23,428). These results indicate that at a time when Australia is facing the challenges of population ageing and an expected increase in demand for health and aged care services, the provision of a restorative service when an older person is referred for home care is potentially a more cost-effective option than providing conventional home care. © 2014 The Authors. Health and Social Care in the Community published by John

  3. Health care financing in South Africa: moving towards universal ...

    African Journals Online (AJOL)

    Advances in Health Economics and Health. Services Research. Bingley, UK: Emerald Group. Publishing Limited, 2009: 133-156. 16. Wagstaff A. Poverty and health sector inequalities. Bull World Health Organ 2002; 80: 97-105. 17. WHO. Macroeconomics and Health: Investing in Health for Economic Development. Geneva:.

  4. Using assistive technology services at differing levels of care: healthy older couples' perceptions.

    Science.gov (United States)

    Harrefors, Christina; Axelsson, Karin; Sävenstedt, Stefan

    2010-07-01

    The aim of the study was to describe healthy older couples' perceptions of using assistive technology services when needing assistance with care. The use of information technology-based assistive technology services in elder care has increased as a result of an increase of care performed in private homes. The use of assistive technology services in care of older people at home has been evaluated as something positive by patients, relatives and nursing staff, while as resistance to their increased use has also been noted. Twelve healthy couples, aged over 70 years, from northern Sweden were interviewed in 2005 about their perceptions of using assistive technology services in the case of being in need of assistance with personal care. Open, individual semi-structured interviews supported by written vignettes describing three levels of caring needs were used and the data analysed with content analysis. The findings were interpreted as one main theme with three categories: Asset or threat depends on caring needs and abilities. Three categories were identified within the theme: Assistive technology services provide an opportunity; The consequences of using assistive technology services are hard to anticipate; and Fear of assistive technology services when completely dependent on care. Trust and security in the care of older people who are severely ill, dependent on care and living at home should be a hallmark in using assistive technology services. Human presence is an important dimension and must be considered when developing concepts for use of assistive technology services.

  5. Virtualization of open-source secure web services to support data exchange in a pediatric critical care research network.

    Science.gov (United States)

    Frey, Lewis J; Sward, Katherine A; Newth, Christopher J L; Khemani, Robinder G; Cryer, Martin E; Thelen, Julie L; Enriquez, Rene; Shaoyu, Su; Pollack, Murray M; Harrison, Rick E; Meert, Kathleen L; Berg, Robert A; Wessel, David L; Shanley, Thomas P; Dalton, Heidi; Carcillo, Joseph; Jenkins, Tammara L; Dean, J Michael

    2015-11-01

    To examine the feasibility of deploying a virtual web service for sharing data within a research network, and to evaluate the impact on data consistency and quality. Virtual machines (VMs) encapsulated an open-source, semantically and syntactically interoperable secure web service infrastructure along with a shadow database. The VMs were deployed to 8 Collaborative Pediatric Critical Care Research Network Clinical Centers. Virtual web services could be deployed in hours. The interoperability of the web services reduced format misalignment from 56% to 1% and demonstrated that 99% of the data consistently transferred using the data dictionary and 1% needed human curation. Use of virtualized open-source secure web service technology could enable direct electronic abstraction of data from hospital databases for research purposes. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  6. 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

  7. The development of hospitalbased palliative care services in public hospitals in the Western Cape South Africa

    Directory of Open Access Journals (Sweden)

    L Gwyther

    2018-02-01

    Full Text Available With the recent approval of a South African (SA National Policy Framework and Strategy for Palliative Care by the National Health Council, it is pertinent to reflect on initiatives to develop palliative care services in public hospitals. This article reviews the development of hospital-based palliative care services in the Western Cape, SA. Palliative care services in SA started in the non-governmental sector in the 1980s. The first SA hospital-based palliative care team was established in Charlotte Maxeke Johannesburg Academic Hospital in 2001. The awareness of the benefit of palliative care in the hospital setting led to the development of isolated pockets of excellence providing palliative care in the public health sector in SA. This article describes models for palliative care at tertiary, provincial and district hospital level, which could inform development of hospital-based palliative care as the national policy for palliative care is implemented in SA.

