Interdisciplinary arts and health practice with an institutional logics perspective

DEFF Research Database (Denmark)

Jensen, Anita

2018-01-01

Background:Investigating the interdisciplinary relationships between stakeholders engaged in arts and health practice in the UK and Denmark, specifically with regard to institutional logics theory. The identified stakeholders: health professionals, museum educators and mental health service users....... Method:Semi-structured interviews were conducted with 30 participants: health professionals, museum educators and service users. Data were collected in Denmark and the UK. A thematic approach was used to analyse the data and theoretical lenses of sociological theories, and institutional logics explored...... the findings. Results:The interdisciplinary work in arts and health is complex, given the different disciplines and institutions involved. Findings illustrate that institutional logics play a vital and ambiguous part in arts and health practice and that this presents a challenge for interdisciplinary working...

Schisms in the church: National Health Service systems and institutional divergence in England and Wales.

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Hughes, David; Vincent-Jones, Peter

2008-12-01

Since devolution, the four countries of the United Kingdom have pursued strikingly different National Health Service (NHS) reforms. While England created a supply-side market more radical than the previous internal market system, Wales moved to a softer version of the purchaser/provider split emphasizing localism. This article deploys institutional theory to analyze the forces shaping change, and describes the hybrid forms of economic organization emerging, including the economic regulation model implemented in England. The schism that has resulted in separate NHS subsystems warrants a different analysis from the more familiar phenomenon of infield divergence. We argue that schism was triggered by political-regulatory influences rather than economic or other social institutional forces, and predict that other decentralized public health care systems may follow a similar path. While political-regulatory, normative, and cognitive institutional influences push in the same direction in Wales, the misalignment of political-regulatory and normative elements in England looks set to result in a period of organizational turbulence.

HUMAN DEVELOPMENT FOR STAFF INVOLVED IN INSTITUTIONS FROM TERTIARY HEALTH CARE: HEALTH SERVICES AND LABOR WELFARE MEDELLIN, COLOMBIA, 2007

Directory of Open Access Journals (Sweden)

Gladys Irene, Arboleda Posada

2011-01-01

Full Text Available The study describes the conditions of human development according to labor welfare and satisfaction with healthcare services from staff employed with an indefinite term contract before January 1997 in health institutions of tertiary care in the city of Medellin (Colombia. It was performed a cross-sectional study designed to measure these components of human development through surveys applied on the staff with the described conditions, without any difference of academic, socioeconomic status or type of position. It was included a population of 1622 persons from five institutions, with a final sample of 242.Among the key findings is highlighted the high degree of staff satisfaction related to received in healthcare services for both, the worker and their beneficiaries; as well as the supply of medicines and diagnostic aids; besides the satisfaction with the work performed in the company and the feeling of being useful and important to it, they find out it is difficult to have promotions by merit and recognition for their work. As factors to strengthen in these institutions are the establishing clear policies for promotion and recognition.

77 FR 29675 - National Institute of Mental Health; Notice of Closed Meetings

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2012-05-18

... Committee: National Institute of Mental Health Special Emphasis Panel; Neural Processes Underlying Sex... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Mental... unwarranted invasion of personal privacy. Name of Committee: National Institute of Mental Health Special...

The ethics of advertising for health care services.

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

2014-01-01

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

Mental health service delivery following health system reform in Colombia.

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Romero-González, Mauricio; González, Gerardo; Rosenheck, Robert A

2003-12-01

In 1993, Colombia underwent an ambitious and comprehensive process of health system reform based on managed competition and structured pluralism, but did not include coverage for mental health services. In this study, we sought to evaluate the impact of the reform on access to mental health services and whether there were changes in the pattern of mental health service delivery during the period after the reform. Changes in national economic indicators and in measures of mental health and non-mental health service delivery for the years 1987 and 1997 were compared. Data were obtained from the National Administrative Department of Statistics of Colombia (DANE), the Department of National Planning and Ministry of the Treasury of Colombia, and from national official reports of mental health and non-mental health service delivery from the Ministry of Health of Colombia for the same years. While population-adjusted access to mental health outpatient services declined by -2.7% (-11.2% among women and +5.8% among men), access to general medical outpatient services increased dramatically by 46%. In-patient admissions showed smaller differences, with a 7% increase in mental health admissions, as compared to 22.5% increase in general medical admissions. The health reform in Colombia imposed competition across all health institutions with the intention of encouraging efficiency and financial autonomy. However, the challenge of institutional survival appears to have fallen heavily on mental health care institutions that were also expected to participate in managed competition, but that were at a serious disadvantage because their services were excluded from the compulsory standardized package of health benefits. While the Colombian health care reform intended to close the gap between those who had and those who did not have access to health services, it appears to have failed to address access to specialized mental health services, although it does seem to have promoted a

42 CFR 440.155 - Nursing facility services, other than in institutions for mental diseases.

Science.gov (United States)

2010-10-01

... institutions for mental diseases. 440.155 Section 440.155 Public Health CENTERS FOR MEDICARE & MEDICAID... PROVISIONS Definitions § 440.155 Nursing facility services, other than in institutions for mental diseases. (a) “Nursing facility services, other than in an institution for mental diseases” means services...

78 FR 77472 - National Institute of Mental Health; Notice of Meeting

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2013-12-23

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Mental Health; Notice of Meeting Pursuant to section 10(a) of the Federal Advisory Committee Act, as amended (5... of Autism Research Coordination, National Institute of Mental Health, NIH, 6001 Executive Boulevard...

78 FR 35293 - National Institute of Mental Health; Notice of Meeting

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2013-06-12

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Mental Health; Notice of Meeting Pursuant to section 10(a) of the Federal Advisory Committee Act, as amended (5... of Autism Research Coordination, National Institute of Mental Health, NIH, 6001 Executive Boulevard...

77 FR 74198 - National Institute of Mental Health; Notice of Meeting

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2012-12-13

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Mental... U.S.C. App.), notice is hereby given of a meeting of the National Advisory Mental Health Council... Institute of Mental Health, NIH, Neuroscience Center, 6001 Executive Blvd., Room 6154, MSC 9609, Bethesda...

78 FR 57865 - National Institute of Mental Health; Notice of Meeting

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2013-09-20

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Mental Health; Notice of Meeting Pursuant to section 10(a) of the Federal Advisory Committee Act, as amended (5... Person: Ms. Lina Perez, Office of Autism Research Coordination, National Institute of Mental Health, NIH...

78 FR 48696 - National Institute of Mental Health; Notice of Meeting

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2013-08-09

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Mental Health; Notice of Meeting Pursuant to section 10(a) of the Federal Advisory Committee Act, as amended (5... Perez, Office of Autism Research Coordination, National Institute of Mental Health, NIH, 6001 Executive...

75 FR 44967 - National Institute for Occupational Safety and Health

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2010-07-30

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institute for Occupational Safety and Health... Occupational Safety and Health (NIOSH), Department of Health and Human Services (HHS). ACTION: Notice. SUMMARY... Occupational Safety and Health (NIOSH), 4676 Columbia Parkway, MS C-46, Cincinnati, OH 45226, Telephone 877-222...

77 FR 68135 - National Institute of Mental Health; Notice of Meeting

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2012-11-15

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Mental Health; Notice of Meeting Pursuant to section 10(a) of the Federal Advisory Committee Act, as amended (5..., National Institute of Mental Health, NIH, 6001 Executive Boulevard, NSC, Room 6182A, Rockville, MD 20852...

75 FR 68612 - National Institute of Mental Health; Notice of Meeting

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2010-11-08

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Mental Health; Notice of Meeting Pursuant to section 10(a) of the Federal Advisory Committee Act, as amended (5... Institute of Mental Health, NIH, 6001 Executive Boulevard, NSC, 8185a, Rockville, MD 20852, Phone: 301-443...

78 FR 12072 - National Institute of Mental Health; Notice of Meeting

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2013-02-21

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Mental Health; Notice of Meeting Pursuant to section 10(a) of the Federal Advisory Committee Act, as amended (5... Institute of Mental Health, NIH, 6001 Executive Boulevard, NSC, Room 6182A, Rockville, MD 20852, Phone: (301...

Cloud-based hospital information system as a service for grassroots healthcare institutions.

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Yao, Qin; Han, Xiong; Ma, Xi-Kun; Xue, Yi-Feng; Chen, Yi-Jun; Li, Jing-Song

2014-09-01

Grassroots healthcare institutions (GHIs) are the smallest administrative levels of medical institutions, where most patients access health services. The latest report from the National Bureau of Statistics of China showed that 96.04 % of 950,297 medical institutions in China were at the grassroots level in 2012, including county-level hospitals, township central hospitals, community health service centers, and rural clinics. In developing countries, these institutions are facing challenges involving a shortage of funds and talent, inconsistent medical standards, inefficient information sharing, and difficulties in management during the adoption of health information technologies (HIT). Because of the necessity and gravity for GHIs, our aim is to provide hospital information services for GHIs using Cloud computing technologies and service modes. In this medical scenario, the computing resources are pooled by means of a Cloud-based Virtual Desktop Infrastructure (VDI) to serve multiple GHIs, with different hospital information systems dynamically assigned and reassigned according to demand. This paper is concerned with establishing a Cloud-based Hospital Information Service Center to provide hospital information software as a service (HI-SaaS) with the aim of providing GHIs with an attractive and high-performance medical information service. Compared with individually establishing all hospital information systems, this approach is more cost-effective and affordable for GHIs and does not compromise HIT performance.

77 FR 68134 - National Institute of Mental Health; Notice of Meeting

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2012-11-15

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Mental Health; Notice of Meeting Pursuant to section 10(a) of the Federal Advisory Committee Act, as amended (5.... Contact Person: Ms. Lina Perez, Office of Autism Research Coordination, National Institute of Mental...

77 FR 43849 - National Institute of Mental Health; Notice of Meeting

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2012-07-26

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Mental Health; Notice of Meeting Pursuant to section 10(a) of the Federal Advisory Committee Act, as amended (5.... Contact Person: Ms. Lina Perez, Office of Autism Research Coordination, National Institute of Mental...

75 FR 53320 - National Institute of Mental Health; Notice of Closed Meetings

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2010-08-31

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Mental...: Bethesda North Marriott Hotel & Conference Center, 5701 Marinelli Road, Bethesda, MD 20852. Contact Person... of Mental Health, National Institutes of Health, 6001 Executive Blvd., Room 6154, MSC 9609, Bethesda...

Oral health service utilization by elderly beneficiaries of the Mexican Institute of Social Security in México city

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Solórzano-Santos Fortino

2007-12-01

Full Text Available Abstract Background The aging population poses a challenge to Mexican health services. The aim of this study is to describe recent oral health services utilization and its association with socio-demographic characteristics and co-morbidity in Mexican Social Security beneficiaries 60 years and older. Methods A sample of 700 individuals aged 60+ years was randomly chosen from the databases of the Mexican Institute of Social Security (IMSS. These participants resided in the southwest of Mexico City and made up the final sample of a cohort study for identifying risk factors for root caries in elderly patients. Sociodemographic variables, presence of cognitive decline, depression, morbidity, medication consumption, and utilization of as well as reasons for seeking oral health services within the past 12 months were collected through a questionnaire. Clinical oral assessments were carried out to determine coronal and root caries experience. Results The sample consisted of 698 individuals aged 71.6 years on average, of whom 68.3% were women. 374 participants (53.6% had made use of oral health services within the past 12 months. 81% of those who used oral health services sought private medical care, 12.8% sought social security services, and 6.2% public health services. 99.7% had experienced coronal caries and 44.0% root caries. Female sex (OR = 2.0, 6 years' schooling or less (OR = 1.4, and caries experience in more than 22 teeth (OR = 0.6 are factors associated with the utilization of these services. Conclusion About half the elderly beneficiaries of social security have made use of oral health services within the past 12 months, and many of them have to use private services. Being a woman, having little schooling, and low caries experience are factors associated with the use of these services.

Characteristics of diabetes care in an institutional network of health services Medellin. 2005-2008

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Sandra M. Agudelo

2011-05-01

Full Text Available Because of its severity, frequency and increasing social and economic impact, Diabetes Mellitus (DM is considered the third priority health problem in the world. Although to date there is no curative treatment, it does have effective measures to reduce its occurrence and limit its complications. Objective: to describe the control program of diabetes in a statewide network of health services in regard to clinical variables, the epidemiology of population served and the control actions, in order to identify strategies for improvement. Methodology: operational research based on secondary data. We reviewed the general conditions of operation of the program based on records of patient care. We studied a random sample of medical records of patients served by the control program of diabetes care units in the network.The results were validated in a meeting with officials of the institution. Results: we detected flaws and points of improvement in the performance of the control program that resulted in specific recommendations for the institutional network. Other failures are due to rules that hinder health system monitoring and control of the DM at the first level. Conclusion:the review of medical records reveals important problems about registration, monitoring and control of diabetics. Other regulatory and contractual provisions of the colombian health system were identified as restrictions that prevent the program to control hyperglycemia and early detection of renal damage. These restrictions could be affecting the programs of control of diabetes in other institutions of the country that are subject to the same rules

76 FR 77239 - National Institute of Mental Health; Notice of Meeting

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2011-12-12

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Mental... U.S.C. App.), notice is hereby given of a meeting of the National Advisory Mental Health Council... clearly unwarranted invasion of personal privacy. Name of Committee: National Advisory Mental Health...

Focus on vulnerable populations and promoting equity in health service utilization ––an analysis of visitor characteristics and service utilization of the Chinese community health service

OpenAIRE

Dong, Xiaoxin; liu, Ling; Cao, Shiyi; Yang, Huajie; Song, Fujian; Yang, Chen; Gong, Yanhong; Wang, Yunxia; Yin, Xiaoxu; Xie, Jun; Sun, Yi; Lu, Zuxun

2014-01-01

Background Community health service in China is designed to provide a convenient and affordable primary health service for the city residents, and to promote health equity. Based on data from a large national study of 35 cities across China, we examined the characteristics of the patients and the utilization of community health institutions (CHIs), and assessed the role of community health service in promoting equity in health service utilization for community residents. Methods Multistage sa...

Differences in the use of outsourcing in public and private institutions providing medical services.

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Czerw, Aleksandra I; Kowalska, Mariola; Religioni, Urszula

2014-06-29

The costs of health care in Poland are continuously increasing. Thus, almost every institution providing medical services aims at their limitation. One of the costs rationalisation methods in the health care sector is outsourcing. The study was conducted in 153 randomly selected institutions providing medical activities. The tool was a questionnaire, available via a web browser. Over 30% of public institutions identified the need for financial savings, as the main reason for outsourcing the cleaning function. Among private institutions, the dominant reason for this is too high maintenance cost of the cleaning staff (less than 40% of responses). The huge number of medical institutions use the services of an external company for laundering. Over 30% of public institutions identified as the most common reason for separation of functions laundering lack of resources to upgrade and modernize facilities. Less than 27% of public institutions indicate too high costs of kitchen staff as the main reason for ordering function of feeding. Another reason is the need for financial savings (22% response rate). Some institutions indicate a desire to focus on key areas (20% of responses) and lack of financial resources to upgrade and modernize the kitchen (20% response rate). Public and private institutions exercise control over the quality and method performed by an external service (71% of public institutions and 59% of private institutions). Private institutions often informally exercise external control (difference confirmed - Fisher's exact test). Less than 90% of public institutions indicated satisfaction with the services provided by external companies. The adaptation of outsourcing in medical facilities leads to financial efficiency improvement. Through the separation of some medical functions and entrusting their realisation to external companies, medical institutions can focus on their basic activity that is the provision of health services.

Factors associated with the utilization of institutional delivery services in Bangladesh.

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Yaya, Sanni; Bishwajit, Ghose; Ekholuenetale, Michael

2017-01-01

Bangladesh has made remarkable progress towards reducing its maternal mortality rate (MMR) over the last two decades and is one of the few countries on track to achieving the MMR-related Millennium Development Goals (MDG-5A). However, the provision of universal access to reproductive healthcare (MDG-5B) and the utilization of maternal healthcare services (MHS) such as institutional delivery, which are crucial to the reduction of maternal mortality, are far behind the internationally agreed-upon target. Effective policymaking to promote the utilization of MHS can be greatly facilitated by the identification of the factors that hinder service uptake. In this study, we therefore aim to measure the prevalence of institutional delivery services and explore the factors associated with their utilization in Bangladesh. Data for this study were extracted from the 2011 Bangladesh Demographic and Health Survey (BDHS, 2011); participants were 7,313 women between the ages of 15 and 49 years, selected from both urban and rural households. Data were analyzed using Chi-square analysis, and conditional logistic regression. According to the findings, fewer than one in three women reported delivering at a health facility. The multivariable regression analysis showed that participants from rural areas were 46.9% less likely to have institutional deliveries compared to urban dwellers (OR = 0.531; pdelivery service utilization compared to those aged 15 to 29 years (OR = 1.236; p = 0.006; 95%CI: 1.062-1.437). Moreover, participants with higher educational attainment were about twice as likely to deliver at a standard health facility when compared to those without formal education (OR = 2.081; pservice utilization of institutional delivery facilities compared to those without formal education (OR = 1.709; pdelivery service use, with participants belonging to the highest economic stratum being more likely to receive skilled care compared to the lowest economic stratum (OR = 2

76 FR 23612 - National Institute of Mental Health; Notice of Meeting

Science.gov (United States)

2011-04-27

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Mental Health; Notice of Meeting Pursuant to section 10(a) of the Federal Advisory Committee Act, as amended (5... Mental Health, NIH, 6001 Executive Boulevard, NSC, Room 8185a, Rockville, MD 20852. Phone: 301-443-6040...

["Podmoskovie"--health resort institution of the Federal Drug Control Service of the Russian Federation celebrates the 20th anniversary].

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Bondar', I V; Minaev, D Iu; Nasretdinov, I N; Petukhov, A E

2014-12-01

The article is dedicated to the 20th anniversary of the Federal government health resort institution of the Federal Drug Control Service of the Russian Federation (FGI "Health resort "Podmoskovie" of the Federal Drug Control Service of the Russian Federation). In this health resort were developed treatment programs for patients with abnormalities of the cardiovascular, respiratory and digestive systems; methods of ultrasonic, laser and magnetic therapy, atmospheric hypoxic, herbal medicine, speleotherapy are employed. Widely used natural healing factors of Ruza district of the Moscow region such as climate therapy, treatment with mineral water group of X type of Smolensk from own wells and balneo-mudtherapy. Over the past 20 years 70 000 patients received an appropriate treatment in this health resort.

[Evaluation of women's health care programs in the main institutions of the Mexican health system].

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Enciso, Graciela Freyermuth; Navarro, Sergio Meneses; Martínez, Martín Romero

2015-01-01

The aim of this study was to analyze the institutional capacity for provision of women's health care services in Mexico in accordance with prevailing regulations. A probabilistic national sample of health care institutions was used to compare performance rates according to services packages based on analysis of variance. No package showed outstanding performance. Adequate performance was seen in referral and counter-referral centers for uterine cervical cancer, childbirth care, breast cancer diagnosis, family planning counseling, and training in sexual and reproductive health. The lowest performance was seen in the prevention of uterine cervical cancer, obstetric urgencies, family and sexual violence, and promotion of family planning. All the institutions showed low performance in the prevention of breast cancer, promotion of family planning, and management of family and gender violence. The Ministry of Health's leadership needs to be strengthened in order to overcome resistance for the institutions to adhere to the prevailing regulations.

42 CFR 440.10 - Inpatient hospital services, other than services in an institution for mental diseases.

Science.gov (United States)

2010-10-01

... an institution for mental diseases. 440.10 Section 440.10 Public Health CENTERS FOR MEDICARE... for mental diseases. (a) Inpatient hospital services means services that— (1) Are ordinarily furnished... and treatment of patients with disorders other than mental diseases; (ii) Is licensed or formally...

78 FR 32259 - National Institute of Environmental Health Sciences; Amended Notice of Meeting

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2013-05-29

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Amended Notice of Meeting Notice is hereby given of a change in the meeting of the National Institute of Environmental Health Sciences Special Emphasis Panel, July 15, 2013, 8:00 a...

Factors associated with the utilization of institutional delivery services in Bangladesh.

Directory of Open Access Journals (Sweden)

Sanni Yaya

Full Text Available Bangladesh has made remarkable progress towards reducing its maternal mortality rate (MMR over the last two decades and is one of the few countries on track to achieving the MMR-related Millennium Development Goals (MDG-5A. However, the provision of universal access to reproductive healthcare (MDG-5B and the utilization of maternal healthcare services (MHS such as institutional delivery, which are crucial to the reduction of maternal mortality, are far behind the internationally agreed-upon target. Effective policymaking to promote the utilization of MHS can be greatly facilitated by the identification of the factors that hinder service uptake. In this study, we therefore aim to measure the prevalence of institutional delivery services and explore the factors associated with their utilization in Bangladesh.Data for this study were extracted from the 2011 Bangladesh Demographic and Health Survey (BDHS, 2011; participants were 7,313 women between the ages of 15 and 49 years, selected from both urban and rural households. Data were analyzed using Chi-square analysis, and conditional logistic regression.According to the findings, fewer than one in three women reported delivering at a health facility. The multivariable regression analysis showed that participants from rural areas were 46.9% less likely to have institutional deliveries compared to urban dwellers (OR = 0.531; p<0.001; 95%CI: 0.467-0.604, and participants aged between 30 and 49 years had a 23.6% higher prevalence of institutional delivery service utilization compared to those aged 15 to 29 years (OR = 1.236; p = 0.006; 95%CI: 1.062-1.437. Moreover, participants with higher educational attainment were about twice as likely to deliver at a standard health facility when compared to those without formal education (OR = 2.081; p<0.001; 95%CI: 1.650-2.624, and similarly, husbands with higher educational attainment exhibited an approximately 71% higher service utilization of institutional

The experiences of health services research and health services research training in Korea.

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Moon, O R

1984-12-01

Early in the 1970s the Korean government recognized the necessity of Health Services Research (HSR). The law of the Korea Health Development Institute was promulgated in 1975, and a contribution from the Republic was combined with an Agency for International Development loan to field test low-cost health service strategies. A program to deploy Community Health Practitioners (CHPs), similar to family nurse practitioners or Medex has been demonstrated to be effective. The CHP training program grew from 9 in 1980 to 1343 in 1984. CHP's main functions are curative, preventive, educative, and administrative. They are selected registered nurses and/or midwives, where possible from serviced communities. They are trained in 24 weeks, including 12 weeks of clinical practice, in an anticipated recruiting post. CHPs help train village health volunteers (VHVs), who are literate women chosen by their communities. They work closely with the CHPs as a liaison with the village and in information gathering. An HSR orientation workshop held in Chuncheon in 1980, discussed role, policy, status, finance components, information systems, behavioral and manpower components, staff training, protocols for project development, HSR in the future and evaluation of the conference. In 1980, a National Workshop on Biomedical Research Methodology was also held, with World Health Organization and Korean consultants. Training of junior scientists would include introduction to scientific method, statement of problems, quantitative study technics, research proposals, and interpretation of results. The Korean Institute of Public Health sponsored a 1982 experts forum on the health care system, medical facilities, organizational management, financing and medical security, and health behavioral aspects. Training of trainers and lower level field workers, orientation of program managers, researchers, and communities themselves should all be training priorities. In future, CHPs should be refresher

76 FR 31620 - National Institute of Environmental Health Sciences; Notice of Closed Meetings

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2011-06-01

... Health Sciences Special Emphasis Panel, Research on Ethics and Integrity of Human and or Animal Subjects... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of..., DVM, Chief, Scientific Review Branch, Division of Extramural Research and Training, National Institute...

Institutions of Higher Education Pre-Service School Health Education Practices

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Davidson, Brad; Telljohann, Susan K.; Dake, Joseph A.; Price, James H.

2010-01-01

Background: The quality of health education teachers is, in large part, dependent on the education they receive from their teacher preparation program. Purpose: This study assessed institutions of higher education (IHE) teaching practices in school health teacher preparation programs regarding the amount of time spent and content taught related to…

Understanding patient e-loyalty toward online health care services.

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

2013-01-01

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

75 FR 46950 - National Institute of Environmental Health Sciences; Notice of Closed Meeting

Science.gov (United States)

2010-08-04

... Health Sciences Special Emphasis Panel, Gulf Oil Spill Health Effects. Date: August 17, 2010. Time: 1 p.m...--Health Risks from Environmental Exposures; 93.142, NIEHS Hazardous Waste Worker Health and Safety... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of...

Institutional analysis of health system governance.

Science.gov (United States)

Abimbola, Seye; Negin, Joel; Martiniuk, Alexandra L; Jan, Stephen

2017-11-01

It is important that researchers who study health system governance have a set of collective understandings of the meanings of governance, which can then inform the methods used in research. We present an institutional framing and definition of health system governance; that is, governance refers to making, changing, monitoring and enforcing the rules that govern the demand and supply of health services. This pervasive, relational view of governance is to be preferred to approaches that focus primarily on structures of governments and health care organizations, because health system governance involves communities and service users, and because governments in many low- and middle-income countries tend to under-govern. Therefore, the study of health system governance requires institutional analysis; an approach that focuses not only on structures, but also on the rules (both formal and informal) governing demand and supply relations. Using this 'structure-relations' lens, and based on our field experience, we discuss how this focus could be applied to the three approaches to framing and studying health system governance that we identified in the literature. In order of decreasing focus on structures ('hardware') and increasing focus on relations ('software'), they are: (1) the government-centred approach, which focuses on the role of governments, above or to the exclusion of non-government health system actors; (2) the building-block approach, which focuses on the internal workings of health care organizations, and treats governance as one of the several building blocks of organizations; and (3) the institutional approach, which focuses on how the rules governing social and economic interactions are made, changed, monitored and enforced. Notably, either or both qualitative and quantitative methods may be used by researchers in efforts to incorporate the analysis of how rules determine relations among health system actors into these three approaches to health system

Health Services Research for Drug and Alcohol Treatment and Prevention.

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McCarty, Dennis; Roman, Paul M; Sorensen, James; Weisner, Constance

2009-01-01

Health services research is a multidisciplinary field that examines ways to organize, manage, finance, and deliver high-quality care. This specialty within substance abuse research developed from policy analyses and needs assessments that shaped federal policy and promoted system development in the 1970s. After the authorization of the National Institute on Alcohol Abuse and Alcoholism (NIAAA) and the National Institute on Drug Abuse (NIDA), patient information systems supported studies of treatment processes and outcomes. Health services research grew substantially in the 1990s when NIAAA and NIDA moved into the National Institutes of Health and legislation allocated 15% of their research portfolio to services research. The next decade will emphasize research on quality of care, adoption and use of evidence-based practices (including medication), financing reforms and integration of substance abuse treatment with primary care and mental health services.

[Hygiene and Infection Prevention in Medical Institutions, Kindergartens and Schools - Statutory Basis, Infection Control Practice and Experiences of the Public Health Services].

Science.gov (United States)

Heudorf, U

2015-07-01

Infection prevention is one of the main tasks of the public health services. The "Protection against infection act" places all medical institutions and facilities for children (kindergartens and schools) under the obligation to assume responsibility and to cooperate. Duties of the institutions are described, and public health services are obliged to perform hygiene control visits.Regarding medical institutions, the guidelines of the German Commission on Hospital Hygiene and Infection Control have to be observed, and the counties were obliged to publish hygiene enactments. Subsequently, good improvements in hygiene management in medical institutions were achieved. In schools, however, severe hygienic problems (i.e. sanitary hygiene, indoor air hygiene) are detected, without any improvement - obviously due to a missing sense of responsibility in the school community. Causes for poor behaviour prevention (hand hygiene, ventilation) and missing situational prevention (i.e. cleaning) are discussed. Without reversion to the obviously needed but nearly forgotten subject school hygiene, obligatory guidelines and the assuming of responsibility, permanent improvements cannot be achieved. © Georg Thieme Verlag KG Stuttgart · New York.

Innovations in plant health services in Nicaragua

DEFF Research Database (Denmark)

Danielsen, Solveig; Centeno, Julio; López, Julio

2013-01-01

to the creation of a ‘National Plant Health System’ offering regular advice to farmers. The innovations were driven by a momentum for change, committed individuals, joint learning and flexibility in programme management. External facilitation encouraged experimentation and bolstered growth of new alliances....... The development of the national plant health system was constrained by existing work cultures that limit the scope of individual and institutional innovations.......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...

Service innovations breaking institutionalized rules of health care

DEFF Research Database (Denmark)

Wallin, Arto; Fuglsang, Lars

2017-01-01

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

Knowledge synthesis and the Canadian Institutes of Health Research

Directory of Open Access Journals (Sweden)

Graham Ian D

2012-02-01

Full Text Available Abstract The Canadian Institutes of Health Research (CIHR is Canada's premier health-research funding agency. We fund nearly 14,000 researchers and trainees in four theme areas: biomedical, clinical, health services, and population and public-health research. Our mandate is 'to excel according to international standards of scientific excellence, in the creation of new knowledge and its translation into improved health for Canadians, more effective health services and products and a strengthened Canadian health care system'. Knowledge synthesis is a key element of the knowledge-translation objectives of CIHR, as outlined in our definition of knowledge-translation.

76 FR 62422 - National Institute of Environmental Health Sciences; Cancellation of Meeting

Science.gov (United States)

2011-10-07

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Cancellation of Meeting Notice is hereby given of the cancellation of the Interagency Breast Cancer and Environmental Research Coordinating Committee, October 12, 2011, 1 p.m. to 3 p.m...

Medicaid managed care for mental health services: the survival of safety net institutions in rural settings.

Science.gov (United States)

Willging, Cathleen E; Waitzkin, Howard; Nicdao, Ethel

2008-09-01

Few accounts document the rural context of mental health safety net institutions (SNIs), especially as they respond to changing public policies. Embedded in wider processes of welfare state restructuring, privatization has transformed state Medicaid systems nationwide. We carried out an ethnographic study in two rural, culturally distinct regions of New Mexico to assess the effects of Medicaid managed care (MMC) and the implications for future reform. After 160 interviews and participant observation at SNIs, we analyzed data through iterative coding procedures. SNIs responded to MMC by nonparticipation, partnering, downsizing, and tapping into alternative funding sources. Numerous barriers impaired access under MMC: service fragmentation, transportation, lack of cultural and linguistic competency, Medicaid enrollment, stigma, and immigration status. By privatizing Medicaid and contracting with for-profit managed care organizations, the state placed additional responsibilities on "disciplined" providers and clients. Managed care models might compromise the rural mental health safety net unless the serious gaps and limitations are addressed in existing services and funding.

Institutional violence and humanization in health: notes to debate.

Science.gov (United States)

Azeredo, Yuri Nishijima; Schraiber, Lilia Blima

2017-09-01

This paper starts from humanization policies and the academic debate around them to reflect about institutional violence inside health services. Based on research on scientific publications in Collective Health, it was observed that violence in relationships between health professionals and users - which is at the core of the humanization's debate - is conceptualized as an excessive power in exercise of professional authority. Using Hannah Arendt thinking as theoretical contributions regarding the concepts of 'authority', 'power' and 'violence', our objective is to define and rethink these phenomena. Melting these reflections with the history of institutionalization of health in Brazil, and especially the changes in medical work during the twentieth century, we conclude that the problem of institutional violence on health services is not based on excess of authority and power of professionals, but rather in its opposite. When there is a vacuum of professional authority, and relationships between people do not happen through power relations, there is space for the phenomenon of violence.

