Farmers have a high rate of suicide (1% of suicides in England and Wales). This study sought to test whether farmers would be less likely to have been in contact with primary or mental health services before death due to their reluctance to seek help. The study also sought to identify other characteristics that differentiated suicide among male farmers from other professional groups. A retrospective case-control design was used comparing male farmers with an age and sex matched control group....
Increase Ibukun Adeosun
Full Text Available There is increasing evidence that delay in the commencement of treatment, following the onset of schizophrenia, may be related to the pathways patients navigate before accessing mental health care. Therefore, insight into the pattern and correlates of pathways to mental care of patients with schizophrenia may inform interventions that could fast track their contact with mental health professionals and reduce the duration of untreated psychosis. This study assessed the pathways to mental health care among patients with schizophrenia (n=138, at their first contact with mental health services at the Federal Neuro-Psychiatric Hospital Yaba Lagos, Nigeria. Traditional and religious healers were the first contact for the majority (69% of the patients. Service users who first contacted nonorthodox healers made a greater number of contacts in the course of seeking help, eventuating in a longer duration of untreated psychosis (P<0.001. However, the delay between the onset of psychosis and contact with the first point of care was shorter in patients who patronized nonorthodox practitioners. The findings suggest that collaboration between orthodox and nonorthodox health services could facilitate the contact of patients with schizophrenia with appropriate treatment, thereby reducing the duration of untreated psychosis. The need for public mental health education is also indicated.
Booth, N; Briscoe, M; Powell, R
Farmers have a high rate of suicide (1% of suicides in England and Wales). This study sought to test whether farmers would be less likely to have been in contact with primary or mental health services before death due to their reluctance to seek help. The study also sought to identify other characteristics that differentiated suicide among male farmers from other professional groups. A retrospective case-control design was used comparing male farmers with an age and sex matched control group. Cases were all members of the farming community within the Exeter Health District on whom suicide or open verdict had been recorded between 1979 and 1994. 63 Cases were identified and entered into the study. Controls were non-farmers with the same verdict who were matched for age (5 year age bands) sex and social class. Farmers were significantly more likely to use firearms to kill themselves (42% of farmers v 11% controls). They were less likely to use a car exhaust or to die by poisoning (9% farmers v 50% controls). Farmers were significantly less likely to leave a suicide note (21% farmers v 41% controls). There was no significant difference between farmers and controls for numbers in contact with their general practitioner or mental health services in the 3 months before death. There may be some differences in help seeking behaviour between farmers and the general population as over 30% of farmers presented with exclusively physical symptoms. General practitioners should consider depressive and suicidal intention in farmers presenting with physical problems. When depression is diagnosed consideration should be given to the temporary removal of firearms as the high rate of suicide in the farming community may be strongly influenced by access to means.
Scotti, Dennis J; Harmon, Joel
The delivery of high-quality service, rendered by health service professionals who interact with customers (patients), increases the likelihood that customers will form positive evaluations of the quality of their service encounters as well as high levels of customer satisfaction. Using linkage theory to develop our conceptual framework, we identify four clusters of variables which contribute to a chain of sequential events that connect organization climate to personal and operational work outcomes. We then examine the perceptual differences of service professionals, grouped by intensity of customer contact, with respect to these variables. National data for this project were obtained from multiple sources made available by the Veterans Healthcare Administration (VHA). Cross-group differences were tested using a series of variance analyses. The results indicate that level of customer-contact intensity plays a significant role in explaining variation in perceptions of support staff, clinical practitioners, and nurses at the multivariate and univariate levels of analysis. Contact intensity appears to be a core determinant of the nature of work performed by health service professionals as well as their psychological responses to organizational and customer-related dynamics. Health service professionals are important resources because of their specialized knowledge, labor expense, and scarcity. Based on findings from our research, managers are advised to survey employees' perceptions of their organizational environment and design practices that respond to the unique viewpoints of each of the professional groups identified in this study. Such tailoring should help executives maximize the value of investments in human resources by underwriting patient satisfaction and financial sustainability.
Takayanagi, Kazue; Hagihara, Yukiko
Under the Japanese Government's strong enforcement of Japanese national medical cost reduction, only hospitals which emphasize patient values, and creation of brands according to them can survive. This study extracted patients' expectations as brand from Campbell's Brand-Contact lists. The authors also proposed to add Brand-strengthening strategies both for short-term strategies (large improvement is not required) and for long-term strategies (restructuring hardware and systems). This method would enable hospitals to collect customers' underlying expectations, and would create high-value brands. Trustful medical service would provide mutual and synergetic medical care effects. It is already considered out of date to conduct qualitative patient satisfaction interviews on current medical services to current customers. It is the only way to survive that hospitals themselves produce their original brands to increase patient loyalty and customer satisfaction. In the process, customer value should be reconsidered from both aspects of the quality of clinical care and of other medically related services. Then hospitals would be able to satisfy both customers' output and process expectations.
Full Text Available Abstract Background The populations of industrialised countries are ageing; as this occurs, those who continue to use alcohol and illicit drugs age also. While alcohol use among older people is well documented, use of illicit drugs continues to be perceived as behaviour of young people and is a neglected area of research. This is the first published qualitative research on the experiences of older drug users in the United Kingdom. Methods Semi-structured interviews were conducted in Merseyside, in 2008, with drug users aged 50 and over recruited through drug treatment services. Interviews were recorded and transcribed and analysed thematically. Only health status and health service contact are reported here. Results Nine men and one woman were interviewed (age range: 54 to 61 years; all but one had been using drugs continuously or intermittently for at least 30 years. Interviewees exhibited high levels of physical and mental morbidity; hepatitis C was particularly prevalent. Injecting-related damage to arm veins resulted in interviewees switching to riskier injecting practices. Poor mental health was evident and interviewees described their lives as depressing. The death of drug-using friends was a common theme and social isolation was apparent. Interviewees also described a deterioration of memory. Generic healthcare was not always perceived as optimal, while issues relating to drug specific services were similar to those arising among younger cohorts of drug users, for example, complaints about inadequate doses of prescribed medication. Conclusion The concurrent effects of drug use and ageing are not well understood but are thought to exacerbate, or accelerate the onset of, medical conditions which are more prevalent in older age. Here, interviewees had poor physical and mental health but low expectations of health services. Older drug users who are not in contact with services are likely to have greater unmet needs. The number of drug users
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Alexander, H. M.
In computer program NOROCA populations statistics from National Center for Health Statistics used with computational procedure to estimate health service utilization rates, physician demands (by specialty) and hospital bed demands (by type of service). Computational procedure applicable to health service area of any size and even used to estimate statewide demands for health services.
In light of the increasing globalization of the health sector, this article examines ways in which health services can be traded, using the mode-wise characterization of trade defined in the General Agreement on Trade in Services. The trade modes include cross- border delivery of health services via physical and electronic means, and cross-border movement of consumers, professionals, and capital. An examination of the positive and negative implications of trade in health services for equity, efficiency, quality, and access to health care indicates that health services trade has brought mixed benefits and that there is a clear role for policy measures to mitigate the adverse consequences and facilitate the gains. Some policy measures and priority areas for action are outlined, including steps to address the "brain drain"; increasing investment in the health sector and prioritizing this investment better; and promoting linkages between private and public health care services to ensure equity. Data collection, measures, and studies on health services trade all need to be improved, to assess better the magnitude and potential implications of this trade. In this context, the potential costs and benefits of trade in health services are shaped by the underlying structural conditions and existing regulatory, policy, and infrastructure in the health sector. Thus, appropriate policies and safeguard measures are required to take advantage of globalization in health services.
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Henderson, Morag; Scourfield, Jonathan; Cheung, Sin Yi; Sharland, Elaine; Sloan, Luke
Objective: This study investigated outcomes of social service contact during teenage years. Method: Secondary analysis was conducted of the Longitudinal Survey of Young People in England (N = 15,770), using data on reported contact with social services resulting from teenagers' behavior. Outcomes considered were educational achievement and…
Ameri, Cinzia; Fiorini, Fulvio
The gradual emergence of marketing activities in public health demonstrates an increased interest in this discipline, despite the lack of an adequate and universally recognized theoretical model. For a correct approach to marketing techniques, it is opportune to start from the health service, meant as a service rendered. This leads to the need to analyse the salient features of the services. The former is the intangibility, or rather the ex ante difficulty of making the patient understand the true nature of the performance carried out by the health care worker. Another characteristic of all the services is the extreme importance of the regulator, which means who performs the service (in our case, the health care professional). Indeed the operator is of crucial importance in health care: being one of the key issues, he becomes a part of the service itself. Each service is different because the people who deliver it are different, furthermore there are many variables that can affect the performance. Hence it arises the difficulty in measuring the services quality as well as in establishing reference standards.
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School health services reduce absenteeism and improve academic achievement according to research. If you have school-aged children, youâll want to listen to this podcast to learn more about healthy school environments and the link between health and academic achievement. Created: 9/13/2017 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP). Date Released: 9/13/2017.
Thomas, Christopher R; Penn, Joseph V
As the second century of partnership begins, child psychiatry and juvenile justice face continuing challenges in meeting the mental health needs of delinquents. The modern juvenile justice system is marked by a significantly higher volume of cases, with increasingly complicated multiproblem youths and families with comorbid medical, psychiatric, substance abuse disorders, multiple family and psychosocial adversities, and shrinking community resources and alternatives to confinement. The family court is faced with shrinking financial resources to support court-ordered placement and treatment programs in efforts to treat and rehabilitate youths. The recognition of high rates of mental disorders for incarcerated youth has prompted several recommendations for improvement and calls for reform [56,57]. In their 2000 annual report, the Coalition for Juvenile Justice advocated increased access to mental health services that provide a continuum of care tailored to the specific problems of incarcerated youth . The specific recommendations of the report for mental health providers include the need for wraparound services, improved planning and coordination between agencies, and further research. The Department of Justice, Office of Juvenile Justice and Delinquency Prevention has set three priorities in dealing with the mental health needs of delinquents: further research on the prevalence of mental illness among juvenile offenders, development of mental health screening assessment protocols, and improved mental health services . Other programs have called for earlier detection and diversion of troubled youth from juvenile justice to mental health systems [31,56]. Most recently, many juvenile and family courts have developed innovative programs to address specific problems such as truancy or substance use and diversionary or alternative sentencing programs to deal with first-time or nonviolent delinquents. All youths who come in contact with the juvenile justice system
Luoma, Jason B.; Martin, Catherine E.; Pearson, Jane L.
Objective This study examined rates of contact with primary care and mental health care professionals by individuals before they died by suicide. Method The authors reviewed 40 studies for which there was information available on rates of health care contact and examined age and gender differences among the subjects. Results Contact with primary care providers in the time leading up to suicide is common. While three of four suicide victims had contact with primary care providers within the year of suicide, approximately one-third of the suicide victims had contact with mental health services. About one in five suicide victims had contact with mental health services within a month before their suicide. On average, 45% of suicide victims had contact with primary care providers within 1 month of suicide. Older adults had higher rates of contact with primary care providers within 1 month of suicide than younger adults. Conclusions While it is not known to what degree contact with mental health care and primary care providers can prevent suicide, the majority of individuals who die by suicide do make contact with primary care providers, particularly older adults. Given that this pattern is consistent with overall health-service-seeking, alternate approaches to suicide-prevention efforts may be needed for those less likely to be seen in primary care or mental health specialty care, specifically young men. PMID:12042175
Guerrero, Erick G; Andrews, Christina; Harris, Lesley; Padwa, Howard; Kong, Yinfei; M S W, Karissa Fenwick
In this mixed-method study, we examined coordination of mental health and public health services in addiction health services (AHS) in low-income racial and ethnic minority communities in 2011 and 2013. Data from surveys and semistructured interviews were used to evaluate the extent to which environmental and organizational characteristics influenced the likelihood of high coordination with mental health and public health providers among outpatient AHS programs. Coordination was defined and measured as the frequency of interorganizational contact among AHS programs and mental health and public health providers. The analytic sample consisted of 112 programs at time 1 (T1) and 122 programs at time 2 (T2), with 61 programs included in both periods of data collection. Forty-three percent of AHS programs reported high frequency of coordination with mental health providers at T1 compared to 66% at T2. Thirty-one percent of programs reported high frequency of coordination with public health services at T1 compared with 54% at T2. Programs with culturally responsive resources and community linkages were more likely to report high coordination with both services. Qualitative analysis highlighted the role of leadership in leveraging funding and developing creative solutions to deliver coordinated care. Overall, our findings suggest that AHS program funding, leadership, and cultural competence may be important drivers of program capacity to improve coordination with health service providers to serve minorities in an era of health care reform.
Lystbæk, Christian Tang
Technology developments create rich opportunities for health service providers to introduce service robots in health care. While the potential benefits of applying robots in health care are extensive, the research into the conceptions of health service robot and its importance for the uptake...... of robotics technology in health care is limited. This article develops a model of the basic conceptions of health service robots that can be used to understand different assumptions and values attached to health care technology in general and health service robots in particular. The article takes...... a discursive approach in order to develop a conceptual framework for understanding the social values of health service robots. First a discursive approach is proposed to develop a typology of conceptions of health service robots. Second, a model identifying four basic conceptions of health service robots...
Papoulias, Constantina; Robotham, Dan; Drake, Gareth; Rose, Diana; Wykes, Til
Recruitment to mental health research can be challenging. 'Consent for Contact' (C4C) is a novel framework which may expedite recruitment and contribute to equitable access to research. This paper discusses stakeholder perspectives on using a C4C model in services for people with psychosis. This is a cross sectional study investigating the views of service users and staff using qualitative methods. Eight focus groups were recruited: five with service users (n = 26) and three with clinicians (n = 17). Purposive sampling was applied in order to reflect the local population in terms of ethnicity, experience of psychiatric services and attitudes towards research. Staff and service users alike associated the principle of 'consent for contact' with greater service user autonomy and favourable conditions for research recruitment. Fears around coercion and inappropriate uses of clinical records were common and most marked in service users identifying as having a negative view to research participation. Staff working in inpatient services reported that consenting for future contact might contribute to paranoid ideation. All groups agreed that implementation should highlight safeguards and the opt-in nature of the register. Staff and service users responded positively to C4C. Clinicians explaining C4C to service users should allay anxieties around coercion, degree of commitment, and use of records. For some service users, researcher access to records is likely to be the most challenging aspect of the consultation.
What we know today as Health Services is a fiction, perhaps shaped involuntarily, but with deep health repercussions, more negative than positive. About 24 centuries ago, Asclepius, god of medicine, and Hygeia, goddess of hygiene and health, generated a dichotomy between disease and health that remains with us until today. The confusing substitution of Health Services with Medical Services began toward the end of the XIX century. But it was in 1948 when the so called English National Health Service became a landmark in the world with its model being adopted by many countries with resulting distortion of the true meaning of Health Services. The consequences of this fiction have been ominous. It is necessary to call things by their names and not deceive society. To correct the serious imbalance between Medical Services and Health Services, Hygeia and Asclepius must become a brother and sisterhood. PMID:24893062
Full Text Available Background: The German statutory health insurance (GKV reimburses all health care services that are deemed sufficient, appropriate, and efficient. According to the German Medical Association (BÄK, individual health services (IGeL are services that are not under liability of the GKV, medically necessary or recommendable or at least justifiable. They have to be explicitly requested by the patient and have to be paid out of pocket. Research questions: The following questions regarding IGeL in the outpatient health care of GKV insurants are addressed in the present report: What is the empirical evidence regarding offers, utilization, practice, acceptance, and the relation between physician and patient, as well as the economic relevance of IGeL? What ethical, social, and legal aspects are related to IGeL? For two of the most common IGeL, the screening for glaucoma and the screening for ovarian and endometrial cancer by vaginal ultrasound (VUS, the following questions are addressed: What is the evidence for the clinical effectiveness? Are there sub-populations for whom screening might be beneficial? Methods: The evaluation is divided into two parts. For the first part a systematic literature review of primary studies and publications concerning ethical, social and legal aspects is performed. In the second part, rapid assessments of the clinical effectiveness for the two examples, glaucoma and VUS screening, are prepared. Therefore, in a first step, HTA-reports and systematic reviews are searched, followed by a search for original studies published after the end of the research period of the most recent HTA-report included. Results: 29 studies were included for the first question. Between 19 and 53% of GKV members receive IGeL offers, of which three-quarters are realised. 16 to 19% of the insurants ask actively for IGeL. Intraocular tension measurement is the most common single IGeL service, accounting for up to 40% of the offers. It is followed by
Gaebel, W.; Muijen, M.; Baumann, A.E.; Bhugra, D.; Wasserman, D.; Gaag, R.J. van der; Heun, R.; Zielasek, J.
PURPOSE: To advance mental health care use by developing recommendations to increase trust from the general public and patients, those who have been in contact with services, those who have never been in contact and those who care for their families in the mental health care system. METHODS: We
van den Brink, Rob H S; Broer, Jan; Tholen, Alfons J; Winthorst, Wim H; Visser, Ellen; Wiersma, Durk
The police are considered frontline professionals in managing individuals experiencing mental health crises. This study examines the extent to which these individuals are disconnected from mental health services, and whether the police response has an influence on re-establishing contact. Police records were searched for calls regarding individuals with acute mental health needs and police handling of these calls. Mental healthcare contact data were retrieved from a Psychiatric Case Register. The police were called upon for mental health crisis situations 492 times within the study year, involving 336 individuals (i.e. 1.7 per 1000 inhabitants per year). Half of these individuals (N=162) were disengaged from mental health services, lacking regular care contact in the year prior to the crisis (apart from contact for crisis intervention). In the month following the crisis, 21% of those who were previously disengaged from services had regular care contact, and this was more frequent (49%) if the police had contacted the mental health services during the crisis. The influence of police referral to the services was still present the following year. However, for the majority (58%) of disengaged individuals police did not contact the mental health services at the time of crisis. The police deal with a substantial number of individuals experiencing a mental health crisis, half of whom are out of contact with mental health services, and police play an important role in linking these individuals to services. Training police officers to recognise and handle mental health crises, and implementing practical models of cooperation between the police and mental health services in dealing with such crises may further improve police referral of individuals disengaged from mental health services.
van den Brink Rob HS
Full Text Available Abstract Background The police are considered frontline professionals in managing individuals experiencing mental health crises. This study examines the extent to which these individuals are disconnected from mental health services, and whether the police response has an influence on re-establishing contact. Methods Police records were searched for calls regarding individuals with acute mental health needs and police handling of these calls. Mental healthcare contact data were retrieved from a Psychiatric Case Register. Results The police were called upon for mental health crisis situations 492 times within the study year, involving 336 individuals (i.e. 1.7 per 1000 inhabitants per year. Half of these individuals (N=162 were disengaged from mental health services, lacking regular care contact in the year prior to the crisis (apart from contact for crisis intervention. In the month following the crisis, 21% of those who were previously disengaged from services had regular care contact, and this was more frequent (49% if the police had contacted the mental health services during the crisis. The influence of police referral to the services was still present the following year. However, for the majority (58% of disengaged individuals police did not contact the mental health services at the time of crisis. Conclusions The police deal with a substantial number of individuals experiencing a mental health crisis, half of whom are out of contact with mental health services, and police play an important role in linking these individuals to services. Training police officers to recognise and handle mental health crises, and implementing practical models of cooperation between the police and mental health services in dealing with such crises may further improve police referral of individuals disengaged from mental health services.
Full Text Available Adolescents represent a large proportion of the population. As they mature and become sexually active, they face more serious health risks. Most face these risks with too little factual information, too little guidance about sexual responsibility and multiple barriers to accessing health care. A typical descriptive and explanatory design was used to determine what the characteristics of an accessible adolescent health service should be. Important results and conclusions that were reached indicate that the adolescent want a medical doctor and a registered nurse to be part of the health team treating them and they want to be served in the language of their choice. Family planning, treatment of sexually transmitted diseases and psychiatric services for the prevention of suicide are services that should be included in an adolescent accessible health service. The provision of health education concerning sexual transmitted diseases and AIDS is a necessity. The service should be available thought out the week (included Saturdays and within easy reach. It is recommended that minor changes in existing services be made, that will contribute towards making a health delivery service an adolescent accessible service. An adolescent accessible health service can in turn make a real contribution to the community’s efforts to improve the health of its adolescents and can prove to be a rewarding professional experience to the health worker.
Mar 17, 2010 ... nurses who are employed at a higher education campus' health service to render a healthcare ..... effectively perform roles and tasks expected of him or her in .... all times by those with whom the individual comes into contact.
Barghadouch, Amina; Kristiansen, Maria; Jervelund, Signe Smith
Purpose: Studies show a high level of mental health problems among refugee children. This study examined whether a subset of refugee children living in Denmark accessed psychiatric healthcare services more than those born in the country. Methods: This study compared 24,427 refugee children from A......-born children. This may indicate that refugee children experience barriers in accessing psychiatric healthcare systems and do not receive adequate assessment of their mental health and subsequent referral to specialist services....
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Arcos González, Pedro; Castro Delgado, Rafael; Cuartas Alvarez, Tatiana; Pérez-Berrocal Alonso, Jorge
Today the terrorism is a problem of global distribution and increasing interest for the international public health. The terrorism related violence affects the public health and the health care services in an important way and in different scopes, among them, increase mortality, morbidity and disability, generates a context of fear and anxiety that makes the psychopathological diseases very frequent, seriously alters the operation of the health care services and produces important social, political and economic damages. These effects are, in addition, especially intense when the phenomenon takes place on a chronic way in a community. The objective of this paper is to examine the relation between terrorism and public health, focusing on its effects on public health and the health care services, as well as to examine the possible frames to face the terrorism as a public health concern, with special reference to the situation in Spain. To face this problem, both the public health systems and the health care services, would have to especially adapt their approaches and operational methods in six high-priority areas related to: (1) the coordination between the different health and non health emergency response agencies; (2) the reinforcement of the epidemiological surveillance systems; (3) the improvement of the capacities of the public health laboratories and response emergency care systems to specific types of terrorism as the chemical or biological terrorism; (3) the mental health services; (4) the planning and coordination of the emergency response of the health services; (5) the relations with the population and mass media and, finally; (6) a greater transparency in the diffusion of the information and a greater degree of analysis of the carried out health actions in the scope of the emergency response.
Merlino, James I; Raman, Ananth
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.
Evaluación del estudio de contactos de tuberculosis: Servicio de Salud Metropolitano Occidente. 1994-2008 Evaluation of the study of tuberculosis contacts in Western Public Health Service of Santiago de Chile: 1994-2008
Victoria Pickett S
Full Text Available Se presenta la evaluación de 15 anos del estudio de contactos de tuberculosis (TBC del Servicio de Salud Metropolitano Occidente de la Región Metropolitana, correspondiente alperíodo 1994-2008, en el que se observa una mejoría creciente de la cobertura de estos estudios, la que incluso superó la meta propuesta por el Ministerio de Salud. El método utilizado para esta investigación consistió en el análisis retrospectivo de los casos ingresados en el período. Para la definición de contacto sano o enfermo se tomó como referencia el Manual de Organización y Normas Técnicas y el Manual de Procedimientos para la Atención Primaria del Programa Nacional de Control de la Tuberculosis de Chile. Se analizó 9.344 contactos intra-domiciliarios y habituales extra-domiciliarios, que correspondieron a 2.129 casos indices de adultos con TBC pulmonar con bacteriología positiva y casos indices infantiles de TBC en todas sus formas. Se evaluó la cobertura, morbilidad, diagnóstico de casos TBC y quimioprofilaxis efectuadas. El estudio de contactos es probablemente la actividad de pesquisa tuberculosa focalizada de mayor rendimiento del Programa de Control. En el menor de 15 anos de edad, este estudio permite pesquisar infecciones recientes, que tratadas adecuadamente con quimioprofilaxis, evitan la aparición de nuevos enfermos y la mantención de la cadena de transmisión de la enfermedad.The evaluation of 15 years of study of TB contacts done in the western area of the Public Health Service of Santiago de Chile, 1994-2008, is presented. During this period an improvement on the coverage of this studies -even beyond the Ministry of Health aims- was observed. For this purpose the retrospective analysis of cases incorporated during the period was used. For definitions of healthy or diseased contact we followed the Manual of Tuberculosis of the National Tuberculosis Control Program of Chile. 9,344 intra-domicilliary and extra-domicilliary contacts
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Full Text Available 14.00 800x600 Normal 0 21 false false false ES-CO X-NONE X-NONE MicrosoftInternetExplorer4 What we know today as Health Services is a fiction, perhaps shaped involuntarily, but with deep health repercussions, more negative than positive. About 24 centuries ago, Asclepius god of medicine and Hygeia goddess of hygiene and health, generated a dichotomy between disease and health that remains until today. The confusing substitution of Health Services with Medical Services began by the end of the XIX century. But it was in 1948 when the so called English National Health Service became a landmark in the world and its model was adopted by many countries, having distorted the true meaning of Health Services. The consequences of this fiction have been ominous. It is necessary to call things by its name not to deceive society and to correct the serious imbalance between Medical Services and Health Services. Hygeia and Asclepius must become a brotherhood.
... Inspection Service Stakeholder Registry AGENCY: Animal and Plant Health Inspection Service, USDA. ACTION... Service stakeholder registry. FOR FURTHER INFORMATION CONTACT: Ms. Hallie Zimmers, Advisor for State and Stakeholder Relations, Legislative and Public Affairs, APHIS, room 1147, 1400 Independence Avenue...
zahra asadi; bahman hajipour
... . According Bandura social - Cognitive theory and the nature of high contact service characteristics contain of communication skills, customer orientation, expertise and reputation of service providers...
Skitsou, Alexandra; Bekos, Christos; Charalambous, George
, ongoing education of health professionals along with relevant education of the community and the broad application of triage in the emergency departments will all contribute to delivering health services more effectively. Keywords: Cyprus, health services, patient rights...... and their families to be essential. Conclusions: The paper concludes that implementing guidelines in accordance with international best practices, the establishment of at-home treatment and nursing facilities, counseling the mentally ill in a way that promotes their social integration and occupational rehabilitation......Background: It has been observed that health services provided to certain patients in Cyprus do not fully meet their human rights. Objective: This study was conducted to identify the main shortcomings of the Health System in Cyprus. Methodology: The relevant administrative decisions...
Department of Health
The Healthcare Materials Management Board (HMMB) was established following the report to the Materials Management Advisory Group on procurement and materials management in the health sector Download the Report here
Anshari, Muhammad; Almunawar, Mohammad Nabil
Mobile technology enables health-care organizations to extend health-care services by providing a suitable environment to achieve mobile health (mHealth) goals, making some health-care services accessible anywhere and anytime. Introducing mHealth could change the business processes in delivering services to patients. mHealth could empower patients as it becomes necessary for them to become involved in the health-care processes related to them. This includes the ability for patients to manage their personal information and interact with health-care staff as well as among patients themselves. The study proposes a new position to supervise mHealth services: the online health educator (OHE). The OHE should be occupied by special health-care staffs who are trained in managing online services. A survey was conducted in Brunei and Indonesia to discover the roles of OHE in managing mHealth services, followed by a focus group discussion with participants who interacted with OHE in a real online health scenario. Data analysis showed that OHE could improve patients' confidence and satisfaction in health-care services.
Full Text Available Abstract Background The municipalities are responsible for the emergency primary health care services in Norway. These services include casualty clinics, primary doctors on-call and local emergency medical communication centres (LEMC. The National centre for emergency primary health care has initiated an enterprise called "The Watchtowers", comprising emergency primary health care districts, to provide routine information (patients' way of contact, level of urgency and first action taken by the out-of-hours services over several years based on a minimal dataset. This will enable monitoring, evaluation and comparison of the respective activities in the emergency primary health care services. The aim of this study was to assess incidence of emergency contacts (potential life-threatening situations, red responses to the emergency primary health care service. Methods A representative sample of Norwegian emergency primary health care districts, "The Watchtowers" recorded all contacts and first action taken during the year of 2007. All the variables were continuously registered in a data program by the attending nurses and sent by email to the National Centre for Emergency Primary Health Care at a monthly basis. Results During 2007 the Watchtowers registered 85 288 contacts, of which 1 946 (2.3% were defined as emergency contacts (red responses, corresponding to a rate of 9 per 1 000 inhabitants per year. 65% of the instances were initiated by patient, next of kin or health personnel by calling local emergency medical communication centres or meeting directly at the casualty clinics. In 48% of the red responses, the first action taken was a call-out of doctor and ambulance. On a national basis we can estimate approximately 42 500 red responses per year in the EPH in Norway. Conclusion The emergency primary health care services constitute an important part of the emergency system in Norway. Patients call the LEMC or meet directly at casualty clinics
Elizabeth Andress: Partnerships Produce a National Center for Home Food Preservation. Diana Friedman: National 4-H Healthy Lifestyles Grant. H. Wallace Goddard: Big Surprises on the Road to Happiness. Nancy Kershaw: Connecting the 4-H Clothing Project and Community. Jane A. Landis: NEAFCS Living Well Public Service Campaign. Rhea Lanting: The Healthy Diabetes Plate. Phyllis B. Lewis: Product Look-Alikes. Anna Martin: Raising Diabetes Awareness in Latino Communities. Earl Mcalexander: Youth Fi...
Roemer, M I
Implementation of social insurance for financing health services has yielded different patterns depending on a country's economic level and its government's political ideology. By the late 19th century, thousands of small sickness funds operated in Europe, and in 1883 Germany's Chancellor Bismarck led the enactment of a law mandating enrollment by low-income workers. Other countries followed, with France completing Western European coverage in 1928. The Russian Revolution in 1917 led to a National Health Service covering everyone from general revenues by 1937. New Zealand legislated universal population coverage in 1939. After World War II, Scandinavian countries extended coverage to everyone and Britain introduced its National Health Service covering everyone with comprehensive care and financed by general revenues in 1948. Outside of Europe Japan adopted health insurance in 1922, covering everyone in 1946. Chile was the first developing country to enact statutory health insurance in 1924 for industrial workers, with extension to all low-income people with its "Servicio Nacional de Salud" in 1952. India covered 3.5 percent of its large population with the Employees' State Insurance Corporation in 1948, and China after its 1949 revolution developed four types of health insurance for designated groups of workers and dependents. Sub-Saharan African countries took limited health insurance actions in the late 1960s and 1970s. By 1980, some 85 countries had enacted social security programs to finance or deliver health services or both.
Elsom, Stephen; Sands, Natisha; Roper, Cath; Hoppner, Cayte; Gerdtz, Marie
The participation of service users in all aspects of mental health service delivery including policy development, service planning and evaluation is increasingly an expectation of contemporary mental health care. Although there are a growing number of publications reporting service-user perspectives in the evaluation of mental health services, little attention has been paid to the views of service users about mental health triage services. The purpose of the study reported here was to examine service-users' (consumers and informal carers) experiences of a telephone-based mental health triage service. Using a framework developed from the World Health Organisation's elements of responsiveness, we conducted structured telephone interviews with service users who had contacted a telephone-based mental health triage service in regional Victoria, Australia. The main findings of the study were that consumers experienced more difficulty than carers in accessing the service and that, although most participants were satisfied, only a minority reported being involved in decision-making. Further work is needed to improve accessibility of mental health triage services and to investigate barriers to consumer self-referral. Professional development and practice support systems should be established to support mental health triage nurses in the development of collaborative, consumer-focused care.
Full Text Available The Chinese health system was once held up as a model for providing universal health care in the developing world in the 1970s, only to have what is now considered one of the least equitable systems in the world according to the World Health Organization. This article begins with a brief look at what equity in health services entails, and considers the inequities in access to health services in China among different segments of the population. This article will consider challenges the current inequities may present to China in the near future if reforms are not implemented. Finally, it will take a look at reforms made by China’s neighbors, Singapore and Thailand, which made their health care more equitable, affordable, and sustainable.
Hofferth, Sandra L; Pinzon, Angela M
Nonresidential father investment of time and money has been shown to ameliorate the negative consequences of family dissolution on children's behavior and achievement; however, no research has shown whether this investment also has positive effects on child health. Using data from the Early Childhood Longitudinal Survey, Kindergarten cohort, this research uses a two-wave cross-lagged model to examine how child support and contact are associated with maternal reports of children's physical health over time following parental separation. Child support in kindergarten is not associated with child health in third grade. Instead, children who are healthier in kindergarten receive greater financial support from their father. Although contact and child support are positively related, greater contact is not associated with better child health.
van den Brink Rob HS; Broer Jan; Tholen Alfons J; Winthorst Wim H; Visser Ellen; Wiersma Durk
Abstract Background The police are considered frontline professionals in managing individuals experiencing mental health crises. This study examines the extent to which these individuals are disconnected from mental health services, and whether the police response has an influence on re-establishing contact. Methods Police records were searched for calls regarding individuals with acute mental health needs and police handling of these calls. Mental healthcare contact data were retrieved from ...
Full Text Available The service sector plays an increasingly large modern market economies. By being unable to provide customers a tangible product in the hands of service providers makes the situation more difficult. Their success depends on customer satisfaction, which expect a certain benefit for the money paid, on quality, on mutual trust and many other attributes. What is very interesting is that they may differ from client to client, and there is no guarantee satisfaction to all customers, even if the service provided is the same. This shows the complex nature of services and efforts on service providers would have to be made permanent in order to attract more customers. This paper addresses the issues of continuous quality improvement of health services as an important part of the services sector. Until recently, these services in Romania although under strict control of the state, had a large number of patients who are given very little attention, which is why quality improvement acestoraa was compulsory. Opening and changing economic environment, increasing customer demands, forced hospitals that serve as a nodal point between these services and their applicants to adopt modern management methods and techniques to become competitive and to give patients the quality service expected. Modern society has always sought to provide the means to ensure good health closer to the needs of modern man. These have become more complex and more expensive and naturally requires financial resources increasingly mari.Este why, every time, all the failures alleging lack of money and resources in general. Is it true? Sometimes yes, often, no! The truth is that human and material resources are not used in an optimal way. The answer lies mainly in quality management. We will see what should be done in this regard.
U.S. Department of Health & Human Services — A search-based Web service that provides access to disease, condition and wellness information via MedlinePlus health topic data in XML format. The service accepts...
BERNSTEIN, ROSE; HERZOG, ELIZABETH
FROM REPORTS AND DATA THAT WERE AVAILABLE TO THE UNITED STATES CHILDREN'S BUREAU THROUGH 1962, A REVIEW WAS MADE OF RESEARCH AND DEMONSTRATIONS THAT RELATED TO AVAILABILITY AND USE OF HEALTH SERVICES BY UNMARRIED MOTHERS. INCLUDED ARE COMPLICATIONS OF PREGNANCY IN BIRTHS OUT OF WEDLOCK--(1) STUDIES OF PRENATAL MEDICAL CARE FOR UNMARRIED MOTHERS,…
Lin, Lewei Allison; Bohnert, Amy S B; Ilgen, Mark A; Pfeiffer, Paul N; Ganoczy, Dara; Blow, Frederic C
Prescription opioid medications are the most commonly implicated substances in unintentional overdoses. Outpatient health care encounters represent a potential opportunity to intervene to reduce opioid overdose risk. This study assessed the timing and type of outpatient provider contacts prior to death from unintentional prescription opioid overdose. This study examined all adult patients nationally in the Veterans Health Administration (VHA) who died from unintentional prescription opioid overdose in fiscal years 2004-2007 and who used VHA services anytime within two years of their deaths (N=1,813). For those whose final treatment contact was in an outpatient setting (N=1,457), demographic, clinical, and treatment characteristics were compared among patients categorized by the location of their last contact. Among individuals last seen in outpatient settings, 33% were seen within one week of their overdose and 62% within one month of their overdose. A substantial proportion of patients (30%) were last seen within one month of death in mental health or substance use disorder outpatient settings. The majority of patients (86%) did not fill an opioid prescription on their last outpatient visit prior to death from unintentional opioid overdose. Most patients who died by unintentional prescription opioid overdose were seen in outpatient settings within a month of their overdose. These settings may provide an opportunity to prevent patients from dying from prescription opioid overdoses. Interventions to reduce risk should not be limited to visits during which an opioid is prescribed.
May 3, 2013 ... perceived service quality among 550 clients and 559 branch contact- .... in banking), this study adds to the premise that having a better understanding of .... instrument for measuring service quality in several different industries ...
Meuleners, Lynn B; Fraser, Michelle L
Interpersonal violence and mental illness are significant public health issues. This study aimed to determine gender differences in risk factors for recurrent mental health contacts after a hospitalization for interpersonal violence in Western Australia between 1997 and 2008. This population-based retrospective cohort study used linked hospital morbidity data and mental health records to identify individuals who were hospitalized due to interpersonal violence and had recurrent mental health contacts following hospitalization. A total of 1,969 individuals had a first-ever mental health contact after their index hospitalization for violence. The most common reasons for a mental health contact after interpersonal violence hospitalization were anxiety and/or depression (n = 396, 20.1%), neurotic disorders (n=338, 11.8%), schizophrenia (n=232, 11.8%), and psychoactive substance use (n = 206, 10.5%). Different risk factors for recurrent contact with mental health services emerged for males and females. For males, factors significantly associated with increased risk of recurrent mental health contacts included advancing age and not being married. However, for females, type of violence, Indigenous status, age, and living in rural or remote areas affected the risk of recurrent mental health contacts, whereas marital status did not. These findings have implications for the targeting of mental health prevention programs tailored specifically for males and females affected by violence.
Tlale, Lebapotswe; Frasso, Rosemary; Kgosiesele, Onalenna; Selemogo, Mpho; Mothei, Quirk; Habte, Dereje; Steenhoff, Andrew
Introduction TB contact tracing rates remain low in high burden settings and reasons for this are not well known. We describe factors that influence health care workers' (HCW) implementation of TB contact tracing (CT) in a high TB burden district of Botswana. Methods Data were collected using questionnaires and in-depth interviews in 31 of the 52 health facilities in Kweneng East Health District. Responses were summarized using summary statistics and comparisons between HCW groups were done using parametric or non-parametric tests as per normality of the data distribution. Results One hundred and four HCWs completed questionnaires. Factors that influenced HCW TB contact tracing were their knowledge, attitudes and practices as well as personal factors including decreased motivation and lack of commitment. Patient factors included living further away from the clinic, unknown residential address and high rates of migration and mobility. Administrative factors included staff shortages, lack of transport, poor reporting of TB cases and poor medical infrastructure e.g. suboptimal laboratory services. A national HCW strike and a restructuring of the health system emerged as additional factors during in-depth interviews of TB coordinators. Conclusion Multiple factors lead to poor TB contact tracing in this district. Interventions to increase TB contact tracing will be informed by these findings. PMID:27800084
... ADMINISTRATION Service Contract Inventory and Corresponding Point of Contact Information Per Section 703 of... Administration. ACTION: Notice. SUMMARY: We are providing the Web site address (URL) for the Service Contract... Consolidated Appropriations Act, Public Law 111-117. FOR FURTHER INFORMATION CONTACT: Dennis Wilhite,...
van den Brink, Rob H. S.; Broer, Jan; Tholen, Alfons J.; Winthorst, Wim H.; Visser, Ellen; Wiersma, Durk
Background: The police are considered frontline professionals in managing individuals experiencing mental health crises. This study examines the extent to which these individuals are disconnected from mental health services, and whether the police response has an influence on re-establishing contact
May 5, 1999 ... the technicians aimed at improving the services in health centres within ... Settings: Twenty seven health centres in Amhara region, north .... man power in the laboratory .... service consumption in a teaching hospital in Gondar,.
There has been, and still is a firm belief that regular use of dental services is beneficial for all. Thus governments in most European countries have shown some interest in training oral health care professionals, distributing the dental workforce and cost sharing. Constantly evolving treatment options and the introduction of new methods make dental clinicians feel uncertain as to which treatments are most useful, who would benefit from them, and which treatments will achieve cost-effective health gain. Although there is a considerable quantity of scientific literature showing that most available preventive measures are effective, and the number of sensible best-practice guidelines in prevention is growing, there are few studies on cost-efficiency of different methods and, secondly, the prevention and treatment guidelines are poorly known among general practitioners. In the eyes of the public, it is obvious that preventive methods practised by patients at home have been eclipsed by clinical procedures performed in dental clinics. Reliance on an increasingly individualistic approach to health care leads to the medicalisation of issues that are not originally health or medical problems. It is important to move general oral disease prevention back to the people who must integrate this in their daily routines. Prevention primarily based on healthy lifestyles, highlighted in the new public health strategy of the European Union (EU), is the key to future health policy.
Hale, F A; Jacobs, A R
While home health services have traditionally been an underused component of the health care system, current trends suggest the desirability of expanding these services. These trends include an increase in the number of elderly who need the benefits of home care, the recognition that long-term chronic illnesses require appropriate management at home, and concern that patients have access to care at the level most appropriate to their illnesses. In New Hampshire, 41 certified home health agencies offer services. Little systematic research has been conducted on the kinds of services they provide and the patients seen by their staffs. Patient encounter data were collected from a sample of eight agencies for a 4-week period. Staff of the agencies used the patient contact record developed by the National Functional Task Analysis Cooperative Study to collect data. The data reflected differences among the agencies in the size of the populations they serve, organizational characteristics, reasons for patients' visits, expected sources of the revenue that supported them, and the diagnosis of the patients they cared for. The agencies served areas with populations ranging from 1,000 to 40,000. The staffs ranged from 1 to 14 full-time persons. Two were public agencies; the others had voluntary sponsorship. When data on reasons for visits were averaged for the eight agencies, it was shown that 72% of the visits were made for disease control activities such as care for a chronic or acute condition or for treatment or a laboratory test. Disease prevention activities such as a checkup for adults, children, prenatal or postnatal care, or health education accounted for only 24% of the visits. This result may indicate that, in areas short of physician manpower, the community health nurse is taking on increasing responsibility for medical care as well as health and education. Reimbursement for the visits came from Medicare, 25%; Medicaid-welfare, 14%; the patients, 18%; and health
Nichols, Don D.
This paper provides a synoptic review of student health services at the community college level while giving a more detailed description of the nature of health services at Orchard Ridge, a campus of Oakland Community College. The present College Health Service program provides for a part-time (24 hrs./wk.) nurse at Orchard Ridge. A variety of…
Jan 18, 2011 ... health services, nursing services, and health education. Other areas ... (2001) sees school health services to be those services that take care of the health needs ..... Network, Family Health International 14:2:30. Chisango, T.
Begun, James W; Kaissi, Amer
The definition and scope of health services administration are important to public policy, educational programs, new entrants to the field, and practitioners. Formal definition of the field of health services administration has not received concerted attention since 1975. Significant changes in the field have occurred since that time, widening opportunities for graduates of educational programs and increasing interdependencies between health services organizations and public policy organizations, supplier organizations, insurers, and other businesses that are not involved directly in health services delivery. Stakeholders in the field of health services administration should consider a broadened definition of the field that would institutionalize and build on those increased opportunities and interdependencies.
Hauff, Alicia J; Secor-Turner, Molly
The effects of homelessness on health are well documented, although less is known about the challenges of health care delivery from the perspective of service providers. Using data from a larger health needs assessment, the purpose of this study was to describe homeless health care needs and barriers to access utilizing qualitative data collected from shelter staff (n = 10) and health service staff (n = 14). Shelter staff members described many unmet health needs and barriers to health care access, and discussed needs for other supportive services in the area. Health service providers also described multiple health and service needs, and the need for a recuperative care setting for this population. Although a variety of resources are currently available for homeless health service delivery, barriers to access and gaps in care still exist. Recommendations for program planning are discussed and examined in the context of contributing factors and health care reform.
Andersen, John Sahl; Olivarius, Niels de Fine; Krasnik, Allan
Abstract Introduction: To describe the Danish National Health Service Register in relation to research. Content: The register contains data collected for administrative and scientific purposes from health contractors in primary health care. It includes information about citizens, providers...
Dixon, Decia Nicole
Latest research on the mental health status of children indicates that schools are key providers of mental health services (U.S. Department of Health and Human Services, 2003). The push for school mental health services has only increased as stakeholders have begun to recognize the significance of sound mental health as an essential part of…
Panini, Roberta; Fiorini, Fulvio
In the last twenty years, the hospitals have become firms, therefore they have had the necessity to differentiate from each other.Thus, as it is done in the commercial firms, in the health service different formality of communication are studied and introduced in order to attract new consumers and to maintain their trust. Furthermore, due to the introduction of the digitization in the Public Administrations, the communication has become more transparent.A systematic application of communication tools is more and more spread among the Sanitary Firms, whether they are Local Firm or Hospital Firm.Regarding the reference population, communication tools are used with different purposes such as educational and informative. In addition, they are applied as institutional marketing tool, in order to show the offered potentialities and also to increase the level of satisfaction in the patients/consumers who perceive the typology of reception and treatment during the sanitary performance.
Hansen, Kristian Schultz; Enemark, Ulrika; Foldspang, Anders
, 1997-2003. Data were extracted from administrative registries including information on individual use of emergency services and other hospital care, contact with GPs and socioeconomic background. Health services' use by the Morsø population was measured before reduction in emergency room opening hours......, during a period of reduced opening hours and after closure, compared with the rest of Viborg County. RESULTS: Emergency service use did not change among Morsø municipality residents compared to other Viborg County residents. Compared to men in other parts of the county, Morsø men did not change their use...