  8. Predicting Early Center Care Utilization in a Context of Universal Access

    Science.gov (United States)

    Zachrisson, Henrik Daae; Janson, Harald; Naerde, Ane

    2013-01-01

    This paper reports predictors for center care utilization prior to 18 months of age in Norway, a country with a welfare system providing up to one-year paid parental leave and universal access to subsidized and publicly regulated center care. A community sample of 1103 families was interviewed about demographics, family, and child characteristics…

  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. Improving student satisfaction of Andalas University Dormitory through Service Quality and Importance Performance Analysis

    Science.gov (United States)

    Putri, Nilda Tri; Anggraini, Larisa

    2018-03-01

    Residential satisfaction of university dormitories serve as one of the significant aspects in the framework of sustainability in higher education. This research investigated the quality of dormitory services in Andalas University Dormitory based on student’s satisfaction. According to management residential, the enrollment of residential student has increased gradually in Andalas University. In 2016, capacity of residential student is 1686, but only 1081 students can stay at dormitory because some rooms in bad condition. There are a lot of problems and complaints regarding dormitory’s service quality i.e water problems, leaky rooms and bathrooms, cleanliness and inadequate facilities in residential college. In addition, there are 20% of last year student’s residential check out before the time of contract runs out. The aim of this research are understanding the level of GAP exists between expectation and perception students’ residential in the content of service quality and evaluating the improvement priority services using Importance Performance Analysis. This study is measuring service quality by using Responsiveness, Assurance, Empathy, Reliability and Tangible dimension. A negative GAP indicates that the actual services are than what was expected and the GAP is highlighted area for improvement. Based on IPA, management should improve this following dimension services : responsiveness, tangible and assurance dimension.

  11. Examining actors into boosting the provision of universal service in the Vietnamese context

    DEFF Research Database (Denmark)

    Do Manh, Thai; Williams, Idongesit

    2017-01-01

    are very important in formulating and implementing universal service policy. Originality/value - There have been a few studies applying actor network theory in analysing the formulation of policy, especially in universal service. The paper wants to close this gap.......Purpose - The paper looks at the formulation of the BMGF-VN project to examine which actors participated in the formulation of this project, how their interests were translated into this project, and what lessons may be drawn for the formulation and implementation of universal service policy...... in Vietnam in general. Design/methodology/approach - The paper recruits the actor network theory and qualitative analysis to analyse the BMGF-VN project. Findings - the involvement of non-government actors in formulating and implementing the project, the focus not only on the supply side but also demand side...

  12. Pre-Service English Teachers’ Beliefs Towards Grammar And Its Teaching At Two Turkish Universities

    Directory of Open Access Journals (Sweden)

    İsmail Zeki DİKİCİ

    2012-07-01

    Full Text Available This paper examines pre-service English teachers’ beliefs towards grammar studying at two Turkish Universities. A total of 90 pre-service English teachers, 57 of whom were studying at Muğla University and 33 of whom were studying at Onsekiz Mart University in Turkey, were involved in this study. The research participants completed two questionnaires. The aim of this paper is to look into pre-service English teachers’ beliefs towards grammar and its teaching as well as their knowledge on the metalanguage of grammar. The findings reveal that although a great majority of the participants favour the use of metalanguage in teaching grammar, and support the deductive grammar teaching practises, they themselves still have serious problems even with the most basic grammatical terminology.