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

African Journals Online (AJOL)

2013-01-16

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

76 FR 53685 - National Institutes of Health

Science.gov (United States)

2011-08-29

..., CSR management to enhance the operations, processes, organization of, and services provided by the... data collection projects, the Center for Scientific Review (CSR), National Institutes of Health (NIH), has submitted to the Office of Management and Budget (OMB) a request to review and approve the...

78 FR 47715 - National Institute of Environmental Health Sciences; Amended Notice of Meeting

Science.gov (United States)

2013-08-06

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Amended Notice of Meeting Notice is hereby given of a change in the meeting of the Environmental Health Sciences Review Committee, July 24, 2013, 08:00 a.m. to July 26, 2013, 02:00...

Developing nursing capacity for health systems and services research in Cuba, 2008-2011.

Science.gov (United States)

Martínez, Nelcy

2012-07-01

Health systems and services research by nursing personnel could inform decision-making and nursing care, providing evidence concerning quality of and patient satisfaction. Such studies are rather uncommon in Cuban research institutes, where clinical research predominates. Assess the results of a strategy implemented between 2008 and 2011 to develop nursing capacity for health systems and services research in 14 national research institutes based in Havana. The study comprised four stages: description of approaches to health systems and services research by nurses worldwide and in Cuba; analysis of current capacities for such research in Cuba; intervention design and implementation; and evaluation. Various techniques were used including: literature review, bibliometric analysis, questionnaire survey, consultation with experts, focus groups, and workshops for participant orientation and design and followup of research projects. Qualitative information reduction and quantitative information summary methods were used. Initially, 32 nursing managers participated; a further 105 nurses from the institutes were involved in research teams formed during intervention implementation. Of all published nursing research articles retrieved, 8.9% (185 of 2081) concerned health systems and services research, of which 26.5% (49 of 185) dealt with quality assessment. At baseline, 75% of Cuban nurses surveyed had poor knowledge of health systems and services research. Orientation, design and followup workshops for all institute teams developed individual and institutional capacity for health systems and services research. Post-intervention, 84.7% (27) of nurses reached good knowledge and 14.3% (5) fair; institutional research teams were formed and maintained in 9 institutes, and 13 projects designed and implemented (11 institutional, 2 addressing ministerial-level priorities) to research nursing issues at selected centers. A systematic strategy to build nursing capacity for health

New Media Institute – Personal Public Service Announcement Project

Centers for Disease Control (CDC) Podcasts

2009-05-15

In this podcast, Erin Edgerton, CDC, and Scott Shamp, New Media Institute, University of Georgia, discuss new media and the personal public service announcement project.  Created: 5/15/2009 by National Center for Health Marketing (NCHM), Division of eHealth Marketing (DeHM).   Date Released: 2/10/2010.

Service-learning: an integral part of undergraduate public health.

Science.gov (United States)

Cashman, Suzanne B; Seifer, Sarena D

2008-09-01

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.

Public Health Services for Foreign Workers in Malaysia.

Science.gov (United States)

Noh, Normah Awang; Wahab, Haris Abd; Bakar Ah, Siti Hajar Abu; Islam, M Rezaul

2016-01-01

The objective of this study was to know the status of the foreign workers' access to public health services in Malaysia based on their utilization pattern. The utilization pattern covered a number of areas, such as frequency of using health services, status of using health services, choice and types of health institutions, and cost of health treatment. The study was conducted on six government hospitals in the Klang Valley area in Kuala Lumpur, Malaysia. Data were collected from 600 foreign patients working in the country, using an interview method with a structured questionnaire. The results showed that the foreign workers' access to public health services was very low. The findings would be an important guideline to formulate an effective health service policy for the foreign workers in Malaysia.

A rapid evidence review on the effectiveness of institutional health partnerships.

Science.gov (United States)

Kelly, Ema; Doyle, Vicki; Weakliam, David; Schönemann, Yvonne

2015-12-14

Institutional Health Partnerships are long-term, institution to institution partnerships between high income and low and middle income countries which seek to build capacity and strengthen health institutions in order to improve health service delivery and outcomes. Funding for Institutional Health Partnerships has increased in recent years. This paper outlines a rapid evidence review on the effectiveness of this modality. A rapid evidence review of published and grey literature was conducted. Content relating to the effectiveness of working in partnership and methods and frameworks used were extracted and analysed. The results of this analysis were used to structure a discussion regarding the next steps to strengthen the evidence base for the effectiveness of institutional health partnerships. The evidence review, including citation mapping, returned 27 published papers and 17 grey literature documents that met all of the inclusion criteria. Most of the literature did not meet the high standards of formal academic rigour and there was no original research amongst this literature that specifically addressed the effectiveness of institutional health partnerships. This was not surprising given institutional health partnerships do not lend themselves easily to case control studies and randomised control trials due to their high level of diversity and operation in complex social systems. There was, however, a body of practice based knowledge and experience. Evidence for the effectiveness of Institutional Health Partnerships is thin both in terms of quantity and academic rigour. There is a need to better define and differentiate Institutional Health Partnerships in order to measure and compare effectiveness across such a diverse group. Effectiveness needs to be measured at the level of individual partnerships, the bodies that facilitate partnership programmes and the level of health service delivery. There is a need to develop indicators and frameworks that specifically

Alternative mechanisms of state public health institutions financing in Ukraine

Directory of Open Access Journals (Sweden)

Hural, Anastasiya

2011-05-01

Full Text Available BACKGROUND. The main source of state public health institutions financing in Ukraine is budgetary funding. In order to overcome the underfunding, the idea of multichannel health financing was proposed in the late 1990s. The main forms of extrabudgetary financial support of public health institutions in Ukraine are voluntary health insurance, non-profit self-financing, charity and sponsorship. The study aims to deeper understand the nature of alternative financing mechanisms of state public health institutions in Ukraine and peculiarities of their use in practice.METHODS. The proposed study is exploratory. Case-study was selected as research method. Nine unstructured interviews were conducted in six health care facilities that have agreed to participate in the study. All studied facilities were in-patient.RESULTS. The sources of financial revenues of the studied institutions were as follows: reimbursement for treatment of insured patients, reimbursement for treatment of sickness funds members, payments for services (medical examinations, counseling, transportation to the hospital, rental of premises, payment for internship from the students of paid forms of medical education, charitable contributions, contracts with companies, contracts with private clinics based in public institutions’ premises (limited liability companies, private entrepreneurs, sponsorship, grants, gifts, payments for services for foreigners, and in-kind revenues. Major health facilities expenditures were the following: salaries (not covered from extrabudgetary revenues; ranged from 70% to 92% of the funds provided to the institutions from state (municipal, regional budget, energy carriers (partially covered from extrabudgetary funds, patients nutrition, medicines, materials, household expenditures, reparation of premises, and purchase of equipment (mostly covered from extrabudgetary revenues. In the studied cases, funds raised by alternative funding mechanisms amounted from

76 FR 23826 - National Institute of Mental Health; Notice of Closed Meetings

Science.gov (United States)

2011-04-28

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Mental....m. Agenda: To review and evaluate grant applications. Place: St. Gregory Hotel, 2033 M Street, NW... Blvd., Room 6154, MSC 9606, Bethesda, MD 20892-9606, 301-443-7861, ds[email protected] . Name of...

75 FR 51818 - National Institute for Occupational Safety and Health; Final Effect of Designation of a Class of...

Science.gov (United States)

2010-08-23

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institute for Occupational Safety and Health...: National Institute for Occupational Safety and Health (NIOSH), Department of Health and Human Services (HHS... a number of work days aggregating at least 250 work days, occurring either solely under this...

75 FR 74733 - National Institute for Occupational Safety and Health; Final Effect of Designation of a Class of...

Science.gov (United States)

2010-12-01

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institute for Occupational Safety and Health...: National Institute for Occupational Safety and Health (NIOSH), Department of Health and Human Services (HHS... aggregating at least 250 work days, occurring either solely under this employment, or in combination with work...

75 FR 51816 - National Institute for Occupational Safety and Health; Final Effect of Designation of a Class of...

Science.gov (United States)

2010-08-23

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institute for Occupational Safety and Health...: National Institute for Occupational Safety and Health (NIOSH), Department of Health and Human Services (HHS... number of work days aggregating at least 250 work days, occurring either solely under this employment or...

75 FR 7485 - Eunice Kennedy Shriver National Institute of Child Health & Human Development; Amended Notice of...

Science.gov (United States)

2010-02-19

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health Eunice Kennedy Shriver National Institute of Child Health & Human Development; Amended Notice of Meeting Notice is hereby given of a change in the meeting of the National Institute of Child Health and Human Development Special...

Climate Services to Improve Public Health

Science.gov (United States)

Jancloes, Michel; Thomson, Madeleine; Costa, María Máñez; Hewitt, Chris; Corvalan, Carlos; Dinku, Tufa; Lowe, Rachel; Hayden, Mary

2014-01-01

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. PMID:24776719

Radon Gas in Ireland Joint Position Statement by the Radiological Protection Institute of Ireland and the Health Service Executive

International Nuclear Information System (INIS)

Part, A.M.; Colgan, P.A.; Fenton, D.; Kelly, I.; Long, S.; O'Mahony, M.; Pollard, D.

2010-04-01

This position statement is written by the Health Service Executive and the Radiological Protection Institute of Ireland with a view to forming and influencing policy in this area. It provides a summary of the health risks associated with radon exposure in Ireland and the steps that can be taken to reduce those risks. It outlines suggested ongoing work to reduce both the population dose from radon and the individual dose to those most at risk and considers future work needed to improve national policy to achieve these objectives

76 FR 62409 - National Institute for Occupational Safety and Health; Final Effect of Designation of a Class of...

Science.gov (United States)

2011-10-07

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institute for Occupational Safety and Health...: National Institute for Occupational Safety and Health (NIOSH), Department of Health and Human Services (HHS..., from January 1, 1961 through June 30, 1970, for a number of work days aggregating at least 250 work...

76 FR 40733 - National Institute for Occupational Safety and Health, (NIOSH), World Trade Center Health Program...

Science.gov (United States)

2011-07-11

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention National Institute for Occupational Safety and Health, (NIOSH), World Trade Center Health Program Science/Technical Advisory Committee (WTCHP-STAC) Correction: This notice was published in the Federal Register on June 23...

78 FR 56902 - National Institute of Environmental Health Sciences; Notice of Closed Meeting

Science.gov (United States)

2013-09-16

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory Committee Act, as amended (5 U.S.C. App.), notice is hereby given of the following meeting. The meeting will be closed to the public in accordance...

78 FR 64221 - National Institute of Environmental Health Sciences; Notice of Closed Meetings

Science.gov (United States)

2013-10-28

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice of Closed Meetings Pursuant to section 10(d) of the Federal Advisory Committee Act, as amended (5 U.S.C. App.), notice is hereby given of the following meetings. The meetings will be closed to the public in accordance...

Health Services Approach to the Communication Audit

OpenAIRE

Tereza Balcarová

2014-01-01

This paper deals with the use of a communication audit as a tool for evaluating the effectiveness of public relations within health services. The research was conducted within healthcare institutions operating in the Czech Republic. Areas of research questions were focused on these aspects of health services: The approach to the implementation of a communication audit: Is the communication audit tied to the level of public relations effectiveness evaluation? Is the approach influenced by publ...

"Make or buy" decisions in the production of health care goods and services: new insights from institutional economics and organizational theory.

Science.gov (United States)

Preker, A. S.; Harding, A.; Travis, P.

2000-01-01

A central theme of recent health care reforms has been a redefinition of the roles of the state and private providers. With a view to helping governments to arrive at more rational "make or buy" decisions on health care goods and services, we propose a conceptual framework in which a combination of institutional economics and organizational theory is used to examine the core production activities in the health sector. Empirical evidence from actual production modalities is also taken into consideration. We conclude that most inputs for the health sector, with the exception of human resources and knowledge, can be efficiently produced by and bought from the private sector. In the health services of low-income countries most dispersed production forms, e.g. ambulatory care, are already provided by the private sector (non-profit and for-profit). These valuable resources are often ignored by the public sector. The problems of measurability and contestability associated with expensive, complex and concentrated production forms such as hospital care require a stronger regulatory environment and skilled contracting mechanisms before governments can rely on obtaining these services from the private sector. Subsidiary activities within the production process can often be unbundled and outsourced. PMID:10916915

Institutional delivery service utilization in Munisa Woreda, South East Ethiopia: a community based cross-sectional study.

Science.gov (United States)

Amano, Abdella; Gebeyehu, Abebaw; Birhanu, Zelalem

2012-10-08

Reducing maternal morbidity and mortality is a global priority which is particularly relevant to developing countries like Ethiopia. One of the key strategies for reducing maternal morbidity and mortality is increasing institutional delivery service utilization of mothers under the care of skilled birth attendants. The aim of this study was to determine the level of institutional delivery service utilization and associated factors. A community-based cross-sectional survey was conducted from April 1-20, 2011, among mothers who gave birth 12 months before the study began in Munesa Woreda, Arsi Zone, Oromia Region, Southeast Ethiopia. A stratified cluster sampling was used to select a sample of 855 participants. Out of all deliveries, only 12.3% took place at health facilities. Women who were urban residents (AOR = 2.27, 95%CI: 1.17, 4.40), women of age at interview less than 20 years (AOR = 6.06, 95%CI: 1.54, 23.78), women with first pregnancy (AOR = 2.41, 95%CI: 1.17, 4.97) and, women who had ANC visit during the last pregnancy (AOR = 4.18, 95%CI: 2.54, 6.89) were more likely to deliver at health institutions. Secondary and above level of mother`s and husband`s education had also a significant effect on health institution delivery with AOR = 4.31 (95%CI: 1.62, 11.46) and AOR = 2.77 (95%CI: 1.07, 7.19) respectively. Institutional delivery service utilization was found to be low in the study area. Secondary and above level of mother`s and husband`s education, urban residence and ANC visit were amongst the main factors that had an influence on health institution delivery. Increasing the awareness of mothers and their partners about the benefits of institutional delivery services are recommended.

Institutional delivery service utilization in Munisa Woreda, South East Ethiopia: a community based cross-sectional study

Directory of Open Access Journals (Sweden)

Amano Abdella

2012-10-01

Full Text Available Abstract Background Reducing maternal morbidity and mortality is a global priority which is particularly relevant to developing countries like Ethiopia. One of the key strategies for reducing maternal morbidity and mortality is increasing institutional delivery service utilization of mothers under the care of skilled birth attendants. The aim of this study was to determine the level of institutional delivery service utilization and associated factors. Methods A community-based cross-sectional survey was conducted from April 1–20, 2011, among mothers who gave birth 12 months before the study began in Munesa Woreda, Arsi Zone, Oromia Region, Southeast Ethiopia. A stratified cluster sampling was used to select a sample of 855 participants. Results Out of all deliveries, only 12.3% took place at health facilities. Women who were urban residents (AOR = 2.27, 95%CI: 1.17, 4.40, women of age at interview less than 20 years (AOR = 6.06, 95%CI: 1.54, 23.78, women with first pregnancy (AOR = 2.41, 95%CI: 1.17, 4.97 and, women who had ANC visit during the last pregnancy (AOR = 4.18, 95%CI: 2.54, 6.89 were more likely to deliver at health institutions. Secondary and above level of mother`s and husband`s education had also a significant effect on health institution delivery with AOR = 4.31 (95%CI: 1.62, 11.46 and AOR = 2.77 (95%CI: 1.07, 7.19 respectively. Conclusion Institutional delivery service utilization was found to be low in the study area. Secondary and above level of mother`s and husband`s education, urban residence and ANC visit were amongst the main factors that had an influence on health institution delivery. Increasing the awareness of mothers and their partners about the benefits of institutional delivery services are recommended.

The health maintenance organization strategy: a corporate takeover of health services delivery.

Science.gov (United States)

Salmon, J W

1975-01-01

This paper presents a political economic framework for viewing the social organization of the delivery of health care servies and predicting a qualitatively different institutional configuration involving the health maintenance organization. The principal forces impacting American capitalism today are leading to a fundamental restructuring for increased social efficiency of the entire social welfare sector, including the health services industry. The method to achieve this restructuring involves health policy directed at raising the contribution to the social surplus from the delivery of health care services and eventual corporate domination. The health maintenance organization conceptualization is examined with suggestions as to how the HMO strategy promoted by the state leads to this corporate takeover. The mechanism and extent of the present corporate involvement are examined and implications of health services as a social control mechanism are presented.

MEDICAL SERVICES OR MEDICAL CARE – AN URGENT ISSUE FOR PUBLIC HEALTH INSTITUTIONS

Directory of Open Access Journals (Sweden)

E. V. Pesennikova

2017-01-01

Full Text Available Purpose. To consider the relationship between the concepts of “medical service” and “medical care” in the work of public medical institutions, based on the analysis of normative legal documents of the modern period.Materials and methods. In the course of the research, more than 18 legal and regulatory documents that were published during the period from 1990 to 2017 were analyzed, an analysis of judicial practice and related literature sources (periodicals was carried out.Results. The analysis made it possible to distinguish the stages in the development of the organizational and legal framework for the provision of paid medical services in the Russian Federation and the dynamics of the relationship between the terms “medical care” and “medical service”. It was revealed that the concept of “medical services” appeared much later and was associated with the development of paid medical services and the need to establish legal aspects of health care. The provision of medical assistance is regulated mainly by public law, and the provision of medical services is governed by private law. The term “medical care” is broader than the “medical service” from the standpoint of the social aspect. At the same time, the concept of “medical service” can be considered more widely than medical care in cases when it is not only about measures aimed at treating the patient, but also about providing additional services to the patient in the process of receiving medical care.Conclusion. Thus, we concluded that the categories of medical care and medical services should not be identified, but also not completely different concepts, but rather enter into a partial intersection relationship. The need to distinguish between the concepts of “medical care” and “medical service” is dictated not only by the category relations or opinion of the population and the medical community, but also by the need for legal support for the process of

Future of Christian health services – an economic perspective

Directory of Open Access Journals (Sweden)

Steffen Flessa

2016-01-01

Full Text Available Although Christian Health Services have a proud history of healing and compassion especially in developing countries, their future is affected by secular changes in the financing and provision of health care services. However, the nature of life as it is evolving in modern society promises a need for the capacity to deal with increasing dynamics, complexity and uncertainty. In these circumstances the potential capacity of Christians in their institutions and churches to provide Unconditional Reliability suggests a new opportunity. The components of Unconditional Reliability and how they affect the portfolio of Christian Health Services is explained. Effective Christian Health Services will require appropriate analysis of their portfolios.

The Distribution of Health Services in Iran Health Care System: A Case Study at East Azerbaijan

Directory of Open Access Journals (Sweden)

Hassan Almaspoor-khangah

2016-10-01

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.

Building institutions for an effective health system: lessons from China's experience with rural health reform.

Science.gov (United States)

Bloom, Gerald

2011-04-01

This paper is concerned with the management of health system changes aimed at substantially increasing the access to safe and effective health services. It argues that an effective health sector relies on trust-based relationships between users, providers and funders of health services, and that one of the major challenges governments face is to construct institutional arrangements within which these relationships can be embedded. It presents the case of China, which is implementing an ambitious health reform, drawing on a series of visits to rural counties by the author over a 10-year period. It illustrates how the development of reform strategies has been a response both to the challenges arising from the transition to a market economy and the result of actions by different actors, which have led to the gradual creation of increasingly complex institutions. The overall direction of change has been strongly influenced by the efforts made by the political leadership to manage a transition to a modern economy which provides at least some basic benefits to all. The paper concludes that the key lessons for other countries from China's experience with health system reform are less about the detailed design of specific interventions than about its approach to the management of institution-building in a context of complexity and rapid change. Copyright © 2011 Elsevier Ltd. All rights reserved.

The impact of institutional ethics on academic health sciences library leadership: a survey of academic health sciences library directors.

Science.gov (United States)

Tooey, Mary Joan M J; Arnold, Gretchen N

2014-10-01

Ethical behavior in libraries goes beyond service to users. Academic health sciences library directors may need to adhere to the ethical guidelines and rules of their institutions. Does the unique environment of an academic health center imply different ethical considerations? Do the ethical policies of institutions affect these library leaders? Do their personal ethical considerations have an impact as well? In December 2013, a survey regarding the impact of institutional ethics was sent to the director members of the Association of Academic Health Sciences Libraries. The objective was to determine the impact of institutional ethics on these leaders, whether through personal conviction or institutional imperative.

Universal service in Vietnam: An institutional approach

DEFF Research Database (Denmark)

Do Manh, Thai; Falch, Morten

2018-01-01

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

Study on Equity and Efficiency of Health Resources and Services Based on Key Indicators in China.

Directory of Open Access Journals (Sweden)

Xinyu Zhang

Full Text Available This study aims to evaluate the dialectical relationship between equity and efficiency of health resource allocation and health service utilization in China.We analyzed the inequity of health resource allocation and health service utilization based on concentration index (CI and Gini coefficient. Data envelopment analysis (DEA was used to evaluate the inefficiency of resource allocation and service utilization. Factor Analysis (FA was used to determine input/output indicators.The CI of Health Institutions, Beds in Health Institutions, Health Professionals and Outpatient Visits were -0.116, -0.012, 0.038, and 0.111, respectively. Gini coefficient for the 31 provinces varied between 0.05 and 0.43; out of these 23 (742% were observed to be technically efficient constituting the "best practice frontier". The other 8 (25.8% provinces were technically inefficient.Health professionals and outpatient services are focused on higher income levels, while the Health Institutions and Beds in Health Institutions were concentrated on lower income levels. In China, a few provinces attained a basic balance in both equity and efficiency in terms of current health resource and service utilization, thus serving as a reference standard for other provinces.

77 FR 38845 - Office of the Director, National Institutes of Health; Notice of Meeting

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2012-06-29

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health Office of the Director, National Institutes of Health; Notice of Meeting Pursuant to section 10(a) of the Federal Advisory Committee Act, as amended (5 U.S.C. App.), notice is hereby given of a meeting of the Scientific Management Review Board. The NIH Reform Act of 2006 ...

75 FR 21642 - Office of the Director, National Institutes of Health; Notice of Meeting

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2010-04-26

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health Office of the Director, National Institutes of Health; Notice of Meeting Pursuant to section 10(a) of the Federal Advisory Committee Act, as amended (5 U.S.C. App.), notice is hereby given of a meeting of the Scientific Management Review Board. The NIH Reform Act of 2006 (Pub....

75 FR 51466 - Office of the Director, National Institutes of Health; Notice of Meeting

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2010-08-20

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health Office of the Director, National Institutes of Health; Notice of Meeting Pursuant to section 10(a) of the Federal Advisory Committee Act, as amended (5 U.S.C. App.), notice is hereby given of a meeting of the Scientific Management Review Board. The NIH Reform Act of 2006 (Pub....

75 FR 72833 - Office of the Director, National Institutes of Health; Notice of Meeting

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2010-11-26

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health Office of the Director, National Institutes of Health; Notice of Meeting Pursuant to section 10(a) of the Federal Advisory Committee Act, as amended (5 U.S.C. App.), notice is hereby given of a meeting of the Scientific Management Review Board. The NIH Reform Act of 2006 (Pub....

78 FR 15021 - Office of the Director, National Institutes of Health; Notice of Meeting

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2013-03-08

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health Office of the Director, National Institutes of Health; Notice of Meeting Pursuant to section 10(a) of the Federal Advisory Committee Act, as amended (5 U.S.C. App.), notice is hereby given of a meeting hosted by the Scientific Management Review Board. The NIH Reform Act of 200...

78 FR 52552 - Office of the Director, National Institutes of Health; Notice of Meeting

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2013-08-23

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health Office of the Director, National Institutes of Health; Notice of Meeting Pursuant to section 10(a) of the Federal Advisory Committee Act, as amended (5 U.S.C. App.), notice is hereby given of a meeting of the Scientific Management Review Board. The NIH Reform Act of 2006 (Pub....

78 FR 33098 - Office of the Director, National Institutes of Health; Notice of Meeting

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2013-06-03

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health Office of the Director, National Institutes of Health; Notice of Meeting Pursuant to section 10(a) of the Federal Advisory Committee Act, as amended (5 U.S.C. App.), notice is hereby given of a meeting hosted by the NIH Scientific Management Review Board (SMRB). Presentations...

76 FR 62081 - Office of the Director, National Institutes of Health; Notice of Meeting

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2011-10-06

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health Office of the Director, National Institutes of Health; Notice of Meeting Pursuant to section 10(a) of the Federal Advisory Committee Act, as amended (5 U.S.C. App.), notice is hereby given of a meeting of the Scientific Management Review Board. The NIH Reform Act of 2006 (Pub....

75 FR 60132 - Office of the Director, National Institutes of Health; Notice of Meeting

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2010-09-29

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health Office of the Director, National Institutes of Health; Notice of Meeting Pursuant to section 10(a) of the Federal Advisory Committee Act, as amended (5 U.S.C. App.), notice is hereby given of a meeting of the Scientific Management Review Board. The meeting will be open to the...

75 FR 66114 - Office of the Director, National Institutes of Health; Notice of Meeting

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2010-10-27

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health Office of the Director, National Institutes of Health; Notice of Meeting Pursuant to section 10(a) of the Federal Advisory Committee Act, as amended (5 U.S.C. App.), notice is hereby given of a meeting of the Scientific Management Review Board. The NIH Reform Act of 2006 (Pub....

78 FR 63230 - Office of the Director, National Institutes of Health; Notice of Meeting

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2013-10-23

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health Office of the Director, National Institutes of Health; Notice of Meeting Pursuant to section 10(a) of the Federal Advisory Committee Act, as amended (5 U.S.C. App.), notice is hereby given of a stakeholder meeting hosted by the NIH Scientific Management Review Board (SMRB)....

Peace corps partnered health services implementation research in global health: opportunity for impact.

Science.gov (United States)

Dykens, Andrew; Hedrick, Chris; Ndiaye, Youssoupha; Linn, Annē

2014-09-01

There is abundant evidence of the affordable, life-saving interventions effective at the local primary health care level in low- and middle-income countries (LMICs). However, the understanding of how to deliver those interventions in diverse settings is limited. Primary healthcare services implementation research is needed to elucidate the contextual factors that can influence the outcomes of interventions, especially at the local level. US universities commonly collaborate with LMIC universities, communities, and health system partners for health services research but common barriers exist. Current challenges include the capacity to establish an ongoing presence in local settings in order to facilitate close collaboration and communication. The Peace Corps is an established development organization currently aligned with local health services in many LMICs and is well-positioned to facilitate research partnerships. This article explores the potential of a community-Peace Corps-academic partnership approach to conduct local primary healthcare services implementation research. The Peace Corps is well positioned to offer insights into local contextual factors because volunteers work closely with local leaders, have extensive trust within local communities, and have an ongoing, constant, well-integrated presence. However, the Peace Corps does not routinely conduct primary healthcare services implementation research. Universities, within the United States and locally, could benefit from the established resources and trust of the Peace Corps to conduct health services implementation research to advance access to local health services and further the knowledge of real world application of local health services in a diversity of settings. The proposed partnership would consist of (1) a local community advisory board and local health system leaders, (2) Peace Corps volunteers, and (3) a US-LMIC academic institutional collaboration. Within the proposed partnership approach

How institutional forces, ideas and actors shaped population health planning in Australian regional primary health care organisations.

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Javanparast, Sara; Freeman, Toby; Baum, Fran; Labonté, Ronald; Ziersch, Anna; Mackean, Tamara; Reed, Richard; Sanders, David

2018-03-20

Worldwide, there are competing norms driving health system changes and reorganisation. One such norm is that of health systems' responsibilities for population health as distinct from a focus on clinical services. In this paper we report on a case study of population health planning in Australian primary health care (PHC) organisations (Medicare Locals, 2011-2015). Drawing on institutional theory, we describe how institutional forces, ideas and actors shaped such planning. We reviewed the planning documents of the 61 Medicare Locals and rated population health activities in each Medicare Local. We also conducted an online survey and 50 interviews with Medicare Local senior staff, and an interview and focus group with Federal Department of Health staff. Despite policy emphasis on population health, Medicare Locals reported higher levels of effort and capacity in providing clinical services. Health promotion and social determinants of health activities were undertaken on an ad hoc basis. Regulatory conditions imposed by the federal government including funding priorities and time schedules, were the predominant forces constraining population health planning. In some Medicare Locals, this was in conflict with the normative values and what Medicare Locals felt ought to be done. The alignment between the governmental and the cultural-cognitive forces of a narrow biomedical approach privileged clinical practice and ascribed less legitimacy to action on social determinants of health. Our study also shed light on the range of PHC actors and how their agency influenced Medicare Locals' performance in population health. The presence of senior staff or community boards with a strong commitment to population health were important in directing action towards population health and equity. There are numerous institutional, normative and cultural factors influencing population health planning. The experience of Australian Medicare Locals highlights the difficulties of planning in

Forging New Service Paths: Institutional Approaches to Providing Research Data Management Services

Directory of Open Access Journals (Sweden)

Regina Raboin

2012-01-01

Full Text Available Objective: This paper describes three different institutional experiences in developing research data management programs and services, challenges/opportunities and lessons learned.Overview: This paper is based on the Librarian Panel Discussion during the 4th Annual University of Massachusetts and New England Region e-Science Symposium. Librarians representing large public and private research universities presented an overview of service models developed at their respective organizations to bring support for data management and eScience to their communities. The approaches described include two library-based, integrated service models and one collaboratively-staffed, center-based service model.Results: Three institutions describe their experiences in creating the organizational capacity for research data management support services. Although each institutional approach is unique, common challenges include garnering administrative support, managing the integration of services with new or existing staff structures, and continuing to meet researchers needs as they evolve.Conclusions: There is no one way to provide research data management services, but any staff position, committee, or formalized center reflects an overarching organizational commitment to data management support.

42 CFR 431.620 - Agreement with State mental health authority or mental institutions.

Science.gov (United States)

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Agreement with State mental health authority or mental institutions. 431.620 Section 431.620 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... GENERAL ADMINISTRATION Relations With Other Agencies § 431.620 Agreement with State mental health...

Patient-professional interactions in mental health institutions in Denmark

DEFF Research Database (Denmark)

Ringer, Agnes

Although qualitative research within the field of mental health is growing, few studies of everyday communication between service users and multidisciplinary professionals within mental health institutions exist. This study examines the everyday interactions between mental health professionals...... by discursive and narrative approaches, the aim of the study is to shed light on how the professionals and users construct patient identities. How are the users and the professionals positioned in their interactions? How are concepts such as psychiatric diagnosis and mental illness negotiated within...

[Health services research for the public health service (PHS) and the public health system].

Science.gov (United States)

Hollederer, A; Wildner, M

2015-03-01

There is a great need for health services research in the public health system and in the German public health service. However, the public health service is underrepresented in health services research in Germany. This has several structural, historical and disciplinary-related reasons. The public health service is characterised by a broad range of activities, high qualification requirements and changing framework conditions. The concept of health services research is similar to that of the public health service and public health system, because it includes the principles of multidisciplinarity, multiprofessionalism and daily routine orientation. This article focuses on a specified system theory based model of health services research for the public health system and public health service. The model is based on established models of the health services research and health system research, which are further developed according to specific requirements of the public health service. It provides a theoretical foundation for health services research on the macro-, meso- and microlevels in public health service and the public health system. Prospects for public health service are seen in the development from "old public health" to "new public health" as well as in the integration of health services research and health system research. There is a significant potential for development in a better linkage between university research and public health service as is the case for the "Pettenkofer School of Public Health Munich". © Georg Thieme Verlag KG Stuttgart · New York.