Full Text Available Families in high mortality settings need regular contact with high quality services, but existing population-based measurements of contacts do not reflect quality. To address this, in 2012, we designed linked household and frontline worker surveys for Gombe State, Nigeria, Ethiopia, and Uttar Pradesh, India. Using reported frequency and content of contacts, we present a method for estimating the population level coverage of high quality contacts.Linked cluster-based household and frontline health worker surveys were performed. Interviews were conducted in 40, 80 and 80 clusters in Gombe, Ethiopia, and Uttar Pradesh, respectively, including 348, 533, and 604 eligible women and 20, 76, and 55 skilled birth attendants. High quality contacts were defined as contacts during which recommended set of processes for routine health care were met. In Gombe, 61% (95% confidence interval 50-72 of women had at least one antenatal contact, 22% (14-29 delivered with a skilled birth attendant, 7% (4-9 had a post-partum check and 4% (2-8 of newborns had a post-natal check. Coverage of high quality contacts was reduced to 11% (6-16, 8% (5-11, 0%, and 0% respectively. In Ethiopia, 56% (49-63 had at least one antenatal contact, 15% (11-22 delivered with a skilled birth attendant, 3% (2-6 had a post-partum check and 4% (2-6 of newborns had a post-natal check. Coverage of high quality contacts was 4% (2-6, 4% (2-6, 0%, and 0%, respectively. In Uttar Pradesh 74% (69-79 had at least one antenatal contact, 76% (71-80 delivered with a skilled birth attendant, 54% (48-59 had a post-partum check and 19% (15-23 of newborns had a post-natal check. Coverage of high quality contacts was 6% (4-8, 4% (2-6, 0%, and 0% respectively.Measuring content of care to reflect the quality of contacts can reveal missed opportunities to deliver best possible health care.
Marchant, Tanya; Tilley-Gyado, Ritgak Dimka; Tessema, Tsegahun; Singh, Kultar; Gautham, Meenakshi; Umar, Nasir; Berhanu, Della; Cousens, Simon; Armstrong Schellenberg, Joanna RM
Background Families in high mortality settings need regular contact with high quality services, but existing population-based measurements of contacts do not reflect quality. To address this, in 2012, we designed linked household and frontline worker surveys for Gombe State, Nigeria, Ethiopia, and Uttar Pradesh, India. Using reported frequency and content of contacts, we present a method for estimating the population level coverage of high quality contacts. Methods and Findings Linked cluster-based household and frontline health worker surveys were performed. Interviews were conducted in 40, 80 and 80 clusters in Gombe, Ethiopia, and Uttar Pradesh, respectively, including 348, 533, and 604 eligible women and 20, 76, and 55 skilled birth attendants. High quality contacts were defined as contacts during which recommended set of processes for routine health care were met. In Gombe, 61% (95% confidence interval 50-72) of women had at least one antenatal contact, 22% (14-29) delivered with a skilled birth attendant, 7% (4-9) had a post-partum check and 4% (2-8) of newborns had a post-natal check. Coverage of high quality contacts was reduced to 11% (6-16), 8% (5-11), 0%, and 0% respectively. In Ethiopia, 56% (49-63) had at least one antenatal contact, 15% (11-22) delivered with a skilled birth attendant, 3% (2-6) had a post-partum check and 4% (2-6) of newborns had a post-natal check. Coverage of high quality contacts was 4% (2-6), 4% (2-6), 0%, and 0%, respectively. In Uttar Pradesh 74% (69-79) had at least one antenatal contact, 76% (71-80) delivered with a skilled birth attendant, 54% (48-59) had a post-partum check and 19% (15-23) of newborns had a post-natal check. Coverage of high quality contacts was 6% (4-8), 4% (2-6), 0%, and 0% respectively. Conclusions Measuring content of care to reflect the quality of contacts can reveal missed opportunities to deliver best possible health care. PMID:26000829
zahra asadi; bahman hajipour
In today's competitive world, all market participants ranging from individuals, organizations should be looking for ways to success in the market. The secret to success high contact service providers as important part of market participants is, compliance and follow customers of high contact service providers the instructions and guidance. In this paper, a model based on Bandura social - Cognitive theory has Provided to customer compliance . According Bandura social - Cognitive theory and t...
Adlung, R.; Carzaniga, A.
The potential for trade in health services has expanded rapidly in recent decades. More efficient communication systems have helped to reduce distance-related barriers to trade; rising incomes and enhanced information have increased the mobility of patients; and internal cost pressures have led various governments to consider possibilities for increased private participation. As yet, however, health services have played only a modest role in the General Agreement on Trade in Services (GATS). ...
... RESEARCH MISCONDUCT Definitions § 93.220 Public Health Service or PHS. Public Health Service or PHS means... 42 Public Health 1 2010-10-01 2010-10-01 false Public Health Service or PHS. 93.220 Section 93.220 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS...
Full Text Available Mary-Louise Jung1, Karla Loria11Division of Industrial Marketing, e-Commerce and Logistics, Lulea University of Technology, SwedenObjective: To investigate older people’s acceptance of e-health services, in order to identify determinants of, and barriers to, their intention to use e-health.Method: Based on one of the best-established models of technology acceptance, Technology Acceptance Model (TAM, in-depth exploratory interviews with twelve individuals over 45 years of age and of varying backgrounds are conducted.Results: This investigation could find support for the importance of usefulness and perceived ease of use of the e-health service offered as the main determinants of people’s intention to use the service. Additional factors critical to the acceptance of e-health are identified, such as the importance of the compatibility of the services with citizens’ needs and trust in the service provider. Most interviewees expressed positive attitudes towards using e-health and find these services useful, convenient, and easy to use.Conclusion: E-health services are perceived as a good complement to traditional health care service delivery, even among older people. These people, however, need to become aware of the e-health alternatives that are offered to them and the benefits they provide.Keywords: health services, elderly, technology, Internet, TAM, patient acceptance, health-seeking behavior
Green, Jennifer Greif; Johnson, Renee M.; Dunn, Erin C.; Lindsey, Michael; Xuan, Ziming; Zaslavsky, Alan M.
Background: Violence-exposed youth rarely receive mental health services, even though exposure increases risk for academic and psychosocial problems. This study examines the association between violence exposure and mental health service contact. The 4 forms of violence exposure were peer, family, sexual, and witnessing. Methods: Data are from…
Thompson, Tess; Kreuter, Matthew W.; Boyum, Sonia
Members of vulnerable populations have heightened needs for health services. One advantage of integrating health risk assessment and referrals into social service assistance systems such as 2-1-1 is that such systems help callers resolve problems in other areas (e.g., housing). Callers to 2-1-1 in Missouri (N = 1,090) with at least one behavioral…
Keune, Hans; Oosterbroek, Bram; Derkzen, Marthe; Subramanian, Suneetha; Payyappalimana, Unnikrishnan; Martens, Pim; Huynen, Maud; Burkhard, Benjamin; Maes, Joachim
The practice of mapping ecosystem services (ES) in relation to health outcomes is only in its early developing phases. Examples are provided of health outcomes, health proxies and related biophysical indicators. This chapter also covers main health mapping challenges, design options and
万方荣; 卢祖洵; 张金隆
Summary: Based on a survey of community health service organization in several cities, communi-ty health service model based on the family clinic was compared with state-owned communityhealth service model, and status quo, advantages and problems of family community health serviceorganization were analyzed. Furthermore, policies for the management of community health ser-vice organization based on the family clinic were put forward.
Jung, Mary-Louise; Loria, Karla
Objective: To investigate older people’s acceptance of e-health services, in order to identify determinants of, and barriers to, their intention to use e-health. Method: Based on one of the best-established models of technology acceptance, Technology Acceptance Model (TAM), in-depth exploratory interviews with twelve individuals over 45 years of age and of varying backgrounds are conducted. Results: This investigation could find support for the importance of usefulness and perceived ease of use of the e-health service offered as the main determinants of people’s intention to use the service. Additional factors critical to the acceptance of e-health are identified, such as the importance of the compatibility of the services with citizens’ needs and trust in the service provider. Most interviewees expressed positive attitudes towards using e-health and find these services useful, convenient, and easy to use. Conclusion: E-health services are perceived as a good complement to traditional health care service delivery, even among older people. These people, however, need to become aware of the e-health alternatives that are offered to them and the benefits they provide. PMID:21289860
Full Text Available Background and objectives : Health Services cost analyzing is an important management tool for evidence-based decision making in health system. This study was conducted with the purpose of cost analyzing and identifying the proportion of different factors on total cost of health services that are provided in urban health centers in Tabriz. Material and Methods : This study was a descriptive and analytic study. Activity Based Costing method (ABC was used for cost analyzing. This cross–sectional survey analyzed and identified the proportion of different factors on total cost of health services that are provided in Tabriz urban health centers. The statistical population of this study was comprised of urban community health centers in Tabriz. In this study, a multi-stage sampling method was used to collect data. Excel software was used for data analyzing. The results were described with tables and graphs. Results : The study results showed the portion of different factors in various health services. Human factors by 58%, physical space 8%, medical equipment 1.3% were allocated with high portion of expenditures and costs of health services in Tabriz urban health centers. Conclusion : Based on study results, since the human factors included the highest portion of health services costs and expenditures in Tabriz urban health centers, balancing workload with staff number, institutionalizing performance-based management and using multidisciplinary staffs may lead to reduced costs of services.
The successful implementation and operation of health care networks and the efficient and effective provision of health care services is dependent upon a number of different factors: Telecommunications infrastructure and technology, medical applications and services, user acceptance, education and training, product and applications/services development and service provision aspects. The business model and market development regarding policy and legal issues also must be considered in the development and deployment of telemedicine services to become an everyday practice. This chapter presents the initiatives, role and contribution of the Greek Telecommunications Company in the health care services area and also refers to specific case-studies focusing upon the key factors and issues of applications related to the telecommunications, informatics, and health care sectors, which can also be the drivers to create opportunities for Citizens, Society and the Industry.
Crotty, Bradley H; Slack, Warner V
Patients are increasingly interacting with their healthcare system through online health services, such as patient portals and telehealth programs. Recently, Shabrabani and Mizrachi provided data outlining factors that are most important for users or potential users of these online services. The authors conclude convincingly that while online health services have great potential to be helpful to their users, they could be better designed. As patients and their families play an increasingly active role in their health care, online health services should be made easier for them to use and better suited to their health-related needs. Further, the online services should be more welcoming to people of all literacy levels and from all socioeconomic backgrounds.
Chen, Alice W; Kazanjian, Arminée; Wong, Hubert
Data from the Canadian Community Health Survey Cycle 1.1 showed that Chinese immigrants to Canada and Chinese individuals born in Canada were less likely than other Canadians to have contacted a health professional for mental health reasons in the previous year in the province of British Columbia. The difference persisted among individuals at moderate to high risk for depressive episode. Both immigrant and Canadian-born Chinese showed similar characteristics of mental health service use. The demographic and health factors that significantly affected their likelihood to consult mental health services included Chinese language ability, restriction in daily activities, frequency of medical consultations, and depression score. Notwithstanding lower levels of mental illness in ethnic Chinese communities, culture emerged as a major factor explaining differences in mental health consultation between Chinese and non-Chinese Canadians.
Krumm, Silvia; Becker, Thomas
User involvement in mental health services research is discussed in Great Britain, and a number of user-led research initiatives can be found. In Germany, less attention is paid to the concept while virtually no initiatives can be found. The concept of user involvement is introduced by reviewing the relevant literature. After discussion of theoretical and methodological implications, practicability of the concept for mental health services research is illustrated by some examples from Great Britain. User involvement in mental health services may promote the provision of user focused services. User involvement aims at the empowerment of mental health service users and can also improve the quality of mental health services research. Frequently, user-led/collaborative studies are focused on mental health service assessment. Some problematic aspects (e. g. representativeness, knowledge/skills of users) are discussed. Although more research is needed to document the additional benefit of user involvement in mental health services research it is conceivable that the concept will gain in importance.
Full Text Available The aim of this paper is to give a short description of the most important developments of mental health services in Finland during the 1990s, examine their influences on the organisation and provision of services, and describe shortly some national efforts to handle the new situation. The Finnish mental health service system experienced profound changes in the beginning of the 1990s. These included the integration of mental health services, being earlier under own separate administration, with other specialised health services, decentralisation of the financing of health services, and de-institutionalisation of the services. The same time Finland underwent the deepest economic recession in Western Europe, which resulted in cut-offs especially in the mental health budgets. Conducting extensive national research and development programmes in the field of mental health has been one typically Finnish way of supporting the mental health service development. The first of these national programmes was the Schizophrenia Project 1981–97, whose main aims were to decrease the incidence of new long-term patients and the prevalence of old long-stay patients by developing an integrated treatment model. The Suicide Prevention Project 1986–96 aimed at raising awareness of this special problem and decreasing by 20% the proportionally high suicide rate in Finland. The National Depression Programme 1994–98 focused at this clearly increasing public health concern by several research and development project targeted both to the general population and specifically to children, primary care and specialised services. The latest, still on-going Meaningful Life Programme 1998–2003 which main aim is, by multi-sectoral co-operation, to improve the quality of life for people suffering from or living with the threat of mental disorders. Furthermore, the government launched in 1999 a new Goal and Action Programme for Social Welfare and Health Care 2000–2003, in
Largo-Wight, Erin; Chen, W William; Dodd, Virginia; Weiler, Robert
Cultivating healthy workplaces is a critical aspect of comprehensive worksite health promotion. The influence of healthy workplace exposures on employee health outcomes warrants research attention. To date, it is unknown if nature contact in the workplace is related to employee stress and health. This study was designed to examine the effects of nature contact experienced at work on employee stress and health. Office staff at a southeastern university (n = 503, 30% response rate) participated in the cross-sectional study. We used a 16-item workplace environment questionnaire, the Nature Contact Questionnaire, to comprehensively measure, for the first time, nature contact at work. The Perceived Stress Questionnaire and 13 established health and behavioral items assessed the dependent variables, general perceived stress, stress-related health behaviors, and stress-related health outcomes. There was a significant, negative association between nature contact and stress and nature contact and general health complaints. The results indicate that as workday nature contact increased, perceived stress and generalized health complaints decreased. The findings suggest that nature contact is a healthy workplace exposure. Increasing nature contact at work may offer a simple population-based approach to enhance workplace health promotion efforts. Future researchers should test the efficacy of nature-contact workplace stress interventions.
Goodwin, John; Cummins, John; Behan, Laura; O'Brien, Sinead M
Current mental health policy emphasises the importance of service user involvement in the delivery of care. Information Technology can have an effect on quality and efficiency of care. The aim of this study is to gain the viewpoint of service users from a local mental health service in developing a mental health app. A qualitative descriptive approach was used. Eight volunteers aged 18-49 years were interviewed with the aid of a semi-structured questionnaire. Interviewees defined a good app by its ease of use. Common themes included availability of contact information, identifying triggers, the ability to rate mood/anxiety levels on a scale, guided relaxation techniques, and the option to personalise the app. The researchers will aim to produce an app that is easily accessible, highly personalisable and will include functions highlighted as important (i.e. contact information, etc.). This research will assist in the development of an easy-to-use app that could increase access to services, and allow service users to take an active role in their care. In previous studies, apps were developed without the involvement of service users. This study recognises the important role of service users in this area.
Mariana A. P. Souza
Full Text Available Objective: This paper describes the development of the Protocol for Identification of Problems for Rehabilitation (PLPR, a tool to standardize collection of functional information based on the International Classification of Functioning, Disability and Health (ICF. Development of the protocol : The PLPR was developed for use during the initial contact with adult patients within a public network of rehabilitation services. Steps to develop the protocol included: survey of the ICF codes most used by clinical professionals; compilation of data from functional instruments; development and pilot testing of a preliminary version in the service settings; discussion with professionals and development of the final version. The final version includes: user identification; social and health information; brief functional description (BFD; summary of the BFD; and PLPR results. Further testing of the final version will be conducted. Conclusions: The protocol standardizes the first contact between the user and the rehabilitation service. Systematic use of the protocol could also help to create a functional database that would allow comparisons between rehabilitation services and countries over time.
Souza, Mariana A. P.; Ferreira, Fabiane R.; César, Cibele C.; Furtado, Sheyla R. C.; Coster, Wendy J.; Mancini, Marisa C.; Sampaio, Rosana F.
Objective: This paper describes the development of the Protocol for Identification of Problems for Rehabilitation (PLPR), a tool to standardize collection of functional information based on the International Classification of Functioning, Disability and Health (ICF). Development of the protocol: The PLPR was developed for use during the initial contact with adult patients within a public network of rehabilitation services. Steps to develop the protocol included: survey of the ICF codes most used by clinical professionals; compilation of data from functional instruments; development and pilot testing of a preliminary version in the service settings; discussion with professionals and development of the final version. The final version includes: user identification; social and health information; brief functional description (BFD); summary of the BFD; and PLPR results. Further testing of the final version will be conducted. Conclusions: The protocol standardizes the first contact between the user and the rehabilitation service. Systematic use of the protocol could also help to create a functional database that would allow comparisons between rehabilitation services and countries over time. PMID:26786075
Full Text Available Companion animals play an important role in our society. However, pregnant women and new mothers might have specific concerns about animal-associated health outcomes because of their altered immune function and posture as well as their newborn babies. The study was conducted to collect baseline data for developing an evidence-based intervention for pregnant women and new mothers to help them adopt certain behaviors to prevent adverse animal-associated health outcomes. A survey, using the Health Belief Model as the theoretical framework, was developed and administered to 326 women attending the Women, Infants, and Children programs in Illinois and Indiana in 2015. Prevalence of dog and cat ownership was estimated to be 39% (95% CI 33%–45% and 26% (95% CI 21%–31%, respectively. Regardless of pet ownership, 74% of the respondents reported having some type of animal contact in the past month. Pregnancy or the birth of a child altered some animal contact practices among the study participants; particularly a discontinuation or decrease in cleaning cat litter boxes. Reports of diseases contracted from animals were low (4% in this study. By contrast, animal-associated injuries were prevalent (42%, and the majority were caused by animals the respondents owned (56%. Overall, respondents indicated that they appreciated the benefits of a program addressing animal-associated health outcomes and did not indicate strong resistance to adopting certain behaviors. The majority recognized human health-care providers as a source of information about animal contact and associated health outcomes but less frequently identified veterinarians as a source for such information. In addition, although most of the respondents felt that health-care providers and veterinarians should initiate discussions about preventing animal-associated illness and injuries, only 41% among those who had visited doctors or prenatal care services reported that their health-care providers
Lusi Herawati Sunyoto Usman Mark Zuidgeest
Full Text Available Equitable health care is a basic right for citizens and must be fulfilled by the government. This research analyzed communitydiscrepancy in access to reach health services in public hospitals and Puskesmas (health centers in Banyuwangi Regency.This research identified community accessibility to health facilities services using travel time and transport modes choiceas indicators. Flowmap tool is used to analyze catchment area of each health facility using different transport modes choice:becak and public transport for poor group and motorcycle and car for non-poor group with different travel time within 30, 60 and more than 60 minutes. It is concluded that there was an accessibility difference between poor and non-poor group. The accessibility to the health facilities of poor group was lower than non-poor group. This condition occurred because the government policy of equitable access to health service facility did not pay attention to accessibility of poor group.
Jepson, Lisa; Juszczak, Linda; Fisher, Martin
Describes the mental-health and medical services provided at a high-school-based service center. Five years after the center's inception mental health visits had quadrupled. One third of students utilizing the center reported substance abuse within their family. Other reasons for center use included pregnancy, suicidal ideation, obesity,…
Perrott, Bruce E
This article will explore the concept and meaning of codesign as it applies to the delivery of health services. The results of a pilot study in health codesign will be used as a research based case discussion, thus providing a platform to suggest future research that could lead to building more robust knowledge of how the consumers of health services may be more effectively involved in the process of developing and delivering the type of services that are in line with expectations of the various stakeholder groups.
Adlung, R; Carzaniga, A
The potential for trade in health services has expanded rapidly in recent decades. More efficient communication systems have helped to reduce distance-related barriers to trade; rising incomes and enhanced information have increased the mobility of patients; and internal cost pressures have led various governments to consider possibilities for increased private participation. As yet, however, health services have played only a modest role in the General Agreement on Trade in Services (GATS). It is possible that Members of the World Trade Organization have been discouraged from undertaking access commitments by the novelty of the Agreement, coordination problems between relevant agencies, widespread inexperience in concepts of services trade, a traditionally strong degree of government involvement in the health sector, and concerns about basic quality and social objectives. However, more than five years have passed since GATS entered into force, allowing hesitant administrations to familiarize themselves with its main elements and its operation in practice. The present paper is intended to contribute to this process. It provides an overview of the basic structure of GATS and of the patterns of current commitments in health services and of limitations frequently used in this context. The concluding section discusses possibilities of pursuing basic policy objectives in a more open environment and indicates issues that may have to be dealt with in current negotiations on services.
Fuller Jeffrey D
Full Text Available Abstract Background Farmers represent a subgroup of rural and remote communities at higher risk of suicide attributed to insecure economic futures, self-reliant cultures and poor access to health services. Early intervention models are required that tap into existing farming networks. This study describes service networks in rural shires that relate to the mental health needs of farming families. This serves as a baseline to inform service network improvements. Methods A network survey of mental health related links between agricultural support, health and other human services in four drought declared shires in comparable districts in rural New South Wales, Australia. Mental health links covered information exchange, referral recommendations and program development. Results 87 agencies from 111 (78% completed a survey. 79% indicated that two thirds of their clients needed assistance for mental health related problems. The highest mean number of interagency links concerned information exchange and the frequency of these links between sectors was monthly to three monthly. The effectiveness of agricultural support and health sector links were rated as less effective by the agricultural support sector than by the health sector (p Conclusion Aligning with agricultural agencies is important to build effective mental health service pathways to address the needs of farming populations. Work is required to ensure that these agricultural support agencies have operational and effective links to primary mental health care services. Network analysis provides a baseline to inform this work. With interventions such as local mental health training and joint service planning to promote network development we would expect to see over time an increase in the mean number of links, the frequency in which these links are used and the rated effectiveness of these links.
Ana Caroline Gonçalves Cavalcante
Full Text Available This descriptive, exploratory and qualitative study was performed with the objective to evaluate the structure of the Mental Health Service Network of the Municipal Health Department of Goiania, the capital city of Goias state, Brazil. Data were collected using a semi-structured instrument and photographic records, and analyzed using Atlas.ti 6.2, and based on Donabedian’s theoretical framework. Various conditions were observed for service facilities; from structures that were precarious and unsuitable for therapy, to facilities that were welcoming and had good accessibility. The main positive aspect was the diversity of multidisciplinary teams. Making service facilities appropriate is imperative, although it is recognized that the municipality is currently undergoing reformulation, aiming at meeting the needs of the National Policy for Mental Health. Furthermore, intersectoral partnerships should be established for evaluation processes, particularly in the academia and service domains, which could generate the desired impact on health care to clients of specialized services. Descriptors: Health Services Evaluation; Mental Health; Structure of Services.
Full Text Available Abstract Background Health workers’ attitudes toward immigrant patients influence behaviour, medical decisions, quality of care and health outcomes. Despite the increasing number of immigrant patients in health services and the potential influence of health workers’ attitudes, there is little research in this area. This study aimed to examine attitudes of different health workers’ groups toward immigrant patients and to identify the associated factors. Methods This cross-sectional study was conducted with a random sample of 400 health workers from primary health care services in the Lisbon region, Portugal. Among those, 320 completed a structured questionnaire. Descriptive analysis and multiple linear regression analysis were used for the evaluation of data. Results Most participants did not agree that immigrant patients tend to behave like victims, but about half considered that some are aggressive and dangerous. Doctors and nurses showed more positive attitudes than office workers. Among doctors, the older ones reported less positive attitudes compared to the younger ones. Health workers who have less daily contact with immigrants revealed more positive attitudes. Most participants evaluated their knowledge and competencies to work with immigrants as moderate or low. Conclusions Although health workers reveal positive attitudes, this study reinforces the need to develop strategies that prevent negative attitudes and stereotyping in health services. Efforts should be made to improve workers’ competencies to deal with culturally diverse populations, in order to promote quality of health care and obtain positive health outcomes among immigrant populations.
Leskinen, Salme; Häyrinen, Kristiina; Saranto, Kaija; Ensio, Anneli
It is often said that we are living in an information society and information technology (IT) is a normal part of life in many fields. But IT is not used effectively in health care. The purpose of this study was to survey what kind of Internet-based health services and related electronic services are offered to clients by the web-pages of health care organizations in Finland.
Full Text Available Abstract Background Health care system reform is a major issue in many countries and therefore how to evaluate the effects of changes is incredibly important. This study measured residents’ satisfaction with community health care service in Shanghai, China, and aimed to evaluate the effect of recent health care system reform. Methods Face-to-face interviews were performed with a stratified random sample of 2212 residents of the Shanghai residents using structured questionnaires. In addition, 972 valid responses were retrieved from internet contact. Controlling for sex, age, income and education, the study used logistic regression modeling to analyze factors associated with satisfaction and to explain the factors that affect the residents’ satisfaction. Results Comparing current attitudes with those held at the initial implementation of the reform in this investigation, four dimensions of health care were analyzed: 1 the health insurance system; 2 essential drugs; 3 basic clinical services; and 4 public health services. Satisfaction across all dimensions improved since the reform was initiated, but differences of satisfaction level were found among most dimensions and groups. Residents currently expressed greater satisfaction with clinical service (average score=3.79, with 5 being most satisfied and the public health/preventive services (average score=3.62; but less satisfied with the provision of essential drugs (average score=3.20 and health insurance schemes (average score=3.23. The disadvantaged groups (the elderly, the retired, those with only an elementary education, those with lower incomes had overall poorer satisfaction levels on these four aspects of health care (P Conclusion The respondents showed more satisfaction with the clinical services (average score=3.79 and public health services/interventions (average score=3.79; and less satisfaction with the health insurance system (average score=3.23 and the essential drug system
Rest, K M
In the rush to capture new segments of the health care market, occupational health services have become an attractive "product line" for some provider groups. However, providers may not appreciate the significant ethical dimensions of delivering occupational health services. The environment of the workplace gives rise to competing goals, interests, and expectations and creates thorny ethical issues for health care providers. It is important that providers develop a framework for recognizing and addressing these ethical issues and the influence of their own and other parties' values on their decision-making processes.
Furukawa, Shunichi; Fujieda, Yumiko; Shimizu, Kimiko; Ishibashi, Aya; Eguchi, Satoshi
Outreach services are very important in community mental health care. There are two types for outreach services. One is mental health activities, such as early intervention and consultation, and the other is intended to prevent recurrence and readmission by supporting the daily living activities of a patient in a community. We have 2.73 psychiatric care beds in hospitals per 1,000 population. So, it is just the beginning in changing from hospital centered psychiatry to community mental health care. Outreach services are being tried in several places in our country. In this essay, we describe mental health outreach services in Japan and we have illustrated vocational rehabilitation and outreach job support in our day treatment program.
Evaluation of Aboriginal Health Services (AHSs) has become a topic of importance to service providers and governments in recent years. This paper examines some of the difficulties AHSs have in conducting evaluation and presents an example of an inappropriate evaluation methodology as proposed by the Commonwealth Department of Aboriginal Affairs (DAA) in 1986. The paper examines the contradictory nature of the DAA proposal and the mistrust it has engendered in many AHSs. It then highlights some of the political difficulties in developing meaningful national and community health objectives as a basis for sound evaluation of health services. The paper concludes by identifying some of the processes whereby more appropriate evaluation methodologies might be developed and suggests that negotiation and consultation with the Aboriginal communities and their health services are imperative to successful evaluation.
Kulyk, Olga Anatoliyivna
In oktober heeft een workshop 'Kwaliteitseisen Digitale Hulpverlening in het Kader van e-health Sense' plaatsgevonden tijdens de digitale leerweek van Soa Aids Nederland en V&VN. Tijdens een focusgroepdiscussie met sociaal-verpleegkundigen seksuele gezondheid kwamen vragen aan de orde over het
... HUMAN SERVICES Health Resources and Services Administration Agency Information Collection Activities... and Services Administration (HRSA) publishes periodic summaries of proposed projects being developed...: The Health Resources and Services Administration (HRSA) plans to conduct a survey of the...
Danielsen, Solveig; Centeno, Julio; López, Julio
Establishing a few community-based plant clinics in Nicaragua led to a series of innovations in plant health service delivery. A grassroots experiment became a nationwide initiative involving local service providers, universities, research institutions and diagnostic laboratories. This led to the...
Palmieri, Giovanni; D'Amore, Carlo; Cecchetti, Rita; Bonamoneta, Nadia; Gonnella, Maria Antonietta; Moio, Margherita; Paoletti, Stefania; Vendetti, Stefania; Schiavella, Rita; Picardi, Angelo
Many patients drop-out from treatment after a single contact; however, characteristics have only rarely been investigated. We aimed at estimating the frequency of early drop-out and identifying possible risk factors. The study was performed at the Palestrina Mental Health Centre, located near Rome, Italy. The clinical charts of all first-time attenders who did not come back during a 7-year index period (2000-2006) were reviewed and information was collected on sociodemographic factors, psychiatric history, clinical presentation, and process of care. During the index period, 97 of 1.001 first-time attenders dropped out after the first contact. We excluded patients with symptoms of organic (N = 9) or severe mental disorders (N = 3). Of the remaining 85 patients, 49 presented with symptoms related to life events or situations ("reactive symptoms", RS), while 36 had "non-reactive symptoms" (NRS). Eighty-five randomly selected patients with comparable conditions (psychogenic reaction; anxiety, dysthymic or somatoform disorder; ICD-9 code 300.x, 308.x, 309.x) who came back to visit were included as controls. First-only contact patients tended to present with RS more often (58% vs. 43%) than controls. Therefore, the analyses were stratified for reactivity of symptoms. Among patients with NRS, first-only contact patients tended to be younger than controls. Among patients with RS, time until the next appointment tended to be longer in first-only contact patients than in controls. No other differences were observed between first-only contact patients and controls on sociodemographic variables, source of referral, and previous treatment history. The occurrence of early drop-out was relatively low. The higher prevalence of RS among first-only contact patients may suggest a greater disposition towards conflict or ambivalence in interpersonal situations. Patient-perceived service availability, in the form of shorter appointment delay, seems to promote maintenance of contact
Purcell, Rachael; McGirr, Joe
To determine health service managers' (HSMs) recommendations on strengthening the health service response to climate change. Self-administered survey in paper or electronic format. Rural south-west of New South Wales. Health service managers working in rural remote metropolitan areas 3-7. Proportion of respondents identifying preferred strategies for preparation of rural health services for climate change. There were 43 participants (53% response rate). Most respondents agreed that there is scepticism regarding climate change among health professionals (70%, n = 30) and community members (72%, n = 31). Over 90% thought that climate change would impact the health of rural populations in the future with regard to heat-related illnesses, mental health, skin cancer and water security. Health professionals and government were identified as having key leadership roles on climate change and health in rural communities. Over 90% of the respondents believed that staff and community in local health districts (LHDs) should be educated about the health impacts of climate change. Public health education facilitated by State or Federal Government was the preferred method of educating community members, and education facilitated by the LHD was the preferred method for educating health professionals. Health service managers hold important health leadership roles within rural communities and their health services. The study highlights the scepticism towards climate change among health professionals and community members in rural Australia. It identifies the important role of rural health services in education and advocacy on the health impacts of climate change and identifies recommended methods of public health education for community members and health professionals. © 2017 National Rural Health Alliance Inc.
... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration Statement of Organization, Functions and Delegations of Authority; Correction AGENCY: Health Resources and Services Administration (HRSA), HHS....
Contact lenses are a convenient and effective alternative to traditional eye glasses, but improper care and use can result in severe damage to the eyes. In this podcast, Dr. Jennifer Cope discusses the importance of proper care and use of contact lenses. Created: 8/18/2016 by MMWR. Date Released: 8/18/2016.
Contact lenses can be a comfortable and convenient alternative to traditional eye glasses, but without proper care, they can cause severe eye problems. In this podcast, Sarah Collier discusses the importance of proper maintenance of contact lenses. Created: 11/20/2014 by MMWR. Date Released: 11/20/2014.
Keratitis is a serious, sometimes blinding, eye infection often associated with poor contact lens hygiene. This podcast discusses healthy ways to care for your contact lenses. Created: 11/20/2014 by MMWR. Date Released: 11/20/2014.
For millions of Americans, contact lenses are a popular alternative to glasses. If not properly worn and cared for, they can put wearers at risk for eye infections. This podcast discusses proper care for contact lenses. Created: 9/3/2015 by MMWR. Date Released: 9/3/2015.
Contact lenses are a convenient alternative to glasses, but improper care and use can result in infections which can lead to eye damage. This podcast discusses contact lens safety. Created: 8/18/2016 by MMWR. Date Released: 8/18/2016.
Coutts, Christopher; Hahn, Micah
Contemporary ecological models of health prominently feature the natural environment as fundamental to the ecosystem services that support human life, health, and well-being. The natural environment encompasses and permeates all other spheres of influence on health. Reviews of the natural environment and health literature have tended, at times intentionally, to focus on a limited subset of ecosystem services as well as health benefits stemming from the presence, and access and exposure to, green infrastructure. The sweeping influence of green infrastructure on the myriad ecosystem services essential to health has therefore often been underrepresented. This survey of the literature aims to provide a more comprehensive picture-in the form of a primer-of the many simultaneously acting health co-benefits of green infrastructure. It is hoped that a more accurately exhaustive list of benefits will not only instigate further research into the health co-benefits of green infrastructure but also promote consilience in the many fields, including public health, that must be involved in the landscape conservation necessary to protect and improve health and well-being.
The general conditions influencing the quality assurance and audit in Polish occupational health services are presented. The factors promoting or hampering the implementation of quality assurance and audits are also discussed. The major influence on the transformation of Polish occupational health services in exorted by employers who are committed to cover the costs of the obligatory prophylactic examination of their employees. This is the factor which also contributes to the improvement of quality if services. The definitions of the most important terms are reviewed to highlight their accordance with the needs of occupational health services in Poland. The examples of audit are presented and the elements of selected methods of auditing are suggested to be adopted in Poland.
... 42 Public Health 1 2010-10-01 2010-10-01 false Health Service Delivery Areas. 136a.15 Section 136a... Receive Care? § 136a.15 Health Service Delivery Areas. (a) The Indian Health Service will designate and... Federal Indian reservations and areas surrounding those reservations as Health Service Delivery Areas....
Tao, Donghua; McCarthy, Patrick G; Krieger, Mary M; Webb, Annie B
The School of Public Health at Saint Louis University is located at a greater distance from the library than other programs on the main medical center campus. Physical distance diminishes the ease of access to direct reference services for public health users. To bridge the gap, the library developed the Mobile Reference Service to deliver on-site information assistance with regular office hours each week. Between September 2006 and April 2007, a total of 57 in-depth reference transactions took place over 25 weeks, averaging 2 transactions per week in a 2-hour period. Overall reference transactions from public health users went up 28%, while liaison contacts with public health users doubled compared to the same period the year before. The Mobile Reference Service program has improved library support for research and scholarship, cultivated and strengthened liaison relationships, and enhanced marketing and delivery of library resources and services to the Saint Louis University School of Public Health.
Full Text Available One of the main objectives of military health services is to prevent suffering, injuries and death caused by wars which lead to great destructions on societies as much as possible. If the subject is considered for Turkish history, it is noted that personnel and duty processes of health services had an institutional feature and that duty was controlled by the government at Ottoman Empire. Public health practices, as a main component of military health services at both peace and war, has great importance. These practices should be determined thoroughly at peacetime by managers and preparations in that direction should be done and implemented. [TAF Prev Med Bull 2012; 11(1.000: 103-118
Ameri, Cinzia; Fiorini, Fulvio
The marketing mix is the combination of the marketing variables that a firm employs with the purpose to achieve the expected volume of business within its market. In the sale of goods, four variables compose the marketing mix (4 Ps): Product, Price, Point of sale and Promotion. In the case of providing services, three further elements play a role: Personnel, Physical Evidence and Processes (7 Ps). The marketing mix must be addressed to the consumers as well as to the employees of the providing firm. Furthermore, it must be interpreted as employees ability to satisfy customers (interactive marketing).
In mental health services, the concept of health is often perceived, from a biomedical perspective, as the absence of disease, involving several negative consequences together with a lack of systematic health-promoting activities. The subjective experiences of health among patients in mental health services are crucial to reinforce the experience of health throughout different phases of life. Positive dimensions of health include interaction between the individual and the environment, subjective experience of individual power as well as possibilities to influence important aspects of the life situation. The aim of the study was to describe and compare attitudes to health among patients and staff in mental health services in terms of the importance of health as measured by the attitude version of the Health Questionnaire. A cross-sectional study including a randomly selected sample of 141 outpatients in contact with the mental health services and 140 mental health staff was performed. Patients and staff share most attitudes towards health, which indicates that health is a concept that applies to human beings irrespective of mental disease in the context of mental health services. The possibility to be able to define, measure, and compare positive dimensions of health may be important in the attempts to divert the focus towards one that promotes health and resources in mental health services and away from one on illness and deficits.
Bernstein, Matthew T; Walker, John R; Chhibba, Tarun; Ivekovic, Melony; Singh, Harminder; Targownik, Laura E; Bernstein, Charles N
We aimed to explore factors associated with health service utilization and preference for services, including alternatives to attending the emergency department (ED) when experiencing mild to moderate or severe symptoms. A total of 1143 persons (46% response rate) aged 18 to 65 years in the population-based University of Manitoba IBD Research Registry participated in the survey. Although 61% had a gastroenterologist, when experiencing active symptoms, only 29% felt they could call their gastroenterologist for an urgent appointment, and 42% could call their gastroenterologist for telephone advice. Nine percent of the respondents visited the ED in the previous year. If having severe symptoms, 48% said that they would attend the ED. Visits to the ED were related to higher bowel symptom severity and high health anxiety. When experiencing severe symptoms, women, persons with Crohn's disease and those with high health anxiety, indicated that they would be more likely to use the ED. Considering services which could be available in the future respondents indicated that if acutely symptomatic they would be very likely or likely to use the following services: phone contact with inflammatory bowel disease nurse (77%), phone contact with a gastroenterologist (75%), and going to a walk-in gastroenterology clinic (71%). Persons with inflammatory bowel disease are receptive to options other than the ED when experiencing inflammatory bowel disease symptoms; however, attending the ED remains a prominent choice. Improved access to specialized care may improve timeliness of care and reduce ED attendance. Future research should include the impact of health anxiety on health care utilization.
Maas, J.; Dillen, S.M.E. van; Verheij, R.A.; Groenewegen, P.P.
This study explored whether social contacts are an underlying mechanism behind the relationship between green space and health. We measured social contacts and health in 10,089 residents of the Netherlands and calculated the percentage of green within 1 and a 3 km radius around the postal code coord
Maas, J.; Dillen, S.M.E. van; Verheij, R.A.; Groenewegen, P.P.
Abstract This study explored whether social contacts are an underlying mechanism behind the relationship between green space and health. We measured social contacts and health in 10,089 residents of the Netherlands and calculated the percentage of green within 1 and a 3 km radius around the postal c
Conner, Jerusha; Erickson, Joseph
Service-learning experiences have the potential to improve participants' attitudes and values toward those whom they serve, but if the experience is poorly designed or poorly implemented, it runs the risk of reinforcing stereotypes and deficit perspectives of the intended beneficiaries of service. This study examines the extent to which Contact…
For millions of Americans, contact lenses are an effective form of vision correction and a popular alternative to glasses. However, if not properly worn and cared for, they can put wearers at risk for eye infections. In this podcast, Dr. Jennifer Cope discusses the importance of proper contact lens care. Created: 9/3/2015 by MMWR. Date Released: 9/3/2015.
Joan E Mackintosh
Full Text Available OBJECTIVES: To identify the reasons why individuals contact, or delay contacting, emergency medical services in response to stroke symptoms. DESIGN: Qualitative interview study with a purposive sample of stroke patients and witnesses, selected according to method of accessing medical care and the time taken to do so. Data were analysed using the Framework approach. SETTING: Area covered by three acute stroke units in the north east of England. PARTICIPANTS: Nineteen stroke patients and 26 witnesses who had called for help following the onset of stroke symptoms. RESULTS: Factors influencing who called emergency medical services and when they called included stroke severity, how people made sense of symptoms and their level of motivation to seek help. Fear of the consequences of stroke, including future dependence or disruption to family life, previous negative experience of hospitals, or involving a friend or relations in the decision to access medical services, all resulted in delayed admission. Lack of knowledge of stroke symptoms was also an important determinant. Perceptions of the remit of medical services were a major cause of delays in admission, with many people believing the most appropriate action was to telephone their GP. Variations in the response of primary care teams to acute stroke symptoms were also evident. CONCLUSIONS: The factors influencing help-seeking decisions are complex. There remains a need to improve recognition by patients, witnesses and health care staff of the need to treat stroke as a medical emergency by calling emergency medical services, as well as increasing knowledge of symptoms of stroke among patients and potential witnesses. Fear, denial and reticence to impose on others hinders the process of seeking help and will need addressing specifically with appropriate interventions. Variability in how primary care services respond to stroke needs further investigation to inform interventions to promote best
Jancloes, Michel; Thomson, Madeleine; Costa, María Mánez; Hewitt, Chris; Corvalan, Carlos; Dinku, Tufa; Lowe, Rachel; Hayden, Mary
A high level expert panel discussed how climate and health services could best collaborate to improve public health. This was on the agenda of the recent Third International Climate Services Conference, held in Montego Bay, Jamaica, 4-6 December 2013. Issues and challenges concerning a demand led approach to serve the health sector needs, were identified and analysed. Important recommendations emerged to ensure that innovative collaboration between climate and health services assist decision-making processes and the management of climate-sensitive health risk. Key recommendations included: a move from risk assessment towards risk management; the engagement of the public health community with both the climate sector and development sectors, whose decisions impact on health, particularly the most vulnerable; to increase operational research on the use of policy-relevant climate information to manage climate- sensitive health risks; and to develop in-country capacities to improve local knowledge (including collection of epidemiological, climate and socio-economic data), along with institutional interaction with policy makers.
Solorio, M Rosa; Milburn, Norweeta G; Andersen, Ronald M; Trifskin, Sharone; Rodríguez, Michael A
The Expanded Behavioral Model for Vulnerable Populations was used to examine the predisposing, enabling, and need factors associated with mental health service use in a homeless adolescent sample (N = 688). Among all youth, 32% perceived a need for help with mental health problems and 15% met Brief-Symptom Inventory (BSI) criteria for emotional distress. The rate of mental health service use in our sample was 32%. One enabling factor, having a case manager/discussed mental health concerns, and one need factor, which met criteria for BSI, were found to be associated with mental health service use in the past 3 months. The majority of youth who used mental health services had obtained services from crisis centers. Among those who perceived a need for help with mental health problems but who did not use services, the most common barrier was not knowing where to go or what service to use (57%). These findings suggest that due to the high prevalence of mental health problems among homeless youth, it would be helpful for service providers coming into contact with youth to make them aware of existing community resources for mental health services; making youth aware of these resources may in turn decrease the rate of crisis center use and instead allow youth to receive mental health services in outpatient settings that provide continuity of care.
Campos, Domingos Fernandes; Negromonte Filho, Rinaldo Bezerra; Castro, Felipe Nalon
Purpose The purpose of this paper is to investigate the expectations and quality gaps in services provided at city public health clinics in the city of Natal, Brazil, from the perspective of patients and healthcare service providers. Design/methodology/approach The research sample consisted of 1,200 patients who used public health services and 265 providers - doctors, nutritionists, physiotherapists, psychologists, pharmacists and managers at three health clinics in the city of Natal, Brazil. A scale with 25 health service attributes was used in data collection. Summary statistics and t-test were used to analyze the data. Findings The results show that the providers think that users have lower levels of expectations than those indicated by the users in all attributes. Providers and users have the most approximate insights into what attributes are considered most important: explanations, level of knowledge and attention dispensed by health professionals. Users and providers perceived similar quality gaps for most of the attributes. The gaps were statistically the same, when comparing the mean quality shortcomings by means of a Student's test, considering a significance level of 5 percent, obtained independently by the manifestation of users and providers. Research limitations/implications The results reveal only a photograph of the moment. The study did not consider the differences that may exist between groups with different income levels, genders or age groups. A qualitative study could improve the understanding of the differences and coincidences of the diverse points of views. A more advanced research could even study possibilities so that health managers could promote changes in the service, some of them low cost, as the health professionals training for contact with patients. Practical implications The evaluation of the service quality complemented by the matrix of opportunities, importance × quality gaps generates information to help make decisions in the
Rudolph, L; Deitchman, S; Dervin, K
Despite the human and monetary costs of occupational injury and illness, occupational health care has focused more on treatment than prevention, and prevention is not part of many clinical occupational health practices. This represents a failure of occupational health care to meet the health care needs of the working patients. MEDLINE searches were conducted for literature on occupational medical treatment and the prevention of occupational injury and illness were reviewed to for linkages between prevention and treatment. Policy discussions which identify examples of programs that integrated prevention and treatment were included. Although examples of the integration of clinical and preventive occupational health services exist, there are challenges and barriers to such integration. These include inaction by clinicians who do not recognize their potential role in prevention; the absence of a relationship between the clinician and an employer willing to participate in prevention; economic disincentives against prevention; and the absence of tools that evaluate clinicians on their performance in prevention. Research is needed to improve and promote clinical occupational health preventive services. Copyright 2001 Wiley-Liss, Inc.