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

    Directory of Open Access Journals (Sweden)

    Angela Dawson

    2016-10-01

    Full Text Available Abstract 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 improve access comprehensive medical and early surgical abortion in high income countries. This review therefore aims to identify quality studies of abortion services to provide insight into how access to services can be improved in Australia. Methods We undertook a structured search of six bibliographic databases and hand-searching to ascertain peer reviewed primary research in English between 2005 and 2015. Qualitative and quantitative study designs were deemed suitable for inclusion. A deductive content analysis methodology was employed to analyse selected manuscripts based upon a framework we developed to examine access to early abortion services. Results This review identified the dimensions of access to surgical and medical abortion at clinic or hospital-outpatient based abortion services, as well as new service delivery approaches utilising a remote telemedicine approach. A range of factors, mostly from studies in the United Kingdom and United States of America were found to facilitate improved access to abortion, in particular, flexible service delivery approaches that provide women with cost effective options and technology based services. Standards, recommendations and targets were also identified that provided services and providers with guidance regarding the quality of abortion care. Conclusions Key insights for service delivery in Australia include the: establishment of standards, provision of choice of procedure, improved provider

  14. Conceptualising health services in terms of level and location of care

    African Journals Online (AJOL)

    location of care, are complex combinations of services. They encompass all levels of care ... expression in the recently published ANC health plan. This more comprehensive ..... business of training PHC providers and basic specialists as.

  15. 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.

  16. Factors that influence the preventive care offered to adolescents accessing Public Oral Health Services, NSW, Australia

    Directory of Open Access Journals (Sweden)

    Masoe AV

    2015-06-01

    Full Text Available Angela V Masoe,1 Anthony S Blinkhorn,2 Jane Taylor,1 Fiona A Blinkhorn1 1School of Health Sciences, Faculty of Health and Medicine, Oral Health, University of Newcastle, Ourimbah, NSW, Australia; 2Department of Population Oral Health, Faculty of Dentistry, University of Sydney, Westmead, NSW, Australia Background: Many adolescents are at risk of dental caries and periodontal disease, which may be controlled through health education and clinical preventive interventions provided by oral health and dental therapists (therapists. Senior clinicians (SCs can influence the focus of dental care in the New South Wales (NSW Public Oral Health Services as their role is to provide clinical support and advice to therapists, advocate for their communities, and inform Local Health District (LHD managers of areas for clinical quality improvement. The objective of this study was to record facilitating factors and strategies that are used by SCs to encourage therapists to provide preventive care and advice to adolescent patients. Methods: In-depth, semistructured interviews were undertaken with 16 SCs from all of the 15 NSW LHDs (nine rural and six metropolitan. A framework matrix was used to systematically code data and enable key themes to be identified for analysis. Results: All SCs from the 15 NSW Health LHDs participated in the study. Factors influencing SCs' ability to integrate preventive care into clinical practice were: 1 clinical leadership and administrative support, 2 professional support network, 3 clinical and educational resources, 4 the clinician's patient management aptitude, and 5 clinical governance processes. Clinical quality improvement and continuing professional development strategies equipped clinicians to manage and enhance adolescents' confidence toward self-care. Conclusion: This study shows that SCs have a clear understanding of strategies to enhance the therapist's offer of scientific-based preventive care to adolescents. The problem

  17. Primary Care Providers' experiences with Pharmaceutical Care-based Medication Therapy Management Services

    Directory of Open Access Journals (Sweden)

    Heather L. Maracle

    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 äóñmedication expertise. All PCPs highly treasure the time and education provided by the MTM pharmacists, their ability to manage and adjust patients' medications, and their capability to

  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. Awareness, knowledge, and barriers to low vision services among eye care practitioners

    Directory of Open Access Journals (Sweden)

    Judy Jose

    2016-01-01

    Conclusion: The study results showed that there is a lack of awareness among eye care practitioners about low vision services, which acts as a major barrier in the effective delivery of these services.

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

    DEFF Research Database (Denmark)

    Tufte, Pernille

    2013-01-01

    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...

  1. 78 FR 38810 - Proposed Information Collection (Application for Furnishing Long-Term Care Service to...