75 FR 65018 - National Institute for Occupational Safety and Health; Designation of a Class of Employees for...

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2010-10-21

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institute for Occupational Safety and Health... Occupational Safety and Health (NIOSH), Department of Health and Human Services (HHS). ACTION: Notice. SUMMARY... aggregating at least 250 work days, occurring either solely under this employment, or in combination with work...

75 FR 57024 - National Institute for Occupational Safety and Health; Designation of a Class of Employees for...

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2010-09-17

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institute for Occupational Safety and Health... Occupational Safety and Health (NIOSH), Department of Health and Human Services (HHS). ACTION: Notice. SUMMARY... number of work days aggregating at least 250 work days, occurring either solely under this employment or...

75 FR 32783 - National Institute for Occupational Safety and Health; Designation of a Class of Employees for...

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2010-06-09

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institute for Occupational Safety and Health... Occupational Safety and Health (NIOSH), Department of Health and Human Services (HHS). ACTION: Notice. SUMMARY... aggregating at least 250 work days, occurring either solely under this employment or in combination with work...

Focus on vulnerable populations and promoting equity in health service utilization--an analysis of visitor characteristics and service utilization of the Chinese community health service.

Science.gov (United States)

Dong, Xiaoxin; Liu, Ling; Cao, Shiyi; Yang, Huajie; Song, Fujian; Yang, Chen; Gong, Yanhong; Wang, Yunxia; Yin, Xiaoxu; Xu, Xing; Xie, Jun; Sun, Yi; Lu, Zuxun

2014-05-26

Community health service in China is designed to provide a convenient and affordable primary health service for the city residents, and to promote health equity. Based on data from a large national study of 35 cities across China, we examined the characteristics of the patients and the utilization of community health institutions (CHIs), and assessed the role of community health service in promoting equity in health service utilization for community residents. Multistage sampling method was applied to select 35 cities in China. Four CHIs were randomly chosen in every district of the 35 cities. A total of 88,482 visitors to the selected CHIs were investigated by using intercept survey method at the exit of the CHIs in 2008, 2009, 2010, and 2011. Descriptive analyses were used to analyze the main characteristics (gender, age, and income) of the CHI visitors, and the results were compared with that from the National Health Services Survey (NHSS, including CHIs and higher levels of hospitals). We also analyzed the service utilization and the satisfactions of the CHI visitors. The proportions of the children (2.4%) and the elderly (about 22.7%) were lower in our survey than those in NHSS (9.8% and 38.8% respectively). The proportion of the low-income group (26.4%) was apparently higher than that in NHSS (12.5%). The children group had the lowest satisfaction with the CHIs than other age groups. The satisfaction of the low-income visitors was slightly higher than that of the higher-income visitors. The utilization rate of public health services was low in CHIs. The CHIs in China appears to fulfill the public health target of uptake by vulnerable populations, and may play an important role in promoting equity in health service utilization. However, services for children and the elderly should be strengthened.

Magnitude and factors associated with institutional delivery service utilization among childbearing mothers in Cheha district, Gurage zone, SNNPR, Ethiopia: a community based cross sectional study.

Science.gov (United States)

Habte, Feleke; Demissie, Meaza

2015-11-17

Ethiopia is one of the six countries that contributes' to more than 50 % of worldwide maternal deaths. While it is revealed that delivery attended by skilled provider at health facility reduced maternal deaths, more than half of all births in Ethiopia takes place at home. According to EDHS 2011 report nine women in every ten deliver at home in Ethiopia. The situation is much worse in southern region. The aim of our study is to measure the prevalence and to identify factors associated with institutional delivery service utilization among childbearing mothers in Cheha District, SNNPR, Ethiopia. A community based cross sectional survey was conducted in Cheha District from Dec 22, 2012 to Jan 11, 2013. Multistage sampling method was employed and 816 women who gave birth within the past 2 years and lived in Cheha district for minimum of one year prior to the survey were involved in the study. Data was entered and analyzed using Epi Info Version 7 and SPSS Version 16. Frequencies and binary logistic regression were done. Factors affecting institutional delivery were determined using multivariate logistic regression. A total of 31 % of women gave birth to their last child at health facility. Place of residence, ability to afford for the whole process to get delivery service at health facility, traveling time that takes to reach to health institution which provides delivery service, husband's attitude towards institutional delivery, counseling about where to deliver during ANC visit and place of birth of the 2(nd) youngest child were found to have statistically significant association with institutional delivery. Institutional delivery is low in the study area. Access to health service was found to be the most important predictor of institutional delivery among others. Accessing health facility within reasonable travel time; providing health education and BCC services to husbands and the community at large on importance of using health institution for delivery service

SPECIFIC OF ACCOUNTING OF NON-FINANCIAL ASSETS IN HEALTH INSTITUTIONS

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Natalya Pryadka

2016-11-01

Full Text Available The purpose of the paper is to analysis of the modern state of accounting of non-financial assets and present accounting in health institutions protection during the period of medical reforms. The account of nonfinancial assets has his specific in medical establishments. Reforms, which implemented in Ukraine, affecting the account of non-financial assets. Medical institutions relate to the General government. Methodology. The survey is based on a comparison of data from the national and international reforms in medical industry. Results of the survey showed that in the dictionary of V. Raizberg next determination is driven: "public sector – it is a set of business units, that carry out economic activity, are in a public domain, controlled by public authorities or designated and hired persons" (Raizberg, 1999. In the Commercial code of Ukraine it is indicated: "The subjects of public sector of economy are subjects that operate on the basis of only public domain, and also subjects, which state share in authorized capital exceeds fifty percents or be value that provides a right to the state for decisive influence on economic activity of these subjects" (СС, 2003. Practical implications. Public sector structure specifies data of International Public Sector Accounting Standards. Substancial load concept "public sector" in national and international practice are relevant (Poznyakovska, 2009. Accounting in health institutions has specific terms, inherent to the government sector. They are determined by the types of activity and terms of assignation (Pasichnik, 2005. Medical services must be accessible to all stratum of population. They must have free basis. They come forward as a public benefit independent of individual possibility to pay for him. Therefore lion's part of general charges for health protection is used on the grant of medical services to the population. At the same time "upgrading of medical services lies inplane providing of

Radiation protection instrumentation at the Andalusian health service

International Nuclear Information System (INIS)

Herrador Cordoba, M.; Garcia Rotllan, J.

1997-01-01

In Andalusia the contributions of radiological risks in the nuclear industry and of natural radiation are small and the same holds for medical applications of individuals and research. The performance models in radiation protection is monitored by the Andalusian Health Service through the public health institutions. This short communication describes the model and results obtained

Determinants of institutional delivery service utilization among pastorals of Liben Zone, Somali Regional State, Ethiopia, 2015

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Zepro NB

2016-12-01

Full Text Available Nejimu Biza Zepro,1 Ahmed Tahir Ahmed2 1College of Health Sciences, Samara University, Samara, Afar, Ethiopia; 2College of Health Science, Jigjiga University, Jigjiga, Somali, Ethiopia Abstract: Maternal health service utilizations are poorly equipped, inaccessible, negligible, and not well documented in the pastoral society. This research describes a quantitative and qualitative study on the determinants of institutional delivery among pastoralists of Liben Zone with special emphasis on Filtu and Deka Suftu woredas of Somali Region, Ethiopia. The study was funded by the project “Fostering health care for refugees and pastoral communities in Somali Region, Ethiopia”. This community-based cross-sectional study was conducted during November 2015. Interviews through a questionnaire and focus group discussions were used to collect the data. Proportional to size allocation followed by systematic sampling technique was used to identify the study units. The major determinants of institutional delivery in the study area were as follows: being apparently healthy, lack of knowledge, long waiting time, poor quality services, cultural beliefs, religious misconception, partner decision, and long travel. Around one-third (133, 34.5% of the women had visited at least once for their pregnancy. More than half (78, 58.6% of the women had visited health facilities due to health problems and only 27 (19.9% women had attended the recommended four antenatal care visits. Majority (268, 69.6% of the pregnant women preferred to give birth at home. Women who attended antenatal care were two times more likely to deliver at health facilities (AOR, 95% confidence interval [CI] =2.38, 1.065–4.96. Women whose family members preferred health facilities had 14 times more probability to give birth in health institutions (AOR, 95% CI =13.79, 5.28–35.8. Women living in proximity to a health facility were 13 times more likely to give birth at health facilities than women

Health-enabling technologies for pervasive health care: on services and ICT architecture paradigms.

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Haux, Reinhold; Howe, Jurgen; Marschollek, Michael; Plischke, Maik; Wolf, Klaus-Hendrik

2008-06-01

Progress in information and communication technologies (ICT) is providing new opportunities for pervasive health care services in aging societies. To identify starting points of health-enabling technologies for pervasive health care. To describe typical services of and contemporary ICT architecture paradigms for pervasive health care. Summarizing outcomes of literature analyses and results from own research projects in this field. Basic functions for pervasive health care with respect to home care comprise emergency detection and alarm, disease management, as well as health status feedback and advice. These functions are complemented by optional (non-health care) functions. Four major paradigms for contemporary ICT architectures are person-centered ICT architectures, home-centered ICT architectures, telehealth service-centered ICT architectures and health care institution-centered ICT architectures. Health-enabling technologies may lead to both new ways of living and new ways of health care. Both ways are interwoven. This has to be considered for appropriate ICT architectures of sensor-enhanced health information systems. IMIA, the International Medical Informatics Association, may be an appropriate forum for interdisciplinary research exchange on health-enabling technologies for pervasive health care.

Relation among the level of development of the competences in the managers of the health services and the institutional quality, Antioquia, 2005

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Libardo A. Giraldo G

2008-06-01

Full Text Available Objective: to determine the relationship between the level of development of the competences of the managers of health services in Antioquia as well as the quality of the institution they conduct. Methodology: a probabilistic stratified random sampling by level of complexity was done and then a simple random sampling in each one. 112 managers constituted the sample. Four instruments were used; three of them to evaluate the competence level of the managers and the other one to evaluate the level of institutional quality. Results: the development of the competences among managers was found between the basic and inexperienced levels, showing a poor performance in their management tasks. Additionally, a high correlation among competences was also identified indicating that the high or low level of development of a competence directly affects the performance of the manager. The quality of the institutions showed levels of business development between incipient and medium, thus revealing some sort of functional units which are determinant in the business development, such as service operations, planning, management control, and marketing. Finally, it was shown that the presence of some competences in the manager positively impacts the development of the functional units. Thus the performance of managers has direct effects on the success or failure of the institution.

77 FR 40622 - Mine Safety and Health Research Advisory Committee, National Institute for Occupational Safety...

Science.gov (United States)

2012-07-10

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Mine Safety and Health Research Advisory Committee, National Institute for Occupational Safety and Health (MSHRAC, NIOSH..., oxygen supply partnership, safety culture, occupational health and safety management systems, preventing...

From theory to practice: improving the impact of health services research

Directory of Open Access Journals (Sweden)

Levine Robert

2005-01-01

Full Text Available Abstract Background While significant strides have been made in health research, the incorporation of research evidence into healthcare decision-making has been marginal. The purpose of this paper is to provide an overview of how the utility of health services research can be improved through the use of theory. Integrating theory into health services research can improve research methodology and encourage stronger collaboration with decision-makers. Discussion Recognizing the importance of theory calls for new expectations in the practice of health services research. These include: the formation of interdisciplinary research teams; broadening the training for those who will practice health services research; and supportive organizational conditions that promote collaboration between researchers and decision makers. Further, funding bodies can provide a significant role in guiding and supporting the use of theory in the practice of health services research. Summary Institutions and researchers should incorporate the use of theory if health services research is to fulfill its potential for improving the delivery of health care.

Health-related behaviour among managers of Slovenian hospitals and institutes of public health

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Jerneja Farkas

2015-12-01

Full Text Available Aim: Behavioural risk factors have a significant impact on health. We aimed to assess health-related behaviour, health status, and use of healthcare services among managers of Slovenian hospitals and institutes of public health. Methods: This was a cross-sectional study which included management (directors, scientific directors, directors’ deputies of Slovenian hospitals and institutes of public health (63 respondents; 57% women; overall mean age: 51±7 years; response rate: 74%. Data were obtained using an anonymous self-administered questionnaire. Results: About 35% of respondents were directors. More than half of the respondents were overweight or obese (52%, the majority were not sufficiently physically active (59% and overloaded with stress (87%. Hypercholesterolemia (36%, spinal disease (17%, and arterial hypertension (16% were most common chronic diseases. Whilst only few participants visited their general practitioner due their health complaints, blood pressure (76%, cholesterol (51%, and glucose (54% were measured within last year in most of the respondents. Conclusion: Our findings point to a high prevalence of overweight and obesity as well as workplace-related stress among Slovenian public health managers. Therefore, effective preventive strategies should be focused on stress management along with promotion of healthy behavioural patterns.

Public health care providers and market competition: the case of Finnish occupational health services.

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Kankaanpää, Eila; Linnosmaa, Ismo; Valtonen, Hannu

2011-02-01

As reforms in publicly funded health systems rely heavily on competition, it is important to know if and how public providers react to competition. In many European countries, it is empirically difficult to study public providers in different markets, but in Finnish occupational health services, both public and private for-profit and non-profit providers co-exist. We studied possible differences in public providers' performance (price, intensity of services, service mix-curative medical services/prevention, productivity and revenues) according to the competitiveness of the market. The Finnish Institute of Occupational Health (FIOH) collected data on clients, services and personnel for 1992, 1995, 1997, 2000 and 2004 from occupational health services (OHS) providers. Employers defray the costs of OHS and apply for reimbursement from the Social Insurance Institution (SII). The SII data was merged with FIOH's questionnaire. The unbalanced panel consisted of about 230 public providers, totalling 1,164 observations. Local markets were constructed from several municipalities based on commuting practices and regional collaboration. Competitiveness of the market was measured by the number of providers and by the Herfindahl index. The effect of competition was studied by ordinary least square regression analysis and panel models. The more competitive the environment was for a public provider the higher were intensity, productivity and the share of medical care. Fixed panel models showed that these differences were not due to differences and changes in the competitiveness of the market. Instead, in more competitive markets public providers had higher unit prices and higher revenues.

Mental Health Services in South Africa: Scaling up and future ...

African Journals Online (AJOL)

“No health without mental health” has become a rallying call for the World Health Organization and numerous service providers, training institutions, health researchers, and advocacy groups around the world. It is timely to consider the implications of this call for South Africa. We review key evidence regarding the burden ...

Developing Institutional Capacity for Reproductive Health in Humanitarian Settings: A Descriptive Study.

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Nguyen-Toan Tran

Full Text Available Institutions play a central role in advancing the field of reproductive health in humanitarian settings (RHHS, yet little is known about organizational capacity to deliver RHHS and how this has developed over the past decade. This study aimed to document the current institutional experiences and capacities related to RHHS.Descriptive study using an online questionnaire tool.Respondents represented 82 institutions from 48 countries, of which two-thirds originated from low-and middle-income countries. RHHS work was found not to be restricted to humanitarian agencies (25%, but was also embraced by development organizations (25% and institutions with dual humanitarian and development mandates (50%. Agencies reported working with refugees (81%, internally-displaced (87% and stateless persons (20%, in camp-based settings (78%, and in urban (83% and rural settings (78%. Sixty-eight percent of represented institutions indicated having an RHHS-related policy, 79% an accountability mechanism including humanitarian work, and 90% formal partnerships with other institutions. Seventy-three percent reported routinely appointing RH focal points to ensure coordination of RHHS implementation. There was reported progress in RHHS-related disaster risk reduction (DRR, emergency management and coordination, delivery of the Minimum Initial Services Package (MISP for RH, comprehensive RH services in post-crisis/recovery situations, gender mainstreaming, and community-based programming. Other reported institutional areas of work included capacity development, program delivery, advocacy/policy work, followed by research and donor activities. Except for abortion-related services, respondents cited improved efforts in advocacy, capacity development and technical support in their institutions for RHHS to address clinical services, including maternal and newborn health, sexual violence prevention and response, HIV prevention, management of sexually-transmitted infections

78 FR 64504 - Safety and Occupational Health Study Section (SOHSS), National Institute for Occupational Safety...

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2013-10-29

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Safety and Occupational Health Study Section (SOHSS), National Institute for Occupational Safety and Health (NIOSH or..., Number 177, Pages 56235-56236. Contact Person for More Information: Price Connor, Ph.D., NIOSH Health...

77 FR 27776 - Safety and Occupational Health Study Section (SOHSS), National Institute for Occupational Safety...

Science.gov (United States)

2012-05-11

... Occupational Health Study Section (SOHSS), National Institute for Occupational Safety and Health (NIOSH) In... Services Office, CDC, pursuant to Public Law 92-463. Purpose: The Safety and Occupational Health Study... standard grants review and funding cycles pertaining to research issues in occupational safety and health...

76 FR 18220 - Safety and Occupational Health Study Section (SOHSS), National Institute for Occupational Safety...

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2011-04-01

... Occupational Health Study Section (SOHSS), National Institute for Occupational Safety and Health (NIOSH) In... Services Office, CDC, pursuant to Public Law 92-463. Purpose: The Safety and Occupational Health Study... standard grants review and funding cycles pertaining to research issues in occupational safety and health...

78 FR 40743 - Mine Safety and Health Research Advisory Committee, National Institute for Occupational Safety...

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2013-07-08

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Mine Safety and Health Research Advisory Committee, National Institute for Occupational Safety and Health (MSHRAC, NIOSH... Director, NIOSH, on priorities in mine safety and health research, including grants and contracts for such...

[A risk-based monitoring model for health care service institutions as a tool to protect health rights in Peru].

Science.gov (United States)

Benites-Zapata, Vicente A; Saravia-Chong, Héctor A; Mezones-Holguin, Edward; Aquije-Díaz, Allen J; Villegas-Ortega, José; Rossel-de-Almeida, Gustavo; Acosta-Saal, Carlos; Philipps-Cuba, Flor

2016-01-01

To describe the monitoring model of the Health Care Service Institutions (HCSI) of the National Health Authority (NHA) and assess the factors associated with risk-adjusted normative compliance (%RANC) within the Peruvian Health System (PHS). We carried out a case study of the experience of the NHA in the development and implementation of a monitoring program based on the ISO 31000-2009. With HCSI as the units of analysis, we calculated the %RANC (a scorein continuous scale ranging from 0 to 100) for comprehensive monitoring (CM) and for specific evaluations made from 2013 to 2015. A higher score in the %RANC means lower operational risk. Also, slope coefficients (β) and their 95% confidence intervals (95% CI) were estimated using generalized linear models to estimate the association between %RANC as outcome, and health subsector, region, level of care and year, as explanatory variables. The NHA made 1444 evaluations. For CM, only the Social Security Administration had higher %RANC than private centers (β=7.7%; 95% CI 3.5 to 11.9). The HCSI of the coastal region (β=-5.2, 95% CI -9.4 to -1.0), andean region (β=-12.5; 95% CI -16.7 to -8.3) and jungle region (β=-12.6, 95% CI% -17.7 to -7.6) had lower %RANC than those located in Lima Metropolitan area. %RANC was higher in 2015 than 2013 (β=10.8; 95% CI 6.4 to 15.3). The %RANC differs by health subsector, region and year of supervision. For CM, the HCSI in the Social Security Administration and in the Lima Metropolitan area had better scores, and scores improved over time. The implementation of actions aimed at improving %RANC in order to foster the full exercise of health rights in the PHS is suggested.

75 FR 12554 - Mine Safety and Health Research Advisory Committee, National Institute for Occupational Safety...

Science.gov (United States)

2010-03-16

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Mine Safety and Health Research Advisory Committee, National Institute for Occupational Safety and Health (MSHRAC, NIOSH... priorities in mine safety and health research, including grants and contracts for such research, 30 U.S.C...

Service learning in teacher education: an institutional model for an ...

African Journals Online (AJOL)

Interest in service learning is growing at a time of curriculum change in teacher education and institutional change in higher education in South Africa. This raises the question ";What models are available to guide institutions to develop service learning?"; This article outlines Pollack's typology of institutional responses to ...

42 CFR 93.213 - Institution.

Science.gov (United States)

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false Institution. 93.213 Section 93.213 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS AND HEALTH EFFECTS STUDIES OF HAZARDOUS SUBSTANCES RELEASES AND FACILITIES PUBLIC HEALTH SERVICE POLICIES ON RESEARCH...

Implementation and integration of regional health care data networks in the Hellenic National Health Service.

Science.gov (United States)

Lampsas, Petros; Vidalis, Ioannis; Papanikolaou, Christos; Vagelatos, Aristides

2002-12-01

Modern health care is provided with close cooperation among many different institutions and professionals, using their specialized expertise in a common effort to deliver best-quality and, at the same time, cost-effective services. Within this context of the growing need for information exchange, the demand for realization of data networks interconnecting various health care institutions at a regional level, as well as a national level, has become a practical necessity. To present the technical solution that is under consideration for implementing and interconnecting regional health care data networks in the Hellenic National Health System. The most critical requirements for deploying such a regional health care data network were identified as: fast implementation, security, quality of service, availability, performance, and technical support. The solution proposed is the use of proper virtual private network technologies for implementing functionally-interconnected regional health care data networks. The regional health care data network is considered to be a critical infrastructure for further development and penetration of information and communication technologies in the Hellenic National Health System. Therefore, a technical approach was planned, in order to have a fast cost-effective implementation, conforming to certain specifications.

Institute for Communication, General Services, Administration

International Nuclear Information System (INIS)

Legrain, C.

2007-01-01

The article describes the key activities of the Institute for Communication, General Services and Administration (CSA) of the Belgian Nuclear Research Centre SCK-CEN. CSA deals with communication and knowledge management and co-ordinates courses on the fundamentals and applications of nuclear research. CSA also comprises the administrative, financial, logistic and central technical services, as well as human resources and ICT

Antenatal care service quality increases the odds of utilizing institutional delivery in Bahir Dar city administration, North Western Ethiopia: A prospective follow up study.

Science.gov (United States)

Ejigu Tafere, Tadese; Afework, Mesganaw Fanthahun; Yalew, Alemayehu Worku

2018-01-01

In Ethiopia, more than 62% of pregnant women attend antenatal care at least once, yet only about one in four women give birth at health facility. This gap has fueled the need to investigate on the quality of ANC services at public health facilities and its link with the use of institutional delivery. To assess the linkage between ANC quality and the use of institutional delivery among pregnant women attending ANC at public health facilities of BDR City Administration. A facility based prospective follow up study was conducted. and nine hundred seventy pregnant women with gestational age ≤ 16 weeks who came for their first ANC visit were enrolled.Women were followed from their first ANC visit until delivery. Longitudinal data was collected during consultation with ANC providers using structured observation checklist. ANC service was considered as acceptable quality if women received ≥75th percentile of the essential ANC services. Generalized Estimating Equation (GEE) was carried out to control cluster effect among women who received ANC in the same facility. Among 823 pregnant women who completed follow up, only about one third (27.6%) received acceptable quality of ANC services. In one health facility syphilis test was not done at all for the last two years. The odds of giving birth at health institution among pregnant women who received acceptable ANC quality service was about 3.38 times higher than among pregnant women who received unacceptable ANC quality service (AOR = 3.38, 95% CI: 1.67, 6.83). In this study the quality of ANC service provision in public health facilities was compromised/low. Provision of quality ANC service had a great role in promoting institutional delivery. Therefore the local authorities at each level of health sector or the nongovernmental organizations working to improve maternal health need to provide training on focused antenatal care protocol for ANC providers.

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

Science.gov (United States)

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

2015-01-01

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

An analysis on intersectional collaboration on non-communicable chronic disease prevention and control in China: a cross-sectional survey on main officials of community health service institutions.

Science.gov (United States)

Li, Xing-Ming; Rasooly, Alon; Peng, Bo; JianWang; Xiong, Shu-Yu

2017-11-10

Our study aimed to design a tool of evaluating intersectional collaboration on Non-communicable Chronic Disease (NCD) prevention and control, and further to understand the current status of intersectional collaboration in community health service institutions of China. We surveyed 444 main officials of community health service institutions in Beijing, Tianjin, Hubei and Ningxia regions of China in 2014 by using a questionnaire. A model of collaboration measurement, including four relational dimensions of governance, shared goals and vision, formalization and internalization, was used to compare the scores of evaluation scale in NCD management procedures across community healthcare institutions and other ones. Reliability and validity of the evaluation tool on inter-organizational collaboration on NCD prevention and control were verified. The test on tool evaluating inter-organizational collaboration in community NCD management revealed a good reliability and validity (Cronbach's Alpha = 0.89,split-half reliability = 0.84, the variance contribution rate of an extracted principal component = 49.70%). The results of inter-organizational collaboration of different departments and management segments showed there were statistically significant differences in formalization dimension for physical examination (p = 0.01).There was statistically significant difference in governance dimension, formalization dimension and total score of the collaboration scale for health record sector (p = 0.01,0.00,0.00). Statistical differences were found in the formalization dimension for exercise and nutrition health education segment (p = 0.01). There were no statistically significant difference in formalization dimension of medication guidance for psychological consultation, medical referral service and rehabilitation guidance (all p > 0.05). The multi-department collaboration mechanism of NCD prevention and control has been rudimentarily established. Community management

Ingredients for Success: Strategies to Support Local Food Use in Health Care Institutions.

Science.gov (United States)

Linton, Emily; Keller, Heather; Duizer, Lisa

2018-06-12

There is growing interest in use of local food within health care institutions such as hospitals and long-term care homes. This study explored stakeholder perspectives on (i) influences on local food use and (ii) strategies that support success and sustainability of use in health care institutions. Fifteen participants who were institutional leaders with experience in implementing or supporting local food use in health care institutions in Ontario were recruited through purposeful and snowball sampling. A semi-structured interview was conducted by telephone and audio-recorded. Qualitative content analysis identified that influences on local food use were: product availability, staff and management engagement, and legislation and resources (e.g., funding, labour). Several strategies were offered for building and sustaining success including: setting goals, requesting local food availability from suppliers, and more clearly identifying local foods in product lists. The influences and potential strategies highlighted in this paper provide a greater understanding for dietitians and food service managers on how local foods can be incorporated into health care institutions.

Institutional Delivery Service Utilization among Women from Rural Districts of Wolaita and Dawro Zones, Southern Ethiopia; a Community Based Cross-Sectional Study.

Directory of Open Access Journals (Sweden)

Mihiretu Alemayehu Arba

Full Text Available The highest number of maternal deaths occur during labour, delivery and the first day after delivery highlighting the critical need for good quality care during this period. Therefore, for the strategies of institutional delivery to be effective, it is essential to understand the factors that influence individual and household factors to utilize skilled birth attendance and institutions for delivery. This study was aimed to assess factors affecting the utilization of institutional delivery service of women in rural districts of Wolaita and Dawro Zones.A community based cross-sectional study was done among mothers who gave birth within the past one year preceding the survey in Wolaita and Dawro Zones, from February 01 -April 30, 2015 by using a three stage sampling technique. Initially, 6 districts were selected randomly from the total of 17 eligible districts. Then, 2 kebele from each district was selected randomly cumulating a total of 12 clusters. Finally, study participants were selected from each cluster by using systematic sampling technique. Accordingly, 957 mothers were included in the survey. Data was collected by using a pretested interviewer administered structured questionnaire. The questionnaire was prepared by including socio-demographic variables and variables of maternal health service utilization factors. Data was entered using Epi-data version 1.4.4.0 and exported to SPSS version 20 for analysis. Bivariate and multiple logistic regressions were applied to identify candidate and predictor variables respectively.Only 38% of study participants delivered the index child at health facility. Husband's educational status, wealth index, average distance from nearest health facility, wanted pregnancy, agreement to follow post-natal care, problem faced during delivery, birth order, preference of health professional for ante-natal care and maternity care were predictors of institutional delivery.The use of institutional delivery service is

Institutional Delivery Service Utilization among Women from Rural Districts of Wolaita and Dawro Zones, Southern Ethiopia; a Community Based Cross-Sectional Study.

Science.gov (United States)

Arba, Mihiretu Alemayehu; Darebo, Tadele Dana; Koyira, Mengistu Meskele

2016-01-01

The highest number of maternal deaths occur during labour, delivery and the first day after delivery highlighting the critical need for good quality care during this period. Therefore, for the strategies of institutional delivery to be effective, it is essential to understand the factors that influence individual and household factors to utilize skilled birth attendance and institutions for delivery. This study was aimed to assess factors affecting the utilization of institutional delivery service of women in rural districts of Wolaita and Dawro Zones. A community based cross-sectional study was done among mothers who gave birth within the past one year preceding the survey in Wolaita and Dawro Zones, from February 01 -April 30, 2015 by using a three stage sampling technique. Initially, 6 districts were selected randomly from the total of 17 eligible districts. Then, 2 kebele from each district was selected randomly cumulating a total of 12 clusters. Finally, study participants were selected from each cluster by using systematic sampling technique. Accordingly, 957 mothers were included in the survey. Data was collected by using a pretested interviewer administered structured questionnaire. The questionnaire was prepared by including socio-demographic variables and variables of maternal health service utilization factors. Data was entered using Epi-data version 1.4.4.0 and exported to SPSS version 20 for analysis. Bivariate and multiple logistic regressions were applied to identify candidate and predictor variables respectively. Only 38% of study participants delivered the index child at health facility. Husband's educational status, wealth index, average distance from nearest health facility, wanted pregnancy, agreement to follow post-natal care, problem faced during delivery, birth order, preference of health professional for ante-natal care and maternity care were predictors of institutional delivery. The use of institutional delivery service is low in the study

How Children Aged 0 to 6 Benefits from Health Services, Permanent Service Resources and the Factors Affecting Them

Directory of Open Access Journals (Sweden)

Saliha Altiparmak

2012-10-01

Full Text Available Abstract Aim: Aim of the research is “How children aged 0 to 6 benefit from health services, permanent service resources and the factors affecting them”. Material and Methods: The 3839 children aged 0-72 months and followed by the 3rd Family Health Center in Manisa comprise the population of this descriptive study. The sample size was determined as 192 based on the Epi info Statcalc statistical program with a prevalence of 8.3%, a sampling error of 12:05, and a confidence limit of 99%. In the study, the following two forms were used: socio-demographic questionnaire, evaluation form for the use of health services. The data were evaluated with the 15.00 SPSS package program. To assess the data points, chi-square test and descriptive statistics such as percentage were used. Results: The distribution of age groups of the children participating in the study is 37.4 ± 22.3 months (min: 0 months, max: 72 months. Of the children in the study, 52.1% were male. Of the 0-6 age group children in the study, 28.6% had a health problem and 20.8% presented to a medical facility. The institutions preferred most were state institutions. All of the children received at least one preventive health service. Of the children, 78.1% had permanent health care and 57.3% of them received health care from family health centers. There was a statistically significant difference between children with and without a congenital disease, and between children with and without social security. Conclusion: One of the results obtained from this study suggests that children with a congenital disease are expected to apply to health facilities more often. Another result is that having health insurance is an important factor which increases the use of health services. [TAF Prev Med Bull 2012; 11(5.000: 599-608

Utilization of institutional delivery service at Wukro and Butajera districts in the Northern and South Central Ethiopia

Science.gov (United States)

2014-01-01

Background Ethiopia has one of the highest maternal mortality in the world. Institutional delivery is the key intervention in reducing maternal mortality and complications. However, the uptake of the service has remained low and the factors which contribute to this low uptake appear to vary widely. Our study aims to determine the magnitude and identify factors affecting delivery at health institution in two districts in Ethiopia. Methods A community based cross sectional household survey was conducted from January to February 2012 in 12 randomly selected villages of Wukro and Butajera districts in the northern and south central parts of Ethiopia, respectively. Data were collected using a pretested questionnaire from 4949 women who delivered in the two years preceding the survey. Results One in four women delivered the index child at a health facility. Among women who delivered at health facility, 16.1% deliveries were in government hospitals and 7.8% were in health centers. The factors that significantly affected institutional delivery in this study were district in which the women lived (AOR: 2.21, 95% CI: 1.28, 3.82), women age at interview (AOR: 1.96, 95% CI: 1.05, 3.62), women’s education (AOR: 3.53, 95% CI: 1.22, 10.20), wealth status (AOR: 16.82, 95% CI: 7.96, 35.54), women’s occupation (AOR: 1.50, 95% CI: 1.01, 2.24), antenatal care (4+) use (AOR: 1.77, 95% CI: 1.42, 2.20), and number of pregnancies (AOR: 0.25, 95% CI: 0.18,0.35). We found that women who were autonomous in decision making about place of delivery were less likely to deliver in health facility (AOR: 0.38, 95% CI: 0.23,0.63). Conclusions Institutional delivery is still low in the Ethiopia. The most important factors that determine use of institutional delivery appear to be women education and household economic status. Women’s autonomy in decision making on place of delivery did not improve health facility delivery in our study population. Actions targeting the disadvantaged, improving

What Impact Does Behavior of Doctors and Patients on Service Integration of Multi-institutional Readmission cross Township—county Hospitals in Rural China

OpenAIRE

Zhang, Yan; Tang, Wenxi; Zhang, Liang

2017-01-01

Background: With the change of rural residents’ disease spectrum and patients with chronic diseases boom, multi-institutional health service utilization of rural residents and the continuous service demands are growing sharply in rural China.Objective: Evaluate the service integration of multi-institutional readmission cross township—county hospitals (MRCTCH) in rural China, and figure out determines of service integration.Methods: This study featured 7 sample counties in rural China. Based o...

