WorldWideScience

Sample records for justice health care

  1. Looking to Hume for justice: on the utility of Hume's view of justice for American health care reform.

    Science.gov (United States)

    Churchill, L R

    1999-08-01

    This essay argues that Hume's theory of justice can be useful in framing a more persuasive case for universal access in health care. Theories of justice derived from a Rawlsian social contract tradition tend to make the conditions for deliberation on justice remote from the lives of most persons, while religiously-inspired views require superhuman levels of benevolence. By contrast, Hume's theory derives justice from the prudent reflections of socially-encumbered selves. This provides a more accessible moral theory and a more realistic path to the establishment of universal access.

  2. Social justice, health disparities, and culture in the care of the elderly.

    Science.gov (United States)

    Dilworth-Anderson, Peggye; Pierre, Geraldine; Hilliard, Tandrea S

    2012-01-01

    Older minority Americans experience worse health outcomes than their white counterparts, exhibiting the need for social justice in all areas of their health care. Justice, fairness, and equity are crucial to minimizing conditions that adversely affect the health of individuals and communities. In this paper, Alzheimer's disease (AD) is used as an example of a health care disparity among elderly Americans that requires social justice interventions. Cultural factors play a crucial role in AD screening, diagnosis, and access to care, and are often a barrier to support and equality for minority communities. The "conundrum of health disparities" refers to the interplay between disparity, social justice, and cultural interpretation, and encourages researchers to understand both (1) disparity caused by economic and structural barriers to access, treatment, and diagnosis, and (2) disparity due to cultural interpretation of disease, in order to effectively address health care issues and concerns among elderly Americans. © 2012 American Society of Law, Medicine & Ethics, Inc.

  3. United States and Canadian approaches to justice in health care: a comparative analysis of health care systems and values.

    Science.gov (United States)

    Jecker, N S; Meslin, E M

    1994-06-01

    The purpose of this study is to compare and contrast the basic ethical values underpinning national health care policies in the United States and Canada. We use the framework of ethical theory to name and elaborate ethical values and to facilitate moral reflection about health care reform. Section one describes historical and contemporary social contract theories and clarifies the ethical values associated with them. Sections two and three show that health care debates and health care systems in both countries reflect the values of this tradition; however, each nation interprets the tradition differently. In the U.S., standards of justice for health care are conceived as a voluntary agreement reached by self-interested parties. Canadians, by contrast, interpret the same justice tradition as placing greater emphasis on concern for others and for the community. The final section draws out the implications of these differences for future U.S. and Canadian health care reforms.

  4. Justice in health care: the contribution of Edmund Pellegrino.

    Science.gov (United States)

    Veatch, R M

    1990-06-01

    Edmund Pellegrino has pioneered work in medical ethics calling for a reconstruction of Hippocratic ethics. In particular, he has spoken of incorporating principles that concern justice and the common good. This article traces his commitment to the common good, concern for the poor, opposition to libertarianism, acknowledgement of the necessity of rationing, and reluctance to give clinicians social allocational tasks. It asks how Pellegrino relates distributive justice to the common good. Drawing on his theory relating autonomy to patient-centered beneficence (in which autonomy is one element of the good rather than a side constraint on the good), the author argues that Pellegrino appears to make justice one element of the common good rather than a distributional moral constraint on promoting the good. He suggests that Pellegrino stands in three consequentialist or teleological moral traditions: professional physician ethics, Aristotelianism, and Catholic moral theology, but that there are the makings of a more independent, more egalitarian theory of justice in his writings.

  5. Health Law as Social Justice.

    Science.gov (United States)

    Wiley, Lindsay F

    2014-01-01

    Health law is in the midst of a dramatic transformation. From a relatively narrow discipline focused on regulating relationships among individual patients, health care providers, and third-party payers, it is expanding into a far broader field with a burgeoning commitment to access to health care and assurance of healthy living conditions as matters of social justice. Through a series of incremental reform efforts stretching back decades before the Affordable Care Act and encompassing public health law as well as the law of health care financing and delivery, reducing health disparities has become a central focus of American health law and policy. This Article labels, describes, and furthers a nascent "health justice" movement by examining what it means to view health law as an instrument of social justice. Drawing on the experiences of the reproductive justice, environmental justice, and food justice movements, and on the writings of political philosophers and ethicists on health justice, I propose that health justice offers an alternative to the market competition and patient rights paradigms that currently dominate health law scholarship, advocacy, and reform. I then examine the role of law in reducing health disparities through the health justice lens. I argue that the nascent health justice framework suggests three commitments for the use of law to reduce health disparities. First, to a broader inquiry that views access to health care as one among many social determinants of health deserving of public attention and resources. Second, to probing inquiry into the effects of class, racial, and other forms of social and cultural bias on the design and implementation of measures to reduce health disparities. And third, to collective action grounded in community engagement and participatory parity. In exploring these commitments, I highlight tensions within the social justice framework and between the social justice framework and the nascent health justice movement

  6. Access to health care: solidarity and justice or egoism and injustice?

    Science.gov (United States)

    Prudil, Lukas

    2008-09-01

    The aim of this paper is to answer the question whether there is a real demand for equal access to health care or--better--to medical care and which interest groups (patients, health care professionals, policy makers and others) are interested in equal access. The focus is on EU countries including recent case law from the European Court of Justice and the European Court of Human Rights. We discuss whether there is a need to have legislative safeguards to protect equal access to medical care and whether such norms really work. The paper concludes that some of the key players in medical care are not primarily governed by a real willingness to have equal and just access to medical care, but by rather egoistic approaches. It seems that policy makers and politicians are the only ones who, surprisingly, must at least formally call for and enforce equal access to medical care. Interests of other groups seem to be different.

  7. Profile of Justice-Involved Marijuana and Other Substance Users: Demographics, Health and Health Care, Family, and Justice System Experiences

    Directory of Open Access Journals (Sweden)

    Nikki Freeman

    2017-09-01

    Full Text Available Substance users are more likely to have co-occurring health problems, and this pattern is intensified among those involved with the criminal justice system. Interview data for 1977 incarcerated men in 5 states from the Multi-site Family Study on Incarceration, Parenting, and Partnering that was conducted between December 2008 and August 2011 were analyzed to compare pre-incarceration substance use patterns and health outcomes between men who primarily used marijuana, primarily used alcohol, primarily used other drugs, and did not use any illicit substances during that time. Using regression modeling, we examined the influence of substance use patterns on physical and mental health. Primary marijuana users comprised the largest portion of the sample (31.5%, closely followed by nonusers (30.0%, and those who primarily used other drugs (30.0%; primary alcohol users comprised the smallest group (19.6%. The substance user groups differed significantly from the nonuser group on many aspects of physical and mental health. Findings suggest that even among justice-involved men who are not using “hard” drugs, substance use merits serious attention. Expanding the availability of substance use treatment during and after incarceration might help to promote physical and mental health during incarceration and reentry.

  8. When constitutional justice has the last word on health care: the case of Chile.

    Science.gov (United States)

    Zúñiga Fajuri, Alejandra

    2014-01-01

    The Chilean health care system is in crisis. Since the recent ruling of the Constitutional Court that declared the risk rating (actuarial insurance) of private health insurers unconstitutional, all of the social actors related to health care have tried to agree on a legislative reform that would overcome the existing highly segmented and inequitable system, which is a legacy of Pinochet's dictatorship. Here we demonstrate how the social and political demands for legislative reform in the health care sector have been supported by the decisions of the courts. To achieve its goals of reducing equity gaps in health and ending the judicialization of health care (claims for protection represent almost 70% of total resources of the courts), the National Congress of Chile is trying to create a new national health insurance system that guarantees the right to a minimum level of health care. Part of this effort involves obtaining the constitutional approval of the courts. In Chile, justice has the final word on health care.

  9. Rawlsian Justice and Palliative Care

    DEFF Research Database (Denmark)

    Knight, Carl; Albertsen, Andreas

    2015-01-01

    Palliative care serves both as an integrated part of treatment and as a last effort to care for those we cannot cure. The extent to which palliative care should be provided and our reasons for doing so have been curiously overlooked in the debate about distributive justice in health and healthcar...... to provide pain relief to those who need it as a supplement to treatment and, without justice-based reasons to provide palliative care to those whose opportunities cannot be restored. We conclude that this makes Daniels' framework much less attractive.......Palliative care serves both as an integrated part of treatment and as a last effort to care for those we cannot cure. The extent to which palliative care should be provided and our reasons for doing so have been curiously overlooked in the debate about distributive justice in health and healthcare....... We argue that one prominent approach, the Rawlsian approach developed by Norman Daniels, is unable to provide such reasons and such care. This is because of a central feature in Daniels' account, namely that care should be provided to restore people's opportunities. Daniels' view is both unable...

  10. Globalization and health care: global justice and the role of physicians.

    Science.gov (United States)

    Toumi, Rabee

    2014-02-01

    In today's globalized world, nations cannot be totally isolated from or indifferent to their neighbors, especially in regards to medicine and health. While globalization has brought prosperity to millions, disparities among nations and nationals are growing raising once again the question of justice. Similarly, while medicine has developed dramatically over the past few decades, health disparities at the global level are staggering. Seemingly, what our humanity could achieve in matters of scientific development is not justly distributed to benefit everyone. In this paper, it will be argued that a global theoretical agreement on principles of justice may prove unattainable; however, a grass-roots change is warranted to change the current situation. The UNESCO Declaration on Bioethics and Human Rights will be considered as a starting point to achieve this change through extracting the main values embedded in its principles. These values, namely, respecting human dignity and tending to human vulnerability with a hospitable attitude, should then be revived in medical practice. Medical education will be one possible venue to achieve that, especially through role models. Future physicians will then become the fervent advocates for a global and just distribution of health care.

  11. The Relationship between Perceived Organizational Justice and Organizational Commitment with Job Satisfaction in Employees of Northern Tehran Health Care Center

    Directory of Open Access Journals (Sweden)

    Mohammad-Hossein Safi

    2016-03-01

    Full Text Available Background and Objective: Today, the organizations are obligated to take sufficient attention to human resources in order to attain greater efficiency and ultimately achieve their goals. Considering the importance of desirable behavior in organizations and its impact on the attitudes and perceptions of employees, it is necessary to pay special attention to the treatment of staff and their needs. The present study was prepared to investigate the relationship between organizational justice and organizational commitment and job satisfaction among health care employees in north Tehran.Materials and Methods: The study was done descriptive-analytical among employees with at least 6 months of experience and with a sample size of 259 patients at the health center. Data collection tools consisted job satisfaction, organizational justice and organizational commitment questionnaires. SPSS software was used for data analysis and Pearson's correlation coefficient and T-test was used for independent groups and regression.Results: The mean (SD of Job satisfaction in employees was 50.1 (12.3, perceived organizational justice was 66.4 (1.17 and organizational commitment was 61.3 (5.7, out of 100. The result value of the correlation coefficient indicates positive and significant relationship between organizational justice and organizational commitment with job satisfaction. Also, components of affective commitment and normative commitment has a significant relationship with job satisfaction, and all of the components of organizational justice (distributive justice, procedural justice, interactional justice have a significant positive correlation with job satisfaction. Regression analysis indicated that organizational justice and organizational commitment are able to predict job satisfaction of the employees. But the components of procedural justice and distributive justice were not able to predict job satisfaction, and job satisfaction can be predicted only

  12. Health care justice and its implications for current policy of a mandatory waiting period for elective tubal sterilization.

    Science.gov (United States)

    Moaddab, Amirhossein; McCullough, Laurence B; Chervenak, Frank A; Fox, Karin A; Aagaard, Kjersti Marie; Salmanian, Bahram; Raine, Susan P; Shamshirsaz, Alireza A

    2015-06-01

    Tubal sterilization during the immediate postpartum period is 1 of the most common forms of contraception in the United States. This time of the procedure has the advantage of 1-time hospitalization, which results in ease and convenience for the woman. The US Collaborative Review of Sterilization Study indicates the high efficacy and effectiveness of postpartum tubal sterilization. Oral and written informed consent is the ethical and legal standard for the performance of elective tubal sterilization for permanent contraception for all patients, regardless of source of payment. Current health care policy and practice regarding elective tubal sterilization for Medicaid beneficiaries places a unique requirement on these patients and their obstetricians: a mandatory waiting period. This requirement originates in decades-old legislation, which we briefly describe. We then introduce the concept of health care justice in professional obstetric ethics and explain how it originates in the ethical concepts of medicine as a profession and of being a patient and its deontologic and consequentialist dimensions. We next identify the implications of health care justice for the current policy of a mandatory 30-day waiting period. We conclude that Medicaid policy allocates access to elective tubal sterilization differently, based on source of payment and gender, which violates health care justice in both its deontologic and consequentialist dimensions. Obstetricians should invoke health care justice in women's health care as the basis for advocacy for needed change in law and health policy, to eliminate health care injustice in women's access to elective tubal sterilization. Copyright © 2015 Elsevier Inc. All rights reserved.

  13. The employee retention triad in health care: Exploring relationships amongst organisational justice, affective commitment and turnover intention.

    Science.gov (United States)

    Perreira, Tyrone A; Berta, Whitney; Herbert, Monique

    2018-04-01

    To increase understanding of the relationships between organisational justice, affective commitment and turnover intention in health care. Turnover in health care is a serious concern, as it contributes to the global nursing shortage and is associated with declines in quality of care, patient safety and patient outcomes. Turnover also impacts care teams and is associated with decreased staff cohesion and morale. A survey was developed and administered to frontline nurses working in the Province of Ontario, Canada. The data were used to test a hypothetical model developed from a review of the literature. The relationships amongst the three constructs were evaluated using structural equation modelling and mediation analysis. The hypothesised model was generally supported, although we were limited to considerations of interpersonal justice, affective commitment to one's organisation and turnover intention. Interpersonal justice is associated with affective commitment to one's organisation, which is negatively associated with turnover intention. Interpersonal justice was also found to be directly and negatively associated with turnover intention. Affective commitment to one's organisation was also found to mediate the relationship between interpersonal justice and turnover intention. The examination of relationships within the "employee retention triad" in a single, comprehensive model is novel and provides new information regarding relational complexity and insights into what healthcare leaders can do to retain employees. Reducing turnover may help to decrease some of the stressors related to turnover for clinical staff remaining at the organisation such as constant onboarding and orientation of new hires, working with less experienced staff and increased workload due to decreased staffing. © 2018 John Wiley & Sons Ltd.

  14. Theories of justice and their implications for priority setting in health care.

    Science.gov (United States)

    Olsen, J A

    1997-12-01

    The paper aims to show how three theories of distributive justice; utilitarianism, egalitarianism and maximum, can provide a clearer understanding of the normative basis of different priority setting regimes in the health service. The paper starts with a brief presentation of the theories, followed by their prescriptions for distribution, as illustrated with their respective preferred points on a utility possibility frontier. After this general discussion, attention is shifted from utils to health. The paper discusses how the recent Norwegian guidelines for priority setting can be understood in the light of the theories.

  15. Consumer-Driven Health Care: Answer to Global Competition or Threat to Social Justice?

    Science.gov (United States)

    Owen, Carol L.

    2009-01-01

    Health planning in the United States is rapidly approaching a fork in the policy road, with one direction leading the nation toward a universal plan with strong government involvement and the other direction strengthening existing market-based reforms and preserving a commercial health insurance industry. "Consumer-driven health care," a slogan…

  16. Towards Communicative Justice in Health.

    Science.gov (United States)

    Briggs, Charles L

    2017-01-01

    This article approaches care from a different angle by looking ethnographically at how it is shaped by structural differences in the power to control the circulation of knowledge. I focus on an investigation conducted by people classified as "indigenous", of an epidemic that killed 38 children and young adults in a Venezuelan rainforest. I trace how health/communicative inequities structured clinical interactions, documents, epidemiological investigations, news stories, and dialogues with healers, thwarting the identification of the epidemic, clinically identified as rabies. Although the Bolivarian socialist government provided access to care, professionals denigrated parents' contributions to care and communication and reduced complex, unequal relations between languages to practical problems of translation. Pointing to parallels with US social movements, I suggest that responding to demands for communicative justice in health requires seeing how health inequities are entangled with health/communicative inequities. The typographical slash points to importance of challenging the subdisciplinary boundary-work that relegates their study to non-overlapping conversations in medical and linguistic anthropology.

  17. Social justice considerations in neonatal care for nurse managers and executives.

    Science.gov (United States)

    Yoder, Linda; Walden, Marlene; Verklan, M Terese

    2010-01-01

    This article presents the struggle between social justice and market justice within the current health care system, specifically issues affecting neonatal care. Community benefit is described and discussed as an aspect of social justice demonstrated by hospitals. The federal and state Children's Health Insurance Program also is discussed in relation to social justice and health care costs. Implications for managers and executives overseeing neonatal care are presented in relation to the economic and social issues.

  18. Global health justice and governance.

    Science.gov (United States)

    Ruger, Jennifer Prah

    2012-01-01

    While there is a growing body of work on moral issues and global governance in the fields of global justice and international relations, little work has connected principles of global health justice with those of global health governance for a theory of global health. Such a theory would enable analysis and evaluation of the current global health system and would ethically and empirically ground proposals for reforming it to more closely align with moral values. Global health governance has been framed as an issue of national security, human security, human rights, and global public goods. The global health governance literature is essentially untethered to a theorized framework to illuminate or evaluate governance. This article ties global health justice and ethics to principles for governing the global health realm, developing a theoretical framework for global and domestic institutions and actors.

  19. Health and legal literacy for migrants: twinned strands woven in the cloth of social justice and the human right to health care.

    Science.gov (United States)

    Vissandjée, Bilkis; Short, Wendy E; Bates, Karine

    2017-04-13

    Based on an analysis of published literature, this paper provides an over-view of the challenges associated with delivering on the right to access quality health care for international migrants to industrialized countries, and asks which group of professionals is best equipped to provide services that increase health and legal literacy. Both rights and challenges are approached from a social justice perspective with the aim of identifying opportunities to promote greater health equity. That is, to go beyond the legal dictates enshrined in principles of equality, and target as an ethical imperative a situation where all migrants receive the particular assistance they need to overcome the barriers that inhibit their equitable access to health care. This assistance is especially important for migrant groups that are further disadvantaged by differing cultural constructions of gender. Viewing the topic from this perspective makes evident a gap in both research literature and policy. The review has found that while health literacy is debated and enshrined as a policy objective, and consideration is given to improving legal literacy as a means of challenging social injustice in developing nations, however, no discussion has been identified that considers assisting migrants to gain legal literacy as a step toward achieving not only health literacy and improved health outcomes, but critical participation as members of their adoptive society. Increasing migrant health literacy, amalgamated with legal literacy, aids migrants to better access their human right to appropriate care, which in turn demonstrably assists in increasing social engagement, citizenship and productivity. However what is not evident in the literature, is which bureaucratic or societal group holds responsibility for assisting migrants to develop critical citizenship literacy skills. This paper proposes that a debate is required to determine both who is best placed to provide services that increase health

  20. Health, personal responsibility, and distributive justice

    DEFF Research Database (Denmark)

    Andersen, Martin Marchman

    explains why we have justice-based reasons to reduce social inequality in health. In my second article I investigate and (partly) object to a suggestion put forward by Shlomi Segall, according to which we should exchange the notion of responsibility with a notion of Reasonable Avoidability in the luck...... responsibility is generally impossible. I argue, nonetheless, that this approach is plausible. In my fourth and final article I proceed under the assumption that responsibility is possible. I examine the relation between responsibility (for one’s own health condition) and cost-responsibility (for health care...

  1. Neoliberal Justice and the Transformation of the Moral: The Privatization of the Right to Health Care in Colombia.

    Science.gov (United States)

    Abadía-Barrero, César Ernesto

    2016-03-01

    Neoliberal reforms have transformed the legislative scope and everyday dynamics around the right to health care from welfare state social contracts to insurance markets administered by transnational financial capital. This article presents experiences of health care-seeking treatment, judicial rulings about the right to health care, and market-based health care legislation in Colombia. When insurance companies deny services, citizens petition the judiciary to issue a writ affirming their right to health care. The judiciary evaluates the finances of all relevant parties to rule whether a service should be provided and who should be responsible for the costs. A 2011 law claimed that citizens who demand, physicians who prescribe, and judges who grant uncovered services use the system's limited economic resources and undermine the state's capacity to expand coverage to the poor. This article shows how the consolidation of neoliberal ideology in health care requires the transformation of moral values around life. © 2015 by the American Anthropological Association.

  2. Exploring the potential for joint training between legal professionals in the criminal justice system and health and social care professionals in the mental-health services.

    Science.gov (United States)

    Hean, Sarah; Heaslip, Vanessa; Warr, Jerry; Staddon, Sue

    2011-05-01

    Effective screening of mentally-ill defendants in the criminal court system requires cooperation between legal professionals in the criminal justice system (CJS), and health and social care workers in the mental-health service (MHS). This interagency working, though, can be problematic, as recognized in the Bradley inquiry that recommended joint training for MHS and CJS professionals. The aim of this study was to examine the experiences and attitudes of workers in the CJS and MHS to inform the development of relevant training. The method was a survey of mental-health workers and legal professionals in the court. The results showed that both agencies were uncertain of their ability to work with the other and there is little training that supports them in this. Both recognized the importance of mentally-ill defendants being dealt with appropriately in court proceedings but acknowledged this is not achieved. There is a shared willingness to sympathize with defendants and a common lack of willingness to give a definite, unqualified response on the relationship between culpability, mental-illness and punishment. Views differ around defendants' threat to security.Findings suggest there is scope to develop interprofessional training programs between the CJS and MHS to improve interagency working and eventually impact on the quality of defendants' lives. Recommendations are made on the type of joint training that could be provided.

  3. Prospects for a genuine revival of primary health care--through the visible hand of social justice rather than the invisible hand of the market: Part II.

    Science.gov (United States)

    Katz, Alison Rosamund

    2010-01-01

    This second part of a two-part article explores the prospects for genuine revival of primary health care (PHC) as announced by the WHO in 2008, with reference, briefly, to Global Health Watch 2, published by the People's Health Movement, Medact, and Equity Gauge Alliance, and, in more depth, to the positions of social and people's movements most closely aligned with the original values and principles of Alma-Ata and the structural foundations of the PHC project. The author argues that the social justice struggle for health cannot be limited to curbing capitalism's excesses. The multiple crises of today--in energy, water, food, the environment, finance, science, information, and democracy--must be recognized as capitalist crises and addressed as such. Particular attention is given to ideology, including the distortion of human nature and society under neoliberal capitalism, and to moral foundations of Health for All. Not only must the invisible hand of the market be replaced by the visible hand of social justice, but the single ideology proclaiming the "end of history" and, by implication, the end of politics and political struggle must be exposed and rejected as neoliberal, totalitarian propaganda. In line with the spirit and intention of the U.N. Charter, PHC remains a political project for a fair and safe world in which Health for All is both possible and necessary.

  4. Caring, objectivity and justice: an integrative view.

    Science.gov (United States)

    van Hooft, Stan

    2011-03-01

    The argument of this article is framed by a debate between the principle of humanity and the principle of justice. Whereas the principle of humanity requires us to care about others and to want to help them meet their vital needs, and so to be partial towards those others, the principle of justice requires us to consider their needs without the intrusion of our subjective interests or emotions so that we can act with impartiality. I argue that a deep form of caring lies behind both approaches and so unites them. In the course of the argument, I reject Michael Slote's sentimentalist form of an ethics of care, and expound Thomas Nagel's moral theory, which seems to lie at the opposite end of a spectrum ranging from moral sentiments to impersonal objectivity. Nevertheless, Nagel's theory of normative realism provides unexpected support for the thesis that a deep and subjective form of caring lies at the base of even our most objective moral reasons.

  5. Why Health Matters to Justice: A Capability Theory Perspective

    DEFF Research Database (Denmark)

    Nielsen, Lasse

    2015-01-01

    The capability approach, originated by Amartya Sen is among the most comprehensive and influential accounts of justice that applies to issues of health and health care. However, although health is always presumed as an important capability in Sen’s works, he never manages to fully explain why...

  6. Diversity in midwifery care: working toward social justice.

    Science.gov (United States)

    Burton, Nadya; Ariss, Rachel

    2014-08-01

    As midwifery moved from lay practice to a regulated health-care profession in Ontario toward the end of the twentieth century, it brought with it many of its social movement goals and aspirations. Among these was the desire to attend to diversity and equity in the provision of birthing care. Drawing on interviews with currently practicing Ontario midwives, this paper focuses on midwives' conceptualizations of diversity and explores their everyday work to support and strengthen diversity among those using and those providing midwifery care. We argue that midwifery's recent relocation within state structured health care means neither that the social change projects of midwifery are complete nor that midwifery has abandoned its movement-based commitment to social change. Responses to social diversity in health care range from efforts to simply improve access to care to analyses of the role of social justice in recognizing the needs of diverse populations. The social justice aspiration to "create a better world" continues to animate the work of midwives postregulation. This paper explores the legacy of midwifery as a social movement, addressing the connections between diversity, social justice and midwifery care.

  7. Organizational justice and health: Contextual determinants and psychobiological consequences

    NARCIS (Netherlands)

    Herr, R.M.

    2015-01-01

    The research presented in this thesis entitled "Organizational Justice and Health: Contextual Determinants and Psychobiological Consequences" aimed to investigate associations between organizational justice and employee health and biological functioning. Organizational justice is an occupational

  8. Health Care Services

    Science.gov (United States)

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

  9. Realising social justice in public health law.

    Science.gov (United States)

    Fox, Marie; Thomson, Michael

    2013-03-01

    Law has played an important, but largely constitutive, role in the development of the public health enterprise. Thus, law has been central to setting up the institutions and offices of public health. The moral agenda has, however, been shaped to a much greater extent by bioethics. While social justice has been placed at the heart of this agenda, we argue that there has been little place within dominant conceptions of social justice for gender equity and women's interests which we see as crucial to a fully realised vision of social justice. We argue that, aside from particular interventions in the field of reproduction, public health practice tends to marginalise women-a claim we support by critically examining strategies to combat the HIV pandemic in sub-Saharan Africa. To counter the marginalisation of women's interests, this article argues that Amartya Sen's capabilities approach has much to contribute to the framing of public health law and policy. Sen's approach provides an evaluative and normative framework which recognises the importance of both gender and health equity to achieving social justice. We suggest that domestic law and international human rights provisions, in particular the emerging human right to health, offer mechanisms to promote capabilities, and foster a robust and inclusive conception of social justice.

  10. Organisational justice and change in justice as predictors of employee health: the Whitehall II study.

    Science.gov (United States)

    Kivimäki, Mika; Ferrie, Jane E; Head, Jenny; Shipley, Martin J; Vahtera, Jussi; Marmot, Michael G

    2004-11-01

    Organisational justice has been proposed as a new way to examine the impact of psychosocial work environment on employee health. This article studied the justice of interpersonal treatment by supervisors (the relational component of organisational justice) as a predictor of health. Prospective cohort study. Phase 1 (1985-88) measured relational justice, job demands, job control, social support at work, effort-reward imbalance, and self rated health. Relational justice was assessed again at phase 2 (1989-90) and self rated health at phase 2 and phase 3 (1991-93). 20 civil service departments originally located in London. 10 308 civil servants (6895 men, 3413 women) aged 35-55. Self rated health. Men exposed to low justice at phase 1 or adverse change in justice between phase 1 and phase 2 were at higher risk of poor health at phase 2 and phase 3. A favourable change in justice was associated with reduced risk. Adjustment for other stress indicators had little effect on results. In women, low justice at phase 1 predicted poor health at phase 2 and phase 3 before but not after adjustment for other stress indicators. Adverse change in justice was associated with worse health prospects irrespective of adjustments. The extent to which people are treated with justice in workplaces seems to predict their health independently of established stressors at work. Evidence on reduced health risk after favourable change in organisational justice implies a promising area for health interventions at workplace.