    Science.gov (United States)

    2013-06-27

    ... (Application for Furnishing Long- Term Care Service to Beneficiaries of Veterans Affairs, and Residential Care.... 2900-0616.'' SUPPLEMENTARY INFORMATION: Title: Residential Care Home Program--Sponsor Application, VA... collection. Abstract: VA Form 10-2407 is an application used by a residential care facility or home that...

  2. Indicators for planning of health services: assessing impacts of social and health care factors on population health.

    Science.gov (United States)

    Wan, T T; Broida, J H

    1983-01-01

    Community health planning requires identification of the level of access to care and factors which affect the differentials in use of health services. In formulating strategies or alternatives for planning, some assessment of the current level or patterns of health services must be made. It is this element of the planning process that is addressed in this paper. In this study sixty-five specifically designated areas (medical market areas) in the Province of Quebec, Canada were selected. The analysis was performed using data obtained from a large scale study of physicians' responses to the introduction of universal medical care insurance in Quebec. Our analysis offered an opportunity to observe the impact of Medicare on access to care for those thought to be underserved.

  3. Applied research and service activities at the University of Missouri Research Reactor Facility (MURR)

    International Nuclear Information System (INIS)

    Alger, D.M.

    1987-01-01

    The University Of Missouri operates MURR to provide an intense source of neutron and gamma radiation for research and applications by experimenters from its four campuses and by experimenters from other universities, government and industry. The 10 MW reactor, which has been operating an average of 155 hours per week for the past eight years, produces thermal neutron fluxes up to 6-7x10 14 n/cm 2 -s in the central flux trap and beamport source fluxes of up to 1.2x10 14 n/cm 2 -s. The mission of the reactor facility, to promote research, education and service, is the same as the overall mission of the university and therefore, applied research and service supported by industrial firms have been welcomed. The university recognized after a few years of reactor operation that in order to build utilization, it would be necessary to develop in-house research programs including people, equipment and activity so that potential users could more easily and quickly obtain the results needed. Nine research areas have been developed to create a broadly based program to support the level of activity needed to justify the cost of operating the facility. Applied research and service generate financial support for about one-half of the annual budget. The applied and service programs provide strong motivation for university/industry association in addition to the income generated. (author)

  4. 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.

  5. 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.

  6. Costs of stroke and stroke services: Determinants of patient costs and a comparison of costs of regular care and care organised in stroke services

    Directory of Open Access Journals (Sweden)

    Koopmanschap Marc A

    2003-02-01

    Full Text Available Abstract Background 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 patient costs after stroke and compares costs between regular and stroke service care. Methods Costs were calculated within the framework of the evaluation of three experiments with stroke services in the Netherlands. Cost calculations are base on medical consumption data and actual costs. Results 598 patients were consecutively admitted to hospital after stroke. The average total costs of care per patient for the 6 month follow-up are estimated at €16,000. Costs are dominated by institutional and accommodation costs. Patients who die after stroke incur less costs. For patients that survive the acute phase, the most important determinants of costs are disability status and having a partner – as they influence patients' stroke careers. These determinants also interact. The most efficient stroke service experiment was most successful in co-ordinating patient flow from hospital to (nursing home, through capacity planning and efficient discharge procedures. In this region the costs of stroke service care are the same as for regular stroke care. The other experiments suffered from waiting lists for nursing homes and home care, leading to "blocked beds" in hospitals and nursing homes and higher costs of care. Costs of co-ordination are estimated at about 3% of total costs of care. Conclusion This paper demonstrates that by organising care for stroke patients in a stroke service, better health effects can be achieved with the same budget. In addition, it provides insight in need, predisposing and enabling factors that determine costs of care after stroke.

  7. 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.