Grunberg, L; Moore, S Y; Greenberg, E
This study examined health and well-being among workers who have experienced varying types of contact with layoffs in an organization undergoing downsizing. Using survey data from a large organization employing both white- and blue-collar workers (N = 2,279), the authors argued that there are important differences among surviving workers as a function of their layoff experiences. Having any kind of personal contact with layoffs is found to be associated with less job security, more symptoms of poor health, depression, and eating changes as compared with having no layoff contact. Being laid off and rehired is associated with more work-related injuries and illnesses and missed work days due to such events than is receiving a "warn" notice, indirect contact (i.e., friends or coworkers laid off), or no contact with layoffs. Job security partially mediates the relationship between type of layoff contact experiences and health.
Scotti, Dennis J; Harmon, Joel; Behson, Scott J
This study assesses the importance of customer-contact intensity at the service encounter level as a determinant of service quality assessments. Using data from the U.S. Department of Veterans Affairs, it shows that performance-driven human resources practices play an important role as determinants of employee customer orientation and service capability in both high-contact (outpatient healthcare) and low-contact (benefits claim processing) human service contexts. However, there existed significant differences across service delivery settings in the salience of customer orientation and the congruence between employee and customer perceptions of service quality, depending on the intensity of customer contact. In both contexts, managerial attention to high-performance work systems and customer-orientation has the potential to favorably impact perceptions of service quality, amplify consumer satisfaction, and enhance operational efficiency.
Fazel, Mina; Garcia, Jo; Stein, Alan
Access to needed mental health services can be particularly difficult for newly arrived refugee and asylum-seeking adolescents, although many attend school. This study examined young refugees' impressions and experience of mental health services integrated within the school system. Semi-structured interviews were conducted with 40 adolescent refugees discharged by three school-based mental health services across the United Kingdom. Two-thirds preferred to be seen at school. Rumination and worry about insecurity in the asylum process had a negative impact particularly on the adolescents' social functioning and ability to focus at school. The important role played by teachers in supporting and mediating contact with mental health services was valued by those interviewed. The study confirms that schools offer an important location for mental health services for adolescent refugees and provide an important portal for integration of services.
Green, Jennifer Greif; McLaughlin, Katie A.; Alegria, Margarita; Costello, E. Jane; Gruber, Michael J.; Hoagwood, Kimberly; Leaf, Philip J.; Olin, Serene; Sampson, Nancy A.; Kessler, Ronald C.
Objective: Although schools are identified as critical for detecting youth mental disorders, little is known about whether the number of mental health providers and types of resources that they offer influence student mental health service use. Such information could inform the development and allocation of appropriate school-based resources to…
Almind, G; Holstein, B E; Holst, E;
The study describes health, social situation, and contact with general practitioners in a random sample of non-institutionalized persons 70-95 years old in Denmark. There was a strong correlation between health and contact with general practitioners. A small group, 3% of the respondents, had...... no health problems, but had been in contact with a general practitioner within the previous month. This group was characterized by a strong social network and a high degree of life satisfaction. Another small group, including 3% of the respondents, had extensive health problems, but had nevertheless...
Villalba, E.; Casas, I.; Abadie, F.
Objectives: The deployment and adoption of Integrated Personal Health and Care Services in Europe has been slow and fragmented. There have been many initiatives and projects of this kind in different European regions, many of which have not gone beyond the pilot stage. We investigated the necessary...... conditions for mainstreaming these services into care provision. Methods: We conducted a qualitative analysis of 27 Telehealth, Telecare and Integrated Personal Health System projects, implemented across 20 regions in eight European countries. The analysis was based on Suter’s ten key principles...... for successful health systems integration. Results: Out of the 27 cases, we focused on 11 which continued beyond the pilot stage. The key facilitators that are necessary for successful deployment and adoption in the European regions of our study are reorganisation of services, patient focus, governance...
Meilman, P W
To provide first-rate services to students, college health services need the best possible staff. Managers and supervisors play a critical role in guiding the work of their employees so as to enhance performance. Reference checks for new employees and regular performance appraisal dialogues for ongoing employees are important tools in this process. The author discusses these issues and suggests formats for reference checks and performance appraisals.
Lopes, P M; Nichols, A W
The concept of a health service district, as a variation of the special tax district, is described and discussed. Tax districts have traditionally been used to support both capital construction (revenue bonds) and operational expenses of single-purpose governmental entities. The health service district, where authorized by state laws, may be used by local areas to subsidize the delivery of ambulatory health care. A particular case, the Ajo-Lukeville Health Service District in Arizona, illustrates what can be accomplished by this mechanism with the cooperation of local residents and outside agencies. Both the process of establishing such a district and the outcome of the Ajo-Lukeville experience is described. Reasons why health service districts may prove potentially attractive at this time are reviewed. Impediments to the development of more health service districts are also explored, including the lack of technical assistance, an inadequate awareness of the potential of health service districts, and the absence of a widespread orientation toward community financed and controlled health care. Movement in this direction should facilitate the development of additional health service districts.
... No: 2012-25192] DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration... Resources and Services Administration (HRSA), Parklawn Building (and via audio conference call), 5600... Service, Health Resources and Services Administration, Parklawn Building, Room 13-64, 5600 Fishers...
Full Text Available We examined the relationship between service use and the number of problem areas as reported by parents and teachers on questionnaires among children aged 7–9 years old in the Bergen Child Study, a total population study including more than 9000 children. A problem area was counted as present if the child scored above the 95th percentile on parent and/or teacher questionnaire. A total number of 13 problem areas were included. Odd ratios (ORs for contact with child and adolescent mental health services (CAMH, school psychology services (SPS, health visiting nurse/physician, and school support were calculated with gender as covariate. The number of symptom areas was highly predictive of service use, showing a dose-response relationship for all services. Children scoring on ≥4 problem areas had a more than hundredfold risk of being in contact with CAMH services compared to children without problems. The mean number of problem areas for children in CAMH and SPS was 6.1 and 4.4 respectively, strongly supporting the ESSENCE model predicting multisymptomatology in children in specialized services. Even after controlling for number of problem areas, boys were twice as likely as girls to be in contact with CAMH, replicating previous findings of female gender being a strong barrier to mental health services.
Campo-Arias, Adalberto; Oviedo, Heidi Celina; Herazo, Edwin
The perceived stigma represents a sociocultural barrier to access mental health services and prevents individuals who meet criteria for a mental disorder the possibility of receiving comprehensive and integred care. To update institutional mechanisms by which stigma related to mental disorders, perceived and perpetrated, acts as a barrier to mental health access. Stigma as a barrier to access to mental health services is due to a reduction in service requests, the allocation of limited resources to mental health, the systematic process of impoverishment of the people who suffer a mental disorder, increased risk of crime, and implications in contact with the legal system, and the invisibility of the vulnerability of these people. Structured awareness and education programs are needed to promote awareness about mental disorders, promote community-based psychosocial rehabilitation, and reintegration into productive life process. In Colombia, the frequency and variables associated with the stigma of mental disorders needs to be studied. This knowledge will enable the implementation of measures to promote the social and labor inclusion of people who meet the criteria for mental disorders. Copyright © 2014 Asociación Colombiana de Psiquiatría. All rights reserved.
Telemedicine is a new adjunct to the delivery of health care services that has been applied to a range of health care specialties, including mental health. When prospective telemedicine programs are planned, telemedicine is often envisaged as simply a question of introducing new technology. The development of a robust, sustainable telemental health program involves clinical, technical, and managerial considerations. The major barriers to making this happen are usually how practitioners and patients adapt successfully to the technology and not in the physical installation of telecommunications bandwidth and the associated hardware necessary for teleconsultation. This article outlines the requirements for establishing a viable telemental health service, one that is based on clinical need, practitioner acceptance, technical reliability, and revenue generation. It concludes that the major challenge associated with the implementation of telemental health does not lie in having the idea or in taking the idea to the project stage needed for proof of concept. The major challenge to the widespread adoption of telemental health is paying sufficient attention to the myriad of details needed to integrate models of remote health care delivery into the wider health care system.
Jocelyne Kane Berman
Full Text Available Despite their numerical superiority women do not occupy positions o f power and authority in the health services generally. This is perceived as being due to a variety of factors which prevent women from realising their ful l potential as managers. In other parts of the world, as well as in South Africa, middle class white males have dominated health services, since medicine became a form al science, usurping the traditional role of women healers. Some research indicates that women are inclined to practice “feminine " management styles. It is suggested that the femine I masculine dichotomy is artificial and that qualities which ensure effective management should not be regarded as genderlinked. Leaders in the health services should strive for interdisciplinary, mixed-gender education and training at all levels. Identification and development of management potential in women health-care professionals, role-modelling and sponsor-mentor relationships should be encouraged to allow women to acquire the full range of management skills and to achieve positions of power and authority in the health services.
Van Hoof, Thomas J; Sherwin, Tierney E; Baggish, Rosemary C; Tacy, Peter B; Meehan, Thomas P
Private schools educate a significant percentage of US children and adolescents. Private schools, particularly where students reside during the academic year, assume responsibility for the health and well-being of their students. Children and adolescents experience mental health problems at a predictable rate, and private schools need a mechanism for addressing their students' mental health needs. Understanding that need requires data to guide the services and programs a school may put in place. Having data helps inform those services, and comparative data from other schools provides feedback and perspective. This project surveyed type and frequency of mental health problems experienced by students who received a formal evaluation at 11 private schools in Connecticut during academic year 2001-2002.
The purpose of this study was to discuss the implementation of nutritional education in public health services from the perspective of health professionals (physicians and nurses) working in them. The study was conducted in the Municipality of Campinas, São Paulo State, Brazil, from October 1993 to July 1995, using action-based research methodology. The results describe the construction of nutritional knowledge in training and professional institutions; behavior towards food-related problems ...
Marcos Paulo Gomes Mol
Full Text Available Abstract Human contact with solid waste poses biological, chemical, and physical health risks for workers involved in waste collection, transportation, and storage. The potential risk to human health resulting from contact with health services waste or household waste still sparks considerable controversy. The aim of this study was to identify the context of scientific discussions on risk/infection from the hepatitis B and C viruses in workers that collect solid waste from health services or households. The search covered publications up to 2013 in Brazilian and international databases, and 11 articles were selected through a literature review. Of these, six conclude that there is an increased risk of infection in workers that collect household waste when compared to those unexposed to waste, three point to greater risk for workers that collect health services waste as compared to those that collect ordinary waste, and the other two found no difference between exposed and unexposed individuals.
El Taguri A
Full Text Available Health services have the functions to define community health problems, to identify unmet needs and survey the resources to meet them, to establish SMART objectives, and to project administrative actions to accomplish the purpose of proposed action programs. For maximum efficacy, health systems should rely on newer approaches of management as management-by-objectives, risk-management, and performance management with full and equal participation from professionals and consumers. The public should be well informed about their needs and what is expected from them to improve their health. Inefficient use of budget allocated to health services should be prevented by tools like performance management and clinical governance. Data processed to information and intelligence is needed to deal with changing disease patterns and to encourage policies that could manage with the complex feedback system of health. e-health solutions should be instituted to increase effectiveness and improve efficiency and informing human resources and populations. Suitable legislations should be introduced including those that ensure coordination between different sectors. Competent workforce should be given the opportunity to receive lifetime appropriate adequate training. External continuous evaluation using appropriate indicators is vital. Actions should be done both inside and outside the health sector to monitor changes and overcome constraints.
Icks, A; Chernyak, N; Bestehorn, K; Brüggenjürgen, B; Bruns, J; Damm, O; Dintsios, C-M; Dreinhöfer, K; Gandjour, A; Gerber, A; Greiner, W; Hermanek, P; Hessel, F; Heymann, R; Huppertz, E; Jacke, C; Kächele, H; Kilian, R; Klingenberger, D; Kolominsky-Rabas, P; Krämer, H; Krauth, C; Lüngen, M; Neumann, T; Porzsolt, F; Prenzler, A; Pueschner, F; Riedel, R; Rüther, A; Salize, H J; Scharnetzky, E; Schwerd, W; Selbmann, H-K; Siebert, H; Stengel, D; Stock, S; Völler, H; Wasem, J; Schrappe, M
On August 30, 2010, the German Network for Health Services Research [Deutsches Netzwerk Versorgungsforschung e. V. (DNVF e. V.)] approved the Memorandum III "Methods for Health Services Research", supported by the member societies mentioned as authors and published in this Journal [Gesundheitswesen 2010; 72: 739-748]. The present paper focuses on methodological issues of economic evaluation of health care technologies. It complements the Memorandum III "Methods for Health Services Research", part 2. First, general methodological principles of the economic evaluations of health care technologies are outlined. In order to adequately reflect costs and outcomes of health care interventions in the routine health care, data from different sources are required (e. g., comparative efficacy or effectiveness studies, registers, administrative data, etc.). Therefore, various data sources, which might be used for economic evaluations, are presented, and their strengths and limitations are stated. Finally, the need for methodological advancement with regard to data collection and analysis and issues pertaining to communication and dissemination of results of health economic evaluations are discussed. © Georg Thieme Verlag KG Stuttgart · New York.
Jensen, Margit Bak; Larsen, Lars Erik
Housing preweaned dairy calves in pairs rather than individually has been found to positively affect behavioral responses in novel social and environmental situations, but concerns have been raised that close contact among very young animals may impair their health. In previous studies, the level...... of social contact permitted in individual housing has been auditory, visual, or physical contact. It is unclear how these various levels of social contact compare with each other and to pair housing, when their effects on behavior and health are considered, and whether the timing of pair housing has...... an effect. To investigate this, 110 Holstein calves (50 males, 60 females) in 11 blocks were paired according to birth date. Within 60 h of birth, each pair of calves was allocated to 1 of 5 treatments: individual housing with auditory contact (I), individual housing with auditory and visual contact (V...
Villalba, E.; Casas, I.; Abadie, F.
Objectives: The deployment and adoption of Integrated Personal Health and Care Services in Europe has been slow and fragmented. There have been many initiatives and projects of this kind in different European regions, many of which have not gone beyond the pilot stage. We investigated the necessa...... of Integrated Personal Health and Care Services in European regions has increased. Further research will reveal the weight of each facilitator and which combinations of facilitators lead to rapid adoption.......Objectives: The deployment and adoption of Integrated Personal Health and Care Services in Europe has been slow and fragmented. There have been many initiatives and projects of this kind in different European regions, many of which have not gone beyond the pilot stage. We investigated the necessary...... conditions for mainstreaming these services into care provision. Methods: We conducted a qualitative analysis of 27 Telehealth, Telecare and Integrated Personal Health System projects, implemented across 20 regions in eight European countries. The analysis was based on Suter’s ten key principles...
Full Text Available The death of the English National Health Service (NHS has been pronounced many times over the years, but the time and cause of death and the murder weapon remains to be fully established. This article reviews some of these claims, and asks for clearer criteria and evidence to be presented.
van 't Klooster, J.W.J.R.
This thesis describes a method to offer personalised healthcare. It is motivated by a desire for more efficient healthcare, as population ages and care demand and costs increase. Developing and testing individually tailored health services using ICT fits in this motivation, as it leads to more
U.S. Department of Health & Human Services — The National Mental Health Services Survey (N-MHSS) is designed to collect information from all specialty mental health facilities in the United States, both public...
LaFleur, E K; Taylor, S L
More than 75% of the female respondents in this study would choose a women's health center (WHC) over a standard health facility. Women who worked outside the home perceived a greater WHC need. And almost all respondents were interested in communications from the center via a quarterly newsletter. Significant test results related to age, income, education, and work status as segmentation variables, offering WHC's an opportunity to target their patients with specialized services such as cosmetic surgery, infertility treatment, breast imaging, etc. If enough resources are allocated, a WHC can design itself to attract highly lucrative patients. Little difference was found in the opinions of women regarding the need for a WHC or the core services desired, but the specific service mix decision must be carefully considered when designing a WHC.
Levy, J S
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.
Lusi Herawati Sunyoto Usman Mark Zuidgeest
as indicators. Flowmap tool is used to analyze catchment area of each health facility using different transport modes choice:becak and public transport for poor group and motorcycle and car for non-poor group with different travel time within 30, 60 and more than 60 minutes. It is concluded that there was an accessibility difference between poor and non-poor group. The accessibility to the health facilities of poor group was lower than non-poor group. This condition occurred because the government policy of equitable access to health service facility did not pay attention to accessibility of poor group.
Oborn, Eivor; Barrett, Michael; Darzi, Ara
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.
Full Text Available The state policy in the health care area must take into account the complexity and specificity of the domain. Health means not only “to treat”, but also “to prevent” and “to recover and rehabilitate the individual physically”. Regardless of the adopted health insurance system, the health system is facing a big problem and this is the insufficient funds necessary to function properly. The underfunding may have various causes, from a wrong health policy, based on “treating” instead of “preventing”, by the misuse of funds. This papers intended to formulate assumptions that underpin the research I am conducting within the Doctoral Research Program held at the Valahia University of Targoviste, which aims at using the management control in increasing the health services performance. The application of the accounting and management control methods in determining health costs can be a beginning to streamline the system. This is also a result of the fact that health care is a public service with specific characteristics: it can not be subject only to market requirements but at the same time he must undergo an administrative savings, representing a typical case of market failure. The increased cost of treatment, as well as the decline in their quality can be determined by the discrepancy between the funding and payment mechanisms. Different payment systems currently available do nothing but perpetuate the shortcomings in the system. Switching to the introduction of cost and budgets by cost centers or object (if solved can be a step forward for a better management of resources. In this context, we consider as a necessity to be imposed the cost analysis on responsibility centers, the definition of the cost object and cost center identification and determination of direct costs and those indirect services to choose the basis for the allocation of cost centers and the determination of each actual cost per diagnosis.
Full Text Available Background: Previous studies of Greenlandic children’s disease pattern and contacts to the health care system are sparse and have focused on the primary health care sector. Objective: We aimed to identify the disease pattern and use of health care facilities of children aged 0–10 in two Greenlandic cohorts. Methods and design: In a retrospective, descriptive follow-up of the Ivaaq (The Greenland Child Cohort and the CLEAR (climate changes, environmental contaminants and reproductive health birth cohorts (total n=1,000, we reviewed medical records of children aged 6–10 in 2012 with residence in Nuuk or Ilulissat (n=332. Data on diseases and health care system contacts were extracted. Diagnoses were validated retrospectively. Primary health care contacts were reviewed for a random sample of 1:6. Results: In 311 children with valid social security number, the total number of health care system contacts was 12,471 equalling 4.6 contacts per child per year. The annual incidence rate of hospital admissions was 1:10 children (total n=266, 1,220 days, 4.6 days/admission, outpatient contacts 2:10 children and primary care 3.6 per child. Contacts were overall more frequent in boys compared with girls, 39.5 versus 34.6 during the study period, p=0.02. The highest annual contact rates for diseases were: hospitalisations/acute respiratory diseases 13.9:1,000; outpatient contacts/otitis media 5.1:1,000; primary care/conjunctivitis or nasopharyngitis 410:1,000 children. Outpatient screening for respiratory tuberculosis accounted 6.2:1,000, primary care non-disease (Z-diagnosis 2,081:1,000 annually. Complete adherence to the child vaccination programme was seen in 40%, while 5% did not receive any vaccinations. Conclusions: In this first study of its kind, the health care contact pattern in Greenlandic children showed a relatively high hospitalisation rate and duration per admission, and a low primary health care contact rate. The overall contact rate and
Chen, Rui; Zhao, Yali; Du, Juan; Wu, Tao; Huang, Yafang; Guo, Aimin
To reveal the equity of health workforce distribution in urban community health service (CHS), and to provide evidence for further development of community health service in China. A community-based, cross-sectional study was conducted in China from September to December 2011. In the study, 190 CHS centers were selected from 10 provinces of China via stratified multistage cluster sampling. Human resources profiles and basic characteristics of each CHS centers were collected. Lorenz curves and Gini Coefficient were used to measure the inequality in the distribution of health workforce in community health service centers by population size and geographical area. Wilcoxon rank test for paired samples was used to analyze the differences in equity between different health indicators. On average, there were 7.37 health workers, including 3.25 doctors and 2.32 nurses per 10,000 population ratio. Significant differences were found in all indicators across the samples, while Beijing, Shandong and Zhejiang ranked the highest among these provinces. The Gini coefficients for health workers, doctors and nurses per 10,000 population ratio were 0.39, 0.44, and 0.48, respectively. The equity of doctors per 10,000 population ratio (G = 0.39) was better than that of doctors per square kilometer (G = 0.44) (P = 0.005). Among the total 6,573 health workers, 1,755(26.7%) had undergraduate degree or above, 2,722(41.4%)had junior college degree and 215(3.3%) had high school education. Significant inequity was found in the distribution of workers with undergraduate degree or above (G = 0.52), which was worse than that of health works per 10000 population (Purban CHS centers.
E-Health applications have to take the business perspective into account. This is achieved by adding a fourth layer reflecting organizational and business processes to an existing three layer model for IT-system functionality and management. This approach is used for designing a state-wide e-Health service delivery allowing for distributed responsibilities: clinical organizations act on the fourth layer and have established mutual cooperation in this state-wide approach based on collectively outsourced IT-system services. As a result, no clinical organization can take a dominant role based on operating the IT-system infrastructure. The implementation relies on a central infrastructure with extended means to guarantee service delivery: (i) established redundancy within the system architecture, (ii) actively controlled network and application availability, (iii) automated routine performance tests fulfilling regulatory requirements and (iv) hub-to-spoke and end-to-end authentication. As a result, about half of the hospitals and some practices of the state have signed-up to the services and guarantee long-term sustainability by sharing the infrastructural costs. Collaboration takes place for more than 1000 patients per month based on second opinion, online consultation and proxy services for weekend and night shifts.
Væggemose, Ulla; Ankersen, Pia Vedel; Aagaard, Jørgen
Co-production involves knowledge and skills based on both lived experiences of citizens and professionally training of staff. In Europe, co-production is viewed as an essential tool for meeting the demographic, political and economic challenges of welfare states. However, co-production is facing ...... for facilitating the co-productive practice of individual staff. Organised in this way, co-production can succeed even in a mental health setting associated with social stigma and in a welfare state dominated by public services........ The study setting was the Community Families programme, which aim to support the social network of mental health users by offering regular contact with selected private families/individuals. The task of the municipalities was to initiate and support Community Families. The analysis built on qualitative data...
Czoski-Murray, C.; Carlton, J; Brazier, J; Kang, H. K.; Young, T A; Papo, N.L.
OBJECTIVE: This paper reports on a study that used contact lenses to simulate the effects of a visual impairment caused by Age Related Macular Degeneration (ARMD). The aim was to examine the feasibility of using this method of simulation and to compare the results from this experiment with those obtained from ARMD patients (n=209) using generic preference-based measures (HUI3 and EQ-5D) and patient time trade-off TTO.\\ud \\ud METHODS: Utility values were elicited from healthy participants (n=1...
Aschbrenner, Kelly A; Mueser, Kim T; Bartels, Stephen J; Pratt, Sarah I
The purpose of this study was to explore the amount of family contact among older persons with serious mental illnesses (SMI), and to examine its relationship to health and mental health. An analysis of baseline data was conducted from a treatment study including 180 adults age 50 and older. The amount of family contact was examined with descriptive statistics. Differences in health and mental health were examined between participants with low, moderate, or high levels of family contact. Analyses also compared these groups on health and mental health functioning, controlling for psychiatric symptoms and the number and severity of medical diseases, respectively. Over three-quarters of respondents (77.8%) reported speaking on the phone with a relative and two-thirds (67.2%) reported seeing a relative at least once during the past month. Older adults who lived with a family member had more severe mood symptoms and poorer mental health functioning. Those who lived with family or had moderate levels of family contact had more comorbid diseases and more disease severity than those with less family contact. These relationships remained significant after controlling for medical conditions or psychiatric symptoms. The majority of older persons have regular family contact and those with the highest levels of family contact appear to have more compromised physical and mental health. Study findings provide new knowledge for practitioners regarding the importance of using family interventions to target physical health and mental illness management for older consumers who may need assistance to access medical care and treatment. Further research on the role of families in psychiatric and physical health management will provide a foundation for family interventions aimed at supporting community living among older adults.
Garcia, Leila Posenato; Zanetti-Ramos, Betina Giehl
The subject of "health services waste" is controversial and widely discussed. Biosafety, the principles of which include safeguarding occupational health, community health, and environmental safety, is directly involved in the issue of medical waste management. There are controversies as to the risks posed by medical waste, as evidenced by diverging opinions among authors: some advocate severe approaches on the basis that medical waste is hazardous, while others contend that the potential for infection from medical waste is nonexistent. The Brazilian National Health Surveillance Agency (ANVISA) has published resolution RDC 33/2003 to standardize medical waste management nationwide. There is an evident need to implement biosafety procedures in this area, including heath care workers' training and provision of information to the general population.
Ryder, Nathan; McNulty, Anna M
Confidentiality concerns are often described as barriers to seeking sexual health care. There has been little research describing the relative importance of confidentiality to clients of sexual health clinics, and whether members of high-risk groups have greater concerns. This study aimed to determine the importance of confidentiality and anonymity to clients of a public sexual health clinic, and determine associations with gender and sexuality. A self-administered questionnaire was offered to consecutive new English-speaking clients in October and November 2007. Participants were asked to describe the reasons for presenting, likelihood of disclosing identifying information, and concern should specific people and agencies become aware of their attendance. Of 350 eligible clients, 270 (77%) participated in the survey. Expert care was included in the top three reasons for choosing a sexual health clinic rather than a general practitioner by over half of participants, while confidentiality and cost were each included in the top three reasons by one-third of respondents respectively. Over 90% of clients reported they were likely to give accurate identifying information to the clinic. Participants were comfortable with disclosure of information to other health-care workers but became increasingly unwilling for information to be shared with services not directly involved in their care. Overall there were few associations with gender or sexuality. Clients choose to attend our clinic for a variety of reasons, with confidentiality and anonymity being of lesser importance than competence and cost. Confidentiality is important to the majority of clients, whereas few desire anonymity. Most clients would accept information being shared with other health services, suggesting that confidentiality may not be a barrier to the use of electronic health records in sexual health clinics.
Mary-Louise Jung; Karla Loria
Mary-Louise Jung1, Karla Loria11Division of Industrial Marketing, e-Commerce and Logistics, Lulea University of Technology, SwedenObjective: To investigate older people’s acceptance of e-health services, in order to identify determinants of, and barriers to, their intention to use e-health.Method: Based on one of the best-established models of technology acceptance, Technology Acceptance Model (TAM), in-depth exploratory interviews with twelve individuals over 45 years of age and of...
... AFFAIRS Health Services Research and Development Service Scientific Merit Review Board; Notice of Meeting... Committee Act) that various subcommittees of the Health Services Research and Development Service Scientific... health care delivery and management, and nursing research. Applications are reviewed for scientific and...
... AFFAIRS Health Services Research and Development Service Scientific Merit Review Board, Notice of Meeting... Committee Act) that various subcommittees of the Health Services Research and Development Service Scientific... health care delivery and management, and nursing research. Applications are reviewed for scientific and...
... AFFAIRS Health Services Research and Development Service Scientific Merit Review Board; Notice of Meeting..., Program Manager, Scientific Merit Review Board, Department of Veterans Affairs, Health Services Research.... App. 2, that the Centers of Innovation subcommittee of the Health Services Research and Development...
... AFFAIRS Health Services Research and Development Service Scientific Merit Review Board, Notice of Meeting... States Code Appendix 2, that the Health Services Research and Development Service Scientific Merit Review... Services Research (HSR) subcommittees and its Nursing Research Initiative (NRI) subcommittee. The HSR...
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.
Evans-Lacko, Sara; London, Jillian; Japhet, Sarah; Rüsch, Nicolas; Flach, Clare; Corker, Elizabeth; Henderson, Claire; Thornicroft, Graham
Stigma and discrimination associated with mental health problems is an important public health issue, and interventions aimed at reducing exposure to stigma and discrimination can improve the lives of people with mental health problems. Social contact has long been considered to be one of the most effective strategies for improving inter-group relations. For this study, we assess the impact of a population level social contact intervention among people with and without mental health problems. This study investigated the impact of social contact and whether presence of specific facilitating factors (equal status, common goals, cooperation and friendship potential): (1) improves intended stigmatising behaviour; (2) increases future willingness to disclose a mental health problem; and (3) promotes behaviours associated with anti-stigma campaign engagement. Two mass participation social contact programmes within England's Time to Change campaign were evaluated via a 2-part questionnaire. 403 participants completed initial questionnaires (70% paper, 30% online) and 83 completed follow-up questionnaires online 4-6 weeks later. This study investigated the impact of social contact and whether presence of specific facilitating factors (equal status, common goals, cooperation and friendship potential): (1) improves intended stigmatising behaviour; (2) increases future willingness to disclose a mental health problem; and (3) promotes behaviours associated with anti-stigma campaign engagement. Two mass participation social contact programmes within England's Time to Change campaign were evaluated via a 2-part questionnaire. 403 participants completed initial questionnaires (70% paper, 30% online) and 83 completed follow-up questionnaires online 4-6 weeks later. Campaign events facilitated meaningful intergroup social contact between individuals with and without mental health problems. Presence of facilitating conditions predicted improved stigma-related behavioural intentions
Full Text Available Abstract Background Stigma and discrimination associated with mental health problems is an important public health issue, and interventions aimed at reducing exposure to stigma and discrimination can improve the lives of people with mental health problems. Social contact has long been considered to be one of the most effective strategies for improving inter-group relations. For this study, we assess the impact of a population level social contact intervention among people with and without mental health problems. Methods This study investigated the impact of social contact and whether presence of specific facilitating factors (equal status, common goals, cooperation and friendship potential: (1 improves intended stigmatising behaviour; (2 increases future willingness to disclose a mental health problem; and (3 promotes behaviours associated with anti-stigma campaign engagement. Two mass participation social contact programmes within England’s Time to Change campaign were evaluated via a 2-part questionnaire. 403 participants completed initial questionnaires (70% paper, 30% online and 83 completed follow-up questionnaires online 4–6 weeks later. Results This study investigated the impact of social contact and whether presence of specific facilitating factors (equal status, common goals, cooperation and friendship potential: (1 improves intended stigmatising behaviour; (2 increases future willingness to disclose a mental health problem; and (3 promotes behaviours associated with anti-stigma campaign engagement. Two mass participation social contact programmes within England’s Time to Change campaign were evaluated via a 2-part questionnaire. 403 participants completed initial questionnaires (70% paper, 30% online and 83 completed follow-up questionnaires online 4–6 weeks later. Campaign events facilitated meaningful intergroup social contact between individuals with and without mental health problems. Presence of facilitating conditions
Bornman, Juan; Alant, Erna; Lloyd, Lyle L.
Primary health care nurses are frequently overlooked when delivering services to children with developmental disabilities, despite the fact that they are often the first contact many primary caregivers have with rehabilitation professionals and usually remain the bridge between caregivers and professionals. A time series one group design with…
Full Text Available OBJECTIVES: To reveal the equity of health workforce distribution in urban community health service (CHS, and to provide evidence for further development of community health service in China. METHODS: A community-based, cross-sectional study was conducted in China from September to December 2011. In the study, 190 CHS centers were selected from 10 provinces of China via stratified multistage cluster sampling. Human resources profiles and basic characteristics of each CHS centers were collected. Lorenz curves and Gini Coefficient were used to measure the inequality in the distribution of health workforce in community health service centers by population size and geographical area. Wilcoxon rank test for paired samples was used to analyze the differences in equity between different health indicators. RESULTS: On average, there were 7.37 health workers, including 3.25 doctors and 2.32 nurses per 10,000 population ratio. Significant differences were found in all indicators across the samples, while Beijing, Shandong and Zhejiang ranked the highest among these provinces. The Gini coefficients for health workers, doctors and nurses per 10,000 population ratio were 0.39, 0.44, and 0.48, respectively. The equity of doctors per 10,000 population ratio (G = 0.39 was better than that of doctors per square kilometer (G = 0.44 (P = 0.005. Among the total 6,573 health workers, 1,755(26.7% had undergraduate degree or above, 2,722(41.4%had junior college degree and 215(3.3% had high school education. Significant inequity was found in the distribution of workers with undergraduate degree or above (G = 0.52, which was worse than that of health works per 10000 population (P<0.001. CONCLUSIONS: Health workforce inequity was found in this study, especially in quality and geographic distribution. These findings suggest a need for more innovative policies to improve health equity in Chinese urban CHS centers.
U.S. Department of Health & Human Services — The National Mental Health Services Survey (N-MHSS) is an annual survey designed to collect statistical information on the numbers and characteristics of all known...
.... This paper examines the opportunities for and constraints to India-EU relations in health services in the context of this agreement, focusing on the EU as a market for India's health services exports and collaboration...
Patient satisfaction with health care services provided at HIV clinics at Amana and ... with the general physical environment of the clinic and with services offered by ... Key words: Patient satisfaction, Antiretroviral therapy, HIV care services ...
Daaleman, Timothy P
To introduce a health services framework of spiritual care that addresses the empirical and applied issues surrounding spirituality and nursing practice. Despite over 20 years of study, the concept of spirituality is still under development, which limits application to nursing practice. Three studies using a health services framework are reviewed: (1) a survey study of dying patients and family that describes the providers, types and outcomes of spiritual care; (2) an exploratory study of the process of spiritual care; and (3) a multi-level study of the structure and outcomes of spiritual care in long-term care facilities. Spiritual care recipients identify family or friends (41%), clergy (17%) and health care providers (29%) as spiritual care providers. The most frequently reported type of spiritual care was help in coping with illness (87%). Just over half (55%) were satisfied with the care that they received. The processes of spiritual care involved: (1) presence, (2) opening eyes, and; (3) co-creating, which was a mutual and fluid activity between patients, family members and care providers. In long term care facilities, decedents who received spiritual care were perceived as receiving better overall care in the last month of life, when compared with those decedents who did not receive spiritual care. A health services framework provides a holistic view of spiritual care, one that is consistent with integrated nursing models. By focusing on the structure, process and outcome elements of spiritual care within organisational settings, nursing management can develop feasible approaches to implement, improve and evaluate the delivery of this unique type of care. © 2012 Blackwell Publishing Ltd.
Stenager, E N; Jensen, Knud
In a study describing suicide attempters' approach to the health and social welfare authorities prior to a suicide attempt, it was found that one-fourth of the patients seeking help requested therapeutic consultations and only a few asked for medicinal treatment. Forty-four percent had taken newly...... with their general practitioner prior to the suicide attempt. Postgraduate courses for practitioners on depression diagnostics and suicidal behaviour are proposed as a measure in suicide prevention....
Dante R. Culqui
Full Text Available Abstract We present the case of the Nahua population of Santa Rosa de Serjali, Peruvian Amazon's population, considered of initial contact. This population consists of human groups that for a long time decided to live in isolation, but lately have begun living a more sedentary lifestyle and in contact with Western populations. There are two fully identified initial contact groups in Peru: the Nahua and the Nanti. The health statistics of the Nahua are scarce. This study offers an interpretation of demographic and epidemiological indicators of the Nahua people, trying to identify if a certain degree of health vulnerability exists. We performed a cross sectional study, and after analyzing their health indicators, as well as the supplemental qualitative analysis of the population, brought us to conclude that in 2006, the Nahua, remained in a state of health vulnerability.
Rosenthal, Beth Spenciner; Wilson, William Cody
The authors present and empirically test a multivariate model of the use of mental health counseling services. Use of such services by 1st-year college students is directly a result of need for these services and willingness to use them. Beliefs about mental health services and demographic characteristics are not directly related to use, but…
Blobel, B; Holena, M
The structure of healthcare systems in developed countries is changing to 'shared care', enforced by economic constraints and caused by a change in the basic conditions of care. That development results in co-operative health information systems across the boundaries of organisational, technological, and policy domains. Increasingly, these distributed and, as far as their domains are concerned, heterogeneous systems are based on middleware approaches, such as CORBA. Regarding the sensitivity of personal and medical data, such open, distributed, and heterogeneous health information systems require a high level of data protection and data security, both with respect to patient information and with respect to users. This paper, relying on experience gained through our activities in CORBAmed, describes the possibilities the CORBA middleware provides to achieve application and communication security. On the background of the overall CORBA architecture, it outlines the different security services previewed in the adopted CORBA specifications which are discussed in the context of the security requirements of healthcare information systems. Security services required in the healthcare domain but not available at the moment are mentioned. A solution is proposed, which on the one hand allows to make use of the available CORBA security services and additional ones, on the other hand remains open to other middleware approaches, such as DHE or HL7.
West, R T; Howard, F H
A study to determine the impact that the Area Health Education Center type of programs may have on health science libraries was conducted by the Extramural Programs, National Library of Medicine, in conjunction with a contract awarded by the Bureau of Health Manpower, Health Resources Administration, to develop an inventory of the AHEC type of projects in the United States. Specific study tasks included a review of these programs as they relate to library and information activities, on-site surveys on the programs to define their needs for library services and information, and a categorization of library activities. A major finding was that health science libraries and information services are generally not included in AHEC program planning and development, although information and information exchange is a fundamental part of the AHEC type of programs. This study suggests that library inadequacies are basically the result of this planning failure and of a lack of financial resources; however, many other factors may be contributory. The design and value of library activities for these programs needs explication.
... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Mental health services... Outpatient Treatment § 17.98 Mental health services. (a) Following the death of a veteran, bereavement... mental health services in connection with treatment of the veteran under 38 U.S.C. 1710, 1712,...
... 19 Customs Duties 1 2010-04-01 2010-04-01 false Public Health Service requirements. 4.70 Section 4... THE TREASURY VESSELS IN FOREIGN AND DOMESTIC TRADES Foreign Clearances § 4.70 Public Health Service... Public Health Service....
... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Public Health Service. 3... Pension, Compensation, and Dependency and Indemnity Compensation Retirement § 3.753 Public Health Service... of the Public Health Service, who was receiving disability compensation on December 31, 1956,...
... 45 Public Welfare 4 2010-10-01 2010-10-01 false Disabilities/health services coordination. 1308.18... DISABILITIES Health Services Performance Standards § 1308.18 Disabilities/health services coordination. (a) The... are met. (b) The grantee must ensure coordination between the disabilities coordinator and the staff...
... Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... items is determined on a case-by-case basis, based on the nature of the item prescribed; (4) Physical therapy, occupational therapy, or speech pathology and audiology services, provided by a home health...
Schonbrun, Yael Chatav; Whisman, Mark A.
Objective: This study was designed to evaluate the association between marital distress and mental health service utilization in a population-based sample of men and women (N = 1,601). Method: The association between marital distress and mental health care service utilization was evaluated for overall mental health service utilization and for…
Joshua G. Behr
Full Text Available The management and treatment of adult asthma has been associated with utilization of health services. Objectives: First, to investigate the likelihood of health service utilization, including primary care, emergency department, and hospital stays, among persons diagnosed with an asthma condition relative to those that do not have an asthma condition. Second, to examine the likelihood of poor physical health among asthma respondents relative to those that do not have an asthma condition. Third, to demonstrate that these relationships vary with frequency of utilization. Fourth, to discuss the magnitude of differences in frequent utilization between asthma and non-asthma respondents. Data Source: Data is derived from a random, stratified sampling of Hampton Roads adults, 18 years and older (n = 1678. Study Design: Study participants are interviewed to identify asthma diagnosis, access to primary care, frequency of emergency department utilization, hospital admissions, and days of poor physical health. Odds-ratios establish relationships with the covariates on the outcome variable. Findings: Those with asthma are found more likely (OR 1.50, 95% CI 1.05–2.15 to report poor physical health relative to non-asthma study participants. Further, asthma respondents are found more likely (OR 4.23, 95% CI 1.56–11.69 to frequently utilize primary care that may be associated with the management of the condition and are also more likely to utilize treatment services, such as the emergency department (OR 1.87, 95% CI 1.32–2.65 and hospitalization (OR 2.21, 95% CI 1.39–3.50, associated with acute and episodic care. Further, it is a novel finding that these likelihoods increase with frequency of utilization for emergency department visits and hospital stays. Conclusion: Continuity in care and better management of the diseases may result in less demand for emergency department services and hospitalization. Health care systems need to recognize that asthma
... HUMAN SERVICES Health Resources and Services Administration National Advisory Council on the National Health Service Corps; Request for Nominations AGENCY: Health Resources and Services Administration, HHS. ACTION: Notice. SUMMARY: The Health Resources and Services Administration (HRSA) is...
Nelson, H Wayne
This article examines the causes and accelerants of dysfunctional health service conflict and how it emerges from the health system's core hierarchical structures, specialized roles, participant psychodynamics, culture, and values. This article sets out to answer whether health care conflict is more widespread and intense than in other settings and if it is, why? To this end, health care power, gender, and educational status gaps are examined with an eye to how they undermine open communication, teamwork, and collaborative forms of conflict and spark a range of dysfunctions, including a pervasive culture of fear; the deny-and-defend lawsuit response; widespread patterns of hierarchical, generational, and lateral bullying; overly avoidant conflict styles among non-elite groups; and a range of other behaviors that lead to numerous human resource problems, including burnout, higher staff turnover, increased errors, poor employee citizenship behavior, patient dissatisfaction, increased patient complaints, and lawsuits. Bad patient outcomes include decreased compliance and increased morbidity and mortality. Health care managers must understand the root causes of these problems to treat them at the source and implement solutions that avoid negative conflict spirals that undermine organizational morale and efficiency.
CUI Huawei; CUI Xiufang; WANG Haidou; XING Zhiguo; JIN Guo
The service condition determines the Rolling Contact Fatigue(RCF) failure mechanism and lifetime under ascertain material structure integrity parameter of thermal spray coating. The available literature on the RCF testing of thermal spray coatings under various condition services is considerable;it is generally difficult to synthesize all of the result to obtain a comprehensive understanding of the parameters which has a great effect on a thermal spray coating’s resistance of RCF. The effects of service conditions(lubrication states, contact stresses, revolve speed, and slip ratio) on the changing of thermal spray coatings’ contact fatigue lifetime is introduced systematically. The effects of different service condition on RCF failure mechanism of thermal spray coating from the change of material structure integrity are also summarized. Moreover, In order to enhance the RCF performance, the parameter optimal design formula of service condition and material structure integrity is proposed based on the effect of service condition on thermal spray coatings’ contact fatigue lifetime and RCF failure mechanism. The shortage of available literature and the forecast focus in future researches are discussed based on available research. The explicit result of RCF lifetime law and parameter optimal design formula in term of lubrication states, contact stresses, revolve speed, and slip ratio, is significant to improve the RCF performance on the engineering application.
Full Text Available The article deals with the problem of debts in polish health service. Author analyzes the macroeconomic reasons of this situation. As a main reasons are indicated: a specificity of the health service market, which leads to a inefficient allocation of health services, lack of reliable data on health care system, too low level of public expenditure on a health care, inappropriate allocation of public capital and a monopolistic position of the payer.
Guindon, G Emmanuel
In recent years, a number of low- and middle-income country governments have introduced health insurance schemes. Yet not a great deal is known about the impact of such policy shifts. Vietnam's recent health insurance experience including a health insurance scheme for the poor in 2003 and a compulsory scheme that provides health insurance to all children under six years of age combined with Vietnam's commitment to universal coverage calls for research that examines the impact of health insurance. Taking advantage of Vietnam's unique policy environment, data from the 2002, 2004 and 2006 waves of the Vietnam Household Living Standard Survey and single-difference and difference-in-differences approaches are used to assess whether access to health insurance--for the poor, for children and for students--impacts on health services utilization and health outcomes in Vietnam. For the poor and for students, results suggest health insurance increased the use of inpatient services but not of outpatient services or health outcomes. For young children, results suggest health insurance increased the use of outpatient services (including the use of preventive health services such as vaccination and check-up) but not of inpatient services.
Palinkas, Lawrence A.