  11. Three Strikes Out: Objections to Segall's Luck Egalitarian Justice in Health

    DEFF Research Database (Denmark)

    Nielsen, Lasse; Axelsen, David Vestergaard

    2012-01-01

    Setting out to defend luck egalitarianism in matters of justice in health, Shlomi Segall outlines a pluralistic version of the luck egalitarian framework allowing egalitarian justice to be traded-off against other moral requirements. The suggested pluralism enables luck egalitarian justice...... to coexist with a concern for meeting everyone’s basic needs thereby avoiding Elizabeth Anderson’s ‘abandonment objection’. In this article, we present three objections to Segall’s luck egalitarian justice in health. Firstly, the account is vulnerable to the common objection that luck egalitarianism becomes...... too expansive, and that Segall’s defence against this is inadequate. Secondly, Segall’s pluralist attempt to balance luck egalitarian justice and other moral requirements ends up compromising its own ideal of justice. Due to the fact that resource scarcity is the reality of health and health care...

  12. Love and justice's dialectical relationship: Ricoeur's contribution on the relationship between care and justice within care ethics.

    Science.gov (United States)

    Van Stichel, Ellen

    2014-11-01

    The relationship between love/care and justice was one of the key tensions from which care ethics originated; to this very day it is subject of debate between various streams of thought within care ethics. With some exceptions (e.g. Christa Schnabl) most approaches have in common the belief that care and justice are mutually exclusive concepts, or at least as so different that their application is situated on different levels. Hence, both are complementary, but distinct, so that there is no real interaction. This paper aims to investigate whether, and if so, how, a deeper understanding of Ricoeur's thoughts on this matter enriches the relationship between care and justice with respect to care ethics. This connection suggests itself from Ricoeur's interpretation of the relationship as a dialectical one in which the logic of superabundance (love) and the logic of equivalence (justice) meet. Care enables people to see the face and individuality of the one, 'le chacun,' within the anonymous structures of justice that tend to reduce all human beings to the anonymous each, 'le on'; justice in its turn is the precondition for love to become incarnated and made real. What may this view--of care and justice standing in close connection, in which they correct and strengthen each other--add to the understanding of concrete practices of care?

  13. Utility and justice in public health.

    Science.gov (United States)

    MacKay, Kathryn

    2017-12-11

    Many public health practitioners and organizations view themselves as engaged in the promotion or achievement of equity. However, discussions around public health frequently assume that practitioners and policy-makers take a utilitarian approach to this work. I argue that public health is better understood as a social justice endeavor. I begin by presenting the utility view of public health and then discuss the equity view. This is a theoretical argument, which should help public health to justify interventions for communicable and non-communicable diseases equally, and which contributes to breaking down the 'old/new' public health divide. This argument captures practitioners' views of the work they are engaged in and allows for the moral and policy justification of important interventions in communicable and non-communicable diseases. Systemic interventions are necessary to remedy high rates of disease among certain groups and, generally, to improve the health of entire populations. By viewing diseases as partly the result of failures of health protective systems in society, public health may justify interventions in communicable and non-communicable diseases equally. Public health holds a duty to improve the health of the worst-off in society; by prioritizing this group, the health of the whole community may improve. © The Author(s) 2017. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  14. Is it enough scintigraphy for everyone? A cross-sectional analysis regarding the impact of justice in the distribution of health care resources.

    Science.gov (United States)

    Miron, S D; Guţu, M; Astărăstoae, V

    2014-01-01

    of health care resources must be reevaluated.

  15. Perceived Organizational Justice in Care Services: creation and multi-sample validation of a measure.

    Science.gov (United States)

    Pérez-Arechaederra, Diana; Briones, Elena; Lind, Allan; García-Ortiz, Luis

    2014-02-01

    Organizational justice (OJ) perceptions predict attitudes and behaviors of customers and employees across a broad range of services. Although OJ has proven predictive power and relevance, it has rarely been studied in health care settings. This stems partially from the lack of a reliable and valid measure of patients' OJ in health care encounters. The objective here was to create and validate a measure of patients' OJ. With that purpose, a survey study with two sampling contexts - the U.S. and Spain - was carried out in order to provide a cross-national validation of the scale in two versions: English (Perceived Organizational Justice in Care Services, PJustCS) and Spanish (Percepción de Justicia Organizacional en el Ámbito Sanitario, PJustAS). Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) were used to select the appropriate items in the final version of the instrument. Reliability and validity of the measure were tested. A total of 406 patients in the U.S. and 473 patients in Spain participated. The measures used were the newly created scale of Perceived Organizational Justice in Care Services (PJustCS/PJustAS) and scales of patients' Satisfaction, Trust and Global Justice. Factor Analyses supported the four dimensional structure of the instrument for each group. Multigroup CFA substantiated invariant factor loadings and invariant structural models across both samples, hence, supporting that the instrument is applicable in its two versions: English and Spanish. Validation results showed expected positive relations of OJ with patients' satisfaction, trust in clinicians and global perceived justice. These results point out the importance of health care customers' perceived organizational justice in the explanation of health care dynamics. The scale has desirable psychometric properties and shows adequate validity, contributing to the potential development of the area. Copyright © 2013 Elsevier Ltd. All rights reserved.

  16. Catalyzing a Reproductive Health and Social Justice Movement.

    Science.gov (United States)

    Verbiest, Sarah; Malin, Christina Kiko; Drummonds, Mario; Kotelchuck, Milton

    2016-04-01

    The maternal and child health (MCH) community, partnering with women and their families, has the potential to play a critical role in advancing a new multi-sector social movement focused on creating a women's reproductive and economic justice agenda. Since the turn of the twenty-first century, the MCH field has been planting seeds for change. The time has come for this work to bear fruit as many states are facing stagnant or slow progress in reducing infant mortality, increasing maternal death rates, and growing health inequities. This paper synthesizes three current, interrelated approaches to addressing MCH challenges-life course theory, preconception health, and social justice/reproductive equity. Based on these core constructs, the authors offer four directions for advancing efforts to improve MCH outcomes. The first is to ensure access to quality health care for all. The second is to facilitate change through critical conversations about challenging issues such as poverty, racism, sexism, and immigration; the relevance of evidence-based practice in disenfranchised communities; and how we might be perpetuating inequities in our institutions. The third is to develop collaborative spaces in which leaders across diverse sectors can see their roles in creating equitable neighborhood conditions that ensure optimal reproductive choices and outcomes for women and their families. Last, the authors suggest that leaders engage the MCH workforce and its consumers in dialogue and action about local and national policies that address the social determinants of health and how these policies influence reproductive and early childhood outcomes.

  17. What Does Health Justice Look Like for People Returning from Incarceration?

    Science.gov (United States)

    Puglisi, Lisa; Calderon, Joseph P; Wang, Emily A

    2017-09-01

    Access to health care is a constitutional right in the United States correctional system, and many incarcerated adults are newly diagnosed with chronic diseases in prison. Despite this right, the quality of correctional health care is variable, largely unmeasured and unregulated, and characterized by patients' widespread distrust of a health system that is intimately tied to a punitive criminal justice system. Upon release, discontinuity of care is the norm, and when continuity is established, it is often hindered by distrust, discrimination, poor communication, and racism in the health system. In this paper, we will propose best practices in transitioning from correctional- to community-based health care and argue that achieving health equity for people with criminal justice involvement in the United States is not possible without ethical provision of health care. © 2017 American Medical Association. All Rights Reserved.

  18. Social inequality in health, responsibility and egalitarian justice

    DEFF Research Database (Denmark)

    Andersen, Martin Marchman; Dalton, Susanne Oksbjerg; Johansen, Christoffer

    2013-01-01

    Are social inequalities in health unjust when brought about by differences in lifestyle? A widespread idea, luck egalitarianism, is that inequality stemming from individuals’ free choices is not to be considered unjust, since individuals, presumably, are themselves responsible for such choices....... Thus, to the extent that lifestyles are in fact results of free choices, social inequality in health brought about by these choices is not in tension with egalitarian justice. If this is so, then it may put in question the justification of free and equal access to health care and existing medical...... not fully establish - that at the most fundamental level people are never responsible in such a way that appeals to individuals’ own responsibility can justify inequalities in health....

  19. Taking health needs seriously: against a luck egalitarian approach to justice in health.

    Science.gov (United States)

    Nielsen, Lasse

    2013-08-01

    In recent works, Shlomi Segall suggests and defends a luck egalitarian approach to justice in health. Concurring with G. A. Cohen's mature position he defends the idea that people should be compensated for "brute luck", i.e. the outcome of actions that it would be unreasonable to expect them to avoid. In his defense of the luck egalitarian approach he seeks to rebut the criticism raised by Norman Daniels that luck egalitarianism is in some way too narrow and in another too wide to uphold justice in health and health care distribution. He points out that a pluralistic outline of luck egalitarianism taking into account the moral requirement of meeting everyone's basic needs can avoid this line of criticism. In this article I argue against the application of such pluralistic luck egalitarianism in matters of health distribution. First of all, Segall has not shown that luck egalitarianism handles well health distributions above a threshold of basic needs. Secondly, his way of avoiding Elizabeth Anderson's abandonment objection is theoretically problematic. Finally, I argue that luck egalitarianism in general fails to acknowledge the moral foundation of health and health care as a basic human entitlement. Thus I conclude that luck egalitarianism fails to take health needs seriously and that it cannot therefore uphold justice in health.

  20. Analyzing the politico-moral foundations of the Iran's health system based on theories of justice.

    Science.gov (United States)

    Akrami, Forouzan; Abbasi, Mahmoud; Karimi, Abbas; Shahrivari, Akbar; Majdzadeh, Reza; Zali, Alireza

    2017-01-01

    Public health ethics is a field that covers both factual and ethical issues in health policy and science, and has positive obligations to improve the well-being of populations and reduce social inequalities. It is obvious that various philosophies and moral theories can differently shape the framework of public health ethics. For this reason, the present study reviewed theories of justice in order to analyze and criticize Iran's general health policies document, served in 14 Articles in 2014. Furthermore, it explored egalitarianism as the dominant theory in the political philosophy of the country's health care system. According to recent theories of justice, however, health policies must address well-being and its basic dimensions such as health, reasoning, autonomy, and the role of the involved agencies and social institutions in order to achieve social justice beyond distributive justice. Moreover, policy-making in the field of health and biomedical sciences based on Islamic culture necessitates a theory of social justice in the light of theological ethics. Educating people about their rights and duties, increasing their knowledge on individual agency, autonomy, and the role of the government, and empowering them will help achieve social justice. It is recommended to design and implement a strategic plan following each of these policies, based on the above-mentioned values and in collaboration with other sectors, to clarify the procedures in every case.

  1. Feminist intersectionality: bringing social justice to health disparities research.

    Science.gov (United States)

    Rogers, Jamie; Kelly, Ursula A

    2011-05-01

    The principles of autonomy, beneficence, non-maleficence, and justice are well established ethical principles in health research. Of these principles, justice has received less attention by health researchers. The purpose of this article is to broaden the discussion of health research ethics, particularly the ethical principle of justice, to include societal considerations--who and what are studied and why?--and to critique current applications of ethical principles within this broader view. We will use a feminist intersectional approach in the context of health disparities research to firmly establish inseparable links between health research ethics, social action, and social justice. The aim is to provide an ethical approach to health disparities research that simultaneously describes and seeks to eliminate health disparities. © The Author(s) 2011

  2. Justice at Work, Job Stress, and Employee Health

    Science.gov (United States)

    Fujishiro, Kaori; Heaney, Catherine A.

    2009-01-01

    A small but growing literature has documented an association between justice at work and employee health. However, the pathways and mechanisms underlying this association are not well understood. This article proposes a conceptual framework that bridges the organizational justice, occupational stress, and occupational epidemiology literatures.…

  3. Taking Health Needs Seriously: Against a Luck Egalitarian Approach to Justice in Health

    DEFF Research Database (Denmark)

    Nielsen, Lasse

    2013-01-01

    In recent works, Shlomi Segall suggests and defends a luck egalitarian approach to justice in health. Concurring with G. A. Cohen’s mature position he defends the idea that people should be compensated for “brute luck”, i.e. the outcome of actions that it would be unreasonable to expect them...... to avoid. In his defense of the luck egalitarian approach he seeks to rebut the criticism raised by Norman Daniels that luck egalitarianism is in some way too narrow and in another too wide to uphold justice in health and health care distribution. He points out that a pluralistic outline of luck...... egalitarianism taking into account the moral requirement of meeting everyone’s basic needs can avoid this line of criticism. In this article I argue against the application of such pluralistic luck egalitarianism in matters of health distribution. First of all, Segall has not shown that luck egalitarianism...

  4. WORK ETHICS, ORGANIZATIONAL ALIENATION AND JUSTICE AMONG HEALTH INFORMATION TECHNOLOGY MANAGERS.

    Science.gov (United States)

    Zadeh, Jamileh Mahdi; Kahouei, Mehdi; Cheshmenour, Omran; Sangestani, Sajjad

    2016-06-01

    Failure to comply with work ethics by employees working in Health Information Technology (HIT) Departments and their negative attitudes about organizational justice may have an adverse impact on patient satisfaction, quality of care, collecting health statistics, reimbursement, and management and planning at all levels of health care; it can also lead to unbearable damages to the health information system in the country. As so far there has been no research on HIT managers to assess the moral and ethical aspects of works and their relationship with organizational alienation and justice, this study aimed to evaluate the relationship between work ethics and organizational justice and alienation among the HIT managers. This study was performed in affiliated hospitals of Semnan University of medical sciences in Semnan, Iran, in 2015. In this study, a census method was used. The data collection tool was a researcher made questionnaire. There was a negative and significant relationship between work ethic and organizational alienation (B= - 0.217, Pethic and organizational justice (B= 0.580, Pethic (B= - 0.215, P=0.034) and organizational justice (B=- 0.147, P=0.047). The results of this study showed that the managers' attitude toward justice and equality in the organization can affect their organizational commitment and loyalty and thus have a significant impact on the work ethics in the work environment. On the other hand, with increasing the education level of the managers, they will have higher expectation of the justice in the organization, and they feel that the justice is not observed in the organization.

  5. Mental health services costs within the Alberta criminal justice system.

    Science.gov (United States)

    Jacobs, Philip; Moffatt, Jessica; Dewa, Carolyn S; Nguyen, Thanh; Zhang, Ting; Lesage, Alain

    2016-01-01

    Mental illness has been widely cited as a driver of costs in the criminal justice system. The objective of this paper is to estimate the additional mental health service costs incurred within the criminal justice system that are incurred because of people with mental illnesses who go through the system. Our focus is on costs in Alberta. We set up a model of the flow of all persons through the criminal justice system, including police, court, and corrections components, and for mental health diversion, review, and forensic services. We estimate the transitional probabilities and costs that accrue as persons who have been charged move through the system. Costs are estimated for the Alberta criminal justice system as a whole, and for the mental illness component. Public expenditures for each person diverted or charged in Alberta in the criminal justice system, including mental health costs, were $16,138. The 95% range of this estimate was from $14,530 to $19,580. Of these costs, 87% were for criminal justice services and 13% were for mental illness-related services. Hospitalization for people with mental illness who were reviewed represented the greatest additional cost associated with mental illnesses. Treatment costs stemming from mental illnesses directly add about 13% onto those in the criminal justice system. Copyright © 2016 Elsevier Ltd. All rights reserved.

  6. Exploration of joint working practices on anti-social behaviour between criminal justice, mental health and social care agencies: A qualitative study.

    Science.gov (United States)

    Krayer, Anne; Robinson, Catherine A; Poole, Rob

    2018-05-01

    Although the police play an important role for people with mental health problems in the community, little is known about joint working practices between mental health, social care and police services. There is potential for tensions and negative outcomes for people with mental health problems, in particular when the focus is on behaviours that could be interpreted as anti-social. This study explores perceptions about joint working between mental health, social care and police services with regard to anti-social behaviour. We conducted a multi-method sequential qualitative study in the UK collecting data between April 2014 and August 2016. Data were collected from two study sites: 60 narrative police logs of routinely gathered information, and semi-structured interviews and focus groups with professionals from a range of statutory and third sector organisations (N = 55). Data sets were analysed individually, using thematic iterative coding before integrating the findings. We also looked at sequencing and turning points in the police logs. Findings mapped on a continuum of joint working practices, with examples more likely to be away from the policy ideal of partnership working as being central to mainstream activities. Joint working was driven by legal obligations and concerns about risk rather than a focus on the needs of a person with mental health problems. This was complicated by different perceptions of the police role in mental health. Adding anti-social behaviour to this mix intensified challenges as conceptualisation of the nature of the problem and agreeing on best practice and care is open to interpretations and judgements. Of concern is an evident lack of awareness of these issues. There is a need to reflect on joint working practices, including processes and goals, keeping in mind the health and welfare needs of people with mental health problems. © 2018 John Wiley & Sons Ltd.

  7. Social inequality in health, responsibility and egalitarian justice.

    Science.gov (United States)

    Marchman Andersen, M; Oksbjerg Dalton, S; Lynch, J; Johansen, C; Holtug, N

    2013-03-01

    Are social inequalities in health unjust when brought about by differences in lifestyle? A widespread idea, luck egalitarianism, is that inequality stemming from individuals' free choices is not to be considered unjust, since individuals, presumably, are themselves responsible for such choices. Thus, to the extent that lifestyles are in fact results of free choices, social inequality in health brought about by these choices is not in tension with egalitarian justice. If this is so, then it may put in question the justification of free and equal access to health care and existing medical research priorities. However, personal responsibility is a highly contested issue and in this article we first consider the case for, and second the case against, personal responsibility for health in light of recent developments in philosophical accounts of responsibility and equality. We suggest-but do not fully establish-that at the most fundamental level people are never responsible in such a way that appeals to individuals' own responsibility can justify inequalities in health.

  8. The impact of criminal justice involvement on victims' mental health.

    Science.gov (United States)

    Parsons, Jim; Bergin, Tiffany

    2010-04-01

    The aftermath of violent crime can leave victims with persistent emotional and mental health problems. Although research has shown the potential benefits of prosecuting cases through the courts, there is also a substantial literature that suggests that common features of the criminal justice system can exacerbate the impact of the initial crime, leading to a secondary victimization. The authors present a review of the research on the positive and negative impact of criminal justice involvement, and common points of failure in the efforts of justice institutions to meet the needs of victims. They conclude with recommendations for future work, including the need for research on restorative justice, victim impact statements, court notification systems, victim services, and victim advocates.

  9. Income, Wealth and Health Inequalities - A Scottish Social Justice Perspective.

    Science.gov (United States)

    Molony, Elspeth; Duncan, Christine

    2016-01-01

    This paper considers health inequalities through a social justice perspective. The authors draw on a variety of existing sources of evidence, including experiential, scientific and contextual knowledge. The authors work with NHS Health Scotland, a national Health Board working to reduce health inequalities and improve health. Working closely with the Scottish Government and with a variety of stakeholders across different sectors, NHS Health Scotland's vision for a fairer, healthier Scotland is founded on the principles of social justice. The paper takes social justice as the starting point and explores what it means for two interlinked paradigms of social injustice-health inequality and income inequality. Utilising the wealth of evidence synthesised by NHS Health Scotland as well as drawing on the writings and evidence of philosophers, epidemiologists, the Scottish Government and international bodies, the authors explore the links between income and wealth inequality, social justice, the right to health and health inequalities. The paper ends by considering the extent to which there is appetite for social change in Scotland by considering the attitudes of the people of Scotland and of Britain to poverty, inequality and welfare.

  10. [Environmental justice as an approach to tackle environmental health inequalities].

    Science.gov (United States)

    Bolte, Gabriele; Bunge, Christiane; Hornberg, Claudia; Köckler, Heike

    2018-06-01

    Current international studies show that environment-related diseases disproportionately affect vulnerable people. This is a case of environmental injustice. Environmental justice goes beyond the mere description of environment- and health-related social inequalities by comprising two dimensions of justice as a normative approach: distributional and procedural justice. Attempts to explain the link between social circumstances, the environment and health deal with both the socially unequal distribution of environmental hazards and environmental resources (exposure variation) and social differences in vulnerability to the health effects of environmental exposures (effect modification). Integrated monitoring approaches provide the basis for deriving interventions under various aspects of environmental justice. Parting from public health research and embedded in the Health in All Policies (HiAP) concept, environmental justice has now been taken up in a number of fields, including politics, administration and practice. There are strategic considerations and attempts to anchor it in politics at the federal, state and the communal level, both by government and non-government groups. Health-promoting urban development is a core field for intervention. The Soziale Stadt (Social City) programme for promoting urban planning and construction as well as place oriented sectoral planning make an important contribution by helping to focus on urban spaces with multiple health hazards and to implement target group-oriented participation processes. There continues to be a need to develop methods and systematically implemented evaluations of political strategies and corresponding interventions regarding their effects on inequalities in health and environmental justice.

  11. Health care law versus constitutional law.

    Science.gov (United States)

    Hall, Mark A

    2013-04-01

    National Federation of Independent Business v. Sebelius, the Supreme Court's ruling on the Patient Protection and Affordable Care Act, is a landmark decision - both for constitutional law and for health care law and policy. Others will study its implications for constitutional limits on a range of federal powers beyond health care. This article considers to what extent the decision is also about health care law, properly conceived. Under one view, health care law is the subdiscipline that inquires how courts and government actors take account of the special features of medicine that make legal or policy issues especially problematic - rather than regarding health care delivery and finance more generically, like most any other economic or social enterprise. Viewed this way, the opinions from the Court's conservative justices are mainly about general constitutional law principles. In contrast, Justice Ruth Bader Ginsburg's dissenting opinion for the four more liberal justices is just as much about health care law as it is about constitutional law. Her opinion gives detailed attention to the unique features of health care finance and delivery in order to inform her analysis of constitutional precedents and principles. Thus, the Court's multiple opinions give a vivid depiction of the compelling contrasts between communal versus individualistic conceptions of caring for those in need, and between health care and health insurance as ordinary commodities versus ones that merit special economic, social, and legal status.

  12. Organisational justice and health of employees: prospective cohort study.

    Science.gov (United States)

    Kivimäki, M; Elovainio, M; Vahtera, J; Ferrie, J E

    2003-01-01

    To examine the association between components of organisational justice (that is, justice of decision making procedures and interpersonal treatment) and health of employees. The Poisson regression analyses of recorded all-cause sickness absences with medical certificate and the logistic regression analyses of minor psychiatric morbidity, as assessed by the General Health Questionnaire, and poor self rated health status were based on a cohort of 416 male and 3357 female employees working during 1998-2000 in 10 hospitals in Finland. Low versus high justice of decision making procedures was associated with a 41% higher risk of sickness absence in men (rate ratio (RR) 1.4, 95% confidence interval (CI) 1.1 to 1.8), and a 12% higher risk in women (RR 1.1, 95% CI 1.0 to 1.2) after adjustment for baseline characteristics. The corresponding odds ratios (OR) for minor psychiatric morbidity were 1.6 (95% CI 1.0 to 2.6) in men and 1.4 (95% CI 1.2 to 1.7) in women, and for self rated health 1.4 in both sexes. In interpersonal treatment, low justice increased the risk of sickness absence (RR 1.3 (95% CI 1.0 to 1.6) and RR 1.2 (95% CI 1.2 to 1.3) in men and women respectively), and minor psychiatric morbidity (OR 1.2 in both sexes). These figures largely persisted after control for other risk factors (for example, job control, workload, social support, and hostility) and they were replicated in initially healthy subcohorts. No evidence was found to support the hypothesis that organisational justice would represent a consequence of health (reversed causality). This is the first longitudinal study to show that the extent to which people are treated with justice in workplaces independently predicts their health.

  13. What does social justice require for the public's health? Public health ethics and policy imperatives.

    Science.gov (United States)

    Gostin, Lawrence O; Powers, Madison

    2006-01-01

    Justice is so central to the mission of public health that it has been described as the field's core value. This account of justice stresses the fair disbursement of common advantages and the sharing of common burdens. It captures the twin moral impulses that animate public health: to advance human well-being by improving health and to do so particularly by focusing on the needs of the most disadvantaged. This Commentary explores how social justice sheds light on major ongoing controversies in the field, and it provides examples of the kinds of policies that public health agencies, guided by a robust conception of justice, would adopt.

  14. The Space That Difference Makes: On Marginality, Social Justice and the Future of the Health Humanities.

    Science.gov (United States)

    Gutierrez, Kevin J; DasGupta, Sayantani

    2016-12-01

    Feminist theorist and educator, bell hooks, asserts that to seek true liberation one must choose marginality. One must choose to occupy the space outside the binary between colonizer-colonized, hegemonic center-periphery, and us-them in order to create a location of possibility. This essay will reveal the practice of social justice as the navigation of the space that difference makes and argue that choosing marginality provides a framework for health humanities work towards social justice in health care. The space of the launderette that is depicted in Hanif Kureishi's 1986 film, My Beautiful Laundrette, provides an example of choosing marginality and illustrates how difference structures both real and imagined spaces, which influences how individuals ultimately perceive one another. We will draw from the work of bell hooks; political geographer, Edward Soja; and Marxist philosopher, Henri Lefebvre, to demonstrate the importance of the health humanities' position at the margin to traditional health care education.

  15. Standards for the mental health care of people with severe ...

    African Journals Online (AJOL)

    Adele

    health policy, human rights and rehabilitation. .... Health Policy staff covering Psycho-social rehabilitation ... They outline the essential aspects of care for the treatment and ..... within the criminal justice system (e.g. prisons and Places of Safety).

  16. Health and justice: the capability to be healthy.

    OpenAIRE

    Venkatapuram, Sridhar

    2009-01-01

    This is an inter-disciplinary argument for a moral entitlement to a capability to be healthy. Motivated by the goal to make a human right to health intelligible and justifiable, the thesis extends the capability approach, advocated by Amartya Sen and Martha Nussbaum, to the theory and practice of the human health sciences. Moral claims related to human health are considered at the level of ethical theory, or a level of abstraction where principles of social justice that determine the purpos...

  17. Solidarity as a national health care strategy.

    Science.gov (United States)

    West-Oram, Peter

    2018-05-02

    The Trump Administration's recent attempts to repeal the Affordable Care Act have reignited long-running debates surrounding the nature of justice in health care provision, the extent of our obligations to others, and the most effective ways of funding and delivering quality health care. In this article, I respond to arguments that individualist systems of health care provision deliver higher-quality health care and promote liberty more effectively than the cooperative, solidaristic approaches that characterize health care provision in most wealthy countries apart from the United States. I argue that these claims are mistaken and suggest one way of rejecting the implied criticisms of solidaristic practices in health care provision they represent. This defence of solidarity is phrased in terms of the advantages solidaristic approaches to health care provision have over individualist alternatives in promoting certain important personal liberties, and delivering high-quality, affordable health care. © 2018 John Wiley & Sons Ltd.

  18. Gender Differences in Implicit Moral Orientation Associations: The Justice and Care Debate Revisited

    Science.gov (United States)

    Agerstrom, Jens; Bjorklund, Fredrik; Carlsson, Rickard

    2011-01-01

    Employing new measures (Implicit Association Test) to study the classic issue of moral orientations, we predicted and found gender differences in implicit associations to the concepts of justice and care. Specifically, we found that men more strongly associate justice vs. care with importance and with themselves than women. However, participants'…

  19. Analyzing the politico-moral foundations of the Iran’s health system based on theories of justice

    Science.gov (United States)

    Akrami, Forouzan; Abbasi, Mahmoud; Karimi, Abbas; Shahrivari, Akbar; Majdzadeh, Reza; Zali, Alireza

    2017-01-01

    Public health ethics is a field that covers both factual and ethical issues in health policy and science, and has positive obligations to improve the well-being of populations and reduce social inequalities. It is obvious that various philosophies and moral theories can differently shape the framework of public health ethics. For this reason, the present study reviewed theories of justice in order to analyze and criticize Iran’s general health policies document, served in 14 Articles in 2014. Furthermore, it explored egalitarianism as the dominant theory in the political philosophy of the country’s health care system. According to recent theories of justice, however, health policies must address well-being and its basic dimensions such as health, reasoning, autonomy, and the role of the involved agencies and social institutions in order to achieve social justice beyond distributive justice. Moreover, policy-making in the field of health and biomedical sciences based on Islamic culture necessitates a theory of social justice in the light of theological ethics. Educating people about their rights and duties, increasing their knowledge on individual agency, autonomy, and the role of the government, and empowering them will help achieve social justice. It is recommended to design and implement a strategic plan following each of these policies, based on the above-mentioned values and in collaboration with other sectors, to clarify the procedures in every case. PMID:29291037

  20. Managing complaints in health and social care.

    Science.gov (United States)

    Holmes-Bonney, Kathy

    2010-04-01

    An important aspect of allowing patients to take control of their health care is the introduction of new procedures for dealing with complaints. This article examines the concepts that underpin the new Department of Health regulations on complaints management and what they will mean for health and social care professionals. It also explains why these regulations focus on restorative justice rather than blame when adverse events occur.