  8. Effect of primary health care reforms in Turkey on health service utilization and user satisfaction.

    Science.gov (United States)

    Hone, Thomas; Gurol-Urganci, Ipek; Millett, Christopher; Başara, Berrak; Akdağ, Recep; Atun, Rifat

    2017-02-01

    Strengthening primary health care (PHC) is considered a priority for efficient and responsive health systems, but empirical evidence from low- and middle-income countries is limited. The stepwise introduction of family medicine across all 81 provinces of Turkey (a middle-income country) between 2005 and 2010, aimed at PHC strengthening, presents a natural experiment for assessing the effect of family medicine on health service utilization and user satisfaction.The effect of health system reforms, that introduced family medicine, on utilization was assessed using longitudinal, province-level data for 12 years and multivariate regression models adjusting for supply-side variables, demographics, socio-economic development and underlying yearly trends. User satisfaction with primary and secondary care services was explored using data from annual Life Satisfaction Surveys. Trends in preferred first point of contact (primary vs secondary, public vs. private), reason for choice and health services issues, were described and stratified by patient characteristics, provider type, and rural/urban settings.Between 2002 and 2013, the average number of PHC consultations increased from 1.75 to 2.83 per person per year. In multivariate models, family medicine introduction was associated with an increase of 0.37 PHC consultations per person (P < 0.001), and slower annual growth in PHC and secondary care consultations. Following family medicine introduction, the growth of PHC and secondary care consultations per person was 0.08 and 0.30, respectively, a year. PHC increased as preferred provider by 9.5% over 7 years with the reasons of proximity and service satisfaction, which increased by 14.9% and 11.8%, respectively. Reporting of poor facility hygiene, difficulty getting an appointment, poor physician behaviour and high costs of health care all declined (P < 0.001) in PHC settings, but remained higher among urban, low-income and working-age populations. © The Author 2016

  9. 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.

  10. University-School Collaboration as a Tool for Promoting Pre-Service Mathematics Teachers’ Professional Skills

    OpenAIRE

    Kilic, Hulya; Tunc Pekkan, Zelha

    2017-01-01

    In this paper, we discuss pre-service mathematics teachers’ professionalgains from a university-school collaboration where they were given opportunityto observe two teacher educators’ instructional practices in a 6th gradeclassroom, interact with students in one-to-one fashion and reflect on theteacher educators’ and their own practices. Three pre-service teachers out ofnine volunteers attended all modelling and practice sessions for 20 weeks. Thedata collected through interviews, field notes...

  11. Food Service Quality Survey at the University of Zimbabwe Private Canteens

    OpenAIRE

    C. Benhura; S.F. Nyagura; V. Dakwa; P.E. Gombiro; P. Ngwenyama; R. Matanhire; A.Garamukanwa; N. Mudita; J. Zhangazha; W. Mashavira

    2012-01-01

    A quality survey was conducted at private food outlets at the University of Zimbabwe from June 2007 to October 2011. The objective of the study was to assess services offered in relation to customers’ expectations. The other objectives were to assess the reason for many food service providers on campus and weigh the advantages and limitations of such a system. Data collection was effected through observation and questionnaire interviews. Rice with chicken, rice and sadza with beef and beverag...

  12. Analisa Dan Perancangan E-Service Portal Untuk Calon Mahasiswa Baru Pada Binus University

    Directory of Open Access Journals (Sweden)

    Eli Suryani

    2010-12-01

    Full Text Available The purpose of this study is to analyze and design the application of e-service portal to help Marketing BINUS university to improve the speed and ease of service for Prospect students with the integration of transaction and information services required prospective students, and can be presented in a personalized to adds its own interesting experience for user. It would create a competitive advantage of the University which also potentially triggering an increase in the number of intake students. The methodology used is the method of analysis, which reviews and interviews conducted directly to the field, distributing questionnaires, observing and analyzing the data and needs, and using the design method, which includes design of business models, user interface design and database design. Results to be achieved is a web portal, where the system can facilitate prospective students to obtain the desired information services in full, and with a presentation that can be personalized and make transactions easier and faster. Conclusions obtained are BINUS University can take advantage of e-service in a web portal for prospective new students as supporting its competitive advantage in the utilization of information technology and support one of its primary missions to create service excellence in all fields. 