Exploring health insurance services in Sudan from the perspectives of insurers.

Science.gov (United States)

Salim, Anas Mustafa Ahmed; Hamed, Fatima Hashim Mahmoud

2018-01-01

It has been 20 years since the introduction of health insurance in Sudan. This study was the first one that explored health insurance services in Sudan from the perspectives of the insurers. This was a qualitative, exploratory, interview study. The sampling frame was the list of Social Health Insurance and Private Health Insurance institutions in Sudan. Participants were selected from the four Social Health Insurance institutions and from five Private Health Insurance companies. The study was conducted in January and February 2017. In-depth individual interviews were conducted with a convenient sample of key executives from the different health insurers. Ideas and themes were identified and analysed using thematic analysis. The result showed that universal coverage was not achieved despite long time presence of Social Health Insurance and Private Health Insurance in Sudan. All participants described their services as comprehensive. All participants have good perception of the quality of the services they provide, although none of them investigated customer satisfaction. The main challenges facing Social Health Insurance are achieving universal coverage, ensuring sustainability and recruitment of the informal sector and self-employed population. Consumers' affordability of the premiums is the main obstacle for Private Health Insurance, while rising healthcare cost due to economic inflation is a challenge facing both Social Health Insurance and Private Health Insurance. In spite of the presence of Social Health Insurance and Private Health Insurance in Sudan, the country is still far from achieving universal coverage. Moreover, the sustainability of health insurance is questionable. The main reasons include low governmental financial resources and lack of affordability by beneficiaries especially for Private Health Insurance. This necessitates finding solutions to improve them or trying other types of health insurance. The quality of services provided by Social

Health System Competency for Maternal Health Services in Balasore District and Jaleswar Block, Balasore, Odisha, India: An Assessment.

Science.gov (United States)

Dehury, Ranjit Kumar; Samal, Janmejaya

2016-08-01

A competent health system is of paramount importance in delivering the desired health services in a particular community. The broad objective of this study was to assess the health system competency for the maternal health services in Balasore District and Jaleswar block of Balasore district, Odisha, India. A mixed method approach was adopted in order to understand the health system competency for maternal health services in the study area. There was poor accessibility through road, poor electricity connection and piped water for the health care centers in the district. Even, existing Primary Health Centres (PHCs) lack ECG and X-Ray machines for proper diagnostic services which jeopardize the catering of health services. Community Health Centres (CHC) lack basic diagnostic and ambulance services making the tribal pockets inaccessible. The tribal dominated Jaleswar block shows poor performance in terms of total registered Antenatal Checkups (ANC) (only 77%). A gradual decrease in the rate of ANC, from first to fourthcheckup, was observed in the district. Lack of public health infrastructure in general and non-compliance to Indian Public Health Standards (IPHS) in particular, affect the health of tribal women resulting in lack of interest in availing the institutional delivery services and other pertinent maternal health services.

The use of the quality model of Parasuraman, Zeithaml and Berry in health services

Directory of Open Access Journals (Sweden)

Mileide Morais Pena

2013-10-01

Full Text Available This is an article about the theoretical model for assessing quality in health services proposed by Parasuraman, Zheitaml and Berry, in order to measure the degree of satisfaction of users. This model is based on the analysis of expectations and perceptions of users of health services, by means of five dimensions: tangibility, reliability, responsiveness, assurance and empathy. From the difference between what is expected by the user and the service offered, gaps or shortcomings are derived that may be the main obstacle for users to perceive the provision of such services with quality. It was observed that the use of the psychometric scale called Service Quality (SERVQUAL in some studies about satisfaction, obtained very favorable results in the institutions in which it was employed. The analysis revealed the need to improve the existing models of evaluation, as well as the importance of measuring user satisfaction in health institutions.

Services trade restrictiveness and manufacturing productivity : the role of institutions

OpenAIRE

BEVERELLI, Cosimo; FIORINI, Matteo; HOEKMAN, Bernard M.

2015-01-01

We study the effect of services trade restrictiveness on manufacturing productivity for a broad cross-section of countries at different stages of economic development. Decreasing services trade restrictiveness has a positive indirect impact on the manufacturing sectors that use services as intermediate inputs in production. We identify a critical role of local institutions in shaping this effect: countries with high institutional capacity benefit the most from services trade policy reforms in...

[Health services access survey for Colombian households].

Science.gov (United States)

Arrivillaga, Marcela; Aristizabal, Juan Carlos; Pérez, Mauricio; Estrada, Victoria Eugenia

The aim of this study was to design and validate a health services access survey for households in Colombia to provide a methodological tool that allows the country to accumulate evidence of real-life access conditions experienced by the Colombian population. A validation study with experts and a pilot study were performed. It was conducted in the municipality of Jamundi, located in the department of Valle del Cauca, Colombia. Probabilistic, multistage and stratified cluster sampling was carried out. The final sample was 215 households. The survey was composed of 63 questions divided into five modules: socio-demographic profile of the head of the household or adult informant, household socioeconomic profile, access to preventive services, access to curative and rehabilitative services and household out of pocket expenditure. In descriptive terms, the promotion of preventive services only reached 44%; the use of these services was always highest among children younger than one year old and up to the age of ten. The perceived need for emergency medical care and hospitalisation was between 82% and 85%, but 36% perceived the quality of care to be low or very low. Delays were experienced in medical visits with GPs and specialists. The designed survey is valid, relevant and representative of access to health services in Colombia. Empirically, the pilot showed institutional weaknesses in a municipality of the country, indicating that health coverage does not in practice mean real and effective access to health services. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

Early onset ageing and service preparation in people with intellectual disabilities: institutional managers' perspective.

Science.gov (United States)

Lin, Jin-Ding; Wu, Chia-Ling; Lin, Pei-Ying; Lin, Lan-Ping; Chu, Cordia M

2011-01-01

Although longevity among older adults with intellectual disabilities is increasing, there is limited information on their premature aging related health characteristics and how it may change with increasing age. The present paper provides information of the institutional manager's perception on early onset aging and service preparation for this population. We used purposive sampling to recruit 54 institutional managers who care for people with intellectual disabilities in Taiwan. The present study employed a cross-sectional design using a self-administrative structured questionnaire that was completed by the respondents in November 2009. The results showed that more than 90% of the respondents agreed with earlier onset aging characteristics of people with ID. However, nearly all of the respondents expressed that the government policies were inadequate and the institution is not capable of caring for aging people with ID, and more than half of them did not satisfy to their provisional care for this group of people. With regard to the service priority of government aging policy for people with ID, the respondent expressed that medical care, financial support, daily living care were the main areas in the future policy development for them. The factors of institutional type, expressed adequacy of government's service, respondent's job position, age, and working years in disability service were variables that can significantly predict the positive perceptions toward future governmental aging services for people with ID (adjusted R(2) = 0.563). We suggest that the future study strategy should underpin the aging characteristics of people with intellectual disabilities and its differences with general population to provide the useful information for the institutional caregivers. Copyright © 2010 Elsevier Ltd. All rights reserved.

Early Onset Ageing and Service Preparation in People with Intellectual Disabilities: Institutional Managers' Perspective

Science.gov (United States)

Lin, Jin-Ding; Wu, Chia-Ling; Lin, Pei-Ying; Lin, Lan-Ping; Chu, Cordia M.

2011-01-01

Although longevity among older adults with intellectual disabilities is increasing, there is limited information on their premature aging related health characteristics and how it may change with increasing age. The present paper provides information of the institutional manager's perception on early onset aging and service preparation for this…

Internet infrastructures and health care systems: a qualitative comparative analysis on networks and markets in the British National Health Service and Kaiser Permanente.

Science.gov (United States)

Séror, Ann C

2002-12-01

The Internet and emergent telecommunications infrastructures are transforming the future of health care management. The costs of health care delivery systems, products, and services continue to rise everywhere, but performance of health care delivery is associated with institutional and ideological considerations as well as availability of financial and technological resources. to identify the effects of ideological differences on health care market infrastructures including the Internet and telecommunications technologies by a comparative case analysis of two large health care organizations: the British National Health Service and the California-based Kaiser Permanente health maintenance organization. A qualitative comparative analysis focusing on the British National Health Service and the Kaiser Permanente health maintenance organization to show how system infrastructures vary according to market dynamics dominated by health care institutions ("push") or by consumer demand ("pull"). System control mechanisms may be technologically embedded, institutional, or behavioral. The analysis suggests that telecommunications technologies and the Internet may contribute significantly to health care system performance in a context of ideological diversity. The study offers evidence to validate alternative models of health care governance: the national constitution model, and the enterprise business contract model. This evidence also suggests important questions for health care policy makers as well as researchers in telecommunications, organizational theory, and health care management.

[Marketing in health service--a necessity or a temporary whim?].

Science.gov (United States)

Dworzański, Wojciech; Dworzańska, Anna; Niezabitowska, Ewa; Czerwonka, Maciej; Madej, Barbara; Burdan, Franciszek

2012-01-01

Permanent changes occurring in economy and politics, open borders, a greater number of people with higher education as well as growing social awareness concerning taking care of health are followed by changes in healthcare sector. In response to an increased social demand, new medical institutions are being founded. They offer their patients a vast array of services ranging from therapeutic to preventive and highly specialized procedures improving their standard of living. In order to attract regular patients, and therefore receive regular income, it is necessary to stabilize such institutions on services market. It can be achieved by numerous marketing tools which, when applied appropriately, enable to create a positive image of a medical institution.

78 FR 56238 - Office of the Director, National Institutes of Health; Notice of Meeting

Science.gov (United States)

2013-09-12

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health Office of the Director... to discuss the findings of two of its working groups: the Brain Research through Advancing Innovative Neurotechnologies (BRAIN) working group and the HeLa Genome Data Access working group. The BRAIN working group...

42 CFR 440.40 - Nursing facility services for individuals age 21 or older (other than services in an institution...

Science.gov (United States)

2010-10-01

... older (other than services in an institution for mental disease), EPSDT, and family planning services... institution for mental disease), EPSDT, and family planning services and supplies. (a) Nursing facility... institution for mental diseases”, means services that are— (i) Needed on a daily basis and required to be...

An Analysis of Canadian Institute for Health Research Funding for Research on Autism Spectrum Disorder

Directory of Open Access Journals (Sweden)

R. Deonandan

2016-01-01

Full Text Available We examined patterns of Canadian Institute for Health Research (CIHR funding on autism spectrum disorder (ASD research. From 1999 to 2013, CIHR funded 190 ASD grants worth $48 million. Biomedical research received 43% of grants (46% of dollars, clinical research 27% (41%, health services 10% (7%, and population health research 8% (3%. The greatest number of grants was given in 2009, but 2003 saw the greatest amount. Funding is clustered in a handful of provinces and institutions, favouring biomedical research and disfavouring behavioural interventions, adaptation, and institutional response. Preference for biomedical research may be due to the detriment of clinical research.

[Determining biomedical equipment calibration in health care Institutions in the Risaralda Department of Colombia].

Science.gov (United States)

López-Isaza, Giovanni A; Llamosa-Rincón, Luis E

2008-01-01

Determining quality features related to tracking biomedical equipment calibration patterns and their electrical safety as implemented by Health Care Institutions in the Risaralda department. This was a descriptive study using non-probabilistic sampling and the criterion of a greater equipment inventory and service demand for Clinics, Aesthetic, Radiology and Dentistry Centres and Hospitals. Census; the instrument was applied to 32 health-care institutions distributed throughout the Risaralda departments 14 municipalities between September 2005 and January 2006. Hospitals was the category having a highest number of electro-medical equipment (56%). Pereira (the capital of Risaralda) had 81% of all electro-medical equipment. All the institutions lacked NTC-ISO-IEC-17025 accreditation regarding standards certified by the Superintendence of Industry and Commerce. None of the institutions externally contracted by the institutions being surveyed was accredited. There is a public health risk in the Risaralda department; all health-care institutions lacked NTC-ISO-IEC-17025 accreditation and external institutions (in turn being hired by them for calibrating their equipment) also lacked accreditation. Based on the information obtained from non-calibrated equipment having international patterns, there is a great danger that determining the quality of biomedical equipment calibration patterns may be erroneous. It also places health-care institutions at a competitive disadvantage when compared to other accredited institutions in Colombia or in other countries.

U.S. Public Health Service Commissioned Corps pharmacists: making a difference in advancing the nation's health.

Science.gov (United States)

Flowers, Louis; Wick, Jeannette; Figg, William Douglas; McClelland, Robert H; Shiber, Michael; Britton, James E; Ngo, Diem-Kieu H; Borders-Hemphill, Vicky; Mead, Christina; Zee, Jerry; Huntzinger, Paul

2009-01-01

To describe how U.S. Public Health Service (PHS) pharmacists serving in jobs that are normal for them, but considerably different than those found in the private sector, are making a difference in advancing the nation's health. Pharmacists who serve in the Commissioned Corps of PHS fill roles that are considerably different than their counterparts in the private sector. Their work takes them out from behind the counter and into the world. Pharmacy officers advance the health and safety of the nation by their involvement in the delivery of direct patient care to medically underserved people, national security, drug vigilance, research, and policy-making endeavors. PHS pharmacists fill essential public health leadership and service roles throughout the U.S. Department of Health and Human Services (HHS) and certain non-HHS federal agencies and programs. The Health Resources and Services Administration, National Institutes of Health, Federal Bureau of Prisons, Indian Health Service, Food and Drug Administration, and U.S. Coast Guard are among the many federal agencies in which pharmacy officers are assigned. In each setting, PHS pharmacists find traditional roles augmented with assignments and challenges that broaden the scope of their practice.

Individual and institutional influences on faith-based health and wellness programming.

Science.gov (United States)

Bopp, Melissa; Fallon, Elizabeth A

2011-12-01

The majority of the US population is affiliated with faith-based organizations (FBO). Health and wellness activities (HWAs) within FBOs have great potential for reach, though the factors influencing faith-based HWA are not well understood. The purpose of this study was to examine individual faith leader and institutional influences on HWAs offered within FBOs. A national convenience sample of faith leaders (N = 844) completed an online survey assessing individual (demographics, health, health behaviors and attitudes) and institutional influences (size, location and external support) on health and HWA within FBO. Respondents were primarily White (93%), male (72%), middle-aged and affiliated with Methodist (42.5%) or Lutheran (20.2%) religions. Respondents reported 4.8 ± 3.2 HWA within their FBO per year. Faith leader education, length of service to the FBO, physical activity and fruit/vegetable intake were positively related to HWA and body mass index was negatively related. Denomination, congregation diversity, location and size were also related to HWA. Results show a strong relationship between faith leaders' health and HWA, indicating the influence of the social environment on health promotion in FBOs. Institutional variables, though not modifiable, were significant predictors of HWA and should be considered when delivering interventions to achieve a significant impact.

Veterans' Mental Health in Higher Education Settings: Services and Clinician Education Needs.

Science.gov (United States)

Niv, Noosha; Bennett, Lauren

2017-06-01

Utilization of the GI Bill and attendance at higher education institutions among student veterans have significantly increased since passage of the Post-9/11 GI Bill. Campus counseling centers should be prepared to meet the mental health needs of student veterans. This study identified the mental health resources and services that colleges provide student veterans and the education needs of clinical staff on how to serve student veterans. Directors of mental health services from 80 California colleges completed a semistructured phone interview. Few schools track the number, demographic characteristics, or presenting needs of student veterans who utilize campus mental health services or offer priority access or special mental health services for veterans. Directors wanted centers to receive education for an average of 5.8 veteran-related mental health topics and preferred workshops and lectures to handouts and online training. Significant training needs exist among clinical staff of campus mental health services to meet the needs of student veterans.

Do Physical Proximity and Availability of Adequate Infrastructure at Public Health Facility Increase Institutional Delivery? A Three Level Hierarchical Model Approach.

Science.gov (United States)

Patel, Rachana; Ladusingh, Laishram

2015-01-01

This study aims to examine the inter-district and inter-village variation of utilization of health services for institutional births in EAG states in presence of rural health program and availability of infrastructures. District Level Household Survey-III (2007-08) data on delivery care and facility information was used for the purpose. Bivariate results examined the utilization pattern by states in presence of correlates of women related while a three-level hierarchical multilevel model illustrates the effect of accessibility, availability of health facility and community health program variables on the utilization of health services for institutional births. The study found a satisfactory improvement in state Rajasthan, Madhya Pradesh and Orissa, importantly, in Bihar and Uttaranchal. The study showed that increasing distance from health facility discouraged institutional births and there was a rapid decline of more than 50% for institutional delivery as the distance to public health facility exceeded 10 km. Additionally, skilled female health worker (ANM) and observed improved public health facility led to significantly increase the probability of utilization as compared to non-skilled ANM and not-improved health centers. Adequacy of essential equipment/laboratory services required for maternal care significantly encouraged deliveries at public health facility. District/village variables neighborhood poverty was negatively related to institutional delivery while higher education levels in the village and women's residing in more urbanized districts increased the utilization. "Inter-district" variation was 14 percent whereas "between-villages" variation for the utilization was 11 percent variation once controlled for all the three-level variables in the model. This study suggests that the mere availability of health facilities is necessary but not sufficient condition to promote utilization until the quality of service is inadequate and inaccessible considering

Do Physical Proximity and Availability of Adequate Infrastructure at Public Health Facility Increase Institutional Delivery? A Three Level Hierarchical Model Approach.

Directory of Open Access Journals (Sweden)

Rachana Patel

Full Text Available This study aims to examine the inter-district and inter-village variation of utilization of health services for institutional births in EAG states in presence of rural health program and availability of infrastructures. District Level Household Survey-III (2007-08 data on delivery care and facility information was used for the purpose. Bivariate results examined the utilization pattern by states in presence of correlates of women related while a three-level hierarchical multilevel model illustrates the effect of accessibility, availability of health facility and community health program variables on the utilization of health services for institutional births. The study found a satisfactory improvement in state Rajasthan, Madhya Pradesh and Orissa, importantly, in Bihar and Uttaranchal. The study showed that increasing distance from health facility discouraged institutional births and there was a rapid decline of more than 50% for institutional delivery as the distance to public health facility exceeded 10 km. Additionally, skilled female health worker (ANM and observed improved public health facility led to significantly increase the probability of utilization as compared to non-skilled ANM and not-improved health centers. Adequacy of essential equipment/laboratory services required for maternal care significantly encouraged deliveries at public health facility. District/village variables neighborhood poverty was negatively related to institutional delivery while higher education levels in the village and women's residing in more urbanized districts increased the utilization. "Inter-district" variation was 14 percent whereas "between-villages" variation for the utilization was 11 percent variation once controlled for all the three-level variables in the model. This study suggests that the mere availability of health facilities is necessary but not sufficient condition to promote utilization until the quality of service is inadequate and

Extending access to essential services against constraints: the three-tier health service delivery system in rural China (1949-1980).

Science.gov (United States)

Feng, Xing Lin; Martinez-Alvarez, Melisa; Zhong, Jun; Xu, Jin; Yuan, Beibei; Meng, Qingyue; Balabanova, Dina

2017-05-23

implementation process involving gradual adaptation and incorporation of the lessons learnt was also essential. China's 60 year experience in establishing a de-professionalized, community-based, health service delivery model that is economically feasible, institutionally and culturally appropriate mechanism can be useful to other low- and middle-income countries (LMICs) seeking to extend essential services. Lessons can be drawn from both reform content and from its implementation pathway, identifying the political, institutional and contextual factors shaping the three-tier delivery model over time.

Capacity of the legal framework of public health institutions in Mexico to support their functional integration

Directory of Open Access Journals (Sweden)

Ignacio Ibarra

2013-05-01

Full Text Available Objective. Evaluate the capacity of the federal legal framework to govern financing of health institutions in the public sector through innovative schemes –otherwise known as functional integration–, enabling them to purchase and sell health services to and from other public providers as a strategy to improve their performance. Materials and methods. Based on indicators of normative alignment with respect to functional integration across public health provider and governance institutions, content analysis was undertaken of national health programs and relevant laws and guidelines for financial coordination. Results. Significant progress was identified in the implementation of agreements for the coordination of public institutions. While the legal framework provides for a National Health System and a health sector, gaps and contradictions limit their scope. The General Register of Health is also moving forward, yet it lacks the necessary legal foundation to become a comprehensive tool for integration. The medical service exchange agreements are also moving forward based on tariffs and shared guidelines. However, there is a lack of incentives to promote the expansion of these agreements. Conclusions. It is recommended to update the legal framework for the coordination of the National Health System, ensuring a more harmonious and general focus to provide functional integration with the needed impulse.

[se-atlas - the health service information platform for people with rare diseases : Supporting research on medical care institutions and support groups].

Science.gov (United States)

Haase, Johanna; Wagner, Thomas O F; Storf, Holger

2017-05-01

se-atlas - the health service information platform for rare diseases - is part of the German National Action Plan for People with Rare Diseases and is funded by the German Federal Ministry of Health. The objective of se-atlas as a web-based platform is to illustrate those medical care institutions that are linked to rare diseases, in a transparent and user-friendly way. The website provides an overview of medical care institutions and support groups focusing on rare diseases in Germany. The primary target groups of se-atlas are affected patients, their relatives and physicians but can also include non-medical professionals and the general public. In order to make it easier to look up medical care institutions or support groups and optimize the search results displayed, various strategies are being developed and evaluated. Hence, the allocation of diseases to appropriate medical care institutions and support groups is currently a main focus. Since its launch in 2015, se-atlas has grown continuously and now incorporates five times more entries than were included 20 months prior. Among this data are the current rare diseases centres in Germany, which play a major role in providing patient-centred healthcare by acting as primary contact points for people with rare diseases. Further expansion and maintenance of the data base raises several organisational and software-related challenges. For one, the data should be completed by adding more high-quality information, while not neglecting the existing entries and maintaining their high level of quality in the long term.

75 FR 39954 - Office of the Director, National Institutes of Health; Notice of a Conference Call of the NIH...

Science.gov (United States)

2010-07-13

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health Office of the Director, National Institutes of Health; Notice of a Conference Call of the NIH Scientific Management Review Board Pursuant to section 10(a) of the Federal Advisory Committee Act, as amended (5 U.S.C. App.), notice is hereby given of a conference call meeting of...

Management system of organizational and economic changes in health services

Directory of Open Access Journals (Sweden)

Natalya Vasilyevna Krivenko

2013-03-01

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

78 FR 20666 - Food and Drug Administration/National Institutes of Health/National Science Foundation Public...

Science.gov (United States)

2013-04-05

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2013-N-0345] Food and Drug Administration/National Institutes of Health/ National Science Foundation Public Workshop... public workshop; request for comments. SUMMARY: The Food and Drug Administration (FDA) is announcing its...

Coverage and accessibility levels of health services in the metropolitan periphery of Mexico City

Directory of Open Access Journals (Sweden)

Flor López

2012-02-01

Full Text Available The aim of this study is two fold: first, to analyze the spatial distribution of health services that different public institutions offer in the metropolitan peripheral municipalities of Mexico City; and second, give some reasons that explain that distribution. The analysis tries to demonstrate a lack of territorial approach in the construction of the social policy in the particular case of the health sector. The spatial range of health service, coverage and accessibility in the eastern part of the State of Mexico was calculate through variables much as number of doctors, nurses, beds and medical center, that the different public institution particularly IMSS, ISSSTE and ISSEMYM, offer. Results tend to show an unequal distribution of health resources either human or material, as well as a territorial disorden in their distribution with a high concentration in urban areas. Thus, analysis shows that space plays a fundamental role as a structuring factor in the application of health policies and in the planning of such services.

An audit of tuberculosis health services in prisons and immigration removal centres.

Science.gov (United States)

Mehay, Anita; Raj, Thara; Altass, Lynn; Newton, Autilia; O'Moore, Eamonn; Railton, Cathie; Tan, Hong; Story, Al; Frater, Alison

2017-06-01

Tuberculosis (TB) is the second leading cause of death worldwide due to a single infectious agent. Rates of active TB in places of prescribed detention (PPD), which include Prisons, Young Offender Institutions and Immigration Removal Centres, are high compared with the general population. PPD therefore present an opportunity to develop targeted health programmes for TB control. This audit aims to assess current service provisions and identify barriers to achieving best practice standards in PPD across London. Twelve healthcare teams within PPD commissioned by NHS England (London Region) were included in the audit. Services were evaluated against the National Institute for Health and Care Excellence standards for TB best practice. None of the health providers with a digital X-ray machine were conducting active case finding in new prisoners and no health providers routinely conduct Latent TB infection testing and preventative treatment. Barriers to implementing standards include the lack of staff skills and staff skills mix, structural and technical barriers, and demands of custodial and health services. This audit restates the importance of national public health TB strategies to consider healthcare provisions across PPD. © The Author 2016. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

The Institutional Work of Payments for Ecosystem Services

DEFF Research Database (Denmark)

Jespersen, Kristjan; Gallemore, Caleb

2018-01-01

creation in the context of the literature on Payments for Ecosystem Services (PES). While a large literature outlines ideal PES models, PES literature tends to overlook the demanding everyday work involved in building and maintaining the institutions upon which successful PES models depend. Drawing...... on the theory of institutional work, we conduct an extensive survey of the literature on PES to find examples of everyday work undertaken to build and maintain PES institutions, or else to disrupt institutions that stand in the way. Finding very limited discussion of the work of institutional creation, we...

Use of information systems in a health institution of Pelotas/RS

Directory of Open Access Journals (Sweden)

Isabel Cristina Rosa Barros Rasia

2012-01-01

Full Text Available This case study was conducted at a single institution Health Pelotas / RS and aimed to describe some of the subsystems of health information used in this institution, in addition to emphasizing the importance of proper record of information, so that they can be used by managers in the construction Indicators of Health was conducted qualitative research with the chief Nurse of the Unit in April 2011, and the data were investigated by content analysis. We stress the importance of this work proper record of information for the construction of reliable health indicators. The information and teamwork and interaction dimensions of organizational, technological and human, provide an excellent service more dignified and humane that will benefit everyone involved. We conclude that there must be an organizational culture of valuing information, and to know and assess the extent and performance of each information system is extremely important for your use and continuous improvement, becoming an instrument to detect priority focus of attention.

USE OF INFORMATION SYSTEMS IN A HEALTH INSTITUTION OF PELOTAS/RS

Directory of Open Access Journals (Sweden)

Isabel Cristina Rosa Barros Rasia

2012-08-01

Full Text Available This case study was conducted at a single institution Health Pelotas / RS and aimed to describe some of the subsystems of health information used in this institution, in addition to emphasizing the importance of proper record of information, so that they can be used by managers in the construction Indicators of Health was conducted qualitative research with the chief Nurse of the Unit in April 2011, and the data were investigated by content analysis. We stress the importance of this work proper record of information for the construction of reliable health indicators. The information and teamwork and interaction dimensions of organizational, technological and human, provide an excellent service more dignified and humane that will benefit everyone involved. We conclude that there must be an organizational culture of valuing information, and to know and assess the extent and performance of each information system is extremely important for your use and continuous improvement, becoming an instrument to detect priority focus of attention.

Trade in health services.

Science.gov (United States)

Chanda, Rupa

2002-01-01

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. PMID:11953795

75 FR 55582 - National Institutes of Health Statement of Organization, Functions, and Delegations of Authority

Science.gov (United States)

2010-09-13

... authority statement: All delegations and redelegations of authority to officers and employees of NIH that..., Functions, and Delegations of Authority Part N, National Institutes of Health, of the Statement of Organization, Functions, and Delegations of Authority for the Department of Health and Human Services (40 FR...

General practitioners in Styria - who is willing to take part in research projects and why? : A survey by the Institute of General Practice and Health Services Research.

Science.gov (United States)

Poggenburg, Stephanie; Reinisch, Manuel; Höfler, Reinhild; Stigler, Florian; Avian, Alexander; Siebenhofer, Andrea

2017-11-01

Increasing recognition of general practice is reflected in the growing number of university institutes devoted to the subject and Health Services Research (HSR) is flourishing as a result. In May 2015 the Institute of General Practice and Evidence-based Health Services Research, Medical University of Graz, initiated a survey of Styrian GPs. The aim of the survey was to determine the willingness to take part in HSR projects, to collect sociodemographic data from GPs who were interested and to identify factors affecting participation in research projects. Of the 1015 GPs who received the questionnaire, 142 (14%) responded and 135 (13%) were included in the analysis. Overall 106 (10%) GPs indicated their willingness to take part in research projects. Factors inhibiting participation were lack of time, administrative workload, and lack of assistance. Overall, 10% of Styrian GPs were willing to participate in research projects. Knowledge about the circumstances under which family doctors are prepared to participate in HSR projects will help in the planning of future projects.

Institutional policy changes aimed at addressing obesity among mental health clients.