  1. Justice and justiciability: advancing solidarity and justice through South Africans' right to health jurisprudence.

    Science.gov (United States)

    Forman, Lisa

    2008-09-01

    The South African Constitutional Court's jurisprudence provides a path-breaking illustration of the social justice potential of an enforceable right to health. It challenges traditional objections to social rights by showing that their enforcement need not be democratically unsound or make zero-sum claims on limited resources. Indeed the South African experience suggests that enforcing health rights may in fact contribute to greater degrees of collective solidarity and justice as the Court has sought to ensure that the basic needs of the poor are not unreasonably restricted by competing public and private interests. This approach has seen the Court adopt a novel fights paradigm which locates individual civil and social rights within a communitarian framework drawing from the traditional African notion of'ubuntu', denoting collective solidarity, humaneness and mutual responsibilities to recognize the respect, dignity and value of all members of society. Yet this jurisprudence also illustrates the limits of litigation as a tool of social transformation, and of social rights that remain embedded in ideological baggage even where they have been constitutionally entrenched and enforced. This paper explores the Constitutional Court's unfolding jurisprudence on the right to health, providing background to the constitutional entrenchment of a justiciable right to health; exploring early Constitutional Court jurisprudence on this right; turning to the forceful application of this right in relation to government policy on AIDS treatment; and concluding with thoughts about the strengths and limits of this jurisprudence in light of subsequent case-law.

  2. Just health care (II): Is equality too much?

    Science.gov (United States)

    Fleck, L M

    1989-12-01

    In a previous essay I criticized Engelhardt's libertarian conception of justice, which grounds the view that society's obligation to assure access to adequate health care for all is a matter of beneficence. Beneficence fails to capture the moral stringency associated with many claims for access to health care. In the present paper I argue that these claims are really matters of justice proper, where justice is conceived along moderate egalitarian lines, such as those suggested by Rawls and Daniels, rather than strong egalitarian lines. Further, given the empirical complexity associated with the distribution of contemporary health care, I argue that what we really need to address the relevant policy issues adequately is a theory of health care justice, as opposed to an all-purpose conception of justice. Daniels has made an important start toward that goal, though there are some large policy areas which I discuss that his account of health care justice does not really speak to. Finally, practical matters of health care justice really need to be addressed in a 'non-ideal' mode, a framework in which philosophers have done little.

  3. Education for climate changes, environmental health and environmental justice

    International Nuclear Information System (INIS)

    Hens, L.; Stoyanov, S.

    2013-01-01

    Full text: The climates changes-health effects-environmental justice nexus is analyzed. The complex issue of climate changes needs to be approached from an interdisciplinary point of view. The nature of the problem necessitates dealing with scientific uncertainty. The health effects caused by climate changes are described and analyzed from a twofold inequalities point of view: health inequalities between rich and poor within countries, and inequalities between northern and southern countries. It is shown thai although the emission of greenhouse gasses is to a large extent caused by the industrialized countries, the effects, including the health effects, will merely impact the South. On the other hand, the southern countries have the highest potential to respond to and offer sustainable energy solutions to counteract climate changes. These inequalities are at the basis to call for environmental justice, of which climate justice is part. This movement calls for diversification of ecologists and their subject of study, more attention for urban ecology, more comprehensive human ecological analyses of complex environmental issues and more participation of stakeholders in the debate and the solution options. The movement advocates a more inclusive ecology targeted to management, sodo-ecological restoration, and comprehensive policies. The fundamental aspects of complexity, inter-disciplinary approaches, uncertainty, and social and natural inequalities should be core issues in environmental health programs. Training on these issues for muitidisciplinary groups of participants necessitates innovative approaches including self-directed, collaborative, and problem oriented learning in which tacit knowledge is important. It is advocated that quality assessments of environmental health programs should take these elements into account. key words: environmental justice, climate changes, sustainable energy solutions

  4. Social justice, epidemiology and health inequalities.

    Science.gov (United States)

    Marmot, Michael

    2017-07-01

    A lifetime spent studying how social determinants of health lead to health inequalities has clarified many issues. First is that social stratification is an appropriate topic of study for epidemiologists. To ignore it would be to ignore a major source of variation in health in society. Not only is the social gradient in health appropriate to study but we have made progress both in understanding its causes and what can be done to address them. Post-modern 'critical theory' raises questions about the social construction of science. Given the attack on science by politicians of bad faith, it is important to recognise that epidemiology and public health have a crucial role to play in providing evidence to improve health of society and reduce inequalities. Evidence gives grounds for optimism that progress can be made both in improving the health of the worst-off in society and narrowing health inequalities. Theoretical debates about 'inequality of what' have been helpful in clarifying theories that drive further gathering of evidence. While it is important to consider alternative explanations of the social gradient in health-principal among them reverse causation-evidence strongly supports social causation. Social action is by its nature political. It is, though, a vital function to provide the evidence that underpins action.

  5. You Can't Fight the System: Strategies of Family Justice in Foster Care Reintegration.

    Science.gov (United States)

    Crenshaw, Wes; Barnum, David

    2001-01-01

    Discusses the issue of justice in family therapy interventions and shares several strategies and ways of thinking about the therapy of foster care. Illustrates a case study and the interventions used to restore justice to a family caught up in the "system." (GCP)

  6. The Age of Criminal Responsibility: "The Frontier between Care and Justice"

    Science.gov (United States)

    Gillen, John

    2006-01-01

    This is an extract from a speech given by Mr Justice Gillen to a conference in Belfast organised by Children Law UK in January 2006. It addresses the potential conflict between the concept of the welfare of children inherent in the family care system and that of responsibility inherent in the criminal justice system. It questions whether the…

  7. Capabilities and Incapabilities of the Capabilities Approach to Health Justice.

    Science.gov (United States)

    Selgelid, Michael J

    2016-01-01

    This first part of this article critiques Sridhar Venkatapuram's conception of health as a capability. It argues that Venkatapuram relies on the problematic concept of dignity, implies that those who are unhealthy lack lives worthy of dignity (which seems politically incorrect), sets a low bar for health, appeals to metaphysically problematic thresholds, fails to draw clear connections between appealed-to capabilities and health, and downplays the importance/relevance of health functioning. It concludes by questioning whether justice entitlements should pertain to the capability for health versus health achievements, challenging Venkatapuram's claims about the strength of health entitlements, and demonstrating that the capabilities approach is unnecessary to address social determinants of health. © 2016 John Wiley & Sons Ltd.

  8. Axioms for health care resource allocation

    DEFF Research Database (Denmark)

    Østerdal, Lars Peter

    2005-01-01

    This paper examines principles of health care resource allocation based on axioms for individual preferences and distributive justice. We establish axioms for representing individual preferences by quality-adjusted life years (QALYs), as well as axioms for existence of a social welfare function...

  9. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    care policy which was intended to make health care which of the two alternative methods of health care available to individuals and families in the financing options of free health or DRF was community at very little or no cost at all. However, preferred by the community members within most health facilities would appear to ...

  10. Problematizing Social Justice in Health Pedagogy and Youth Sport: Intersectionality of Race, Ethnicity, and Class

    Science.gov (United States)

    Dagkas, Symeon

    2016-01-01

    Social justice education recognizes the discrepancies in opportunities among disadvantaged groups in society. The purpose of the articles in this special topic on social justice is to (a) provide a critical reflection on issues of social justice within health pedagogy and youth sport of Black and ethnic-minority (BME) young people; (b) provide a…

  11. An expanded model of the moral self: Beyond care and justice.

    Science.gov (United States)

    Miles, Andrew; Upenieks, Laura

    2018-05-01

    Most research on moral identities conceptualizes morality exclusively in terms of care and justice, but work from across the social sciences indicates that these represent only a corner of the moral landscape. Emphasizing care and justice alone severely restricts the scope of moral identity models, and risks under-estimating the influence of moral self-processes. To address this, we develop and validate measures of moral identity focused on group loyalty, authority, and purity, three additional facets of morality highlighted in Moral Foundations Theory. Although the loyalty identity is remarkably similar to the care/justice identity, the authority and purity identities are distinct, and demonstrate adequate convergent, divergent, and nomological validity. These identities also predict a wide range of behaviors that traditional care/justice focused moral identities miss. Taken together, our work indicates that the moral self is more complex - and has a much wider scope of influence - than previously supposed. Copyright © 2018 Elsevier Inc. All rights reserved.

  12. Respiratory Home Health Care

    Science.gov (United States)

    ... Us Home > Healthy Living > Living With Lung Disease > Respiratory Home Health Care Font: Aerosol Delivery Oxygen Resources ... Teenagers Living With Lung Disease Articles written by Respiratory Experts Respiratory Home Health Care Respiratory care at ...

  13. Pregnancy Rates among Juvenile Justice Girls in Two Randomized Controlled Trials of Multidimensional Treatment Foster Care

    Science.gov (United States)

    Kerr, David C. R.; Leve, Leslie D.; Chamberlain, Patricia

    2009-01-01

    Preventing adolescent pregnancy is a national research priority that has had limited success. In the present study, the authors examined whether Multidimensional Treatment Foster Care (MTFC) relative to intervention services as usual (group care [GC]) decreased pregnancy rates among juvenile justice girls mandated to out-of-home care. Girls (13-17…

  14. Health care operations management

    NARCIS (Netherlands)

    Carter, M.W.; Hans, Elias W.; Kolisch, R.

    2012-01-01

    Health care operations management has become a major topic for health care service providers and society. Operations research already has and further will make considerable contributions for the effective and efficient delivery of health care services. This special issue collects seven carefully

  15. Social and occupational justice barriers in the transition from foster care to independent adulthood.

    Science.gov (United States)

    Paul-Ward, Amy

    2009-01-01

    The professional discourse on social justice suggests that more critical work is needed to sufficiently address the societal issues that affect occupational therapy practitioners' ability to advocate for and with clients. Occupational therapy offers unique opportunities for the scholarly discussion of social justice and for clinical practice to address these issues. This article discusses the importance of incorporating a social justice perspective into occupational therapy by using an example from the author's research program. The experiences of adolescents in foster care were documented in an ongoing qualitative participatory study. An overview of adolescents' (N = 40) perceived independent living and vocational service needs is provided, and several barriers that affect adolescents' ability to develop the skills needed to achieve independent adulthood are described. The article concludes with a discussion of social justice implications as they relate to the myriad issues in the foster care system, occupational therapy research, and practice.

  16. The rights of the medically uninsured: an analysis of social justice and disparate health outcomes.

    Science.gov (United States)

    Chandler, Michelle

    2006-01-01

    As technological advances in the United States continue to improve the effectiveness of medical interventions, expectations among Americans of both improved health and extended life expectancy have also increased. At the same time, many of the population continue to lack the insurance necessary to access even the most basic healthcare services (Institute of Medicine, 2004; Tunzi, 2004; Saha & Bindman, 2001). With approximately 18,000 avoidable deaths attributed annually to inadequate medical coverage and 43.6 million individuals currently without insurance benefits, the need to address the disparity in access to treatment and a means of social justice in the distribution of health care is all too clear (Crispen & Whalen, 2004). As a nation relying on market mechanisms to regulate the costs and quality of available health resources (Baldor, 2003; Saha&Bindman, 2001), the welfare of society as a whole may soon be threatened by the provision of marginal services to a select minority as increasing numbers of the uninsured continue to experience less favorable clinical outcomes and higher mortality rates (Tunzi, 2004; Litaker & Cebul, 2003; Jackson, 2001; Sox, Burstin, Edwards, O'Neil et al., 1998). The author will first examine the consequences of being among the growing number of uninsured individuals in the United States. Attention will then be given to exploring the social justice issues inherent in this critical problem and evaluating these issues through the perspective of both libertarian and feminist theory. Using these theories, innovative strategies for attaining distributive justice in the provision of health care will be offered with recommendations for utilizing these alternative approaches to develop and implement future health policy.

  17. Organisational justice and mental health: a systematic review of prospective studies.

    Science.gov (United States)

    Ndjaboué, Ruth; Brisson, Chantal; Vézina, Michel

    2012-10-01

    The models most commonly used, to study the effects of psychosocial work factors on workers' health, are the demand-control-support (DCS) model and Effort-Reward Imbalance (ERI) model. An emerging body of research has identified Organisational Justice as another model that can help to explain deleterious health effects. This review aimed: (1) to identify prospective studies of the associations between organisational justice and mental health in industrialised countries from 1990 to 2010; (2) to evaluate the extent to which organisational justice has an effect on mental health independently of the DCS and ERI models; and (3) to discuss theoretical and empirical overlap and differences with previous models. The studies had to present associations between organisational justice and a mental health outcome, be prospective, and be entirely available in English or in French. Duplicated papers were excluded. Eleven prospective studies were selected for this review. They provide evidence that procedural justice and relational justice are associated with mental health. These associations remained significant even after controlling for the DCS and ERI models. There is a lack of prospective studies on distributive and informational justice. In conclusion, procedural and relational justice can be considered a different and complementary model to the DCS and ERI models. Future studies should evaluate the effect of change in exposure to organisational justice on employees' mental health over time.

  18. Envisioning the Next Generation of Behavioral Health and Criminal Justice Interventions

    Science.gov (United States)

    Epperson, Matthew W.; Wolff, Nancy; Morgan, Robert D.; Fisher, William H.; Frueh, B. Christopher; Huening, Jessica

    2014-01-01

    The purpose of this paper is to cast a vision for the next generation of behavioral health and criminal justice interventions for persons with serious mental illnesses in the criminal justice system. The limitations of first generation interventions, including their primary focus on mental health treatment connection, are discussed. A person-place framework for understanding the complex factors that contribute to criminal justice involvement for this population is presented. We discuss practice and research recommendations for building more effective interventions to address both criminal justice and mental health outcomes. PMID:24666731

  19. Health care reform and federalism.

    Science.gov (United States)

    Greer, Scott L; Jacobson, Peter D

    2010-04-01

    Health policy debates are replete with discussions of federalism, most often when advocates of reform put their hopes in states. But health policy literature is remarkably silent on the question of allocation of authority, rarely asking which levels of government ought to lead. We draw on the larger literatures about federalism, found mostly in political science and law, to develop a set of criteria for allocating health policy authority between states and the federal government. They are social justice, procedural democracy, compatibility with value pluralism, institutional capability, and economic sustainability. Of them, only procedural democracy and compatibility with value pluralism point to state leadership. In examining these criteria, we conclude that American policy debates often get federalism backward, putting the burden of health care coverage policy on states that cannot enact or sustain it, while increasing the federal role in issues where the arguments for state leadership are compelling. We suggest that the federal government should lead present and future financing of health care coverage, since it would require major changes in American intergovernmental relations to make innovative state health care financing sustainable outside a strong federal framework.

  20. Justice and care: the implications of the Kohlberg-Gilligan debate for medical ethics.

    Science.gov (United States)

    Sharpe, V A

    1992-12-01

    Carol Gilligan has identified two orientations to moral understanding; the dominant 'justice orientation' and the under-valued 'care orientation'. Based on her discernment of a 'voice of care', Gilligan challenges the adequacy of a deontological liberal framework for moral development and moral theory. This paper examines how the orientations of justice and care are played out in medical ethical theory. Specifically, I question whether the medical moral domain is adequately described by the norms of impartiality, universality, and equality that characterize the liberal ideal. My analysis of justice-oriented medical ethics, focuses on the libertarian theory of H.T. Engelhardt and the contractarian theory of R.M. Veatch. I suggest that in the work of E.D. Pellegrino and D.C. Thomasma we find not only a more authentic representation of medical morality but also a project that is compatible with the care orientation's emphasis on human need and responsiveness to particular others.

  1. Global Information Justice: Rights, Responsibilities, and Caring Connections.

    Science.gov (United States)

    Smith, Martha

    2001-01-01

    Explains the concept of global information justice and describes it as an ethical ideal, as an organizing principle for a model for analysis, and as a direction for policy making. Discusses the use of new technologies; access to technology; ownership; privacy; security; community; and the Universal Declaration of Human Rights. (Author/LRW)

  2. Enhancing John Rawls's Theory of Justice to Cover Health and Social Determinants of Health.

    Science.gov (United States)

    Ekmekci, Perihan Elif; Arda, Berna

    2015-11-01

    The vast improvements in medical technology reviled the crucial role of social determinants of health for the etiology, prevalence and prognosis of diseases. This changed the content of the right to health concept from a demand of health services, to a claim of having access to all social determinants of health. Thus, the just allocation of scarce resources of health and social determinants of health became an issue of ethical theories. John Rawls developed a theory of justice. His theory suggests that the principles of justice should be determined by individuals in a hypothetic initial position. In the initial position, individuals agree on principles of justice. Rawls puts forth that the institutions of the society should be structured in compliance with these principles to reach a fair social system. Although Rawls did not justify right to health in his theory, the efforts to enlarge the theory to cover right to health flourished quite fast. In this paper first the basic components of Rawls theory is explained. Then the most outstanding approaches to enlarge his theory to cover right to health is introduced and discussed within the discourse of Rawls theory of justice.

  3. Consumer Directed Health Care

    OpenAIRE

    John Goodman

    2006-01-01

    Consumer driven health care (CDHC) is a potential solution to two perplexing problems: (1) How to choose between health care and other uses of money, and (2) how to allocate resources in an industry where normal market forces have been systemically suppressed. In the consumer-driven model, consumers occupy the primary decision-making role regarding the health care that they receive. From an employee benefits perspective, consumer driven health care in the broadest sense may refer to limited e...

  4. Mob justice as an emerging medico-legal, social and public health ...

    African Journals Online (AJOL)

    Background: Mob-justice poses a medico-legal, social and public health problem in most developing countries including Tanzania and has shown to have negative effects on social and health of the country, communities, and families. This study was conducted to analyze the mob-justice situation in north-western Tanzania ...

  5. What Makes Health Care Special?: An Argument for Health Care Insurance.

    Science.gov (United States)

    Horne, L Chad

    2017-01-01

    While citizens in a liberal democracy are generally expected to see to their basic needs out of their own income shares, health care is treated differently. Most rich liberal democracies provide their citizens with health care or health care insurance in kind. Is this "special" treatment justified? The predominant liberal account of justice in health care holds that the moral importance of health justifies treating health care as special in this way. I reject this approach and offer an alternative account. Health needs are not more important than other basic needs, but they are more unpredictable. I argue that citizens are owed access to insurance against health risks to provide stability in their future expectations and thus to protect their capacities for self-determination.

  6. Humanity and Justice in Global Health: Problems with Venkatapuram's Justification of the Global Health Duty.

    Science.gov (United States)

    Kollar, Eszter; Laukötter, Sebastian; Buyx, Alena

    2016-01-01

    One of the most ambitious and sophisticated recent approaches to provide a theory of global health justice is Sridhar Venkatapuram's recent work. In this commentary, we first outline the core idea of Venkatapuram's approach to global health justice. We then argue that one of the most important elements of the account, Venkatapuram's basis of global health duties, is either too weak or assumed implicitly without a robust justification. The more explicit grounding of the duty to protect and promote health capabilities is based on Martha Nussbaum's version of the capability approach. We argue that this foundation gives rise to humanitarian duties rather than duties of justice proper. Venkatapuram's second argument from the social determinants of health thesis is instead a stronger candidate for grounding duties of justice. However, as a justificatory argument, it is only alluded to and has not yet been spelled out sufficiently. We offer plausible justificatory steps to fill this gap and draw some implications for global health action. We believe this both strengthens Venkatapuram's approach and serves to broaden the basis for future action in the area of global health. © 2016 John Wiley & Sons Ltd.

  7. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    the_monk

    Journal of Community Medicine and Primary Health Care. 26 (1) 12-20 .... large proportions of the population work in the poor people use health care services far less than. 19 ... hypertension, cancers and road traffic accidents) below 1 dollar ...

  8. Social justice in pandemic preparedness.

    Science.gov (United States)

    DeBruin, Debra; Liaschenko, Joan; Marshall, Mary Faith

    2012-04-01

    Pandemic influenza planning in the United States violates the demands of social justice in 2 fundamental respects: it embraces the neutrality of procedural justice at the expense of more substantive concern with health disparities, thus perpetuating a predictable and preventable social injustice, and it fails to move beyond lament to practical planning for alleviating barriers to accessing care. A pragmatic social justice approach, addressing both health disparities and access barriers, should inform pandemic preparedness. Achieving social justice goals in pandemic response is challenging, but strategies are available to overcome the obstacles. The public engagement process of one state's pandemic ethics project influenced the development of these strategies.

  9. Health equality, social justice and the poverty of autonomy.

    Science.gov (United States)

    Newdick, Christopher

    2017-10-01

    How does the concept of autonomy assist public responses to 'lifestyle' diseases? Autonomy is fundamental to bioethics, but its emphasis on self-determination and individuality hardly supports public health policies to eat and drink less and take more exercise. Autonomy rejects a 'nanny' state. Yet, the cost of non-communicable diseases is increasing to individuals personally and to public health systems generally. Health care systems are under mounting and unsustainable pressure. What is the proper responsibility of individuals, governments and corporate interests working within a global trading environment? When public health care resources are unlikely to increase, we cannot afford to be so diffident to the cost of avoidable diseases.

  10. Health Care Delivery.

    Science.gov (United States)

    Starfield, Barbara

    1987-01-01

    The article reviews emerging health care delivery options for handicapped children. Cost structures, quality of care, and future prospects are considered for Health Maintenance Organizations, Preferred Provider Organizations, Tax Supported Direct Service Programs, Hospital-Based Services, and Ambulatory Care Organizations. (Author/DB)

  11. Technology use in linking criminal justice reentrants to HIV care in the community: a qualitative formative research study.

    Science.gov (United States)

    Peterson, James; Cota, Michelle; Gray, Holly; Bazerman, Lauri; Kuo, Irene; Kurth, Ann; Beckwith, Curt

    2015-01-01

    Innovative interventions increasing linkage, adherence, and retention in care among HIV-infected persons in the criminal justice system are needed. The authors conducted a qualitative study to investigate technology-based tools to facilitate linkage to community-based care and viral suppression for HIV-infected jail detainees on antiretroviral medications being released to the community. The authors conducted 24 qualitative interview-12 in Rhode Island and 12 in Washington, DC-among recently incarcerated HIV-infected persons to elicit their perceptions on the use of technology tools to support linkage to HIV care among criminal justice populations. This article discusses participants' perceptions of the acceptability of technological tools such as (a) a computer-based counseling and (b) text messaging interventions. The participants reported positive experiences when previewing the technology-based tools to facilitate linkage to HIV care and adherence to HIV medications. Successful linkage to care has been shown to improve HIV-associated and non-HIV-associated health outcomes, as well as prevent criminal recidivism and facilitate reentrants' successful and meaningful transition. These findings can be used to inform the implementation of interventions aimed at promoting adherence to antiretroviral medications and linkage to care for HIV-infected persons being released from the correctional setting.

  12. Displacement and Suicide Risk for Juvenile Justice-Involved Youth with Mental Health Issues

    Science.gov (United States)

    Kretschmar, Jeff M.; Flannery, Daniel J.

    2011-01-01

    This article examined the relationship between suicide behaviors and displacement, as defined by out-of-home placement, in a sample of juvenile-justice-involved youth with mental health issues. Participants included boys and girls between the ages of 10 and 18 who were enrolled in a juvenile justice diversion program for children with mental or…

  13. Health care delivery systems.

    NARCIS (Netherlands)

    Stevens, F.; Zee, J. van der

    2007-01-01

    A health care delivery system is the organized response of a society to the health problems of its inhabitants. Societies choose from alternative health care delivery models and, in doing so, they organize and set goals and priorities in such a way that the actions of different actors are effective,

  14. Introducing advance directives in the Nigerian health care Setting ...

    African Journals Online (AJOL)

    Patients and their families have rights to respect, compassion, attentive and skilled physical and psychosocial care, and spiritual support provided in a holistic manner by the health care team. The four bioethical principles of beneficence, autonomy, non-maleficence and justice should form the framework upon which ...

  15. US health care crisis.

    Science.gov (United States)

    Cirić, Ivan

    2013-01-01

    The United States health care is presently challenged by a significant economic crisis. The purpose of this report is to introduce the readers of Medicinski Pregled to the root causes of this crisis and to explain the steps undertaken to reform health care in order to solve the crisis. It is hoped that the information contained in this report will be of value, if only in small measure, to the shaping of health care in Serbia.

  16. How Do Finnish Children Express Care and Justice in Comic Strips and Written Narratives?

    Science.gov (United States)

    Johansson, Juha; Hannula, Markku S.

    2014-01-01

    This case study explored how children's moral expressions like love and violence differ according to the mode of narrative, comic strips or written narratives. Sixteen third-grade children from a primary school in Finland took part in the study. Children's moral expressions were divided into justice and care. Reading frequency of fairy tales and…

  17. Justice and Caring and the Problem of Moral Relativism: Reframing the Gender Question in Ethics.

    Science.gov (United States)

    Brell, Carl D., Jr.

    1989-01-01

    Examines the issue of moral relativism as it pertains to conceptualizations of gender effect on moral development. Reviews positions of theorists regarding the importance of formal and contextually relative criteria to the development of moral reasoning. Argues that neither a justice nor a caring ethic alone can solve the problem of moral…

  18. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    adedamla

    Quarry industry has become a major means of livelihood in Ebonyi state, but insufficient data exists on their operations ... of Dust Mask among Crushers of Selected Quarry (Crushed ... Journal of Community Medicine and Primary Health Care.

  19. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    2Primary Health Care Department, Ikpoba Okha Local Government Area, Benin City, ... selected from each of the ten wards in the LGA using multistage sampling technique. ..... Knowledge of HIV/AIDS Insurance Companies in Lagos State.

  20. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    adedamla

    Background: The well-being of women and children is one of the major determinants ... The Sample for the study were women recruited from 11 primary health care ... respondents educational level and knowledge of preconception care (X =24.76, ... single adult or married couple) are in an optimal state .... The major site for.

  1. Preserving community in health care.

    Science.gov (United States)

    Emanuel, E J; Emanuel, L L

    1997-02-01

    There are two prominent trends in health care today: first, increasing demands for accountabilty, and second, increasing provision of care through managed care organizations. These trends promote the question: What form of account-ability is appropriate to managed care plans? Accountability is the process by which a party justifies its actions and policies. Components of accountability include parties that can be held or hold others accountable, domains and content areas being assessed, and procedures of assessment. Traditionally, the professional model of accountability has operated in medical care. In this model, physicians establish the standards of accountability and hold each other accountable through professional organizations. This form of accountability seems outdated and inapplicable to managed care plans. The alternatives are the economic and the political models of accountability. In the economic model, medicine becomes more like a commodity, and "exit" (consumers changing providers for reasons of cost and quality) is the dominant procedure of accountability. In the political model, medicine becomes more like a community good, and "voice" (citizens communicating their views in public forums or on policy committees, or in elections for representatives) is the dominant procedure of accountability. The economic model's advantages affirm American individualism, make minimal demands on consumers, and use a powerful incentive, money. Its disadvantages undermine health care as a nonmarket good, undermine individual autonomy, undermine good medical practice, impose significant demands on consumers to be informed, sustain differentials of power, and use indirect procedures of accountability. The political model's advantages affirm health care as a matter of justice, permit selecting domains other than price and quality for accountability, reinforce good medical practice, and equalize power between patients and physicians. Its disadvantages include inefficiency in

  2. Health Care Reform: a Socialist Vision

    Directory of Open Access Journals (Sweden)

    Martha Livingston

    2010-04-01

    Full Text Available At first glance, it doesn't seem as though socialism and health-care reform have a whole lot to do with each other. After all, the most visible "left" position in the current discussion of health-care reform merely advocates for the government to assume the function of national insurer, leaving the delivery of health care - from its often-questionable content to its hierarchical relationships - firmly in place. As such, a single payer, Medicare-for-All insurance program is a modest, even tepid reform. Those of us on the left who have been active in the single payer movement have always seen it as a steppingstone toward health-care justice: until the question of access to care is solved, how do we even begin to address not only health care but also health inequities? How, for example, can working-class Americans, Americans of color, and women demand appropriate, respectful, humane, first-rate care when our ability to access any health-care services at all is so tightly constrained?