  13. Live-In Versus Live-Out Home Care in Israel: Satisfaction With Services and Caregivers' Outcomes.

    Science.gov (United States)

    Ayalon, Liat; Green, Ohad

    2015-08-01

    The present study provides a preliminary examination of the relationship between the type of home care services (live-in vs. live-out; i.e., round the clock vs. several hours per week), the caregiver's satisfaction with services, and the caregiver's burden, distress, well-being, and subjective health status within the conceptual framework of caregiving outcomes proposed by Yates and colleagues (Yates, M. E., Tennstedt, S., & Chang, B. H. [1999]. Contributors to and mediators of psychological well-being for informal caregivers. Journal of Gerontology: Psychological Sciences, 54, P12 -P22. doi:10.1093/geronb/54B.1.P12). A random stratified sample of family caregivers of older adults more than the age of 70 who receive live-in (442) or live-out (244) home care services through the financial assistance of the National Insurance institute of Israel was selected. A path analysis was conducted. Satisfaction with services was higher among caregivers under the live-in home care arrangement and positively related to well-being. Among caregivers, live-in home care was directly associated with higher levels of subjective health and indirectly associated with better well-being via satisfaction with services. The present study emphasizes the potential benefits of live-in home care services for caregivers of older adults who suffer from high levels of impairment and the importance of assessing satisfaction with services as a predictor of caregivers' outcomes. © The Author 2013. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  14. Demographics and complaints of university students who sought help at a campus mental health service between 1987 and 2004

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    Maria Lilian Coelho de Oliveira

    Full Text Available CONTEXT AND OBJECTIVE: Client characterization is an important step in evaluating the services offered by campus counseling and mental health centers and in their further planning and development. The objectives here were to describe reported complaints and demographics among students who sought counseling/mental healthcare at a Brazilian campus mental health service over a 17-year period and to compare these characteristics with those of the general university student body. DESIGN AND SETTING: Retrospective study at the Psychological and Psychiatric Service for Students (SAPPE, Universidade Estadual de Campinas (Unicamp. METHODS: The participants were all of the 2,194 students who sought counseling/mental health care at SAPPE from 1987 to 2004. Information was obtained from clients’ clinical charts. Unicamp’s database was consulted for general information on its students. RESULTS: The findings indicated overrepresentation, among the clients, of undergraduates, female students, students from Brazilian states other than São Paulo, students living in the campus residence hall and those whose main source of income was a scholarship grant. We also found overrepresentation of Humanities and Arts students among the clients. The most frequently reported complaints were difficulties in interpersonal relationships, family conflicts and poor academic performance. CONCLUSION: Course level (undergraduate or postgraduate, study field, living in a university residential facility and reliance on a scholarship grant were found to influence the behavior of seeking mental health counseling among Brazilian university students in this study. Course level was found to influence the pattern of complaints reported at first contact with the mental health service.

  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. Inequity in hospitalization care: a study on utilization of healthcare services in West Bengal, India.

    Science.gov (United States)

    Bose, Montu; Dutta, Arijita

    2015-01-01

    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 utilization to 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. National Sample Survey Organization (NSSO) has collected information on all hospitalized cases (60(th) 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. 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 placed patients, both socially and

  17. 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.

  18. Parent and child usual source of care and children's receipt of health care services.

    Science.gov (United States)

    DeVoe, Jennifer E; Tillotson, Carrie J; Wallace, Lorraine S; Angier, Heather; Carlson, Matthew J; Gold, Rachel