Science.gov (United States)

Knol, Linda L; Pritchett, Kelly; Dunkin, Jeri

2010-05-01

People with mental illness often experience unique barriers to healthy eating and physical activity. For these clients, interventions should focus on changes in the immediate environment to change behaviors. The purpose of this project was to implement and evaluate policy changes that would limit calorie intake and increase calorie expenditure of clients receiving mental health services. This intervention was implemented in a rural mental health system in the southeastern United States. Clients live in small group homes, where they are served breakfast, dinner, and a snack, and attend outpatient day treatment programs, where they are served lunch and can purchase snacks from vending machines. This intervention included institutional policy changes that altered menus and vending machine options and implemented group walking programs. Primary outcome measures were changes in clients' weight at 3 and 6 months after policy implementation. At the 3-month follow-up, the median weight loss for overweight/obese clients (n = 45) was 1.4 kg. The 33 overweight/obese clients who were still in the group homes at the 6-month follow-up either maintained or continued to lose weight. Institutional policy changes aimed at improving dietary intake and physical activity levels among clients receiving mental health services can promote weight loss in overweight clients.

Italian public health care organizations: specialization, institutional deintegration, and public networks relationships.

Science.gov (United States)

Del Vecchio, Mario; De Pietro, Carlo

2011-01-01

The Italian National Health Service (INHS) has undergone profound changes over the past three decades. With establishment of the INHS in 1978--a tax-based public health care system with universal coverage--one of the underlying principles was integration. The recognition of health and health care as requiring integrated answers led to the creation of a single public organization, the Local Health Unit, responsible for the health status of the population of its catchment area. At the beginning of the 1990s, the scenario radically changed. The creation of hospital trusts, the development of quasi-market mechanisms and management control tools, the adoption of a prospective payment system for reimbursing health care providers--all were signs of deintegration and institutional unbundling. Two structural changes have deeply sustained this deintegration: patients' empowerment and the increased possibilities for outsourcing practices. In more recent years, a new reintegration effort has occurred, often led by regional governments and based on institutional cooperation and network relationships. However, the earlier structural changes require innovative approaches and solutions if public health care organizations want to retain their leading role.

What Factors Influence Employee Service Recovery Performance and What Are the Consequences in Health Care?

Science.gov (United States)

Nadiri, Halil; Tanova, Cem

2016-01-01

We analyzed the extent to which the service recovery performance of frontline employees in private health care institutions is influenced by employee perceptions of manager attitudes toward service quality, workplace support, and manager fairness and organizational commitment. We also examined the relationship of service recovery performance to employee job satisfaction and turnover intentions. Partial least square path modeling of data from 178 frontline employees in private health care institutions in North Cyprus was utilized. Although empowerment and role clarity were positively related to service recovery performance, perceived managerial attitudes toward hospital customer service, teamwork, and customer service-oriented training as indicators of workplace support were not related to frontline employees' service recovery performance. Organizational justice was related to affective commitment, which in turn was related to service recovery performance. Although service recovery performance was not related to employee turnover intentions, it was related to job satisfaction. Managerial implications of these study findings are presented in the light of the cognitive evaluation theory. Health services differ from other service organizations in the way that intrinsic and extrinsic rewards influence the service recovery efforts of frontline employees. To ensure high quality services, managers should focus on intrinsic rewards, empower and give more autonomy to staff.

76 FR 47594 - National Institutes of Health; Proposed Collection; Comment Request; Simulations for Drug Related...

Science.gov (United States)

2011-08-05

... DEPARTMENT OF HEALTH AND HUMAN SERVICES [Billing Code 4140-01-P] National Institutes of Health... request for a one-time clearance to evaluate an interactive multimedia module developed by ArchieMD. This evaluation seeks to determine whether the multimedia module Archie MD: The Science of Drugs (1) Increases...

Health workers' perceptions of facilitators of and barriers to institutional delivery in Tigray, Northern Ethiopia.

Science.gov (United States)

Gebrehiwot, Tesfay; San Sebastian, Miguel; Edin, Kerstin; Goicolea, Isabel

2014-04-10

Evidence shows that the three delays, delay in 1) deciding to seek medical care, 2) reaching health facilities and 3) receiving adequate obstetric care, are still contributing to maternal deaths in low-income countries. Ethiopia is a major contributor to the worldwide death toll of mothers with a maternal mortality ratio of 676 per 100,000 live births. The Ethiopian Ministry of Health launched a community-based health-care system in 2003, the Health Extension Programme (HEP), to tackle maternal mortality. Despite strong efforts, universal access to services remains limited, particularly skilled delivery attendance. With the help of 'the three delays' framework, this study explores health-service providers' perceptions of facilitators and barriers to the utilization of institutional delivery in Tigray, a northern region of Ethiopia. Twelve in-depth interviews were carried out with eight health extension workers (HEWs) and four midwives. Each interview lasted between 90 and 120 minutes. Data were analysed through a thematic analysis approach. Three themes emerged from the analysis: the struggle between tradition and newly acquired knowledge, community willingness to deal with geographical barriers, and striving to do a good job with insufficient resources. These themes represent the three steps in the path towards receiving adequate institutional delivery care at a health facility. Of the themes, 'increased community awareness', 'organization of the community' and 'hospital with specialized staff' were recognized as facilitators. On the other hand, 'delivery as a natural event', 'cultural tradition and rituals', 'inaccessible transport', 'unmet community expectation' and 'shortage of skilled human resources' were represented as barriers to institutional delivery. The participants in this study gave emphasis to the major barriers to institutional delivery that are closely connected with the three delays model. Despite the initiatives being implemented by the Tigray

[Hospital biomedical research through the satisfaction of a Health Research Institute professionals].

Science.gov (United States)

Olmedo, C; Plá, R; Bellón, J M; Bardinet, T; Buño, I; Bañares, R

2015-01-01

A Health Research Institute is a powerful strategic commitment to promote biomedical research in hospitals. To assess user satisfaction is an essential quality requirement. The aim of this study is to evaluate the professional satisfaction in a Health Research Institute, a hospital biomedical research centre par excellence. Observational study was conducted using a satisfaction questionnaire on Health Research Institute researchers. The explored dimensions were derived from the services offered by the Institute to researchers, and are structured around 4 axes of a five-year Strategic Plan. A descriptive and analytical study was performed depending on adjustment variables. Internal consistency was also calculated. The questionnaire was completed by 108 researchers (15% response). The most valued strategic aspect was the structuring Areas and Research Groups and political communication and dissemination. The overall rating was 7.25 out of 10. Suggestions for improvement refer to the need for help in recruitment, and research infrastructures. High internal consistency was found in the questionnaire (Cronbach alpha of 0.9). So far research policies in health and biomedical environment have not been sufficiently evaluated by professionals in our field. Systematic evaluations of satisfaction and expectations of key stakeholders is an essential tool for analysis, participation in continuous improvement and advancing excellence in health research. Copyright © 2015 SECA. Published by Elsevier Espana. All rights reserved.

Global health leadership training in resource-limited settings: a collaborative approach by academic institutions and local health care programs in Uganda.

Science.gov (United States)

Nakanjako, Damalie; Namagala, Elizabeth; Semeere, Aggrey; Kigozi, Joanitor; Sempa, Joseph; Ddamulira, John Bosco; Katamba, Achilles; Biraro, Sam; Naikoba, Sarah; Mashalla, Yohana; Farquhar, Carey; Sewankambo, Nelson

2015-11-18

Due to a limited health workforce, many health care providers in Africa must take on health leadership roles with minimal formal training in leadership. Hence, the need to equip health care providers with practical skills required to lead high-impact health care programs. In Uganda, the Afya Bora Global Health Leadership Fellowship is implemented through the Makerere University College of Health Sciences (MakCHS) and her partner institutions. Lessons learned from the program, presented in this paper, may guide development of in-service training opportunities to enhance leadership skills of health workers in resource-limited settings. The Afya Bora Consortium, a consortium of four African and four U.S. academic institutions, offers 1-year global health leadership-training opportunities for nurses and doctors. Applications are received and vetted internationally by members of the consortium institutions in Botswana, Kenya, Tanzania, Uganda, and the USA. Fellows have 3 months of didactic modules and 9 months of mentored field attachment with 80% time dedicated to fellowship activities. Fellows' projects and experiences, documented during weekly mentor-fellow meetings and monthly mentoring team meetings, were compiled and analyzed manually using pre-determined themes to assess the effect of the program on fellows' daily leadership opportunities. Between January 2011 and January 2015, 15 Ugandan fellows (nine doctors and six nurses) participated in the program. Each fellow received 8 weeks of didactic modules held at one of the African partner institutions and three online modules to enhance fellows' foundation in leadership, communication, monitoring and evaluation, health informatics, research methodology, grant writing, implementation science, and responsible conduct of research. In addition, fellows embarked on innovative projects that covered a wide spectrum of global health challenges including critical analysis of policy formulation and review processes

[Stigma: Barrier to Access to Mental Health Services].

Science.gov (United States)

Campo-Arias, Adalberto; Oviedo, Heidi Celina; Herazo, Edwin

2014-01-01

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.

Marketing aspects of development of medical waste management in health care institutions in Ukraine

Directory of Open Access Journals (Sweden)

Inesa Gurinа

2015-02-01

Full Text Available The concept of marketing approach to medical waste management in health care is suggested.The goal of research was to study the state of marketing activities of health care institutions on medical waste management and development trends of   resolution of outstanding issues.Methods. The methods, which were used in the research, are the methods of mathematical statistics, social studies and scientific knowledge.Results. Environmental marketing institutions of healthcare means perfectly safe for the environment provision of health services. The main directions of environmental marketing concept in health care institutions is the acceptance generally binding legal standards of Use Resources, strict control the formation and licensing of medical waste; economic incentives for workers, aimed at minimizing their interest in the volumes of medical waste; financing of R & D relative to the development of new waste and sound technologies; develop a system of taxes and penalties for polluting the environment and so on.Conclusions. As a result of the implementation of marketing strategies for managing medical waste of healthcare institutions are obtained strategic, social, environmental and economic benefits.

Rural health service managers' perspectives on preparing rural health services for climate change.

Science.gov (United States)

Purcell, Rachael; McGirr, Joe

2018-02-01

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.

[Terrorism, public health and health services].

Science.gov (United States)

Arcos González, Pedro; Castro Delgado, Rafael; Cuartas Alvarez, Tatiana; Pérez-Berrocal Alonso, Jorge

2009-01-01

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.

Conceptions of health service robots

DEFF Research Database (Denmark)

Lystbæk, Christian Tang

2015-01-01

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...

[The treatment received by public health services users in Mexico].

Science.gov (United States)

Puentes Rosas, Esteban; Gómez Dantés, Octavio; Garrido Latorre, Francisco

2006-06-01

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

Analysis and lessons learned instituting an instant messaging reference service at an academic health sciences library: the first year.

Science.gov (United States)

Kipnis, Daniel G; Kaplan, Gary E

2008-01-01

In February 2006, Thomas Jefferson University went live with a new instant messaging (IM) service. This paper reviews the first 102 transcripts to examine question types and usage patterns. In addition, the paper highlights lessons learned in instituting the service. IM reference represents a small proportion of reference questions, but based on user feedback and technological improvements, the library has decided to continue the service.

[Conceptualization of knowledge management in medium and high complexity health institutions].

Science.gov (United States)

Arboleda-Posada, Gladys I

2016-06-01

Objective To identify the familiarization, conceptualization and incorporation of employees of medium and high complexity health institutions in the Valle de Aburrá, Colombia into the strategic knowledge management platform in 2011. Methodology Cross sectional study. The study was carried out by applying surveys to 224 employees to assess knowledge management. The population included staff who working in the Health Providing Institutions (IPS) of high (52) and medium complexity (322) in the Valle de Aburrá in 2011. In both the public and private institutions surveyed, 38.8 % of the respondents said they were not familiar with knowledge management. Among those who had administrative training, the ignorance was less than among care workers. It was also noted that as the level of education increased, knowledge of the concept was greater. A high proportion (65.2 % ) of respondents placed the concept in line with the creation, organization, storage, retrieval, transfer and application of knowledge systematically. 78.7 % of respondents from public institutions said that knowledge management was part of the strategic platform of the institution. 58.3 % from private institutions said the same. Conclusions In general terms the concept of knowledge management is not well conceived or familiar to the staff working in these institutions. The study confirmed a lack of empowerment in the field to promote the development of new ideas and to ensure that they become service innovations or processes that contribute to the development of institutional knowledge.

76 FR 65203 - National Institute on Aging

Science.gov (United States)

2011-10-20

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute on Aging... unwarranted invasion of personal privacy. Name of Committee: National Institute on Aging Special Emphasis... and evaluate grant applications. Place: National Institute on Aging, Gateway Building, 7201 Wisconsin...

Service functions of private community health stations in China: A comparison analysis with government-sponsored community health stations.

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Hou, Wanli; Fan, Hong; Xu, Jing; Wang, Fang; Chai, Yun; Xu, Hancheng; Li, Yongbin; Liu, Liqun; Wang, Bin; Jin, Jianqiang; Lu, Zuxun

2012-04-01

In China, with the restructuring of health care system moving forward, private community health facilities have been playing a complementary but increasingly important role in providing public health and basic medical care services in urban areas. However, only limited evidence is available concerning the service functions of private community health facilities in China. The aim of this study was to explore the functions of private community health stations (PCHSs) to provide evidence-based recommendations for policy-making and practice in the development of urban community health services systems. A total of 818 PCHSs and 4320 government-sponsored community health stations (GCHSs) located in 28 cities of China were investigated in 2008. The percentages of stations that provided health services and the annual workload per community health worker (CHW) were compared between the two types of institutions. The results showed that the percentages of PCHSs providing public health services were significantly higher than those of GCHSs (P0.05). The annual workloads of all the public health services and basic medical services per CHW in PCHSs were lighter than those in GCHSs (P0.05). At present, the GCHSs are still the mainstream in urban China, which will last for a long period in future. However, our findings showed that the annual workloads of CHWs in PCHSs were no heavier than those in GCHSs, and the PCHSs were willing to provide public health services. In view of current inadequacy of health resources in China, it is feasible to further develop PCHSs under the guidance of the government, given that PCHSs can perform the basic functions of community health services, which is useful for the formation of public-private partnerships (PPP) and the improvement of community health services.

Health Care Service Utilization of Dementia Patients before and after Institutionalization: A Claims Data Analysis

Directory of Open Access Journals (Sweden)

Larissa Schwarzkopf

2014-06-01

Full Text Available Background: Community-based and institutional dementia care has been compared in cross-sectional studies, but longitudinal information on the effect of institutionalization on health care service utilization is sparse. Methods: We analyzed claims data from 651 dementia patients via Generalized Estimation Equations to assess health care service utilization profiles and corresponding expenditures from four quarters before to four quarters after institutionalization. Results: In all domains, utilization increased in the quarter of institutionalization. Afterwards, the use of drugs, medical aids, and non-physician services (e.g., occupational therapy and physiotherapy remained elevated, but use of in- and outpatient treatment decreased. Cost of care showed corresponding profiles. Conclusion: Institutional dementia care seems to be associated with an increased demand for supportive services but not necessarily for specialized medical care.

[Management committees in health services: an empirical study].

Science.gov (United States)

Cecilio, Luiz Carlos de Oliveira

2010-03-01

The aim of the article, based on field data collected from a continuing education program for primary health clinic administrators, was to analyze the functioning of a health service management strategy called "management committees". Different meanings and operational modalities emerged in the committees. Various antimonies appeared in the way the committees operate (autonomy versus heteronomy, reproduction of "instituted" versus "instituting" processes, and communicative versus instrumental reasoning), thus reflecting the level of complexity in this management mechanism. Healthcare provision per se by the clinics only appeared occasionally on the committees' agenda, which mainly focused on administrative issues. The article suggests that further research is needed on the coordinator's involvement in the field of forces constituting the management committee, besides developing pedagogical strategies to support the clinic coordinators and health teams in building the committees. The primary data were submitted to an epistemological discussion anchored in the idea of double hermeneutics, multiple validation of research results, and the relationship between theory and practice.

The mental health service crisis of neoliberalism -- an antipodean perspective.

Science.gov (United States)

Carney, Terry

2008-01-01

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.

A national industrial health service on a voluntary basis.

Science.gov (United States)

NATVIG, H

1955-01-01

this service is about 20-30 Norwegian kroner (3-4 US dollars) per worker per year.There is co-operation and co-ordination between the industrial health services and the public health services. Many local public health officers work as part-time industrial physicians, and many industrial physicians co-operate closely with the local boards of health, especially in the field of tuberculosis control.The special form of industrial health service adopted in Norway has sprung out of the particular situation there, which made possible the establishment of an industrial health service without danger of weakening the medical services as a whole. Any lack of physicians would have prevented the creation of this service, and the system is therefore not to be recommended for a country with a shortage of physicians. The geographical extent of Norway and the difficult communications in many places have necessitated the delegation of preventive health work mainly to the private physicians, the health centres and institutes playing but a small part in such work.

Autism spectrum disorder in adults: diagnosis, management, and health services development

Directory of Open Access Journals (Sweden)

Murphy CM

2016-07-01

Full Text Available Clodagh M Murphy,1,2 C Ellie Wilson,1–3 Dene M Robertson,1,2 Christine Ecker,1,4 Eileen M Daly,1,2 Neil Hammond,1,2 Anastasios Galanopoulos,1,2 Iulia Dud,1,2 Declan G Murphy,1,2 Grainne M McAlonan1,2 1Sackler Institute for Translational Neurodevelopment, Department of Forensic and Neurodevelopmental Sciences, King’s College London, Institute of Psychiatry, Psychology & Neuroscience, 2Behavioural and Developmental Psychiatry Clinical Academic Group, Behavioural Genetics Clinic, National Adult Autism Service, South London and Maudsley Foundation NHS Trust, London, UK; 3Individual Differences, Language and Cognition Lab, Department of Developmental and Educational Psychology, University of Seville, Spain; 4Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, Goethe-University, Frankfurt am Main, Germany Abstract: Autism spectrum disorder (ASD is a common neurodevelopmental disorder characterized by pervasive difficulties since early childhood across reciprocal social communication and restricted, repetitive interests and behaviors. Although early ASD research focused primarily on children, there is increasing recognition that ASD is a lifelong neurodevelopmental disorder. However, although health and education services for children with ASD are relatively well established, service provision for adults with ASD is in its infancy. There is a lack of health services research for adults with ASD, including identification of comorbid health difficulties, rigorous treatment trials (pharmacological and psychological, development of new pharmacotherapies, investigation of transition and aging across the lifespan, and consideration of sex differences and the views of people with ASD. This article reviews available evidence regarding the etiology, legislation, diagnosis, management, and service provision for adults with ASD and considers what is needed to support adults with ASD as they age. We conclude

Institutional Services for Teaching Improvement

Science.gov (United States)

Lindquist, Jack

1975-01-01

A teaching improvement program is suggested that is based on four models now in use. Designed for individual, departmental, and institutional levels it includes diagnosis, help with problem-identification, linkage to new information, involvement of authorities, increase in organizational health, support for implementation, and more diagnosis. (JT)

Introduction: The provision of animal health services in a changing world.

Science.gov (United States)

de Haan, C

2004-04-01

In the future, animal health services in developing countries will need to operate in a continuously changing policy, institutional and commercial environment. Firstly, the changing policies and priorities of national policy-makers regarding public and private sector roles, reinforced in Africa by the donors, have reduced funding and support for the large number of tasks that animal health services have traditionally performed, and there is continuing pressure from policy-makers to focus on what the public sector can do best. Secondly, poverty reduction has become one of the main criteria guiding the allocation of official development assistance, which has major implications for the main target clientele of veterinary services. Thirdly, population growth, increasing income and urbanisation are causing a marked increase in demand for livestock products in the developing world. As a result, the entire livestock commodity chain is undergoing major structural changes, which has significant implications for the definition and control of food safety standards. Fourthly, globalisation, and increasing trade and travel have greatly increased the risk of disease transmission between different countries and continents. Veterinary institutions in the developing world need to adapt to these challenges. They will have to be able to focus on the essential public sector roles. At the same time they must deliver those essential services to the poor, and provide the policy framework to ensure that the inevitable structural changes in the commodity chain take place in an equitable and sustainable fashion, with an acceptable level of health risk for the consumer. According to the weight given to these different objectives, changes in the institutional set-up need to be considered. This issue of the Scientific and Technical Review addresses these challenges. It begins by reviewing the basic economic characteristics underlying the provision of animal health services, and then examines

Public health service options for affordable and accessible noncommunicable disease and related chronic disease prevention and management

OpenAIRE

Brownie, Sharon; Hills, Andrew P; Rossiter, Rachel

2014-01-01

Sharon Brownie,1,2 Andrew P Hills,3,4 Rachel Rossiter51Workforce and Health Services, Griffith Health, Griffith University, Gold Coast, QLD, Australia; 2Oxford PRAXIS Forum, Green Templeton College, Oxford University, Oxford, United Kingdom; 3Allied Health Research, Mater Research Institute – The University of Queensland and Mater Mothers' Hospital, South Brisbane, QLD, Australia; 4Griffith Health Institute, Griffith Health, Griffith University, Gold Coast, QLD, Australia; 5...

Public health service options for affordable and accessible noncommunicable disease and related chronic disease prevention and management

Directory of Open Access Journals (Sweden)

Brownie S

2014-11-01

Full Text Available Sharon Brownie,1,2 Andrew P Hills,3,4 Rachel Rossiter51Workforce and Health Services, Griffith Health, Griffith University, Gold Coast, QLD, Australia; 2Oxford PRAXIS Forum, Green Templeton College, Oxford University, Oxford, United Kingdom; 3Allied Health Research, Mater Research Institute – The University of Queensland and Mater Mothers' Hospital, South Brisbane, QLD, Australia; 4Griffith Health Institute, Griffith Health, Griffith University, Gold Coast, QLD, Australia; 5MMHN and Nurse Practitioner Programs, School of Nursing and Midwifery, University of Newcastle, Callaghan, NSW, AustraliaAbstract: Globally, nations are confronted with the challenge of providing affordable health services to populations with increasing levels of noncommunicable and chronic disease. Paradoxically, many nations can both celebrate increases in life expectancy and bemoan parallel increases in chronic disease prevalence. Simply put, despite living longer, not all of that time is spent in good health. Combined with factors such as rising levels of obesity and related noncommunicable disease, the demand for health services is requiring nations to consider new models of affordable health care. Given the level of disease burden, all staff, not just doctors, need to be part of the solution and encouraged to innovate and deliver better and more affordable health care, particularly preventative primary health care services. This paper draws attention to a range of exemplars to encourage and stimulate readers to think beyond traditional models of primary health service delivery. Examples include nurse-led, allied health-led, and student-led clinics; student-assisted services; and community empowerment models. These are reported for the interest of policy makers and health service managers involved in preventative and primary health service redesign initiatives.Keywords: primary health care planning, community health care, nurse-led clinics, allied health personnel

Developing an ‘integrated health system’: the reform of health and social services in Quebec

Science.gov (United States)

Levine, David

2008-01-01

The Quebec health care system, founded in 1970 as a public, single payer, state run system had by 2004 reached a turning point. Rising costs, working in silos, difficulty accessing physicians, increased waiting time for diagnostic imaging and surgical intervention led policy makers and politicians to propose a new model for the organisation and delivery of care. Based on populational responsibility and the clear distinction between a community primary care and specialised services a new model was proposed to develop integrated health networks. The 7.2 million population of Quebec was divided into 95 territories. 95 Health and social service centres were created by merging a community hospital, rehab centre, long-term care centres, home care and primary care services into a single institution with a new CEO and board of directors. These new networks received the mandate to manage the health and well being of their population, to manage the utilisation of services by their population and to manage all primary care services on their territory. The implementation of a chronic care model, the development of primary care multidisciplinary teams, empowering the population and performance management, are the key elements of Montreal's vision in implementing the Reform. After three years of operation the results are promising.

Public-private implementation of integrated emergency response services: Case study of GVK Emergency Management and Research Institute in Karnataka, India.

Science.gov (United States)

Sriram, Veena M; Gururaj, Gopalkrishna; Hyder, Adnan A

2017-12-01

Emergency medical services are important to the functioning of health systems, but these services tend to be neglected in low- and middle-income countries, such as India. In recent years, several models of pre-hospital emergency medical services have emerged in India. Research on these models holds important lessons for existing and future emergency medical service programs in low- and middle-income countries. Our objective was to provide a comprehensive description of the organizational structure and service delivery model of a public-private partnership in the southern Indian state of Karnataka, GVK Emergency Management and Research Institute, with a particular focus on its operations in Bengaluru. A case study methodology was used to explore systematically the organizational model of GVK Emergency Management and Research Institute in Karnataka. Qualitative data were collected through an in-person site visit to GVK Emergency Management and Research Institute headquarters in Bengaluru in July 2013. Three sources were used: in-depth, semistructured interviews, document review, and nonparticipant observation. Data were analyzed according to the health system "building blocks" proposed by the World Health Organization. The organization follows a standardized model across the states and union territories where they have contractual arrangements, including Karnataka. Processes for fleet maintenance, information systems/information technology and training, and deployment were well structured at the organizational level. The public-private partnership appears pro-poor in orientation; however, further demand-side research is required on the perspective of patients. Our study reveals a functional structure at the organizational level, which provides a key service at no cost to users. Detailed analyses of this nature can help inform global efforts for the development and strengthening of emergency medical services systems. Copyright © 2017 Elsevier Inc. All rights reserved.

Vocational Home Economics Curriculum Guide for Occupational Home and Institutional Services.

Science.gov (United States)

Dewald, Margaret R.

The training program outlined in this guide focuses upon the development of students for gainful employment through a two-year course of study in home and institutional services. Instructional topics are provided in nine areas: orientation to home and institutional services, cleaning supplies and equipment, cleaning surfaces, cleaning clothes and…

Implementing the Institute of Medicine definition of disparities: an application to mental health care.

Science.gov (United States)

McGuire, Thomas G; Alegria, Margarita; Cook, Benjamin L; Wells, Kenneth B; Zaslavsky, Alan M

2006-10-01

In a recent report, the Institute of Medicine (IOM) defines a health service disparity between population groups to be the difference in treatment or access not justified by the differences in health status or preferences of the groups. This paper proposes an implementation of this definition, and applies it to disparities in outpatient mental health care. Health Care for Communities (HCC) reinterviewed 9,585 respondents from the Community Tracking Study in 1997-1998, oversampling individuals with psychological distress, alcohol abuse, drug abuse, or mental health treatment. The HCC is designed to make national estimates of service use. Expenditures are modeled using generalized linear models with a log link for quantity and a probit model for any utilization. We adjust for group differences in health status by transforming the entire distribution of health status for minority populations to approximate the white distribution. We compare disparities according to the IOM definition to other methods commonly used to assess health services disparities. Our method finds significant service disparities between whites and both blacks and Latinos. Estimated disparities from this method exceed those for competing approaches, because of the inclusion of effects of mediating factors (such as income) in the IOM approach. A rigorous definition of disparities is needed to monitor progress against disparities and to compare their magnitude across studies. With such a definition, disparities can be estimated by adjusting for group differences in models for expenditures and access to mental health services.

[Marketing in health service].

Science.gov (United States)

Ameri, Cinzia; Fiorini, Fulvio

2014-01-01

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.

76 FR 21386 - National Institute on Aging

Science.gov (United States)

2011-04-15

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute on Aging... personal privacy. Name of Committee: National Institute on Aging Special Emphasis Panel; Organelle Lifespan.... Place: National Institute on Aging, Gateway Building, 7201 Wisconsin Avenue, Suite 2C212, Bethesda, MD...

Addressing governance challenges in the provision of animal health services: A review of the literature and empirical application transaction cost theory.

Science.gov (United States)

Ilukor, John; Birner, Regina; Nielsen, Thea

2015-11-01

Providing adequate animal health services to smallholder farmers in developing countries has remained a challenge, in spite of various reform efforts during the past decades. The focuses of the past reforms were on market failures to decide what the public sector, the private sector, and the "third sector" (the community-based sector) should do with regard to providing animal health services. However, such frameworks have paid limited attention to the governance challenges inherent in the provision of animal health services. This paper presents a framework for analyzing institutional arrangements for providing animal health services that focus not only on market failures, but also on governance challenges, such as elite capture, and absenteeism of staff. As an analytical basis, Williamson's discriminating alignment hypothesis is applied to assess the cost-effectiveness of different institutional arrangements for animal health services in view of both market failures and governance challenges. This framework is used to generate testable hypotheses on the appropriateness of different institutional arrangements for providing animal health services, depending on context-specific circumstances. Data from Uganda and Kenya on clinical veterinary services is used to provide an empirical test of these hypotheses and to demonstrate application of Williamson's transaction cost theory to veterinary service delivery. The paper concludes that strong public sector involvement, especially in building and strengthening a synergistic relation-based referral arrangement between paraprofessionals and veterinarians is imperative in improving animal health service delivery in developing countries. Copyright © 2015 Elsevier B.V. All rights reserved.

Military Personnel Who Seek Health and Mental Health Services Outside the Military.

Science.gov (United States)

Waitzkin, Howard; Cruz, Mario; Shuey, Bryant; Smithers, Daniel; Muncy, Laura; Noble, Marylou

2018-05-01

Although research conducted within the military has assessed the health and mental health problems of military personnel, little information exists about personnel who seek care outside the military. The purpose of this study is to clarify the personal characteristics, mental health diagnoses, and experiences of active duty U.S. military personnel who sought civilian sector services due to unmet needs for care. This prospective, multi-method study included 233 clients, based in the United States, Afghanistan, South Korea, and Germany, who obtained care between 2013 and 2016 from a nationwide network of volunteer civilian practitioners. A hotline organized by faith-based and peace organizations received calls from clients and referred them to the network when the clients described unmet needs for physical or mental health services. Intake and follow-up interviews at 2 wk and 2 mo after intake captured demographic characteristics, mental health diagnoses, and reasons for seeking civilian rather than military care. Non-parametric bootstrap regression analyses identified predictors of psychiatric disorders, suicidality, and absence without leave (AWOL). Qualitative analyses of clients' narratives clarified their experiences and reasons for seeking care. The research protocol has been reviewed and approved annually by the Institutional Review Board at the University of New Mexico. Depression (72%), post-traumatic stress disorder (62%), alcohol use disorder (27%), and panic disorder (25%) were the most common diagnoses. Forty-eight percent of clients reported suicidal ideation. Twenty percent were absence without leave. Combat trauma predicted post-traumatic stress disorder (odds ratio [OR] = 8.84, 95% confidence interval [CI] 1.66, 47.12, p = 0.01) and absence without leave (OR = x3.85, 95% CI 1.14, 12.94, p = 0.03). Non-combat trauma predicted panic disorder (OR = 3.64, 95% CI 1.29, 10.23, p = 0.01). Geographical region was associated with generalized anxiety disorder

National Institute of Mental Health

Science.gov (United States)

... to content Home Health Information Health Information Home Mental Health Information Statistics Consumer Health Publications Help for Mental ... signs and symptoms of depression in men. More Mental Health Services Research Conference Register now for the nation’s ...

Product policy - the main component of the marketing mix in the Romanian health services.