  3. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    adedamla

    enrol in an insurance scheme feeling that they need more information on health insurance and the willingness to enrol in a ... and utilize the benefits of different types of health insurance services. Conclusion: The findings ..... improvements in access and quality of care, and the ... the 'rising tide' of and information technology.

  4. Benchmarking HIV health care

    DEFF Research Database (Denmark)

    Podlekareva, Daria; Reekie, Joanne; Mocroft, Amanda

    2012-01-01

    ABSTRACT: BACKGROUND: State-of-the-art care involving the utilisation of multiple health care interventions is the basis for an optimal long-term clinical prognosis for HIV-patients. We evaluated health care for HIV-patients based on four key indicators. METHODS: Four indicators of health care we...... document pronounced regional differences in adherence to guidelines and can help to identify gaps and direct target interventions. It may serve as a tool for assessment and benchmarking the clinical management of HIV-patients in any setting worldwide....

  5. 77 FR 40366 - Glen R. Justice: Debarment Order

    Science.gov (United States)

    2012-07-09

    ... bribery, payment of illegal gratuities, fraud, perjury, false statement, racketeering, blackmail... of Dr. Justice's fraudulent business practices, health care benefit programs suffered losses between...

  6. Bourdieu does environmental justice? Probing the linkages between population health and air pollution epidemiology.

    Science.gov (United States)

    Buzzelli, Michael

    2007-03-01

    The environmental justice literature faces a number of conceptual and methodological shortcomings. The purpose of this paper is to probe ways in which these shortcomings can be remedied via recent developments in related literatures: population health and air pollution epidemiology. More sophisticated treatment of social structure, particularly if based on Pierre Bourdieu's relational approach to forms of capital, can be combined with the methodological rigour and established biological pathways of air pollution epidemiology. The aim is to reformulate environmental justice research in order to make further meaningful contributions to the wider movement concerned with issues of social justice and equity in health research.

  7. [Health care networks].

    Science.gov (United States)

    Mendes, Eugênio Vilaça

    2010-08-01

    The demographic and epidemiologic transition resulting from aging and the increase of life expectation means an increment related to chronic conditions. The healthcare systems contemporary crisis is characterized by the organization of the focus on fragmented systems turned to the acute conditions care, in spite of the chronic conditions prevalence, and by the hierarchical structure without communication flow among the different health care levels. Brazil health care situation profile is now presenting a triple burden of diseases, due to the concomitant presence of infectious diseases, external causes and chronic diseases. The solution is to restore the consistence between the triple burden of diseases on the health situation and the current system of healthcare practice, with the implantation of health care networks. The conclusion is that there are evidences in the international literature on health care networks that these networks may improve the clinical quality, the sanitation results and the user's satisfaction and the reduction of healthcare systems costs.

  8. Imagining Global Health with Justice: In Defense of the Right to Health.

    Science.gov (United States)

    Friedman, Eric A; Gostin, Lawrence O

    2015-12-01

    The singular message in Global Health Law is that we must strive to achieve global health with justice--improved population health, with a fairer distribution of benefits of good health. Global health entails ensuring the conditions of good health--public health, universal health coverage, and the social determinants of health--while justice requires closing today’s vast domestic and global health inequities. These conditions for good health should be incorporated into public policy, supplemented by specific actions to overcome barriers to equity. A new global health treaty grounded in the right to health and aimed at health equity--a Framework Convention on Global Health (FCGH)--stands out for its possibilities in helping to achieve global health with justice. This far-reaching legal instrument would establish minimum standards for universal health coverage and public health measures, with an accompanying national and international financing framework, require a constant focus on health equity, promote Health in All Policies and global governance for health, and advance the principles of good governance, including accountability. While achieving an FCGH is certainly ambitious, it is a struggle worth the efforts of us all. The treaty’s basis in the right to health, which has been agreed to by all governments, has powerful potential to form the foundation of global governance for health. From interpretations of UN treaty bodies to judgments of national courts, the right to health is now sufficiently articulated to serve this role, with the individual’s right to health best understood as a function of a social, political, and economic environment aimed at equity. However great the political challenge of securing state agreement to the FCGH, it is possible. States have joined other treaties with significant resource requirements and limitations on their sovereignty without significant reciprocal benefits from other states, while important state interests would

  9. Climate Change & Social Justice: Why We Should Care

    Science.gov (United States)

    Nesbitt, Nathan T.

    2015-03-01

    In the past several years the global impacts brought about by climate change have become increasingly apparent through the advent of numerous natural disasters. In these events the social costs of climate change have materialized demonstrating high costs in lives, livelihoods, and equity. Due to geographic bad-luck many of the countries most affected by climate change are those that contributed least, a challenge that's exacerbated by a lack of robust infrastructure in these countries. Wealthy nations remain at risk themselves and incidents such as Hurricanes Sandy & Katrina have demonstrated that in times of crisis even institutions like the Red Cross will abandon the poor to their deaths. As necessary action on climate change would cost the fossil fuel industry 20 trillion, money in politics has stymied action. Recently, however, a groundswell grassroots movement (e.g. People's Climate March in NYC) and great strides in energy technology and policy have begun to create necessary change. Reports quantifying the impacts of climate change will be discussed, as well as an update on the current state of the global climate justice movement. The important contributions from scientists to this movement will be highlighted. This material is based upon work supported by the National Science Foundation Graduate Research Fellowship under Grant No. (DGE-1258923).

  10. [AN EVALUATION OF JUSTICE AND RIGHT TO HEALTH CONCEPTS IN THE PERSPECTIVES OF ETHICAL THEORIES].

    Science.gov (United States)

    Ekmekçi, Perihan Elif; Arda, Berna

    Right to health is considered as a fundamental human right. However the realization of right to health is facing obstacles due to the scarce resources which are needed for the provision of health services. Besides the vast technological improvements in medical area leads to the development of diagnosis and treatment possibilities each and every day. Thus, the provision of health services becomes a subject of distributive justice. To define the concept of justice, first one should identify the conditions of demanding right to have something and then determine how and who is obliged to give the deserved. Ethical theories form their own paradigms of acting right regarding their anchor points and priority values. The basic concepts such as justice or right to health are considered and conceptualized within the paradigms of the ethical theories. Thus some ethical theories consider right to health as a natural constituent of human being, while some may consider it contextual and others may reject it completely. In a similar vein, justice and related concepts of justice such as formal and material principles of justice differ regarding the paradigm of the ethical theory in which we position ourselves. The paradigms of ethical theories demand different approaches from each other both in defining the concepts and implementations in practical life. This paper sets forth how justice and right to health is conceptualized in the virtue ethics, deontological ethics, liberal ethical theory and communitarian ethical theories. To this end first the general frame of each ethical theory and how justice is conceptualized within this frame is defined. Following that a discussion of the possibility of justification of the right to health within the context of ethical theory is perused.

  11. Health care for Micronesians and constitutional rights.

    Science.gov (United States)

    Shek, Dina; Yamada, Seiji

    2011-11-01

    Under the Compacts of Free Association (COFA), people from the Freely Associated States--the Republic of Palau (ROP), the Republic of the Marshall Islands (RMI), and the Federated States of Micronesia (FSM)--have been migrating to the United States in increasing numbers. In 1996, Congress passed broad welfare reform (Personal Responsibility and Work Opportunity Reconciliation Act) which limited certain federal benefits previously available to COFA migrants, including Medicaid benefits. Prior to July 2010, the State of Hawai'i had continued to include COFA migrants under its state-funded Medicaid program. In the face of budget constraints, the State removed these people from its Medicaid rolls. A challenge on the legal basis of the denial of equal protection of the laws, ie, the Fourteenth Amendment to the US Constitution, was successful in reinstating health care to the COFA migrants in December 2010. From the health worker's perspective, regardless of various social justice arguments that may have been marshaled in favor of delivering health care to the people, it was an appeal to the judicial system that succeeded. From the attorney's perspective, the legal victories are potentially limited to the four walls of the courtroom without community involvement and related social justice movements. Together, the authors propose that in order to better address the issue of health care access for Micronesian peoples, we must work together, as health and legal advocates, to define a more robust vision of both systems that includes reconciliation and community engagement.

  12. Climate Change, Climate Justice, and Environmental Health: Implications for the Nursing Profession.

    Science.gov (United States)

    Nicholas, Patrice K; Breakey, Suellen

    2017-11-01

    Climate change is an emerging challenge linked to negative outcomes for the environment and human health. Since the 1960s, there has been a growing recognition of the need to address climate change and the impact of greenhouse gas emissions implicated in the warming of our planet. There are also deleterious health outcomes linked to complex climate changes that are emerging in the 21st century. This article addresses the social justice issues associated with climate change and human health and discussion of climate justice. Discussion paper. A literature search of electronic databases was conducted for articles, texts, and documents related to climate change, climate justice, and human health. The literature suggests that those who contribute least to global warming are those who will disproportionately be affected by the negative health outcomes of climate change. The concept of climate justice and the role of the Mary Robinson Foundation-Climate Justice are discussed within a framework of nursing's professional responsibility and the importance of social justice for the world's people. The nursing profession must take a leadership role in engaging in policy and advocacy discussions in addressing the looming problems associated with climate change. Nursing organizations have adopted resolutions and engaged in leadership roles to address climate change at the local, regional, national, and global level. It is essential that nurses embrace concepts related to social justice and engage in the policy debate regarding the deleterious effects on human health related to global warming and climate change. Nursing's commitment to social justice offers an opportunity to offer significant global leadership in addressing the health implications related to climate change. Recognizing the negative impacts of climate change on well-being and the underlying socioeconomic reasons for their disproportionate and inequitable distribution can expand and optimize the profession's role

  13. Organizing Rural Health Care

    DEFF Research Database (Denmark)

    Bunkenborg, Mikkel

    2012-01-01

    to organize rural health care is more regulatory and distanced in its emphasis on nudging patients and doctors towards the right decisions through economic incentives. This bureaucratic approach to organizing health individually offers a sharp contrast to the religious collectivities that form around health...

  14. Management and governance processes in community health coalitions: a procedural justice perspective.

    Science.gov (United States)

    Weiner, Bryan J; Alexander, Jeffrey A; Shortell, Stephen M

    2002-12-01

    Community-based coalitions are a popular strategy for promoting community health despite the fact that coalitions often fail to achieve measurable results. Using a procedural justice framework, this study seeks to advance knowledge about the relationship between coalition governance and management processes and indicators of coalition functioning. Member survey data from 25 coalitions participating in the Community Care Network Demonstration Program were analyzed using two-stage least squares regression. Results show that personal influence in decision making. decision process clarity, and collaborative conflict resolution were significantly associated with procedural fairness perceptions. Procedural fairness perceptions, in turn, were positively associated with member satisfaction with coalition decisions, but not personal engagement in the coalition or organizational integration of coalition goals and activities. Personal influence in decision making and collaborative conflict resolution also exhibited direct relationships with all three indicators of coalition functioning examined in the study.

  15. Ethical dilemmas in community mental health care.

    Science.gov (United States)

    Liégeois, A; Van Audenhove, C

    2005-08-01

    Ethical dilemmas in community mental health care is the focus of this article. The dilemmas are derived from a discussion of the results of a qualitative research project that took place in five countries of the European Union. The different stakeholders are confronted with the following dilemmas: community care versus hospital care (clients); a life with care versus a life without care (informal carers); stimulation of the client toward greater responsibility versus protection against such responsibility (professionals); budgetary control versus financial incentives (policy makers), and respect for the client versus particular private needs (neighbourhood residents). These dilemmas are interpreted against the background of a value based ethical model. This model offers an integral approach to the dilemmas and can be used to determine policy. The dilemmas are discussed here as the result of conflicting values-namely autonomy and privacy, support and safety, justice and participation, and trust and solidarity.

  16. American Health Care Association

    Science.gov (United States)

    ... MO - St. Louis, Qualifications Required: Bachelor’s degree in business, marketing, health care administration or a related field Current ... Work for AHCA/NCAL News Provider Daily Publications Social Media News Releases LTC Leader Blog Research and Data ...

  17. Resilient health care

    DEFF Research Database (Denmark)

    Hollnagel, E.; Braithwaite, J.; Wears, R. L.

    Health care is everywhere under tremendous pressure with regard to efficiency, safety, and economic viability - to say nothing of having to meet various political agendas - and has responded by eagerly adopting techniques that have been useful in other industries, such as quality management, lean...... production, and high reliability. This has on the whole been met with limited success because health care as a non-trivial and multifaceted system differs significantly from most traditional industries. In order to allow health care systems to perform as expected and required, it is necessary to have...... engineering's unique approach emphasises the usefulness of performance variability, and that successes and failures have the same aetiology. This book contains contributions from acknowledged international experts in health care, organisational studies and patient safety, as well as resilience engineering...

  18. HealthCare.gov

    Science.gov (United States)

    ... CAN CHANGE Looking for coverage for a small business? Learn more Need to submit documents? SEE HOW ... Find Local Help Visit the HealthCare.gov blog Facebook Twitter YouTube Google+ All Topics | Glossary | Contact Us | ...

  19. Your Health Care Team

    Science.gov (United States)

    ... Rights Employment Discrimination Health Care Professionals Law Enforcement Driver's License For Lawyers Food & Fitness Home Food MyFoodAdvisor ... Fit Types of Activity Weight Loss Assess Your Lifestyle Getting Started Food Choices In My Community Home ...

  20. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    the_monk

    one strategy that could be conducted anywhere, if the health care workers are trained and positively disposed ... places; regulate advertising, manufacturing. 13 .... Gender. Male. 52 (46.0). 61 (54.0). 0.0001. Significant. Female. 82 (73.2).

  1. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    user

    about teething the world over and especially ... children`s out-patients, dental and the ear, nose and throat clinics of a tertiary hospital in south-west Nigeria. ... parents, health care workers and personal experiences were the sources of beliefs ... None (0%) of the respondents had prior knowledge of proven causes of ear.

  2. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    the_monk

    VPDs, this represents 17% of global total. 1 ... Knowledge, Attitude and Practice of Childhood Immunization ... Department of Community Health & Primary Care, College of Medicine, University of Lagos, Idi-Araba, P.M.B. 12003, ... include access to services, parental (maternal) ... Calmette Guerin (BCG) vaccine Oral Polio.

  3. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    the_monk

    2012-05-01

    May 1, 2012 ... with the quality of care in a tertiary health facility in Delta State, Nigeria ... includes contributions from families, charges have been .... employees at 23.5%, self employed 19.1% of showed that most of the respondents (41.3%).

  4. Revisiting public health preparedness: Incorporating social justice principles into pandemic preparedness planning for influenza.

    Science.gov (United States)

    Kayman, Harvey; Ablorh-Odjidja, Angela

    2006-01-01

    Public health professionals are responsible for ensuring the health of the nation, which requires that planners for public health emergencies recognize that not including protection for underserved or marginalized communities poses a risk to the entire population. To assure the protection of these populations in the event of a pandemic outbreak, preparedness planning will benefit from the application of several principles of social justice in assuring the protection of all individuals. This article will review the history between public health and social justice, provide a brief review of pandemic preparedness planning efforts, discuss the importance of and make recommendations for the incorporation of principles of social justice in the development of pandemic preparedness plans, and highlight some of the challenges faced by public health in effectively and equitably meeting its charge to protect the nation's health.

  5. Health care engineering management.

    Science.gov (United States)

    Jarzembski, W B

    1980-01-01

    Today, health care engineering management is merely a concept of dreamers, with most engineering decisions in health care being made by nonengineers. It is the purpose of this paper to present a rationale for an integrated hospital engineering group, and to acquaint the clinical engineer with some of the salient features of management concepts. Included are general management concepts, organization, personnel management, and hospital engineering systems.

  6. Justice and care: decision making by medical school student promotions committees.

    Science.gov (United States)

    Green, Emily P; Gruppuso, Philip A

    2017-06-01

    The function of medical school entities that determine student advancement or dismissal has gone largely unexplored. The decision making of 'academic progress' or student promotions committees is examined using a theoretical framework contrasting ethics of justice and care, with roots in the moral development work of theorists Kohlberg and Gilligan. To ascertain promotions committee members' conceptualisation of the role of their committee, ethical orientations used in member decision making, and student characteristics most influential in that decision making. An electronic survey was distributed to voting members of promotions committees at 143 accredited allopathic medical schools in the USA. Descriptive statistics were calculated and data were analysed by gender, role, institution type and class size. Respondents included 241 voting members of promotions committees at 55 medical schools. Respondents endorsed various promotions committee roles, including acting in the best interest of learners' future patients and graduating highly qualified learners. Implementing policy was assigned lower importance. The overall pattern of responses did not indicate a predominant orientation toward an ethic of justice or care. Respondents indicated that committees have discretion to take individual student characteristics into consideration during deliberations, and that they do so in practice. Among the student characteristics with the greatest influence on decision making, professionalism and academic performance were paramount. Eighty-five per cent of participants indicated that they received no training. Promotions committee members do not regard orientations of justice and care as being mutually exclusive and endorse an array of statements regarding the committee's purpose that may conflict with one another. The considerable variance in the influence of student characteristics and the general absence of committee member training indicate a need for clear delineation of the

  7. Health, Traffic, and Environmental Justice: Collaborative Research and Community Action in San Francisco, California

    Science.gov (United States)

    Sciammas, Charlie; Seto, Edmund; Bhatia, Rajiv; Rivard, Tom

    2009-01-01

    Health impacts on neighborhood residents from transportation systems can be an environmental justice issue. To assess the effects of transportation planning decisions, including the construction of an intraurban freeway, on residents of the Excelsior neighborhood in southeast San Francisco, PODER (People Organizing to Demand Environmental and Economic Rights), a local grassroots environmental justice organization; the San Francisco Department of Public Health; and the University of California, Berkeley, collaborated on participatory research. We used our findings regarding traffic-related exposures and health hazards in the area to facilitate community education and action to address transportation-related health burdens on neighborhood residents. PMID:19890147

  8. Controlling Health Care Costs

    Science.gov (United States)

    Dessoff, Alan

    2009-01-01

    This article examines issues on health care costs and describes measures taken by public districts to reduce spending. As in most companies in America, health plan designs in public districts are being changed to reflect higher out-of-pocket costs, such as higher deductibles on visits to providers, hospital stays, and prescription drugs. District…

  9. Criminal Justice Contact, Stressors, and Obesity-Related Health Problems Among Black Adults in the USA.

    Science.gov (United States)

    Archibald, Paul C; Parker, Lauren; Thorpe, Roland

    2018-04-01

    Criminal justice contact-defined as lifetime arrest, parole, or incarceration, seems to exacerbate chronic conditions, and those who are most likely to have had contact with the criminal justice system, such as Black adults, often already have pre-existing disproportionately high rates of stress and chronic conditions due to the social determinants of health that affect underrepresented minorities. Findings from this study suggest that there is a mechanism that links the stressors among Black adults manifested by such factors as family, financial, neighborhood, and personal problems with criminal justice contact to obesity-related health status. Using the National Survey of American Life (NSAL), modified Poisson regression analyses were used to determine the association between criminal justice contact, stressors, and obesity-related health problems among a national sample of Black adults (n = 5008). In the full model, the odds of experiencing obesity-related health problems for Black adults who had criminal justice contact was reduced (PR, 1.23 to 1.14) and not statistically significant. Black adults who reported experiencing family stressors (PR, 1.21; 95% CI, 1.08, 1.36), financial stressors (PR, 1.30; 95% CI, 1.16, 1.47), and personal stressors (PR, 1.16; 95% CI, 1.02, 1.31) were statistically significant and higher than those who reported not experiencing any of these stressors; neighborhood stressors was not statistically significant. The evidence suggests a relationship between the stressors associated with criminal justice contact and obesity-related health status. These findings emphasize the need to further explore the family, financial, and personal stressors for Black adults with criminal justice contact in order to further our understanding of their obesity-related health problems.ᅟ.

  10. Social Justice and Human Caring: A Model of Caring Science as a Hopeful Paradigm for Moral Justice for Humanity.

    Science.gov (United States)

    Watson, Jean

    2018-04-01

    The only true standard of greatness of any civilization is our sense of social and moral responsibility in translating material wealth to human values and achieving our full potential as a caring society. -The Right Honorable Norman Kirk, Former Prime Minister of New Zealand.

  11. Mode of effective connectivity within a putative neural network differentiates moral cognitions related to care and justice ethics.

    Science.gov (United States)

    Cáceda, Ricardo; James, G Andrew; Ely, Timothy D; Snarey, John; Kilts, Clinton D

    2011-02-25

    Moral sensitivity refers to the interpretive awareness of moral conflict and can be justice or care oriented. Justice ethics is associated primarily with human rights and the application of moral rules, whereas care ethics is related to human needs and a situational approach involving social emotions. Among the core brain regions involved in moral issue processing are: medial prefrontal cortex, anterior (ACC) and posterior (PCC) cingulate cortex, posterior superior temporal sulcus (pSTS), insula and amygdala. This study sought to inform the long standing debate of whether care and justice moral ethics represent one or two different forms of cognition. Model-free and model-based connectivity analysis were used to identify functional neural networks underlying care and justice ethics for a moral sensitivity task. In addition to modest differences in patterns of associated neural activity, distinct modes of functional and effective connectivity were observed for moral sensitivity for care and justice issues that were modulated by individual variation in moral ability. These results support a neurobiological differentiation between care and justice ethics and suggest that human moral behavior reflects the outcome of integrating opposing rule-based, self-other perspectives, and emotional responses.

  12. Mode of Effective Connectivity within a Putative Neural Network Differentiates Moral Cognitions Related to Care and Justice Ethics

    Science.gov (United States)

    Cáceda, Ricardo; James, G. Andrew; Ely, Timothy D.; Snarey, John; Kilts, Clinton D.

    2011-01-01

    Background Moral sensitivity refers to the interpretive awareness of moral conflict and can be justice or care oriented. Justice ethics is associated primarily with human rights and the application of moral rules, whereas care ethics is related to human needs and a situational approach involving social emotions. Among the core brain regions involved in moral issue processing are: medial prefrontal cortex, anterior (ACC) and posterior (PCC) cingulate cortex, posterior superior temporal sulcus (pSTS), insula and amygdala. This study sought to inform the long standing debate of whether care and justice moral ethics represent one or two different forms of cognition. Methodology/Principal Findings Model-free and model-based connectivity analysis were used to identify functional neural networks underlying care and justice ethics for a moral sensitivity task. In addition to modest differences in patterns of associated neural activity, distinct modes of functional and effective connectivity were observed for moral sensitivity for care and justice issues that were modulated by individual variation in moral ability. Conclusions/Significance These results support a neurobiological differentiation between care and justice ethics and suggest that human moral behavior reflects the outcome of integrating opposing rule-based, self-other perspectives, and emotional responses. PMID:21364916

  13. Mode of effective connectivity within a putative neural network differentiates moral cognitions related to care and justice ethics.

    Directory of Open Access Journals (Sweden)

    Ricardo Cáceda

    Full Text Available BACKGROUND: Moral sensitivity refers to the interpretive awareness of moral conflict and can be justice or care oriented. Justice ethics is associated primarily with human rights and the application of moral rules, whereas care ethics is related to human needs and a situational approach involving social emotions. Among the core brain regions involved in moral issue processing are: medial prefrontal cortex, anterior (ACC and posterior (PCC cingulate cortex, posterior superior temporal sulcus (pSTS, insula and amygdala. This study sought to inform the long standing debate of whether care and justice moral ethics represent one or two different forms of cognition. METHODOLOGY/PRINCIPAL FINDINGS: Model-free and model-based connectivity analysis were used to identify functional neural networks underlying care and justice ethics for a moral sensitivity task. In addition to modest differences in patterns of associated neural activity, distinct modes of functional and effective connectivity were observed for moral sensitivity for care and justice issues that were modulated by individual variation in moral ability. CONCLUSIONS/SIGNIFICANCE: These results support a neurobiological differentiation between care and justice ethics and suggest that human moral behavior reflects the outcome of integrating opposing rule-based, self-other perspectives, and emotional responses.

  14. Procedural justice in mental health courts: Judicial practices, participant perceptions, and outcomes related to mental health recovery

    Science.gov (United States)

    Kopelovich, Sarah; Yanos, Philip; Pratt, Christina; Koerner, Joshua

    2015-01-01

    Research on mental health courts (MHCs) to date has been disproportionately focused on the study of recidivism and reincarceration over the potential of these problem solving courts to facilitate the recovery process and affect the slope of recovery. This study attempts to shift the focal point of interest from well-established criminal justice outcomes to the experiences and perceptions of MHC participants. The authors hypothesize that the actions of MHC judges that are consistent with procedural justice theory will engender high perceptions of procedural justice among this sample of divertees with SMI. Defendant perceptions of procedural justice in 4 NYC-area MHCs were also compared to those of uninvolved observers. Results suggest that defendant perceptions are distinct from observer perceptions, which tended to be more sensitive to the differences in judges between the four courts. Overall, participants' perceptions of procedural justice were moderate and increased between baseline and 4-month follow-up. Procedural justice was negatively correlated with symptoms at baseline and was positively correlated with participant's attitudes toward their own recovery. Between baseline and 4-month follow-up, participants in our sample tended to increase in perceptions of procedural justice; interestingly, the increase in procedural justice was associated with a decrease in symptoms but not to an increase in attitudes toward the recovery. Implications and future directions are discussed. PMID:23415372

  15. Health Care, the Arab Spring and After

    Directory of Open Access Journals (Sweden)

    Sonia Alianak

    2016-10-01

    Full Text Available This study analyzes the effect of health care on Middle Eastern countries on the eve of and soon after the Arab Spring. It posits that countries that were most stable were the healthiest ones; countries which underwent revolutions were the unhealthiest ones; whereas countries that settled for reforms were moderate in health. It presents a hypothesis, the Inverted Funnel Model Hypothesis, that states that as the level of health care of a country rises so does its stability, which in turn leads to better health care as if down an inverted funnel to hypothetical maximums of both health care and stability. To test the hypothesis both quantitative and qualitative methods are used. The quantitative part involves first of all compiling seven health indicators based on the World Health Organization Annual Reports on twelve individual countries, for a period of five years preceding the Arab Spring’s onset in 2011 and in the immediate aftermath of 2011, and, second of all running correlations with political stability of each country, grouped in a three-way typology of countries. This is supplemented by a qualitative part which analyzes the health perceptions and demands of Arab Spring protesters in search of social justice.

  16. Autonomy and its vulnerability: Ricoeur's view on justice as a contribution to care ethics.

    Science.gov (United States)

    Hettema, Theo L

    2014-11-01

    We examine an article of Paul Ricoeur on autonomy and vulnerability. Ricoeur presents the two notions in the field of justice as intricately woven into each other. He analyzes their interdependence on three levels of human agency. Ricoeur's exposition has a focus on judicial judgment. After presenting Ricoeur's argument and an analysis of his main points, the author argues that Ricoeur's reflection lines up with some essential intentions of care ethics. Ricoeur's contribution to care ethics is given in a delicate balance of autonomy and its vulnerability.

  17. Income, Wealth and Health Inequalities — A Scottish Social Justice Perspective

    Directory of Open Access Journals (Sweden)

    Elspeth Molony

    2016-04-01

    Full Text Available This paper considers health inequalities through a social justice perspective. The authors draw on a variety of existing sources of evidence, including experiential, scientific and contextual knowledge. The authors work with NHS Health Scotland, a national Health Board working to reduce health inequalities and improve health. Working closely with the Scottish Government and with a variety of stakeholders across different sectors, NHS Health Scotland’s vision for a fairer, healthier Scotland is founded on the principles of social justice. The paper takes social justice as the starting point and explores what it means for two interlinked paradigms of social injustice—health inequality and income inequality. Utilising the wealth of evidence synthesised by NHS Health Scotland as well as drawing on the writings and evidence of philosophers, epidemiologists, the Scottish Government and international bodies, the authors explore the links between income and wealth inequality, social justice, the right to health and health inequalities. The paper ends by considering the extent to which there is appetite for social change in Scotland by considering the attitudes of the people of Scotland and of Britain to poverty, inequality and welfare.