Qualitative and mixed methods play a prominent role in mental health services research. However, the standards for their use are not always evident, especially for those not trained in such methods. This paper reviews the rationale and common approaches to using qualitative and mixed methods in mental health services and implementation research based on a review of the papers included in this special series along with representative examples from the literature. Qualitative methods are used to provide a “thick description” or depth of understanding to complement breadth of understanding afforded by quantitative methods, elicit the perspective of those being studied, explore issues that have not been well studied, develop conceptual theories or test hypotheses, or evaluate the process of a phenomenon or intervention. Qualitative methods adhere to many of the same principles of scientific rigor as quantitative methods, but often differ with respect to study design, data collection and data analysis strategies. For instance, participants for qualitative studies are usually sampled purposefully rather than at random and the design usually reflects an iterative process alternating between data collection and analysis. The most common techniques for data collection are individual semi-structured interviews, focus groups, document reviews, and participant observation. Strategies for analysis are usually inductive, based on principles of grounded theory or phenomenology. Qualitative methods are also used in combination with quantitative methods in mixed method designs for convergence, complementarity, expansion, development, and sampling. Rigorously applied qualitative methods offer great potential in contributing to the scientific foundation of mental health services research. PMID:25350675
Restall, Gayle; Strutt, Carolyn
The participation of people who use mental health services in service planning and evaluation has become increasingly important in recent years. Health planners and people who use services are seeking information about how to enable participation that is meaningful and impacts positively on service delivery. This qualitative study explored the perspectives of people who use mental health services on participation in mental health service planning and evaluation. Sixty-three people from diverse backgrounds participated in either a focus group or interview. Themes were extracted from the data and resulted in a conceptual framework that can be used to guide the development and evaluation of participation.
Forrest, Christopher B; Martin, Diane P; Holve, Erin; Millman, Anne
This manuscript presents an initial description of doctoral level core competencies for health services research (HSR). The competencies were developed by a review of the literature, text analysis of institutional accreditation self-studies submitted to the Council on Education for Public Health, and a consensus conference of HSR educators from US educational institutions. The competencies are described in broad terms which reflect the unique expertise, interests, and preferred learning methods of academic HSR programs. This initial set of core competencies is published to generate further dialogue within and outside of the US about the most important learning objectives and methods for HSR training and to clarify the unique skills of HSR training program graduates. PMID:19555485
Full Text Available Abstract This manuscript presents an initial description of doctoral level core competencies for health services research (HSR. The competencies were developed by a review of the literature, text analysis of institutional accreditation self-studies submitted to the Council on Education for Public Health, and a consensus conference of HSR educators from US educational institutions. The competencies are described in broad terms which reflect the unique expertise, interests, and preferred learning methods of academic HSR programs. This initial set of core competencies is published to generate further dialogue within and outside of the US about the most important learning objectives and methods for HSR training and to clarify the unique skills of HSR training program graduates.
... AFFAIRS Health Services Research and Development Service, Scientific Merit Review Board; Notice of Meeting.... App. 2, that the Health Services Research and Development Service (HSR&D) Scientific Merit Review..., Washington, DC; HSR 7--Aging and Diminished Capacity in the Context of Aging on Tuesday, August 27, 2013,...
Chisholm, Katharine; Patterson, Paul; Torgerson, Carole; Turner, Erin; Jenkinson, David; Birchwood, Max
To investigate whether intergroup contact in addition to education is more effective than education alone in reducing stigma of mental illness in adolescents. A pragmatic cluster randomised controlled trial compared education alone with education plus contact. Blocking was used to randomly stratify classes within schools to condition. Random allocation was concealed, generated by a computer algorithm, and undertaken after pretest. Data was collected at pretest and 2-week follow-up. Analyses use an intention-to-treat basis. Secondary schools in Birmingham, UK. The parents and guardians of all students in year 8 (age 12-13 years) were approached to take part. A 1-day educational programme in each school led by mental health professional staff. Students in the 'contact' condition received an interactive session with a young person with lived experience of mental illness. The primary outcome was students' attitudinal stigma of mental illness. Secondary outcomes included knowledge-based stigma, mental health literacy, emotional well-being and resilience, and help-seeking attitudes. Participants were recruited between 1 May 2011 and 30 April 2012. 769 participants completed the pretest and were randomised to condition. 657 (85%) provided follow-up data. At 2-week follow-up, attitudinal stigma improved in both conditions with no significant effect of condition (95% CI -0.40 to 0.22, p=0.5, d=0.01). Significant improvements were found in the education-alone condition compared with the contact and education condition for the secondary outcomes of knowledge-based stigma, mental health literacy, emotional well-being and resilience, and help-seeking attitudes. Contact was found to reduce the impact of the intervention for a number of outcomes. Caution is advised before employing intergroup contact with younger student age groups. The education intervention appeared to be successful in reducing stigma, promoting mental health knowledge, and increasing mental health literacy, as
... Definitions § 440.20 Outpatient hospital services and rural health clinic services. (a) Outpatient hospital... agency may exclude from the definition of “outpatient hospital services” those types of items and... 42 Public Health 4 2010-10-01 2010-10-01 false Outpatient hospital services and rural health...
... developmental services. (a) Determining child health status. (1) In collaboration with the parents and as... recommendations from the local Health Services Advisory Committee that are based on prevalent community health... 45 CFR 1304.40(f)(2) (i) and (ii) to enroll and participate in a system of ongoing family health care...
Killaspy, Helen; Marston, Louise; Omar, Rumana Z; Green, Nicholas; Harrison, Isobel; Lean, Melanie; Holloway, Frank; Craig, Tom; Leavey, Gerard; King, Michael
Current health policy assumes better quality services lead to better outcomes. To investigate the relationship between quality of mental health rehabilitation services in England, local deprivation, service user characteristics and clinical outcomes. Standardised tools were used to assess the quality of mental health rehabilitation units and service users' autonomy, quality of life, experiences of care and ratings of the therapeutic milieu. Multiple level modelling investigated relationships between service quality, service user characteristics and outcomes. A total of 52/60 (87%) National Health Service trusts participated, comprising 133 units and 739 service users. All aspects of service quality were positively associated with service users' autonomy, experiences of care and therapeutic milieu, but there was no association with quality of life. Quality of care is linked to better clinical outcomes in people with complex and longer-term mental health problems. Thus, investing in quality is likely to show real clinical gains.
... Order from the National Technical Information Service NCHS Marriage, Cohabitation, and Men's Use of Preventive Health Care ... health care visit in the past 12 months. Marriage was associated with greater likelihood of a health ...
The data-collection method of choice for this study was focus group ... Barriers related to governance, for example lack of national policy guidelines for school ... Keywords: school health services; health-promoting schools; health care policy; ...
McFadyen, J A; Farrington, A
AIM AND KEY ISSUES: This article reviews the theoretical basis of strategic management in an attempt to provide managers with a better understanding of the underpinning concepts and consequent actions they need to take to avoid loss of control and ultimate failure. The authors argue that community care for the severely mentally ill is failing and that in part the reason for this perceived failure is a closer allegiance to primary care that has shifted the focus away from mental illness. Such a shift, coupled with poor management and a desire by Community Mental Health Nurses (CMHNs) to retain a broad focus and maintain the 'autonomy' they gain when not held in the gravitational grasp of Consultant Psychiatrists, has resulted in strategic drift. The authors suggest 10 possible reasons to explain why CMHNs currently fail to meet the needs of the severely mentally ill. Among these are a lack of explicit strategic implementation plans, professional ambivalence and self-interest, poor management of resources and conflicting demands from key interest groups. It seems that mental health services in this country have reached the point where resistance to change should be crumbling in the face of perceived failure to deliver the required services. Whilst it could be argued that a major and potent source of internal change is performance gaps, few things force change more than sudden and unexpected information about poor organizational performance.
Grytten, Jostein; Skau, Irene
The number of specialists within dental health services has increased over the last few years. This raises the issue of how the services should be organized and funded. We describe the effect of one way of organizing the services, which is by relying on competition. In Norway, some oral specialists face real competition with general dental practitioners for the same patients (prosthetists, periodontists and endodontists), while other specialists do not (orthodontists and oral surgeons). The latter specialists have skills that give them exclusive possibilities to practice their profession. We find that competition can be effective for the specialists who experience real competition with general dental practitioners for patients. In situations where real competition does not exist, specialists can obtain market power and raise their fees. Our results are based on an analysis of a representative set of data from general dental practitioners and specialists in Norway. The specialities in which practitioners can exercise market power raise challenges related to the type of public policy that can reduce this market power in an appropriate way, and without involving too large costs for the authorities.
Panthongviriyakul, Charnchai; Kessomboon, Pattapong; Sutra, Sumitr
Health problems and service utilization patterns among Thai populations have changed significantly over the past three decades. It is imperative to scrutinize the changes so that the health service and human resource development systems can appropriately respond to the changing health needs. To synthesize critical issues for future planning of health service reforms, medical education reforms and health research for Thai society. The authors analyzed data on health service utilization, types of illnesses and hospital deaths among Thais in the fiscal year 2010. Information on the illnesses of in-/out-patients and hospital deaths was extracted from the three main health insurance schemes providing coverage to 96% of the population. The authors then synthesized the key issues for reforming medical education and health services. In summary, Thai patients have better access to health services. The total number of out-patient visits was 326,230,155 times or 5.23 visits per population. The total number of in-patient admissions was 6,880,815 times or 0.11 admissions per population. The most frequent users were between 40-59 years of age. The most common conditions seen at OPD and IPD and the causes of in-hospital mortality varied between age-groups. The key health issues identified were: psychosocial conditions, health behaviour problems, perinatal complications, congenital malformations, teenage pregnancy, injury, infectious diseases, cardiovascular diseases and neoplasms. Medical education reforms need to be designed in terms of both undergraduate and post-graduate education and/or specialty clinical needs. Health service reforms should be designed in terms of patient care systems, roles of multidisciplinary teams and community involvement. The government and other responsible organizations need to actively respond by designing the health service systems and human resource development systems that are relevant, appropriate and integrated. Different levels of care need to
Cohen, Bevin; Hyman, Sandra; Rosenberg, Lauren; Larson, Elaine
Article-at-a-Glance Background Contact with health care workers may be an important means of infection transmission between patients, yet little is known about patterns of patient contact with staff and visitors in hospitals. In a cross-sectional study, the frequency, type, and duration of contacts made by health care workers, other hospital staff, and visitors to patients in acute care settings were documented. Methods Patients were observed in seven units of three academic hospitals, with recording of each occurrence of someone’s entry into the patient’s room. The health care worker’s role, the duration of the visit, and the highest level of patient contact made were noted. Staff were also surveyed to determine their perception of how many patients per hour they come into contact with, how long they spend with patients, and the level of patient contact that occurs. Findings Hourly room entries ranged from 0 to 28 per patient (median, 5.5), and patients received visits from 0 to 18 different persons per hour (median, 3.5). Nurses made the most visits (45%), followed by personal visitors (23%), medical staff (17%), nonclinical staff (7%), and other clinical staff (4%). Visits lasted 1 to 124 minutes (median, 3 minutes for all groups). Persons entering patients’ rooms touched nothing inside the room, only the environment, the patient’s intact skin, or the patient’s blood/body fluids 22%, 33%, 27%, and 18% of the time, respectively. Medical staff estimated visiting an average of 2.8 different patients per hour (range, 0.5–7.0), and nursing staff estimated visiting an average of 4.5 different patients per hour (range, 0.5–18.0). Conclusions Examining patterns of patient contact may improve understanding of transmission dynamics in hospitals. New transmission models should consider the roles of health care workers beyond patients’ assigned nurses and physicians. PMID:23240264
Morsi Magdi M
Full Text Available Abstract Background Recent corpus of research suggests that psychiatric disorders amongst adolescents and youths are an emerging global challenge, but there is paucity of studies exploring health services utilization by this age group in Arab region. Aim This study focus on the health services utilization and the barriers among school going adolescents and youths with DSM IV disorders in the country Oman, whose population is predominantly youthful. Methods Representative sample of secondary school Omani adolescents and youths were concurrently interviewed for the (i presence of DSM IV mental disorders using the face-to-face interview, World Mental Health-Composite International Diagnostic Interview (WMH-CIDI, (ii tendency for health care utilization and (iii predictors of utilization with clinical and demographic background. Results The proportions of lifetime cases having ever made treatment contact are low, being 5.2% for any anxiety disorder and 13.2% for any mood disorder category. None of these anxiety cases made treatment contact in the year of onset of the disorder, and the median delay when they eventually made treatment contact is about 14 years. In any mood disorders category only 3.6% made contact within the 1st year of onset with the median delay in initial treatment contact is two years for the Bipolar disorder (broad, four years for Any Mood disorder and nine years for the Major Depressive Disorder group. Male gender is significantly associated with less likelihood of making treatment contact when suffering from Social phobia (p = 0.000, Major Depressive Disorder (p = 0.000 and Bipolar Disorder (p = 0.000. The younger cohorts of 14-16 years and 17-18 years of Social phobic made significantly less lifetime any treatment contact (p = 0.000. The 14-16 year olds were significantly less likely to make lifetime any treatment contact for Bipolar Mood disorder (p = 0.000, while the 17-18 group were 1.5 times more likely to do so. Over past
Afifi, Tracie O; MacMillan, Harriet L; Taillieu, Tamara; Cheung, Kristene; Turner, Sarah; Tonmyr, Lil; Hovdestad, Wendy
Much of what is known about child abuse in Canada has come from reported cases of child abuse and at-risk samples, which likely represent the most severe cases of child abuse in the country. The objective of the current study is to examine the prevalence of a broad range of child abuse experiences (physical abuse, sexual abuse, and exposure to IPV) and investigate how such experiences and sociodemographic variables are related to contact with child protection organizations in Canada using a representative general population sample. Data were drawn from the 2012 Canadian Community Health Survey: Mental Health collected from the 10 provinces using a multistage stratified cluster design (n=23,395; household response rate=79.8%; aged 18 years and older). Physical abuse only (16.8%) was the most prevalent child abuse experience reported with the exposure to specific combinations of two or more types of child abuse ranging from 0.4% to 3.7%. Only 7.6% of the adult population with a history of child abuse reported having had contact with child protection organizations. Experiencing all three types of child abuse was associated with the greatest odds of contact with child protection organizations (AOR=15.8; 95% CI=10.1 to 24.6). Physical abuse only was associated with one of the lowest odds of contact with child protection organizations. Preventing child abuse is widely acknowledged as an important, but challenging public health goal. Strategies to increase reporting of child abuse may help to protect children and to connect families with necessary services. One obvious priority would be physical abuse.
Jolles, M P; Wells, R
Many children in contact with child welfare agencies do not receive needed health services. These agencies have used participatory decision making (PDM) practices as a way to increase families' use of recommended services. However, we lack evidence of whether caregiver participation in PDM increases children's use of health services. This study uses a national sample of children involved with child welfare to compare their health service use between those children serve through a PDM practice and those who did not experience it. Cross-sectional analyses using the 2009-2010 National Survey of Child and Adolescent Well-Being. Propensity score analysis accounted for observed selection bias. PDM practice was measured as whether the caregiver was included in decision-making during service planning meetings. Health service use was measured as child's receipt of any primary or mental health care services in the past year. Primary health care need was measured using standardized measures and caseworker report. The sample was comprised of children ages 2-17 with primary or mental health needs in contact with a child welfare agency. In the unmatched sample of 1,358 children, 14% were served through a PDM service practice, and 12% had a primary health care and 37% a mental health need. Families served through PDM were also reported by caseworkers as more cooperative during the child welfare investigation, and with fewer reports of domestic violence and agency re-referrals (P children received services compared with 40% for non-PDM children (P = 0.004). Group differences were not significant for mental health services. Lower-risk families were more likely to be served through PDM which was positively associated with child use of primary health services. Inclusion of caregivers in decision making may not be sufficient to overcome barriers to children's mental health service use. © 2016 John Wiley & Sons Ltd.
A socialist health service cannot be a socialist island in a sea of capitalism, as the record of the British National Health Service shows. Nonetheless, since health is a basic need, it can be a key component of the advocacy of socialism. I propose two central socialist principles. On the basis of these I suggest that a socialist health system would emphasise care rather than service; insist on democratic structures and control of resources; and require the prohibition of private medicine.
Bai, Yu; Wells, Rebecca; Hillemeier, Marianne M.
Objective: Interorganizational relationships (IORs) between child welfare agencies and mental health service providers may facilitate mental health treatment access for vulnerable children. This study investigates whether IORs are associated with greater use of mental health services and improvement in mental health status for children served by…
Simon, Janet E; Docherty, Carrie L
Previous researchers have shown that current health-related quality of life (HRQoL) is lower in former National Collegiate Athletic Association Division I athletes than in nonathletes. However, evidence supports the idea that individuals in collision sports (football) may suffer more serious injuries that may affect them later in life. To measure HRQoL in former Division I collision, contact, and limited-contact athletes. Cross-sectional study. Research laboratory. A total of 374 former Division I athletes between the ages of 40 and 65 years were separated into collision, contact, and limited-contact groups. All individuals completed the Short Form 36 version 2 via a computer. The dependent variables were the physical component and mental component summary scores and the physical functioning, physical role functioning, bodily pain, general health, vitality, social role functioning, emotional role functioning, and mental health scales. An initial multivariate analysis of covariance included data from the 2 domains: physical component and mental component summary scores. The second multivariate analysis of covariance included data from the 8 dimensions: physical function, role physical, bodily pain scale, general health, mental health, role emotional, social function, and vitality scales. The α level was set at P contact and limited-contact athletes for the summary scores (F2,370 = 90.09, P contact athletes for the bodily pain and role physical scales, with mean differences of 12.91 and 11.80 points, respectively. Competing at the Division I level can be strenuous on an athlete's physical, mental, and social dimensions, which can affect the athlete later in life. Based on these data, collision athletes may sacrifice their future HRQoL compared with contact and limited-contact athletes.
Andersen, John Sahl; Olivarius, Niels de Fine; Krasnik, Allan
the following is registered: 1. The citizen: The unique personal identification number and the allocation to a general practice. The number make it possible to register the age and sex of the citizen, follow the individual contacts with health care over time and merge with other registers. 2. The provider......: Identification number of the practice, referral to specialist and fees. 3. The service: Consultations, telephone consultations, home visits, e-mail consultations and preventive consultations. Also laboratory and additional services like anti-conception counselling are registered. The clinical information...... is small or absent. The possibilities for linking to other registers containing health and social information or with ad hoc collected data make NHSR an interesting research tool. Validity and coverage: All citizens registers with the personal identification number when contacting the health care system...
Connor, Margaret; Nelson, Katherine; Maisey, Jane
Health Reporoa Inc. offers a first contact rural nursing service to the village of Reporoa and surrounding districts. From 2003 to 2006 it became a project site through selection for the Ministry of Health (MoH) primary health care nursing innovation funding. Health Reporoa Inc. successfully achieved its project goals and gained an ongoing contract from Lakes District Health Board to consolidate and further expand its services at the close of the funding period. This paper examines the impact of the innovation funding during the project period and in the two years that followed. The major impact came through an expansion of the accessible free health service to the local population; advancing nursing practice; increased connection to the nursing profession and wider health community, and enhanced affirmation of the nursing contribution. The rural nursing service model developed at Health Reporoa, through the benefit of innovation funding, can now act as a blueprint for other rural health services, particularly those in high deprivation areas.
Efforts to expand mental health manpower have taken three major directions: (1) increased use of consultation, (2) creating entirely new roles, and (3) offering training to persons engaged in roles or occupations presumably at strategic points of contact between the public and the mental health system (clergy, police, hairdressers, and bartenders). In this paper the role of modern clergy is examined along several dimensions in order to provide a more rational basis for determining their true potential as mental health service extenders or gatekeepers. Role aspects examined are: public acceptance, approachability, community stature, role separation, and professional identity. Clergy seem to be both appropriate and available as mental health resources.
Gebreegziabher, Ewunetu Aberra; Astawesegn, Feleke Hailemichael; Anjulo, Antehun Alemayehu; Kerie, Mirkuzie Woldie
Ethiopia has been deploying specially trained new cadres of community based health workers in urban areas of the country known as urban health extension professionals since 2009. At present, relatively little work has focused on understanding to what extent this new program is accepted and used by the community. Both qualitative and quantitative surveys were performed from March 10, 2012 to March 25, 2012 to explore the utilization of urban health extension services in Bishoftu Town, Oromia regional state, Central Ethiopia using a cross sectional study design. Qualitative data were collected using a total of 4 focus group discussions and 26 in-depth interviews. Quantitative data were collected from 418 randomly selected households using pre-tested, structured, interviewer-administered questionnaires. Data entry and analysis were done using SPSS version 16.0. Qualitative data were analyzed thematically. Of the 418 interviewed households, 72.8% of them had at least one service related contact with urban health extension professionals in the previous 6 month. The mean frequency of service related contact with Urban Health Extension Professionals was found to be 2.24 (±1) contacts per 6 months. The total number of households graduated as a model family in the study area was 3974 (14.3%). Though participants felt that urban health extension professionals faced community resistance at program implementation, its acceptability greatly improved in this study. Despite this, individual competencies of urban health extension professionals, availability of supply and logistic system, and the level of support from kebele officials were reported to influence the program acceptability and utilization. The introduction of urban health extension professionals positively changed the attitude of the majority of the households involved and improved the acceptability of the program. All stake holders, governmental and nongovernmental organizations, should have supportive systems to
Ackerman, Ashley M.; Wantz, Richard A.; Firmin, Michael W; Poindexter, Dawn C.; Pujara, Amita L.
Undergraduate perceptions of the overall effectiveness of six types of mental health service providers (MHSPs) were obtained with a survey. Although many mental health services are available to consumers in the United States, research has indicated that these services are underutilized. Perceptions have been linked to therapeutic outcomes and may…
Larson, Satu; Chapman, Susan; Spetz, Joanne; Brindis, Claire D.
Background: Children and adolescents exposed to chronic trauma have a greater risk for mental health disorders and school failure. Children and adolescents of minority racial/ethnic groups and those living in poverty are at greater risk of exposure to trauma and less likely to have access to mental health services. School-based health centers…
Vellar, Lucia; Mastroianni, Fiorina; Lambert, Kelly
Objective The aim of the present study was to describe how one regional health service the Illawarra Shoalhaven Local Health District embedded health literacy principles into health systems over a 3-year period.Methods Using a case study approach, this article describes the development of key programs and the manner in which clinical incidents were used to create a health environment that allows consumers the right to equitably access quality health services and to participate in their own health care.Results The key outcomes demonstrating successful embedding of health literacy into health systems in this regional health service include the creation of a governance structure and web-based platform for developing and testing plain English consumer health information, a clearly defined process to engage with consumers, development of the health literacy ambassador training program and integrating health literacy into clinical quality improvement processes via a formal program with consumers to guide processes such as improvements to access and navigation around hospital sites.Conclusions The Illawarra Shoalhaven Local Health District has developed an evidence-based health literacy framework, guided by the core principles of universal precaution and organisational responsibility. Health literacy was also viewed as both an outcome and a process. The approach taken by the Illawarra Shoalhaven Local Health District to address poor health literacy in a coordinated way has been recognised by the Australian Commission on Safety and Quality in Health Care as an exemplar of a coordinated approach to embed health literacy into health systems.What is known about the topic? Poor health literacy is a significant national concern in Australia. The leadership, governance and consumer partnership culture of a health organisation can have considerable effects on an individual's ability to access, understand and apply the health-related information and services available to them
Covarrubias, Irene; Han, Meekyung
In this study, the attitudes toward and beliefs about serious mental illness (SMI) held by a group of graduate social work students in the northwestern United States were examined. Mental health stigma was examined with relation to the following factors: participants' level of social contact with SMI populations, adherence to stereotypes about SMI…
Covarrubias, Irene; Han, Meekyung
In this study, the attitudes toward and beliefs about serious mental illness (SMI) held by a group of graduate social work students in the northwestern United States were examined. Mental health stigma was examined with relation to the following factors: participants' level of social contact with SMI populations, adherence to stereotypes about SMI…
Dabiri, O M
Nigerians did not readily accept family planning when Family Health Services (FHS) began in 1988. FHS has made much headway in training, IEC (information, education, and communication), and constituency building and advocacy. Its staff have identified obstacles to implementation, especially program sustainability and management structure. Key limits to sustainability of IEC efforts were inadequately trained personnel and inability of trained personnel to apply what they learned at work stations. The Federal Ministry and Social Services' role in the FHS project was not clearly defined. Some private sector factors contributing to a confused management structure were inadequate method mix, high contraceptive cost, poor monitoring of quality of care, and no coordination of family planning training with the public factor. FHS has since decided to focus its efforts on increasing the demand for and availability of modern contraceptives and improving the quality of family planning services of both the public and private sectors. FHS hopes that accomplishing these activities will reduce fertility, morbidity, and mortality. Strategic plans include a regional focus, quality of care, a variety of methods offered, intensification, hospital and clinics, a management information system, contraceptive logistics, distribution regulations, and addressing social, cultural, and behavioral factors. To effectively implement the strategy, USAID and the Federal Ministry held a workshop in 1993 to effect full integration of Nigerian experience in the 2nd phase of the project (FHS II). Participants reviewed the strengths and weaknesses of the first phase and agreed on implementation. For example, nongovernmental organizations should implement FHS II. FHS II includes training, IEC, and commodities/logistics.
Sweeney, R E; Franklin, S P
This article illustrates how management in one type of service industry, the health maintenance organization (HMO), have attempted to formalize pricing. This effort is complicated by both the intangibility of the service delivered and the relatively greater influence in service industries of non-cost price factors such as accessibility, psychology, and delays. The presentation describes a simple computerized approach that allows the marketing manager to formally estimate the effect of incremental changes in rates on the firm's projected patterns of enrollment growth and net revenues. The changes in turn reflect underlying variations in the mix of pricing influences including psychological and other factors. Enrollment projections are crucial to the firm's financial planning and staffing. In the past, most HMO enrollment and revenue projections of this kind were notoriously unreliable. The approach described here makes it possible for HMOs to fine-tune their pricing policies. It also provides a formal and easily understood mechanism by which management can evaluate and reach consensus on alternative scenarios for enrollment growth, staff recruitment and capacity expansion.
Ouden, D.J. den; Velden, P.G. van der; Grievink, L.; Morren, M.; Dirkzwager, A.J.E.; Yzermans, C.J.
BACKGROUND: Given the high prevalence of mental health problems after disasters it is important to study health services utilization. This study examines predictors for mental health services (MHS) utilization among survivors of a man-made disaster in the Netherlands (May 2000). METHODS: Electronic
... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Public Health Services Act; Delegation of Authority Notice is hereby given that I have delegated to the Director, Office of Public Health...
Nix, Mary P.
There is always room for improvement in the delivery of health services. This article discusses the U.S. Agency for Healthcare Research and Quality's (AHRQ) Health Care Innovations Exchange (www.innovations.ahrq.gov), a comprehensive program that aims to increase awareness of innovative strategies to meet health service delivery challenges and…
Grove, A L; Meredith, J O; Macintyre, M; Angelis, J; Neailey, K
This paper presents the findings of a 13-month lean implementation in National Health Service (NHS) primary care health visiting services from May 2008 to June 2009. Lean was chosen for this study because of its reported success in other healthcare organisations. Value-stream mapping was utilised to map out essential tasks for the participating health visiting service. Stakeholder mapping was conducted to determine the links between all relevant stakeholders. Waste processes were then identified through discussions with these stakeholders, and a redesigned future state process map was produced. Quantitative data were provided through a 10-day time-and-motion study of a selected number of staff within the service. This was analysed to provide an indication of waste activity that could be removed from the system following planned improvements. The value-stream map demonstrated that there were 67 processes in the original health visiting service studied. Analysis revealed that 65% of these processes were waste and could be removed in the redesigned process map. The baseline time-and-motion data demonstrate that clinical staff performed on average 15% waste activities, and the administrative support staff performed 46% waste activities. Opportunities for significant waste reduction have been identified during the study using the lean tools of value-stream mapping and a time-and-motion study. These opportunities include simplification of standard tasks, reduction in paperwork and standardisation of processes. Successful implementation of these improvements will free up resources within the organisation which can be redirected towards providing better direct care to patients.
Full Text Available 1.1.Aim of the Study:To analyse the mental health status and psychological well being of the keratoconus patients using rigid contact lenses compared to spectacle corrected ones. The objective is to study if the correcting vision with contact lenses impacts the mental health status of the patients suffering from keratoconus. 1.2.Methodology:In the month of January to April, 2015 a cross sectional study was conducted in Ahooja eye hospital, Gurgaon, Haryana, India and Rajan eye care hospital, Tnagar, Chennai, Tamilnadu, India. Thirty two keratoconus patients were enrolled for the study and subjects were asked to the mental health status questionnaire MHI 38 with informed consent. Fifteen were habitual contact lens wearers and seventeen non contact lens wearers who volunteered to participate this study. Study included those contact lens users who wore lenses all waking hours and had been wearing them for atleast one year. All the questions were score coded for entering the data in Microsoft Excel sheet. The status of mental health was based on eight indicises which provided information on mental well being. 1.3.Results:17 males and 15 females participated in this study. The mean age of the participant was 28.03± 5.56 (range 20-39 years. The mean score of keratoconus patients of non contact lens wearer and contact lens wearer in Anxiety was 32.84 ± 2.99 &18.79 ± 3.67, Depression 13.34 ± 4.08 & 7.71 ± 2.19, Loss of behavioural / Emotion Control 30.29 ± 2.22 & 22.77 ± 6.70, General Positive Affect 49.00 ± 3.86 & 29.73 ± 4.48, Emotion Ties 10.17 ± 1.44 & 5.28 ± 1.71, Life Satisfaction 3.44 ± 0.96 & 4.94 ± 0.73, Psychological Distress 81.28 ± 4.48 & 53.15 ± 9.62, Psychological Well Being 41.15 ± 4.75 & 69.08 ± 5.26, Mental Health Index 119.81 ± 5.53 & 185.82 ± 11.03 respectively. Our results show that P value is <0.05 is statistically significant in all subscales and on the global scale variable of MHI 38. It suggests those who wear
Jun 15, 2011 ... that patients with depression are high utilizers of medical services. Objectives: The ... people's health and quality of life. It accounts for more than ..... Charlson ME, et al. Depression and service utilization in elderly primary care.
Federal Laboratory Consortium — The Tri-Service Center for Oral Health Studies (TSCOHS), a service of the Postgraduate Dental College, is chartered by the Department of Defense TRICARE Management...
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.
Tilahun Mesfin; Mengistie Bezatu; Egata Gudina; Reda Ayalu A
Abstract Background Adolescents in developing countries face a range of sexual and reproductive health problems. Lack of health care service for reproductive health or difficulty in accessing them are among them. In this study we aimed to examine health care workers' attitudes toward sexual and reproductive health services to unmarried adolescents in Ethiopia. Methods We conducted a descriptive cross-sectional survey among 423 health care service providers working in eastern Ethiopia in 2010....
Polsa, Pia; Fuxiang, Wei; Sääksjärvi, Maria; Shuyuan, Pei
Several service quality studies show how cultural features may influence the way service quality is perceived. However, few studies specifically describe culture's influence on health service quality. Also, there are few studies that take into account patients' health service quality perceptions. This article seeks to present a first step to fill these gaps by examining patients' cultural values and their health service quality assessments. The study draws on published work and applies its ideas to Chinese healthcare settings. Data consist of hospital service perceptions in the People's Republic of China (PRC), a society that is socially, economically and culturally undergoing major changes. In total, 96 patients were surveyed. Data relationships were tested using partial least square (PLS) analysis. Findings show that Chinese patients' cultural values and their health service assessments are related and that the cultural values themselves seem to be changing. Additionally, further analyses provided interesting results pointing to which cultural values influenced service quality perceptions. The strongest service quality predictor was power distance. The sample is relatively small and collected from only one major hospital in China. Therefore, future research should extend the sample size and scope. Follow-up research could also include cross-cultural investigations of perceived health service quality to substantiate cultural influences on health service quality perceptions. In line with similar research in other contexts, the study confirms that power distance has a significant relationship with service quality perceptions. The study contributes to existing health service literature by offering patients' views on health service quality and by describing relationships between health service perceptions and cultural values--the study's main contribution.
Carlos Arturo Meza Carvajalino
Full Text Available This document studies the theoretical foundations, the different controversies regarding the health service and the conceptions adopted from the hypotheses related to the market efficiency in the provision of a public service and the consequent market failures. The author thinks that when the health public service was delegated to the market in Colombia they originated failures in the competition, externalities, preference goods and services, asymmetry and redistribution, among the most relevant ones.
Vlad, R.S.; Petersen, P.E.
Attitudes, dental status, socioeconomic factors, oral health care, production of oral health, health status, quality of life......Attitudes, dental status, socioeconomic factors, oral health care, production of oral health, health status, quality of life...
Cunningham, Charles E; Chen, Yvonne; Deal, Ken; Rimas, Heather; McGrath, Patrick; Reid, Graham; Lipman, Ellen; Corkum, Penny
Parents seeking help for children with mental health problems are often assigned to a waiting list. We used a discrete choice conjoint experiment to model preferences for interim services that might be used while waiting for the formal assessment and treatment process to begin. A sample of 1,059 parents (92 % mothers) seeking mental health services for 4 to 16 year olds chose between hypothetical interim services composed by experimentally varying combinations of the levels of 13 interim service attributes. Latent Class analysis yielded a four-segment solution. All segments preferred interim options helping them understand how agencies work, enhancing their parenting knowledge and skill, and providing an opportunity to understand or begin dealing with their own difficulties. The Group Contact segment (35.1 %) preferred interim services in meetings with other parents, supported by phone contacts, frequent checkup calls, and wait-time updates. Virtual Contact parents (29.2 %) preferred to meet other parents in small internet chat groups supported by e-mail contact. Membership in this segment was linked to higher education and computer skills. Frequent Contact parents (24.4 %) preferred face-to-face interim services supported by weekly progress checks and wait time updates. Limited Contact parents (11.3 %) were less intent on using interim services. They preferred to pursue interim services alone, with contacts by phone, supported by fewer check-up calls and less frequent wait time updates. All segments were more likely to enroll in interim services involving their child.
Shi, Yishao; Chen, Huajie; Chen, Yongjian
Assuring equitable health service is an important factor for promoting sustainable development and constructing harmonious society. Its concept is very necessary for policy makers and health planners. Recent advances in the field of health geography have greatly improved our understanding of the role played by equitable geographic distribution of health services. But equity is difficult to operationalize because it is influenced by lots of non-spatial factors. This paper presents a notion that analyzes spatial equity of health service integrating theories and techniques of spatial accessibility and GIS. By means of modified spatial accessibility index, the authors analyze relative equity status of each subdistrict based on geo-referenced and socio-demographic census exemplified by Minhang District of Shanghai. Due to the demand of residents and using efficiency of every health service are added in the method of accessibility, it makes equity research more valid. The paper also discusses the influence of floating population on spatial equity of health service.
Full Text Available While objective parameters like sufficiency of the resources and the number of people benefiting from services are considered to evaluate the health services, the attitudes and behaviors which patients meet during taking this health service and ethical issues like patient rights are considered as second importance. But ethical parameters are more important for patients. Military health organizations have much responsibility about ethical issues; because they are usually the only institutions for the personnel who they serve to took health service, requested health service are usually indispensable and the patient couldn?t select the physician because of the structure of the organization and military conditions. It is necessary to educate personnel in military health organizations as well as in all of the health institutions about gaining communication skills and patient rights in order to reach the desired level in ethical issues. [TAF Prev Med Bull 2005; 4(1.000: 37-45
Gorman, Lisa A; Blow, Adrian J; Ames, Barbara D; Reed, Philip L
.... The purpose of this cross-sectional study was to assess mental health symptoms, utilization of mental health services, and perceived barriers to service use among National Guard members and their significant others...
Swan, J H; Fox, P J; Estes, C L
Data gathered from a recent survey of CMHC's suggest that the elderly are increasing their utilization of CMHC services. As more responsibility for mental health services is shifted to the states, a commitment to mental health services for the elderly increasingly becomes an issue of state discretion, and of state finances. This makes it probable that accessibility to mental health services for the elderly will become more variable and problematic on a national basis. This is especially important in light of data that indicates an increasing awareness by CMHC's of the mental health needs of the elderly.
Roussy, Véronique; Livingstone, Charles
Until now, comprehensive service planning has been uncommon in the Victorian community health sector. Where it has occurred, it has primarily been undertaken by community health services embedded within larger, hospital-based health services. Reflections on the utility and efficacy of community health service planning are largely absent from the Australian peer-reviewed literature. Using a case study focussed on a specific centre in Melbourne's outer suburbs, this paper explores how community health service planning is shaped by the current policy context, the legal status of registered community health services, and the data and methodologies available to inform planning. It argues that regular and systematic service planning could support registered community health centres to better understand their unique position within the primary health-care landscape, having regard to their inherent opportunities and vulnerabilities. Furthermore, consistent and effective service planning is proposed to benefit agencies in establishing themselves as critical players in promoting local population health initiatives and driving improved health outcomes.
Full Text Available Fadia S AlBuhairan,1–3 Tina M Olsson3,4 1Department of Pediatrics, King Abdulaziz Medical City, Riyadh, Saudi Arabia; 2King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; 3King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; 4School of Social Work, Lund University, Lund, Sweden Background: Adolescent health is regarded as central to global health goals. Investments made in adolescent health and health services protect the improvements witnessed in child health. Though Saudi Arabia has a large adolescent population, adolescent health-care only began to emerge in recent years, yet widespread uptake has been very limited. Health-care providers are key in addressing and providing the necessary health-care services for adolescents, and so this study was conducted with the aim of identifying opportunities for the advancement of knowledge transfer for adolescent health services in Saudi Arabia. Methods: This Web-based, cross-sectional study was carried out at four hospitals in Saudi Arabia. Physicians and nurses were invited to participate in an online survey addressing their contact with adolescent patients, and training, knowledge, and attitudes towards adolescent health-care. Results: A total of 232 professionals participated. The majority (82.3% reported sometimes or always coming into contact with adolescent patients. Less than half (44%, however, had received any sort of training on adolescent health during their undergraduate or postgraduate education, and only 53.9% reported having adequate knowledge about the health-care needs of adolescents. Nurses perceived themselves as having more knowledge in the health-care needs of adolescents and reported feeling more comfortable in communicating with adolescents as compared with physicians. The majority of participants were interested in gaining further skills and knowledge in adolescent health-care and agreed or strongly agreed that adolescents have
Lennox, Charlotte; Mason, Julie; McDonnell, Sharon; Shaw, Jenny; Senior, Jane
Offenders with mental health problems often have complex and interrelated needs which separately challenge the criminal justice system (CJS) and National Health Service (NHS) in the United Kingdom (U.K.). Consequently, interagency collaboration and timely information sharing are essential. This study focused on the sharing of information about people with mental health problems in contact with the CJS. Questionnaires were distributed to a range of health and criminal justice personnel. The results showed that there was a mismatch between what service user information criminal justice agencies felt they needed and what was routinely received. Prison Service staff received more information (between 15% and 37%) from health agencies than the police (between 6% and 22%). Health professionals received most of the information they needed from criminal justice agencies (between 55% and 85%). Sharing service user information was impeded by incompatible computer systems and restrictions due to data protection/confidentiality requirements. In the U.K., recent governmental publications have highlighted the importance of information sharing; however there remains a clear mismatch between what health related information about service users criminal justice agencies need, and what is actually received. Better guidance is required to encourage and empower people to share.
... other diagnostic tests. (f) X-ray therapy and other radiation therapy services. (g) Medical supplies, appliances, and devices. (h) Durable medical equipment. (i) Ambulance services. (j) Rural health...
Yang, Jun; Guo, Aimin; Wang, Yadong; Zhao, Yali; Yang, Xinhua; Li, Hang; Duckitt, Roger; Liang, Wannian
PURPOSE We report a study on the developmental status of human resource staffing and service functions of community health services (CHS) in China and offer recommendations for improving the CHS in the future.
Because of the aging working population and the increasing age of retirement the number of workers with chronic illnesses and disabilities is growing. It is important that workers with health complaints receive efficient health care in order to remain fully or at least partly productive. To explore workers' opinions about the effectiveness of contact with health care providers in shortening sickness absence duration. Data come from a four-wave study from 2005 to 2008 among Dutch workers (n=1,424). Data were obtained on visits to health care providers, sickness absence and workers' opinions on whether and how their absence could have been shortened. A third of the workers were of the opinion that the health care provider (most often the general practitioner, GP) had played a role in preventing sickness absence and 35% were of the opinion that the health care provider had limited their absence. Most often the physical therapist (71%) and mental health therapist (61%) shortened sickness absence duration, in contrast to the occupational physician (OP, 25%) and GP (32%). The effectiveness of the health care providers' treatment was associated with the cause of sickness absence. Approximately 15% of the workers reported that their sickness absence could have been shortened if health care providers had provided the proper treatment and if waiting times had been reduced. Health care providers differ in their potential to shorten sickness absence duration. Health care providers can further reduce sickness absence and health care costs by providing the proper treatment and by reducing waiting times.
Rodriguez, Aubrey J; Margolin, Gayla
Although military service, and particularly absence due to deployment, has been linked to risk for depression and anxiety among some spouses and children of active duty service members, there is limited research to explain the heterogeneity in family members' reactions to military service stressors. The current investigation introduces the Timeline Followback Military Family Interview (TFMFI) as a clinically useful strategy to collect detailed time-linked information about the service member's absences. Two dimensions of parent absence--the extent to which absences coincide with important family events and cumulative time absent--were tested as potential risks to family members' mental health. Data from 70 mother-adolescent pairs revealed that the number of important family events missed by the service member was linked to elevated youth symptoms of depression, even when accounting for the number of deployments and cumulative duration of the service member's absence. However, youth who reported more frequent contact with the service member during absences were buffered from the effects of extensive absence. Mothers' symptoms were associated with the cumulative duration of the service members' time away, but not with family events missed by the service member. These results identify circumstances that increase the risk for mental health symptoms associated with military family life. The TFMFI provides an interview-based strategy for clinicians wishing to understand military family members' lived experience during periods of service-member absence. (c) 2015 APA, all rights reserved).
Austen, Sally; McGrath, Melissa
Long-distance travel to provide mental health services for deaf people has implications for efficiency, safety, and equality of service. However, uptake of Telemental Health (TMH) has been slow in both deaf and general mental health services. A quantitative study was used to investigate access to TMH and whether staff confidence, experience, or…
Martinez, Jonathan I.; Lau, Anna S.
Social support networks may encourage or dissuade help-seeking for youth behavior problems in ways that contribute to racial/ethnic disparities in mental health services. The authors examined how parental social network characteristics were related to the use of mental health services in a diverse sample of families in contact with Child Welfare.…
Correct understanding of the risks of treatments is essential for consumers of health services. Yet, existing research has not examined how consumers understand risk in mixed-market health service environments, where private sector firms operate alongside established public sector providers, such as is the case in the UK. As the range and complexity of private sector health services increases, there remains uncertainty about how individuals will perceive, and respond to, the ri...
Kirchengast, Sylvia; Haslinger, Beatrix
Over the last century population ageing is a well described phenomenon all over the world. The dramatic absolute and relative increase in the population component of the elderly and the very old has influenced not only population structure but also the relationships within families, in particular between older parents and their adult children. The aim of the present study was to examine the impact of intergenerational contact frequency on health related quality of life among 62 men and 98 women ranging in age between 60 and 94 years. All participants of the study were healthy and lived independently in their private homes. Data concerning subjective well being and health related quality of life were collected by personal interviews based on structured questionnaires. Health related quality of life was tested by means of the WHOQOL-BREF. The main finding of this study is that the frequency of intergenerational contacts has a significant impact on health related quality of life. Contact frequency with grandchildren per month correlated significantly (pquality of life increased significantly (pquality of life during old age.
Naseer, Aisha; Stergioulas, Lampros K
HealthGrids represent the next generation of advanced healthcare IT and hold the promise to untangle complex healthcare-data problems by integrating health information systems and healthcare entities. Healthcare could benefit from a new delivery approach using HealthGrids to better meet the biomedical and health-related needs. Specialized services are needed to provide unified discovery of and ubiquitous access to available HealthGrid resources. The different types of services available on HealthGrids are classified into two levels, the operational-level services and the management-level services. This paper takes a fresh approach to address the problems of resource discovery in HealthGrids based on Web services (WS) and WS technologies and proposes a WS-based resource discovery model.
Aboagye, Emmanuel; Agyemang, Otuo Serebour
This paper examines how organization and financing of maternal health services influence health-seeking behavior in Bosomtwe district, Ghana. It contributes in furthering the discussions on maternal health-seeking behavior and health outcomes from a health system perspective in sub-Saharan Africa. From a health system standpoint, the paper first presents the resources, organization and financing of maternal health service in Ghana, and later uses case study examples to explain how Ghana's hea...
Aboagye, Emmanuel; Agyemang, Otuo Serebour
This paper examines how organization and financing of maternal health services influence health-seeking behavior in Bosomtwe district, Ghana. It contributes in furthering the discussions on maternal health-seeking behavior and health outcomes from a health system perspective in sub-Saharan Africa. From a health system standpoint, the paper first presents the resources, organization and financing of maternal health service in Ghana, and later uses case study examples to explain how Ghana's hea...