Science.gov (United States)

Coculescu, B I; Purcarea, V L; Coculescu, E C

2016-01-01

The objectives of the reforms in the EU healthcare systems are based on the implementation of the marketing concept in the health systems, which are, among other things: • efficient management of the financial resources and control costs of the rendered health services; • increased satisfaction of the clients of health care services; • broad accessibility to health services; • effective implementation of modern technologies; • rational stimulation of medical services consumption; • achievement of a fair and neutral competition between the public/ private providers and health insurance companies; • introduction of performance criteria in order to increase the incomes of the medical staff and hierarchy in hospitals; • implementation of modern management methods in health services management; • decentralization of the public healthcare system. Product policy in the medical system of healthcare - the most important component of the marketing mix - is the attitude that addresses a medical organization to the volume, structure, and diversity of services subject to their own activities in relation to the requirements of the services market and the competitive actions of other medical institutions.

Perceived needs of health tutors in rural and urban health training institutions in Ghana: Implications for health sector staff internal migration control.

Science.gov (United States)

Alhassan, Robert Kaba; Beyere, Christopher B; Nketiah-Amponsah, Edward; Mwini-Nyaledzigbor, Prudence P

2017-01-01

The population of Ghana is increasingly becoming urbanized with about 70% of the estimated 27 million people living in urban and peri-urban areas. Nonetheless, eight out of the ten regions in Ghana remain predominantly rural where only 32% of the national health sector workforce works. Moreover, the rural-urban disparities in the density of health tutors (staff responsible for pre-service training of health professionals) are enormous. This paper explores perceived needs of health tutors in rural and urban health training institutions in Ghana. This is a descriptive qualitative study conducted in the Greater Accra and Northern regions of Ghana. The Study used the deductive thematic and sub-thematic analysis approaches. Five health training institutions were randomly sampled, and 72 tutors engaged in separate focus group discussions with an average size of 14 participants per group in each training institution. Perceived rural-urban disparities among health tutors were found in the payment of extra duty allowances; school infrastructure including libraries and internet connectivity; staff accommodation; and opportunities for scholarships and higher education. Health tutors in rural areas generally expressed more frustration with these work conditions than those in urban areas. There is the need to initiate and sustain work incentives that promote motivation of rural health tutors to control ongoing rural-urban migration of qualified staff. It is recommended the following incentives be prioritized to promote retention of qualified health tutors in rural health training schools: payment of research, book and rural allowances; early promotion of rural staff; prioritizing rural tutors for scholarships, and introduction of national best health tutor awards.

Forensic mental health services: Current service provision and ...

African Journals Online (AJOL)

Forensic mental health services: Current service provision and planning for a prison mental health service in the Eastern Cape. Kiran Sukeri, Orlando A. Betancourt, Robin Emsley, Mohammed Nagdee, Helmut Erlacher ...

Access to health services in six Colombian cities: limitations and consequences

Directory of Open Access Journals (Sweden)

Julián Vargas J

2009-08-01

Full Text Available Objective: To understand the characteristics of access to the General System of Social Security in health (SGSS, from the perspective of doctors, nurses, administrators and users. Methodology: based on the grounded theory we present a study in six cities in Colombia: Barranquilla, Bucaramanga, Bogota, Leticia, Medellín and Pasto, for which interviews were conducted in-depth with health professionals involved in service delivery and focus groups with service users. Results: The findings indicate that insurance has become an end in itself, and being affiliated to SGSSS does not guarantee effective access to services. The dominance of the market, the financial profitability of insurers, imposed cost-containment mechanisms over the right to health. There are limitations from the rules, benefit plans that create geographical, economic and cultural barriers from the various actors involved in the chain of decisions. Additionally, display individual and institutional ethical shortcomings, clientelism and corruption in the management of resources, coupled with poverty and geographical dispersion of communities, mean that further limiting access to health services.

Elderly long-stay institutions: possibilities contemporary housing

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Eliana Novaes Procopio de Araujo

2011-09-01

Full Text Available The elderly process proposes new challenges. The elderly living will be discussed. The overload in family nucleous direct for the necessity in institutions service. The work about management in psycogerontology services in institutions aimed the humanization of elderly care, families and health professionals. The construction of a new project of life in institutions promotes a better quality of life to elderly, as well as to their families and health professionals.  

European practices of providing of efficiency of self-organizations institutions of population in the context of public services

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T. V. Serohina

2017-06-01

Full Text Available The research revealed that European countries devote sufficient attention to ensuring the effectiveness of the institutions of self-organization in the context of their public services. The most common areas where they operate are a system of health, education and assistance during emergencies. The study showed that in the development of public services, there were significant transformations in terms of subject-provider. Historically it was confessional organizations working on a voluntary basis, and linked their activity with the realization of Christian mission. Subsequently, when there had been formation of a «welfare state», the state took over responsibility for the area of public services. In favor of institutions of self-organization has been a change in the system when it became clear that they are best in the provide public services, especially in the social sphere, because they are the demonstrating of social needs. The main mechanisms of cooperation between institutions of self-organization and the public sector are, first, subsidies for statutory activities of the organization. Another mechanism is delegating services or outsourcing and in this case contracts mostly are for one year with possibility of further extension. In addition there is auxiliary element of providing of effectiveness institutions of self-organization, it consists in deprivation of their donors from taxes. Although institutions of self-organization are financed mainly by public authorities, they remain independent, because they have opportunity of funding from other sources. German experience showed that the starting point in the system of public services is the understanding of the necessity of paying taxes as acknowledgment of the rights of all members of society. That is why every taxpayer expects to receive public services at the appropriate level. This unwritten rule contributes to a very high level of provision of public services through an adequate

Health research barriers in the faculties of two medical institutions in India

Directory of Open Access Journals (Sweden)

Alamdari A

2012-08-01

(Research and Provision of health care services as a major activity (P < 0.01. The majority of faculty members at UCMS and GTB Hospital were professors, whereas most of the faculty members at AIIMS were associate professors (P < 0.01. Of 47 barriers and facilitating factors, there were 26 barriers and 21 facilitating factors at AIIMS and 39 barriers and eight facilitating factors at UCMS. Faculty members at UCMS had 6.572 times more barriers to health research than those at AIIMS.Conclusion: Close proximity between AIIMS and the Indian Council of Medical Research and the National Medical Library, housing, transport, and a good reference library with an adequate knowledge support system provided suitable opportunities for faculty members at AIIMS to do research. To overcome the barriers, institutions must have enough financial support, decreased nonessential clinical, laboratory, and service schedule duties on the part of faculty members, preparation of good and relevant statistical courses and workshops, and access to good statistical software packages.Keywords: health research, barriers, facilitators, medical institutions

Inequity in maternal health care service utilization in Gujarat: analyses of district-level health survey data.

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Saxena, Deepak; Vangani, Ruchi; Mavalankar, Dileep V; Thomsen, Sarah

2013-03-06

Two decades after the launch of the Safe Motherhood campaign, India still accounts for at least a quarter of maternal death globally. Gujarat is one of the most economically developed states of India, but progress in the social sector has not been commensurate with economic growth. The purpose of this study was to use district-level data to gain a better understanding of equity in access to maternal health care and to draw the attention of the policy planers to monitor equity in maternal care. Secondary data analyses were performed among 7,534 ever-married women who delivered since January 2004 in the District Level Household and Facility Survey (DLHS-3) carried out during 2007-2008 in Gujarat, India. Based on the conceptual framework designed by the Commission on the Social Determinants of Health, associations were assessed between three outcomes - Institutional delivery, antenatal care (ANC), and use of modern contraception - and selected intermediary and structural determinants of health using multiple logistic regression. Inequities in maternal health care utilization persist in Gujarat. Structural determinants like caste group, wealth, and education were all significantly associated with access to the minimum three antenatal care visits, institutional deliveries, and use of any modern method of contraceptive. There is a significant relationship between being poor and access to less utilization of ANC services independent of caste category or residence. Poverty is the most important determinant of non-use of maternal health services in Gujarat. In addition, social position (i.e. caste) has a strong independent effect on maternal health service use. More focused and targeted efforts towards these disadvantaged groups needs to be taken at policy level in order to achieve targets and goals laid out as per the MDGs. In particular, the Government of Gujarat should invest more in basic education and infrastructural development to begin to remove the structural causes

Inequity in maternal health care service utilization in Gujarat: analyses of district-level health survey data

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Dileep V. Mavalankar

2013-03-01

Full Text Available Background: Two decades after the launch of the Safe Motherhood campaign, India still accounts for at least a quarter of maternal death globally. Gujarat is one of the most economically developed states of India, but progress in the social sector has not been commensurate with economic growth. The purpose of this study was to use district-level data to gain a better understanding of equity in access to maternal health care and to draw the attention of the policy planers to monitor equity in maternal care. Methods: Secondary data analyses were performed among 7,534 ever-married women who delivered since January 2004 in the District Level Household and Facility Survey (DLHS-3 carried out during 2007–2008 in Gujarat, India. Based on the conceptual framework designed by the Commission on the Social Determinants of Health, associations were assessed between three outcomes – Institutional delivery, antenatal care (ANC, and use of modern contraception – and selected intermediary and structural determinants of health using multiple logistic regression. Results: Inequities in maternal health care utilization persist in Gujarat. Structural determinants like caste group, wealth, and education were all significantly associated with access to the minimum three antenatal care visits, institutional deliveries, and use of any modern method of contraceptive. There is a significant relationship between being poor and access to less utilization of ANC services independent of caste category or residence. Discussion and conclusions: Poverty is the most important determinant of non-use of maternal health services in Gujarat. In addition, social position (i.e. caste has a strong independent effect on maternal health service use. More focused and targeted efforts towards these disadvantaged groups needs to be taken at policy level in order to achieve targets and goals laid out as per the MDGs. In particular, the Government of Gujarat should invest more in basic

[Effect of implementation of essential medicine system in the primary health care institution in China].

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Huang, Donghong; Ren, Xiaohua; Hu, Jingxuan; Shi, Jingcheng; Xia, Da; Sun, Zhenqiu

2015-02-01

Our primary health care institution began to implement national essential medicine system in 2009. In past fi ve years, the goal of national essential medicine system has been initially achieved. For examples, medicine price is steadily reducing, the quality of medical services is improving and residents' satisfaction is substantial increasing every year. However, at the same time, we also found some urgent problems needed to be solved. For examples, the range of national essential medicine is limited, which is difficult to guarantee the quality of essential medication. In addition, how to compensate the primary health care institution is still a question.

STRATEGIES FOR ADVANCE IN DEVELOPMENT OF A HEALTH CARE INSTITUTION FOR SPECIALIZED PRE-HOSPITAL MEDICAL AID

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Desislava Todorova

2017-12-01

Full Text Available which brings about a competitive environment for an increase of the quality of services offered. The aim of the study is making evident the recommendatory strategies of a health care institution for specialized pre-hospital medical aid in Sofia City for activity performed in the period from the year 2016 to 2018. The task assigned is an analysis of the opportunities for the widening of the activity, products, and markets of "DCC XXIVth-Sofia" EOOD. The chosen healthcare institution is active in a competitive environment in Sofia City, and in the district that it serves. Data from the health care institution, data from the institutions of National Statistics, and scientific literature on the topic were used in connection with the analysis. Some essential approaches of management were applied - analysis of the market share, and SWOT analysis, for determination of strategy. The conclusions of the analysis performed showed four possible strategies of advance in development and opportunities for activity in each of them. The administration of "DCC XXIVth-Sofia" EOOD had opportunities to all practical purposes for minimization of the negative effects, induced by the weaknesses and threats, and to successfully develop the activity - during the period from the year 2016 to 2018. Both the activity of the healthcare institution and the public health services of the population in the corresponding village/town/city depend on the choice of the administration and on its execution by the personnel.

Child Health Care Services in Austria.

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

2016-10-01

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

Health status, health service use, and satisfaction according to sexual identity of young Australian women.

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McNair, Ruth; Szalacha, Laura A; Hughes, Tonda L

2011-01-01

we sought to compare physical and mental health status, health service use, and satisfaction among young Australian women of varying sexual identity; and to explore associations of all of these variables with satisfaction with their general practitioner (GP). data are from the youngest cohort of women in the Australian Longitudinal Study on Women's Health surveyed in 2003. The sample included women aged 25 to 30 who identified as exclusively heterosexual (n = 8,083; 91.3%), mainly heterosexual (n = 568; 6.4%), bisexual (n = 100; 1.1%), or lesbian (n = 99; 1.1%). Univariate analyses compared self-reported mental health, physical health, access to GP services, and satisfaction across the four sexual identity groups. Linear regression, controlling for education, income, and residence, was used to identify factors associated with GP satisfaction. sexual minority women (lesbian, bisexual, and mainly heterosexual) were significantly more likely than were heterosexual women to report poorer mental health and to have more frequently used health services; depression was strongly associated with mental health services use. Bisexual and mainly heterosexual women were most likely to report poorer general health, abnormal Pap tests, sexually transmissible infections, urinary tract infections, hepatitis B or C virus infection, and asthma. Lesbians were most likely to have never had a Pap test or be underscreened. All sexual minority women had lower continuity of GP care and lower satisfaction with that care than heterosexual women. underlying social determinants of physical and mental health disparities experienced by sexual minority women require exploration, including the possible effects of discrimination and marginalization on higher levels of risk taking. Lower continuity of care and lower satisfaction with GP services also need further investigation. 2011 Jacobs Institute of Women's Health. Published by Elsevier Inc.

Integration services to enable regional shared electronic health records.

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Oliveira, Ilídio C; Cunha, João P S

2011-01-01

eHealth is expected to integrate a comprehensive set of patient data sources into a coherent continuum, but implementations vary and Portugal is still lacking on electronic patient data sharing. In this work, we present a clinical information hub to aggregate multi-institution patient data and bridge the information silos. This integration platform enables a coherent object model, services-oriented applications development and a trust framework. It has been instantiated in the Rede Telemática de Saúde (www.RTSaude.org) to support a regional Electronic Health Record approach, fed dynamically from production systems at eight partner institutions, providing access to more than 11,000,000 care episodes, relating to over 350,000 citizens. The network has obtained the necessary clearance from the Portuguese data protection agency.

Community health promotion approaches within institutions for disabled

DEFF Research Database (Denmark)

Holm, Jesper

From a two years study of 3 special educational institutions for disabled in Zealand, Denmark, we have done qualitative studies of the focus-areas that the institutions have pointed out as their Best Practices of Health Promotion in everyday life. We have in general followed research questions......: What practices do special institutions for people with developmental disabilities believe to be health promoting, and will a research based reconstruction of these practices with health promotion concepts have anything to offer for professionals in this area? How will the involved parties experience...... each other practices and is possible to establish a mutual institutional learning process, as a surplus to normal quality control (NPM)? What understandings of psyche, individual, mind-body-spirit, health promotion etc. are involved in these practices, and how do they relate to the institutional...

Impacts of Sustained Institutional Participation in Service-Learning: Perspectives from faculty, staff and administrators

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Amanda L. Vogel

2011-11-01

Full Text Available The movement for greater civic engagement in higher education in the United States has taken hold across the core academic missions of teaching, research and service. One manifestation of this movement has been growing participation in service-learning, a teaching method grounded in community-university partnerships in which students provide services that simultaneously address community-identified concerns and meet key learning objectives. In order to assess the benefits of long-term sustained institutional involvement in service-learning, in 2007–2008 we interviewed 23 faculty members, staff and administrators from 16 academic institutions that had participated in a national demonstration program for service-learning, which ended in 1998. We found that 15 of these institutions had sustained service-learning to some degree and 12 had integrated service-learning into the curriculum, with varying degrees of institutional support. Interview participants described five main impacts of their institutions’ sustained participation in service-learning: 1 increased community engagement and community-engaged scholarship, and increased valuation of both, among participating faculty members; 2 greater capacity for community-university partnerships among academic and community partners; 3 improved community-university relations; 4 diffusion of service-learning and/or principles of community-university partnerships to other departments and schools; and 5 recruitment of students seeking community engagement opportunities. This study provides evidence that sustained institutional participation in service-learning can foster an understanding of the scholarly value of community-engaged teaching and research among participating faculty, and increase community-engaged activities at participating academic institutions. These findings suggest that funding agencies, faculty members and academic administrators can use service-learning as a strategy to foster a

Health care needs assessment among adolescents in correctional institutions in Zambia: an ethical analysis.

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Kumwenda, Maureen; Nzala, Selestine; Zulu, Joseph M

2017-08-22

While health care needs assessments have been conducted among juveniles or adolescents by researchers in developed countries, assessments using an ethics framework particularly in developing countries are lacking. We analysed the health care needs among adolescents at the Nakambala Correctional Institution in Zambia, using the Beauchamp and Childress ethics framework. The ethics approach facilitated analysis of moral injustices or dilemmas triggered by health care needs at the individual (adolescent) level. The research team utilized 35 in-depth interviews with juveniles, 6 key informant interviews and 2 focus group discussions to collect data. We analysed the data using thematic analysis. The use of three sources of data facilitated triangulation of data. Common health problems included HIV/AIDS, STIs, flu, diarrhoea, rashes, and malaria. Although there are some health promotion strategies at the Nakambala Approved School, the respondents classified the health care system as inadequate. The unfavourable social context which included clouded rooms and lack of adolescent health friendly services unfairly exposed adolescents to several health risks and behaviours thus undermining the ethics principle of social justice. In addition, the limited prioritisation of adolescent centres by the stakeholders and erratic funding also worsened injustices by weakening the health care system. Whereas the inadequate medical and drug supplies, shortage of health workers in the nearby health facilities and weak referral systems excluded the juveniles from enjoying maximum health benefits thus undermining adolescents' wellbeing or beneficence. Inadequate medical and drug supplies as well as non-availability of adolescent friendly health services at the nearest health facility did not only affect social justice and beneficence ethics principles but also threatened juveniles' privacy, liberty and confidentiality as well as autonomy with regard to health service utilisation

Service user governors in mental health foundation trusts: accountability or business as usual?

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MacDonald, Dee; Barnes, Marian; Crawford, Mike; Omeni, Edward; Wilson, Aaron; Rose, Diana

2015-12-01

National Health Foundation Trusts present opportunities for individual mental health service users to be active in the governance of trusts. This is one of a range of mechanisms for patient and public involvement and one which promotes an individual rather than collective approach to involvement. Within the context of a broader study of the impact of service user involvement in mental health services, the objective of this article was to explore the experience of service user governors in foundation trusts and their capacity to hold boards to account. The Council of Governors in three foundation trusts were observed for a year. Focus groups with service user governors were undertaken in each trust. Service users had different expectations and understandings of the role and approached it in different ways. Key themes that emerged concerned: the role of a governor, conduct and content of meetings, agenda setting, relationships and representation. The experiences of mental health service user governors need to be understood within the complex environment of patient and public involvement in general and of mental health service user involvement in particular. The dislocation of the service user governor role from other forms of service user activity and involvement result in confusion about how notions of holding a trust to account and representation of other service users can be addressed within a boundaried institutional environment. © 2014 John Wiley & Sons Ltd.

Educational services in health sciences libraries: an analysis of the periodical literature, 1975-1986.

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Zachert, M J

1987-07-01

The periodical literature on group instructional services in health sciences libraries was analyzed to determine the nature of these services, their target audiences, and their institutional settings. Three kinds of reports were identified: descriptions of services (70%), reviews of the literature (10.5%), and future-oriented articles that advocate various group instructional services (19.5%). Five target audiences were identified: library users, staff, librarian peers, library science students, and patients. Instructional services were offered primarily in medical school/center libraries, hospital libraries, and the National Library of Medicine and its Regional Medical Libraries (RMLs). To a lesser extent, health sciences educational services are offered through other professional school libraries, library associations and consortia, and schools of library science. There are gaps in the literature in the areas of library experience with marketing, evaluation, administration of the offered educational services, and continuing education for health sciences librarians.

76 FR 13097 - Institute of Museum and Library Services; Evaluation by Grantees

Science.gov (United States)

2011-03-10

... With Institutions of Higher Education, Hospitals, and Other Non-Profit Organizations, provides, in part... Services; Evaluation by Grantees AGENCY: Institute of Museum and Library Services, National Foundation On.... IMLS amends 45 CFR 1180.46, Evaluation by the grantee, to ensure that IMLS requirements conform to the...

Homeless health needs: shelter and health service provider perspective.

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Hauff, Alicia J; Secor-Turner, Molly

2014-01-01

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.

Franchising reproductive health services.

Science.gov (United States)

Stephenson, Rob; Tsui, Amy Ong; Sulzbach, Sara; Bardsley, Phil; Bekele, Getachew; Giday, Tilahun; Ahmed, Rehana; Gopalkrishnan, Gopi; Feyesitan, Bamikale

2004-12-01

Networks of franchised health establishments, providing a standardized set of services, are being implemented in developing countries. This article examines associations between franchise membership and family planning and reproductive health outcomes for both the member provider and the client. Regression models are fitted examining associations between franchise membership and family planning and reproductive health outcomes at the service provider and client levels in three settings. Franchising has a positive association with both general and family planning client volumes, and the number of family planning brands available. Similar associations with franchise membership are not found for reproductive health service outcomes. In some settings, client satisfaction is higher at franchised than other types of health establishments, although the association between franchise membership and client outcomes varies across the settings. Franchise membership has apparent benefits for both the provider and the client, providing an opportunity to expand access to reproductive health services, although greater attention is needed to shift the focus from family planning to a broader reproductive health context.

Global payment for health services as a solution in the financial crisis in Europe.

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Schrijvers, Guus

2012-10-01

In these financial difficult years many European governments used global ceilings to control costs of health services. Two scenarios are thinkable. The first is that all individual providers get a budget for their own costs: general practitioners, specialists, hospitals, nursing homes and mental health institutes. The second scenario is to work with global budgets for health care providers servicing a total population. Scientists and policy makers in Europe, North America and Asia need time to design new payment systems based on the idea of global budgeting, bundled payment and shared savings.

Institutional Roles for In-Service Education of School Administrators.

Science.gov (United States)

Lynch, Patrick D., Ed.; Blackstone, Peggy L., Ed.

This document is a compilation of papers read at a 4-day conference attended by 60 participants from throughout the United States. Chapters include (1) "In-Service Education of School Administrators: Background, Present Status, and Problems," by Robert B. Howsam; (2) "Notes on Institutional Relationships in the In-Service Education of the…

A qualitative evaluation of medication management services in six Minnesota health systems.

Science.gov (United States)

Sorensen, Todd D; Pestka, Deborah; Sorge, Lindsay A; Wallace, Margaret L; Schommer, Jon

2016-03-01

The initiation, establishment, and sustainability of medication management programs in six Minnesota health systems are described. Six Minnesota health systems with well-established medication management programs were invited to participate in this study: Essentia Health, Fairview Health Services, HealthPartners, Hennepin County Medical Center, Mayo Clinic, and Park Nicollet Health Services. Qualitative methods were employed by conducting group interviews with key staff from each institution who were influential in the development of medication management services within their organization. Kotter's theory of eight steps for leading organizational change served as the framework for the question guide. The interviews were audio recorded, transcribed, and analyzed for recurring and emergent themes. A total of 13 distinct themes were associated with the successful integration of medication management services across the six healthcare systems. Identified themes clustered within three stages of Kotter's model for leading organizational change: creating a climate for change, engaging and enabling the whole organization, and implementing and sustaining change. The 13 themes included (1) external influences, (2) pharmacists as an untapped resource, (3) principles and professionalism, (4) organizational culture, (5) momentum champions, (6) collaborative relationships, (7) service promotion, (8) team-based care, (9) implementation strategies, (10) overcoming challenges, (11) supportive care model process, (12) measuring and reporting results, and (13) sustainability strategies. A qualitative survey of six health systems that successfully implemented medication management services in ambulatory care clinics revealed that a supportive culture and team-based collaborative care are among the themes identified as necessary for service sustainability. Copyright © 2016 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Assessing the performance of mental health service facilities for meeting patient priorities and health service responsiveness.

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Bramesfeld, A; Stegbauer, C

2016-10-01

The World Health Organisation has defined health service responsiveness as one of the key-objectives of health systems. Health service responsiveness relates to the ability to respond to service users' legitimate expectations on non-medical issues when coming into contact with the services of a healthcare system. It is defined by the areas showing respect for persons and patient orientation. Health service responsiveness is particularly relevant to mental health services, due to the specific vulnerability of mental health patients but also because it matches what mental health patients consider as good quality of care as well as their priorities when seeking healthcare. As (mental) health service responsiveness applies equally to all concerned services it would be suitable as a universal indicator for the quality of services' performance. However, performance monitoring programs in mental healthcare rarely assess health service performance with respect to meeting patient priorities. This is in part due of patient priorities as an outcome being underrepresented in studies that evaluate service provision. The lack of studies using patient priorities as outcomes transmits into evidence based guidelines and subsequently, into underrepresentation of patient priorities in performance monitoring. Possible ways out of this situation include more intervention studies using patient priorities as outcome, considering evidence from qualitative studies in guideline development and developing performance monitoring programs along the patient pathway and on key-points of relevance for service quality from a patient perspective.

Variations in prison mental health services in England and Wales.

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Forrester, Andrew; Exworthy, Tim; Olumoroti, Olumuyiwa; Sessay, Mohammed; Parrott, Janet; Spencer, Sarah-Jane; Whyte, Sean

2013-01-01

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. Copyright © 2013 Elsevier Ltd. All rights reserved.

Correlates of and Barriers to the Utilization of Health Services for Delivery in South Asia and Sub-Saharan Africa

Directory of Open Access Journals (Sweden)

Nai-Peng Tey

2013-01-01

Full Text Available The high maternal and neonatal mortality rates in South Asia and Sub-Saharan Africa can be attributed to the lack of access and utilization of health services for delivery. Data from the Demographic and Health Surveys conducted in Bangladesh, India, Pakistan, Kenya, Nigeria, and Tanzania show that more than half of the births in these countries were delivered outside a health facility. Institutional delivery was closely associated with educational level, family wealth, place of residence, and women’s media exposure status, but it was not influenced by women’s work status and their roles in decision-making (with the exception of Nigeria. Controlling for other variables, higher parity and younger women were less likely to use a health facility for delivery. Within each country, the poorer, less educated and rural women had higher unmet need for maternal care services. Service related factors (accessibility in terms of cost and distance and sociocultural factors (e.g., did not perceive the need for the services and objections from husband and family also posed as barriers to institutional delivery. The paper concludes with some suggestions to increase institutional delivery.

Examining clinicians’ experiences providing sexual health services for LGBTQ youth: considering social and structural determinants of health in clinical practice

Science.gov (United States)

Knight, R. E.; Shoveller, J. A.; Carson, A. M.; Contreras-Whitney, J. G.

2014-01-01

Although barriers related to lesbian, gay, bisexual, transgender and queer (LGBTQ) youth’s experiences accessing sexual health services have been examined in detail, research into the experiences and perceptions of clinicians providing these services has been conspicuously absent. The aim of this article is to explore the perceptions and experiences of clinicians providing sexual health services for LGBTQ youth. Drawing on in-depth, semi-structured interviews, this study examines 24 clinicians’ experiences providing sexual health services to LGBTQ youth in five communities in British Columbia, Canada. Our findings reveal how many clinicians provide services to LGBTQ youth with a lack of cultural competency—either implicitly (e.g. by describing heteronormative practices) or explicitly (e.g. by expressing frustration that they had not been sufficiently provided with appropriate training related to LGBTQ youth sexual health). Institutional norms and values were identified as the dominant barriers in the effective provision of LGBTQ-tailored services. Many clinicians find themselves unprepared to provide culturally competent sexual health services that have both the capacity to address individual-level issues (e.g. promoting condom use) while considering (and adapting services to) the broader socio-cultural and structural conditions that can render LGBTQ youth socially vulnerable. PMID:24412811

Microeconomic institutions and personnel economics for health care delivery: a formal exploration of what matters to health workers in Rwanda.

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Serneels, Pieter; Lievens, Tomas

2018-01-26

Most developing countries face important challenges regarding the quality of health care, and there is a growing consensus that health workers play a key role in this process. Our understanding as to what are the key institutional challenges in human resources, and their underlying driving forces, is more limited. A conceptual framework that structures existing insights and provides concrete directions for policymaking is also missing. To gain a bottom-up perspective, we gather qualitative data through semi-structured interviews with different levels of health workers and users of health services in rural and urban Rwanda. We conducted discussions with 48 health workers and 25 users of health services in nine different groups in 2005. We maximized within-group heterogeneity by selecting participants using specific criteria that affect health worker performance and career choice. The discussion were analysed electronically, to identify key themes and insights, and are documented with a descriptive quantitative analysis relating to the associations between quotations. The findings from this research are then revisited 10 years later making use of detailed follow-up studies that have been carried out since then. The original discussions identified both key challenges in human resources for health and driving forces of these challenges, as well as possible solutions. Two sets of issues were highlighted: those related to the size and distribution of the workforce and those related to health workers' on-the-job performance. Among the latter, four categories were identified: health workers' poor attitudes towards patients, absenteeism, corruption and embezzlement and lack of medical skills among some categories of health workers. The discussion suggest that four components constitute the deeper causal factors, which are, ranked in order of ease of malleability, incentives, monitoring arrangements, professional and workplace norms and intrinsic motivation. Three

Estimating the Cost of Providing Foundational Public Health Services.

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Mamaril, Cezar Brian C; Mays, Glen P; Branham, Douglas Keith; Bekemeier, Betty; Marlowe, Justin; Timsina, Lava

2017-12-28

To estimate the cost of resources required to implement a set of Foundational Public Health Services (FPHS) as recommended by the Institute of Medicine. A stochastic simulation model was used to generate probability distributions of input and output costs across 11 FPHS domains. We used an implementation attainment scale to estimate costs of fully implementing FPHS. We use data collected from a diverse cohort of 19 public health agencies located in three states that implemented the FPHS cost estimation methodology in their agencies during 2014-2015. The average agency incurred costs of $48 per capita implementing FPHS at their current attainment levels with a coefficient of variation (CV) of 16 percent. Achieving full FPHS implementation would require $82 per capita (CV=19 percent), indicating an estimated resource gap of $34 per capita. Substantial variation in costs exists across communities in resources currently devoted to implementing FPHS, with even larger variation in resources needed for full attainment. Reducing geographic inequities in FPHS may require novel financing mechanisms and delivery models that allow health agencies to have robust roles within the health system and realize a minimum package of public health services for the nation. © Health Research and Educational Trust.

Building a partnership to evaluate school-linked health services: the Cincinnati School Health Demonstration Project.

Science.gov (United States)

Rose, Barbara L; Mansour, Mona; Kohake, Kelli

2005-12-01

The Cincinnati School Health Demonstration Project was a 3-year collaboration that evaluated school-linked health services in 6 urban elementary (kindergarten to eighth grade) schools. Partners from the Cincinnati Health Department, Cincinnati Public Schools, Cincinnati Children's Hospital Medical Center, and The Health Foundation of Greater Cincinnati wanted to determine if levels of school-linked care made a difference in student quality of life, school connectedness, attendance, emergency department use, and volume of referrals to health care specialists. School nurses, principals and school staff, parents and students, upper-level managers, and health service researchers worked together over a 2.5-year period to learn about and use new technology to collect information on student health, well-being, and outcome measures. Varying levels of school health care intervention models were instituted and evaluated. A standard model of care was compared with 2 models of enhanced care and service. The information collected from students, parents, nurses, and the school system provided a rich database on the health of urban children. School facilities, staffing, and computer technology, relationship building among stakeholders, extensive communication, and high student mobility were factors that influenced success and findings of the project. Funding for district-wide computerization and addition of school health staff was not secured by the end of the demonstration project; however, relationships among the partners endured and paved the way for future collaborations designed to better serve urban school children in Cincinnati.