  18. Income, Wealth and Health Inequalities — A Scottish Social Justice Perspective

    Science.gov (United States)

    Molony, Elspeth; Duncan, Christine

    2016-01-01

    This paper considers health inequalities through a social justice perspective. The authors draw on a variety of existing sources of evidence, including experiential, scientific and contextual knowledge. The authors work with NHS Health Scotland, a national Health Board working to reduce health inequalities and improve health. Working closely with the Scottish Government and with a variety of stakeholders across different sectors, NHS Health Scotland's vision for a fairer, healthier Scotland is founded on the principles of social justice. The paper takes social justice as the starting point and explores what it means for two interlinked paradigms of social injustice—health inequality and income inequality. Utilising the wealth of evidence synthesised by NHS Health Scotland as well as drawing on the writings and evidence of philosophers, epidemiologists, the Scottish Government and international bodies, the authors explore the links between income and wealth inequality, social justice, the right to health and health inequalities. The paper ends by considering the extent to which there is appetite for social change in Scotland by considering the attitudes of the people of Scotland and of Britain to poverty, inequality and welfare. PMID:29546160

  19. From Healthcare to Health: An Update of Norman Daniels’s Approach to Justice

    Directory of Open Access Journals (Sweden)

    Daniel Skinner

    2014-04-01

    Full Text Available Here is a health policy riddle: despite the fact that we are not always clear as to what we are trying to achieve, even on the most basic level, we must make policy anyway. Odder still: this is as we might expect it to be, and perhaps even as it should be. After all, part of what makes health policy important is precisely the fact that it raises critical questions about our most basic human values and social commitments. The conversation should be fluid. Norman Daniels has long been an important participant in these conversations. Just Health: Meeting Health Needs Fairly—a titular play on his 1985 book, Just Health Care (1—is Daniels’s attempt to wrestle with contemporary challenges that have forced him to rethink his positions. At its most basic level, then, Just Health can be read as a reminder of the tentativeness of scholarly positions on the core questions of health as well as the importance of being willing to revise both the questions we ask and the positions we take. In Just Health care, Daniels identified six important areas of concern: 1. Adequate nutrition, 2. Sanitary, safe, unpolluted living and working conditions, 3. Exercise, rest, and such important lifestyle features as avoiding substance abuse and practicing safe sex, 4. Preventive, curative, rehabilitative, and compensatory personal medical services (and devices, and 5. Nonmedical personal and social support services (pp. 42–3. Just Health adds a sixth critical component: other social determinants of health. To get to this level, Daniels uses early chapters to establish the “special moral importance of health” as an object of inquiry (Chapter 2, and to look beyond healthcare to a more-inclusive and socially-expansive view of health (Chapter 3. As Daniels notes, “bioethics has not looked ‘upstream’ from the point of delivery of medical services to the role of the healthcare system in improving population health.” As a result, it tends to miss

  20. Three Strikes Out: Objections to Segall's Luck Egalitarian Justice in Health

    DEFF Research Database (Denmark)

    Nielsen, Lasse; Axelsen, David Vestergaard

    2012-01-01

    distribution, this problem would often arise in actual health policy. Finally, the account has a way of intensifying blameworthy behaviour which seems contrary to luck egalitarian principles. Based on these three objections, we conclude that Segall’s luck egalitarian account of justice in health must either...... to coexist with a concern for meeting everyone’s basic needs thereby avoiding Elizabeth Anderson’s ‘abandonment objection’. In this article, we present three objections to Segall’s luck egalitarian justice in health. Firstly, the account is vulnerable to the common objection that luck egalitarianism becomes...

  1. Health care utilization

    DEFF Research Database (Denmark)

    Jacobsen, Christian Bøtcher; Andersen, Lotte Bøgh; Serritzlew, Søren

    An important task in governing health services is to control costs. The literatures on both costcontainment and supplier induced demand focus on the effects of economic incentives on health care costs, but insights from these literatures have never been integrated. This paper asks how economic cost...... containment measures affect the utilization of health services, and how these measures interact with the number of patients per provider. Based on very valid register data, this is investigated for 9.556 Danish physiotherapists between 2001 and 2008. We find that higher (relative) fees for a given service...... make health professionals provide more of this service to each patient, but that lower user payment (unexpectedly) does not necessarily mean higher total cost or a stronger association between the number of patients per supplier and the health care utilization. This implies that incentives...

  2. Health care in the Netherlands.

    NARCIS (Netherlands)

    Weel, C. van; Schers, H.J.; Timmermans, A.

    2012-01-01

    This article analyzes Dutch experiences of health care reform--in particular in primary care--with emphasis on lessons for current United States health care reforms. Recent major innovations were the introduction of private insurance based on the principles of primary care-led health care and

  3. Health care reforms.

    Science.gov (United States)

    Marušič, Dorjan; Prevolnik Rupel, Valentina

    2016-09-01

    In large systems, such as health care, reforms are underway constantly. The article presents a definition of health care reform and factors that influence its success. The factors being discussed range from knowledgeable personnel, the role of involvement of international experts and all stakeholders in the country, the importance of electoral mandate and governmental support, leadership and clear and transparent communication. The goals set need to be clear, and it is helpful to have good data and analytical support in the process. Despite all debates and experiences, it is impossible to clearly define the best approach to tackle health care reform due to a different configuration of governance structure, political will and state of the economy in a country.

  4. Health care reforms

    Directory of Open Access Journals (Sweden)

    Marušič Dorjan

    2016-09-01

    Full Text Available In large systems, such as health care, reforms are underway constantly. The article presents a definition of health care reform and factors that influence its success. The factors being discussed range from knowledgeable personnel, the role of involvement of international experts and all stakeholders in the country, the importance of electoral mandate and governmental support, leadership and clear and transparent communication. The goals set need to be clear, and it is helpful to have good data and analytical support in the process. Despite all debates and experiences, it is impossible to clearly define the best approach to tackle health care reform due to a different configuration of governance structure, political will and state of the economy in a country.

  5. Health care need

    DEFF Research Database (Denmark)

    Hasman, Andreas; Hope, Tony; Østerdal, Lars Peter

    2006-01-01

    The argument that scarce health care resources should be distributed so that patients in 'need' are given priority for treatment is rarely contested. In this paper, we argue that if need is to play a significant role in distributive decisions it is crucial that what is meant by need can be precis......The argument that scarce health care resources should be distributed so that patients in 'need' are given priority for treatment is rarely contested. In this paper, we argue that if need is to play a significant role in distributive decisions it is crucial that what is meant by need can...... be precisely articulated. Following a discussion of the general features of health care need, we propose three principal interpretations of need, each of which focuses on separate intuitions. Although this account may not be a completely exhaustive reflection of what people mean when they refer to need...

  6. Governance and Justice | IDRC - International Development ...

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

    This program fosters better governance and justice systems so people can lead ... A man peers through a hole in a wall that separates Tijuana, Mexico, from the United States. ... Denial of health care or an education is unthinkable for most.

  7. Family-Centered Care in Juvenile Justice Institutions: A Mixed Methods Study Protocol.

    Science.gov (United States)

    Simons, Inge; Mulder, Eva; Rigter, Henk; Breuk, René; van der Vaart, Wander; Vermeiren, Robert

    2016-09-12

    Treatment and rehabilitation interventions in juvenile justice institutions aim to prevent criminal reoffending by adolescents and to enhance their prospects of successful social reintegration. There is evidence that these goals are best achieved when the institution adopts a family-centered approach, involving the parents of the adolescents. The Academic Workplace Forensic Care for Youth has developed two programs for family-centered care for youth detained in groups for short-term and long-term stay, respectively. The overall aim of our study is to evaluate the family-centered care program in the first two years after the first steps of its implementation in short-term stay groups of two juvenile justice institutions in the Netherlands. The current paper discusses our study design. Based on a quantitative pilot study, we opted for a study with an explanatory sequential mixed methods design. This pilot is considered the first stage of our study. The second stage of our study includes concurrent quantitative and qualitative approaches. The quantitative part of our study is a pre-post quasi-experimental comparison of family-centered care with usual care in short-term stay groups. The qualitative part of our study involves in-depth interviews with adolescents, parents, and group workers to elaborate on the preceding quantitative pilot study and to help interpret the outcomes of the quasi-experimental quantitative part of the study. We believe that our study will result in the following findings. In the quantitative comparison of usual care with family-centered care, we assume that in the latter group, parents will be more involved with their child and with the institution, and that parents and adolescents will be more motivated to take part in therapy. In addition, we expect family-centered care to improve family interactions, to decrease parenting stress, and to reduce problem behavior among the adolescents. Finally, we assume that adolescents, parents, and the

  8. Is organizational justice climate at the workplace associated with individual-level quality of care and organizational affective commitment?

    DEFF Research Database (Denmark)

    Berthelsen, Hanne; Conway, Paul Maurice; Clausen, Thomas

    2017-01-01

    with both the individual staff members' affective commitment and perceived quality of care. These findings suggest a potential for that addressing organizational justice climate may be a way to promote quality of care and enhancing affective commitment. However, longitudinal studies are needed to support......PURPOSE: The aim of this study is to investigate whether organizational justice climate at the workplace level is associated with individual staff members' perceptions of care quality and affective commitment to the workplace. METHODS: The study adopts a cross-sectional multi-level design. Data...... were collected using an electronic survey and a response rate of 75% was obtained. Organizational justice climate and affective commitment to the workplace were measured by items from Copenhagen Psychosocial Questionnaire and quality of care by three self-developed items. Non-managerial staff working...

  9. Medical tourism's impacts on health worker migration in the Caribbean: five examples and their implications for global justice.

    Science.gov (United States)

    Snyder, Jeremy; Crooks, Valorie A; Johnston, Rory; Adams, Krystyna; Whitmore, Rebecca

    2015-01-01

    Medical tourism is a practice where individuals cross international borders in order to access medical care. This practice can impact the global distribution of health workers by potentially reducing the emigration of health workers from destination countries for medical tourists and affecting the internal distribution of these workers. Little has been said, however, about the impacts of medical tourism on the immigration of health workers to medical tourism destinations. We discuss five patterns of medical tourism-driven health worker migration to medical tourism destinations: 1) long-term international migration; 2) long-term diasporic migration; 3) long-term migration and 'black sheep'; 4) short-term migration via time share; and 5) short-term migration via patient-provider dyad. These patterns of health worker migration have repercussions for global justice that include potential negative impacts on the following: 1) health worker training; 2) health worker distributions; 3) local provision of care; and 4) local economies. In order to address these potential negative impacts, policy makers in destination countries should work to ensure that changes in health worker training and licensure aimed at promoting the medical tourism sector are also supportive of the health needs of the domestic population. Policy makers in both source and destination countries should be aware of the effects of medical tourism on health worker flows both into and out of medical tourism destinations and work to ensure that the potential harms of these worker flows to both groups are mitigated.

  10. Medical tourism's impacts on health worker migration in the Caribbean: five examples and their implications for global justice

    Science.gov (United States)

    Snyder, Jeremy; Crooks, Valorie A.; Johnston, Rory; Adams, Krystyna; Whitmore, Rebecca

    2015-01-01

    Medical tourism is a practice where individuals cross international borders in order to access medical care. This practice can impact the global distribution of health workers by potentially reducing the emigration of health workers from destination countries for medical tourists and affecting the internal distribution of these workers. Little has been said, however, about the impacts of medical tourism on the immigration of health workers to medical tourism destinations. We discuss five patterns of medical tourism-driven health worker migration to medical tourism destinations: 1) long-term international migration; 2) long-term diasporic migration; 3) long-term migration and ‘black sheep’; 4) short-term migration via time share; and 5) short-term migration via patient-provider dyad. These patterns of health worker migration have repercussions for global justice that include potential negative impacts on the following: 1) health worker training; 2) health worker distributions; 3) local provision of care; and 4) local economies. In order to address these potential negative impacts, policy makers in destination countries should work to ensure that changes in health worker training and licensure aimed at promoting the medical tourism sector are also supportive of the health needs of the domestic population. Policy makers in both source and destination countries should be aware of the effects of medical tourism on health worker flows both into and out of medical tourism destinations and work to ensure that the potential harms of these worker flows to both groups are mitigated. PMID:25865122

  11. Medical tourism's impacts on health worker migration in the Caribbean: five examples and their implications for global justice

    Directory of Open Access Journals (Sweden)

    Jeremy Snyder

    2015-04-01

    Full Text Available Medical tourism is a practice where individuals cross international borders in order to access medical care. This practice can impact the global distribution of health workers by potentially reducing the emigration of health workers from destination countries for medical tourists and affecting the internal distribution of these workers. Little has been said, however, about the impacts of medical tourism on the immigration of health workers to medical tourism destinations. We discuss five patterns of medical tourism-driven health worker migration to medical tourism destinations: 1 long-term international migration; 2 long-term diasporic migration; 3 long-term migration and ‘black sheep’; 4 short-term migration via time share; and 5 short-term migration via patient-provider dyad. These patterns of health worker migration have repercussions for global justice that include potential negative impacts on the following: 1 health worker training; 2 health worker distributions; 3 local provision of care; and 4 local economies. In order to address these potential negative impacts, policy makers in destination countries should work to ensure that changes in health worker training and licensure aimed at promoting the medical tourism sector are also supportive of the health needs of the domestic population. Policy makers in both source and destination countries should be aware of the effects of medical tourism on health worker flows both into and out of medical tourism destinations and work to ensure that the potential harms of these worker flows to both groups are mitigated.

  12. Teaching and Learning Health Justice: Best Practices and Recommendations for Innovation

    Science.gov (United States)

    Rentmeester, Christy A.; Chapple, Helen S.; Haddad, Amy M.; Stone, John R.

    2016-01-01

    We describe the development and implementation of an online graduate bioethics program that weaves a theme of health justice throughout the curriculum. Our account relies on a constructionist model of curriculum development and adult teaching and learning theory. Our curriculum draws upon core values of Jesuit higher education, including content…

  13. Work, Health, Diversity, and Social Justice: Expanding and Extending the Discussion

    Science.gov (United States)

    Borges, Nicole J.; McNally, Christopher J.; Maguire, Colleen P.; Werth, James L., Jr.; Britton, Paula J.

    2008-01-01

    This article presents the authors' response to the reactions by Blustein, Catraio, Coutinho, and Murphy (2008), Chwalisz (2008), Conyers (2008), and Elliott and Johnson (2008) to their articles in "The Counseling Psychologist" on integrating health psychology, vocational psychology, multicultural psychology, and social justice (Maguire, McNally,…

  14. Chinese concepts of euthanasia and health care.

    Science.gov (United States)

    Sleeboom-Faulkner, Margaret

    2006-08-01

    This article argues that taking concepts of euthanasia out of their political and economic contexts leads to violations of the premises on which the Stoic ideal of euthanasia is based: 'a quick, gentle and honourable death.' For instance, the transplantation of the narrowly defined concept of euthanasia developed under the Dutch welfare system into a developing country, such as the People's Republic of China (PRC), seems inadequate. For it cannot deal with questions of anxiety about degrading forms of dying and suffering without reference to its economic rationale, demanded by a scarcity (unequal distribution) of health care resources. The weakness of health care provisions for the terminally ill in Mainland China has become increasingly poignant since the collapse of collective health care institutions in the countryside since the reforms of the late-1980s. As in most cases where health care facilities are wanting, it is difficult to apply the criteria of gentleness and dignity at reaching death. Its solution lies not in a faster relief from suffering by euthanasia, but in extending the quality of life through distributive justice within Chinese healthcare policy-making. This paper begins with a brief description of the Dutch euthanasia law, after which it discusses Chinese conceptions of euthanasia in biomedical textbooks, the media and in surveys. It concludes by pointing out the need for a transnational framework in which both the specifics and generalities of euthanasia can be discussed.

  15. Health Care Industry Study

    Science.gov (United States)

    2002-01-01

    press conference with President Toledo of Peru on March 23, 2002, President Bush proclaimed, “education, jobs, and health care are the greatest...allow patients with chronic illnesses such as diabetes and high blood pressure to “visit” their doctors “on-line” while in the comfort and privacy of...to maintain a healthy lifestyle. As a result, non-communicable disease such as 10 heart disease, stroke, diabetes , and cancer are prevalent throughout

  16. The ethical self-fashioning of physicians and health care systems in culturally appropriate health care.

    Science.gov (United States)

    Shaw, Susan J; Armin, Julie

    2011-06-01

    Diverse advocacy groups have pushed for the recognition of cultural differences in health care as a means to redress inequalities in the U.S., elaborating a form of biocitizenship that draws on evidence of racial and ethnic health disparities to make claims on both the state and health care providers. These efforts led to federal regulations developed by the U.S. Office of Minority Health requiring health care organizations to provide Culturally and Linguistically Appropriate Services. Based on ethnographic research at workshops and conferences, in-depth interviews with cultural competence trainers, and an analysis of postings to a moderated listserv with 2,000 members, we explore cultural competence trainings as a new type of social technology in which health care providers and institutions are urged to engage in ethical self-fashioning to eliminate prejudice and embody the values of cultural relativism. Health care providers are called on to re-orient their practice (such as habits of gaze, touch, and decision-making) and to act on their own subjectivities to develop an orientation toward Others that is "culturally competent." We explore the diverse methods that cultural competence trainings use to foster a health care provider's ability to be self-reflexive, including face-to-face workshops and classes and self-guided on-line modules. We argue that the hybrid formation of culturally appropriate health care is becoming detached from its social justice origins as it becomes rationalized by and more firmly embedded in the operations of the health care marketplace.

  17. COMMUNITY MEDICINE & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    Client Satisfaction with Antenatal Care Services in Primary Health Care. Centres in Sabon ... important information about how well clinicians and the population of women within child bearing. 8 ..... model. Health and Quality of Life outcomes.

  18. Integrating social justice concerns into economic evaluation for healthcare and public health: A systematic review.

    Science.gov (United States)

    Dukhanin, Vadim; Searle, Alexandra; Zwerling, Alice; Dowdy, David W; Taylor, Holly A; Merritt, Maria W

    2018-02-01

    Social justice is the moral imperative to avoid and remediate unfair distributions of societal disadvantage. In priority setting in healthcare and public health, social justice reaches beyond fairness in the distribution of health outcomes and economic impacts to encompass fairness in the distribution of policy impacts upon other dimensions of well-being. There is an emerging awareness of the need for economic evaluation to integrate all such concerns. We performed a systematic review (1) to describe methodological solutions suitable for integrating social justice concerns into economic evaluation, and (2) to describe the challenges that those solutions face. To be included, publications must have captured fairness considerations that (a) involve cross-dimensional subjective personal life experience and (b) can be manifested at the level of subpopulations. We identified relevant publications using an electronic search in EMBASE, PubMed, EconLit, PsycInfo, Philosopher's Index, and Scopus, including publications available in English in the past 20 years. Two reviewers independently appraised candidate publications, extracted data, and synthesized findings in narrative form. Out of 2388 publications reviewed, 26 were included. Solutions sought either to incorporate relevant fairness considerations directly into economic evaluation or to report them alongside cost-effectiveness measures. The majority of reviewed solutions, if adapted to integrate social justice concerns, would require their explicit quantification. Four broad challenges related to the implementation of these solutions were identified: clarifying the normative basis; measuring and determining the relative importance of criteria representing that basis; combining the criteria; and evaluating trade-offs. All included solutions must grapple with an inherent tension: they must either face the normative and operational challenges of quantifying social justice concerns or accede to offering incomplete policy

  19. Using a social justice and health framework to assess European climate change adaptation strategies.

    Science.gov (United States)

    Boeckmann, Melanie; Zeeb, Hajo

    2014-11-28

    Climate change puts pressure on existing health vulnerabilities through higher frequency of extreme weather events, changes in disease vector distribution or exacerbated air pollution. Climate change adaptation policies may hold potential to reduce societal inequities. We assessed the role of public health and social justice in European climate change adaptation using a three-fold approach: a document analysis, a critical discourse analysis of a subgroup of strategies, and a ranking of strategies against our social justice framework. The ranking approach favored planning that includes various adaptation types, social issues and infrastructure changes. Themes on values identified in the five subgroup documents showed that risks are perceived as contradictory, technology is viewed as savior, responsibilities need to be negotiated, and social justice is advocated by only a few countries. Of 21 strategy documents assessed overall, those from Austria, England and Sweden received the highest scores in the ranking. Our qualitative assessment showed that in European adaptation planning, progress could still be made through community involvement into adaptation decisions, consistent consideration of social and demographic determinants, and a stronger link between infrastructural adaptation and the health sector. Overall, a social justice framework can serve as an evaluation guideline for adaptation policy documents.

  20. Problematizing Social Justice in Health Pedagogy and Youth Sport: Intersectionality of Race, Ethnicity, and Class.

    Science.gov (United States)

    Dagkas, Symeon

    2016-09-01

    Social justice education recognizes the discrepancies in opportunities among disadvantaged groups in society. The purpose of the articles in this special topic on social justice is to (a) provide a critical reflection on issues of social justice within health pedagogy and youth sport of Black and ethnic-minority (BME) young people; (b) provide a framework for the importance of intersectionality research (mainly the intersection of social class, race, and ethnicity) in youth sport and health pedagogy for social justice; and (c) contextualize the complex intersection and interplay of social issues (i.e., race, ethnicity, social classes) and their influence in shaping physical culture among young people with a BME background. The article argues that there are several social identities in any given pedagogical terrain that need to be heard and legitimized to avoid neglect and "othering." This article suggests that a resurgence of interest in theoretical frameworks such as intersectionality can provide an effective platform to legitimize "non-normative bodies" (diverse bodies) in health pedagogy and physical education and sport by voicing positionalities on agency and practice.

  1. Reducing Ex-offender Health Disparities through the Affordable Care Act: Fostering Improved Health Care Access and Linkages to Integrated Care

    Directory of Open Access Journals (Sweden)

    Lacreisha Ejike-King

    2014-04-01

    Full Text Available Despite steadily declining incarceration rates overall, racial and ethnic minorities, namely African Americans, Latinos, and American Indians and Alaska Natives, continue to be disproportionately represented in the justice system. Ex-offenders commonly reenter communities with pressing health conditions but encounter obstacles to accessing care and remaining in care. The lack of health insurance coverage and medical treatment emerge as the some of the most reported reentry health needs and may contribute to observed health disparities. Linking ex-offenders to care and services upon release increases the likelihood that they will remain in care and practice successful disease management. The Affordable Care Act (ACA offers opportunities to address health disparities experienced by the reentry population that places them at risk for negative health outcomes and recidivism. Coordinated efforts to link ex-offenders with these newly available opportunities may result in a trajectory for positive health and overall well-being as they reintegrate into society.

  2. An integrated public health and criminal justice approach to gangs: What can research tell us?

    Directory of Open Access Journals (Sweden)

    Erika Gebo

    2016-12-01

    Full Text Available There has been a call to better link public health and criminal justice approaches to best address crime problems generally, and youth and gang violence in particular. Importantly, there has yet to be a systematic examination of how criminal justice approaches can be integrated within a public health framework. This paper examines the strengths and challenges with mapping gang research and evidence-informed practices onto a public health approach. Conceptual examination reveals benefits to utilizing an integrated framework, but it also exposes core problems with identification and prediction of gang joining and gang membership. The gang label as a master status is called into question. It is argued that a public health framework can inform public policy approaches as to when the focus should be youth violence versus gangs and gang violence.

  3. Fostering a supportive moral climate for health care providers: Toward cultural safety and equity

    Directory of Open Access Journals (Sweden)

    Adel F. Almutairi

    Full Text Available In Western forms of health care delivery around the globe, research tells us that nurses experience excessive workloads as they face increasingly complex needs in the populations they serve, professional conflicts, and alienation from leadership in health care bureaucracies. These problems are practical and ethical as well as cultural. Cultural conflicts can arise when health care providers and the populations they serve come from diverse economic, ethnic, and cultural backgrounds. The purpose in this paper is to draw from Almutairi’s research with health care teams in Saudi Arabia to show the complexity of culturally and morally laden interactions between health care providers and patients and their families. Then, I will argue for interventions that promote social justice and cultural safety for nurses, other health care providers, and the individuals, families, and communities they serve. This will include addressing international implications for nursing practice, leadership, policy and research. Keywords: Moral climate, Social justice, Equity, Cultural diversity

  4. The retailing of health care.

    Science.gov (United States)

    Paul, T; Wong, J

    1984-01-01

    A number of striking parallels between recent developments in health care marketing and changes in the retailing industry exist. The authors have compared retailing paradigms to the area on health care marketing so strategists in hospitals and other health care institutions can gain insight from these parallels. Many of the same economic, demographic, technological and lifestyle forces may be at work in both the health care and retail markets. While the services or products offered in health care are radically different from those of conventional retail markets, the manner in which the products and services are positioned, priced or distributed is surprisingly similar.

  5. Health care engineering

    CERN Document Server

    Frize, Monique

    2013-01-01

    Part II of Health Care Engineering begins with statistics on the occurrence of medical errors and adverse events, and includes some technological solutions. A chapter on electronic medical records follows. The knowledge management process divided into four steps is described; this includes a discussion on data acquisition, storage, and retrieval. The next two chapters discuss the other three steps of the knowledge management process (knowledge discovery, knowledge translation, knowledge integration and sharing). The last chapter briefly discusses usability studies and clinical trials.This two-

  6. Violence towards health care workers in a Public Health Care Facility in Italy: a repeated cross-sectional study

    Science.gov (United States)

    2012-01-01

    Background Violence at work is one of the major concerns in health care activities. The aim of this study was to identify the prevalence of physical and non-physical violence in a general health care facility in Italy and to assess the relationship between violence and psychosocial factors, thereby providing a basis for appropriate intervention. Methods All health care workers from a public health care facility were invited to complete a questionnaire containing questions on workplace violence. Three questionnaire-based cross-sectional surveys were conducted. The response rate was 75 % in 2005, 71 % in 2007, and 94 % in 2009. The 2009 questionnaire contained the VIF (Violent Incident Form) for reporting violent incidents, the DCS (demand/control/support) model for job strain, the Colquitt 20 item questionnaire for perceived organizational justice, and the GHQ-12 General Health Questionnaire for the assessment of mental health. Results One out of ten workers reported physical assault, and one out of three exposure to non-physical violence in the workplace in the previous year. Nurses and physicians were the most exposed occupational categories, whereas the psychiatric and emergency departments were the services at greatest risk of violence. Workers exposed to non-physical violence were subject to high job strain, low support, low perceived organizational justice, and high psychological distress. Conclusion Our study shows that health care workers in an Italian local health care facility are exposed to violence. Workplace violence was associated with high demand and psychological disorders, while job control, social support and organizational justice were protective factors. PMID:22551645

  7. Violence towards health care workers in a Public Health Care Facility in Italy: a repeated cross-sectional study

    Directory of Open Access Journals (Sweden)

    Magnavita Nicola

    2012-05-01

    Full Text Available Abstract Background Violence at work is one of the major concerns in health care activities. The aim of this study was to identify the prevalence of physical and non-physical violence in a general health care facility in Italy and to assess the relationship between violence and psychosocial factors, thereby providing a basis for appropriate intervention. Methods All health care workers from a public health care facility were invited to complete a questionnaire containing questions on workplace violence. Three questionnaire-based cross-sectional surveys were conducted. The response rate was 75 % in 2005, 71 % in 2007, and 94 % in 2009. The 2009 questionnaire contained the VIF (Violent Incident Form for reporting violent incidents, the DCS (demand/control/support model for job strain, the Colquitt 20 item questionnaire for perceived organizational justice, and the GHQ-12 General Health Questionnaire for the assessment of mental health. Results One out of ten workers reported physical assault, and one out of three exposure to non-physical violence in the workplace in the previous year. Nurses and physicians were the most exposed occupational categories, whereas the psychiatric and emergency departments were the services at greatest risk of violence. Workers exposed to non-physical violence were subject to high job strain, low support, low perceived organizational justice, and high psychological distress. Conclusion Our study shows that health care workers in an Italian local health care facility are exposed to violence. Workplace violence was associated with high demand and psychological disorders, while job control, social support and organizational justice were protective factors.