    2011-01-01

    PURPOSE In the United States, children who have a usual source of care (USC) have better access to health care than those who do not, but little is known about how parental USC affects children's access. We examined the association between child and parent USC patterns and children's access to health care services. METHODS We undertook a secondary analysis of nationally representative, cross-sectional data from children participating in the 2002-2007 Medical Expenditure Panel Survey (n = 56,302). We assessed 10 outcome measures: insurance coverage gaps, no doctor visits in the past year, less than yearly dental visits, unmet medical and prescription needs, delayed care, problems getting care, and unmet preventive counseling needs regarding healthy eating, regular exercise, car safety devices, and bicycle helmets. RESULTS Among children, 78.6% had a USC and at least 1 parent with a USC, whereas 12.4% had a USC but no parent USC. Children with a USC but no parent USC had a higher likelihood of several unmet needs, including an insurance coverage gap (adjusted risk ratio [aRR] 1.33; 95% confidence interval [CI], 1.21-1.47), an unmet medical or prescription need (aRR 1.70; 95% CI 1.09-2.65), and no yearly dental visits (aRR 1.12; 95% CI 1.06-1.18), compared with children with a USC whose parent(s) had a USC. CONCLUSIONS Among children with a USC, having no parent USC was associated with a higher likelihood of reporting unmet needs when compared with children whose parent(s) had a USC. Policy reforms should ensure access to a USC for all family members.

  19. Analysis of Service-learning activities adopted in health courses of Federal University of Bahia.

    Science.gov (United States)

    Baldoino, Aline Silva; Veras, Renata Meira

    2016-06-01

    is study aimed to raise and discuss the data about the integration of health courses teaching and service activities o ered at the Federal University of Bahia (UFBA), pre- senting scenarios practices and major di culties existing in the relationship between the university and the services of health. is was a qualitative study of descriptive explo- ratory character, using a questionnaire as a research tool applied to the coordinators of selected health courses. e selection was by reading the political pedagogical project, the following courses were selected: nursing, physical therapy, speech therapy, medicine, nu- trition, dentistry and public health. e results indicated eight types of teaching-service integration activities, 57 scenarios of practice and the main di culties. It was concluded that these courses are sticking to changes in academic training in health, in view of the large number of basic health units in the teaching service process. us, it emphasizes that the UFBA includes activities in health care that enable the integration-education in the higher education process, although there are some di culties in this relationship indicated by the coordinators. Esse estudo teve como objetivo levantar e discutir os dados acerca das atividades de integração ensino-serviço de cursos de saúde oferecidos na Universidade Federal da Bahia (UFBA), apresentando os cenários de práticas e as principais di culdades existentes na relação entre a uni- versidadeeosserviçosdesaúde.Tratou-sedeumapesquisaqualitativa,decaráterdescritivoexploratório,utilizando-seumquestionáriocomo instrumento de investigação aplicado aos coordenadores dos cursos de saúde selecionados. A seleção foi mediante a leitura do projeto político pedagógico, sendo selecionados os seguintes cursos: enfermagem, sioterapia, fonoaudiologia, medicina, nutrição, odontologia e saúde coletiva. Os resultados indicaram 8 tipos de atividades de integração ensino-serviço, 57 cenários de pr

  20. Adapting services to the needs of children and families with complex migration experiences: The Toulouse University Hospital's intercultural consultation.

    Science.gov (United States)

    Sturm, Gesine; Guerraoui, Zohra; Bonnet, Sylvie; Gouzvinski, Françoise; Raynaud, Jean-Philippe

    2017-08-01

    This article presents the recently created intercultural consultation at the Medical and Psychological Health Care Service (CMP) of the University Hospital la Grave at Toulouse. The approach of the intercultural consultation was elaborated in response to the increasing diversity of children and families using the service in Toulouse. It is also based on local research that indicates the difficulties service providers encounter when trying to establish a solid therapeutic alliance with families with complex migration backgrounds who accumulate different disadvantaging factors. The intercultural consultation adapts existing models of culture-sensitive consultations in child mental health care in France and Canada to the local context in Toulouse. We describe the underlying principles of the intercultural consultation work, the therapeutic and mediation techniques used, and the way the work is integrated into the global service provision of the CMP. The process is illustrated with a case study followed by a discussion of the innovations.