[Organization and functioning of health services of the IMSS-Solidaridad program].

Science.gov (United States)

Velázquez-Díaz, G

1992-01-01

In this report the organization and performance of the IMSS-Solidaridad Program of Mexico is described. This program is managed by the Mexican Institute for Social Security, which services 10.5 million inhabitants of the rural underserved areas, with federal government resources in 18 states. This study compares the structure and functioning of the IMSS-Solidaridad Program with Local Health Systems, as they have been proposed by the Panamerican Health Organization for country members and by the Ministry of Health of Mexico, particularly in relation to the decision-making process at local level. Some assets and limitations of the IMSS-Solidaridad Program are analyzed and, finally, concrete procedures to improve coordination between the IMSS-Solidaridad Program and other health services for similar populations (populations without social security protection) in Mexico are suggested, with the purpose of using resources more adequately and succeed in the national goal to achieve equity in health.

[Current status of occupational health activities and the way that occupational health services should be offered to small- and medium-scale enterprises].

Science.gov (United States)

Kayashima, Kotaro

2013-10-01

Activating occupational safety and health activities among Small- and Medium-scale Enterprises (SMEs) is a major issue because more than 80% of Japanese workers belong to these enterprises, in which the number of workers are less than 300 people. However, as the size of the enterprise decreases, the occurrence of problems of safety and health management systems and safety and health activities increases. Reasons for this include both the limitations of investments shortages of human resources. Occupational health services in SMEs has been provided by the cooperation of the following institutions: public associations (such as Regional Occupational Health Centers, Occupational Health Promotion Centers, Japan Industrial Safety and Health Association (JISHA)), occupational health agencies which provide checkup services, health insurance associations, and regional medical services. In contrast to the low coverage of occupational health services among SMEs in Japan, there are some countries in Europe in which this coverage is almost 100%. This is because of the development of occupational health services outside the company. To show the benefits of the safety and health activities to managers of SMEs, and to motivate them to take advantage of the services, it is important to consider measurements. Also, establishing systems that provide those services, improving the quality of specialists such as occupational physicians, and educating human resources, are all necessary.

Franchising Reproductive Health Services

Science.gov (United States)

Stephenson, Rob; Tsui, Amy Ong; Sulzbach, Sara; Bardsley, Phil; Bekele, Getachew; Giday, Tilahun; Ahmed, Rehana; Gopalkrishnan, Gopi; Feyesitan, Bamikale

2004-01-01

Objectives Networks of franchised health establishments, providing a standardized set of services, are being implemented in developing countries. This article examines associations between franchise membership and family planning and reproductive health outcomes for both the member provider and the client. Methods Regression models are fitted examining associations between franchise membership and family planning and reproductive health outcomes at the service provider and client levels in three settings. Results Franchising has a positive association with both general and family planning client volumes, and the number of family planning brands available. Similar associations with franchise membership are not found for reproductive health service outcomes. In some settings, client satisfaction is higher at franchised than other types of health establishments, although the association between franchise membership and client outcomes varies across the settings. Conclusions Franchise membership has apparent benefits for both the provider and the client, providing an opportunity to expand access to reproductive health services, although greater attention is needed to shift the focus from family planning to a broader reproductive health context. PMID:15544644

The Association of Health Insurance with institutional delivery and access to skilled birth attendants: evidence from the Kenya Demographic and health survey 2008-09.

Science.gov (United States)

Were, Lawrence P O; Were, Edwin; Wamai, Richard; Hogan, Joseph; Galarraga, Omar

2017-07-03

Healthcare financing through health insurance is gaining traction as developing countries strive to achieve universal health coverage and address the limited access to critical health services for specific populations including pregnant women and their children. However, these reforms are taking place despite limited evaluation of impact of health insurance on maternal health in developing countries including Kenya. In this study we evaluate the association of health insurance with access and utilization of obstetric delivery health services for pregnant women in Kenya. Nationally representative data from the Kenya Demographic and Health Survey 2008-09 was used in this study. 4082 pregnant women with outcomes of interest - Institutional delivery (Yes/No - delivery at hospital, dispensary, maternity home, and clinic) and access to skilled birth attendants (help by a nurse, doctor, or trained midwife at delivery) were selected from 8444 women ages 15-49 years. Linear and logistic regression, and propensity score adjustment are used to estimate the causal association of enrollment in insurance on obstetric health outcomes. Mothers with insurance are 23 percentage points (p insured. In addition mothers of lower socio-economic status benefit more from enrollment in insurance compared to mothers of higher socio-economic status. For both institutional delivery and access to skilled birth attendants, the average difference of the association of insurance enrollment compared to not enrolling for those of low SES is 23 percentage points (p health insurance is associated with increased access and utilization of obstetric delivery health services for pregnant women. Notably, those of lower socio-economic status seem to benefit the most from enrollment in insurance.

[Environmental medicine in public health service--a social responsibility and its consequences].

Science.gov (United States)

Thriene, B

2001-02-01

The special committee for "Environmental Medicine" established by the Federal Association of Doctors in the German Public Health Service presents its paper entitled "Environmental Medicine in the Public Health Service--A Social Responsibility and its Consequences: Propositions with regard to the situation, aims, strategies, and opportunities for action". The paper includes core ideas and responsibilities in the public health service. It aims at providing a number of guidelines for implementing "Environment and Health" ("Umwelt und Gesundheit"), an action programme by the Federal Ministry of Environmental Protection and the Ministry of Health, as well as "Health 21" ("Gesundheit 21"), the framework concept "Health for all" for the WHO's European Region. The paper also aims at initiating and facilitating steps for joint action by the Public Health Service. These theses were passed on to Mrs. Andrea Fischer, the Federal Minister of Health, during a meeting with the Board of the Association. In Germany, environment-related public health protection is well established in the Public Health Departments and state institutes/departments within the scope of public health provision and disease prevention. Typical responsibilities include environmental hygiene and environment-related medical services which have increased in importance. The range of responsibilities and its current political importance are a result of environment-related public health risks, the social situation of the population, also with regard to health issues, and the scope of responsibilities and competencies by doctors and staff in the public health departments. With the people's demands for health, quality of life and life expectancy, this need for action increases. In this paper, judicial, professional, and personal consequence are presented which arise as public health authorities assume these responsibilities.

Magnitude of institutional delivery service utilization and associated factors among women in pastoral community of Awash Fentale district Afar Regional State, Ethiopia.

Science.gov (United States)

Assefa, Luelseged; Alemayehu, Mussie; Debie, Ayal

2018-03-02

Reduction of maternal mortality is a global priority particularly in developing countries like Ethiopia where maternal mortality ratio is one of the highest in the world. Most deliveries in developing countries occur at home without skilled birth attendants. Therefore, the objective of this study was to assess institutional delivery service utilization and associated factors among women in pastoral community of Awash Fentale district, Ethiopia. Overall, 35.2% of women delivered at health facilities. Women who had good knowledge AOR = 2.1, 95% CI 1.32, 4.87), Ante Natal Care (ANC) follow up (AOR = 3.2, 95% CI 1.55, 6.63), resided in a place where distance to reach at the nearby health facilities takes delivery place (AOR = 1.9; 95% CI 1.49, 5.07) were more likely to deliver at health facility. Therefore, strengthening ANC services, improving maternal knowledge, involving husbands in decision of delivery place and expanding health facilities in the community would enhance institutional delivery.

Cost of Delivering Health Care Services in Public Sector Primary and Community Health Centres in North India.

Science.gov (United States)

Prinja, Shankar; Gupta, Aditi; Verma, Ramesh; Bahuguna, Pankaj; Kumar, Dinesh; Kaur, Manmeet; Kumar, Rajesh

2016-01-01

With the commitment of the national government to provide universal healthcare at cheap and affordable prices in India, public healthcare services are being strengthened in India. However, there is dearth of cost data for provision of health services through public system like primary & community health centres. In this study, we aim to bridge this gap in evidence by assessing the total annual and per capita cost of delivering the package of health services at PHC and CHC level. Secondly, we determined the per capita cost of delivering specific health services like cost per antenatal care visit, per institutional delivery, per outpatient consultation, per bed-day hospitalization etc. We undertook economic costing of fourteen public health facilities (seven PHCs and CHCs each) in three North-Indian states viz., Haryana, Himachal Pradesh and Punjab. Bottom-up costing method was adopted for collection of data on all resources spent on delivery of health services in selected health facilities. Analysis was undertaken using a health system perspective. The joint costs like human resource, capital, and equipment were apportioned as per the time value spent on a particular service. Capital costs were discounted and annualized over the estimated life of the item. Mean annual costs and unit costs were estimated along with their 95% confidence intervals using bootstrap methodology. The overall annual cost of delivering services through public sector primary and community health facilities in three states of north India were INR 8.8 million (95% CI: 7,365,630-10,294,065) and INR 26.9 million (95% CI: 22,225,159.3-32,290,099.6), respectively. Human resources accounted for more than 50% of the overall costs at both the level of PHCs and CHCs. Per capita per year costs for provision of complete package of preventive, curative and promotive services at PHC and CHC were INR 170.8 (95% CI: 131.6-208.3) and INR162.1 (95% CI: 112-219.1), respectively. The study estimates can be used

Religious institutions and the politics of access to basic services in displacement contexts

DEFF Research Database (Denmark)

Lauterbach, Karen

This paper provides a study of religious institutions as service providers in contexts of crises and displacement. Religious institutions, as well as other non-state institutions, provide access to a vast range of resources and services (such as food, housing, clothes, counseling, money, and access...... to networks). In contexts of displacement access to basic services is formally regulated by one’s status (e.g. as refugee or national citizen) and by physical location (e.g. in settlements/camps or urban areas). The paper discusses what role religious institutions play when access to services provided...... by the state or the international humanitarian system is limited or non-existent and what kind of relations of exchange that is at stake. Empirically the project deals with Congolese churches in Kampala, Uganda of which many pastors and members have refugee status. The paper analyses the range and categories...

Moving global health forward in academic institutions

Directory of Open Access Journals (Sweden)

Didier Wernli

2016-06-01

Full Text Available Global health has attracted growing attention from academic institutions. Its emergence corresponds to the increasing interdependence that characterizes our time and provides a new worldview to address health challenges globally. There is still a large potential to better delineate the limits of the field, drawing on a wide perspective across sciences and geographical areas. As an implementation and integration science, academic global health aims primarily to respond to societal needs through research, education, and practice. From five academic institutions closely engaged with international Geneva, we propose here a definition of global health based on six core principles: 1 cross–border/multilevel approach, 2 inter–/trans–disciplinarity, 3 systems thinking, 4 innovation, 5 sustainability, and 6 human rights/equity. This definition aims to reduce the century–old divide between medicine and public health while extending our perspective to other highly relevant fields. Overall, this article provides an intellectual framework to improve health for all in our contemporary world with implications for academic institutions and science policy.

Older Californians and the Mental Health Services Act: Is an Older Adult System of Care Supported?

Science.gov (United States)

Kietzman, Kathryn G; Dupuy, Danielle; Damron-Rodriguez, JoAnn; Palimaru, Alina; del Pino, Homero E; Frank, Janet C

2018-01-01

This policy brief summarizes findings from the first study to evaluate how California's public mental health delivery system has served older adults (60 years of age and over) since the passage of the Mental Health Services Act (MHSA) in 2004. Study findings indicate that there are unmet needs among older adults with mental illness in the public mental health delivery system. There are deficits in the involvement of older adults in the required MHSA planning processes and in outreach and service delivery, workforce development, and outcomes measurement and reporting. There is also evidence of promising programs and strategies that counties have advanced to address these deficits. Recommendations for improving mental health services for older adults include designating a distinct administrative and leadership structure for older adult services in each county; enhancing older adult outreach and documentation of unmet need; promoting standardized geriatric training of providers; instituting standardized data-reporting requirements; and increasing service integration efforts, especially between medical, behavioral health, aging, and substance use disorder services.

Characteristics of Indigenous primary health care service delivery models: a systematic scoping review.

Science.gov (United States)

Harfield, Stephen G; Davy, Carol; McArthur, Alexa; Munn, Zachary; Brown, Alex; Brown, Ngiare

2018-01-25

Indigenous populations have poorer health outcomes compared to their non-Indigenous counterparts. The evolution of Indigenous primary health care services arose from mainstream health services being unable to adequately meet the needs of Indigenous communities and Indigenous peoples often being excluded and marginalised from mainstream health services. Part of the solution has been to establish Indigenous specific primary health care services, for and managed by Indigenous peoples. There are a number of reasons why Indigenous primary health care services are more likely than mainstream services to improve the health of Indigenous communities. Their success is partly due to the fact that they often provide comprehensive programs that incorporate treatment and management, prevention and health promotion, as well as addressing the social determinants of health. However, there are gaps in the evidence base including the characteristics that contribute to the success of Indigenous primary health care services in providing comprehensive primary health care. This systematic scoping review aims to identify the characteristics of Indigenous primary health care service delivery models. This systematic scoping review was led by an Aboriginal researcher, using the Joanna Briggs Institute Scoping Review Methodology. All published peer-reviewed and grey literature indexed in PubMed, EBSCO CINAHL, Embase, Informit, Mednar, and Trove databases from September 1978 to May 2015 were reviewed for inclusion. Studies were included if they describe the characteristics of service delivery models implemented within an Indigenous primary health care service. Sixty-two studies met the inclusion criteria. Data were extracted and then thematically analysed to identify the characteristics of Indigenous PHC service delivery models. Culture was the most prominent characteristic underpinning all of the other seven characteristics which were identified - accessible health services, community

Mental Health Service Delivery Systems and Perceived Qualifications of Mental Health Service Providers in School Settings

Science.gov (United States)

Dixon, Decia Nicole

2009-01-01

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…

77 FR 74676 - National Human Genome Research Institute; Notice of Closed Meeting

Science.gov (United States)

2012-12-17

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Human Genome... Human Genome Research Institute, National Institutes of Health, 5635 Fishers Lane, Suite 4075, Bethesda.... 93.172, Human Genome Research, National Institutes of Health, HHS) Dated: December 11, 2012. David...

76 FR 10909 - National Human Genome Research Institute; Notice of Closed Meeting

Science.gov (United States)

2011-02-28

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Human Genome..., National Human Genome Research Institute, National Institutes of Health, 5635 Fishers Lane, Suite 4076, MSC..., Human Genome Research, National Institutes of Health, HHS). Dated: February 18, 2011. Jennifer S. Spaeth...

77 FR 35991 - National Human Genome Research Institute; Notice of Closed Meeting

Science.gov (United States)

2012-06-15

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Human Genome... Human Genome Research Institute, National Institutes of Health, 5635 Fishers Lane, Suite 4075, Bethesda.... 93.172, Human Genome Research, National Institutes of Health, HHS) Dated: June 8, 2012. Jennifer S...

75 FR 8977 - National Human Genome Research Institute; Notice of Closed Meeting

Science.gov (United States)

2010-02-26

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Human Genome..., National Human Genome Research Institute, National Institutes of Health, 5635 Fishers Lane, Suite 4076, MSC..., Human Genome Research, National Institutes of Health, HHS) Dated: February 18, 2010. Jennifer Spaeth...

Commercial and Institutional Waste

DEFF Research Database (Denmark)

Christensen, Thomas Højlund; Fruergaard, Thilde

2011-01-01

Commercial and institutional waste is primarily from retail (stores), hotels, restaurants, health care (except health risk waste), banks, insurance companies, education, retirement homes, public services and transport. Within some of these sectors, e.g. retail and restaurants, large variations...... are found in terms of which products and services are offered. Available data on unit generation rates and material composition as well as determining factors are discussed in this chapter. The characterizing of commercial and institutional waste is faced with the problem that often only a part of the waste...... is handled in the municipal waste system, where information is easily accessible. An important part of commercial and institutional waste is packaging waste, and enterprises with large quantities of clean paper, cardboard and plastic waste may have their own facilities for baling and storing their waste...

Do microfinance institutions benefit from integrating financial and nonfinancial services?

NARCIS (Netherlands)

Lensink, Robert; Mersland, Roy; Vu, Nhung Thi Hong; Zamore, Stephen

2018-01-01

This article examines the impact of microfinance ‘plus’ (i.e. coordinated combination of financial and nonfinancial services) on the performance of microfinance institutions (MFIs). Using a global data set of MFIs in 77 countries, we find that the provision of nonfinancial services does not harm nor

Institutions and service employment: a panel study for OECD countries

OpenAIRE

Messina, Julián

2004-01-01

We live in a service economy, but the extent of development of service employment differs across developed countries. This paper assesses the role of structural factors and institutions in explaining the common patterns and main di?erences in the recent expansion of service employment in OECD countries. It finds that GDP per capita, the size of the government sector and the extent of urbanization are positively associated with the service employment share. However, the evidence suggests that ...

Health Services Cost Analyzing in Tabriz Health Centers 2008

Directory of Open Access Journals (Sweden)

Massumeh gholizadeh

2015-08-01

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. ​

School Mental Health Resources and Adolescent Mental Health Service Use

Science.gov (United States)

Green, Jennifer Greif; McLaughlin, Katie A.; Alegría, Margarita; Costello, E. Jane; Gruber, Michael J.; Hoagwood, Kimberly; Leaf, Philip J.; Olin, Serene; Sampson, Nancy A,; Kessler, Ronald C.

2014-01-01

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 they offer influence student mental health service use. Such information could inform the development and allocation of appropriate school-based resources to increase service use. This paper examines associations of school resources with past-year mental health service use among students with 12-month DSM-IV mental disorders. Method Data come from the U.S. National Comorbidity Survey Adolescent Supplement (NCS-A), a national survey of adolescent mental health that included 4,445 adolescent-parent pairs in 227 schools in which principals and mental health coordinators completed surveys about school resources-policies for addressing student emotional problems. Adolescents and parents completed the Composite International Diagnostic Interview and reported mental health service use across multiple sectors. Multilevel multivariate regression was used to examine associations of school mental health resources and individual-level service use. Results Roughly half (45.3%) of adolescents with a 12-month DSM-IV disorder received past-year mental health services. Substantial variation existed in school resources. Increased school engagement in early identification was significantly associated with mental health service use for adolescents with mild/moderate mental and behavior disorders. The ratio of students-to-mental health providers was not associated with overall service use, but was associated with sector of service use. Conclusions School mental health resources, particularly those related to early identification, may facilitate mental health service use and influence sector of service use for youths with DSM disorders. PMID:23622851

[Occupational health services as the insurance product and insurance economic instruments].

Science.gov (United States)

Rydlewska-Liszkowska, Izabela

2014-01-01

One of the most controversial issues in restructuring the Polish health insurance system is the implementation of private voluntary insurance and creation within it a new insurance product known as occupational health services (OHS). In this article some opportunities and dilemmas likely to be faced by providers and employers/employees, when contracting with insurance institutions, are considered as a contribution to the discussion on private insurance in Poland. The basic question is how private insurance institutions could influence the promotion of different preventive activities at the company level by motivating both OHS providers and employers. The descriptive qualitative method has been applied in the analysis of legal acts, scientific publications selected according to keywords (Pubmed), documents and expert evaluations and research project results. Taking into account the experiences of European countries, described in publications, international experts' opinions and results of research projects the solution proposed in Poland could be possible under the following several prerequisites: inclusion of a full scope of occupational health services into the insurance product, constant supervision of occupational medicine professionals, monitoring of the health care quality and the relations between private insurers and OHS provider and implementation of the economic incentives scheme to ensure an adequate position of OHS providers on the market. The proposed reconstruction of the health insurance system, comprising undoubtedly positive elements, may entail some threats in the area of health, organization and economy. Private voluntary health insurance implementation requires precisely defined solutions concerning the scope of insurance product, motivation scheme and information system.

77 FR 76057 - National Cancer Institute; Notice of Closed Meeting

Science.gov (United States)

2012-12-26

..., Scientific Review Officer, Resources and Training Review Branch, Division of Extramural Activities, National... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute...--Institutional Training and Education Institutional Training and Education Grant. Date: February 25-26, 2013...

STRATEGIC MANAGEMENT GUIDANCE IN HEALTH INSTITUTIONS MANAGEMENT: DETERMINATION OF MISSIONVISION- STRATEGY SELCUK UNIVERSITY MEDICAL FACULTY HOSPITAL SAMPLE

OpenAIRE

GÖKBEL, Hakkı; GÜLEŞ, Hasan Kürşat; ERGEN IŞIKLAR, Zeynep; ŞENER, Tuğba

2016-01-01

As the nature of the services they offer and areas in which they operate health care institutions are always in the process of change. Especially with the impact of technological advances, new techniques are constantly emerging in health care presentation, in parallel to innovation in health care change is also becoming necessary in the way of health care management. On the other hand today, research conducted in hospitals has reached a holisticand administrative size with the understanding t...

Acceptance of Swedish e-health services

Directory of Open Access Journals (Sweden)

Mary-Louise Jung

2010-11-01

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

National Institutes of Health Funding in Plastic Surgery: A Crisis?

Science.gov (United States)

Silvestre, Jason; Abbatematteo, Joseph M; Serletti, Joseph M; Chang, Benjamin

2016-09-01

Decreasing funding rates and increasing competition for National Institutes of Health research grants have prompted diverse interventions in various fields of biomedicine. Currently, the state of National Institutes of Health funding for plastic surgery research is poorly understood. The purpose of this study was to describe the portfolio of National Institutes of Health grants in academic plastic surgery. Plastic surgery faculty at integrated and independent programs were queried individually in the National Institutes of Health RePORTER database for grants awarded in 2014. Funding totals, mechanisms, and institutes were calculated. Abstracts were categorized by research type and field of interest. Characteristics of National Institutes of Health-funded principal investigators were elucidated. Eight hundred sixty-one academic plastic surgeons at 94 programs were queried, and only 18 investigators (2.1 percent) were funded at 12 programs (12.8 percent). National Institutes of Health-funded investigators were predominately male (72 percent), fellowship-trained (61 percent), and aged 49.3 ± 7.8 years. A total of 20 awards amounted to $6,916,886, with an average award of $345,844 ± $222,909. Costs were primarily awarded through the R01 mechanism (77.2 percent). The top three National Institutes of Health institutes awarded 72.9 percent of the entire portfolio. Funding supported clinical (41.1 percent), translational (36.9 percent), and basic science (22.0 percent) research. Craniofacial (20.5 percent), hand (18.7 percent), and breast (16.2 percent) had the greatest funding. Few programs and faculty drive the National Institutes of Health portfolio of plastic surgery research. These data suggest a tenuous funding situation that may be susceptible to future spending cuts. Future research is needed to identify barriers to National Institutes of Health funding procurement in academic plastic surgery.

Comparative study: TQ and Lean Production ownership models in health services.

Science.gov (United States)

Eiro, Natalia Yuri; Torres-Junior, Alvair Silveira

2015-01-01

compare the application of Total Quality (TQ) models used in processes of a health service, cases of lean healthcare and literature from another institution that has also applied this model. this is a qualitative research that was conducted through a descriptive case study. through critical analysis of the institutions studied it was possible to make a comparison between the traditional quality approach checked in one case and the theoretical and practice lean production approach used in another case and the specifications are described below. the research identified that the lean model was better suited for people that work systemically and generate the flow. It also pointed towards some potential challenges in the introduction and implementation of lean methods in health.

Sexual and reproductive health services according to adolescents boys (Bucaramanga, Colombia

Directory of Open Access Journals (Sweden)

Elvinia Pinilla G

2009-08-01

Full Text Available Adolescents face different dilemmas, which may happen tobe not timely solved, pose major risks to health. Objective:To characterize the basic needs and expectations of maleadolescents in Bucaramanga, Colombia, from its perception with respect to services for sexual and reproductive health(SRH. Methodology: qualitative ethnographic study, using astrategy of discussion groups. We used informal discussions,interviews and focal point. Was selected by a conveniencesample of male adolescents in Bucaramanga, 2-6 strata, frompublic and private institutions, and school, between 13 and 18years, with a total of 52 participants and 7 focus groups.Results: Despite the cultural and socioeconomic differences,young people are consistent in their perceptions, needs andexpectations about sexuality and SRH services. The finalanalysis showed four categories: service experiences SSR, SSR ideal services, pornography and sexuality. Conclusions:It is apparent invisibility of the SSR and the perception ofunfavorable, from the experience of those who know her.Nevertheless, adolescents need to consider this type of service.This research leads to reflection on the ignorance of youngboys from their being, their feelings and their wish to be.

Community participation in health service reform: the development of an innovative remote Aboriginal primary health-care service.

Science.gov (United States)

Reeve, Carole; Humphreys, John; Wakerman, John; Carroll, Vicki; Carter, Maureen; O'Brien, Tim; Erlank, Carol; Mansour, Rafik; Smith, Bec

2015-01-01

The aim of this study was to describe the reorientation of a remote primary health-care service, in the Kimberley region of Australia, its impact on access to services and the factors instrumental in bringing about change. A unique community-initiated health service partnership was developed between a community-controlled Aboriginal health organisation, a government hospital and a population health unit, in order to overcome the challenges of delivering primary health care to a dispersed, highly disadvantaged Aboriginal population in a very remote area. The shared goals and clear delineation of responsibilities achieved through the partnership reoriented an essentially acute hospital-based service to a prevention-focussed comprehensive primary health-care service, with a focus on systematic screening for chronic disease, interdisciplinary follow up, health promotion, community advocacy and primary prevention. This formal partnership enabled the primary health-care service to meet the major challenges of providing a sustainable, prevention-focussed service in a very remote and socially disadvantaged area.

Racial/Ethnic Disparities in Mental Health Care Utilization among U.S. College Students: Applying the Institution of Medicine Definition of Health Care Disparities.

Science.gov (United States)

Hunt, Justin B; Eisenberg, Daniel; Lu, Liya; Gathright, Molly

2015-10-01

The authors apply the Institute of Medicine's definition of health care disparities to college students. The analysis pools data from the first two waves of the Healthy Minds Study, a multicampus survey of students' mental health (N = 13,028). A probit model was used for any past-year service utilization, and group differences in health status were adjusted by transforming the entire distribution for each minority population to approximate the white distribution. Disparities existed between whites and all minority groups. Compared to other approaches, the predicted service disparities were greater because this method included the effects of mediating SES variables. Health care disparities persist in the college setting despite improved access and nearly universal insurance coverage. Our findings emphasize the importance of investigating potential sources of disparities beyond geography and coverage.

Danish and Norwegian hospital social workers’ cross-institutional work amidst inter-sectoral restructuring of health and social welfare

DEFF Research Database (Denmark)

Søbjerg Nielsen, Ulla; Harsløf, Ivan; Feiring, Marte

2017-01-01

, they report increasing difficulties in ‘making their way through’ the state-municipal bureaucracy. However, by drawing on the formal health knowledge derived from medical settings and the symbolic capital it bestows on them, they often manage to negotiate the work-and-welfare services, thereby transforming......-makers have instituted economic incentives to both individuals and the health and welfare organisations who handle them. Through an institutional logics approach, this paper explores how hospital social workers in these countries are experiencing these changes. The ‘social’ part of post-treatment care...

Ghana Health Services and the Irish health system – bridging the gap.

LENUS (Irish Health Repository)

Akaateba, D

2017-02-01

The University of Limerick Hospitals Group (ULHG), and the University of Limerick (UL), are committed to fostering links with the developing world and contributing to solutions of the challenges these countries face. In 2016 a group from UL and ULHG visited the Upper West Region of Ghana1 to explore the possibility of establishing a partnership with Ghana Health Services (GHS). In this article, we describe aspects of GHS and outline some of the challenges for Irish institutions trying to engage with the realties of the developing world.

THE IMPACT OF ONLINE ENVIRONMENT ON THE DECISION OF THE CONSUMER OF HEALTH SERVICES

Directory of Open Access Journals (Sweden)

Bodog Simona-Aurelia

2014-12-01

Full Text Available The online environment has opened new opportunities for consumers of health services, both in terms of the need for information on identified health problem and the possibilities of solving them and choosing the desired health service, resulting in a significant impact on decision of the consumer of health services. The consumers of health services use the internet to get information on identified health problems both before consulting a health service or its buying decision, because of their desire to be informed when acquiring health service, and its subsequent purchase to verify the correctness of service received. In this context, the health care provider cannot create and promote his own desires and beliefs if he wants to be the top choice of the consumers of health services. This paper aims to analyze the impact of the online environment on the decisions of the consumer of health services. The study was conducted on a sample of 223 patients admitted to two public hospitals in Oradea. The patients were given a questionnaire with 20 items, which mainly focused on: information sources, accessing sites with medical content, the moment of accessing the site, verification of information and information from the online influence on their behavior. From the analysis it appears that the information sought by patients online are general, fewer patients frequently access sites of medical institutions, health care facilities or health blogs and forums. The decisions of the Consumers of health care services are influenced to a lesser extent by the information from the online environment, the decisive role in terms of making a decision represent the information received from the doctor. Finally, for the consumer of health care services is difficult to choose because, to some extent even if the needs are becoming increasingly difficult to satisfy a substrate remains related to the personality and mentality of each, of the personal factors regarding

The Effect of Each Other Perceived Service Quality and Institutional Image In Pre - sc hool Education

Directory of Open Access Journals (Sweden)

Ebru Sönmez Karapınar

2015-12-01

Full Text Available Main purpose of this study is to examine the effect of service quality and dimensions of perceived institutional image; and effect of perceived institutional image and perceived service quality in pre-school education facilities. Two models were developed for that purpose. Perceived service quality was evaluated in five dimensions (empathy, reliability, responsiveness, assurance and tangibles and perceived institutional image was evaluated in four dimensions (quality image institutional communication, social image and institutional perspective. Influence of independent variable on dependent variable was mentioned in both of two models. Sample of the study consists of 250 families who use service provided by pre-schools in Kayseri. Data was collected by the way of a questionnaire which formed in the basis of two scales named as “servperf scale” and “institutional image scale”. Factor analysis, KMO test and regression analysis were used in order to test data. Findings indicate that there was a positive affect each other perceived service quality and perceived institutional image.

75 FR 8374 - National Human Genome Research Institute; Notice of Closed Meeting

Science.gov (United States)

2010-02-24

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Human Genome... unwarranted invasion of personal privacy. Name of Committee: National Human Genome Research Institute Special... Officer, Scientific Review Branch, National Human Genome Research Institute, National Institutes of Health...

78 FR 21382 - National Human Genome Research Institute; Notice of Closed Meeting

Science.gov (United States)

2013-04-10

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Human Genome... applications. Place: National Human Genome Research Institute, Suite 4076, 5635 Fisher's Lane, Bethesda, MD..., National Human Genome Research Institute, National Institutes of Health, 5635 Fishers Lane, Suite 4075...

77 FR 8268 - National Human Genome Research Institute; Notice of Closed Meetings

Science.gov (United States)

2012-02-14

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Human Genome... applications. Place: National Human Genome Research Institute, 5635 Fisher's Lane, Room 4076, Rockville, MD..., CIDR, National Human Genome Research Institute, National Institutes of Health, 5635 Fishers Lane, Suite...