  8. Operations management in health care.

    Science.gov (United States)

    Henderson, M D

    1995-01-01

    Health care operations encompass the totality of those health care functions that allow those who practice health care delivery to do so. As the health care industry undergoes dramatic reform, so will the jobs of those who manage health care delivery systems. Although health care operations managers play one of the most vital and substantial roles in the new delivery system, the criteria for their success (or failure) are being defined now. Yet, the new and vital role of the operations manager has been stunted in its development, which is primarily because of old and outdated antipathy between hospital administrators and physicians. This article defines the skills and characteristics of today's health care operations managers.

  9. Sanitary justice in scarcity

    Directory of Open Access Journals (Sweden)

    Miguel Kottow

    Full Text Available Justice in health care and the allocation of scarce medical resources must be analyzed differently in affluent as compared to economically weaker societies. The protective functions of the state must be extended to cover basic needs for those too poor to meet them on their own. Medical needs are a high priority, since poor health hampers the ability to secure other basic needs. The state may operate as either a health care provider or supervisor, guaranteeing that citizens be treated fairly by nongovernmental institutions. Two-tiered systems with a vigorous private health care sector are compatible with the explicit right to health care, provided the private tier operates without directly or indirectly draining public funds.

  10. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    Colorectal cancer (CRC) is a public health challenge in developed countries and an emerging public health problem in developing ... and public health challenges in their immigrant countries. More so ..... The nutrition transition in Brazil. 46.

  11. Bread and Roses: A Gender Perspective on Environmental Justice and Public Health.

    Science.gov (United States)

    Bell, Karen

    2016-10-12

    Gender continues to be a relatively marginal issue in environmental justice debates and yet it remains an important aspect of injustice. To help redress the balance, this article explores women's experience of environmental justice through a review of the existing literature and the author's prior qualitative research, as well as her experience of environmental activism. The analysis confirms that women tend to experience inequitable environmental burdens (distributional injustice); and are less likely than men to have control over environmental decisions (procedural injustice), both of which impact on their health (substantive injustice). It is argued that these injustices occur because women generally have lower incomes than men and are perceived as having less social status than their male counterparts as a result of entwined and entrenched capitalist and patriarchal processes. In the light of this analysis, it is proposed that environmental justice research, teaching, policy and practice should be made more gender aware and feminist orientated. This could support cross-cutting debates and activities in support of the radical social change necessary to bring about greater social and environmental justice more generally.

  12. Bread and Roses: A Gender Perspective on Environmental Justice and Public Health

    Directory of Open Access Journals (Sweden)

    Karen Bell

    2016-10-01

    Full Text Available Gender continues to be a relatively marginal issue in environmental justice debates and yet it remains an important aspect of injustice. To help redress the balance, this article explores women’s experience of environmental justice through a review of the existing literature and the author’s prior qualitative research, as well as her experience of environmental activism. The analysis confirms that women tend to experience inequitable environmental burdens (distributional injustice; and are less likely than men to have control over environmental decisions (procedural injustice, both of which impact on their health (substantive injustice. It is argued that these injustices occur because women generally have lower incomes than men and are perceived as having less social status than their male counterparts as a result of entwined and entrenched capitalist and patriarchal processes. In the light of this analysis, it is proposed that environmental justice research, teaching, policy and practice should be made more gender aware and feminist orientated. This could support cross-cutting debates and activities in support of the radical social change necessary to bring about greater social and environmental justice more generally.

  13. Bread and Roses: A Gender Perspective on Environmental Justice and Public Health

    Science.gov (United States)

    Bell, Karen

    2016-01-01

    Gender continues to be a relatively marginal issue in environmental justice debates and yet it remains an important aspect of injustice. To help redress the balance, this article explores women’s experience of environmental justice through a review of the existing literature and the author’s prior qualitative research, as well as her experience of environmental activism. The analysis confirms that women tend to experience inequitable environmental burdens (distributional injustice); and are less likely than men to have control over environmental decisions (procedural injustice), both of which impact on their health (substantive injustice). It is argued that these injustices occur because women generally have lower incomes than men and are perceived as having less social status than their male counterparts as a result of entwined and entrenched capitalist and patriarchal processes. In the light of this analysis, it is proposed that environmental justice research, teaching, policy and practice should be made more gender aware and feminist orientated. This could support cross-cutting debates and activities in support of the radical social change necessary to bring about greater social and environmental justice more generally. PMID:27754351

  14. Reforming the health care system: implications for health care marketers.

    Science.gov (United States)

    Petrochuk, M A; Javalgi, R G

    1996-01-01

    Health care reform has become the dominant domestic policy issue in the United States. President Clinton, and the Democratic leaders in the House and Senate have all proposed legislation to reform the system. Regardless of the plan which is ultimately enacted, health care delivery will be radically changed. Health care marketers, given their perspective, have a unique opportunity to ensure their own institutions' success. Organizational, managerial, and marketing strategies can be employed to deal with the changes which will occur. Marketers can utilize personal strategies to remain proactive and successful during an era of health care reform. As outlined in this article, responding to the health care reform changes requires strategic urgency and action. However, the strategies proposed are practical regardless of the version of health care reform legislation which is ultimately enacted.

  15. After Foster Care and Juvenile Justice: A Preview of the Youth Villages Transitional Living Evaluation. Policy Brief

    Science.gov (United States)

    Muller-Ravett, Sara; Jacobs, Erin

    2012-01-01

    Young people who are leaving the foster care and juvenile justice systems often experience a difficult transition to adulthood that is characterized by a number of troubling outcomes, including poverty, low levels of education and employment, and housing instability. While some services are available for these populations, there is little evidence…

  16. South-South cooperation in health: bringing in theory, politics, history, and social justice.

    Science.gov (United States)

    Birn, Anne-Emanuelle; Muntaner, Carles; Afzal, Zabia

    2017-10-02

    Since the mid-2000s, the practice of South-South cooperation in health (SSC) has attracted growing attention among policymakers, health and foreign affairs ministries, global health agencies, and scholars from a range of fields. But the South-South label elucidates little about the actual content of the cooperation and conflates the "where" with the "who, what, how, and why". While there have been some attempts to theorize global health diplomacy and South-South cooperation generally, these efforts do not sufficiently distinguish among the different kinds of practices and political values that fall under the South-South rubric, ranging from economic and geopolitical interests to social justice forms of solidarity. In the spirit of deepening theoretical, historical, and social justice analyses of SSC, this article: (1) critically revisits international relations theories that seek to explain SSC, exploring Marxian and other heterodox theories ignored in the mainstream literature; (2) traces the historical provenance of a variety of forms of SSC; and (3) introduces the concept of social justice-oriented South-South.

  17. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    dearth of information on patient satisfaction with HIV/AIDS care. This study sought ... with the doctor. Satisfaction rates were: 94.9% technical quality, ... of the delivery of care into several dimensions of contributed by studies carried out in Western. 14 ... efficiency of services as an index of patient needs of its clients. Secondly ...

  18. Engaging men in health care.

    Science.gov (United States)

    Malcher, Greg

    2009-03-01

    Engaging men in health care involves a multifaceted approach that has as its main principle the recognition that men consume health care differently to women. This article identifies barriers to engaging men in health care and offers potential and existing solutions to overcome these barriers in a range of health care settings. The concept of multiple masculinities recognises that not all men can be engaged via a particular technique or strategy. The perception that men are disinterested in their health is challenged and a range of approaches discussed, both in the community and in health care facilities. In the general practice setting opportunities exist for the engagement of men at the reception desk and waiting room, as well as during the consultation. Use of the workplace in engaging men is discussed. Future activities to build the capacity of health care providers to better engage men are identified and the role of policy and program development is addressed.

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

    Science.gov (United States)

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

    2014-12-01

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

  20. Distributive justice in American healthcare: institutions, power, and the equitable care of patients.

    Science.gov (United States)

    Putsch, Robert W; Pololi, Linda

    2004-09-01

    The authors argue that the American healthcare system has developed in a fashion that permits and may support ongoing, widespread inequities based on poverty, race, gender, and ethnicity. Institutional structures also contribute to this problem. Analysis is based on (1) discussions of a group of experts convened by the Office of Minority Health, US Department of Health and Human Services at a conference to address healthcare disparities; and (2) review of documentation and scientific literature focused on health, health-related news, language, healthcare financing, and the law. Institutional factors contributing to inequity include the cost and financing of American healthcare, healthcare insurance principles such as mutual aid versus actuarial fairness, and institutional power. Additional causes for inequity are bias in decision making by healthcare practitioners, clinical training environments linked to abuse of patients and coworkers, healthcare provider ethnicity, and politics. Recommendations include establishment of core attributes of trust, relationship and advocacy in health systems; universal healthcare; and insurance systems based on mutual aid. In addition, monitoring of equity in health services and the development of a set of ethical principles to guide systems change and rule setting would provide a foundation for distributive justice in healthcare. Additionally, training centers should model the behaviors they seek to foster and be accountable to the communities they serve.

  1. Accountability in Health Care

    DEFF Research Database (Denmark)

    Vrangbæk, Karsten; Byrkjeflot, Haldor

    2016-01-01

    The debate on accountability within the public sector has been lively in the past decade. Significant progress has been made in developing conceptual frameworks and typologies for characterizing different features and functions of accountability. However, there is a lack of sector specific...... adjustment of such frameworks. In this article we present a framework for analyzing accountability within health care. The paper makes use of the concept of "accountability regime" to signify the combination of different accountability forms, directions and functions at any given point in time. We show...... that reforms can introduce new forms of accountability, change existing accountability relations or change the relative importance of different accountability forms. They may also change the dominant direction and shift the balance between different functions of accountability. We further suggest...

  2. Federalism and Health Care

    Directory of Open Access Journals (Sweden)

    G. Alan Tarr

    2011-10-01

    Full Text Available President Barack Obama proposed a major overhaul of the American healthsystem, and in 2010 the U.S. Congress enacted his proposal, the PatientProtection and Affordable Care Act. Opponents of the Act challenged itsconstitutionality in federal court, claiming that it exceeds the powers grantedto the federal government under the Commerce Clause and the NecessaryProper Clause of the federal Constitution. Some courts have upheldthe law, but others have agreed with the critics, in particular ruling thatthe provision requiring citizens to buy health insurance is unconstitutional.Eventually the U.S. Supreme Court will rule on the issue. This article tracesthe controversy, surveys the interpretation of pertinent constitutional provisionsin past cases, analyzes the constitutional arguments presented byproponents and opponents of the Act, and concludes that the Act is constitutional.

  3. Occupational Health for Health Care Providers

    Science.gov (United States)

    Health care workers are exposed to many job hazards. These can include Infections Needle injuries Back injuries ... prevention practices. They can reduce your risk of health problems. Use protective equipment, follow infection control guidelines, ...

  4. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    user

    2Department of Community Health, University of Benin, Benin City, Nigeria. ... Mental morbidity is a public health problem that can lead to a great burden of disability in the community. ..... community study in Sao Paulo, Brazil where.

  5. Environmental Justice and Health Effects of Urban Air Pollution.

    Science.gov (United States)

    Stewart, John A; Mitchell, Mark A; Edgerton, Victor S; VanCott, Robert

    2015-02-01

    Minority communities often bear the burden of "hosting" pollution sources. This report assesses whether there are any health effects from living near such pollution sources and whether health effects of pollution vary by sex, ethnicity, or income. The air pollution emissions from Hartford area, point sources are modeled and exposures are estimated for the residents who participated in a geographically-based health survey. The pollution intensities and other individual and neighborhood characteristics are used to predict an individual's reported respiratory problems. The results indicate that respiratory problems are correlated significantly with pollution levels, especially sulfur dioxide from the local trash-to-energy incinerator-the fifth largest one in the U.S. The effects of a given pollution level tend to be more serious for specific subgroups based upon sex, ethnicity, poverty, and age. Even when controlling for other factors, air pollution levels are significantly correlated with health problems, especially for Hispanics. This air pollution may contribute to health disparities. © 2015 National Medical Association. Published by Elsevier Inc. All rights reserved.

  6. The longitudinal relationship between job mobility, perceived organizational justice, and health

    Directory of Open Access Journals (Sweden)

    Ekberg Kerstin

    2008-05-01

    Full Text Available Abstract Background The main purpose of the present study was to examine the 2-year longitudinal and reciprocal relationship between job mobility and health and burnout. A second aim was to elucidate the effects of perceived organizational justice and turnover intentions on the relationship between job mobility (non-, internally and externally mobile, and health (SF-36 and burnout (CBI. Methods The study used questionnaire data from 662 Swedish civil servants and the data were analysed with Structural Equation Modeling statistical methods. Results The results showed that job mobility was a better predictor of health and burnout, than health and burnout were as predictors of job mobility. The predictive effects were most obvious for psychosocial health and burnout, but negligible as far as physical health was concerned. Organizational justice was found to have a direct impact on health, but not on job mobility; whereas turnover intentions had a direct effect on job mobility. Conclusion The predictive relationship between job mobility and health has practical implications for health promotive actions in different organizations.

  7. Improving Environmental Health Literacy and Justice through Environmental Exposure Results Communication

    Directory of Open Access Journals (Sweden)

    Monica D. Ramirez-Andreotta

    2016-07-01

    Full Text Available Understanding the short- and long-term impacts of a biomonitoring and exposure project and reporting personal results back to study participants is critical for guiding future efforts, especially in the context of environmental justice. The purpose of this study was to evaluate learning outcomes from environmental communication efforts and whether environmental health literacy goals were met in an environmental justice community. We conducted 14 interviews with parents who had participated in the University of Arizona’s Metals Exposure Study in Homes and analyzed their responses using NVivo, a qualitative data management and analysis program. Key findings were that participants used the data to cope with their challenging circumstances, the majority of participants described changing their families’ household behaviors, and participants reported specific interventions to reduce family exposures. The strength of this study is that it provides insight into what people learn and gain from such results communication efforts, what participants want to know, and what type of additional information participants need to advance their environmental health literacy. This information can help improve future report back efforts and advance environmental health and justice.

  8. International Youth Justice Systems: Promoting Youth Development and Alternative Approaches: A Position Paper of the Society for Adolescent Health and Medicine.

    Science.gov (United States)

    2016-10-01

    Youth incarceration is an international public health concern among developed and developing countries. Worldwide, youth are held in incarceration, detention, and other secure settings that are inappropriate for their age and developmental stages, jeopardizing their prosocial development, and reintegration into society. Youth incarceration lacks evidence and cost-effectiveness. The well-being of youth is a key indicator of the welfare of families, communities, and society at large; therefore, the Society for Adolescent Health and Medicine (SAHM) supports a paradigm shift in the role of the justice system as it relates to treatment of youth. SAHM recommends justice systems focus greater attention and resources on identifying and reducing the antecedents of high-risk and criminal behaviors, recognizing the rights and freedom of young persons, and prioritizing the well-being of youth over punitive measures that may harm and disrupt healthy adolescent development. SAHM supports the following positions: (1) incarceration is a last option for selected offenders who have committed the most serious violent crimes and are unable to remain safely in the community; (2) youth justice policies, programs, and practices affecting youth be evidence based and trauma informed; (3) youth justice policies, programs, and practices must incorporate research and ongoing program evaluation; (4) youth justice policies shall protect the privacy and dignity of children younger than 18 years; and (5) health care professionals and media will promote positive portrayals of youth in healthy relationships within their communities and reduce representations and images of youth that are negative, violent, deviant, and threatening. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  9. Expanding a community's justice response to sex crimes through advocacy, prosecutorial, and public health collaboration: introducing the RESTORE program.

    Science.gov (United States)

    Koss, Mary P; Bachar, Karen J; Hopkins, C Quince; Carlson, Carolyn

    2004-12-01

    Problems in criminal justice system response to date-acquaintance rape and nonpenetration sexual offenses include (a) they are markers of a sexual offending career, yet are viewed as minor; (b) perpetrators are not held accountable in ways that reduce reoffense; and (c) criminal justice response disappoints and traumatizes victims. To address these problems, a collaboration of victim services, prosecutors, legal scholars, and public health professionals are implementing and evaluating RESTORE, a victim-driven, community-based restorative justice program for selected sex crimes. RESTORE prepares survivors, responsible persons (offenders), and both parties' families and friends for face-to-face dialogue to identify the harm and develop a redress plan. The program then monitors the offender's compliance for 12 months. The article summarizes empirical data on problems in criminal justice response, defines restorative justice models, and examines outcome. Then the RESTORE program processes and goals are described. The article highlights community collaboration in building and sustaining this program.

  10. Procedural justice and prisoners’ mental health problems: A longitudinal study

    NARCIS (Netherlands)

    Beijersbergen, K.A.; Dirkzwager, A.J.E.; Eichelsheim, V.I.; van der Laan, P.H.; Nieuwbeerta, P.

    2013-01-01

    Background Given the high prevalence of mental health problems among prisoners, knowledge on its determinants is important. Prior cross-sectional studies suggest that procedurally just treatment within prison is a significant predictor; however, longitudinal research is lacking. Aim The aims of this

  11. Health Care Provider Value Chain

    OpenAIRE

    Kawczynski , Lukasz; Taisch , Marco

    2009-01-01

    International audience; In every society there is a need for an efficient health care system. This paper aims to propose a value definition and a value chain model within the health care. In order to define value patients and experts were surveyed. The proposed definition offers a complex way of looking at the value within the health care sector. The proposal of the value chain model is anticipated with a value stream mapping activities and experts interviews. Proposed model offers consistent...

  12. Health and Disability: Partnerships in Health Care

    Science.gov (United States)

    Tracy, Jane; McDonald, Rachael

    2015-01-01

    Background: Despite awareness of the health inequalities experienced by people with intellectual disability, their health status remains poor. Inequalities in health outcomes are manifest in higher morbidity and rates of premature death. Contributing factors include the barriers encountered in accessing and receiving high-quality health care.…

  13. National Health-Care Reform

    Science.gov (United States)

    2009-03-24

    and pre/ post partum care during delivery. America should select measures that reflect the health-care goals of the nation. As an example, the Healthy...accidents (8) More than 50% of patients with diabetes, hypertension, tobacco addiction, hyperlipidemia, congestive heart failure, asthma, depression ...reflect the cumulative efforts of different types of individual care. For example, infant mortality is a reflection of pre-natal care, post - natal care

  14. Optimizing Health Care Environmental Hygiene.

    Science.gov (United States)

    Carling, Philip C

    2016-09-01

    This article presents a review and perspectives on aspects of optimizing health care environmental hygiene. The topics covered include the epidemiology of environmental surface contamination, a discussion of cleaning health care patient area surfaces, an overview of disinfecting health care surfaces, an overview of challenges in monitoring cleaning versus cleanliness, a description of an integrated approach to environmental hygiene and hand hygiene as interrelated disciplines, and an overview of the research opportunities and challenges related to health care environmental hygiene. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Moral agency as enacted justice: a clinical and ethical decision-making framework for responding to health inequities and social injustice.

    Science.gov (United States)

    Edwards, Ian; Delany, Clare M; Townsend, Anne F; Swisher, Laura Lee

    2011-11-01

    This is the second of 2 companion articles in this issue. The first article explored the clinical and ethical implications of new emphases in physical therapy codes of conduct reflecting the growing evidence regarding the importance of social determinants of health, epidemiological trends for health service delivery, and the enhanced participation of physical therapists in shaping health care reform in a number of international contexts. The first article was theoretically oriented and proposed that a re-thinking of ethical frameworks expressed in codes of ethics could both inform and underpin practical strategies for working in primary health care. A review of the ethical principle of "justice," which, arguably, remains the least consensually understood and developed principle in the ethics literature of physical therapy, was provided, and a more recent perspective-the capability approach to justice-was discussed. The current article proposes a clinical and ethical decision-making framework, the ethical reasoning bridge (ER bridge), which can be used to assist physical therapy practitioners to: (1) understand and implement the capability approach to justice at a clinical level; (2) reflect on and evaluate both the fairness and influence of beliefs, perspectives, and context affecting health and disability through a process of "wide reflective equilibrium" and assist patients to do this as well; and (3) nurture the development of moral agency, in partnership with patients, through a transformative learning process manifest in a mutual "crossing" and "re-crossing" of the ER bridge. It is proposed that the development and exercise of moral agency represent an enacted justice that is the result of a shared reasoning and learning experience on the part of both therapists and patients.

  16. Global health and justice: re-examining our values.

    Science.gov (United States)

    Benatar, Solomon R

    2013-07-01

    Widening disparities in health within and between nations reflect a trajectory of 'progress' that has 'run its course' and needs to be significantly modified if progress is to be sustainable. Values and a value system that have enabled progress are now being distorted to the point where they undermine the future of global health by generating multiple crises that perpetuate injustice. Reliance on philanthropy for rectification, while necessary in the short and medium terms, is insufficient to address the challenge of economic and other systems spinning out of control. Innovative approaches are required and it is suggested that these could best emerge from in-depth multidisciplinary research supported by endeavours to promote a 'global mind-set.' © 2013 John Wiley & Sons Ltd.

  17. ECONOMIC EQUALITY OR JUSTICE

    Directory of Open Access Journals (Sweden)

    Ekrem Tufan

    2017-12-01

    Full Text Available From the beginning of economic life, equality has been a matter for human. Intrinsically human has two legs: Selfish and Groupish. Our selfish side does not care equality while Groupish side cares. What about the justice? Does human wants justice more than equalities in economic life? In this research, we have applied a questionnaire to find these two questions answer. As a result we can report that respondents prefer equality rather than justice in negative outcomes. On the other hand, they tend to prefer justice if there is possibility for positive outcomes. We cannot give evidence about gender, education and age differences effect on equality and justice preference.

  18. Public Health, Embodied History, and Social Justice: Looking Forward.

    Science.gov (United States)

    Krieger, Nancy

    2015-01-01

    This essay was delivered as a commencement address at the University of California-Berkeley School of Public Health on May 17, 2015. Reflecting on events spanning from 1990 to 1999 to 2015, when I gave my first, second, and third commencement talks at the school, I discuss four notable features of our present era and offer five insights for ensuring that health equity be the guiding star to orient us all. The four notable features are: (1) growing recognition of the planetary emergency of global climate change; (2) almost daily headlines about armed conflicts and atrocities; (3) growing public awareness of and debate about epic levels of income and wealth inequalities; and (4) growing activism about police killings and, more broadly, "Black Lives Matter." The five insights are: (1) public health is a public good, not a commodity; (2) the "tragedy of the commons" is a canard; the lack of a common good is what ails us; (3) good science is not enough, and bad science is harmful; (4) good evidence--however vital--is not enough to change the world; and (5) history is vital, because we live our history, embodied. Our goal: a just and sustainable world in which we and every being on this planet may truly thrive. © The Author(s) 2015.

  19. Multipurpose Health Care Telemedicine System

    National Research Council Canada - National Science Library

    Kyriacou, E

    2001-01-01

    .... Ambulances, Rural Health Centers (RHC) or other remote health location, Ships navigating in wide seas and Airplanes in flight are common examples of possible emergency sites, while critical care telemetry, and telemedicine home follow-ups...

  20. Allergies And Asthma : Employing Principles Of Social Justice As A Guide In Public Health Policy Development

    Directory of Open Access Journals (Sweden)

    Jason Behrmann

    2010-05-01

    Full Text Available The growing epidemic of allergy and allergy-induced asthma poses a significant challenge to population health. This article, written for a target audience of policy-makers in public health, aims to contribute to the development of policies to counter allergy morbidities by demonstrat- ing how principles of social justice can guide public health initiatives in reducing allergy and asthma triggers. Following a discussion of why theories of social justice have utility in analyzing allergy, a step-wise policy assessment protocol formulated on Rawlsian principles of social jus- tice is presented. This protocol can serve as a tool to aid in prioritizing public health initiatives and identifying ethically problematic policies that necessitate reform. Criteria for policy assess- ment include: 1 whether a tentative public health intervention would provide equal health ben- efit to a range of allergy and asthma sufferers, 2 whether targeting initiatives towards particu- lar societal groups is merited based on the notion of ‘worst-off status’ of certain population seg- ments, and 3 whether targeted policies have the potential for stigmatization. The article con- cludes by analyzing three examples of policies used in reducing allergy and asthma triggers in order to convey the general thought process underlying the use of the assessment protocol, which public health officials could replicate as a guide in actual, region-specific policy development.

  1. Mental health courts: serving justice and promoting recovery.

    Science.gov (United States)

    Wren, Ginger Lerner

    2010-01-01

    This article begins and ends with a call for more empirical research to understand the connection between societal views of mental illness and the legal system. The author asserts that changing social perceptions of mental illness certainly affect legal outcomes and commitment levels, but the degree remains unknown. This article explores the above two topics through the framework of the Circuit Court 'split' regarding the Constitutional rights of persons committed to state mental health institutions. A main facet of the 'split' is centered on the Circuits' disagreement about whether or not all mentally ill patients committed to institutions deserve the same Constitutional protections.

  2. A broader view of justice.

    Science.gov (United States)

    Jecker, Nancy S

    2008-10-01

    In this paper I argue that a narrow view of justice dominates the bioethics literature. I urge a broader view. As bioethicists, we often conceive of justice using a medical model. This model focuses attention at a particular point in time, namely, when someone who is already sick seeks access to scarce or expensive services. A medical model asks how we can fairly distribute those services. The broader view I endorse requires looking upstream, and asking how disease and suffering came about. In contrast to a medical model, a social model of justice considers how social determinants affect the health of a population. For example, social factors such as access to clean drinking water, education, safe workplaces, and police protection, profoundly affect risk for disease and early death. I examine one important social determinant of health, health care coverage, to show the limits of a medical model and the merits of a broader view.

  3. Health care economy II

    International Nuclear Information System (INIS)

    Beer, G.; Slovak, K.

    2008-01-01

    In Slovakia a strange approach to the purchase of health care equipment has not been limited to ophthalmology. Suspicious procurements are symptomatic. This applies also to specialisation where the correct spending of money can make the difference between life and death and can greatly effect the quality of life. More than a year ago, the Ministry of Health started the procurement of linear accelerators for oncology units in three hospitals. This plan placed on the market a potential order worth more than 11 million EUR without VAT. Three companies produce this complex equipment. The US company, Varian, the German company, Siemens, and the Swedish company, Elekta. Three suppliers, three hospitals. What a coincidence that each hospital - in Presov, Banska Bystrica and Bratislava - received only one envelope with an offer. Each from a different supplier. If anyone wanted to prove that the suppliers did not agree on a common approach, he would soon get into trouble. Each tender was organized by Pro-Tender, Kosice. The tender for the purchase of linear accelerators observed all the legal regulations. For each hospital there was only one offer and so it won. No-one complained, because each company got an order. Amedis Piestany will deliver a Varian product to Bystrica. In Narodny onkologicky ustav in Bratislava the winner was Transkontakt with Elekta products. And in Presov it was Ad Rem from Dunajska Streda that succeeded. The small company owned by a local vet joined up with Siemens and is now opening the doors of state-owned and regional hospitals to the company. (authors)

  4. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    Department of Epidemiology and Community Health, University of Ilorin, Ilorin, Nigeria .... exercise. All pupils in the selected school later done under the light ..... increased the likelihood of intestinal parasitic of Ilechukwu et al in which a ...

  5. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    Subject and Methods: ... To the best of the authors' knowledge, ... increase in percentage of women visiting health categories were decided on because ..... leadership resulted in an empowering work Significant differences in the proportions of.

  6. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    Immunization is a proven cost-effective ... immunization programme and control of Vaccine was conducted to assess the ..... HFs where emphasis is on profit maximization revealed that the widespread ... World Health Organization (WHO).

  7. Health care's service fanatics.

    Science.gov (United States)

    Merlino, James I; Raman, Ananth

    2013-05-01

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

  8. The TERRA framework: conceptualizing rural environmental health inequities through an environmental justice lens.

    Science.gov (United States)

    Butterfield, Patricia; Postma, Julie

    2009-01-01

    The deleterious consequences of environmentally associated diseases are expressed differentially by income, race, and geography. Scientists are just beginning to understand the consequences of environmental exposures under conditions of poverty, marginalization, and geographic isolation. In this context, we developed the TERRA (translational environmental research in rural areas) framework to explicate environmental health risks experienced by the rural poor. Central to the TERRA framework is the premise that risks exist within physical-spatial, economic-resources, and cultural-ideologic contexts. In the face of scientific and political uncertainty, a precautionary risk reduction approach has the greatest potential to protect health. Conceptual and technical advances will both be needed to achieve environmental justice.