Sacks, Jilian A; Zehe, Elizabeth; Redick, Cindil; Bah, Alhoussaine; Cowger, Kai; Camara, Mamady; Diallo, Aboubacar; Gigo, Abdel Nasser Iro; Dhillon, Ranu S; Liu, Anne
Challenges in data availability and quality have contributed to the longest and deadliest Ebola epidemic in history that began in December 2013. Accurate surveillance data, in particular, has been difficult to access, as it is often collected in remote communities. We describe the design, implementation, and challenges of implementing a smartphone-based contact tracing system that is linked to analytics and data visualization software as part of the Ebola response in Guinea. The system, built on the mobile application CommCare and business intelligence software Tableau, allows for real-time identification of contacts who have not been visited and strong accountability of contact tracers through timestamps and collection of GPS points with their surveillance data. Deployment of this system began in November 2014 in Conakry, Guinea, and was expanded to a total of 5 prefectures by April 2015. To date, the mobile system has not replaced the paper-based system in the 5 prefectures where the program is active. However, as of April 30, 2015, 210 contact tracers in the 5 prefectures were actively using the mobile system to collectively monitor 9,162 contacts. With proper training, some investment in technical hardware, and adequate managerial oversight, there is opportunity to improve access to surveillance data from difficult-to-reach communities in order to inform epidemic control strategies while strengthening health systems to reduce risk of future disease outbreaks.
Noirhomme-Renard, F; Bullens, Q; Malchair, A; Gosset, C
The current health needs of children largely exceeds the biomedical model. The school doctor occupies a special position where he can take into account the social determinants of health and identify vulneirable children. After the detection by the school health service, the harmonious development of, the child requires that health professionals cooperate in a "preventive network".
Agampodi Thilini C
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
Brauner-Otto, Sarah R; Axinn, William G; Ghimire, Dirghaj J
We use detailed measures of social change over time, increased availability of various health services, and couples' fertility behaviors to document the independent effects of health services on fertility limitation. Our investigation focuses on a setting in rural Nepal that experienced a transition from virtually no use of birth control in 1945 to the widespread use of birth control by 1995 to limit fertility. Changes in the availability of many different dimensions of health services provide the means to evaluate their independent influences on contraceptive use to limit childbearing. Findings show that family planning as well as maternal and child health services have independent effects on the rate of ending childbearing. For example, the provision of child immunization services increases the rate of contraceptive use to limit fertility independently of family planning services. Additionally, new Geographic Information System (GIS)-based measures also allow us to test many alternative models of the spatial distribution of services. These tests reveal that complex, geographically defined measures of all health service providers outperform more simple measures. These results provide new information about the consequences of maternal and child health services and the importance of these services in shaping fertility transitions.
Full Text Available Abstract Background Persons with schizophrenia and related disorders may be particularly sensitive to a number of determinants of service use, including those related with illness, socio-demographic characteristics and organizational factors. The objective of this study is to identify factors associated with outpatient contacts at community mental health services of patients with schizophrenia or related disorders. Methods This cross-sectional study analyzed 1097 patients. The main outcome measure was the total number of outpatient consultations during one year. Independent variables were related to socio-demographic, clinical and use of service factors. Data were collected from clinical records. Results The multilevel linear regression model explained 46.35% of the variance. Patients with significantly more contacts with ambulatory services were not working and were receiving welfare benefits (p = 0.02, had no formal education (p = 0.02, had a global level of severity of two or three (four being the most severe (p Conclusions As expected, the variables that explained the use of community service could be viewed as proxies for severity of illness. The most surprising finding, however, was that a group of four psychiatrists was also independently associated with use of ambulatory services by patients with schizophrenia or related disorders. More research is needed to carefully examine how professional support networks interact to affect use of mental health.
Anaf, Julia; Baum, Fran; Freeman, Toby; Labonte, Ron; Javanparast, Sara; Jolley, Gwyn; Lawless, Angela; Bentley, Michael
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.
... maintenance, and other activities involving live vertebrate animals conducted under contract (see Public Health Service Policy on Humane Care and Use of Laboratory Animals (PHS Policy), Rev. 1986, Repr. 1996... Compliance with the Public Health Service Policy on Humane Care and Use of Laboratory Animals,...
... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration Agency Information Collection Activities... development of a technical assistance tracker for RWHAP grantees to monitor and assess changes in the mix...
Erickson, Chris D.; Al-Timimi, Nada R.
This paper presents background information on the cultural sociopathology of the Arab American experience. It discusses how, in order to effectively deliver services, mental health workers need to be aware of their own biases. It explores ways to provide culturally relevant mental health services to Arab Americans. (JDM)
Westerholm, Peter; Hasle, Peter; Fortuin, Rick
A discussion of the possibilities for professionals from the occupational health service to act as external agents of change in introducing preventive activities in enterprises.......A discussion of the possibilities for professionals from the occupational health service to act as external agents of change in introducing preventive activities in enterprises....
Gong-Guy, Elizabeth; And Others
Serious limitations exist in the delivery of mental health services to refugees throughout the resettlement process: fragmentation, instability, language barriers, culturally inappropriate treatment methods, and severe staff shortages. Suggested improvements for refugee mental health services emphasize outreach, prevention, treatment approaches,…
Full Text Available The infusion of information communication technology (ICT into health services is emerging as an active area of research. It has several advantages but perhaps the most important one is providing medical benefits to one and all irrespective of geographic boundaries in a cost effective manner, providing global expertise and holistic services, in a time bound manner. This paper provides a systematic review of technological growth in eHealth services. The present study reviews and analyzes the role of four important technologies, namely, satellite, internet, mobile, and cloud for providing health services.
... HUMAN SERVICES Health Resources and Services Administration National Advisory Council on the National Health Service Corps; Request for Nominations AGENCY: Health Resources and Services Administration... Administration (HRSA) is requesting nominations to fill five vacancies on the National Advisory Council (NAC)...
Bains, Ranbir Mangat; Diallo, Ana F.
Mental health issues affect 20-25% of children and adolescents, of which few receive services. School-based health centers (SBHCs) provide access to mental health services to children and adolescents within their schools. A systematic review of literature was undertaken to review evidence on the effectiveness of delivery of mental health services…
Baker, Dian L.; Hebbeler, Kathleen; Davis-Alldritt, Linda; Anderson, Lori S.; Knauer, Heather
Children with special health care needs (CSHCN) are at risk for school failure when their health needs are not met. Current studies have identified a strong connection between school success and health. This study attempted to determine (a) how schools meet the direct service health needs of children and (b) who provides those services. The study…
Baker, Dian L.; Hebbeler, Kathleen; Davis-Alldritt, Linda; Anderson, Lori S.; Knauer, Heather
Children with special health care needs (CSHCN) are at risk for school failure when their health needs are not met. Current studies have identified a strong connection between school success and health. This study attempted to determine (a) how schools meet the direct service health needs of children and (b) who provides those services. The study…
Harris, Jeffrey R; Hammerback, Kristen R; Hannon, Peggy A; McDowell, Julie; Katzman, Avi; Clegg-Thorp, Catherine; Gallagher, John
Small employers are underserved with workplace health promotion services, so we explored the potential for group purchasing of these services. We conducted semistructured telephone interviews of member organizations serving small employers, as well as workplace health promotion vendors, in Washington State. We interviewed 22 employer organizations (chambers of commerce, trade associations, and an insurance trust) and vendors (of fitness facilities, healthy vending machines, fresh produce delivery, weight management services, and tobacco cessation quitlines). Both cautiously supported the idea of group purchasing but felt that small employers' workplace health promotion demand must increase first. Vendors providing off-site services, for example, quitline, found group purchasing more feasible than vendors providing on-site services, for example, produce delivery. Employer member organizations are well-positioned to group purchase workplace health promotion services; vendors are receptive if there is potential profit.
Murphy, Sarah Anne; Cerqua, Judith
A customer contact center offers academic libraries the ability to consistently improve their telephone, e-mail, and IM services. This paper discusses the establishment of a contact center and the benefits of implementing the contact center model at this institution. It then introduces a practical methodology for developing a valid measurement…
Murphy, Sarah Anne; Cerqua, Judith
A customer contact center offers academic libraries the ability to consistently improve their telephone, e-mail, and IM services. This paper discusses the establishment of a contact center and the benefits of implementing the contact center model at this institution. It then introduces a practical methodology for developing a valid measurement…
Arunanondchai, Jutamas; Fink, Carsten
Promoting quality health services to large population segments is a key ingredient to human and economic development. At its core, healthcare policymaking involves complex trade-offs between promoting equitable and affordable access to a basic set of health services, creating incentives for efficiencies in the healthcare system and managing constraints in government budgets. International trade in health services influences these trade-offs. It presents opportunities for cost savings and access to better quality care, but it also raises challenges in promoting equitable and affordable access. This paper offers a discussion of trade policy in health services for the ASEAN region. It reviews the existing patterns of trade and identifies policy measures that could further harness the benefits from trade in health services and address potential pitfalls that deeper integration may bring about.
Ross, Claire; Dimitrova, Stoyanka; Howard, Louise M; Dewey, Michael; Zimmerman, Cathy; Oram, Siân
Objectives (1) To estimate the proportion of National Health Service (NHS) professionals who have come into contact with trafficked people and (2) to measure NHS professionals’ knowledge and confidence to respond to human trafficking. Design A cross-sectional survey. Setting Face-to-face mandatory child protection and/or vulnerable adults training sessions at 10 secondary healthcare provider organisations in England, and meetings of the UK College of Emergency Medicine. Participants 782/892 (84.4%) NHS professionals participated, including from emergency medicine, maternity, mental health, paediatrics and other clinical disciplines. Measures Self-completed questionnaire developed by an expert panel. Questionnaire asks about prior training and contact with potential victims of trafficking, perceived and actual human trafficking knowledge, confidence in responding to human trafficking, and interest in future human trafficking training. Results 13% participants reported previous contact with a patient they knew or suspected of having been trafficked; among maternity services professionals this was 20.4%. However, 86.8% (n=679) reported lacking knowledge of what questions to ask to identify potential victims and 78.3% (n=613) reported that they had insufficient training to assist trafficked people. 71% (n=556), 67.5% (n=528) and 53.4% (n=418) lacked confidence in making appropriate referrals for men, women and children, respectively, who had been trafficked. 95.3% (n=746) of respondents were unaware of the scale of human trafficking in the UK, and 76.5% (n=598) were unaware that calling the police could put patients in more danger. Psychometric analysis showed that subscales measuring perceived knowledge, actual knowledge and confidence to respond to human trafficking demonstrated good internal consistency (Cronbach's αs 0.93, 0.63 and 0.64, respectively) and internal correlations. Conclusions NHS professionals working in secondary care are in contact with potential
Ross, Claire; Dimitrova, Stoyanka; Howard, Louise M; Dewey, Michael; Zimmerman, Cathy; Oram, Siân
(1) To estimate the proportion of National Health Service (NHS) professionals who have come into contact with trafficked people and (2) to measure NHS professionals' knowledge and confidence to respond to human trafficking. A cross-sectional survey. Face-to-face mandatory child protection and/or vulnerable adults training sessions at 10 secondary healthcare provider organisations in England, and meetings of the UK College of Emergency Medicine. 782/892 (84.4%) NHS professionals participated, including from emergency medicine, maternity, mental health, paediatrics and other clinical disciplines. Self-completed questionnaire developed by an expert panel. Questionnaire asks about prior training and contact with potential victims of trafficking, perceived and actual human trafficking knowledge, confidence in responding to human trafficking, and interest in future human trafficking training. 13% participants reported previous contact with a patient they knew or suspected of having been trafficked; among maternity services professionals this was 20.4%. However, 86.8% (n=679) reported lacking knowledge of what questions to ask to identify potential victims and 78.3% (n=613) reported that they had insufficient training to assist trafficked people. 71% (n=556), 67.5% (n=528) and 53.4% (n=418) lacked confidence in making appropriate referrals for men, women and children, respectively, who had been trafficked. 95.3% (n=746) of respondents were unaware of the scale of human trafficking in the UK, and 76.5% (n=598) were unaware that calling the police could put patients in more danger. Psychometric analysis showed that subscales measuring perceived knowledge, actual knowledge and confidence to respond to human trafficking demonstrated good internal consistency (Cronbach's αs 0.93, 0.63 and 0.64, respectively) and internal correlations. NHS professionals working in secondary care are in contact with potential victims of human trafficking, but lack knowledge and confidence in
Full Text Available Abstract Background Investigating mortality in those with mental disorder is one way of measuring effects of mental health care reorganisation. This study's aim was to investigate whether the excess mortality in those with severe mental disorder remains high in Sweden after the initiation of the Community Mental Health Care Reform. We analysed excess mortality by gender, type of mental health service and psychiatric diagnosis in a large community-based cohort with long-term mental disorder. Methods A survey was conducted in Stockholm County, Sweden in 1997 to identify adults with long-term disabling mental disorder (mental retardation and dementia excluded. The 12 103 cases were linked to the Hospital Discharge Register and the Cause of Death Register. Standardised mortality ratios (SMRs for 1998–2000 were calculated for all causes of death, in the entire cohort and in subgroups based on treatment setting and diagnosis. Results Mortality was increased in both genders, for natural and external causes and in all diagnostic subgroups. Excess mortality was greater among those with a history of psychiatric inpatient care, especially in those with substance use disorder. For the entire cohort, the number of excess deaths due to natural causes was threefold that due to external causes. SMRs in those in contact with psychiatric services where strikingly similar to those in contact with social services. Conclusion Mortality remains high in those with long-term mental disorder in Sweden, regardless of treatment setting. Treatment programs for persons with long-term mental disorder should target physical as well as mental health.
Introduction: For families of children with mental illness, adolescence is a major struggle and few parents find service systems to be helpful during this period . These difficulties seem to span across various dimensions such as availability of health, educational and community resources, barriers to accessing services, understanding of health care providers and specially those related to the transition to adult healthcare service system and the restrictions imposed by confidentially. Par...
Billi, John E; Pai, Chih-Wen; Spahlinger, David A
When tertiary health centers face capacity constraint, one feasible strategy to meet service demand is outsourcing clinical services to qualified community providers. Clinical outsourcing enables tertiary health centers to meet the expectations of service timeliness and provides good opportunities to collaborate with other health care providers. However, outsourcing may result in dependence and loss of control for the tertiary health centers. Other parties involved in clinical outsourcing such as local partners, patients, and payers may also encounter potential risks as well as enjoy benefits in an outsourcing arrangement. Recommendations on selecting potential outsourcing partners are given to minimize the risks associated with an outsourcing contract.
Malm, Annika; Axelsson, Gösta; Barregard, Lars; Ljungqvist, Jakob; Forsberg, Bertil; Bergstedt, Olof; Pettersson, Thomas J R
There are relatively few studies on the association between disturbances in drinking water services and symptoms of gastrointestinal (GI) illness. Health Call Centres data concerning GI illness may be a useful source of information. This study investigates if there is an increased frequency of contacts with the Health Call Centre (HCC) concerning gastrointestinal symptoms at times when there is a risk of impaired water quality due to disturbances at water works or the distribution network. The study was conducted in Gothenburg, a Swedish city with 0.5 million inhabitants with a surface water source of drinking water and two water works. All HCC contacts due to GI symptoms (diarrhoea, vomiting or abdominal pain) were recorded for a three-year period, including also sex, age, and geocoded location of residence. The number of contacts with the HCC in the affected geographical areas were recorded during eight periods of disturbances in the water works (e.g. short stops of chlorine dosing), six periods of large disturbances in the distribution network (e.g. pumping station failure or pipe breaks with major consequences), and 818 pipe break and leak repairs over a three-year period. For each period of disturbance the observed number of calls was compared with the number of calls during a control period without disturbances in the same geographical area. In total about 55, 000 calls to the HCC due to GI symptoms were recorded over the three-year period, 35 per 1000 inhabitants and year, but much higher (>200) for children water works or in the distribution network. Our results indicate that GI symptoms due to disturbances in water works or the distribution network are rare. The number of serious failures was, however limited, and further studies are needed to be able to assess the risk of GI illness in such cases. The technique of using geocoded HCC data together with geocoded records of disturbances in the drinking water network was feasible.
Hovenga, Evelyn J S
This chapter gives an educational overview of: * many competing characteristics within national health systems * national primary information and knowledge flows between health care entities * the role of information technologies in assisting health organizations become sustainable enterprises * the business of maintaining healthy populations for any nation * desirable e-health strategy objectives.
Booth, Mark; Boxall, Anne-Marie
Commissioning is set to become a stronger feature in the Australian health system as Primary Health Networks embrace it as a tool for improving population health outcomes. International experience shows that developing into a commissioning organisation is not always easy. Drawing on international experiences of commissioning, as well as those from the Australian hospital sector, will help smooth the path for Primary Health Networks.
Schenker, Yael; Arnold, Robert M; London, Alex John
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.
Shivram, Raghuram; Bankart, John; Meltzer, Howard; Ford, Tamsin; Vostanis, Panos; Goodman, Robert
Children with conduct disorders (CD) and their families are in contact with multiple agencies, but there is limited evidence on their patterns of service utilization. The aim of this study was to establish the patterns, barriers and correlates of service use by analysing the cohort of the 2004 Great Britain child mental health survey (N = 7,977). Use of social services was significantly higher by children with CD than emotional disorders (ED) in the absence of co-morbidity, while use of specialist child mental health and paediatric was significantly higher by children with hyperkinetic disorders (HD) than CD. Children who had comorbid physical disorders used more primary healthcare services compared to those without physical disorders. Utilization of specialist child mental heath and social services was significantly higher among children with unsocialized CD than socialized CD and oppositional defiant disorders. Services utilization and its correlates varied with the type of service. Overall, specialist services use was associated with co-morbidity with learning disabilities, physical and psychiatric disorders. Several correlates of services use in CD appeared non-specific, i.e. associated with use of different services indicating the possibility of indiscriminate use of different types of services. The findings led to the conclusion that there is the need for effective organization and co-ordination of services, and clear care pathways. Involvement of specialist child mental health services should be requested in the presence of mental health co-morbidity.
Dee, Cheryl R
Two years after the initial 2002 study, a greater number of academic health science libraries are offering digital reference chat services, and this number appears poised to grow in the coming years. This 2004 follow-up study found that 36 (27%) of the academic health science libraries examined provide digital chat reference services; this was an approximately 6% increase over the 25 libraries (21%) located in 2002. Trends in digital reference services in academic health science libraries were derived from the exploration of academic health science library Web sites and from digital correspondence with academic health science library personnel using e-mail and chat. This article presents an overview of the current state of digital reference service in academic health science libraries.
Rogers, Bonnie; Kono, Keiko; Marziale, Maria Helena Palucci; Peurala, Marjatta; Radford, Jennifer; Staun, Julie
Access to occupational health services for primary prevention and control of work-related injuries and illnesses by the global workforce is limited (World Health Organization [WHO], 2013). From the WHO survey of 121 (61%) participating countries, only one-third of the responding countries provided occupational health services to more than 30% of their workers (2013). How services are provided in these countries is dependent on legal requirements and regulations, population, workforce characteristics, and culture, as well as an understanding of the impact of workplace hazards and worker health needs. Around the world, many occupational health services are provided by occupational health nurses independently or in collaboration with other disciplines' professionals. These services may be health protection, health promotion, or both, and are designed to reduce health risks, support productivity, improve workers' quality of life, and be cost-effective. Rantanen (2004) stated that basic occupational health services must increase rather than decline, especially as work becomes more complex; workforces become more dynamic and mobile, creating new models of work-places; and jobs become more precarious and temporary. To better understand occupational health services provided by occupational health nurses globally and how decisions are made to provide these services, this study examined the scope of services provided by a sample of participating occupational health nurses from various countries.
Ruotsalainen, Pekka; Blobel, Bernd
Trust is a social code and glue between persons and organizations in any business domain including health. pHealth is a complex concept that is built around health service providers, individuals and artefacts such as sensors, mobile devices, networks, computers, and software applications. It has many stakeholders such as organizations, persons, patients, customers, and tele-operators. pHealth services are increasingly offered in insecure information space, and used over organizational, geographical and jurisdictional borders. This all means that trust is an essential requirement for successful pHealth services. To make pHealth a successful business, organizations offering pHealth services should establish inter-organizational trust and trusted relationship between their customers. Before starting to use services, the pHealth user should have a possibility to define how much it trusts on the service provider and on the surrounding information infrastructure. The authors' analysis show that trust models used in today's health care and e-commerce are insufficient for networked pHealth. Calculated trust as proposed by the authors is stronger than the predefined dispositional trust model currently used in health care, other's recommendations used in e-commerce and risk assessment. Until now, caused by the lack of business incentive, lack of regulatory and political pressure, pHealth providers have not demonstrated meaningful interest in moving from the current unsatisfactory situation to trust calculation by making information necessary for this methodology available. To make pHealth successful, a combination of legal, political, organizational, technological and educational efforts is needed to initiate the paradigm change and start the era of trust-based pHealth services.
Willoughby, Jessica Fitts; Muldrow, Adrienne
Objectives: Text message-based interventions may provide sexual health information to young people through a number of service types, from sending information on a regularly scheduled timeline, to providing an automated menu, to allowing young people to connect directly with health educators. While such service types exist, it is not clear which…
Willoughby, Jessica Fitts; Muldrow, Adrienne
Objectives: Text message-based interventions may provide sexual health information to young people through a number of service types, from sending information on a regularly scheduled timeline, to providing an automated menu, to allowing young people to connect directly with health educators. While such service types exist, it is not clear which…
Fox, Amanda; Gardner, Glenn; Osborne, Sonya
Health service managers and policy makers are increasingly concerned about the sustainability of innovations implemented in health care settings. The increasing demand on health services requires that innovations are both effective and sustainable; however, research in this field is limited, with multiple disciplines, approaches and paradigms influencing the field. These variations prevent a cohesive approach, and therefore the accumulation of research findings, in the development of a body of knowledge. The purpose of this paper is to provide a thorough examination of the research findings and provide an appropriate theoretical framework to examine sustainability of health service innovation. This paper presents an integrative review of the literature available in relation to sustainability of health service innovation and provides the development of a theoretical framework based on integration and synthesis of the literature. A theoretical framework serves to guide research, determine variables, influence data analysis and is central to the quest for ongoing knowledge development. This research outlines the sustainability of innovation framework; a theoretical framework suitable for examining the sustainability of health service innovation. If left unaddressed, health services research will continue in an ad hoc manner, preventing full utilisation of outcomes, recommendations and knowledge for effective provision of health services. The sustainability of innovation theoretical framework provides an operational basis upon which reliable future research can be conducted.
Martínez-Caro, Eva; Cegarra-Navarro, Juan Gabriel; Solano-Lorente, Marcelina
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.
Alexander-Bratcher, Kimberly M; Martin, Grier; Purcell, William R; Watson, Michael; Silberman, Pam
The North Carolina Institute of Medicine Task Force on Behavioral Health Services for the Military and Their Families examined the adequacy of Medicaid- and state-funded services for mental health conditions, developmental disabilities (including traumatic brain injury), and substance abuse that are currently available in North Carolina to military service members, veterans, and their families. The task force determined that there are several gaps in services and made 13 recommendations related to federal, state, and local community resources. This article reviews the work of the task force and current efforts to improve services in North Carolina.
Ravindran, T K Sundari
Privatisation in Pakistan's health sector was part of the Structural Adjustment Programme that started in 1998 following the country's acute foreign exchange crisis. This paper examines three examples of privatisation which have taken place in service delivery, management and capacity-building functions in the health sector: 1) large-scale contracting out of publicly-funded health services to private, not-for-profit organisations; 2) social marketing/franchising networks providing reproductive health services; and 3) a public-private partnership involving a consortium of private players and the government of Pakistan. It assesses the extent to which these initiatives have contributed to promoting equitable access to good quality, comprehensive reproductive health services. The paper concludes that these forms of privatisation in Pakistan's health sector have at best made available a limited range of fragmented reproductive health services, often of sub-optimal quality, to a fraction of the population, with poor returns in terms of health and survival, especially for women. This analysis has exposed a deep-rooted malaise within the health system as an important contributor to this situation. Sustained investment in health system strengthening is called for, where resources from both public and private sectors are channelled towards achieving health equity, under the stewardship of the state and with active participation by and accountability to members of civil society.
... testing of new methods of health care delivery and management, and nursing research. Applications are... Research and Development Officer. On August 31, the subcommittee on Nursing Research Initiative will... AFFAIRS Health Services Research and Development Service Merit Review Board; Notice of Meeting...
... methods of health care delivery and management, and nursing research. Applications are reviewed for... Development Officer. On August 30, the subcommittees on Nursing Research Initiatives and Research Best... AFFAIRS Health Services Research and Development Service Merit Review Board; Notice of Meeting...
... methods of health care delivery and management, and nursing research. Applications are reviewed for... Development Officer. On March 2, the subcommittee on Nursing Research Initiative will convene from 8 a.m. to... AFFAIRS Health Services Research and Development Service Merit Review Board; Notice of Meeting...
Chen, Shu-Ping; Koller, Michelle; Krupa, Terry; Stuart, Heather
This study evaluated eighteen Canadian anti-stigma programs targeting high-school students. The purpose was to identify critical domains and develop a program model of contact-based interventions. Three steps were implemented. The first step involved collecting program information through twenty in-depth interviews with stakeholders and field observations of seven programs. The second step involved constructing critical ingredients into domains for conceptual clarity and component modeling. The third step involved validating the program model by stakeholders review and initial fidelity testing with program outcomes. A program model with an overarching theme "engaging contact reduces stigma" and three underlying constructs (speakers, message, and interaction) were developed. Within each construct three specific domains were identified to explain the concepts. Connection, engagement, and empowerment are critical domains of anti-stigma programs for the youth population. Findings from this study have built on the scientific knowledge about the change theory underpinning youth contact-based intervention.
Higgins, A; Maguire, G; Watts, M; Creaner, M; McCann, E; Rani, S; Alexander, J
In recent years, there is an ever increasing call to involve people who use mental health services in the development, delivery and evaluation of education programmes. Within Ireland, there is very little evidence of the degree of service user involvement in the educational preparation of mental health practitioners. This paper presents the findings on service user involvement in the education and training of professionals working in mental health services in Ireland. Findings from this study indicate that in the vast majority of courses curricula are planned and delivered without consultation or input from service users. Currently the scope of service user involvement is on teaching, with little involvement in curriculum development, student assessment and student selection. However, there is evidence that this is changing, with many respondents indicating an eagerness to move this agenda forward.
Jankowski, T A; Martin, E. R.
Mediated search services, usually offered for a fee, are commonplace in academic health sciences libraries. At the same time, users of these services have numerous self-service options available to them; for example, CD-ROMs and locally mounted databases. In keeping with its philosophy of access to rather than ownership of information, the University of Washington Health Sciences Library and Information Center (HSLIC) changed its policy from charging clients for mediated searching to offering...
Full Text Available Health services and social assistance is a branch that is interrelated with other branches of the national economy and the tertiary sector in particular. This interdependence provides to health and social services a great importance in contemporary society.The expansion of the service sector is the reason of increasing concerns on the one hand, for defining and clarifying the content of the phenomenas and processes that sphere of activity, and on the other hand, to deepen mechanisms and design analysis tools and action that characterizes the practical approach of profile organizations.We have proposed in this paper to analyze the position they have health services in Romanian economy using statistical data on main indicators that can be assimilated by positioning the health services in the Romania's economy.
Greeff, M; van der Walt, E; Strydom, C; Wessels, C; Schutte, P J
For several years the School of Nursing Science and the School of Psychosocial Behavioural Science, of a specific university, have been offering health care services in response to some of the health needs of a disadvantaged community as part of their students' experiential learning. However, these health care services were rendered independently by these two schools, implying that no feedback system existed to evaluate the worth and quality of these student-rendered health care services. The objectives of this research were to explore and describe the experiences of senior nursing and social work students, the experiences of health service delivery organisations concerned and the experiences of the disadvantaged community members receiving such health care services, as well as to investigate which communication models were apparent with regard to the major factors within health communication. An exploratory descriptive qualitative research design was used. Focus group discussions were held, interviews were conducted and field notes taken. Focus group discussions and interviews were transcribed and analysed by the research team to determine themes and sub-themes using the open coding technique. The results of the three groups showed similarities. The health service delivery organisations also identified a communication barrier, although the students were prepared to bridge it. The health service delivery organisations and the community felt positive towards the students and what they offered to the organisations and to the patients. A greater need for multi-disciplinary team work was recognised by al parties concerned. Recommendations focus on improved student accompaniment by lecturers; extending health care delivery to include a multi-disciplinary team approach by students; as well as improving the delivery of health care services.
Gillette, Joyce L.; And Others
Five hundred college students who had used Kent State University's School Health Service were surveyed to determine patient satisfaction with health care services. Overall satisfaction with the services was high, and satisfaction was significantly influenced by patients' perceptions of practitioners' technical competence and by the adequacy of the…
... hospital services must include short-term rehabilitation services and physical therapy, the provision of... hospitalization; (13) Whole blood and blood plasma; (14) Long-term physical therapy and rehabilitation; (15....101 Section 417.101 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND...
Full Text Available Abstract Background Due to demographic changes and an un-equal distribution of physicians, regional analyses of service utilization of elderly patients are crucial, especially for diseases with an impact like dementia. This paper focuses on dementia patients. The aim of the study is to identify differences in service utilization of incident dementia patients in urban and rural areas. Methods Basis for the analysis were all insured persons of a German Health Insurance fund (the GEK aged 65 years and older living in rural and urban areas. We focussed on physician contacts in the outpatient sector during the first year after an incidence diagnosis of dementia. Special attention was given to contacts with primary care physicians and neurologists/psychiatrists. The dementia cohort was analyzed together with a non-dementia control group drawn according to age, gender and amount of physician contacts. Uni- and bivariate as well as multivariate analysis were performed to estimate the influences on service utilization. Results Results show that the provision of primary care seems to be equally given in urban and rural areas. For specialists contacts however, rural patients are less likely to consult neurologists or psychiatrists. This trend can already be seen before the incident diagnosis of dementia. All consultations rise in the quarter of the incident dementia diagnosis compared to the control group. The results were also tested in a linear and a logistic regression, showing a higher chance for persons living in urban areas to visit a specialist and an overall higher rate in service utilization for dementia patients. Conclusions Because of a probable increase in the number of dementia patients, service provision has to be accessible even in rural areas. Due to this and the fact that demographic change is happening at different paces in different regions, regional variations have to be considered to ensure the future service provision.
Klee, Linnea; And Others
Recommendations concerning California's efforts to provide for the health needs of its children were developed at the California Conference on Health Care for Children in Foster Care. The conference was organized to discuss California's implementation of the Child Welfare League of America's Standards for Health Care Services for Children in…
Jaruseviciene, L.; Valius, L.; Lazarus, J.V.
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...
Cashman, Suzanne B; Seifer, Sarena D
In 2003, the Institute of Medicine (IOM) described public health as "an essential part of the training of citizens," a body of knowledge needed to achieve a public health literate citizenry. To achieve that end, the IOM recommended that "all undergraduates should have access to education in public health." Service-learning, a type of experiential learning, is an effective and appropriate vehicle for teaching public health and developing public health literacy. While relatively new to public health, service-learning has its historical roots in undergraduate education and has been shown to enhance students' understanding of course relevance, change student and faculty attitudes, encourage support for community initiatives, and increase student and faculty volunteerism. Grounded in collaborative relationships, service-learning grows from authentic partnerships between communities and educational institutions. Through emphasizing reciprocal learning and reflective practice, service-learning helps students develop skills needed to be effective in working with communities and ultimately achieve social change. With public health's enduring focus on social justice, introducing undergraduate students to public health through the vehicle of service-learning as part of introductory public health core courses or public health electives will help ensure that our young people are able to contribute to developing healthy communities, thus achieving the IOM's vision.
The involvement of mental health service users in service delivery is a new and growing phenomenon. Such involvement is complex, given the history of paternalism in the mental health system, the power differential between service providers and service users, and the very differing views each group holds on multiple issues. Unless such differences are addressed, there can be no meaningful involvement. Service user involvement needs to apply to all aspects of the service delivery system, including professional training, service design, delivery, evaluation, and research. User/survivors, and their organizations, have developed a body of experience and knowledge that needs to be recognized and respected. Unless there are multiple opportunities for ongoing and open dialogue on these many difficult issues, real user involvement will not occur.
Gong-Guy, E; Cravens, R B; Patterson, T E
Serious limitations exist in the delivery of mental health services to refugees throughout the resettlement process. Having survived harrowing physical and psychological traumas prior to reaching refugee camps, many refugees encounter mental health services in overseas camps that are characterized by fragmentation, instability, language barriers, and severe staff shortages. Refugees requiring mental health intervention after resettlement in the United States confront additional barriers, including frequent misdiagnosis, inappropriate use of interpreters and paraprofessionals, and culturally inappropriate treatment methods. Suggestions for improving mental health services for refugee populations emphasize modifying diagnostic assumptions and treatment approaches, recognizing potential problems associated with using interpreters and paraprofessionals, and examining the role of consultation, prevention, and outreach services in addressing refugee mental health concerns.
U.S. Environmental Protection Agency — This compilation of geospatial data is for the purpose of managing and communicating information about current EPA project officers, tribal contacts, and tribal...
Wen-ji YANG; Bi-huan MAI; Min ZhOU; Qi-min SHI; Xin CAO; Wen-ying HE; Feng-ying ZOU; Xiao YING
Objective To understand the sexual and reproductive health knowledge among unmarried migrant population and their service demands as well as current services delivered by local family planning departments, so as to provide scientific evidences on conducting reproductive health education and appropriate service for migrant population in the district.Methods A questionnaire survey was conducted among a convenient sample of unmarried young migrant population between 15 and 25 years old in Dongshan District. All data were entered into database with the software Foxpro6.0 and analyzed with the statistics software SPSS10.0.Results Unmarried migrant population had some kinds of sexual and reproductive health knowledge and was eager to access to reproductive health service. They hoped that relevant governmental departments could provide them more information,education and service on sexuality and reproductive health.Conclusion Relevant departments should work together to popularize reproductive health knowledge among unmarried migrant population and meet their demands on reproductive health service, so as to improve their current reproductive health situation.
James, Anthony M
Young people with mental illness face many barriers in accessing care and often have different needs to those of adult consumers. Young people's participation in mental health services is one way of addressing quality and access issues, through receiving feedback and implementing youth-driven and youth-friendly strategies. headspace, the National Youth Mental Health Foundation, established in July 2006, highlights the mental health care sector's commitment to young people. Existing youth participation programs provide examples of what can be achieved at national and local levels and with varying levels of financial and other support. These include: Ybblue, the youth program of beyondblue; Reach Out!, a web-based service; Headroom, providing health promotion and a website; and Platform Team (ORYGEN Youth Health), comprising current and past clients who advise the service and provide peer support. Current practice in youth participation in mental health services involves a variety of methods, such as ensuring information and education is appropriate for a youth audience, and participating in peer-support programs and staff selection panels. Challenges in the future development of youth participation in mental health services include avoiding tokenism, acknowledging that young people are not a uniform group, translating national strategies into local improvements in services, and gaining the support and cooperation of health care workers in genuine participation.
Salinas, Hugo; Erazo, Marcia; Reyes, Alvaro; Carmona, Sergio; Veloz, Patricio; Bocaz, Francisca; Silva, Paulina; Carvajal, Rodrigo
Chile has a National Health Services System, formed by 29 Health Services. An efficient resource distribution among this services is crucial for an efficient health care delivery. To obtain indices from the Chilean Public Health Services, that could improve allocation of resources. Information from the Chilean Public Health Services, corresponding to activities during 2001 budgetary period, was collected. This is the latest complete and official information for the totality of Health Services in the country. Seventeen variables generated or monitored by the Instituto Nacional de Estadísticas (INE), the Ministerio de Salud (MINSAL), the Ministerio de Hacienda, the Ministerio de Planificación y Cooperación (MIDEPLAN) and the Fondo Nacional de Salud (FONASA) were studied. The Main Components Analysis (ACP) was used, obtained from the R correlation matrix. The first two main components were selected, with an accumulated percentage of explained variability of 63.05%. The first component is related to the population assigned to each Health Service. This corresponds to the number of people needed to treat in the hospitals of these Services and their answer to this demand, justified by the expenses in which each Health Service incurs. There is an inverse relation of the first component with health indicators, measured by burden of disease and death. The second main component would represent the social and economic characteristics of the population, poor and very poor populations and public health insurance beneficiaries, to take care of in each Health Service. Health indicators in each Health Service are not considered a priority for resource distribution among Health Services in the country. The transference is done considering the indices contained in the two main components defined.
Bjørnstad, Siv; Patil, Grete G; Raanaas, Ruth K
Improving social support, and providing nature contact at work are potential health promoting workplace interventions. The objective was to investigate whether nature contact at work is associated with employee's health and participation, and to study whether the possible associations between nature contact and health can be explained by perceived organizational support. Data were collected through a web-based, cross-sectional survey of employees in seven public and private office workplaces in Norway (n = 707, 40% response rate). Multiple linear and logistic regression analysis were performed on 565 participants fulfilling inclusion criteria. A greater amount of indoor nature contact at work was significantly associated with less job stress (B = -0.18, CI = -0.318 to -0.042), fewer subjective health complaints (B = -0.278, CI = -0.445 to -0.112) and less sickness absence (B = -0.061, CI = -0.009 to -0.002). Perceived organizational support mediated the associations between indoor nature contact and job stress and sickness absence, and partly mediated the association with subjective health complaints. Outdoor nature contact showed no reliable association with the outcomes in this study. Extending nature contact in the physical work environment in offices, can add to the variety of possible health-promoting workplace interventions, primarily since it influences the social climate on the workplace.
O'Hagan, Joshua; Persaud, David
Improving customer-service in health care organizations has been linked to better patient care, satisfied staff, a reduction in preventable medical errors, fewer malpractice lawsuits and improved revenue. However, it has been observed that there is sometimes a gap between the level of customer-service provided by health care organizations and their clients' expectations. This paper integrates, synthesizes and extends theory and practice from existing literature to provide health care organizations with strategies for closing this gap. Methods are also outlined for creating, implementing and evaluating an organizational plan for improving customer-service.
Radloff, D; Blouin, A S; Larsen, L; Kripp, M E
When planning for growth and management efficiency across urban health systems, economic and market factors present significant service line challenges and opportunities. This article describes the evolutionary integration of emergency services in St John Health System, a large, religious-sponsored health care system located in Detroit, Michigan. Critical business elements, including the System's vision, mission, and economic context, are defined as the framework for site-specific and System-wide planning. The impact of managed care and market changes prompted St John's clinicians and executives to explore how integrating emergency services could create a competitive market advantage.
Maryland State Dept. of Education, Baltimore.
This guide for Maryland schools outlines the role of school health services and proper facility design for these services. Chapter 1 provides an overview, describing coordinated school health programs, school health services programs, school health services programs in Maryland, how school health services are delivered, trends, the number of…
Moore, Michele Johnson; Barr, Elissa; Wilson, Kristina; Griner, Stacey
Background: Numerous studies document support for sexuality education in the schools. However, there is a dearth of research assessing support for sexual health services offered through school-based health clinics (SBHCs). The purpose of this study was to assess voter support for offering 3 sexual health services (STI/HIV testing, STI/HIV…
Taghrid S. Suifan
Full Text Available Problem statement: Quality of services measurement has been the concern of many scholars who have tried to develop scales for it. The most popular scale used was SERVQUAL. Hence the aim of this study is to discover the quality of health services provided to Iraqis at Jordan Red Crescent Health Centers in Amman. Approach: A sample study was derived from (1652 male and female patients from five health centers: Ashrafieh Health Center; Al-Hashemi Health Center; Marka Health Center; Al-Taj Health Center and AL-Hussein Health Center. Means, Standard Deviation, Independent Sample T-Test, simple regression and the Scheffe Test were used to answer the study's main questions. Results: It was found that the quality of health services provided to the Iraqis at Jordan Red Crescent health centers was high in all dimensions, the highest quality dimensions displayed among the health service available at Jordan Red Crescent health centers were tangibles and assurance, whereas the lowest quality dimensions were empathy and responsiveness, there was a significant difference in the quality of health services provided to Iraqis at Jordan Red Crescent Health Centers (Ashrafieh Health Center, Al-Hashemi Health Center, Marka Health Center, Al-Taj Health Center and AL-Hussein Health Center from one center to another and there was a significant difference in the quality of health services provided to Iraqis at Jordan Red Crescent health centers based on the number of visits the Iraqis made to the center. Conclusion: The main recommendation presented in this study is that there is a need to expand the health services in cooperation with international humanitarian organizations in order to accommodate the rising number of Iraqis frequenting the centers.
Scholz, Brett; Gordon, Sarah; Happell, Brenda
Contemporary mental health policies call for greater involvement of mental health service consumers in all aspects and at all levels of service planning, delivery, and evaluation. The extent to which consumers are part of the decision-making function of mental health organizations varies. This systematic review synthesizes empirical and review studies published in peer-reviewed academic journals relating to consumers in leadership roles within mental health organizations. The Cochrane Library, Medline, and PsycINFO were searched for articles specifically analysing and discussing consumers' mental health service leadership. Each article was critically appraised against the inclusion criteria, with 36 articles included in the final review. The findings of the review highlight current understandings of organizational resources and structures in consumer-led organizations, determinants of leadership involvement, and how consumer leadership interacts with traditional mental health service provision. It appears that organizations might still be negotiating the balance between consumer leadership and traditional structures and systems. The majority of included studies represent research about consumer-run organizations, with consumer leadership in mainstream mental health organizations being less represented in the literature. Advocates of consumer leadership should focus more on emphasizing how such leadership itself can be a valuable resource for organizations and how this can be better articulated. This review highlights the current gaps in understandings of consumer leadership in mental health, including a need for more research exploring the benefits of consumer leadership for other consumers of services. © 2016 Australian College of Mental Health Nurses Inc.
Severo, Ana Kalliny de Sousa; Amorim, Ana Karenina de Melo Arraes; Romagnoli, Roberta Carvalho
This article discusses the internships at the psychosocial health system of Natal, Northeast region of Brazil, as part of training in psychology. The objective of these internships is to offer students work experiences in public health both inside and outside health services. Based on Institutional Analysis and Schizoanalysis, these experiences were examined through two analysers: (1) the power of knowledge and (2) the need for by-passes. We conclude that health provokes tensions between instituted practices in health services and those instituted in psychology training.
Lefkowitz, Ayla R F; Mannell, Jenevieve
Transgender youth often face difficulties when accessing sexual health services. However, few studies investigate health service providers' perceptions of transgender youth, and fewer focus on sexual health. To fill this gap, our study draws on social representations theory to examine sexual health service providers' perceptions of transgender youth and how this influences the provision of health services for this marginalised population in England. A thematic analysis of 20 semi-structured interviews with service providers, conducted between March and June 2014, resulted in five main themes centred on: binary representations of transgender; transgender as homosexuality; uncertain bodies; unstable mental states; and too young to know. Of the service providers interviewed, many understood transgender within a male/female binary, and perceived being transgender to be synonymous with being gay. There was confusion among service providers regarding transgender youths' sexual organs, and most of those interviewed saw transgender youth as mentally unstable and confused. Finally, many service providers perceived that transgender youth are too young to know that they are transgender and make decisions about their body. Some of these representations were potentially stigmatising and many conflicted with transgender youths' representations of themselves. Training by transgender people is recommended to help address these misunderstandings.
Bobocea, L; Gheorghe, I R; Spiridon, St; Gheorghe, C M; Purcarea, V L
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.
There is increasing pressure on researchers and research funding bodies to demonstrate the value of research. Simple approaches, consistent with the biomedical paradigm, based on relating the cost of research to its supposed impact are being investigated and adopted in laboratory and clinical research. While this may be appropriate in such research areas, it should not be applied to health services research which aims to alter the ways policy-makers and managers think about health, disease and health care or, as John Maynard Keynes put it, 'the gradual encroachment of ideas'. By considering six fundamental assumptions about health care that have been successfully challenged and overturned over the past few decades, the profound and sustained impact of health services research can be demonstrated. The application of economic models of 'payback' would fail to recognize such contributions which, in turn, could threaten future funding of health services research.
Kimerling, Rachel; Baumrind, Nikki
The Anderson behavioral model was used to investigate racial and ethnic disparities in access to specialty mental health services among women in California as well as factors that might account for such disparities. The study was a cross-sectional examination of a probability sample of 3,750 California women. The main indicators of access to services were perceived need, service seeking, and service use. Multivariate models were constructed that accounted for need and enabling and demographic variables. Significant racial and ethnic variations in access to specialty mental health services were observed. African-American, Hispanic, and Asian women were significantly less likely to use specialty mental health services than white women. Multivariate analyses showed that Hispanic and Asian women were less likely than white women to report perceived need, even after frequent mental distress had been taken into account. Among women with perceived need, African-American and Asian women were less likely than white women to seek mental health services after differences in insurance status had been taken into account. Among women who sought services, Hispanic women were less likely than white women to obtain services after adjustment for the effects of poverty. Need and enabling factors did not entirely account for the observed disparities in access to services. Additional research is needed to identify gender- and culture-specific models for access to mental health services in order to decrease disparities in access. Factors such as perceived need and decisions to seek services are important factors that should be emphasized in future studies.