77 FR 71604 - National Human Genome Research Institute; Notice of Closed Meeting

Science.gov (United States)

2012-12-03

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Human Genome... unwarranted invasion of personal privacy. Name of Committee: National Human Genome Research Institute Special..., Scientific Review Branch, National Human Genome Research Institute, National Institutes of Health, 5635...

75 FR 53703 - National Human Genome Research Institute; Notice of Closed Meeting

Science.gov (United States)

2010-09-01

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Human Genome..., Scientific Review Branch, National Human Genome Research Institute, National Institutes of Health, 5635.... (Catalogue of Federal Domestic Assistance Program Nos. 93.172, Human Genome Research, National Institutes of...

Acceptance of Swedish e-health services

Science.gov (United States)

Jung, Mary-Louise; Loria, Karla

2010-01-01

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

Garrison Institute on Aging – Lubbock Retired and Senior Volunteer Program (RSVP Provides Services to South Plains, Texas

Directory of Open Access Journals (Sweden)

Joan eBlackmon

2015-12-01

Full Text Available The Texas Tech University Health Sciences (TTUHSC Garrison Institute on Aging (GIA was established to promote healthy aging through cutting edge research on Alzheimer ’s disease (AD and other diseases of aging, through innovative educational and community outreach opportunities for students, clinicians, researchers, health care providers, and the public. The GIA sponsors the Lubbock Retired and Senior Volunteer Program (RSVP. According to RSVP Operates Handbook, RSVP is one of the largest volunteer efforts in the nation. Through this program, volunteer skills and talents can be matched to assist with community needs. It is a federally funded program under the guidance of the Corporation for National and Community Service (CNCS and Senior Corps (SC. Volunteers that participate in RSVP provide service in the following areas: food security, environmental awareness building and education, community need-based volunteer programs, and veteran services.

42 CFR 440.20 - Outpatient hospital services and rural health clinic services.

Science.gov (United States)

2010-10-01

... Definitions § 440.20 Outpatient hospital services and rural health clinic services. (a) Outpatient hospital... services that are not generally furnished by most hospitals in the State. (b) Rural health clinic services... 42 Public Health 4 2010-10-01 2010-10-01 false Outpatient hospital services and rural health...

Mapping the institutional consolidation of EU human health expertise

NARCIS (Netherlands)

de Ruijter, A.

The EU’s role in the field of human health is solidifying in terms of law and policy, but also with respect to the institutional organisation of human health expertise. In light of the emerging health-care union and questions regarding the nature and scope of a European health law, the institutional

Mapping the institutional consolidation of EU human health expertise

NARCIS (Netherlands)

de Ruijter, Anniek

2016-01-01

The EU’s role in the field of human health is solidifying in terms of law and policy, but also with respect to the institutional organisation of human health expertise. In light of the emerging health-care union and questions regarding the nature and scope of a European health law, the institutional

Institutional Provider and Beneficiary Summary PUF

Data.gov (United States)

U.S. Department of Health & Human Services — The CMS IPBS PUFs are aggregated files in which each record summarizes information for a particular institutional provider. An institutional provider refers to a...

Mixed-methods designs in mental health services research: a review.

Science.gov (United States)

Palinkas, Lawrence A; Horwitz, Sarah M; Chamberlain, Patricia; Hurlburt, Michael S; Landsverk, John

2011-03-01

Despite increased calls for use of mixed-methods designs in mental health services research, how and why such methods are being used and whether there are any consistent patterns that might indicate a consensus about how such methods can and should be used are unclear. Use of mixed methods was examined in 50 peer-reviewed journal articles found by searching PubMed Central and 60 National Institutes of Health (NIH)-funded projects found by searching the CRISP database over five years (2005-2009). Studies were coded for aims and the rationale, structure, function, and process for using mixed methods. A notable increase was observed in articles published and grants funded over the study period. However, most did not provide an explicit rationale for using mixed methods, and 74% gave priority to use of quantitative methods. Mixed methods were used to accomplish five distinct types of study aims (assess needs for services, examine existing services, develop new or adapt existing services, evaluate services in randomized controlled trials, and examine service implementation), with three categories of rationale, seven structural arrangements based on timing and weighting of methods, five functions of mixed methods, and three ways of linking quantitative and qualitative data. Each study aim was associated with a specific pattern of use of mixed methods, and four common patterns were identified. These studies offer guidance for continued progress in integrating qualitative and quantitative methods in mental health services research consistent with efforts by NIH and other funding agencies to promote their use.

75 FR 67380 - National Human Genome Research Institute; Notice of Closed Meeting

Science.gov (United States)

2010-11-02

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Human Genome... Review Branch, National Human Genome Research Institute, National Institutes of Health, 5635 Fishers Lane.... (Catalogue of Federal Domestic Assistance Program Nos. 93.172, Human Genome Research, National Institutes of...

Predictors of maternal health services utilization by poor, rural women: a comparative study in Indian States of Gujarat and Tamil Nadu.

Science.gov (United States)

Vora, Kranti Suresh; Koblinsky, Sally A; Koblinsky, Marge A

2015-07-31

India leads all nations in numbers of maternal deaths, with poor, rural women contributing disproportionately to the high maternal mortality ratio. In 2005, India launched the world's largest conditional cash transfer scheme, Janani Suraksha Yojana (JSY), to increase poor women's access to institutional delivery, anticipating that facility-based birthing would decrease deaths. Indian states have taken different approaches to implementing JSY. Tamil Nadu adopted JSY with a reorganization of its public health system, and Gujarat augmented JSY with the state-funded Chiranjeevi Yojana (CY) scheme, contracting with private physicians for delivery services. Given scarce evidence of the outcomes of these approaches, especially in states with more optimal health indicators, this cross-sectional study examined the role of JSY/CY and other healthcare system and social factors in predicting poor, rural women's use of maternal health services in Gujarat and Tamil Nadu. Using the District Level Household Survey (DLHS)-3, the sample included 1584 Gujarati and 601 Tamil rural women in the lowest two wealth quintiles. Multivariate logistic regression analyses examined associations between JSY/CY and other salient health system, socio-demographic, and obstetric factors with three outcomes: adequate antenatal care, institutional delivery, and Cesarean-section. Tamil women reported greater use of maternal healthcare services than Gujarati women. JSY/CY participation predicted institutional delivery in Gujarat (AOR = 3.9), but JSY assistance failed to predict institutional delivery in Tamil Nadu, where mothers received some cash for home births under another scheme. JSY/CY assistance failed to predict adequate antenatal care, which was not incentivized. All-weather road access predicted institutional delivery in both Tamil Nadu (AOR = 3.4) and Gujarat (AOR = 1.4). Women's education predicted institutional delivery and Cesarean-section in Tamil Nadu, while husbands

Peruvian Mental Health Reform: A Framework for Scaling-up Mental Health Services

Science.gov (United States)

Toyama, Mauricio; Castillo, Humberto; Galea, Jerome T.; Brandt, Lena R.; Mendoza, María; Herrera, Vanessa; Mitrani, Martha; Cutipé, Yuri; Cavero, Victoria; Diez-Canseco, Francisco; Miranda, J. Jaime

2017-01-01

Background: Mental, neurological, and substance (MNS) use disorders are a leading cause of disability worldwide; specifically in Peru, MNS affect 1 in 5 persons. However, the great majority of people suffering from these disorders do not access care, thereby making necessary the improvement of existing conditions including a major rearranging of current health system structures beyond care delivery strategies. This paper reviews and examines recent developments in mental health policies in Peru, presenting an overview of the initiatives currently being introduced and the main implementation challenges they face. Methods: Key documents issued by Peruvian governmental entities regarding mental health were reviewed to identify and describe the path that led to the beginning of the reform; how the ongoing reform is taking place; and, the plan and scope for scale-up. Results: Since 2004, mental health has gained importance in policies and regulations, resulting in the promotion of a mental health reform within the national healthcare system. These efforts crystallized in 2012 with the passing of Law 29889 which introduced several changes to the delivery of mental healthcare, including a restructuring of mental health service delivery to occur at the primary and secondary care levels and the introduction of supporting services to aid in patient recovery and reintegration into society. In addition, a performance-based budget was approved to guarantee the implementation of these changes. Some of the main challenges faced by this reform are related to the diversity of the implementation settings, eg, isolated rural areas, and the limitations of the existing specialized mental health institutes to substantially grow in parallel to the scaling-up efforts in order to be able to provide training and clinical support to every region of Peru. Conclusion: Although the true success of the mental healthcare reform will be determined in the coming years, thus far, Peru has achieved a

Peruvian Mental Health Reform: A Framework for Scaling-up Mental Health Services

Directory of Open Access Journals (Sweden)

Mauricio Toyama

2017-09-01

Full Text Available Background Mental, neurological, and substance (MNS use disorders are a leading cause of disability worldwide; specifically in Peru, MNS affect 1 in 5 persons. However, the great majority of people suffering from these disorders do not access care, thereby making necessary the improvement of existing conditions including a major rearranging of current health system structures beyond care delivery strategies. This paper reviews and examines recent developments in mental health policies in Peru, presenting an overview of the initiatives currently being introduced and the main implementation challenges they face. Methods Key documents issued by Peruvian governmental entities regarding mental health were reviewed to identify and describe the path that led to the beginning of the reform; how the ongoing reform is taking place; and, the plan and scope for scale-up. Results Since 2004, mental health has gained importance in policies and regulations, resulting in the promotion of a mental health reform within the national healthcare system. These efforts crystallized in 2012 with the passing of Law 29889 which introduced several changes to the delivery of mental healthcare, including a restructuring of mental health service delivery to occur at the primary and secondary care levels and the introduction of supporting services to aid in patient recovery and reintegration into society. In addition, a performance-based budget was approved to guarantee the implementation of these changes. Some of the main challenges faced by this reform are related to the diversity of the implementation settings, eg, isolated rural areas, and the limitations of the existing specialized mental health institutes to substantially grow in parallel to the scaling-up efforts in order to be able to provide training and clinical support to every region of Peru. Conclusion Although the true success of the mental healthcare reform will be determined in the coming years, thus far, Peru

Organizational capacity for service integration in community-based addiction health services.

Science.gov (United States)

Guerrero, Erick G; Aarons, Gregory A; Palinkas, Lawrence A

2014-04-01

We examined factors associated with readiness to coordinate mental health, public health, and HIV testing among community-based addiction health services programs. We analyzed client and program data collected in 2011 from publicly funded addiction health services treatment programs in Los Angeles County, California. We analyzed a sample of 14 379 clients nested in 104 programs by using logistic regressions examining odds of service coordination with mental health and public health providers. We conducted a separate analysis to examine the percentage of clients receiving HIV testing in each program. Motivational readiness and organizational climate for change were associated with higher odds of coordination with mental health and public health services. Programs with professional accreditation had higher odds of coordinating with mental health services, whereas programs receiving public funding and methadone and residential programs (compared with outpatient) had a higher percentage of clients receiving coordinated HIV testing. These findings provide an evidentiary base for the role of motivational readiness, organizational climate, and external regulation and funding in improving the capacity of addiction health services programs to develop integrated care.

A global survey on occupational health services in selected international commission on occupational health (ICOH) member countries.

Science.gov (United States)

Rantanen, Jorma; Lehtinen, Suvi; Valenti, Antonio; Iavicoli, Sergio

2017-10-05

The United Nations General Assembly (UNGA), the International Labour Organization (ILO), the World Health Organization (WHO), the International Commission on Occupational Health (ICOH), and the European Union (EU) have encouraged countries to organize occupational health services (OHS) for all working people irrespective of the sector of economy, size of enterprise or mode of employment of the worker. The objective of this study was to survey the status of OHS in a sample of countries from all continents. A questionnaire focusing on the main aspects of OHS was developed on the basis of ILO Convention No. 161 and several other questionnaire surveys used in various target groups of OHS. The questionnaire was sent to 58 key informants: ICOH National Secretaries. A total of 49 National Secretaries responded (response rate 84.5%), from countries that employ 70% of the total world labour force. The majority of the respondent countries, 67%, had drawn up an OHS policy and implement it with the help of national occupational safety and health (OSH) authorities, institutes of occupational health or respective bodies, universities, and professional associations. Multidisciplinary expert OHS resources were available in the majority (82%) of countries, but varied widely in quantitative terms. The average OHS coverage of workers was 24.8%, with wide variation between countries. In over two thirds (69%) of the countries, the content of services was mixed, consisting of preventive and curative services, and in 29% preventive only. OHS financing was organized according to a mixed model among 63% and by employers only among 33% of the respondents. The majority of countries have drawn up policies, strategies and programmes for OHS. The infrastructures and institutional and human resources for the implementation of strategies, however, remain insufficient in the majority of countries (implementation gap). Qualitatively, the content and multidisciplinary nature of OHS corresponds to

Human Rights and Health Services

DEFF Research Database (Denmark)

Skitsou, Alexandra; Bekos, Christos; Charalambous, George

2016-01-01

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 of the Ombuds......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...... 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......, 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...

Forensic mental health services: Current service provision and planning for a prison mental health service in the Eastern Cape

Directory of Open Access Journals (Sweden)

Kiran Sukeri

2016-05-01

Full Text Available Objectives: No research data exists on forensic psychiatric service provision in the Eastern Cape, Republic of South Africa. The objective of this research was to assess current forensic psychiatric service provision and utilisation rates at Fort England Hospital. This is important in improving and strengthening the service. A related objective was to develop a model for a provincial prison mental health service. Methodology: This study is a situational analysis of an existing forensic psychiatric service in the Eastern Cape. The design of the study was cross sectional. An audit questionnaire was utilised to collate quantitative data, which was submitted to Fort England Hospital, Grahamstown. A proposed prison mental health service was developed utilising prevalence rates of mental illness among prisoners to calculate bed and staff requirements for an ambulatory and in-patient service. Results: During the study period a total of 403 remand detainees were admitted to the forensic psychiatry division of Fort England Hospital. The average length of stay was 494 days and the bed utilisation rate was determined at 203.54%. We estimate that to provide a provincial prison mental health service to treat psychotic illnesses and major depression the province requires a 52 bedded facility and a total staff complement of approximately 31. Conclusions: Forensic psychiatric services include the assessment, management and treatment of mentally disordered persons in conflict with the law and prisoners requiring psychiatric assessments. The Eastern Cape Province does not have plans or policies to assess and manage mentally ill offenders, resulting in an increased load on available services. We recommend that an inter-departmental task team, which includes Health, Justice and Constitutional Development and Correctional Services, should be established in the province, to develop a strategy to assist in the development of an effective and efficient forensic

GUIDANCE COUNSELOR INSTITUTE FOR HEALTH CAREERS (JULY 7-22, 1966).

Science.gov (United States)

MORGAN, PHILIP W.

THE INSTITUTE, SPONSORED BY A FEDERATED CHARITY REPRESENTING 78 NONPROFIT VOLUNTARY HOSPITALS IN NEW YORK CITY, WAS ATTENDED BY 48 HIGH SCHOOL AND EMPLOYMENT SERVICE COUNSELORS. THE NEED FOR SUCH INSTITUTES WAS DOCUMENTED BY A PRE-INSTITUTE QUESTIONNAIRE TO LICENSED GUIDANCE COUNSELORS. TO EVALUATE THE INSTITUTE, THE PROFESSIONAL EXAMINATION…

77 FR 36564 - National Institute on Minority Health and Health Disparities; Notice of Closed Meeting

Science.gov (United States)

2012-06-19

... Minority Health and Health Disparities; Notice of Closed Meeting Pursuant to section 10(d) of the Federal... and Health Disparities Special Emphasis Panel; NIMHD Support for Conference and Scientific meetings... Institutes of Health, National Institute on Minority Health and Health Disparities, 6707 Democracy Blvd...

Involving mental health service users in suicide-related research: a qualitative inquiry model.

Science.gov (United States)

Lees, David; Procter, Nicholas; Fassett, Denise; Handley, Christine

2016-03-01

To describe the research model developed and successfully deployed as part of a multi-method qualitative study investigating suicidal service-users' experiences of mental health nursing care. Quality mental health care is essential to limiting the occurrence and burden of suicide, however there is a lack of relevant research informing practice in this context. Research utilising first-person accounts of suicidality is of particular importance to expanding the existing evidence base. However, conducting ethical research to support this imperative is challenging. The model discussed here illustrates specific and more generally applicable principles for qualitative research regarding sensitive topics and involving potentially vulnerable service-users. Researching into mental health service users with first-person experience of suicidality requires stakeholder and institutional support, researcher competency, and participant recruitment, consent, confidentiality, support and protection. Research with service users into their experiences of sensitive issues such as suicidality can result in rich and valuable data, and may also provide positive experiences of collaboration and inclusivity. If challenges are not met, objectification and marginalisation of service-users may be reinforced, and limitations in the evidence base and service provision may be perpetuated.

Evaluation of the National School Health Coordinator Leadership Institute

Science.gov (United States)

Ottoson, Judith M.; Streib, Greg; Thomas, John Clayton; Rivera, Mark; Stevenson, Beth

2004-01-01

In 1999 the American Cancer Society (ACS) launched the National School Health Coordinator Leadership Institute, a groundbreaking initiative designed to enhance and invigorate school health in the nation's schools by training individual school health coordinators to act as change agents. The Institute consisted of three, week-long summer training…

[Development of a service on line advice and information technology management for health].

Science.gov (United States)

Berrospi Polo, Victor; Rodriguez Abad, Juan; Bobadilla Aguilar, Juan; Di Liberto Moreno, Carlos; Díaz Arroyo, Cecilia; Rafael Quipan, Carlos

2015-10-01

To validate an advisory service and online information technology management for health and helps to make assessment and acquisition processes an informed medical equipment according to the market and the needs of the health institutions. Internet via a technological solution supported ona data base containing systematic and updated information on technical specifications of 25 compared medical equipment, the same reference prices, list of suppliers, agents and / or producers and technical standards are developed. The"virtual" technical assistance was made with the support of a team of specialists in Health Technology Management, the decision makers in the planning, evaluation and procurement of biomedical equipment. The validation of the service was conducted by involving specialists in the field of Health Technology Management, from different disciplines and institutions who worked in health, public and private. They used the service for a period of time to verify its feasibility of use as well as its usefulness for their planning, evaluation and procurement of biomedical equipment. To these experts we applied a survey before and after them about the software developed in this project. We found that it is common to use the internet to search for information on medical equipment.Also,an increase on the view that the application will help in procurement of biomedical equipment(40% to 78%) was observed, it will improve the information system(40% to 89%) and communication among physicians,nurses, planners, engineers and other professionals involved in this process(20% to 78%). There is a need for a technological tool available with such features contribute to technology management in Peru.

76 FR 9353 - National Cancer Institute; Notice of Closed Meetings

Science.gov (United States)

2011-02-17

....gov . Name of Committee: National Cancer Institute Special Emphasis Panel; Molecular Pharmacodynamic... Detection and Diagnosis Research; 93.395, Cancer Treatment Research; 93.396, Cancer Biology Research; 93.397... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute...

National Institute for Occupational Safety and Health

Science.gov (United States)

... Submit Search The CDC The National Institute for Occupational Safety and Health (NIOSH) Note: Javascript is disabled or is not ... and Events NIOSH Contact Information Related Federal Agencies Occupational Safety and Health Administration Mine Safety and Health Administration Follow NIOSH ...

Public Hospital Spending in England: Evidence from National Health Service Administrative Records

OpenAIRE

Kelly, E.; Stoye, G.; Vera-Hernández, M.

2016-01-01

© 2016 The Authors. Fiscal Studies published by John Wiley & Sons Ltd. on behalf of Institute for Fiscal StudiesHealth spending per capita in England has almost doubled since 1997, yet relatively little is known about how that spending is distributed across the population. This paper uses administrative National Health Service (NHS) hospital records to examine key features of public hospital spending in England. We describe how costs vary across the life cycle, and the concentration of spendi...

76 FR 29772 - National Human Genome Research Institute; Notice of Closed Meetings

Science.gov (United States)

2011-05-23

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Human Genome... clearly unwarranted invasion of personal privacy. Name of Committee: National Human Genome Research... of Scientific Review, National Human Genome Research Institute, National Institutes of Health...

Study protocol for the development of a European measure of best practice for people with long term mental health problems in institutional care (DEMoBinc

Directory of Open Access Journals (Sweden)

Killaspy Helen

2009-06-01

Full Text Available Abstract Background This study aims to build a measure for assessing and reviewing the living conditions, care and human rights of people with longer term mental health problems in psychiatric and social care institutions. Protection of their human rights is imperative since impaired mental capacity secondary to mental illness can make them vulnerable to abuse and exploitation from others. They also constitute a major resource pressure for mental health services, social services, informal carers and society as a whole. Methods/Design This study uses an iterative methodology to develop a toolkit to assess internationally agreed domains of care that are considered most important for recovery. These domains are identified by collating results from: i a systematic review of the literature on institutional care for this service user group; ii a review of the relevant care standards in each participating country; iii Delphi exercises in partner countries with mental health professionals, service users, carers and advocates. Common domains and cross-cutting themes are agreed by the principal researchers and an international expert panel. Items are developed to assess these domains and incorporated into the toolkit which is designed to be administered through a face to face interview with the institution's manager. The toolkit is refined in response to inter-rater reliability testing, feedback from interviewers and interviewees regarding its utility, and feedback from key stakeholders in each country about its ability to deliver information that can be used within each country's established systems for quality assessment and review. Cross-validation of the toolkit ratings against service users' quality of life, autonomy and markers of recovery tests whether it can deliver a proxy-measure of the service users' experiences of care and the institution's promotion of their human rights and recovery. The ability of the toolkit to assess the "value for money

Community/hospital indicators in South African public sector mental health services.

Science.gov (United States)

Lund, Crick; Flisher, Alan J

2003-12-01

The need to balance resources between community and hospital-based mental health services in the post-deinstitutionalisation era has been well-documented. However, few indicators have been developed to monitor the relationship between community and hospital services, in either developed or developing countries. There is a particular need for such indicators in the South African context, with its history of inequitable services based in custodial institutions under apartheid, and a new policy that proposes the development of more equitable community-based care. Indicators are needed to measure the distribution of resources and the relative utilisation of community and hospital-based services during the reform process. These indicators are potentially useful for assessing the implementation of policy objectives over time. To develop and document community/hospital indicators in public sector mental health services in South Africa. A questionnaire was distributed to provincial mental health coordinators requesting numbers of full-time equivalent (FTE) staff who provide mental health care at all service levels, annual patient admissions to hospitals and annual patient attendances at ambulatory care facilities. The information was supplemented by consultations with mental health coordinators in each of the 9 provinces. Population data were obtained from preliminary findings of the 1996 census. The community/hospital indicator measuring staff distribution was defined as the ratio of staff employed in community settings to all staff, expressed as a percentage. The community/hospital indicator measuring patient service utilisation was defined as the ratio of the annual ambulatory care attendance rate per 100,000 population to the sum of this rate and the annual hospital admission rate per 100,000 population, expressed as a percentage. Of psychiatric public sector staff, 25% are located in community settings in South Africa (provincial range: 11-70%). If hospital outpatient

42 CFR 441.15 - Home health services.

Science.gov (United States)

2010-10-01

... Provisions § 441.15 Home health services. With respect to the services defined in § 440.70 of this subchapter, a State plan must provide that— (a) Home health services include, as a minimum— (1) Nursing services... 42 Public Health 4 2010-10-01 2010-10-01 false Home health services. 441.15 Section 441.15 Public...

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

Directory of Open Access Journals (Sweden)

Manulik S

2016-08-01

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

Workforce diversity and community-responsive health-care institutions.

Science.gov (United States)

Nivet, Marc A; Berlin, Anne

2014-01-01

While the levers for the social determinants of health reside largely outside institutional walls, this does not absolve health professional schools from exercising their influence to improve the communities in which they are located. Fulfilling this charge will require a departure from conventional thinking, particularly when it comes to educating future health professionals. We describe efforts within medical education to transform recruitment, admissions, and classroom environments to emphasize diversity and inclusion. The aim is to cultivate a workforce with the perspectives, aptitudes, and skills needed to fuel community-responsive health-care institutions.

78 FR 65345 - National Institute on Minority Health and Health Disparities; Notice of Closed Meeting

Science.gov (United States)

2013-10-31

... Minority Health and Health Disparities; Notice of Closed Meeting Pursuant to section 10(d) of the Federal... and Health Disparities Special Emphasis Panel; NIMHD Research Center in Minority Institution Program... applications. Place: National Institute on Minority Health and Health Disparities, 6707 Democracy Blvd., Suite...

77 FR 5035 - National Human Genome Research Institute; Notice of Closed Meetings

Science.gov (United States)

2012-02-01

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Human Genome... clearly unwarranted invasion of personal privacy. Name of Committee: National Human Genome Research... Officer, Scientific Review Branch, National Human Genome Research Institute, National Institutes of Health...

76 FR 5597 - National Cancer Institute; Notice of Closed Meetings

Science.gov (United States)

2011-02-01

... Cancer Institute Special Emphasis Panel; Vaccine for Prevention of HIV Infection. Date: February 24, 2011... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute... concerning individuals associated with the grant applications and/or contract proposals, the disclosure of...

78 FR 8156 - National Cancer Institute; Notice of Closed Meetings

Science.gov (United States)

2013-02-05

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute... proposals. Place: Bethesda North Marriott Hotel & Conference Center, Montgomery County Conference Center... Institute, NIH, 6116 Executive Blvd., Suite 703, Room 7072, Bethesda, md 20892-8329, 301-594-1408, Stoicaa2...

75 FR 14172 - National Cancer Institute; Notice of Closed Meetings

Science.gov (United States)

2010-03-24

... Cancer Institute Special Emphasis Panel, Nucleic Acid Analysis for the Molecular Characterization of... Treatment Research; 93.396, Cancer Biology Research; 93.397, Cancer Centers Support; 93.398, Cancer Research... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute...

76 FR 14675 - National Cancer Institute; Notice of Closed Meetings

Science.gov (United States)

2011-03-17

...-7565, [email protected] . Name of Committee: National Cancer Institute Special Emphasis Panel; Molecular... Research; 93.395, Cancer Treatment Research; 93.396, Cancer Biology Research; 93.397, Cancer Centers... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute...

77 FR 33476 - National Cancer Institute; Notice of Closed Meetings

Science.gov (United States)

2012-06-06

... Cancer Institute Special Emphasis Panel; Biopsy Instruments and Devices That Preserve Molecular Profiles... Detection and Diagnosis Research; 93.395, Cancer Treatment Research; 93.396, Cancer Biology Research; 93.397... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute...

77 FR 19674 - National Cancer Institute; Notice of Closed Meetings

Science.gov (United States)

2012-04-02

... Institute Special Emphasis Panel; Innovative Molecular Analysis Technologies for Cancer (R21). Date: June 26... Diagnosis Research; 93.395, Cancer Treatment Research; 93.396, Cancer Biology Research; 93.397, Cancer... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute...

75 FR 5092 - National Cancer Institute; Notice of Closed Meetings

Science.gov (United States)

2010-02-01

... . Name of Committee: National Cancer Institute Special Emphasis Panel, Quantitative Cell-Based Imaging....396, Cancer Biology Research; 93.397, Cancer Centers Support; 93.398, Cancer Research Manpower; 93.399... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute...

Occupational Health Services Integrated in Primary Health Care in Iran.

Science.gov (United States)

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

2015-01-01

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

78 FR 64222 - National Human Genome Research Institute; Notice of Closed Meetings

Science.gov (United States)

2013-10-28

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Human Genome... clearly unwarranted invasion of personal privacy. Name of Committee: National Human Genome Research... Review, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD 20892, 301...

75 FR 19984 - National Human Genome Research Institute; Notice of Closed Meetings

Science.gov (United States)

2010-04-16

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Human Genome..., National Human Genome Research Institute, National Institutes of Health, 5635 Fishers Lane, Suite 4075... Nakamura, PhD, Scientific Review Officer, Scientific Review Branch, National Human Genome Research...

Building Comprehensive and Sustainable Health Informatics Institutions in Developing Countries: Moi University Experience.

Science.gov (United States)

Were, Martin C; Siika, Abraham; Ayuo, Paul O; Atwoli, Lukoye; Esamai, Fabian

2015-01-01

Current approaches for capacity building in Health Informatics (HI) in developing countries mostly focus on training, and often rely on support from foreign entities. In this paper, we describe a comprehensive and multidimensional capacity-building framework by Lansang & Dennis, and its application for HI capacity building as implemented in a higher-education institution in Kenya. This framework incorporates training, learning-by-doing, partnerships, and centers of excellence. At Moi University (Kenya), the training dimensions include an accredited Masters in HI Program, PhD in HI, and HI short courses. Learning-by-doing occurs through work within MOH facilities at the AMPATH care and treatment program serving 3 million people. Moi University has formed strategic HI partnerships with Regenstrief Institute, Inc. (USA), University of Bergen (Norway), and Makerere University (Uganda), among others. The University has also created an Institute of Biomedical Informatics to serve as an HI Center of Excellence in the region. This Institute has divisions in Training, Research, Service and Administration. The HI capacity-building approach by Moi provides a model for adoption by other institutions in resource-limited settings.

Dissemination research: the University of Wisconsin Population Health Institute.

Science.gov (United States)

Remington, Patrick L; Moberg, D Paul; Booske, Bridget C; Ceraso, Marion; Friedsam, Donna; Kindig, David A

2009-08-01

Despite significant accomplishments in basic, clinical, and population health research, a wide gap persists between research discoveries (ie, what we know) and actual practice (ie, what we do). The University of Wisconsin Population Health Institute (Institute) researchers study the process and outcomes of disseminating evidence-based public health programs and policies into practice. This paper briefly describes the approach and experience of the Institute's programs in population health assessment, health policy, program evaluation, and education and training. An essential component of this dissemination research program is the active engagement of the practitioners and policymakers. Each of the Institute's programs conducts data collection, analysis, education, and dialogue with practitioners that is closely tied to the planning, implementation, and evaluation of programs and policies. Our approach involves a reciprocal exchange of knowledge with non-academic partners, such that research informs practice and practice informs research. Dissemination research serves an important role along the continuum of research and is increasingly recognized as an important way to improve population health by accelerating the translation of research into practice.

[Universal coverage of health services in Mexico].

Science.gov (United States)

2013-01-01

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

Power rather than path dependency? The dynamics of institutional change under health care federalism.

Science.gov (United States)

Rico, Ana; Costa-Font, Joan

2005-01-01

Proposals for government decentralization rank high on the political reform agenda of health systems worldwide. Their impact on welfare state performance and change, however, is still under theoretical scrutiny. This article examines the impact of devolution on the construction of the Spanish National Health Service (NHS) in an attempt to shed some light on this debate. Against widespread claims of path dependency, we argue that the specific nature of the devolution model developed in Spain, given the more egalitarian sociopolitical structure that resulted from democratization, fostered policy innovation and institutional change. Consolidation of an NHS system was compatible with some regional diversity and apparently prevented the rise of significant territorial inequalities. The Spanish case also suggests that policy change depends more on the distribution of social power than on institutions. It underlines the key role of financial and knowledge transfers vis-à-vis institutional reforms in effecting social change as well as the potential for state intervention in supporting the development of collective action resources by social groups.

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

Directory of Open Access Journals (Sweden)

M Eugenia Socías

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

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

Science.gov (United States)

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

2016-01-01

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

The Work of US Public Health Service Officers in Puerto Rico, 1898-1919.