  9. Applying a global justice lens to health systems research ethics: an initial exploration.

    Science.gov (United States)

    Pratt, Bridget; Hyder, Adnan A

    2015-03-01

    Recent scholarship has considered what, if anything, rich people owe to poor people to achieve justice in global health and the implications of this for international research. Yet this work has primarily focused on international clinical research. Health systems research is increasingly being performed in low and middle income countries and is essential to reducing global health disparities. This paper provides an initial description of the ethical issues related to priority setting, capacity-building, and the provision of post-study benefits that arise during the conduct of such research. It presents a selection of issues discussed in the health systems research literature and argues that they constitute ethical concerns based on their being inconsistent with a particular theory of global justice (the health capability paradigm). Issues identified include the fact that priority setting for health systems research at the global level is often not driven by national priorities and that capacity-building efforts frequently utilize one-size-fits-all approaches.

  10. "Symptoms of something all around us": Mental health, Inuit culture, and criminal justice in Arctic communities in Nunavut, Canada.

    Science.gov (United States)

    Ferrazzi, Priscilla; Krupa, Terry

    2016-09-01

    Rehabilitation-oriented criminal court mental health initiatives to reduce the number of people with mental illness caught in the criminal justice system exist in many North American cities and elsewhere but not in the mainly Inuit Canadian Arctic territory of Nunavut. This study explores whether the therapeutic aims of these resource-intensive, mainly urban initiatives can be achieved in criminal courts in Nunavut's resource constrained, culturally distinct and geographically remote communities. A qualitative multiple-case study in the communities of Iqaluit, Arviat and Qikiqtarjuaq involved 55 semi-structured interviews and three focus groups with participants representing four sectors essential to these initiatives: justice, health, community organizations and community members. These interviews explored whether the therapeutic jurisprudence (TJ) principles that guide criminal court mental health initiatives and the component objectives of these principles could be used to improve the criminal court response to people with mental illness in Nunavut. Interviews revealed 13 themes reflecting perceptions of Inuit culture's influence on the identification of people with mental illness, treatment, and collaboration between the court and others. These themes include cultural differences in defining mental illness, differences in traditional and contemporary treatment models, and the importance of mutual cultural respect. The findings suggest Inuit culture, including its recent history of cultural disruption and change, affects the vulnerability of Nunavut communities to the potential moral and legal pitfalls associated with TJ and criminal court mental health initiatives. These pitfalls include the dominance of biomedical approaches when identifying a target population, the medicalization of behaviour and culture, the risk of "paternalism" in therapeutic interventions, and shortcomings in interdisciplinary collaboration that limit considerations of Inuit culture. The

  11. Health Justice: A Framework (and Call to Action) for the Elimination of Health Inequity and Social Injustice.

    Science.gov (United States)

    Benfer, Emily A

    Every aspect of society is dependent upon the health of its members. Health is essential to an individual’s well-being, quality of life, and ability to participate in society. Yet the healthcare industry, even at its optimal level of functioning, cannot improve the health of the population without addressing the root causes of poor health. The health of approximately 46.7 million individuals, most of whom are low-income and racial minorities, is threatened by economic, societal, cultural, environmental, and social conditions. Poor health in any population group affects everyone, leading to higher crime rates, negative economic impacts, decreased residential home values, increased healthcare costs, and other devastating consequences. Despite this fact, efforts to improve health among low-income and minority communities are impeded by inequitable social structures, stereotypes, legal systems, and regulatory schemes that are not designed to take into account the social determinants of health in decision making models and legal interpretation. As a result, a large segment of the population is continually denied the opportunity to live long, productive lives and to exercise their rights under democratic principles. Health, equity, and justice make up the keystone of a functional, thriving society. These principles are unsatisfied when they do not apply equally to all members of society. This Article describes the social and legal roots of poor health and how health inequity, social injustice, and poverty are inextricably linked. For example, it provides an in depth overview of the social determinants of health, including poverty, institutional discrimination and segregation, implicit bias, residential environmental hazards, adverse childhood experiences, and food insecurity. It then discusses how the law is a determinant of health due to court systems that do not evaluate individual circumstances, the enactment of laws that perpetuate poor health, and the lack of

  12. Diaspora, disease, and health care.

    Science.gov (United States)

    Wick, Jeannette Y; Zanni, Guido R

    2007-03-01

    When groups of people relocate from their homelands to other nations, especially if the movement is involuntary, minority populations are created in the countries that receive them. The issues related to these diaspora and diasporic communities--any groups that have been dispersed outside their traditional homelands--are financial, social, historical, political, or religious. In health care, issues include heritable diseases, cultural barriers, patients' health care beliefs, and unique disease presentations. In long-term care, many residents and health care providers have relocated to the United States from other countries.

  13. The Quiet Health Care Revolution.

    Science.gov (United States)

    Herzlinger, Regina

    1994-01-01

    Discusses how entrepreneurs have helped reduce costs in health care and examines the major changes in the health care system that are simultaneously lowering costs and increasing quality. The author then explains how current reform proposals might affect these entrepreneurial innovations. (GLR)

  14. Wealth, justice and freedom: Objective and subjective measures predicting poor mental health in a study across eight countries.

    Science.gov (United States)

    Scholten, Saskia; Velten, Julia; Neher, Torsten; Margraf, Jürgen

    2017-12-01

    Macro-level factors (MF) such as wealth, justice and freedom measured with objective country-level indicators (objective MF), for instance the Gross Domestic Product (GDP), have been investigated in relation to health and well-being, but rarely in connection with depression, anxiety and stress subsumed as poor mental health. Also, a combination of different objective MF and of how individuals perceive those MF (subjective MF) has not been taken into consideration. In the present study, we combined subjective and objective measures of wealth, justice and freedom and examined their relationship with poor mental health. Population-based interviews were conducted in France, Germany, Poland, Russia, Spain, Sweden, U.K. and U.S.A. (n ≈ 1000 per country). GDP, GINI coefficient, Justice Index and Freedom Index were used as objective MF, whereas subjective MF were perceived wealth, justice and freedom measured at the individual level. Poor mental health was assessed as a combination of symptoms of depression, anxiety and stress. In a random-intercept-model, GINI coefficient and Freedom Index were significant positive country-level, and perceived wealth, justice, and freedom significant negative individual-level predictors of symptoms of poor mental health. Multiple subjective and objective MF should be combined to assess the macrosystem's relationship with poor mental health more precisely. The relationship between MF and poor mental health indicates that the macrosystem should be taken into account as relevant context for mental health problems, too.

  15. Organizing emotions in health care.

    Science.gov (United States)

    Mark, Annabelle

    2005-01-01

    To introduce the articles in this special issue, discussing emotion in the in health-care organisations. Discusses such topics as what makes health care different, editorial perspectives, how health care has explored emotion so far, and the impact of emotion on patients and the consequences for staff. Health care provides a setting that juxtaposes emotion and rationality, the individual and the body corporate, the formal and the deeply personal, the public and the private, all of which must be understood better if changes in expectations and delivery are to remain coherent. The papers indicate a shared international desire to understand meaning in emotion that is now spreading across organizational process and into all professional roles within health care.

  16. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    adedamla

    compared the perceived availability of essential drugs and patronage of health facilities in a BI and non-BI Local government areas (LGA) of ... 2Medical Directorate, Hospitals Management Board, Uyo, Akwa Ibom State ... majority of the population in Malaysia had access to .... Ethical clearance for this study was obtained.

  17. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    The level of knowledge of HIV/AIDS among senior secondary school students in Ikpoba Okha LGA was poor. Parents were mainly the first source of information on HCT for the respondents. There is need for more research to update knowledge and information on adolescent health issues and services related to HIV/AIDS.

  18. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    A nation's disease control effort is often as good as the surveillance and notification system put in place, .... Department. Community Health. 11. 4.9. Dentistry. 28. 12.5. Family Medicine. 14 .... formal training and a posting in the Infection control.

  19. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    adedamla

    Latin America and Southeast Asia. Cervical ... screening method based on visual Inspection with. 10-13 .... 56(49.6%) had poor knowledge while relating to practice of ... articulated road map and policy frame work to address ... European formal of Public ... Knowledge attitude and Practice ... Tertiary Health Institution. Int J.

  20. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    the mobile phones of health workers and their role as a source of hospital acquired infection. The study utilised ..... grew organisms which is much lower than may not be as effective as regular hand. 7 .... Akinyemi KO, Atapu AD, Adetona. 2011 ...

  1. How to connect bioethics and environmental ethics: health, sustainability, and justice.

    Science.gov (United States)

    Dwyer, James

    2009-11-01

    In this paper, I explore one way to bring bioethics and environmental ethics closer together. I focus on a question at the interface of health, sustainability, and justice: How well does a society promote health with the use of no more than a just share of environmental capacity? To address this question, I propose and discuss a mode of assessment that combines a measurement of population health, an estimate of environmental sustainability, and an assumption about what constitutes a fair or just share. This mode of assessment provides an estimate of the just and sustainable life expectancy of a population. It could be used to monitor how well a particular society promotes health within just environmental limits. It could also serve as a source of information that stakeholders use when they deliberate about programs, policies, and technologies. The purpose of this work is to focus attention on an ethical task: the need to fashion institutions and forms of life that promote health in ways that recognize the claims of sustainability and justice.

  2. Effectuation of right to health and its relationship to social justice

    Directory of Open Access Journals (Sweden)

    d'Ávila L. S.

    2017-02-01

    Full Text Available Thinking of health as a universal right is a complex task, given the inequalities in accessing decent living conditions. In this sense, this paper aims to discuss the effectuation of right to health, since this right is central to the pursuit of social justice. This is a reflection based on an extensive review of the literature, which involved references related to the right to health and to several fields of legal doctrine (human rights, social rights, Constitutional Law and Economic Law, due to their relevance to the matter. It was shown that despite the advances in realization of social rights in Brazil, there remains much to be done, particularly in times of economic crisis, as budget cuts directly affect social policies, which penalize the most vulnerable citizens and those in the most adverse situations. The right to health is entirely connected to the human development and training and quality of life among people and communities; non-compliance of this right goes further of Brazilian National Public Health System implementation. Thus, the effectuation of the right to heath is an instrument of social justice, as it not only leads to the realization of other rights, but requires the rethinking of long-rooted structures and behaviors, leading to the establishment of new relations among powers, promoting social inclusion.

  3. Health care of hunting dogs

    OpenAIRE

    Spasojević-Kosić, Ljubica; Savić, Sara

    2013-01-01

    There are two basic aspects of hunting dog’s health care: infectious diseases of hunting dogs and dog’s hunting performance. Concerning infectious diseases of hunting dogs, special attention is paid to public health, preventing possible dangers that could possibly arise. On the other hand, hunting performance of dogs depends on their nutrition. A complete analysis of hunting dogs’ health care in our country requires an assessment of awareness level in hunte...

  4. Caring for the Trafficked Patient: Ethical Challenges and Recommendations for Health Care Professionals.

    Science.gov (United States)

    Macias-Konstantopoulos, Wendy L

    2017-01-01

    Human trafficking is an egregious human rights violation with profound negative physical and psychological consequences, including communicable diseases, substance use disorders, and mental illnesses. The health needs of this population are multiple, complex, and influenced by past and present experiences of abuse, neglect, and exploitation. Effective health care services for trafficked patients require clinicians to consider individual patients' needs, wishes, goals, priorities, risks, and vulnerabilities as well as public health implications and even resource allocation. Applying the bioethical principles of respect for autonomy, nonmaleficence, beneficence, and justice, this article considers the ethics of care model as a trauma-informed framework for providing health care to human trafficking victims and survivors. © 2017 American Medical Association. All Rights Reserved.

  5. Gender disparities in health care.

    Science.gov (United States)

    Kent, Jennifer A; Patel, Vinisha; Varela, Natalie A

    2012-01-01

    The existence of disparities in delivery of health care has been the subject of increased empirical study in recent years. Some studies have suggested that disparities between men and women exist in the diagnoses and treatment of health conditions, and as a result measures have been taken to identify these differences. This article uses several examples to illustrate health care gender bias in medicine. These examples include surgery, peripheral artery disease, cardiovascular disease, critical care, and cardiovascular risk factors. Additionally, we discuss reasons why these issues still occur, trends in health care that may address these issues, and the need for acknowledgement of the current system's inequities in order to provide unbiased care for women in the future. © 2012 Mount Sinai School of Medicine.

  6. Hope for health and health care.

    Science.gov (United States)

    Stempsey, William E

    2015-02-01

    Virtually all activities of health care are motivated at some level by hope. Patients hope for a cure; for relief from pain; for a return home. Physicians hope to prevent illness in their patients; to make the correct diagnosis when illness presents itself; that their prescribed treatments will be effective. Researchers hope to learn more about the causes of illness; to discover new and more effective treatments; to understand how treatments work. Ultimately, all who work in health care hope to offer their patients hope. In this paper, I offer a brief analysis of hope, considering the definitions of Hobbes, Locke, Hume and Thomas Aquinas. I then differentiate shallow and deep hope and show how hope in health care can remain shallow. Next, I explore what a philosophy of deep hope in health care might look like, drawing important points from Ernst Bloch and Gabriel Marcel. Finally, I suggest some implications of this philosophy of hope for patients, physicians, and researchers.

  7. [A Maternal Health Care System Based on Mobile Health Care].

    Science.gov (United States)

    Du, Xin; Zeng, Weijie; Li, Chengwei; Xue, Junwei; Wu, Xiuyong; Liu, Yinjia; Wan, Yuxin; Zhang, Yiru; Ji, Yurong; Wu, Lei; Yang, Yongzhe; Zhang, Yue; Zhu, Bin; Huang, Yueshan; Wu, Kai

    2016-02-01

    Wearable devices are used in the new design of the maternal health care system to detect electrocardiogram and oxygen saturation signal while smart terminals are used to achieve assessments and input maternal clinical information. All the results combined with biochemical analysis from hospital are uploaded to cloud server by mobile Internet. Machine learning algorithms are used for data mining of all information of subjects. This system can achieve the assessment and care of maternal physical health as well as mental health. Moreover, the system can send the results and health guidance to smart terminals.

  8. Reducing Urban Violence: A Contrast of Public Health and Criminal Justice Approaches.

    Science.gov (United States)

    Cerdá, Magdalena; Tracy, Melissa; Keyes, Katherine M

    2018-01-01

    Cities are investing millions in Cure Violence, a public health approach to reduce urban violence by targeting at-risk youth and redirecting conflict to nonviolent responses. The impact of such a program compared with criminal justice responses is unknown because experiments directly comparing criminal justice and public health approaches to violence prevention are infeasible with observational data. We simulated experiments to test the influence of two interventions on violence: (1) Cure Violence and (2) directed police patrol in violence hot spots. We used an agent-based model to simulate a 5% sample of the New York City (NYC) adult population, with agents placed on a grid representing the land area of NYC, with neighborhood size and population density proportional to land area and population density in each community district. Agent behaviors were governed by parameters drawn from city data sources and published estimates. Under no intervention, 3.87% (95% CI, 3.84, 3.90) of agents were victimized per year. Implementing the violence interrupter intervention for 10 years decreased victimization by 13% (to 3.35% [3.32, 3.39]). Implementing hot-spots policing and doubling the police force for 10 years reduced annual victimization by about 11% (to 3.46% [3.42, 3.49]). Increasing the police force by 40% combined with implementing the violence interrupter intervention for 10 years decreased violence by 19% (to 3.13% [3.09, 3.16]). Combined investment in a public health, community-based approach to violence prevention and a criminal justice approach focused on deterrence can achieve more to reduce population-level rates of urban violence than either can in isolation. See video abstract at, http://links.lww.com/EDE/B298.

  9. Home Health Care Agencies

    Data.gov (United States)

    U.S. Department of Health & Human Services — A list of all Home Health Agencies that have been registered with Medicare. The list includes addresses, phone numbers, and quality measure ratings for each agency.

  10. Conscientious objection in health care

    Directory of Open Access Journals (Sweden)

    Kuře Josef

    2016-12-01

    Full Text Available The paper deals with conscientious objection in health care, addressing the problems of scope, verification and limitation of such refusal, paying attention to ideological agendas hidden behind the right of conscience where the claimed refusal can cause harm or where such a claim is an attempt to impose certain moral values on society or an excuse for not providing health care. The nature of conscientious objection will be investigated and an ethical analysis of conscientious objection will be conducted. Finally some suggestions for health care policy will be proposed.

  11. Adherence and health care costs

    Directory of Open Access Journals (Sweden)

    Iuga AO

    2014-02-01

    Full Text Available Aurel O Iuga,1,2 Maura J McGuire3,4 1Johns Hopkins Bloomberg School of Public Health, 2Johns Hopkins University, 3Johns Hopkins Community Physicians, 4Johns Hopkins University School of Medicine, Baltimore, MD, USA Abstract: Medication nonadherence is an important public health consideration, affecting health outcomes and overall health care costs. This review considers the most recent developments in adherence research with a focus on the impact of medication adherence on health care costs in the US health system. We describe the magnitude of the nonadherence problem and related costs, with an extensive discussion of the mechanisms underlying the impact of nonadherence on costs. Specifically, we summarize the impact of nonadherence on health care costs in several chronic diseases, such as diabetes and asthma. A brief analysis of existing research study designs, along with suggestions for future research focus, is provided. Finally, given the ongoing changes in the US health care system, we also address some of the most relevant and current trends in health care, including pharmacist-led medication therapy management and electronic (e-prescribing. Keywords: patient, medication, adherence, compliance, nonadherence, noncompliance, cost

  12. Breastfeeding and feminism: A focus on reproductive health, rights and justice

    Science.gov (United States)

    Labbok, Miriam H; Smith, Paige Hall; Taylor, Emily C

    2008-01-01

    The annual Breastfeeding and Feminism Symposia aim to reposition breastfeeding as a valued part of women's (re)productive lives and rights. The symposia are designed to raise the profile of breastfeeding within the women's advocacy and feminist studies' communities, and to increase recognition among breastfeeding supporters that breastfeeding promotion could receive more socio-political support by partnering with those concerned with women's reproductive health, rights and justice, women's economic advancement, and the elimination of social, economic and health inequities. The third symposium (2007) sought to build dialogue and increase communications between and among these diverse communities. The nine articles presented in this thematic series were selected by the journal editors, and represent the core discussions at the symposium. This editorial presents the areas of synergy and strategies for action that emerged from the discussions. These strategies and this thematic issue are intended to reassert the momentum that evolved among participants, and to stimulate involvement among individuals and organizations not in attendance in promoting breastfeeding as a women's reproductive health, rights and justice concern. PMID:18680575

  13. Breastfeeding and feminism: a focus on reproductive health, rights and justice.

    Science.gov (United States)

    Labbok, Miriam H; Smith, Paige Hall; Taylor, Emily C

    2008-08-04

    The annual Breastfeeding and Feminism Symposia aim to reposition breastfeeding as a valued part of women's (re)productive lives and rights. The symposia are designed to raise the profile of breastfeeding within the women's advocacy and feminist studies' communities, and to increase recognition among breastfeeding supporters that breastfeeding promotion could receive more socio-political support by partnering with those concerned with women's reproductive health, rights and justice, women's economic advancement, and the elimination of social, economic and health inequities. The third symposium (2007) sought to build dialogue and increase communications between and among these diverse communities. The nine articles presented in this thematic series were selected by the journal editors, and represent the core discussions at the symposium. This editorial presents the areas of synergy and strategies for action that emerged from the discussions. These strategies and this thematic issue are intended to reassert the momentum that evolved among participants, and to stimulate involvement among individuals and organizations not in attendance in promoting breastfeeding as a women's reproductive health, rights and justice concern.

  14. Towards Sustainable Health Care Organizations

    Directory of Open Access Journals (Sweden)

    Mauro ROMANELLI

    2017-09-01

    Full Text Available Health care organizations have to develop a sustainable path for creating public value by seeking legitimacy for building and maintaining public trust with patients as social and economic institutions creating value and sustaining both health and wealth for people and communities within society. Health care organizations having at disposal decreasing resources and meeting increasing demands of citizens are following an unsustainable path. Designing sustainable health care systems and organizations is emerging as a strategic goal for developing the wealth of people and communities over time. Building sustainable organizations relies on valuing human resources, designing efficient and effective processes, using technology for better managing the relationships within and outside organizations. Sustainable health care organizations tend to rediscover the importance of human resource management and policies for effectively improving communication with patients and building trust-based relationships. While processes of accreditation contribute to legitimizing effectiveness and quality of health care services and efficient processes, introducing and using new information and communication technologies (ICTs and informatics helps communication leading to restore trust-based relationships between health care institutions and patients for value creation within society.

  15. Aged care nurses' job control influence satisfaction and mental health.

    Science.gov (United States)

    Elliott, Kate-Ellen J; Rodwell, John; Martin, Angela J

    2017-10-01

    Relationships exist between aged care nurses' perceptions of psychosocial work characteristics, job satisfaction and mental health, suggesting these characteristics may be important for the management of aged care services. An expanded demand-control-support model that included justice perceptions was examined to determine its impact on multiple types of psychological and organisational well-being outcomes (i.e. job satisfaction, psychological distress and depression). Data were collected from a sample of 173 aged care nurses using a self-report survey and analysed using hierarchical multiple regression. A significant proportion (27-28%) of the variance in aged care nurses' satisfaction, depression and psychological distress was explained by the psychosocial factors included in the model. Job control had the most consistent impact with direct effects on job satisfaction, psychological distress and depression. Informational justice was associated with both psychological distress and depression. Targeting job control may provide the biggest response for nurse managers in aged care, as it is likely to influence nurses' job satisfaction, psychological distress and depression. Facility managers should implement organisational policies and procedures that promote higher levels of control over how nurses perform their work in order to improve nurse well-being in aged care settings. © 2017 John Wiley & Sons Ltd.

  16. Understanding your health care costs

    Science.gov (United States)

    ... ency/patientinstructions/000878.htm Understanding your health care costs To use the sharing features on this page, ... on out-of-pocket costs. Out-of-Pocket Costs The good news is there is a limit ...

  17. COMMUNITY MEDICINE & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    Journal of Community Medicine and Primary Health Care. ... Ladoke Akintola University of Technology, PMB 4400, Osogbo, Osun State. ... weak management and poor adherence to the basic infrastructure e.g. primary, secondary and tertiary.

  18. COMMUNITY MEDICINE & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    ajiboro

    3Department of Community and Primary Health Care, College of Medicine, University of Lagos, Idiaraba, ... Some of the participants (45.3%) carry out physical exercises such as walking ..... hypertension, continuous effective management of.

  19. COMMUNITY MEDICINE & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    the_monk

    %) was the least common. On bivariate analysis ... the power to determine what their wives do or fail to ... pregnancy care while joint decision-making ... Other maternal health services rendered This data collection was done by a team of trained.

  20. Czechoslovakia's changing health care system.

    Science.gov (United States)

    Raffel, M W; Raffel, N K

    1992-01-01

    Before World War II, Czechoslovakia was among the most developed European countries with an excellent health care system. After the Communist coup d'etat in 1948, the country was forced to adapt its existing health care system to the Soviet model. It was planned and managed by the government, financed by general tax money, operated in a highly centralized, bureaucratic fashion, and provided service at no direct charge at the time of service. In recent years, the health care system had been deteriorating as the health of the people had also been declining. Life expectancy, infant mortality rates, and diseases of the circulatory system are higher than in Western European countries. In 1989, political changes occurred in Czechoslovakia that made health care reform possible. Now health services are being decentralized, and the ownership of hospitals is expected to be transferred to communities, municipalities, churches, charitable groups, or private entities. Almost all health leaders, including hospital directors and hospital department heads, have been replaced. Physicians will be paid according to the type and amount of work performed. Perhaps the most important reform is the establishment of an independent General Health Care Insurance Office financed directly by compulsory contributions from workers, employers, and government that will be able to negotiate with hospitals and physicians to determine payment for services.

  1. Why managers should care about fairness: the effects of aggregate justice perceptions on organizational outcomes.

    Science.gov (United States)

    Simons, Tony; Roberson, Quinetta

    2003-06-01

    This work examines the aggregation of justice perceptions to the departmental level and the business-unit level, the impact of these aggregate perceptions on business-unit-level outcomes, and the usefulness of the distinction between procedural and interpersonal justice at different levels of analysis. Latent variables analyses of individual-level and department-level data from 4,539 employees in 783 departments at 97 hotel properties showed that the 2 justice types exercise unique paths of impact on employees' organizational commitment and thus on turnover intentions and discretionary service behavior. Business-unit-level analyses further demonstrate paths of association between aggregate justice perceptions, aggregate commitment levels, and the business-unit-level outcomes of employee turnover rates and customer satisfaction ratings.

  2. Who Cares about Unions? Ethical Support for Labor as a Matter of Social Justice.

    Science.gov (United States)

    Zweig, Michael

    1994-01-01

    Labor law reform centers on competitiveness considerations rather than ethics. A social justice perspective suggests religious arguments (dignity of work, accountability) and economic arguments (fairness, democracy) for changing labor law. (SK)

  3. [Corruption and health care system].

    Science.gov (United States)

    Marasović Šušnjara, Ivana

    2014-06-01

    Corruption is a global problem that takes special place in health care system. A large number of participants in the health care system and numerous interactions among them provide an opportunity for various forms of corruption, be it bribery, theft, bureaucratic corruption or incorrect information. Even though it is difficult to measure the amount of corruption in medicine, there are tools that allow forming of the frames for possible interventions.

  4. Chiropractic and social justice: a view from the perspective of Beauchamp's principles.

    Science.gov (United States)

    Green, Bart N; Johnson, Claire

    2010-01-01

    Social justice in public health involves the process and product of a community acting to fairly distribute advantages and burdens to improve the health of its population and to reasonably take care of the disadvantaged. Although publications are available about chiropractic public health history, programs, and policy, the potential role of chiropractic in social justice has received little attention. This article discusses Beauchamp's 4 principles of social justice and suggests actions that the chiropractic profession may consider to participate in the practice of social justice in the field of public health. Copyright 2010 National University of Health Sciences. Published by Mosby, Inc. All rights reserved.

  5. Does subsequent criminal justice involvement predict foster care and termination of parental rights for children born to incarcerated women?

    Science.gov (United States)

    Kubiak, Sheryl Pimlott; Kasiborski, Natalie; Karim, Nidal; Schmittel, Emily

    2012-01-01

    This longitudinal study of 83 incarcerated women, who gave birth during incarceration and retained their parental rights through brief sentences, examines the intersection between subsequent criminal justice involvement postrelease and child welfare outcomes. Ten years of multiple state-level administrative data sets are used to determine if arrest or conviction predict foster care and/or termination of parental rights. Findings indicate that only felony arrest is a significant predictor of foster care involvement. Additionally, 69% of mothers retained legal custody, despite subsequent criminal involvement for many, suggesting supportive parenting programs and resources need to be available to these women throughout and after incarceration.

  6. Sex and Race Differences in Mental Health Symptoms in Juvenile Justice: The MAYSI-2 National Meta-Analysis

    Science.gov (United States)

    Vincent, Gina M.; Grisso, Thomas; Terry, Anna; Banks, Steven

    2008-01-01

    The study uses the MAYSI-2 gathered data from multiple US juvenile justice systems to examine whether mental health symptoms were connected to consistent sex and ethnicity/race-related differences. Results concluded a greater proportion of girls having serious mental health problems and though whites had problems with alcohol and drugs, they were…

  7. Health care entrepreneurship: financing innovation.

    Science.gov (United States)

    Grazier, Kyle L; Metzler, Bridget

    2006-01-01

    Entrepreneurship is often described as the ability to create new ventures from new or existing concepts, ideas and visions. There has been significant entrepreneurial response to the changes in the scientific and social underpinnings of health care services delivery. However, a growing portion of the economic development driving health care industry expansion is threatened further by longstanding use of financing models that are suboptimal for health care ventures. The delayed pace of entrepreneurial activity in this industry is in part a response to the general economy and markets, but also due to the lack of capital for new health care ventures. The recent dearth of entrepreneurial activities in the health services sector may also due to failure to consider new approaches to partnerships and strategic ventures, despite their mutually beneficial organizational and financing potential. As capital becomes more scarce for innovators, it is imperative that those with new and creative ideas for health and health care improvement consider techniques for capital acquisition that have been successful in other industries and at similar stages of development. The capital and added expertise can allow entrepreneurs to leverage resources, dampen business fluctuations, and strengthen long term prospects.