Mutalemwa, Prince P; Kisinza, William N; Munga, Michael; Urassa, Janesta A E; Kibona, Stafford; Mwingira, Upendo; Lasway, Christina; Kilima, Stella; Tenu, Filemoni; Mujaya, Stella; Kisoka, William J
In Tanzania, reproductive health and HIV services are coordinated by the Ministry of Health and Social Welfare in two separate units namely Reproductive and Child Health Section and the National AIDS Control Programme. The importance of integrating the two services that are vertically run is expected to improve access to and uptake of key essential services and extend coverage to underserved and vulnerable populations and thus minimizing missed opportunities. Experts around the world recognize the central role of Sexual and Reproductive Health (SRH) services in preventing HIV infection. Evidence suggests that improving access to contraception for women to prevent pregnancy is an important and cost-effective way to prevent HIV-positive births. Integrating SRH and HlV services therefore verifies its importance for improving maternal and child health as well as leading to prevention of HIV infection. The primary objective of this review was to gain an understanding of the current linkages between SRH and HIV within Tanzania's policies, programmes, systems and services. Policy documents, guidelines, national laws, and published reports on SRH and HIV were reviewed. The majority of the reviewed documents mentioned fundamentals of integration between SRH and HIV. Majority of policies and guidelines both in family planning (FP) and HIV documents mandate bi-directional linkages. This review suggests that there are linkages between the two services and can be operationalised together. However, policies and guidelines only specify services to be integrated without due consideration of resources and structural orientation for linked services.
Horney, Jennifer A; Bamrara, Sanjana; Macik, Maria Lazo; Shehane, Melissa
Although public health degree programs typically require practica and other field experiences, service-learning courses, with a focus on civic engagement and the application of classroom learning in real world settings, can go beyond these requirements and provide benefits to students and community-based practice partners. The goal of this paper is to assess potential benefits of service-learning programs for both graduate-level public health students and state and local public health agency partners. EpiAssist is a new service-learning program developed at the School of Public Health of the Texas A and M University Health Science Center, USA, in January 2015. EpiAssist was integrated into a new course, Methods in Field Epidemiology. The integration of service-learning was guided by a partnership with the Texas A and M Center for Teaching Excellence. State, regional, and local public health partners requested EpiAssist via email or telephone. A listserv was used to recruit student volunteers to meet requests. 54 of 86 registered EpiAssist students (63%) participated in at least one of ten service-learning and three training activities between January and June, 2015. Service-learning activities included questionnaire development, in-person and telephone data collection, and data analysis. Training topics for students included the Epi Info™ software, community assessment and communicable disease reporting. Students and partner organizations provided generally positive assessments of this service learning program through an online evaluation. Service-learning provides students with enhanced classroom learning through applied public health experience in state, regional and local health departments. These experiences provide both needed surge capacity to public health departments and valuable hands-on field experience to students.
Full Text Available BACKGROUND. Reforming healthcare system in Ukraine would imply changing financial mechanisms and involving patients into copayment for physician services. Therefore, it is important to understand patients’ willingness to pay (WTP and its main drivers. This study aims to investigate patients’ willingness to pay for physician services at a primary contact, its levels and determinants.METHODS. Contingent valuation method was applied to a nationally representative sample of 303 adult respondents surveyed in 2009. Respondents stated their willingness to pay for a visit to four hypothetical physicians, whose profiles were designed in a way to estimate separate effects of physician’s specialization and joint improvement in three quality-related attributes of a service: the state of medical equipment, maintenance of the physician’s office, and reduction in waiting time. A random effect tobit regression was applied to model effect of these service characteristics and socio-demographic characteristics on WTP.RESULTS. The strongest predictors (insensitive to model specifications associated with higher WTP for physician services were quality improvements in the three characteristics of the physician’s profile, higher income, and presence of private insurance policy, while the one associated with reduced WTP was age over 70. Consultation with a medical specialist instead of a general practitioner was also associated with higher WTP, though the magnitude of effect was much lower than for the abovementioned factors.CONCLUSIONS. Ukrainians are willing to pay for physician services at a primary contact, but the highest WTP would be expected for services of improved clinical and social quality and access. There might be an intention in the society or some of its groups to avoid the gatekeeper general practitioner at a primary level and to refer directly to the medical specialist. Finally, if patient payments are introduced, special caution should be
Meynard, Anne; Pfarrwaller, Eva; Lazarevic, Claire-Anne Wyler
Recent immigrantyouth have multiple health needs that need to be adapted to the context of migration. School health services provide a systematic health check to allyoung immigrants starting school in Geneva, including a tuberculin skin test if coming from a middle or high incidence country. Positive tests are confirmed with Interferon Gamma Release Assay (IGRA) and if indicated, offered treatment of latent tuberculosis even in the absence of clear guidelines. Collective and individual benefits outweigh the difficult logistics: reducing risk of reactivation of latent tuberculosis for populations living in promiscuity, effective collaboration between primary care and school health services to answer the needs of these underserved youth.
... mental health services. 51.46 Section 51.46 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND... a provider of mental health services. (a) Except as provided in paragraph (b) of this section, if a... of mental health services, it may not disclose information from such records to the individual who...
... reduce in Nigeria. KEYWORDS: Infant mortality, Maternal health care, Pregnancy care, Delivery care, Nigeria ... not go for antenatal care, and as a result may not access other cares ...... Inadequate Use of Prenatal Services Among. Brazilian ...
U.S. Department of Health & Human Services — The use of Charlson related expenditures did not result in improved mortality prediction. CCI models perform less well in population subgroups with higher underlying...
Because rheumatic fever is a potentially serious complication of a streptococcal sore throat which can lead to permanent heart disease, this article advocates the expansion of school health services in medically underserved areas. (JMF)
a Nutritional Intervention Research Unit, Medical Research Council ab Currently from Center of Excellence in Nutrition, North West ... Inadequate health services and an unhealthy environment are ..... Lack/shortage of diagnostic equipment.
Mar 17, 2010 ... nurses who are employed at a higher education campus' health service to render a healthcare ..... extremely diverse in terms of gender, age, religion, culture, .... the environment, with relative freedom from pain, disability,.
Satisfaction with health facility delivery care services and ssociated factors: The ... of care ranging from 30% reporting to be satisfied with management of labour pains ... women comfortable and satisfied with the process of delivery elsewhere.
In developing countries the increasing tendency to charge for the use of health services is the result of the collapse of government funding for health programs and the general trend toward privatization. Restraints on government spending, especially on social programs, have been reinforced by loan conditions imposed by the International Monetary Fund and the World Bank. On the other hand, governments have committed themselves to the objectives of Health for All, and they have to maximize access to essential services for prevention and treatment of diseases. Charges are sometimes advocated as a means of reducing frivolous use of services. Studies have suggested that in Peru and rural Ivory Coast a modest rise in charges is likely to reduce use of services substantially for those on very low incomes, while those whose needs are the lest will continue to use services. Scarce facilities, skilled professionals, and other services provided at public expense are involved in the provision of basic health care. It is particularly difficult to recover the cost of training of doctors and nurses. Provision of technically advanced services for a minority who can afford to pay is almost always subsidized by governments and may deprive the rest of the population of key resources. The trend to introduce charges for family planning services and services for the treatment and prevention of communicable disease may have serious consequences. However, the collapse of government funding for health services in many developing countries requires alternative sources of funding for basic primary care. Some user charges may be justified, especially if these revenues result insubstantial improvements in the quality and availability of services. Development of feasible mechanisms for greater risk sharing in the longer term remains a priority if the most regressive effects of charges are to be avoided.
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U.S. Department of Health & Human Services — A database of agencies listed by state and topic to provide you with contact information for specific organizations or help you get answers to your Medicare related...
Indonesia, Kenya, Nigeria, Pakistan, Sudan, and the. United Republic of ... these poor health outcomes among women and children was the ... and anemia. The 2007 .... likely to use ANC services compared to women whose ... indicators of utilization of this service. .... prophylaxis, iron and folic acid tablets and helping.
Garralda, Elena M
Outcome auditing of specialist child and adolescent mental health services (CAMHS) is now well under way internationally. There is, however, debate about objectives and tools. A case is made for the achievable goal of enhancing service accountability through user satisfaction information and clinician-rated contextualised measures of improvements in symptoms and impairment.
This report gives an update on the status of planning and delivery of mental health services for people with intellectual disability who have psychiatric disorders in Australia and New Zealand. A number of innovative approaches in policy and planning, legislative support, education, consultation, and coordination among services are discussed.…
Moore, Gaye; Manias, Elizabeth; Gerdtz, Marie Frances
Homeless people face many challenges in accessing and utilising health services to obtain psychosocial supports offered in hospital and community settings. The complex nature of health issues is compounded by lack of accessibility to services and lack of appropriate and safe housing. To examine the perceptions and experiences of homeless people in relation to their health service needs as well as those of service providers involved with their care. A purposive sampling approach was undertaken with a thematic framework analysis of semi-structured interviews. Participants. Interviews were undertaken with 20 homeless people who accessed the emergency department in an acute hospital in Melbourne, Australia and 27 service providers involved in hospital and community care. Six key themes were identified from interviews: complexity of care needs, respect for homeless people and co-workers, engagement as a key strategy in continued care, lack of after-hour services, lack of appropriate accommodation and complexity of services. Findings revealed the complex and diverse nature of health concerns in homeless people. The demand on hospital services continues to increase and unless government policies take into consideration the psychosocial demands of the communities most vulnerable people efforts to divert hospital demand will continue to fail.
Owan, Tom Choken, Ed.
This sourcebook contains 19 papers which discuss the mental health service needs of Southeast Asian refugees in the United States. The volume is divided into five sections: Treatment; Prevention; Services; Training; and Research. The papers (and their authors) are: (1) "Psychiatric Care for Southeast Asians: How Different Is Different?"…
Ohinmaa, Arto; Roine, Risto; Hailey, David; Kuusimäki, Marja-Leena; Winblad, Ilkka
The utilization of telemental health (TMH) services in Finland was surveyed in 2006. In total, 135 health-care units provided responses. Eighty-four responses were received from primary care units (health-care centres and clinics) and eight from other clinics, in all hospital districts. The overall rate of TMH consultations was 4 per 100,000 population. The highest TMH consultation per population ratio, 22 per 100,000, was in northern Finland. Most of the sites used telepsychiatry services for less than 10% of clinical outpatient services. The sites with over 20% utilization of clinical TMH services from all psychiatric consultations were all rural health centres. Compared with Finland, the utilization rates of TMH were higher in Canada; that might be due to differences between the countries in the organization of mental health services in primary and specialized care. In Finland TMH consultations made up only a very small proportion of all mental health services. The use of TMH was particularly common in remote areas; however, there were many rural centres that did not utilize clinical TMH. TMH was widely utilized for continuing and medical education.
Murcott, W J
A young person's transition of care from child and adolescent mental health services to adult mental health services can be an uncertain and distressing event that can have serious ramifications for their recovery. Recognition of this across many countries and recent UK media interest in the dangers of mental health services failing young people has led practitioners to question the existing processes. This paper reviews the current theories and research into potential failings of services and encourages exploration for a deeper understanding of when and how care should be managed in the transition process for young people. Mental health nurses can play a vital role in this process and, by adopting the assumptions of this paradigm, look at transition from this unique perspective. By reviewing the current ideas related to age boundaries, service thresholds, service philosophy and service design, it is argued that the importance of the therapeutic relationship, the understanding of the cultural context of the young person and the placing of the young person in a position of autonomy and control should be central to any decision and process of transfer between two mental health services.
Higgins, C W; Phillips, B U
This paper reviews the major trends in financing reform, emphasizing their impact on those characteristics of the market for health services that economists have viewed as monopolistic, and discusses the implications of structural change for the allied health professions. Hopefully, by understanding the fundamental forces of change and responding to uncertainty with flexibility and imagination, the allied health professions can capitalize on the opportunities afforded by structural change. Overall, these trends should result in the long-term outlook for use of allied health services to increase at an average annual rate of 9% to 10%. Allied health professionals may also witness an increase in independent practice opportunities. Finally, redistribution of jobs will likely occur in favor of outpatient facilities, home health agencies, and nontraditional settings. This in turn will have an impact on allied health education, which will need to adapt to these types of reforms.
Secker, J; Gulliver, P; Peck, E; Robinson, J; Bell, R; Hughes, J
Alongside mental health policies emphasising the need to focus on people experiencing serious, long-term problems, recent general healthcare policy is leading to the development in the UK of a primary care-led National Health Service. While most primary care-led mental health initiatives have focused on supporting general practitioners (GPs) in managing milder depression and anxiety, this article describes an evaluation comparing primary care-based and secondary care-based services for people with serious long-term problems. A survey of service users was carried out at three points in time using three measures: the Camberwell Assessment of Need, the Verona Satisfaction with Services Scales and the Lancashire Quality of Life Profile. Staff views were sought at two time intervals and carers' views were obtained towards the end of the 2-year study period. The results indicate that both services reduced overall needs and the users' need for information. The primary care service also reduced the need for help with psychotic symptoms whereas the secondary care service reduced users' need for help with benefits and occupation. There were no major differences in terms of satisfaction or quality of life. Primary care-based services therefore appear to have the potential to be as effective as more traditional secondary care services. However, a more comprehensive range of services is required to address the whole spectrum of needs, a conclusion supported by the views of staff and carers.
Full Text Available Background: The aim of health service integration is to provide a sustainable and integrated health system that better meets the needs of the end user. Yet definitions of health service integration, methods for integrating health services and expected outcomes are varied. This review was commissioned by Queensland Health, the government department responsible for health service delivery in Queensland, Australia, to inform efforts to integrate their mental health services. This review reports on the characteristics, reported outcomes, and design quality of studies included in systematic reviews of health service integration research. Method: The review was developed by systematically searching nine electronic databases to find peer-reviewed Australian and international systematic reviews with a focus on health service integration. Reviews were included if they were in the English language and published between 2000 and 2015. A standardised assessment tool was used to analyse the study design quality of included reviews. Data relating to the integration types, methods and reported outcomes of integration were synthesised. Results: Seventeen publications met the inclusion criteria. Eleven (65% reviews were published during the past five years, which may indicate a trend for increased awareness of the need for service integration. The majority of reviews were published by researchers in the UK (8/47%, USA (3/18%, and Australia (3/18%. Included reviews focused on a variety of integration types, including integrated care pathways, governance models, integration of interventions, collaborative/ integrated care models, and integration of different types of healthcare. Most (53% of reviews reported on the cost-effectiveness of service integration, e.g. positive results, no effect, or inconclusive. Only one of the reviews reported on the importance of consumer involvement. The overall design of 70% of the reviews was high, 18% medium, and 12% low
Rousseau, Cécile; Nadeau, Lucie; Pontbriand, Annie; Johnson-Lafleur, Janique; Measham, Toby; Broadhurst, Joanna
The importance of children and youth mental health is increasingly recognized. This rapidly developing field cannot be conceptualized as an extension of adult services to a younger age group and its developmental and organizational specificities are the object of debate. Reviewing recent literature in this domain and some preliminary information about the Quebec Mental Health Plan implementation, this paper addresses some of the questions which structure this debate in Quebec.Quebec mental health plan has put at the forefront collaboration among disciplines and partnership among institutions. In spite of having produced significant improvement in the field, discontinuities in services, which interfere with an ecosystemic model of care, persist. Recent studies suggest that the organisational climate which surrounds youth mental health services has a direct impact on the quality of services and on youth health outcomes. A flexible management structure, which engages clinicians and health workers, favors empowerment, minimizes work stress and facilitates partnership, is needed to foster successful interdisciplinary and intersectorial collaboration. This collaboration is the cornerstone of youth mental health services.
Papanikolaou, Vicky; Zygiaris, Sotiris
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.
Papanikolaou, Vicky; Zygiaris, Sotiris
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
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
To develop a quality of care instrument that is grounded in the service user perspective and validate it in a mental health service. The instrument (SEQUenCE (SErvice user QUality of CarE)) was developed through analysis of focus group data and clinical practice guidelines, and refined through field-testing and psychometric analyses. All participants were attending an independent mental health service in Ireland. Participants had a diagnosis of bipolar affective disorder (BPAD) or a psychotic disorder. Twenty-nine service users participated in six focus group interviews. Seventy-one service users participated in field-testing: 10 judged the face validity of an initial 61-item instrument; 28 completed a revised 52-item instrument from which 12 items were removed following test-retest and convergent validity analyses; 33 completed the resulting 40-item instrument. Test-retest reliability, internal consistency and convergent validity of the instrument. The final instrument showed acceptable test-retest reliability at 5-7 days (r = 0.65; P Service Satisfaction Scale (r = 0.84, P service user perspective and suitable for routine use. It may serve as a useful tool in individual care planning, service evaluation and research. The instrument was developed and validated with service users with a diagnosis of either BPAD or a psychotic disorder; it does not yet have established external validity for other diagnostic groups. © The Author 2015. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.
Stathi, Sofia; Tsantila, Katerina; Crisp, Richard J
Research has demonstrated widespread negative attitudes held toward people with mental health problems. Our study investigated whether a new prejudice reduction technique, imagined intergroup contact (Crisp & Turner, 2009), could combat stigma against people with mental illness, and the mediating processes through which it may exert this beneficial effect. We found that compared to a control condition, participants who imagined a positive encounter with a schizophrenic person reported weakened stereotypes and formed stronger intentions to engage in future social interactions with schizophrenic people in general. Importantly, these intentions were formed due to reduced feelings of anxiety about future interactions. We discuss the implications of these findings for improving the social inclusion of people with mental health problems.
Full Text Available The association between mental illness and poor physical health and socioeconomic outcomes has been well established. In the twenty-first century, the challenge of how mental illnesses such as psychosis are managed in the provision of public health services remains complex. Developing effective clinical mental health support and interventions for individuals requires a coordinated and robust mental health system supported by social as well as health policy that places a priority on addressing socioeconomic disadvantage in mental health cohorts. This paper thus examines the complex relationship between socioeconomic disadvantage, family/social supports, physical health and health service utilisation in a community sample of 402 participants diagnosed with psychosis. The paper utilises quantitative data collected from the 2010 Survey of High Impact Psychosis research project conducted in a socioeconomically disadvantaged region of Adelaide, South Australia. Participants (42% female provided information about socio-economic status, education, employment, physical health, contact with family and friends, and health service utilisation. The paper highlights that socio-economic disadvantage is related to increased self-reported use of emergency departments, decreased use of general practitioners for mental health reasons, higher body mass index, less family contact and less social support. In particular, the paper explores the multifaceted relationship between socioeconomic disadvantage and poor health confronting individuals with psychosis, highlighting the complex link between socioeconomic disadvantage and poor health. It emphasizes that mental health service usage for those with higher levels of socioeconomic disadvantage differs from those experiencing lower levels of socioeconomic disadvantage. The paper also stresses that the development of health policy and practice that seeks to redress the socioeconomic and health inequalities created by
Karbach, U; Stamer, M; Holmberg, C; Güthlin, C; Patzelt, C; Meyer, T
This is the second part of a 3-part discussion paper by the working group on "Qualitative Methods" in the German network of health services research (DNVF) that shall contribute to the development of a memorandum concerning qualitative health services research. It aims to depict the different types of qualitative research that are conducted in health services research in Germany. In addition, the authors present a specific set of qualitative data collection and analysis tools to demonstrate the potential of qualitative research for health services research. QUALITATIVE RESEARCH IN HEALTH SERVICES RESEARCH - AN OVERVIEW: To give an overview of the types of qualitative research conducted in German health services research, the abstracts of the 8th German Conference on Health Services Research were filtered to identify qualitative or mixed-methods studies. These were then analysed by looking at the context which was studied, who was studied, the aims of the studies, and what type of methods were used. Those methods that were mentioned most often for data collection and analysis are described in detail. QUALITATIVE RESEARCH AT THE CONFERENCE FOR HEALTH SERVICES RESEARCH 2009: Approximately a fifth of all abstracts (n=74) had a qualitative (n=47) or a mixed-methods approach combining quantitative and qualitative methods (n=27). Research aims included needs assessment (41%), survey development (36%), evaluation (22%), and theorizing (1%). Data collection mostly consisted of one-on-one interviews (n=45) and group discussions (n=29). Qualitative content analysis was named in 35 abstracts, 30 abstracts did not reference their method of analysis. In addition to a quantitative summary of the abstract findings, the diversity of fields addressed by qualitative methods is highlighted. Although drawing conclusions on the use of qualitative methods in German health services research from the analysis of conference abstracts is not possible, the overview we present demonstrates the
Lander, Dorothy Agnes
Reframes student services policy-making by providing traditionally aged college students with a speaking position in formulating contractual arrangements affecting them and binding them into adulthood. Student-services educators must take responsibility for initiating a policy-making intervention that bridges social contract and carnival…
A recent Population Council publication, Reproductive Health Approach to Family Planning, discusses integration of reproductive health into family planning programs in a series of edited presentations that Council staff and colleagues gave at a 1994 meeting of the US Agency for International Development (USAID) cooperating agencies. The presentations reflect the Council's view that family planning programs ought to help individuals achieve their own reproductive goals in a healthful manner. The report discusses four areas of reproductive health: reproductive tract infections (RTIs), including sexually transmitted diseases; prevention and treatment of unsafe abortion; pregnancy, labor, and delivery care; and postpartum care. Christopher Elias (Senior Associate, Programs Division) argued that family planning programs ought to provide services that target RTIs, given that these illnesses afflict a significant proportion of reproductive-age women. The family planning community has an ethical responsibility to provide services to women who experience an unwanted pregnancy. They must have access to high-quality postabortion care, including family planning services. Professional midwives are ideally suited to serve as integrated reproductive health workers trained to combat the five major maternal killers: hemorrhage, sepsis, pregnancy-induced hypertension, obstructed labor, and unsafe abortion. This was demonstrated in a highly successful Life-Saving Skills for Midwives program undertaken in Ghana, Nigeria, and Uganda, and soon to start in Vietnam in conjunction with the Council's Safe Motherhood research program. Family planning services should be viewed as part of a comprehensive set of health services needed by postpartum women, which include appropriate contraception, maternal health checks, well-baby care, and information about breastfeeding, infant care, and nutrition. Family planning programs should incorporate breastfeeding counseling into their services. When
McEachern, Aiden; Cholewa, David
The Government of Alberta continues to improve delivery of healthcare by allowing Albertans to access their health information online. Alberta is the only province in Canada with provincial electronic health records for all its citizens. These records are currently made available to medical practitioners, but Alberta Health believes that providing Albertans access to their health records will transform the delivery of healthcare in Alberta. It is important to have a high level of assurance that the health records are provided to the correct Albertan. Alberta Health requires a way for Albertans to obtain a digital identity with a high level of identity assurance prior to releasing health records via the Personal Health Portal. Service Alberta developed the MyAlberta Digital ID program to provide a digital identity verification service. The Ministry of Health is leveraging MyAlberta Digital ID to enable Albertans to access their personal health records through the Personal Health Portal. The Government of Alberta is advancing its vision of patient-centred healthcare by enabling Albertans to access a trusted source for health information and their electronic health records using a secure digital identity.
Riggs, Elisha; Davis, Elise; Gibbs, Lisa; Block, Karen; Szwarc, Jo; Casey, Sue; Duell-Piening, Philippa; Waters, Elizabeth
Often new arrivals from refugee backgrounds have experienced poor health and limited access to healthcare services. The maternal and child health (MCH) service in Victoria, Australia, is a joint local and state government operated, cost-free service available to all mothers of children aged 0-6 years. Although well-child healthcare visits are useful in identifying health issues early, there has been limited investigation in the use of these services for families from refugee backgrounds. This study aims to explore experiences of using MCH services, from the perspective of families from refugee backgrounds and service providers. We used a qualitative study design informed by the socioecological model of health and a cultural competence approach. Two geographical areas of Melbourne were selected to invite participants. Seven focus groups were conducted with 87 mothers from Karen, Iraqi, Assyrian Chaldean, Lebanese, South Sudanese and Bhutanese backgrounds, who had lived an average of 4.7 years in Australia (range one month-18 years). Participants had a total of 249 children, of these 150 were born in Australia. Four focus groups and five interviews were conducted with MCH nurses, other healthcare providers and bicultural workers. Four themes were identified: facilitating access to MCH services; promoting continued engagement with the MCH service; language challenges; and what is working well and could be done better. Several processes were identified that facilitated initial access to the MCH service but there were implications for continued use of the service. The MCH service was not formally notified of new parents arriving with young children. Pre-arranged group appointments by MCH nurses for parents who attended playgroups worked well to increase ongoing service engagement. Barriers for parents in using MCH services included access to transportation, lack of confidence in speaking English and making phone bookings. Service users and providers reported that
Deen, Tisha L.; Bridges, Ana J.; McGahan, Tara C.; Andrews, Arthur R., III
Purpose: Rural individuals utilize specialty mental health services (eg, psychiatrists, psychologists, counselors, and social workers) at lower rates than their urban counterparts. This study explores whether cognitive appraisals (ie, individual perceptions of need for services, outcome expectancies, and value of a positive therapeutic outcome) of…
Sheila Cristina Vargas
Full Text Available Background and Objectives: Health care for people with disabilities (PwD must be guaranteed by the state, health professionals and community involved, covering a multidisciplinary approach. This study aims to discuss the assistance to persons with disabilities in public health services. Method: This is a literature review of the descriptive study type with scientific publications on search sites Scielo, LILACS and Pubmed from descriptors: accessibility, people with disabilities, access to health services, totaling 514 articles, which fall under 22 the themes addressed. Results: Accessibility is a result of the availability of professionals and health services as well as access of Persons with Disabilities these services offered. We need planning actions by the multidisciplinary team, in order to seek to minimize the front inequalities behavioral barriers, architectural, geographical, which form gaps that prevent an egalitarian, unanimous and universal care as recommended by the health system. In oral health the principle of comprehensiveness includes the promotion, recovery and oral rehabilitation. Conclusion: Health promotion activities need to be encouraged so that it promotes the welfare of the health service user and that such actions occur in an integrated manner, adding resources from the comprehensive and multidisciplinary work. Accessibility to health services in conjunction with actions aimed at promoting the health of PwD can provide higher quality in health care and higher quality of life.
Gant, Larry; Benn, Rita; Gioia, Deborah; Seabury, Brett
More than one third of Americans practice complementary and alternative medicine (CAM). Social workers continue to provide most first-line health, mental health, and psychological referral and direct practice services in the United States, despite a lack of systematic education and training opportunities in CAM. Schools of social work are…
This publication identifies, discusses, and lists areas for further research for five ethical issues related to health services: 1) the right to health care; 2) death and euthanasia; 3) human experimentation; 4) genetic engineering; and, 5) abortion. Following a discussion of each issue is a selected annotated bibliography covering the years 1967…
Mancoske, Ronald J.; Lewis, Marva L.; Bowers-Stephens, Cheryll; Ford, Almarie
This study describes the relationships between clients' perception of cultural competency of mental health providers and service outcomes. A study was conducted of a public children's mental health program that used a community-based, systems of care approach. Data from a subsample (N = 111) of families with youths (average age 12.3) and primarily…
... 5 items) Post-Traumatic Stress Disorder (27 items) Schizophrenia (84 items) Social Phobia (5 items) Populations Children and Adolescents (158 items) Diversity and Ethnic Groups (23 items) Men’s Mental Health (12 items) Women’s Mental Health (16 items) Military Service Members (6 ...
Perceptions and factors affecting utilization of health services in a rural ... to gender (p=0.889, OR=1.04; 0.55-2.00), educational level (p=0.707, OR=1.16; 0.50-2.79) and ... Identified barriers to access and effective use of qualitative health care ...
Background: Maternal mortality remains a public health challenge claiming ... across many developing countries around the world. .... 19.8. Community Factors place of residence. Rural. 13.0. 14.0. 13.3. Urban .... hood among women who were exposed to either radio or ..... maternal health care services in Southern India.
Full Text Available Remote health monitoring and Health Relationship Management Services (HRMS can provide health care solutions for the elderly, the fastest-growing segment of the U.S. population. The year 2030 Problem questions whether enough resources and an operative service system will be available fourteen years from now when the elderly population will be greater than what it is today. One solution for reducing elder health care costs is home care, which is a preferable alternative to institutionalization. Many elderly have access to health services or outreach medical care, but do not use them due to lack of accessibility to safe transportation. The elderly often have problems with medication misuse stemming from the aging process, such as loss of memory, poor vision, and fixed-incomes. Seniors have dietary problems that weaken immune systems, leading to dehydration and other health issues. They also experience depression and loneliness from living alone or even with family members. The elderly who experience these problems can benefit from Health Relationship Management Services (HRMS, a new healthcare paradigm using remote health monitoring in the home.
Hagan, Brian J.; And Others
Warns that community mental health services are threatened by reductions in federal support and increased numbers of clients. Reviews literature on the effect of adverse economic events on mental health. Identifies issues and answers for managing this dilemma including planning, financial diversification, and inter-agency cooperation. (Author/JAC)
Full Text Available The migration is a multidimensional and complex problem of modern times. The social, political, economic and cultural negative circumstances prevailing in many states and communities of the world are pushing people into new places and destinations to permanent or temporary residence. In recent years, Greece is a country of immigration destination resulting in a entrance of people with different national and racial characteristics. The installation of the population in the country and use of structures and services of the state has a big change in the political, economic and social developments affecting major systems and subsystems of the state including the health system.The use of social structures and particularly of Primary Health Care, by immigrants occurs quite reduced compared to the native people. The use of Primary Health Care limited in emergencies situations and less in health prevention. Factors such as language, the high economic cost of providing medical services and remote Primary Health Care services seems to have a negative impact on search on medical treatment and nursing care. Important seen the role of the state and health professionals to use the Primary Health Care services from the immigrant population. Actions such as removing social exclusion and implementation of specialized prevention programs, can contribute greatly to the health of immigrants
Miller, Marilyn P.; Swanson, Elizabeth
Community health nursing students performed community assessments and proposed and implemented service learning projects that addressed adolescent smoking in middle schools, home safety for elderly persons, industrial worker health, and sexual abuse of teenaged girls. Students learned to apply epidemiological research methods, mobilize resources,…
The history of the development of mental health services in Africa falls into four phases, ... ical process described above still prevails in almost all the rural areas in Africa ... most countries in the region have had a decentralisation policy for mental health ... Constant departure or brain drain of well-trained and spe- cialised ...
Poulymenopoulou, M; Papakonstantinou, D; Malamateniou, F; Vassilacopoulos, G
The increasingly large amount of data produced in healthcare (e.g. collected through health information systems such as electronic medical records - EMRs or collected through novel data sources such as personal health records - PHRs, social media, web resources) enable the creation of detailed records about people's health, sentiments and activities (e.g. physical activity, diet, sleep quality) that can be used in the public health area among others. However, despite the transformative potential of big data in public health surveillance there are several challenges in integrating big data. In this paper, the interoperability challenge is tackled and a semantic Extract Transform Load (ETL) service is proposed that seeks to semantically annotate big data to result into valuable data for analysis. This service is considered as part of a health analytics engine on the cloud that interacts with existing healthcare information exchange networks, like the Integrating the Healthcare Enterprise (IHE), PHRs, sensors, mobile applications, and other web resources to retrieve patient health, behavioral and daily activity data. The semantic ETL service aims at semantically integrating big data for use by analytic mechanisms. An illustrative implementation of the service on big data which is potentially relevant to human obesity, enables using appropriate analytic techniques (e.g. machine learning, text mining) that are expected to assist in identifying patterns and contributing factors (e.g. genetic background, social, environmental) for this social phenomenon and, hence, drive health policy changes and promote healthy behaviors where residents live, work, learn, shop and play.
Full Text Available Healthcare delivery systems are facing fundamental challenges. New ways of organising theses systems based on the different needs of stakeholders’ are required to meet these challenges. While medicine is currently undergoing remarkable developments from its morphological and phenotype orientation to a molecular and genotype orientation, promoting the importance of prognosis and prediction, the discussion about the relevance of genome-based information and technologies for the health care system as a whole and especially for public health is still in its infancy. The following article discusses the relevance of genome-based information and technologies for individual health information management, health policy development and effective health services.
Wouterse, B.; Huisman, M.; Meijboom, Bert; Deeg, D.J.H.; Polder, Johan
Background The effect of population aging on future health services use depends on the relationship between longevity gains and health. Whether further gains in life expectancy will be paired by improvements in health is uncertain. We therefore analyze the effect of population ageing on health servi
This paper discusses the use of bilingual workers who do not have formal mental health training as mediators and providers of mental health care for refugees. The introduction provides a background discussion of the need for refugee mental health services, the characteristics of bilingual mental health workers, and the work places and expectations…
Kortteisto, Tiina; Laitila, Minna; Pitkänen, Anneli
Patient-centred care and user involvement in healthcare services are much emphasised globally. This study was the first step in a multicentre research project in Finland to improve service users' and carers' opportunities to be more involved in mental health services. The aim of the study was to assess attitudes of professionals towards service user involvement. The data were collected via an online questionnaire from 1069 mental health professionals in four hospital districts. Altogether, 351 professionals responded. Data were analysed using appropriate statistical methods. According to the results, attitudes of healthcare professionals were more positive towards service users' involvement in their own treatment than in other levels of services. There were also differences in gender, age groups, working places and experiences in the attitudes of professionals concerning service users' involvement in their own treatment. These should be taken into account in the future when planning education for mental health professionals. In spite of governmental guidance on service user involvement and the growing body of knowledge of the benefits associated with it, change in attitudes towards user involvement is slow. Special attention should be paid to the attitudes of professionals working in inpatient care and of those with less working experience. © 2017 Nordic College of Caring Science.
THERE IS ABOUT 80% of total population in ruralChina. Rural health care is an important content ofbuilding socialism new villages, and is a big thing tosafeguard peasants’ health and protect agricultureproductivity, invigorate rural economy and maintainsocial stability. So, rural health acre is a pivot ofChina’s health development. In 1997, the policy “tostrengthen rural health organization constructionand to perfect three-level health services systemincluding the county, the town and the village” wasdefini...
This Annual Report provides the first comprehensive survey carried out on community CAMHS teams and includes preliminary data collected by The Health Research Board on the admission of young people under the age of 18 years to inpatient mental health facilities. As many measures in this report do not have historic comparators it provides a baseline foundation that will be built upon in subsequent years providing an indication of trends that cannot yet be drawn on the basis of this report. The next report will include day hospital, liaison and inpatient services. Subsequent reports will further extend the mapping of mental health services for young people.
Bayes, Marjorie; Neill, T. Kerby
Issues of changing positions and roles for paraprofessionals are considered in the context of the hierarchical structure and process of mental health organizations. Discussion focuses on problems arising when paraprofessionals are promoted in the functional hierarchy while continuing to occupy the lowest level in the professional caste system.…
Major mental illness exists all over the world with a remarkably similar prevalence. ... Physical health suffers in this environment with malaria and dysentery ... working in the. Southern Sudan or those Healthcare. Professionals in other parts of the world seeking ... return from internal and external displacement. Drugs and ...
Agabiti, Nera; Davoli, Marina; Fusco, Danilo; Stafoggia, Massimo; Perucci, Carlo A
This introductory guide represents an operative tool to conduct epidemiological studies in the area of comparative outcomes evaluation. It is based on the experience of epidemiological research in this field conducted in Italy within national (BPAC-Esiti del bypass aortocoronarico, Progetto mattoni outcome, Progetto Progressi) or regional (P.Re.Val.E. Programma Regionale di Valutazione degli Esiti, Lazio) health care outcomes projects and the National outcome programme. This guide is aimed to all those interested in conducting or interpreting health care outcomes studies within different levels of the Italian NHS. It gives an introductory description of the operative steps to build outcome indicators and to perform comparative analyses, with the general objective of measuring and promoting improvement in health care. A specific emphasis is given to the use of routinely collected health care databases that have found widespread use for epidemiological purposes. This guide has two parts: part A includes an introduction and comments on critical methodological points, part B shows three example of epidemiological studies (A. Complications after cholecystectomy: comparison between two surgical techniques, B. 30-day mortality after acute myocardial infarction: comparison among hospitals, C. 30-day mortality after acute myocardial infarction: comparison between time periods). The online version of this guide is organised as a hypertext as practical instrument of appraisal.
Nyonator, Frank K; Awoonor-Williams, J Koku; Phillips, James F; Jones, Tanya C; Miller, Robert A
Research projects demonstrating ways to improve health services often fail to have an impact on what national health programmes actually do. An approach to evidence-based policy development has been launched in Ghana which bridges the gap between research and programme implementation. After nearly two decades of national debate and investigation into appropriate strategies for service delivery at the periphery, the Community-based Health Planning and Services (CHPS) Initiative has employed strategies tested in the successful Navrongo experiment to guide national health reforms that mobilize volunteerism, resources and cultural institutions for supporting community-based primary health care. Over a 2-year period, 104 out of the 110 districts in Ghana started CHPS. This paper reviews the development of the CHPS initiative, describes the processes of implementation and relates the initiative to the principles of scaling up organizational change which it embraces. Evidence from the national monitoring and evaluation programme provides insights into CHPS' success and identifies constraints on future progress.
Full Text Available Background and Objective: Quality is a major concern in the services offered by the health sector. The first basic step, in formulating any quality-improvement program, is recognizing consumers’ perceptions and expectations of the services' quality. The aim of this study is to determine the gaps in the health services and provide solutions to increase clients' satisfaction in the clinics of Shomal Health Center of Tehran.Material and Methods: This cross-sectional and descriptive study was done in 2013. The sample size was 325, proportionately selected from the recipients of primary health care in each clinic. Data was collected by a questionnaire, based on the five dimensions of service quality gap SERVQUAL instrument; which includes 22 questions. The collected data was statistically analyzed using SPSS software. Results: There was a significant difference between the client's perception and expectation in each of the five dimensions of service quality. The smallest gap was in the communion (0.68 and the largest gap in the concrete (0/88 service. The client's education was significantly associated with the quality gap.Conclusion: None of the service dimensions were beyond the expectations of the respondents. Therefore, there is an ample room for improving the service processes.Keywords: Health center, Quality of service, SERVQUAL, Shomal Health Center, Primary Health
MacStravic, R S
Service marketing is the engineering of satisfaction, and the key to success is to identify and influence potential customers' expectations and then to fulfill those expectations. Patient satisfaction largely determines both a program's revenues and expenditures and the effectiveness of care received by patients. A program's ability to satisfy patients rests upon three basic elements: research, design, and communication. Research should be on two levels. The first is basic market assessment and analysis, and should reveal overall market potential by focusing on consumers' expectations, unmet needs, and level of satisfaction. From this stage of research, the organization should be able to identify current programs that are secure and stable, those which have significant growth potential, those which are threatened by competition, and those which have little future. This research also should indicate the potential for new programs and for new markets for existing programs. The second level of research focuses on a specific program (whether current or proposed) and is the basis for program design. The organization can tailor the program to consumers' expectations in everything from services provided to price of parking and other amenities. Research also provides a basis for communications. Not only can communications influence a potential customer to try a provider, but also care providers can use communications during and after the service experience to reinforce what might have been a casual decision. Ideally, all communication that occurs between patients and providers should serve marketing as well as diagnostic and therapeutic purposes. It can shape patients' expectations, reinforce satisfaction when those expectations have been fulfilled, and convey the provider's caring and concern.
Natalya Vasilyevna Krivenko
Full Text Available In the article, the definitions of the concept organizational and economic changes in institution problems of changes in public health service, the purpose and issues of the management system of organizational and economic changes in the field are considered. The combined strategy of development and innovative changes in management is offered. The need of resource-saving technologies implementation is shown. Expediency of use of marketing tools in a management system of organizational and economic changes is considered the mechanism of improvement of planning and pricing in public health service is offered. The author’s model of management of organizational and economic changes in health services supporting achievement of medical, social, economic efficiency in Yekaterinburg's trauma care is presented. Strategy of traumatism prevention is determined on the basis of interdepartmental approach and territorial segmentation of health care market
Hui, Ada; Stickley, Theodore
This paper is a report of an exploration of the concept of service user involvement in mental health nursing using a discourse analysis approach. Service user involvement has come to be expected in mental health nursing policy and practice. This concept, however, is often applied somewhat ambiguously and some writers call for a clearer understanding of what service users actually want. A Foucauldian discourse analysis was conducted in 2005, examining literature and health policies published by the United Kingdom government and service users. The discursive perspectives of both were explored and conceptual themes were generated from the data. Concepts occurring within government discourse include language relating to service users, the notion of service user involvement and power. Concepts from the service user discourse include power, change and control, theory, policy and practice, and experiential expertise. Differences in perspectives were found within these themes which distinguished government from service user discourses. Greater flexibility in ideas and perspectives was demonstrated by service users, with a seemingly greater range of theoretical underpinnings. Greater awareness is needed of the significance of language, of how subtle inferences may be drawn from the rhetorical language of policies, of how these might affect the involvement of service users, and of the implications for the role of mental health nurses. Nurses need to be aware of these tensions and conflicts in managing their practice and in creating a mental health nursing philosophy of 'involvement'. If true 'involvement' is to ensue, nurses may also need to consider the transfer of power to service users.
Full Text Available BACKGROUND: School mental health services are important contact points for children and adolescents with mental disorders, but their ability to provide comprehensive treatment is limited. The main objective was to estimate in mentally disordered adolescents of a nationally representative United States cohort the role of school mental health services as guide to mental health care in different out-of-school service sectors. METHODS: Analyses are based on weighted data (N = 6483 from the United States National Comorbidity Survey Replication Adolescent Supplement (participants' age: 13-18 years. Lifetime DSM-IV mental disorders were assessed using the fully structured WHO CIDI interview, complemented by parent report. Adolescents and parents provided information on mental health service use across multiple sectors, based on the Service Assessment for Children and Adolescents. RESULTS: School mental health service use predicted subsequent out-of-school service utilization for mental disorders i in the medical specialty sector, in adolescents with affective (hazard ratio (HR = 3.01, confidence interval (CI = 1.77-5.12, anxiety (HR = 3.87, CI = 1.97-7.64, behavior (HR = 2.49, CI = 1.62-3.82, substance use (HR = 4.12, CI = 1.87-9.04, and eating (HR = 10.72, CI = 2.31-49.70 disorders, and any mental disorder (HR = 2.97, CI = 1.94-4.54, and ii in other service sectors, in adolescents with anxiety (HR = 3.15, CI = 2.17-4.56, behavior (HR = 1.99, CI = 1.29-3.06, and substance use (HR = 2.48, CI = 1.57-3.94 disorders, and any mental disorder (HR = 2.33, CI = 1.54-3.53, but iii not in the mental health specialty sector. CONCLUSIONS: Our findings indicate that in the United States, school mental health services may serve as guide to out-of-school service utilization for mental disorders especially in the medical specialty sector across various mental disorders, thereby
Bujnowska-Fedak, Maria M; Mastalerz-Migas, Agnieszka
Internet and e-health services have a substantial potential to support efficient and effective care for the elderly. The aim of the study was to investigate the use of Internet for health-related purposes among Polish elderly, the frequency and reasons of use, the importance of e-health services, and factors affecting their use. A total of 242 elderly at the age of ≥60 years were selected from the Polish population by random sampling. Data collection was carried out by phone interviews in October-November 2012. The study shows that the Internet was ever used by 32% of the elderly and 1/5 claimed a regular use. Among the Internet users, 81% of older people used it to obtain information about health or illness. The Internet was one of the less important sources of information (important for 27% of respondents), face to face contact with health professionals and family and friends are still the most required source of medical information (75%). Only 7% of elderly Internet users approached the family physician, specialists, or other health professionals over the Internet. Factors that positively affected the use of Internet among elderly were male gender, younger age, higher education, living with family, mobile phone use, and a subjective assessment of one's own health as good. The doctor's provision of Internet-based services was important in the opinion of approximately 1/4 of older people. We conclude that the development of information and communications technology (ICT) tools increasingly meets the evolving needs of patients in the field of e-health. More and more elderly become beneficiaries of these services.
Southern African Business Review ... A superior level of service quality is an important objective for South African retail banks. ... segments to use when adopting marketing strategies, and the demographic factors of age, race and geographical ...
Rockland-Miller, Harry S.; Eells, Gregory T.
The increase in the level of severity of student psychological difficulties and the growing need for psychological services in higher education settings has placed considerable pressure on college and university mental health services to respond effectively to this demand. One way several of these services have responded has been to implement…
Gilbert, T; Cochrane, A; Greenwell, S
This study focuses upon the effect of social policy upon a particular area of service provision. It is influenced by the Foucauldian concept of governmentality and the proposition by Lewis et al. that social policy needs to be understood in local contexts. Only through understanding the partial and fragmented impact of policy can we gain a clear insight into the outcomes for users. The study is undertaken through an exploration of the micro politics of organisations providing health and welfare services for people with learning disabilities. It involves an approach to discourse analysis that focuses upon text developed from interviews with service providers, which is brought into contact with published literature in an iterative process. The interpretation of the text produces four themes: power, trust, citizenship and managerialism. The development of these themes and a further holistic interpretation of the text suggest an emerging organisational typology. A typology based upon different articulations of the themes noted that work to produce particular outcomes for service users.
Full Text Available Jane Burns, Emma Birrell Young and Well Cooperative Research Centre, Abbotsford, VIC, Australia Abstract: International studies have shown that the prevalence of mental illness, and the fundamental contribution it make to the overall disease burden, is greatest in children and young people. Despite this high burden, adolescents and young adults are the least likely population group to seek help or to access professional care for mental health problems. This issue is particularly problematic given that untreated, or poorly treated, mental disorders are associated with both short- and long-term functional impairment, including poorer education and employment opportunities, potential comorbidity, including drug and alcohol problems, and a greater risk for antisocial behavior, including violence and aggression. This cycle of poor mental health creates a significant burden for the young person, their family and friends, and society as a whole. Australia is enviably positioned to substantially enhance the well-being of young people, to improve their engagement with mental health services, and – ultimately – to improve mental health. High prevalence but potentially debilitating disorders, such as depression and anxiety, are targeted by the specialized youth mental health service, headspace: the National Youth Mental Health Foundation and a series of Early Psychosis Prevention and Intervention Centres, will provide early intervention specialist services for low prevalence, complex illnesses. Online services, such as ReachOut.com by Inspire Foundation, Youthbeyondblue, Kids Helpline, and Lifeline Australia, and evidence-based online interventions, such as MoodGYM, are also freely available, yet a major challenge still exists in ensuring that young people receive effective evidence-based care at the right time. This article describes Australian innovation in shaping a comprehensive youth mental health system, which is informed by an evidence
Full Text Available Objective. Mental health service users experience high rates of cardiometabolic disorders and have a 20–25% shorter life expectancy than the general population from such disorders. Clinician-led health behavior programs have shown moderate improvements, for mental health service users, in managing aspects of cardiometabolic disorders. This study sought to potentially enhance health initiatives by exploring (1 facilitators that help mental health service users engage in better health behaviors and (2 the types of health programs mental health service users want to develop. Methods. A qualitative study utilizing focus groups was conducted with 37 mental health service users attending a psychosocial rehabilitation center, in Northern British Columbia, Canada. Results. Four major facilitator themes were identified: (1 factors of empowerment, self-value, and personal growth; (2 the need for social support; (3 pragmatic aspects of motivation and planning; and (4 access. Participants believed that engaging with programs of physical activity, nutrition, creativity, and illness support would motivate them to live more healthily. Conclusions and Implications for Practice. Being able to contribute to health behavior programs, feeling valued and able to experience personal growth are vital factors to engage mental health service users in health programs. Clinicians and health care policy makers need to account for these considerations to improve success of health improvement initiatives for this population.
Full Text Available Abstract Background Rural communities throughout Australia are experiencing demographic ageing, increasing burden of chronic diseases, and de-population. Many are struggling to maintain viable health care services due to lack of infrastructure and workforce shortages. Hence, they face significant health disadvantages compared with urban regions. Primary health care yields the best health outcomes in situations characterised by limited resources. However, few rigorous longitudinal evaluations have been conducted to systematise them; assess their transferability; or assess sustainability amidst dynamic health policy environments. This paper describes the study protocol of a comprehensive longitudinal evaluation of a successful primary health care service in a small rural Australian community to assess its performance, sustainability, and responsiveness to changing community needs and health system requirements. Methods/Design The evaluation framework aims to examine the health service over a six-year period in terms of: (a Structural domains (health service performance; sustainability; and quality of care; (b Process domains (health service utilisation and satisfaction; and (c Outcome domains (health behaviours, health outcomes and community viability. Significant international research guided the development of unambiguous reliable indicators for each domain that can be routinely and unobtrusively collected. Data are to be collected and analysed for trends from a range of sources: audits, community surveys, interviews and focus group discussions. Discussion This iterative evaluation framework and methodology aims to ensure the ongoing monitoring of service activity and health outcomes that allows researchers, providers and administrators to assess the extent to which health service objectives are met; the factors that helped or hindered achievements; what worked or did not work well and why; what aspects of the service could be improved and how
Globalization is a key challenge facing health policy-makers. A significant dimension of this is trade in health services. Traditionally, the flow of health services exports went from North to South, with patients travelling in the opposite direction. This situation is changing and a number of papers have discussed the growth of health services exports from Southern countries in its different dimensions. Less attention has been paid to assess the real scope of this trade at the global level and its potential impact at the local level. Given the rapid development of this area, there are little empirical data. This paper therefore first built an estimate of the global size and of the growth trend of international trade in health services since 1997, which is compared with several country-based studies. The second purpose of the paper is to demonstrate the significant economic impact of this trade at the local level for the exporting country. We consider the case of health providers in the South-Mediterranean region for which the demand potential, the economic effects and the consequence for the health system are presented. These issues lead to the overall conclusion that different policy options would be appropriate, in relation to the nature of the demand. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
Nguyen Huu Son
This article concerns the quality of services provided by the different groups sponsored by the Japan International Cooperation Agency (JICA) Reproductive Health project. Nguyen Huu Son, Chairperson of the People's Committee of Thanh Tien Commune, cites that the JICA project has helped improve their Commune Health Center (CHC). The project has provided basic medical equipment that has been lacking in the CHCs, subsequently making the task of providing quality services easier and more comfortable for midwives and other health personnel. For the Thanh Tien Commune Health Center, Nguyen Hoang An reports that the JICA project has brought about improvement in their CHC fields; namely, 1) providing health knowledge to community people; 2) increase in health staff's skills through training; 3) keeping record of management and the CHC services; and 4) renovating health facilities. As a result, clients have increased and many of the community people now have confidence in their services. For the Women's Union of Thanh Tien Commune, Nguyen Thi Loc reports that the assistance provided by JICA has greatly helped in the acquisition of necessary skills for disseminating adequate information to women.
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.
Rae, John; Green, Bill
A model is proposed for supporting reflexivity in qualitative health research, informed by arguments from Bourdieu and Finlay. Bourdieu refers to mastering the subjective relation to the object at three levels-the overall social space, the field of specialists, and the scholastic universe. The model overlays Bourdieu's levels of objectivation with Finlay's three stages of research (pre-research, data collection, and data analysis). The intersections of these two ways of considering reflexivity, displayed as cells of a matrix, pose questions and offer prompts to productively challenge health researchers' reflexivity. Portraiture is used to show how these challenges and prompts can facilitate such reflexivity, as illustrated in a research project. © The Author(s) 2016.
Detmer Don E
Full Text Available Abstract Background Improving health in our nation requires strengthening four major domains of the health care system: personal health management, health care delivery, public health, and health-related research. Many avoidable shortcomings in the health sector that result in poor quality are due to inaccessible data, information, and knowledge. A national health information infrastructure (NHII offers the connectivity and knowledge management essential to correct these shortcomings. Better health and a better health system are within our reach. Discussion A national health information infrastructure for the United States should address the needs of personal health management, health care delivery, public health, and research. It should also address relevant global dimensions (e.g., standards for sharing data and knowledge across national boundaries. The public and private sectors will need to collaborate to build a robust national health information infrastructure, essentially a 'paperless' health care system, for the United States. The federal government should assume leadership for assuring a national health information infrastructure as recommended by the National Committee on Vital and Health Statistics and the President's Information Technology Advisory Committee. Progress is needed in the areas of funding, incentives, standards, and continued refinement of a privacy (i.e., confidentiality and security framework to facilitate personal identification for health purposes. Particular attention should be paid to NHII leadership and change management challenges. Summary A national health information infrastructure is a necessary step for improved health in the U.S. It will require a concerted, collaborative effort by both public and private sectors. If you cannot measure it, you cannot improve it. Lord Kelvin
Pakistan is not on track to achieve most Millennium Development Goals (MDGs) related to health, nutrition and population. Given its current rate of progress, in 2015 Pakistan's infant mortality rate (IMR) will be 65 deaths per 1,000 live births and the under-five mortality rate (U5MR) will be 78, considerably above the MDG4 targets of 33 and 43 deaths per 1000 births respectively. Pakistan...
... served by the Indian Health Service, Tribal health programs, and urban Indian organization health programs. 489.29 Section 489.29 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION PROVIDER AGREEMENTS AND...
Giotakos, O; Tsouvelas, G; Kontaxakis, V
Some studies have shown that access to mental health services can have an impact on mental health outcomes, including the suicide rates. The aim of the present study was to examine the relationship between regional and prefecture suicide rates (suicides per 100.000 residents) and both the number of primary and mental health-care service providers and the number of mental health infrastructures in Greece. Data were taken mainly from the Hellenic Statistical Authority (EL.STAT.) and the Ministry of Health for the period 2002-2009. Spearman correlations were used to examine the relationship between primary health-care, mental health providers and suicide rates per 100,000 residents at the prefecture, administrative region and geographical region levels. Men showed significantly higher suicide rates than women (U=-7.20, pGreece: Crete (4.76 vs 3.65), Thrace (4.45 vs 2.02) Central Greece (3.61 vs 1.39) Aegean Islands (3.03 vs 1.28). The highest correlations between suiciderutes and health services at the geographic regional level were found to be during the period 2007-2009, where suicide rates showed a significant negative correlation with privately practicing psychiatrists (rho=-0.71, pGreece. It should be noted that the running financial crisis in Greece seems to have many effects on quality of life, since the most common effects of an economic crisis are unemployment, spending power cuts,general insecurity and public spending retrenchment, including health related budget cuts. Having in mind the above situation, further analyses are needed to determine the relationship between mental health-care services, suicide rates and other psychosocial indices, in order to provide a strategic plan for a better design of mental health-care policy in Greece.
Ishida, Yutaka; Hikita, Kazuo
Japan International Cooperation Agency (JICA) implemented a 5-year long bilateral technical cooperation project, "Leprosy Control and Basic Health Services Project" in Myanmar. The project was implemented by National Leprosy Control Program, Department of Health with close technical collaboration of JICA experts mainly from International Medical Center of Japan (IMCJ) and National Sanatoriums of leprosy in Japan. It accelerated to achieve the elimination of leprosy at national level, which was declared in January 2003, and at sub-national level onward. It also developed the appropriate technologies for prevention of disability and prevention of worsening of disability (POD/POWD), which were introduced in 9 townships as a pilot service program. The Government stratified the POD/POWD services as a national program since 2005 by taking up the former pilot area to start with. The project also strengthened the function of referral system of leprosy control (Diagnosis and treatment), POD/POWD and physical rehabilitation. Beside leprosy, the project conducted a series of refresher trainings for primary health care givers, Basic Health Service Staff (BHS), of project areas (48 townships) to improve the services on tuberculosis, Malaria, Leprosy, Trachoma and HIV/AIDS for 3 years (2001-2003), which was evaluated in 2004. It contributed to improve the services at township level hospitals in procurement of audio-visual equipments and in conducting microscope training on leprosy, Malaria and tuberculosis at project areas.
Godbole, A; Temkin, T; Cradock, C
The authors originally circulated the concepts in this proposal during May 1995. The purpose was to support an open, public dialogue regarding the restructuring of the mental health and substance abuse services in Illinois in anticipation of Medicaid funding changes. Restructuring mental health and substance abuse service systems should follow certain key principles. These principles are applicable to other states, particularly those large in territory and population. The authors propose the temporary use of multiple managed care companies serving as administrative services only (ASO) organizations, each of whom would have responsibility for a given geographic portion of a state. The role of the ASOs would be to organize providers into networks on a regional basis and transfer managed care expertise in financing and clinical management to the relevant state departments and provider groups. Changes in the service delivery system would be phased in over time with reorganization of key components of the system during each phase. Where the provision of mental health, substance abuse, and social services is split among multiple state agencies, these agencies would be merged to achieve unified funding and administrative efficiency. Patients and advocacy organizations would play a key role in overseeing and shaping system restructuring at all levels, including a governmental board reporting to the governor, overseeing ASO organizations' operations and assuring quality and access at the provider level. The authors propose funding of public behavioral health services through use of a tiered, integrated funding model.
Forrester, Andrew; Exworthy, Tim; Olumoroti, Olumuyiwa; Sessay, Mohammed; Parrott, Janet; Spencer, Sarah-Jane; Whyte, Sean
In responding to high levels of psychiatric morbidity amongst prisoners and recognising earlier poor quality prison mental health care, prison mental health in-reach teams have been established in England and Wales over the last decade. They are mostly provided by the National Health Service (NHS), which provides the majority of UK healthcare services. Over the same period, the prison population has grown to record levels, such that prisons in England and Wales now contain almost 90,000 of the world's overall prison population of over 10 million people (roughly the size of Paris or Istanbul). This study provides an overview of mental health in-reach services in prisons in England and Wales, including variations between them, through a telephone survey of senior staff in all prisons and young offender institutions in England and Wales. 73% of prisons took part; of them 13% had no in-reach team at all (usually low security establishments) and the majority of services were run by NHS teams, usually according to a generic community mental health team (CMHT) model rather than other specialist models. Team size was unrelated to prison size. Each nurse covered around 500 prisoners, each doctor over 3700. Many provided few or no healthcare cells and 24-h psychiatric cover (including on-call cover) was uncommon. Despite developments in recent years, mental health in-reach services still fall short of community equivalence and there is wide variation in service arrangements that cannot be explained by prison size or function. The aim of community equivalence has not yet been reached in prison healthcare and a more sophisticated measure of service improvement and standardisation would now be useful to drive and monitor future development.
McLean, R A
Fundamental changes in domestic healthcare delivery in the '90s have prompted many U.S. healthcare organizations to consider entering international markets. Opportunities available to U.S. organizations include investing in foreign organizations, controlling foreign facilities, and obtaining referrals from extraterritorial or cooperating foreign providers. Before entering into these arrangements, however, organizations must consider the benefits, risks, and constraints they may face, specifically with regard to reimbursement and cash flow, currency risk, regulation, and political risk. To succeed in international service delivery ventures, organizations also may need to make adjustments in the training of healthcare financial managers who will face the international marketplace. Being sensitive to the culture of the countries with which they will be dealing is just as important as knowing the currency and financial regulations.
Stowers, Chanelle; Healey, Loretta; O'Connor, Catherine C
A trial of using Short Message Service (SMS) broadcasting at a metropolitan sexual health clinic in 2013 to promote the awareness and uptake of influenza vaccinations in HIV-positive patients resulted in a significant increase in the number of patients contacted (35% vs 81% Pbroadcasting is an efficient and inexpensive method of communicating health messages to large numbers of patients.
McClintock, Martha K.; Waite, Linda J.
Introduction. Wave 2 of the National Social Life, Health, and Aging Project (NSHAP) includes new measures of sexual interest and behavior, as well as new measures of the context of sexual experience and the frequency and appeal of physical contact. This is the first time many of these constructs have been measured in a nationally representative sample. Method. We describe the new measures and compare the distributions of each across gender and age groups, in some cases by partnership status. Results. Two components of sexuality decrease with age among both men and women: frequency of finding an unknown person sexually attractive and receptivity to a partner’s sexual overtures. In contrast, the inclination to make one’s self sexually attractive to others was a more complicated function of partner status, gender, and age: partnered women and unpartnered men made the most effort, with the more effortful gender’s effort decreasing with age. Both men and women find nonsexual physical contact appealing but sexual physical contact is more appealing to men than women. Finally, two fifths of men and women report dissatisfaction with their partner’s frequency of caring behaviors that make later sexual interactions pleasurable, and a fifth of women and a quarter of men who had vaginal sex in the past year report dissatisfaction with amount of foreplay. Discussion. These data offer the opportunity to characterize sexual motivation in older adulthood more precisely and richly and to examine how the context of sexual experience and the nonsexual aspects of physical intimacy correlate with sexual behavior, enjoyment, and problems. PMID:25360027
Galinsky, Adena M; McClintock, Martha K; Waite, Linda J
Wave 2 of the National Social Life, Health, and Aging Project (NSHAP) includes new measures of sexual interest and behavior, as well as new measures of the context of sexual experience and the frequency and appeal of physical contact. This is the first time many of these constructs have been measured in a nationally representative sample. We describe the new measures and compare the distributions of each across gender and age groups, in some cases by partnership status. Two components of sexuality decrease with age among both men and women: frequency of finding an unknown person sexually attractive and receptivity to a partner's sexual overtures. In contrast, the inclination to make one's self sexually attractive to others was a more complicated function of partner status, gender, and age: partnered women and unpartnered men made the most effort, with the more effortful gender's effort decreasing with age. Both men and women find nonsexual physical contact appealing but sexual physical contact is more appealing to men than women. Finally, two fifths of men and women report dissatisfaction with their partner's frequency of caring behaviors that make later sexual interactions pleasurable, and a fifth of women and a quarter of men who had vaginal sex in the past year report dissatisfaction with amount of foreplay. These data offer the opportunity to characterize sexual motivation in older adulthood more precisely and richly and to examine how the context of sexual experience and the nonsexual aspects of physical intimacy correlate with sexual behavior, enjoyment, and problems. © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: firstname.lastname@example.org.
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.
Hom, Melanie A; Stanley, Ian H; Schneider, Matthew E; Joiner, Thomas E
Research has demonstrated that military service members are at elevated risk for a range of psychiatric problems, and mental health services use is a conduit to symptom reduction and remission. Nonetheless, there is a notable underutilization of mental health services in this population. This systematic review aimed to identify and critically examine: (1) rates of service use; (2) barriers and facilitators to care; and (3) programs and interventions designed to enhance willingness to seek care and increase help-seeking behaviors among current military personnel (e.g., active duty, National Guard, Reserve). Overall, 111 peer-reviewed articles were identified for inclusion. Across studies, the rate of past-year service use among service members with mental health problems during the same time frame was 29.3% based on weighted averages. Studies identified common barriers to care (e.g., concerns regarding stigma, career impact) and facilitators to care (e.g., positive attitudes toward treatment, family/friend support, military leadership support) among this population. Although programs (e.g., screening, gatekeeper training) have been developed to reduce these barriers, leverage facilitators, and encourage service use, further research is needed to empirically test the effectiveness of these interventions in increasing rates of service utilization. Critical areas for future research on treatment engagement among this high-risk population are discussed. Copyright © 2017 Elsevier Ltd. All rights reserved.
Belay, Tekabe; Couffinhal, Agnes; Haq, Inaam; Kazi, Shahnaz; Loevinsohn, Benjamin
Pakistan is not on track to achieve most Millennium Development Goals (MDGs) related to health, nutrition and population. Given its current rate of progress, in 2015 Pakistan's infant mortality rate (IMR) will be 65 deaths per 1,000 live births and the under-five mortality rate (U5MR) will be 78, considerably above the MDG4 targets of 33 and 43 deaths per 1000 births respectively. Pakistan will not achieve the MDG related to nutrition. The review aims to develop a limited set of practical opt...
Tsai, Meng-Che; Lin, Sheng-Hsiang; Chou, Yen-Yin; Lin, Shio-Jean
There have been few reports about adolescent experiences with and expectations of health service utilization in an Asian societal setting. The aim of this study is to analyze the use of healthcare services in relation to health status and explore adolescents' preferences for youth-friendly service among Taiwanese high school students. A cross-sectional questionnaire-based survey was conducted on Taiwanese adolescents aged 12–18 years in 2010.We invited participants to rate their health status, report their previous healthcare service use, and rank their health service preferences.We used logistic regression analysis to investigate the association between self-rated health status and healthcare utilization and used nonparametric analysis to compare health service preferences among sociodemographic subgroups. A total of 4,907 students (97.2 % response rate) returned valid questionnaires for analysis. Poor health status and chronic illness were most salient factors independently associated with frequent healthcare service use. Only 40 % of respondents reported having a regular doctor, and pediatrics (57.7 %) was the most commonly identified professional source of medical care. A great majority (86.2 %) of respondents made clinical visits with parents. For characteristics of youth-friendly clinician, the top-ranked items included competency and patience, while having helpful and friendly personnel was highlighted for clinical setting. Family participation is critical in healthcare for adolescents in Asian cultures. Health service use is significantly influenced by health status and chronic illness in the general health insurance system. Understanding these background influences on expectations for healthcare may help to create youth-friendly health services that are more culturally appropriate.
Ipatova, O M; Medvedeva, N V; Archakov, A I; Grigor'ev, A I
Increasing distance between practical public health services and collecting of theoretical information in the field of biomedical researches reflects the necessity of professional contact between clinicians and scientists in many areas associated with medicine for active carrying over ("translation") of the modern basic researches in which mechanisms of basic metabolic processes and possibilities of their correction are detected, to effective medical help to individual patient, i.e., personified medicine. Such approach was called transmitting medicine. Examples of the personified medicine in which biomedical researches together with the anamnesis morbi of individual patient that are responsible for treatment strategy including doses and regimens are discussed.
Full Text Available Los objetivos de este trabajo son tres: en primer lugar, se revisan las causas de las desigualdades sociales en salud incluyendo el papel que juegan los servicios sanitarios en las mismas; posteriormente se analiza la influencia de la financiación y la organización de los servicios sanitarios en las desigualdades y finalmente, se muestra un ejemplo de las desigualdades en la utilización de los servicios sanitarios en Cataluña, comunidad autónoma del Estado Español donde existe un Sistema Nacional de Salud. Se analizan las siguientes causas de las desigualdades en salud: los estilos de vida o conductas relacionadas con la salud, los servicios sanitarios, los factores materiales o estructurales, las desigualdades de renta y los factores políticos. Los servicios sanitarios no son los determinantes principales de la salud ni de las desigualdades en salud. Pero la existencia de servicios sanitarios adecuados es una necesidad fundamental y el acceso a los mismos debería ser un derecho de todas las personas sin distinciones sociales. Tanto la calidad como la cobertura de los servicios sanitarios son una parte integral de la definición del desarrollo en sí mismo y constituyen unos de los principales indicadores de bienestar social. Finalmente, se muestra un ejemplo sobre las desigualdades según clase social en la utilización de servicios sanitarios en Cataluña en 1994 y en 2002, desigualdades que son prácticamente inexistentes en el caso de los servicios sanitarios curativos, pero que se mantienen en los servicios preventivos.The objectives of this paper are three: first to review the causes of inequalities in health and the role played by health services; second, to analyze the influence of health care financing and the organization of health services on inequalities in health and to show an example of the study of inequalities in health services utilization in Catalonia, an autonomous community of Spain where a National Health System
Full Text Available Abstract Background To date, no studies have assessed in detail the characteristics, organisation, and functioning of Child and Adolescent Mental Health Services (CAMHS. This information gap represents a major limitation for researchers and clinicians because most mental disorders have their onset in childhood or adolescence, and effective interventions can therefore represent a major factor in avoiding chronicity. Interventions and mental health care are delivered by and through services, and not by individual, private clinicians, and drawbacks or limitations of services generally translate in inappropriateness and ineffectiveness of treatments and interventions: therefore information about services is essential to improve the quality of care and ultimately the course and outcome of mental disorders in childhood and adolescence. The present paper reports the results of the first study aimed at providing detailed, updated and comprehensive data on CAMHS of a densely populated Italian region (over 4 million inhabitants with a target population of 633,725 subjects aged 0-17 years. Methods Unit Chiefs of all the CAMHS filled in a structured 'Facility Form', with activity data referring to 2008 (data for inpatient facilities referred to 2009, which were then analysed in detail. Results Eleven CAMHS were operative, including 110 outpatient units, with a ratio of approximately 20 child psychiatrists and 23 psychologists per 100,000 inhabitants aged 0-17 years. All outpatient units were well equipped and organized and all granted free service access. In 2008, approximately 6% of the target population was in contact with outpatient CAMHS, showing substantial homogeneity across the eleven areas thereby. Most patients in contact in 2008 received a language disorder- or learning disability diagnosis (41%. First-ever contacts accounted for 30% of annual visits across all units. Hospital bed availability was 5 per 100,000 inhabitants aged 0-17 years
Kapadia, Dharmi; Nazroo, James; Tranmer, Mark
The reasons for ethnic differences in women's mental health service use in England remain unclear. The aims of this study were to ascertain: ethnic differences in women's usage of mental health services, if social networks are independently associated with service use, and if the association between women's social networks and service use varies between ethnic groups. Logistic regression modelling of nationally representative data from the Ethnic Minority Psychiatric Illness Rates in the Community (EMPIRIC) survey conducted in England. The analytic sample (2260 women, aged 16-74 years) was drawn from the representative subsample of 2340 women in EMPIRIC for whom data on mental health services, and social networks were available. Pakistani and Bangladeshi women were less likely than White women to have used mental health services (Pakistani OR = 0.23, CI = 0.08-0.65, p = .005; Bangladeshi OR = 0.25, CI = 0.07-0.86, p = .027). Frequent contact with relatives reduced mental health service use (OR = 0.45, CI = 0.23-0.89, p = .023). An increase in perceived inadequate support in women's close networks was associated with increased odds of using mental health services (OR = 1.91, CI = 1.11-3.27, p = .019). The influence of social networks on mental health service use did not differ between ethnic groups. The differential treatment of women from Pakistani and Bangladeshi ethnic groups in primary care settings could be a possible reason for the observed differences in mental health service use.
Gallagher, E B; Searle, C M
Health services occupy a high priority in the development agenda of Saudi Arabia, Saudi culture--devotion to Islam, extended-family values, the segregated status of females and the Al Saud monarchic hegemony--is being formulated in an increasingly deliberate fashion, constituting a new 'political culture' which acts as a screen to insure that technological and human progress remain within acceptable bounds. There is a general disposition on the part of the Saudi populace to use modern health services as these become available, largely under governmental auspice. The role of the government in providing health care for pilgrims during the hajj to Mecca is of particular culture importance. Cultural sensitivities concerning male physicians and female patients will be minimized by the training of a substantial number of Saudi female physicians, whose efforts will be directed toward female patients. At present, most health care in the Kingdom is delivered by male expatriate physicians, as part of the general massive reliance upon expatriate workers: although the expatriates will eventually be replaced by Saudi physicians, this dependency, which is felt to threaten Saudi culture, will continue for a decade or more. Private medicine is rapidly increasing though not on the same scale as government medicine. The provision of government health services is a source of legitimation for the Al Saud regime. In general, health services appear to constitute a form of modernization which meets the test of cultural compatibility.
Peters, David H; Noor, Ayan Ahmed; Singh, Lakhwinder P; Kakar, Faizullah K; Hansen, Peter M; Burnham, Gilbert
The Ministry of Public Health (MOPH) in Afghanistan has developed a balanced scorecard (BSC) to regularly monitor the progress of its strategy to deliver a basic package of health services. Although frequently used in other health-care settings, this represents the first time that the BSC has been employed in a developing country. The BSC was designed via a collaborative process focusing on translating the vision and mission of the MOPH into 29 core indicators and benchmarks representing six different domains of health services, together with two composite measures of performance. In the absence of a routine health information system, the 2004 BSC for Afghanistan was derived from a stratified random sample of 617 health facilities, 5719 observations of patient-provider interactions, and interviews with 5597 patients, 1553 health workers, and 13,843 households. Nationally, health services were found to be reaching more of the poor than the less-poor population, and providing for more women than men, both key concerns of the government. However, serious deficiencies were found in five domains, and particularly in counselling patients, providing delivery care during childbirth, monitoring tuberculosis treatment, placing staff and equipment, and establishing functional village health councils. The BSC also identified wide variations in performance across provinces; no province performed better than the others across all domains. The innovative adaptation of the BSC in Afghanistan has provided a useful tool to summarize the multidimensional nature of health-services performance, and is enabling managers to benchmark performance and identify strengths and weaknesses in the Afghan context.
Schmidt-Weitmann, Sabine; Schulz, Urs; Schmid, Daniel Max; Brockes, Christiane
The University Hospital of Zurich offers a text-based, Medical Online Consultation Service to the public since 1999. Users asked health questions anonymously to tele-doctors. This study focused on the characteristics of male enquirers with intimate health problems, the content of their questions, the medical advice given by tele-doctors and the rating of the service to prove the benefit of an online service for medical laymen. This retrospective study included 5.1% of 3,305 enquiries from 2008 to 2010 using the International Classification of Diseases-10 and International Classification of Primary Care codes relevant for intimate and sexual health problems in men. A professional text analysis program (MAXQDA) supported the content analysis, which is based on the procedure of inductive category development described by Mayring. The average age was 40 years, 63.1% enquirers had no comorbidity, in 62.5% it was the first time they consulted a doctor, and 70.2% asked for a specific, single, intimate health issue. In 64.3%, the most important organ of concern was the penis. Overall, 30.4% asked about sexually transmitted diseases. In 74.4% a doctor visit was recommended to clarify the health issue. The rating of the problem solving was very good. The service was mainly used by younger men without comorbidity and no previous contact with a doctor with regard to an intimate health problem. The anonymous setting of the teleconsultation provided men individual, professional medical advice and decision support. Teleconsultation is suggested to empower patients by developing more health literacy.
Turvey, Carolyn; Coleman, Mirean; Dennison, Oran; Drude, Kenneth; Goldenson, Mark; Hirsch, Phil; Jueneman, Robert; Kramer, Greg M; Luxton, David D; Maheu, Marlene M; Malik, Tania S; Mishkind, Matt C; Rabinowitz, Terry; Roberts, Lisa J; Sheeran, Thomas; Shore, Jay H; Shore, Peter; van Heeswyk, Frank; Wregglesworth, Brian; Yellowlees, Peter; Zucker, Murray L; Krupinski, Elizabeth A; Bernard, Jordana
Table of Contents PREAMBLE SCOPE INTRODUCTION Internet-Based Telemental Health Models of Care Today CLINICAL GUIDELINES A. Professional and Patient Identity and Location 1. Provider and Patient Identity Verification 2. Provider and Patient Location Documentation 3. Contact Information Verification for Professional and Patient 4. Verification of Expectations Regarding Contact Between Sessions B. Patient Appropriateness for Videoconferencing-Based Telemental Health 1. Appropriateness of Videoconferencing in Settings Where Professional Staff Are Not Immediately Available C. Informed Consent D. Physical Environment E. Communication and Collaboration with the Patient's Treatment Team F. Emergency Management 1. Education and Training 2. Jurisdictional Mental Health Involuntary Hospitalization Laws 3. Patient Safety When Providing Services in a Setting with Immediately Available Professionals 4. Patient Safety When Providing Services in a Setting Without Immediately Available Professional Staff 5. Patient Support Person and Uncooperative Patients 6. Transportation 7. Local Emergency Personnel G. Medical Issues H. Referral Resources I .Community and Cultural Competency TECHNICAL GUIDELINES A. Videoconferencing Applications B. Device Characteristics C. Connectivity D. Privacy ADMINISTRATIVE GUIDELINES A. Qualification and Training of Professionals B. Documentation and Record Keeping C. Payment and Billing REFERENCES.
Clement, Sarah; Williams, Paul; Farrelly, Simone; Hatch, Stephani L; Schauman, Oliver; Jeffery, Debra; Henderson, R Claire; Thornicroft, Graham
This study aimed to test the hypothesis that mental health-related discrimination experienced by adults receiving care from community mental health teams is associated with low engagement with services and to explore the pathways between these two variables. In this cross-sectional study, 202 adults registered with inner-city community mental health teams in the United Kingdom completed interviews assessing their engagement with mental health services (service user-rated version of the Service Engagement Scale), discrimination that they experienced because of mental illness, and other variables. Structural equation modeling was conducted to examine the relationship of experienced discrimination and service engagement with potential mediating and moderating variables, such as anticipated discrimination (Questionnaire on Anticipated Discrimination), internalized stigma (Internalized Stigma of Mental Illness Scale), stigma stress appraisal (Stigma Stress Appraisal), mistrust in services, the therapeutic relationship (Scale to Assess Therapeutic Relationships), difficulty disclosing information about one's mental health, and social support. Analyses controlled for age, race-ethnicity, and symptomatology. No evidence was found for a direct effect between experienced discrimination and service engagement. The total indirect effect of experienced discrimination on service engagement was statistically significant (coefficient=1.055, 95% confidence interval [CI]=.312-2.074, p=.019), mainly via mistrust in mental health services and therapeutic relationships (coefficient=.804, CI=.295-1.558, p=.019). A 1-unit increase in experienced discrimination via this pathway resulted in .804-unit of deterioration in service engagement. Findings indicate the importance of building and maintaining service users' trust in mental health services and in therapeutic relationships with professionals and countering the discrimination that may erode trust.
Anshari, Muhammad; Almunawar, Mohammad Nabil
Web technology provides healthcare organizations the ability to broaden services beyond usual practices, and thus provides a particularly advantageous environment to achieve complex e-health goals. Furthermore, introducing web technology in healthcare services may add value to the overall healthcare process. Web technology helps healthcare organizations to extend the online health services (e-health) beyond their traditional mechanism. The changes enable customers (patients) to participate more in the process of healthcare, such as through their ability to generate personal health data to their personalized web-based interface. It allows patients to have greater control of information flow between healthcare organizations and customers, and among customers themselves. In this study the authors investigate the extended role of healthcare staff that provide e-health services. The authors have developed e-health models that accommodate customers' participation to engage more actively in the healthcare system. Through the model the authors developed a prototype--namely Clinic 2.0. Clinic 2.0 is set up to facilitate interactions between healthcare providers and customers. In the proposed systems, the authors introduced Online Health Educator (OHE)--a healthcare staff that is specifically responsible for administering Clinic 2.0. The authors have conducted a survey in Indonesia to draw the expectation of participants regarding the important role of OHE in Clinic 2.0 through a semi-structured interview conducted with participants to further investigate the pivotal roles of OHE. The authors found that e-health services need OHE to achieve customers' satisfaction.
O'Hara, Rebecca; Jackson, Sarah
The continuity of care for people with neurological conditions in a remote northwest Queensland town as services are currently only available intermittently. Mixed methods design using questionnaires and staff review of the program and processes. Intermittent community rehabilitation service for clients with neurological conditions has been offered in Mount Isa and is supported by a similar fulltime service in Townsville. Both services use a unique client-centred, student-assisted, interprofessional model of care. Understanding participant experiences by obtaining feedback from clients, students and allied health professionals (AHPs) regarding their experiences of using telehealth in this setting. Previous clients of the North West Community Rehabilitation service were offered a review assessment using telehealth by an interprofessional team. Using telehealth enabled the client, remote AHP and students in Mount Isa to be connected to expert assistance in Townsville. The findings suggest that telehealth was useful in a community rehabilitation setting to provide review services for clients. This improved continuity of care for these clients because without this telehealth assessment, the clients would have had to wait up to 12 months for the next service period in Mount Isa or travel to a major urban centre to access a similar service. Feedback from clients, students and AHPs was positive; however, some challenges were identified. Recommendations for future service delivery using telehealth are outlined in the paper. © 2015 National Rural Health Alliance Inc.
Graetz, V.; Rechel, B.; Groot, W.
Introduction: Our study reviewed the empirical evidence on the utilization of health care services by migrants in Europe, and on differences in health service utilization between migrants and non-migrants across European countries. Sources of data: A systematic literature review was performed......, searching the databases Medline, Cinahl and Embase and covering the period from January 2009 to April 2016. The final number of articles included was 39. Areas of agreement: Utilization of accident and emergency services and hospitalizations were higher among migrants compared with non-migrants in most...... countries for which evidence was available. In contrast, screening and outpatient visits for specialized care were generally used less often by migrants. Areas of controversy: Utilization of general practitioner services among migrants compared with non-migrants presents a diverging picture. Growing points...
Full Text Available The W.H.O. (1982 estimates that the annual risk of infection with tuberculosis in most developing countries is in the order of 3 to 5%. Every year 4-million to 5-million highly infectious cases of tuberculosis occur in those countries, according to the WHO Technical Report No. 671. This report also states that case finding and chemotherapy, combined as one entity, must be considered to be the most powerful weapon in tuberculosis control. Since case finding in those countries depends principally on the examination of patients presenting with relevant symptoms to a health facility, it is recommended that all staff at such facilities should be properly trained and motivated to identify potential tuberculosis patients.
Dr. Mary Wakefield is the administrator of the Health Resources and Services Administration. She came from the University of North Dakota, where she directed the Center for Rural Health. She has served as director of the Center for Health Policy, Research and Ethics at George Mason University and has worked with the World Health Organization's Global Programme on AIDS in Geneva, Switzerland. She is a fellow in the American Academy of Nursing and was elected to the Institute of Medicine of the National Academies. A native of North Dakota, Wakefield holds a doctoral degree in nursing from the University of Texas.
Full Text Available Background: It is necessary that various aspects of health information and statistics are identified and measured since health problems are getting more complex day by day. Objective: This study is aimed to investigate the distribution of health services in the health care system in Iran and the case of study is East Azerbaijan province. Methods: This research was a retrospective, descriptive, cross-sectional study. The statistical population included all health service providers in East Azerbaijan Province in the public, private, charity, military, social security, and NGO sectors. In this study, the data from all functional health sectors, including hospitals, health centers, and clinical, rehabilitation centers and all clinics and private offices were studied during 2014. The data relevant to performance were collected according to a pre-determined format (researcher- built checklist which was approved by five professionals and experts Health Services Management (content validity. Results: The study findings showed that the public sector by 45.28% accounted for the highest share of provided services and the private sector, social security, military institutions, charities and NGOs institutions by 25.47%, 18.92%, 4.37%, 3.3%, and 2.66% next rank in providing health services in East Azerbaijan province have been allocated. Conclusion: The results show that most of the health services in East Azerbaijan Province belongs to the public sector and the private sector has managed to develop its services in some parts surpassed the public sector. According to the study findings, Policies should be aimed to create balance and harmony in the provision of services among all service providers.
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.
Wakeley, P J; Marshall, S B; Foster, E C
In an increasingly information-based society, hospitals need a variety of information for multiple purposes--direct patient care, staff development and training, continuing education, patient and community education, and administrative decision support. Health science library and information services play a key role in providing broad-based information support within the hospital. This guide identifies resources that will help administrators plan information services that are appropriate to their needs.
Ford, Adriana E S; Graham, Hilary; White, Piran C L
The pace and scale of environmental change is undermining the conditions for human health. Yet the environment and human health remain poorly integrated within research, policy and practice. The ecosystem services (ES) approach provides a way of promoting integration via the frameworks used to represent relationships between environment and society in simple visual forms. To assess this potential, we undertook a scoping review of ES frameworks and assessed how each represented seven key dimensions, including ecosystem and human health. Of the 84 ES frameworks identified, the majority did not include human health (62%) or include feedback mechanisms between ecosystems and human health (75%). While ecosystem drivers of human health are included in some ES frameworks, more comprehensive frameworks are required to drive forward research and policy on environmental change and human health.
Seligman, Jamie; Felder, Stephanie S; Robinson, Maryann E
The Substance Abuse and Mental Health Services Administration (SAMHSA) in the Department of Health and Human Services offers extensive disaster behavior health resources to assist disaster survivors in preparing for, responding to, and recovering from natural and manmade disasters. One of SAMHSA's most innovative resources is the SAMHSA Behavioral Health Disaster Response App (SAMHSA Disaster App). The SAMHSA Disaster App prepares behavioral health responders for any type of traumatic event by allowing them to access disaster-related materials and other key resources right on their phone, at the touch of a button. The SAMHSA Disaster App is available on iPhone, Android, and BlackBerry devices.
Full Text Available Background Decentralisation aims to bring services closer to the community and has been advocated in the health sector to improve quality, access and equity, and to empower local agencies, increase innovation and efficiency and bring healthcare and decision-making as close as possible to where people live and work. Fiji has attempted two approaches to decentralisation. The current approach reflects a model of deconcentration of outpatient services from the tertiary level hospital to the peripheral health centres in the Suva subdivision. Methods Using a modified decision space approach developed by Bossert, this study measures decision space created in five broad categories (finance, service organisation, human resources, access rules, and governance rules within the decentralised services. Results Fiji’s centrally managed historical-based allocation of financial resources and management of human resources resulted in no decision space for decentralised agents. Narrow decision space was created in the service organisation category where, with limited decision space created over access rules, Fiji has seen greater usage of its decentralised health centres. There remains limited decision space in governance. Conclusion The current wave of decentralisation reveals that, whilst the workload has shifted from the tertiary hospital to the peripheral health centres, it has been accompanied by limited transfer of administrative authority, suggesting that Fiji’s deconcentration reflects the transfer of workload only with decision-making in the five functional areas remaining largely centralised. As such, the benefits of decentralisation for users and providers are likely to be limited.
Background The reliability of self-report regarding health care utilization in inflammatory bowel disease (IBD) is unknown. If proven reliable, it could help justify self-report as a means of determining health care utilization and associated costs. Methods The Manitoba IBD Cohort Study is a population-based longitudinal study of participants diagnosed within 7 years of enrollment. Health care utilization was assessed through standardized interview. Participants (n = 352) reported the total number of nights hospitalized, frequency of physician contacts in the prior 12 months and whether the medical contacts were for IBD-related reasons or not. Reports of recent antibiotic use were also recorded. Actual utilization was drawn from the administrative database of Manitoba Health, the single comprehensive provincial health insurer. Results According to the administrative data, 15% of respondents had an overnight hospitalization, while 10% had an IBD-related hospitalization. Self-report concordance was highly sensitive (92%; 82%) and specific (96%; 97%, respectively). 97% of participants had contact with a physician in the previous year, and 69% had IBD-related visits. Physician visits were significantly under-reported and there was a trend to over-report the number of nights in hospital. Conclusions Self-report data can be helpful in evaluating health service utilization, provided that the researcher is aware of the systematic sources of bias. Outpatient visits are well identified by self-report. The discordance for the type of outpatient visit may be either a weakness of self-report or a flaw in diagnosis coding of the administrative data. If administrative data are not available, self-report information may be a cost-effective alternative, particularly for hospitalizations. PMID:21627808
Walker John R
Full Text Available Abstract Background The reliability of self-report regarding health care utilization in inflammatory bowel disease (IBD is unknown. If proven reliable, it could help justify self-report as a means of determining health care utilization and associated costs. Methods The Manitoba IBD Cohort Study is a population-based longitudinal study of participants diagnosed within 7 years of enrollment. Health care utilization was assessed through standardized interview. Participants (n = 352 reported the total number of nights hospitalized, frequency of physician contacts in the prior 12 months and whether the medical contacts were for IBD-related reasons or not. Reports of recent antibiotic use were also recorded. Actual utilization was drawn from the administrative database of Manitoba Health, the single comprehensive provincial health insurer. Results According to the administrative data, 15% of respondents had an overnight hospitalization, while 10% had an IBD-related hospitalization. Self-report concordance was highly sensitive (92%; 82% and specific (96%; 97%, respectively. 97% of participants had contact with a physician in the previous year, and 69% had IBD-related visits. Physician visits were significantly under-reported and there was a trend to over-report the number of nights in hospital. Conclusions Self-report data can be helpful in evaluating health service utilization, provided that the researcher is aware of the systematic sources of bias. Outpatient visits are well identified by self-report. The discordance for the type of outpatient visit may be either a weakness of self-report or a flaw in diagnosis coding of the administrative data. If administrative data are not available, self-report information may be a cost-effective alternative, particularly for hospitalizations.
Hernandez, Stephen H A; Morgan, Brenda J; Parshall, Mark B
The aim of this concept analysis is to clarify military service members' stigma associated with seeking mental health services (MHS). Since 2001, over 2 million military service members have been deployed for or assigned to support military operations. Many service members develop a mental health concern during or after a deployment. Although researchers have assessed perceptions of stigma associated with accessing MHS, defining stigma is difficult, and conceptual clarity regarding stigma is lagging behind studies focused on its effects. Stigma was explored using Walker and Avant's method of concept analysis. Thirty articles were found in the PsycARTICLES, PsycINFO, and PubMed databases and selected for inclusion and synthesis. Military service member stigma is a set of beliefs, based on the member's military and prior civilian enculturation, that seeking MHS would be discrediting or embarrassing, cause harm to career progression, or cause peers or superiors to have decreased confidence in the member's ability to perform assigned duties. Nurses are ideally suited and situated to play an important role in decreasing stigma inhibiting service members from seeking MHS. Healthcare providers and civilian and uniformed leaders must communicate the value of seeking MHS to ensure service members' health, unit readiness, and overall force preparedness. © 2016 Wiley Periodicals, Inc.
Andreassen, U K; Hein, E
In recent years, Danish society has focused on the service and the information available for patients in health care. A test sample out of 1,000 members of the Danish Medical Association selected at random revealed that the majority had positive attitudes to service and information in health care. The study also indicated that doctors do not consider that any particular dress code is particularly appropriate but consider that personal appearance and the way patients are addressed are individual matters. This individualistic attitude which is consistent with Mintzberg's sociological structural theory does not invariably seem appropriate.
Thompson, Richard; Dancy, Barbara L; Wiley, Tisha R A; Najdowski, Cynthia J; Perry, Sylvia P; Wallis, Jason; Mekawi, Yara; Knafl, Kathleen A
A cross-sectional qualitative descriptive design was used to examine the links among expectations about, experiences with, and intentions toward mental health services. Individual face-to-face interviews were conducted with a purposive sample of 32 African American youth/mothers dyads. Content analysis revealed that positive expectations were linked to positive experiences and intentions, that negative expectations were not consistently linked to negative experiences or intentions, nor were ambivalent expectations linked to ambivalent experiences or intentions. Youth were concerned about privacy breeches and mothers about the harmfulness of psychotropic medication. Addressing these concerns may promote African Americans' engagement in mental health services.
Campbell, B F; King, J B
Joint ventures between service and academia are designed to enhance the quality of client services, enrich faculty teaching experiences and skills, and strengthen communication channels. The joint venture described in this article is an example of how public health nursing services and academia can be united through faculty participation in administration. Included in the discussion are the impetus for the project, the contract negotiations, the positive outcomes and disadvantages of the venture, and questions that should be raised when a similar venture is considered.
Jane F. Namatovu
Full Text Available Background: Community involvement has been employed in the development of both vertical and horizontal health programmes. In Uganda, there is no empirical evidence on whether and how communities are involved in their health services.Aim and Setting: The aim of this study was to establish the existence of community involvement in health services and to identify its support mechanisms in Namayumba and Bobi health centres in Wakiso and Gulu districts, respectively.Methods: Participants were selected with the help of a community mobiliser. Key informants were selected purposively depending on their expertise and the roles played in their respective communities. The focus group discussions and key informant interviews were audio-recorded and transcribed verbatim. The transcripts were analysed manually for emerging themes and sub-themes.Results: Several themes emerged from the transcripts and we categorised them broadly into those that promote community involvement in health services and those that jeopardise it. Easy community mobilisation and several forms of community and health centre efforts promote community involvement, whilst lack of trust for health workers and poor communication downplay community involvement in their health services.Conclusion: Community involvement is low in health services in both Namayumba and Bobi health centres.
Kanchanachitra, Churnrurtai; Lindelow, Magnus; Johnston, Timothy; Hanvoravongchai, Piya; Lorenzo, Fely Marilyn; Huong, Nguyen Lan; Wilopo, Siswanto Agus; dela Rosa, Jennifer Frances
In this paper, we address the issues of shortage and maldistribution of health personnel in southeast Asia in the context of the international trade in health services. Although there is no shortage of health workers in the region overall, when analysed separately, five low-income countries have some deficit. All countries in southeast Asia face problems of maldistribution of health workers, and rural areas are often understaffed. Despite a high capacity for medical and nursing training in both public and private facilities, there is weak coordination between production of health workers and capacity for employment. Regional experiences and policy responses to address these challenges can be used to inform future policy in the region and elsewhere. A distinctive feature of southeast Asia is its engagement in international trade in health services. Singapore and Malaysia import health workers to meet domestic demand and to provide services to international patients. Thailand attracts many foreign patients for health services. This situation has resulted in the so-called brain drain of highly specialised staff from public medical schools to the private hospitals. The Philippines and Indonesia are the main exporters of doctors and nurses in the region. Agreements about mutual recognition of professional qualifications for three groups of health workers under the Association of Southeast Asian Nations Framework Agreement on Services could result in increased movement within the region in the future. To ensure that vital human resources for health are available to meet the needs of the populations that they serve, migration management and retention strategies need to be integrated into ongoing efforts to strengthen health systems in southeast Asia. There is also a need for improved dialogue between the health and trade sectors on how to balance economic opportunities associated with trade in health services with domestic health needs and equity issues. Copyright © 2011
... 42 Public Health 1 2010-10-01 2010-10-01 false Establishment of contract health service delivery... Services § 136.22 Establishment of contract health service delivery areas. (a) In accordance with the..., contract health service delivery areas are established as follows: (1) The State of Alaska; (2) The...
MARIA MALLIAROU & SOFIA ZYGA
Full Text Available Nursing Information System (NIS has been defined as “a part of a health care information system that deals with nursing aspects, particularly the maintenance of the nursing record”. Nursing Uses of Information Systems in order to assess patient acuity and condition, prepare a plan of care or critical pathway, specify interventions, document care, track outcomes and control quality in the given patient care. Patient care processes, Communication, research, education and ward management can be easily delivered using NIS. There is a specific procedure that should be followed when implementing NISs. The electronic databases CINAHL and Medline were used to identify studies for review. Studies were selected from a search that included the terms ‘nursing information systems’, ‘clinical information systems’, ‘hospital information systems’, ‘documentation’, ‘nursing records’, combined with ‘electronic’ and ‘computer’. Journal articles, research papers, and systematic reviews from 1980 to 2007 were included. In Greek Hospitals there have been made many trials and efforts in order to develop electronic nursing documentation with little results. There are many difficulties and some of them are different levels of nursing education, low nurse to patient ratios, not involvement of nurses in the phases of their implementation, resistance in change. Today’s nursing practice in Greece needs to follow others counties paradigm and phase its controversies and problems in order to follow the worldwide changes in delivering nursing care.
Ownby, Raymond L; Acevedo, Amarilis; Jacobs, Robin J; Caballero, Joshua; Waldrop-Valverde, Drenna
Researchers have identified significant limitations in some currently used measures of health literacy. The purpose of this paper is to present data on the relation of health-related quality of life, health status, and health service utilization to performance on a new measure of health literacy in a nonpatient population. The new measure was administered to 475 English- and Spanish-speaking community-dwelling volunteers along with existing measures of health literacy and assessments of health-related quality of life, health status, and healthcare service utilization. Relations among measures were assessed via correlations and health status and utilization was tested across levels of health literacy using ANCOVA models. The new health literacy measure is significantly related to existing measures of health literacy as well as to participants' health-related quality of life. Persons with lower levels of health literacy reported more health conditions, more frequent physical symptoms, and greater healthcare service utilization. The new measure of health literacy is valid and shows relations to measures of conceptually related constructs such as quality of life and health behaviors. FLIGHT/VIDAS may be useful to researchers and clinicians interested in a computer administered and scored measure of health literacy. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
Health insurance funds need the results of health services research more than ever due to the socio-legal and socio-economic conditions currently prevailing. This should be possible by taking transparency and data protection into consideration, by cooperating with outside researchers while ensuring flexible use of routine data and if necessary gathering additional data, and by establishing links to epidemiological and registry data. It should become normative to clear the way for health insurance funds to regularly include this type of research in budget planning and to this end provide access to a suitable source of funds. In conclusion, it can simply be stated that it no longer suffices to effectively make a new clinically tested procedure, product, and service available because health insurance funds and their partners must know more precisely what this all accomplishes in practice.
James, L C; Folen, R A; Porter, R I; Kellar, M A
The military patient population, the demanding environment in which medical services are provided, and the rigors of the operational environment create a unique challenge for service members as well as military health care providers. Within the military medical system, the subspecialty of clinical health psychology may provide patient care and consultation interventions necessary to meet the demands of the unique Army medical and military communities. As funding and other resources decrease, military health psychologists can provide high-quality care to difficult-to-manage patients while increasing outcome efficacy and decreasing costs to the hospital. This paper provides a definition of clinical health psychology and a description of its unique interventions and applications and how these unique skills augment medical services. Moreover, we offer a conceptual model for an innovative health psychology program that will assist other military treatment facilities in designing programs to increase outcome efficacy and concurrently reduce costs and utilization of services.
Mohammadi, Ali; Mohammadi, Jamshid
To assess quality of health services in Zanjan health centres based on clients' expectations and perceptions. The study was conducted by using service quality (SERVQUAL) scale on a sample of 300 females, clients of health care centres in the district of Zanjan, selected by cluster sampling. The results indicated that there were negative quality gaps at five SERVQUAL dimensions. The most and least negative quality gap mean scores were in reliability dimension (-2.1) and tangible (-1.13) respectively. There was statistically significant difference between clients' perceptions and expectations mean scores at all of the five service quality dimensions (P<0.001). The negative quality gap level in health service dimensions can be used as a guideline for redistribution of resources and managerial attempts to reduce quality gaps and improvement of health care quality.
Lopez, Diego M; Blobel, Bernd G M E
Improving public health services requires comprehensively integrating all services including medical, social, community, and public health ones. Therefore, developing integrated health information services has to start considering business process, rules and information semantics of involved domains. The paper proposes a business and information architecture for the specification of a future-proof national integrated system, concretely the requirements for semantic integration between public health surveillance and clinical information systems. The architecture is a semantically interoperable approach because it describes business process, rules and information semantics based on national policy documents and expressed in a standard language such us the Unified Modeling Language UML. Having the enterprise and information models formalized, semantically interoperable Health IT components/services development is supported.
Carrara, Paola; Antoninetti, Massimo; Bacai, Hina; Basoni, Anna; Bosc, Christelle; Clave, Magali; Cornacchia, Carmela; L'Astorina, Alba; Monbet, Philippe; Mueller, Bastian; Nicolau, Sonia; Pergola, Nicola; Rampini, Anna; Tramutoli, Valerio; Schumacher, Volker; Wells, Alan; Zepeda Juarez, Jesus; Zolotikova, Svetlana
which have significant impact on the economy, environment and the quality of life of the citizens To this aim since 2011 the system of Regional Contact Offices (RCOs) was promoted by the EU FP7 DORIS_Net (Downsteam Observatory organized by Regions Active in Space - Network, http://www.doris-net.eu/) project as the regional link to the services provided by the European GMES programme. Since then a first nucleus of 12 pilot European Regions were working together establishing 6 first RCOs around Europe. This paper will present RCOs network goals, achievements and perspectives as well as its planned actions devoted to improve quality of Space Technology products from one side, to promote awareness and use of them by potential end-users (and particularly LRAs), from the other side.
Nissen, Nina Konstantin; Madsen, Mette; Olsen Zwisler, Ann-Dorthe
AIMS: Relatives of heart patients experience anxiety, uncertainty, and low quality of life, and the hospitalization of a heart patient is associated with increased risk of death for the partner. Relatives' physical and mental problems may be rectified by activities established by the health...... systematically reviewed to clarify what the health services do for relatives of heart patients and to assess the effects of interventions. We searched Medline, EMBASE, PsycINFO, CINAHL database, CSA and the Cochrane Library from January 2000 to March 2006. RESULTS: Only six scientific articles reported...... on interventions testing health service activities for relatives of heart patients, and one literature review scrutinized earlier studies within the field. All the interventions indicate positive effects on patients' and/or relatives' health and well-being, in accordance with nurses' assessments. Nevertheless...
Mayhew, S H; Lush, L; Cleland, J; Walt, G
In the wake of the 1994 International Conference on Population and Development in Cairo, considerable activity has occurred both in national policymaking for reproductive health and in research on the implementation of the Cairo Program of Action. This report considers how effectively a key component of the Cairo agenda--integration of the management of sexually transmitted infections, including human immunodeficiency virus, with maternal and child health-family planning services--has been implemented. Quantitative and qualitative data are used to illuminate the difficulties faced by implementers of reproductive health programs in Ghana, Kenya, South Africa, and Zambia. In these countries, clear evidence is found of a critical need to reexamine the continuing focus on family planning services and the nature of the processes by which managers implement reproductive health policies. Implications of findings for policy and program direction are discussed.
Major transformations in forms of governance of the liberal state have been wrought over the course of the last century, including the rise of neoliberalism and 'new public management.' Mental health too has witnessed change, with pharmacological treatment displacing residential care, a shift to community-based services, mainstreaming with general health care, and greater reliance on civil society institutions such as the family or markets. This article considers whether mental health law, and its court/tribunal 'gatekeepers' have kept pace with those changes. It argues that the focus of the liberal project needs to shift to measures which will better guarantee access to mental health services, and keep a more watchful eye on both 'hidden' coercion of people on community treatment orders, and passive neglect of human need.
Delfini, Patricia Santos de Souza; Reis, Alberto Olavo Advincula
The objective of this paper was to describe and analyze the articulation between children and adolescent mental health care interventions undertaken by teams working under the Family Health Strategy (FHS) and Psychosocial Care Centers for Children and Adolescents (CAPSI). In order to achieve these objectives, semi-structured interviews were conducted with five CAPSI and 13 FHS managers from five different regions of the city of São Paulo, Brazil. The 18 interviews were transcribed and analyzed froma hermeneutic perspective. It was found that interactions between the FHS and CAPSI occur mainly through referral of cases, matrix support or partnerships in cases concerning CAPSI. Obstacles, such as a lack of human resources, productivity goals and lack of training in mental health of FHS professionals were mentioned. The referral system and passing responsibility for mental health cases to specialized services and the hegemonic biomedical model and the fragmentation of care are common place in these services.
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.
Pfefferle, Susan G; Spitznagel, Edward L
OBJECTIVE: This observational study explores pathways towards any past year use of child mental health services. METHODS: Data from the 2002 National Survey of American Families were used to explore the relationship between past month maternal mental health and past year child mental health services use. Observations were limited to the 8072 most knowledgeable adults who were the mothers of target children aged 6-11. Logistic regressions were performed to determine the odds of any child mental health service use followed by path analyses using Maximum Likelihood estimation with robust standard errors. RESULTS: Multiple factors were associated with odds of any child mental health service use. In the path analytic model poor past month maternal mental health was associated with increased aggravation which in turn was associated with increased use of mental health visits. Negative child behaviors as reported by the mother were also associated with increased maternal aggravation and increased service use. CONCLUSIONS: Parental perception of child behaviors influences treatment seeking, both directly and indirectly through parental aggravation. Parental mental health influences tolerance for child behaviors. Findings are consistent with other studies. Interventions should address the entire family and their psychosocial circumstances through collaboration between multiple service sectors.
Mapira, P; Morgan, C
Access to maternal health services is one key to the reduction of maternal mortality in Papua New Guinea. Church health services (CHS) are known to administer around 45% of rural health facilities. We undertook a descriptive analysis based on health facility service provision data for 2009 from the National Health Information System (NHIS), supported by document review and interviews. We recoded NHIS data on facilities by administration by CHS or government health service, judged their capacity for emergency obstetric care (EmOC) and analysed service provision for 2009. For rural services (i.e., outside of provincial capitals), CHS were recorded as providing 58% of health facility childbirth care and 38% of first antenatal visits. Obstetric referral patterns and facility capacity suggested many facilities were likely to have only basic EmOC and limited referral options. Nationally, CHS provided 21% of temporary methods of contraception (measured in couple-year protection) but 85% of referrals for permanent contraception. There was marked variation across provinces with clear implications for where health system strengthening could be beneficial to maternal survival. Our findings also disclosed gaps in the NHIS around monitoring of complicated childbirth and inclusion of community-based care.
Studies have described the opportunities and challenges of applying service design techniques to health services, but empirical evidence on how such techniques can be implemented in the context of eHealth services is still lacking. This paper presents how a service design thinking approach can be applied for specification of an existing and new eHealth service by supporting evaluation of the current service and facilitating suggestions for the future service. We propose Service Journey Modelling Language and Service Journey Cards to engage stakeholders in the design of eHealth services.
Blashki, Grant; Armstrong, Greg; Berry, Helen Louise; Weaver, Haylee J; Hanna, Elizabeth G; Bi, Peng; Harley, David; Spickett, Jeffery Thomas
Although the implications of climate change for public health continue to be elucidated, we still require much work to guide the development of a comprehensive strategy to underpin the adaptation of the health system. Adaptation will be an evolving process as impacts emerge. The authors aim is to focus on the responses of the Australian health system to health risks from climate change, and in particular how best to prepare health services for predicted health risks from heat waves, bushfires, infectious diseases, diminished air quality, and the mental health impacts of climate change. In addition, the authors aim to provide some general principles for health system adaptation to climate change that may be applicable beyond the Australian setting. They present some guiding principles for preparing health systems and also overview some specific preparatory activities in relation to personnel, infrastructure, and coordination. Increases in extreme weather-related events superimposed on health effects arising from a gradually changing climate will place additional burdens on the health system and challenge existing capacity. Key characteristics of a climate change-prepared health system are that it should be flexible, strategically allocated, and robust. Long-term planning will also require close collaboration with the nonhealth sectors as part of a nationwide adaptive response.
Vaeggemose, Ulla; Ankersen, Pia Vedel; Aagaard, Jørgen; Burau, Viola
Co-production involves knowledge and skills based on both lived experiences of citizens and professionally training of staff. In Europe, co-production is viewed as an essential tool for meeting the demographic, political and economic challenges of welfare states. However, co-production is facing challenges because public services and civil society are rooted in two very different logics. These challenges are typically encountered by provider organisations and their staff who must convert policies and strategies into practice. Denmark is a welfare state with a strong public services sector and a relatively low involvement of volunteers. The aim of this study was to investigate how provider organisations and their staff navigate between the two logics. The present analysis is a critical case study of two municipalities selected from seven participating municipalities, for their maximum diversity. The study setting was the Community Families programme, which aim to support the social network of mental health users by offering regular contact with selected private families/individuals. The task of the municipalities was to initiate and support Community Families. The analysis built on qualitative data generated at the organisational level in the seven participating municipalities. Within the two "case study" municipalities, qualitative interviews were conducted with front-line co-ordinators (six) and line managers (two). The interviews were recorded, transcribed verbatim and coded using the software program NVivo. The results confirm the central role played by staff and identify a close interplay between public services and civil society logics as essential for the organisation of co-production. Corresponding objectives, activities and collaborative relations of provider organisations are keys for facilitating the co-productive practice of individual staff. Organised in this way, co-production can succeed even in a mental health setting associated with social stigma
Full Text Available Abstract Background In Bangladesh, widespread dissatisfaction with government health services did not improve during the Health and Population Sector Programme (HPSP reforms from 1998-2003. A 2003 national household survey documented public and health service users' views and experience. Attitudes and behaviour of health workers are central to quality of health services. To investigate whether the views of health workers influenced the reforms, we surveyed local health workers and held evidence-based discussions with local service managers and professional bodies. Methods Some 1866 government health workers in facilities serving the household survey clusters completed a questionnaire about their views, experience, and problems as workers. Field teams discussed the findings from the household and health workers' surveys with local health service managers in five upazilas (administrative sub-districts and with the Bangladesh Medical Association (BMA and Bangladesh Nurses Association (BNA. Results Nearly one half of the health workers (45% reported difficulties fulfilling their duties, especially doctors, women, and younger workers. They cited inadequate supplies and infrastructure, bad behaviour of patients, and administrative problems. Many, especially doctors (74%, considered they were badly treated as employees. Nearly all said lack of medicines in government facilities was due to inadequate supply, not improved during the HPSP. Two thirds of doctors and nurses complained of bad behaviour of patients. A quarter of respondents thought quality of service had improved as a result of the HPSP. Local service managers and the BMA and BNA accepted patients had negative views and experiences, blaming inadequate resources, high patient loads, and patients' unrealistic expectations. They said doctors and nurses were demotivated by poor working conditions, unfair treatment, and lack of career progression; private and unqualified practitioners sought to
McFarlane, Kathryn; Devine, Sue; Judd, Jenni; Nichols, Nina; Watt, Kerrianne
Aboriginal Community Controlled Health Services deliver holistic and culturally appropriate primary health care to over 150 communities in Australia. Health promotion is a core function of comprehensive primary health care; however, little has been published on what enables or challenges health promotion practice in an Aboriginal Community Controlled Health Service. Apunipima Cape York Health Council (Apunipima) delivers primary health care to 11 remote north Queensland communities. The workforce includes medical, allied health, Aboriginal and Torres Strait Islander health workers and health practitioners and corporate support staff. This study aimed to identify current health promotion practices at Apunipima, and the enablers and challenges identified by the workforce, which support or hinder health promotion practice. Sixty-three staff from across this workforce completed an online survey in February 2015 (42% response rate). Key findings were: (1) health promotion is delivered across a continuum of one-on-one approaches through to population advocacy and policy change efforts; (2) the attitude towards health promotion was very positive; and (3) health promotion capacity can be enhanced at both individual and organisational levels. Workforce insights have identified areas for continued support and areas that, now identified, can be targeted to strengthen the health promotion capacity of Apunipima.
India and the EU are currently negotiating a Trade and Investment Agreement which also covers services. This paper examines the opportunities for and constraints to India-EU relations in health services in the context of this agreement, focusing on the EU as a market for India's health services exports and collaboration. The paper provides an overview of key features of health services in the EU and India and their bearing on bilateral relations in this sector. Twenty six semi-structured, in-person, and telephonic interviews were conducted in 2007-2008 in four Indian cities. The respondents included management and practitioners in a variety of healthcare establishments, health sector representatives in Indian industry associations, health sector officials in the Indian government, and official representatives of selected EU countries and the European Commission based in New Delhi. Secondary sources were used to supplement and corroborate these findings. The interviews revealed that India-EU relations in health services are currently very limited. However, several opportunity segments exist, namely: (i) Telemedicine; (ii) Clinical trials and research in India for EU-based pharmaceutical companies; (iii) Medical transcriptions and back office support; (iv) Medical value travel; and (v) Collaborative ventures in medical education, research, training, staff deployment, and product development. However, various factors constrain India's exports to the EU. These include data protection regulations; recognition requirements; insurance portability restrictions; discriminatory conditions; and cultural, social, and perception-related barriers. The interviews also revealed several constraints in the Indian health care sector, including disparity in domestic standards and training, absence of clear guidelines and procedures, and inadequate infrastructure. The paper concludes that although there are several promising areas for India-EU relations in health services, it will be
Full Text Available Abstract Background India and the EU are currently negotiating a Trade and Investment Agreement which also covers services. This paper examines the opportunities for and constraints to India-EU relations in health services in the context of this agreement, focusing on the EU as a market for India's health services exports and collaboration. The paper provides an overview of key features of health services in the EU and India and their bearing on bilateral relations in this sector. Methods Twenty six semi-structured, in-person, and telephonic interviews were conducted in 2007-2008 in four Indian cities. The respondents included management and practitioners in a variety of healthcare establishments, health sector representatives in Indian industry associations, health sector officials in the Indian government, and official representatives of selected EU countries and the European Commission based in New Delhi. Secondary sources were used to supplement and corroborate these findings. Results The interviews revealed that India-EU relations in health services are currently very limited. However, several opportunity segments exist, namely: (i Telemedicine; (ii Clinical trials and research in India for EU-based pharmaceutical companies; (iii Medical transcriptions and back office support; (iv Medical value travel; and (v Collaborative ventures in medical education, research, training, staff deployment, and product development. However, various factors constrain India's exports to the EU. These include data protection regulations; recognition requirements; insurance portability restrictions; discriminatory conditions; and cultural, social, and perception-related barriers. The interviews also revealed several constraints in the Indian health care sector, including disparity in domestic standards and training, absence of clear guidelines and procedures, and inadequate infrastructure. Conclusions The paper concludes that although there are several
Guerrero, Erick G; Harris, Lesley; Padwa, Howard; Vega, William A; Palinkas, Lawrence
Little is known about how the Affordable Care Act (ACA) will be implemented in publicly funded addiction health services (AHS) organizations. Guided by a conceptual model of implementation of new practices in health care systems, this study relied on qualitative data collected in 2013 from 30 AHS clinical supervisors in Los Angeles County, California. Interviews were transcribed, coded, and analyzed using a constructivist grounded theory approach with ATLAS.ti software. Supervisors expected several potential effects of ACA implementation, including increased use of AHS services, shifts in the duration and intensity of AHS services, and workforce professionalization. However, supervisors were not prepared for actions to align their programs' strategic change plans with policy expectations. Findings point to the need for health care policy interventions to help treatment providers effectively respond to ACA principles of improving standards of care and reducing disparities.
Karthikeyan, N; Sukanesh, R
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
Costa, M C; Formigli, V L
To evaluate the technical and scientific quality of care provided adolescents, pregnant adolescents and their offspring by the Emaús community's health service in Belém, state of Pará, Brazil, between 1994 and 1996. Data for population and health care assessment were collected from medical records and compared with the PAHO/WHO and Brazilian Ministry of Health guidelines. The following features were satisfactory: anthropometric measurements and sexual maturity in adolescent health care program; visits scheduling, weight and blood pressure recording and proceedings in the event of medical problem in prenatal care; early registration in the health program, completing of the immunization schedule, weight and motor development recording and adequacy of medical visits in children care. Other aspects were less satisfactory, such as poor recording of clinical procedures and high level of inadequate or partially adequate procedures for the adolescent group; late admission to prenatal care and low recording of pregnant anti-tetanus immunization in prenatal care; high prevalence of early weaning and poor recording of children's height. This easy-to-perform assessment allowed to evaluate the quality of care provided and made it possible to reallocate services and medical procedures to offer health care service better organized and of better quality to meet the population needs.
Full Text Available To estimate the prevalence and analyze factors associated with both public and private health services utilization in women population in a western district of Iran.A cross-sectional study with 1200 individuals aged 18-49 years carried out in different districts of Sanandaj City, western Iran, in 2012. The main outcome variable was use of health service in the previous 12 months. The in-dependent variables were age, education level, place of residence, marital and pregnancy status, household wealth, oc-cupation and duration time of employment, and rating of quality of health services.The prevalence of public and private health services utilization were 60.8% [95%CI: 57.8, 63.8] and 53.8% [95%CI: 50.8%, 56.8%], respectively (P=0.001. After controlling other investigated factors using logistic regression; the academic educational level (OR=1.36, 95%CI: 1.03, 1.80; OR=1.76, 95%CI: 1.33, 2.33, residents of urban (OR=1.65, 95%CI: 1.10, 2.47; OR=1.60, 95%CI: 1.10, 2.42, pregnancy status (OR=2.38, 95%CI: 1.60, 3.55; OR=2.36, 95%CI: 1.61, 3.47, and high level of quality of health services (OR=1.61, 95%CI: 1.15, 2.27; OR=1.70, 95%CI: 1.20, 2.40 were found to be predictors of utilization of both public and private health care respectively. There was also statistically relation between high level of household wealth (OR=3.01, 95% CI: 2.00, 4.57 and private health services utilization.Prevalence of health services utilization varied according to the individual and social factors of popula-tion studied. Present study emphasizes the need to develop care models that focus on the characteristics and demands of the subjects.
Geissler, Kimberley H; Leatherman, Sheila
The simultaneous burdens of communicable and chronic non-communicable diseases cause significant morbidity and mortality in middle-income countries. The poor are at particular risk, with lower access to health care and higher rates of avoidable mortality. Integrating health-related services with microfinance has been shown to improve health knowledge, behaviors, and access to appropriate health care. However, limited evidence is available on effects of fully integrating clinical health service delivery alongside microfinance services through large scale and sustained long-term programs. Using a conceptual model of health services access, we examine supply- and demand-side factors in a microfinance client population receiving integrated services. We conduct a case study using data from 2010 to 2012 of the design of a universal screening program and primary care services provided in conjunction with microfinance loans by Pro Mujer, a women's development organization in Latin America. The program operates in Argentina, Bolivia, Mexico, Nicaragua, and Peru. We analyze descriptive reports and administrative data for measures related to improving access to primary health services and management of chronic diseases. We find provision of preventive care is substantial, with an average of 13% of Pro Mujer clients being screened for cervical cancer each year, 21% receiving breast exams, 16% having a blood glucose measurement, 39% receiving a blood pressure measurement, and 46% having their body mass index calculated. This population, with more than half of those screened being overweight or obese and 9% of those screened having elevated glucose measures, has major risk factors for diabetes, high blood pressure, and cardiovascular disease without intervention. The components of the Pro Mujer health program address four dimensions of healthcare access: geographic accessibility, availability, affordability, and acceptability. Significant progress has been made to meet basic
Hughes, D C; Brindis, C; Halfon, N; Newacheck, P W
Increasingly, the public and private sectors are turning to "service integration" efforts to reduce, if not eliminate, barriers to needed care created by categorical programs. In 1991, the Robert Wood Johnson Foundation established a new national demonstration project, called the Child Health Initiative, intended to test the feasibility of developing mechanisms at the community level to coordinate the delivery of health services and to pay for those services through a flexible pool of previously categorical funds. This article presents the findings of an independent evaluation of the Child Health Initiative. The evaluation utilized a combination of qualitative methods to assess and describe the experiences of the communities as they developed and implemented integrated health services. It used a repeated measures design involving two site visits and interim telephone interviews, as well as review of documents. Overall, the demonstration project achieved mixed success. Both care coordination and the production of community health report cards were found to be achievable within the relatively short life of the foundation grant. However, many sites experienced significant delays in the production of report cards and implementing care coordination plans because the sites largely did not benefit from the successful models already in existence. Little clear progress was made in implementing the decategorization component of the project. Sites experienced difficulties due to lack of previous experience with this new undertaking, the inability to secure active cooperation from local, state, and federal agencies, the relatively short duration of the project, and other factors. A number of lessons were learned from this project that may be useful in future decategorization experiments, including (1) a clear understanding of the concept and its applications among all parties is essential, (2) high-level political commitments to the effort are needed between all levels of
Hilverding, Austin T; DiPietro Mager, Natalie A
The primary objective was to assess attitudes from Ohio pharmacists about contraceptive authority. Secondary objectives included determining pharmacists' perceptions of benefits, barriers, and preparedness for offering such services and examining attitudes about and experiences with other reproductive health topics to inform future research. An anonymous 26-question Institutional Review Board-approved electronic survey was developed and distributed via Qualtrics to a random sample of 500 licensed pharmacists in Ohio. Two months were allotted for survey completion. A link to free Accreditation Council for Pharmacy Education-approved continuing pharmacy education (CPE) through Ohio Northern University was offered as an incentive for completing the survey. One hundred thirty-eight pharmacists completed the survey (62% female). Fifty-eight percent worked in community pharmacy and 34% in health-system pharmacy. The majority indicated that oral and transdermal contraceptive methods should be pharmacist-initiated (57% and 54%, respectively) through a collaborative practice agreement or statewide protocol. More pharmacists supported provision of hormonal contraception through a collaborative practice agreement rather than a statewide protocol. Increased access to care and convenience for patients were identified most frequently as potential benefits. Time constraints, concerns of increased liability, and other barriers for initiating such services were identified by pharmacists. Pharmacists most frequently listed clinical guidelines, CPE, and patient education materials as tools needed to successfully initiate contraceptive therapy regimens. Pharmacists responding to the survey were also proponents of increasing involvement in other aspects of sexual and reproductive health, such as expedited partner therapy (64%) and human papilloma virus vaccination (67%). Respondents indicated a potential lack of experience or training in topics such as expedited partner therapy and
Puentes Rosas, Esteban; Gómez Dantés, Octavio; Garrido Latorre, Francisco
To document the fact that differences in the treatment received by health services users in Mexico are mainly dependent on the type of provider, regardless of the users' socioeconomic status. The data were obtained by means of a survey of 18 018 users who visited 73 health services in 13 states within Mexico. They were asked to grade the way the institution had performed in seven of the eight domains that define appropriate user treatment (autonomy, confidentiality, communication, respectful manner, condition of basic facilities, access to social assistance networks, and free user choice). The questionnaire included some vignettes to help determine user expectations. A composite ordinal probit model was applied; the perception of quality in connection with each of the appropriate treatment domains was the independent variable, whereas gender, educational level, age, type of provider, and user expectations were used as control variables. The type of provider was the main factor that determined users' perceptions regarding the treatment they received when visiting health services in Mexico. Institutions belonging to the social security system performed the worst, while the services provided under the program targeting the rural population (IMSS Oportunidades) received the highest scores. Overall, the domain that was most highly ranked was respectful manner, whereas the lowest score was given to the ability to choose the provider. Men felt they had been able to communicate better than women, while respectful manner, communication, and social support showed a significant negative association with educational level (P < 0.05). Differences were noted in the way different public health service providers in Mexico treat their users, regardless of the latter's socioeconomic status. Social security system providers showed the greatest deficiencies in this respect. Respectful manner was the domain that received the highest scores in the case of all providers. Organizational
Hung, Ming-Chien; Jen, Wen-Yuan
As their populations age, many countries are facing the increasing economic pressure of providing healthcare to their people. In Taiwan, this problem is exacerbated by an increasing rate of obesity and obesity-related conditions. Encouraging the adoption of personal health management services is one way to maintain current levels of personal health and to efficiently manage the distribution of healthcare resources. This study introduces Mobile Health Management Services (MHMS) and employs the Technology Acceptance Model (TAM) to explore the intention of students in Executive Master of Business Management programs to adopt mobile health management technology. Partial least squares (PLS) was used to analyze the collected data, and the results revealed that "perceived usefulness" and "attitude" significantly affected the behavioral intention of adopting MHMS. Both "perceived ease of use" and "perceived usefulness," significantly affected "attitude," and "perceived ease of use" significantly affected "perceived usefulness" as well. The results also show that the determinants of intention toward MHMS differed with age; young adults had higher intention to adopt MHMS to manage their personal health. Therefore, relevant governmental agencies may profitably promote the management of personal health among this population. Successful promotion of personal health management will contribute to increases in both the level of general health and the efficient management of healthcare resources.
Healey, Priscilla; Stager, Megan L; Woodmass, Kyler; Dettlaff, Alan J; Vergara, Andrew; Janke, Robert; Wells, Susan J
Membership in diverse racial, ethnic, and cultural groups is often associated with inequitable health and mental health outcomes for diverse populations. Yet, little is known about how cultural adaptations of standard services affect health and mental health outcomes for service recipients. This systematic review identified extant themes in the research regarding cultural adaptations across a broad range of health and mental health services and synthesized the most rigorous experimental research available to isolate and evaluate potential efficacy gains of cultural adaptations to service delivery. MEDLINE, PsycINFO, CINAHL, EMBASE, and grey literature sources were searched for English-language studies published between January 1955 and January 2015. Cultural adaptations to any aspect of a service delivery were considered. Outcomes of interest included changes in service provider behavior or changes in the behavioral, medical, or self-reported experience of recipients. Thirty-one studies met the inclusion criteria. The most frequently tested adaptation occurred in preventive services and consisted of modifying the content of materials or services delivered. None of the included studies focused on making changes in the provider's behavior. Many different populations were studied but most research was concerned with the experiences and outcomes of African Americans. Seventeen of the 31 retained studies observed at least one significant effect in favor of a culturally adapted service. However there were also findings that favored the control group or showed no difference. Researchers did not find consistent evidence supporting implementation of any specific type of adaptation nor increased efficacy with any particular cultural group. Conceptual frameworks to classify cultural adaptations and their resultant health/mental health outcomes were developed and applied in a variety of ways. This review synthesizes the most rigorous research in the field and identifies
Full Text Available Abstract Background Although young people's transition from Child and Adolescent Mental Health Services (CAMHS to Adult Mental Health Services (AMHS in England is a significant health issue for service users, commissioners and providers, there is little evidence available to guide service development. The TRACK study aims to identify factors which facilitate or impede effective transition from CAHMS to AMHS. This paper presents findings from a survey of transition protocols in Greater London. Methods A questionnaire survey (Jan-April 2005 of Greater London CAMHS to identify transition protocols and collect data on team size, structure, transition protocols, population served and referral rates to AMHS. Identified transition protocols were subjected to content analysis. Results Forty two of the 65 teams contacted (65% responded to the survey. Teams varied in type (generic/targeted/in-patient, catchment area (locality-based, wider or national and transition boundaries with AMHS. Estimated annual average number of cases considered suitable for transfer to AMHS, per CAMHS team (mean 12.3, range 0–70, SD 14.5, n = 37 was greater than the annual average number of cases actually accepted by AMHS (mean 8.3, range 0–50, SD 9.5, n = 33. In April 2005, there were 13 active and 2 draft protocols in Greater London. Protocols were largely similar in stated aims and policies, but differed in key procedural details, such as joint working between CAHMS and AMHS and whether protocols were shared at Trust or locality level. While the centrality of service users' involvement in the transition process was identified, no protocol specified how users should be prepared for transition. A major omission from protocols was procedures to ensure continuity of care for patients not accepted by AMHS. Conclusion At least 13 transition protocols were in operation in Greater London in April 2005. Not all protocols meet all requirements set by government policy. Variation in
... 42 Public Health 1 2010-10-01 2010-10-01 false What nondiscrimination requirements apply to National Health Service Corps sites? 23.13 Section 23.13 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF... Corps Personnel § 23.13 What nondiscrimination requirements apply to National Health Service Corps sites...
Full Text Available Introduction: Calculating cost is an important management tool for programming, control, supervision and evaluation of health services in order that informed decisions can be done. This study was done to determine the cost of services provided by health centers, and health house in Shahroud in 2009.Methods: In this study, all health centers in urban and rural regions were studied. 70 forms for provided services, public and specific materials used for each service, medicine and equipment, time required for each service and activities, buildings and equipment depreciation costs were used to collect the data. Then the costs of each unit including direct and indirect costs (overhead, as well as the costs of one center and one health care home were calculated through cost analysis software. Results: Findings from data analysis showed that 44.4% of health care providers were male and 55.6% were female. 22.8% of the personnel were working in health house, 26.1% in rural health centers, 9.1% in urban health centers, health centers 24.5% in urban boarding health centers, 2.6% in health care posts and 14.9% were working in Healthcare Department. The highest cost were personnel costs (66.1% followed by central department costs (12.8%. Next were the costs for drug consumption with 11.0% and specific use with 3.8%. The highest cost was also for training healthcare providers (1325209 RLS and lowest cost was for sampling of influenza (3872 RLS. Conclusion: Due to high personnel costs, increasing of productivity will play an important role in reducing labor costs .Also, moderating workforce and the using private sector participation in services and outsourcing costly units can play an important role in optimum utilization of resources.
Full Text Available The typical worker spends about 47 hours a week commuting sitting in cars, trains, buses, or sitting at their desks. These statistics show that maintaining a healthy work and life balance has become progressively important. Workplace wellness and health promotion are of central importance for any organization in today's world. People are becoming highly conscious about their health and seek to ensure that they are provided with best medical services and facilities in case of any health issue. Organizations have switched to proactive strategies for the healthcare of their employees. Billions of dollars are spent on the workforce only after illnesses or injuries have occurred. Over the past several decades, healthcare services have drastically changed, altering the manner in which healthcare was previously managed. Technological advancements in medical systems have revolutionized the healthcare industry, and digital health tracking has been quite successful in monitoring patients’ health. Since patients are continuously monitored, no matter where they are, these systems can indicate patients’ adherence to medical protocols and act as a warning sign for such diseases as heart problems, Alzheimer’s disease, and many others. Health Relationship Management Services (HRMS is a new paradigm which defines comprehensive healthcare for an individual. HRMS is a complete health ecosystem suitable for the workplace, which enables healthcare providers to collect personal health data from various sources, analyze it for positive outcomes, and take action to preserve an employee’s good health to reduce absenteeism or turnover. HRMS can act as a preventative sentinel for corporate well-being as well.
Pointer, D D
One of six different strategies must be selected for a health service offering to provide consumers with distinctive value and achieve sustainable competitive advantage in a market or market segment. Decisions must be made regarding objectives sought, market segmentation, market scope, and the customer-value proposition that will be pursued.
Zascavage, Victoria; Winterman, Kathleen G.; Buot, Max; Wies, Jennifer R.; Lyzinski, Natalie
In order to better understand the effects of student-life stress on Education and Health Service majors (n = 195) at a private, religious, Midwestern university in the USA, we assessed student perception of overall stress level and physical stress level using the Student-life Stress Inventory. The targeted sample consisted of students with…
de Vries, J.; Huijsman, R.
Purpose - This paper seeks to concentrate on the question whether any parallels can be found between the industrial sector and health care services with respect to the developments that have taken place in the area of Supply Chain Management. Starting from an analysis of existing literature, it is i
Michalski, Daniel S.; Kohout, Jessica L.
Numerous efforts to describe the health service provider or clinical workforce in psychology have been conducted during the past 30 years. The American Psychological Association (APA) has studied trends in the doctoral education pathway and the resultant effects on the broader psychology workforce. During this period, the creation and growth of…
Russo, Nancy Felipe; And Others
Provides a profile of Hispanic women's use of inpatient mental health facilities. Presents gender differences for Hispanic and non-Hispanic inpatient admissions regarding age, marital status, and diagnosis. Women, particularly Hispanics, used service less than men; admission rates were higher for men with schizophrenia and alcohol-related…
Zascavage, Victoria; Winterman, Kathleen G.; Buot, Max; Wies, Jennifer R.; Lyzinski, Natalie
In order to better understand the effects of student-life stress on Education and Health Service majors (n = 195) at a private, religious, Midwestern university in the USA, we assessed student perception of overall stress level and physical stress level using the Student-life Stress Inventory. The targeted sample consisted of students with…
Werff, Albert; Hirsch, Gary; Barnard, Keith
The Advanced Research Institute on "Health Services Systems" was held under the auspices of the NATO Special Programme Panel on Systems Science as a part of the NATO Science Committee's continuous effort to promote the advancement of science through international cooperation. A special word is said in this respect supra by Pro fessor Checkland, Chairman of the Systems Science Panel. The Advanced Research Institute (ARI) was organized for the purpose of bringing together senior scientists to seek a consensus on the assessment of the present state of knowledge on the specific topic of "health services systems" and to present views and recom mendations for future health services research directions, which should be of value to both the scientific community and the people in charge of reorienting health services. The conference was structured so as to permit the assembly of a variety of complementary viewpoints through intensive group discussions to be the basis of this final report. Invitees were selected fr...
Rigbye, Jane; Griffiths, Mark D.
According to the latest British Gambling Prevalence Survey, there are approximately 300,000 adult problem gamblers in Great Britain. In January 2007, the "British Medical Association" published a report recommending that those experiencing gambling problems should receive treatment via the National Health Service (NHS). This study…
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
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.
de Vries, J.; Huijsman, R.
Purpose - This paper seeks to concentrate on the question whether any parallels can be found between the industrial sector and health care services with respect to the developments that have taken place in the area of Supply Chain Management. Starting from an analysis of existing literature, it is
Qureshi, Muhammad Imran; Rasli, Amran Md; Awan, Usama; Ma, Jian; Ali, Ghulam; Faridullah; Alam, Arif; Sajjad, Faiza; Zaman, Khalid
The objective of the study is to establish the link between air pollution, fossil fuel energy consumption, industrialization, alternative and nuclear energy, combustible renewable and wastes, urbanization, and resulting impact on health services in Malaysia. The study employed two-stage least square regression technique on the time series data from 1975 to 2012 to possibly minimize the problem of endogeniety in the health services model. The results in general show that air pollution and environmental indicators act as a strong contributor to influence Malaysian health services. Urbanization and nuclear energy consumption both significantly increases the life expectancy in Malaysia, while fertility rate decreases along with the increasing urbanization in a country. Fossil fuel energy consumption and industrialization both have an indirect relationship with the infant mortality rate, whereas, carbon dioxide emissions have a direct relationship with the sanitation facility in a country. The results conclude that balancing the air pollution, environment, and health services needs strong policy vistas on the end of the government officials.
Niniek Lely Pratiwi
Full Text Available Background: The MDG target to increase maternal health will be achieved when 50% of maternal deaths can be prevented through improvment the coverage of K1, K4, to make sure that midwife stay in the village improve the delivery by health workers in health facilities, increase coverage long-term contraceptive methods participant as well as family and community empowerment in health. Methods: This study is a further analysis of Riskesdas in 2010 to assess how big the accessibility of services in family planning in Indonesia. Results: Women of 3–4 children in rural greater and prevalence (27.1% compared to women who live in urban areas (25.0%. The main reason of not using contraception mostly because they want to have children 27.0% in urban, 28.2% rural whereas, the second reason is the fear of side effects 23.1% in urban, 16.5% rural. There is 10% of respondent did not use contraceptives, because they did not need it. Health seeking behavior of pregnant women with family planning work status has a significant relationship (prevalence ratio 1.073. The jobless mothers has better access to family planning services compared to working mother. Conclusions: Accessibility of family planning services is inadequate, because not all rural ‘Poskesdes’ equipped with infrastructure and family planning devices, a lack of knowledge of family planning in rural areas. Health seeking behavior of family planning services is mostly to the midwives, the scond is to community health centers and than polindes, ‘poskesdes’ as the ranks third.
U.S. Department of Health & Human Services — A Web service that allows patient portals and electronic health record (EHR) systems to use existing code sets to link to relevant, authoritative health information...
Effects of health-care services and commodities cost on the patients at the primary ... the monthly income of the clients and the experience of financial stress and a ... Commodities, National Health Act, primary health care, regulation, services ...
In February 1989 Prime Minister Margaret Thatcher presented her Proposals in a White Paper. These proposals imply essential changes in the National Health Service (NHS) in Great Britain. The changes will result in a more commercial way of managing both the hospitals and the offices of general practitioners. Among other things, they will imply buying and selling health services. Important objectives in the proposals are cost control, quality assurance and a greater choice for patients. During a visit to London this winter, the author studied the main topics of the proposals. This article discusses the content and aims of the White Paper, also with relevance to Norwegian health policy. Some aspects of the British health system today are also considered, with special reference to the development of the NHS during last 10 to 15 years.
Leach, F N
Most regional health authorities throughout the United Kingdom have established drug information units to provide health service staff with a wide range of information about drugs and drug use. The units, which are staffed by drug information pharmacists, provide their service mainly by answering inquiries, although some disseminate information more positively through lectures and bulletins.An analysis of inquiries received by regional information units during 1976 showed that most were submitted by hospital doctors or pharmacists; comparatively few were received from general practitioners. Topics of inquiry included adverse effects of drugs, source of supply and identification, current treatment, dosage, route, precautions, and pharmaceutical problems such as stability or formulation of drug preparations. A more detailed analysis of the inquiries received by the North-western Regional Drug Information Service at Manchester over three years showed that the number of inquiries gradually increased and that more were received from general practitioners after a programme of lectures had been introduced to tell them about the service. The North-western service also received more requests from hospital pharmacists than other units, though many originated from clinicians.The regional drug information units consulted widely with clinical and other specialists in answering questions, but about a quarter of all inquiries were pharmaceutical, relating to stability and incompatibility. A multidisciplinary approach therefore seems necessary to provide a comprehensive and advisory drug information service.