  8. Health Care Wide Hazards

    Science.gov (United States)

    ... Glossary | References | Site Map | Credits Freedom of Information Act | Privacy & Security Statement | Disclaimers | Important Web Site Notices | International | Contact Us U.S. Department of Labor | Occupational Safety & Health Administration | 200 Constitution Ave., NW, Washington, DC 20210 ...

  9. Primary health care in India.

    Science.gov (United States)

    Deodhar, N S

    1982-03-01

    Concurrently with the development of the general health services infrastructure in India, serveral special health programs were instituted at the national level to provide a massive and concentrated assault on the major public health problems of malaria, smallpox, cholera, trachoma, tuberculosis, leprosy, filariasis, and the rapid population growth. These vertical programs were expected to reduce the heavy morbidity and mortality within the shortest possible time to where they were no longer major public health problems. The impact was variable. Major steps toward providing integrated health care were taken during the first 5-year plan. Emphasis was on the provision of a packet of inttegrated health, family planning, and nutrition services to the vulnerable groups, i.e., children, pregnant women, and nursing mothers. To rectify past shortcomings ssuch as the failures of the national health programs, ineffective coordination in the nutrition programs, and slow rate of development as a result of interdependence of different sectors, it was necessary to improve the health infrastructure and to launch a frontal attack on poverty. The Multipurpose Health Workers Scheme was planned to rationalize the organization and use of available manpower to reduce the area and population covered by each of the field staff in order to reduce travel time and to make services more effective and more satisfactory. Each multipurpose health worker was entrusted with the task of providing comprehensive health care to about 5000 people. Communicable diseases were the main public health problems, and many specific control/eradication programs were launched. the immunization programs against common childhood diseases have not taken deep roots and coverage continues to be poor. The adoption of the Western model of medical services has resulted in emphasis on "cure" rather than on "care". Another problem is maldistribution of the facilities. Overemphasis on medical education has resulted in the

  10. Prison health-care wings: psychiatry's forgotten frontier?

    Science.gov (United States)

    Forrester, Andrew; Chiu, Katrina; Dove, Samantha; Parrott, Janet

    2010-02-01

    There is worldwide evidence of high rates of mental disorder among prisoners, with significant co-morbidity. In England and Wales, mental health services have been introduced from the National Health Service to meet the need, but prison health-care wings have hardly been evaluated. To conduct a service evaluation of the health-care wing of a busy London remand (pre-trial) prison and examine the prevalence and range of mental health problems, including previously unrecognised psychosis. Service-use data were collected from prison medical records over a 20-week period in 2006-2007, and basic descriptive statistics were generated. Eighty-eight prisoners were admitted (4.4 per week). Most suffered from psychosis, a third of whom were not previously known to services. Eleven men were so ill that they required emergency compulsory treatment in the prison under Common Law before hospital transfer could take place. Over a quarter of the men required hospital transfer. Problem behaviours while on the prison health-care wing were common. Prison health-care wings operate front-line mental illness triaging and recognition functions and also provide care for complex individuals who display behavioural disturbance. Services are not equivalent to those in hospitals, nor the community, but instead reflect the needs of the prison in which they are situated. There is a recognised failure to divert at earlier points in the criminal justice pathway, which may be a consequence of national failure to fund services properly. Hospital treatment is often delayed.

  11. Private sector in public health care systems

    OpenAIRE

    Matějusová, Lenka

    2008-01-01

    This master thesis is trying to describe the situation of private sector in public health care systems. As a private sector we understand patients, private health insurance companies and private health care providers. The focus is placed on private health care providers, especially in ambulatory treatment. At first there is a definition of health as a main determinant of a health care systems, definition of public and private sectors in health care systems and the difficulties at the market o...

  12. Equity in mobility : learning from health care, education and especially housing

    NARCIS (Netherlands)

    Jeekel, J.F.; Martens, K.

    2016-01-01

    The objective of the paper is, first, to identify the principles of justice that guide the policy domains of health care, education and housing, and, second, to explore what lessons could be drawn for the domain of transportation. Like policies in the three other domains, interventions in the

  13. Help Yourself to Health Care.

    Science.gov (United States)

    Snyder, Sarah

    A booklet on health care for limited English speakers provides information on choosing the right doctor, buying medicine, paying the bill, and the individual's role in maintaining his or her health. Cartoons, questions and puzzles concerning the message in cartoons and narrative passages, checklists about an individual's personal habits related to…

  14. Health care marketing: Basic features

    OpenAIRE

    Gajić-Stevanović Milena

    2006-01-01

    Paper discuss an introduction to importance's as well as challenges facing health care sector in many countries. Particular attention is devoted to the preconditions and/or basic requirements have to be developed in order to make health sector to functioned. Focusing to end users as well as employing marketing tools ought to be right orientation.

  15. Babesiosis for Health Care Providers

    Centers for Disease Control (CDC) Podcasts

    2012-04-25

    This podcast will educate health care providers on diagnosing babesiosis and providing patients at risk with tick bite prevention messages.  Created: 4/25/2012 by Center for Global Health, Division of Parasitic Diseases and Malaria.   Date Released: 4/25/2012.

  16. COMMUNITY MEDICINE & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    ajiboro

    ... Experience in a primary health care facility in Rivers State, South-South Nigeria. ... health center increased by 3.09% (p-value > 0.05); the patients that had their babies in the facility were ... 100, 000 live births, based on historical studies and.

  17. Health care in rural areas.

    Science.gov (United States)

    Nath, L M

    1994-02-01

    In India, although the health care system infrastructure is extensive, the people often regard government facilities as family planning (FP) centers instead of primary health care centers. This problem has been compounded by the separation of health care and FP at all stages, even down to the storage of the same medication in two different locations depending upon whether it is to be used for "health" or for "FP." In rural areas where the government centers are particularly desolate, the community has chosen to erect its own health care system of private practitioners of all sorts and qualifications. Even in rural areas where a comprehensive health service is provided, with each household visited regularly by health workers, and where this service has resulted in a lowering of the crude death rate from 14.6 to 7 and the maternal mortality rate from 4.7 to 0.5/1000, people depend upon practitioners of various types. Upon analysis, it was discovered that the reason for using this multiplicity of practitioners had nothing to do with the level of satisfaction with the government service or with the accessibility of the services. Rather, when ill, the people make a diagnosis and then go to the proper place for treatment. If, for instance, they believe their malady was caused by the evil eye, they consult a magico-religious practitioner. These various types of practitioners flourish in areas with the best primary health care because they fulfill a need not met by the primary health care staff. If government agencies work with the local practitioners and afford them the proper respect, their skills can be upgraded in selected areas and the whole community will benefit.

  18. EVALUATION OF HEALTH CARE QUALITY

    Directory of Open Access Journals (Sweden)

    Zlatko Fras

    2002-12-01

    Full Text Available Background. It is possible to evaluate quality characteristics of different aspects of health care by many different measures. For these purposes, in various countries all over the world authorised institutions and/or agencies developed number of methodological accessories, criteria and tools for selection of more or less appropriately and optimally defined criteria and indicators of quality clinical performance.Conclusions. Recently we have started with activities for gradual introduction of systematic monitoring, assessment and improvement of quality of health care in Slovenia as well. One of the key prerequisites for selection of valid, practicable, efficient and reliable quality indicators is the establishment of continuous and methodologically appropriate system of development and implementation of evidence-based clinical practice guidelines. We started this process within the framework of national Health Sector Management Project, where all potential key stakeholders from health care sector participated. Also the project on Quality in Health Care in Slovenia, started, leaded and performed by the Medical Chamber of Slovenia, represents one of the important parallel starting steps towards assurance of reliable data on development/establishment of appropriate set of quality indicators and standards of health care in our country.

  19. Music making for health, well-being and behaviour change in youth justice settings: a systematic review.

    Science.gov (United States)

    Daykin, Norma; de Viggiani, Nick; Pilkington, Paul; Moriarty, Yvonne

    2013-06-01

    Youth justice is an important public health issue. There is growing recognition of the need to adopt effective, evidence-based strategies for working with young offenders. Music interventions may be particularly well suited to addressing risk factors in young people and reducing juvenile crime. This systematic review of international research seeks to contribute to the evidence base on the impact of music making on the health, well-being and behaviour of young offenders and those considered at risk of offending. It examines outcomes of music making identified in quantitative research and discusses theories from qualitative research that might help to understand the impact of music making in youth justice settings.

  20. Rural migration and health care

    DEFF Research Database (Denmark)

    Svendsen, Gunnar Lind Haase; Jensen, Marit Vatn

    This literature study focuses on possible links between access to health services and migration in rural areas. Why do people move to or from rural areas or why do they stay? What determines where people settle? And, in this context, do local health care services play an important or minor role......, or no role at all? First, the paper reports on key findings from rural migration studies, in order to shed light on two migration trends: urbanization and counter-urbanization. Then we take a closer look on settlement preferences in rural areas, including the impact of health care facilities. Finally, we end...... up with a more deepgoing review of the relatively small number of studies, which explicitly deal with settlement preferences related to access to health care....

  1. Marketing occupational health care.

    Science.gov (United States)

    Norris, M J; Harris, J C

    1981-01-01

    A very basic part of marketing success is determining areas of your business in which you have a competitive advantage. In drafting a marketing plan for the Denver Clinic, the competitive advantages group practices have in the area of occupational health were quickly realized. This competitive edge is presented along with the Denver Clinic's marketing strategies and plans to capitalize on occupational healthcare advantages.

  2. A right to health care? Participatory politics, progressive policy, and the price of loose language.

    Science.gov (United States)

    Reidy, David A

    2016-08-01

    This article begins by clarifying and noting various limitations on the universal reach of the human right to health care under positive international law. It then argues that irrespective of the human right to health care established by positive international law, any system of positive international law capable of generating legal duties with prima facie moral force necessarily presupposes a universal moral human right to health care. But the language used in contemporary human rights documents or human rights advocacy is not a good guide to the content of this rather more modest universal moral human right to health care. The conclusion reached is that when addressing issues of justice as they inevitably arise with respect to health policy and health care, both within and between states, there is typically little to gain and much to risk by framing deliberation in terms of the human right to health care.

  3. [Social and health impact of Institutes of Legal Medicine in Spain: beyond justice].

    Science.gov (United States)

    Barbería, Eneko; Xifró, Alexandre; Suelves, Josep María; Arimany-Manso, Josep

    2014-03-01

    The main mission of Spanish Institutes of Legal Medicine (ILMs) is to serve the justice system. We review the potential broader role of the work done by ILMs, with an emphasis on forensic pathology. The relevance of forensic information to increase the quality of mortality statistics is highlighted, taking into account the persistence of the low validity of the external causes of death in the Mortality Register that was already detected more than a decade ago. The new statistical form and reporting system for the deaths under ILMs jurisdiction, as introduced by the Spanish Instituto Nacional de Estadística in 2009, are also described. The IMLs role in the investigation of the following mortality causes and of their determinants is reviewed in detail: traffic accidents, suicide, drugs of abuse, child deaths and sudden deaths. We conclude that an important public role of IMLs is emerging beyond their valuable service to the justice system, mainly through the gathering of data critical to assess and prevent several medical and public health and safety issues of great social impact and through their participation in epidemiologic research and surveillance. Copyright © 2014 Elsevier España, S.L. All rights reserved.

  4. Access to Health Care

    Centers for Disease Control (CDC) Podcasts

    This podcast is based on the November, 2010 CDC Vital Signs report which indicates that more than one in four adults 18-64 years old (about 50 million) report being uninsured for at least part of the past 12 months, and focuses on the growing number of middle-income adults and those with a chronic illness or disability who have no health insurance.

  5. Mental health research in the criminal justice system: The need for common approaches and international perspectives.

    Science.gov (United States)

    Roesch, R; Ogloff, J R; Eaves, D

    1995-01-01

    There is a need for researchers and policy makers in the area of mental health and law to collaborate and develop common methods of approach to research. Although we have learned a great deal about the prevalence and needs of mentally ill offenders in jails and prisons, there are a number of research questions that remain. If the "second generation" of research is to be fruitful--and useful to policy makers--we need to be sure that the methods we employ are valid and that the findings we obtain are reliable. By collaborating with colleagues in other jurisdictions, we can begin to learn whether some of the existing findings are of a general nature, or dependent upon the system in which they were found. Similarly, while the first-generation research has alerted us to the needs of mentally ill offenders in jails and prisons, second-generation research is needed to help identify factors that may help prevent the "revolving door phenomenon," which results in mentally ill people being volleyed among mental health, criminal justice, and community settings. One area that has received embarrassingly little attention has been the need for considering the relationship between substance abuse and mental disorders. In our own work, we have found an alarmingly high degree of substance abuse among offenders, including mentally ill offenders. We have come to realize the importance of considering the role that substance abuse coupled with other mental disorders may play in the criminal justice system. As a result of this concern, the Surrey Mental Health Project recently hired a full-time drug and alcohol counselor whose job it is to work with inmates with substance abuse disorders while in the jail, and to help arrange continuing treatment resources upon their release. As Wilson et al. (1995) discuss, intensive case management projects may be particularly useful at targeting the unique needs of mentally ill offenders with multiple problems. Much of the research conducted with

  6. Wearing the crown of Solomon? Chief Justice Roberts and the Affordable Care Act "tax".

    Science.gov (United States)

    Muise, Robert J; Yerushalmi, David

    2013-04-01

    Attempting to play the role of King Solomon in his PPACA decision, Chief Justice John Roberts split the baby perversely by ruling it was not a tax under the Anti-Injunction Act, which would have likely deprived the Court of jurisdiction to hear this pre-enforcement challenge to the individual mandate, but it was a tax for taxing and spending purposes even though Congress said it was a "penalty" and not a tax. And the Chief Justice had to twist further his "wisdom" to hold that it was not an unconstitutional direct tax, even though that is exactly what it is, if it is a tax in the first instance.

  7. Nanotechnology in health care

    CERN Document Server

    Sahoo, Sanjeeb K

    2012-01-01

    Nanomedicine: Emerging Field of Nanotechnology to Human HealthNanomedicines: Impacts in Ocular Delivery and TargetingImmuno-Nanosystems to CNS Pathologies: State of the Art PEGylated Zinc Protoporphyrin: A Micelle-Forming Polymeric Drug for Cancer TherapyORMOSIL Nanoparticles: Nanomedicine Approach for Drug/Gene Delivery to the BrainMagnetic Nanoparticles: A Versatile System for Therapeutic and Imaging SystemNanobiotechnology: A New Generation of Biomedicine Application of Nanotechnology-Based Drug Delivery and Targeting to LungsAptamers and Nanomedicine in C

  8. Access to Health Care

    Centers for Disease Control (CDC) Podcasts

    2010-11-09

    This podcast is based on the November, 2010 CDC Vital Signs report which indicates that more than one in four adults 18-64 years old (about 50 million) report being uninsured for at least part of the past 12 months, and focuses on the growing number of middle-income adults and those with a chronic illness or disability who have no health insurance.  Created: 11/9/2010 by Centers for Disease Control and Prevention (CDC).   Date Released: 11/9/2010.

  9. Health Care Sharing Ministries and Their Exemption From the Individual Mandate of the Affordable Care Act.

    Science.gov (United States)

    Galarneau, Charlene

    2015-06-01

    The U.S. 2010 Patient Protection and Affordable Care Act (ACA) exempts members of health care sharing ministries (HCSMs) from the individual mandate to have minimum essential insurance coverage. Little is generally known about these religious organizations and even less critical attention has been brought to bear on them and their ACA exemption. Both deserve close scrutiny due to the exemption's less than clear legislative justification, their potential influence on the ACA's policy and ethical success, and their salience to current religious liberty debates surrounding the expansion of religious exemptions from ACA responsibilities for both individuals and corporations. Analyzing documents of the United States' three largest health care sharing ministries and related material, I examine these organizations and their ACA exemption with particular consideration of their ethical dimensions. Here a thick description of the nature and workings of health care sharing ministries precedes a similar account of the ACA exemption. From these empirical analyses, five ethical and policy concerns emerge: (1) the charity versus insurance status of these ministries; (2) the conflation of two ACA religious exemptions; (3) the tension between the values of religious liberty and of justice; (4) the potential undermining of ACA policy goals; and (5) the questionable compliance of health care sharing ministries with ACA exemption requirements.  An accurate and informed understanding of HCSMs is required for policymakers and others to justify the ACA exemption of health care sharing ministry members. A sufficient justification would address at least the five ethical and policy concerns raised here.

  10. Phytotherapy in primary health care

    Science.gov (United States)

    Antonio, Gisele Damian; Tesser, Charles Dalcanale; Moretti-Pires, Rodrigo Otavio

    2014-01-01

    OBJECTIVE To characterize the integration of phytotherapy in primary health care in Brazil. METHODS Journal articles and theses and dissertations were searched for in the following databases: SciELO, Lilacs, PubMed, Scopus, Web of Science and Theses Portal Capes, between January 1988 and March 2013. We analyzed 53 original studies on actions, programs, acceptance and use of phytotherapy and medicinal plants in the Brazilian Unified Health System. Bibliometric data, characteristics of the actions/programs, places and subjects involved and type and focus of the selected studies were analyzed. RESULTS Between 2003 and 2013, there was an increase in publications in different areas of knowledge, compared with the 1990-2002 period. The objectives and actions of programs involving the integration of phytotherapy into primary health care varied: including other treatment options, reduce costs, reviving traditional knowledge, preserving biodiversity, promoting social development and stimulating inter-sectorial actions. CONCLUSIONS Over the past 25 years, there was a small increase in scientific production on actions/programs developed in primary care. Including phytotherapy in primary care services encourages interaction between health care users and professionals. It also contributes to the socialization of scientific research and the development of a critical vision about the use of phytotherapy and plant medicine, not only on the part of professionals but also of the population. PMID:25119949

  11. Innovation in Health Care Delivery.

    Science.gov (United States)

    Sharan, Alok D; Schroeder, Gregory D; West, Michael E; Vaccaro, Alexander R

    2016-02-01

    As reimbursement transitions from a volume-based to a value-based system, innovation in health care delivery will be needed. The process of innovation begins with framing the problem that needs to be solved along with the strategic vision that has to be achieved. Similar to scientific testing, a hypothesis is generated for a new solution to a problem. Innovation requires conducting a disciplined form of experimentation and then learning from the process. This manuscript will discuss the different types of innovation, and the key steps necessary for successful innovation in the health care field.

  12. Health Care Regulation Spending Trap

    Directory of Open Access Journals (Sweden)

    Timothy McTighe

    2017-07-01

    Full Text Available Our health care system has faced many challenges over the past 40 plus years. Now these challenges have forced us into a complicated situation that makes it confusing on how best to proceed. Today third party insurance payers make most health care payments. Our premiums are paid into a risk pool-on medical services for other people. Consumers are disconnected from knowing the cost of goods or services that they are receiving. This commentary reviews the current situation and provides a few common sense approaches for pursuing the best potential policies.

  13. Health care's ills: A Catholic diagnosis

    Science.gov (United States)

    Sibley, Angus

    2016-01-01

    Catholic teaching is emphatic on the need to “guarantee adequate [health] care to all,” as Pope Benedict XVI has stated. America has been slower than other advanced countries in progressing towards this goal. Reasons for this delay can be found in certain attitudes that have long been present in American culture, and have been reinforced by the wave of libertarianism (free-market ideology) that swept the world in the late twentieth century. Catholic theology and social/economic teaching can help us understand the flaws in these attitudes, which involve fundamental philosophical and theological principles, but which are far from academic, since they have serious and very practical consequences. In the light of Catholic teaching, we can look towards a sounder understanding of healthcare needs and effective ways of meeting them. Lay Summary: This article argues that access to healthcare, at least up to the level of basic necessity, falls under the heading of distributive justice. It is a human right owed by the community to each of its citizens. And since rights entail obligations, this right entails an obligation upon each citizen to contribute, as circumstances permit, to the costs, which need to be shared equitably; they cannot be met simply by each individual providing solely for oneself. Also discussed are the problems of excessive costs in healthcare administration and in pharmacological research, as well as harmful tendencies in private-sector firms to over-reward top management and to target maximum (rather than adequate) profits. PMID:28392590

  14. Health disparities among health care workers.

    Science.gov (United States)

    Mawn, Barbara; Siqueira, Eduardo; Koren, Ainat; Slatin, Craig; Devereaux Melillo, Karen; Pearce, Carole; Hoff, Lee Ann

    2010-01-01

    In this article we describe the process of an interdisciplinary case study that examined the social contexts of occupational and general health disparities among health care workers in two sets of New England hospitals and nursing homes. A political economy of the work environment framework guided the study, which incorporated dimensions related to market dynamics, technology, and political and economic power. The purpose of this article is to relate the challenges encountered in occupational health care settings and how these could have impacted the study results. An innovative data collection matrix that guided small-group analysis provided a firm foundation from which to make design modifications to address these challenges. Implications for policy and research include the use of a political and economic framework from which to frame future studies, and the need to maintain rigor while allowing flexibility in design to adapt to challenges in the field.

  15. FastStats: Home Health Care

    Science.gov (United States)

    ... this? Submit What's this? Submit Button NCHS Home Home Health Care Recommend on Facebook Tweet Share Compartir Data are ... National Study of Long-Term Care Providers Nursing Home Care Residential Care Communities Centers for Medicare and Medicaid ...

  16. Costs of health care across primary care models in Ontario.

    Science.gov (United States)

    Laberge, Maude; Wodchis, Walter P; Barnsley, Jan; Laporte, Audrey

    2017-08-01

    The purpose of this study is to analyze the relationship between newly introduced primary care models in Ontario, Canada, and patients' primary care and total health care costs. A specific focus is on the payment mechanisms for primary care physicians, i.e. fee-for-service (FFS), enhanced-FFS, and blended capitation, and whether providers practiced as part of a multidisciplinary team. Utilization data for a one year period was measured using administrative databases for a 10% sample selected at random from the Ontario adult population. Primary care and total health care costs were calculated at the individual level and included costs from physician services, hospital visits and admissions, long term care, drugs, home care, lab tests, and visits to non-medical health care providers. Generalized linear model regressions were conducted to assess the differences in costs between primary care models. Patients not enrolled with a primary care physicians were younger, more likely to be males and of lower socio-economic status. Patients in blended capitation models were healthier and wealthier than FFS and enhanced-FFS patients. Primary care and total health care costs were significantly different across Ontario primary care models. Using the traditional FFS as the reference, we found that patients in the enhanced-FFS models had the lowest total health care costs, and also the lowest primary care costs. Patients in the blended capitation models had higher primary care costs but lower total health care costs. Patients that were in multidisciplinary teams (FHT), where physicians are also paid on a blended capitation basis, had higher total health care costs than non-FHT patients but still lower than the FFS reference group. Primary care and total health care costs increased with patients' age, morbidity, and lower income quintile across all primary care payment types. The new primary care models were associated with lower total health care costs for patients compared to the

  17. Perceptions of Recidivism Among Incarcerated Youth: The Relationship Between Exposure to Childhood Trauma, Mental Health Status, and the Protective Effect of Mental Health Services in Juvenile Justice Settings

    Directory of Open Access Journals (Sweden)

    Jamie R. Yoder

    2017-09-01

    Full Text Available Research suggests that youth involved the juvenile justice system have trauma histories that are two times higher than the general youth population. Juvenile justice-involved youth also have high rates of mental health symptoms. Fewer studies have examined how trauma links to mental health symptoms among youth offenders, and even less research focuses on how mental health status and service delivery can impact their perceived likelihood for success. This study examines the effects of mental health screening and service delivery on perceived future criminal justice interactions— arrest and incarceration—among adjudicated youth (n=7,073 housed in correctional facilities. Secondary data were used to examine trauma histories, mental health needs, and mental health screening and service delivery. Significant relationships between traumatic events and mental health problems were found, along with relationships between mental health problems and mental health screening and service delivery. Most interestingly, results pointed to the strong inverse relationship between mental health service delivery and youth’s perceived likelihood for recidivism. These findings show the promise of juvenile justice systems appropriately responding to the mental health concerns of youth.

  18. Child Welfare and Juvenile Justice: Several Factors Influence the Placement of Children Solely To Obtain Mental Health Services.

    Science.gov (United States)

    General Accounting Office, Washington, DC.

    Recent reports have documented how some parents choose to place their children in the child welfare or juvenile justice systems in order to obtain the mental health services that their children need. Senators Susan Collins and Joseph Lieberman of the Senate Committee on Governmental Affairs asked the General Accounting Office (GAO) to testify on:…

  19. Girls With Mental Health Needs in the Juvenile Justice System: Challenges and Inequities Confronting a Vulnerable Population

    Science.gov (United States)

    Quinn, Mary Magee; Poirier, Jeffrey M.; Garfinkel, Lili

    2005-01-01

    Recent trends show noticeable increases in the involvement of girls in the juvenile justice system. A disproportionately high number of these girls have co-occurring mental health diagnoses that are related in part to their victimization through sexual, physical, and emotional abuse. Many girls also come from unstable families, whereas others are…

  20. Judicialization of health and contributions of the Norman Daniels’ Theory of Justice

    Directory of Open Access Journals (Sweden)

    MACHADO, Teresa Robichez

    2015-07-01

    Full Text Available The judicialization of health generates debate in various areas of knowledge, with particular contri-butions from legal experts, doctors, and policymakers. Because of the diversity of those involved, several topics are considered. Some studies highlight positive arguments for the judicialization of health, whereas others defend the need for establishing criteria for or limitations to judicial action. Furthermore, others still report concerns over the possible negative consequences of this process. In order to offer an analysis on this topic, this study provides a review of the literature and adopts the theoretical instrument by Norman Daniels, who proposes a reflection on the needs for health and the ways in which these needs can be met, the moral importance of health and the inequalities in health to be an injustice. In conclusion, it can be affirmed that some of these studies defended in the Brazilian national debate cannot be sustained in light of the data presented herein. Throughout Norman Daniels’ thoughts on the Theory of Justice in terms of questions of health, it can be deduced that, in the Brazilian debate, there are few conflicts over the moral importance of the topic; in addition, not much is known about the second aspect of the theory, which is the reflection when inequality in health can be considered unjust. It is therefore proposed that Daniels’ theory adds two important points to the national debate. The first involves the need to place health problems within a greater reflection in public policy. The second, which involves the need to establish limits to meeting health demands, fits into a public policy that seeks to better meet the needs of the population, which is not a simple cost-benefit assessment.

  1. Islamic Cultures: Health Care Beliefs and Practices.

    Science.gov (United States)

    Kemp, Charles

    1996-01-01

    Presents an overview of Islamic health care beliefs and practices, noting health-related social and spiritual issues, fundamental beliefs and themes in Islam, health care beliefs and practices common among Muslims, and health-affecting social roles among Muslims. Cultural, religious, and social barriers to health care and ways to reduce them are…

  2. Harm reduction through a social justice lens.

    Science.gov (United States)

    Pauly, Bernadette

    2008-02-01

    People who are street involved such as those experiencing homelessness and drug use face multiple inequities in health and access to health care. Morbidity and mortality are significantly increased among those who are street involved. Incorporation of a harm reduction philosophy in health care has the potential to shift the moral context of health care delivery and enhance access to health care services. However, harm reduction with a primary focus on reducing the harms of drug use fails focus on the harms associated with the context of drug use such as homelessness, violence and poverty. Ethical analysis of the underlying values of harm reduction and examination of different conceptions of justice are discussed as a basis for action that addresses a broad range of harms associated with drug use. Theories of distributive justice that focus primarily on the distribution of material goods are limited as theoretical frameworks for addressing the root causes of harm associated with drug use. Social justice, reconceptualised and interpreted through a critical lens as described by Iris Marion Young, is presented as a promising alternative ethical framework. A critical reinterpretation of social justice leads to insights that can illuminate structural inequities that contribute to the harms associated with the context of drug use. Such an approach provides promise as means of informing policy that aims to reduce a broad range of harms associated with drug use such as homelessness and poverty.

  3. The Chinese Health Care System

    DEFF Research Database (Denmark)

    Hougaard, Jens Leth; Østerdal, Lars Peter; Yu, Yi

    In the present paper we describe the structure of the Chinese health care system and sketch its future development. We analyse issues of provider incentives and the actual burden sharing between government, enterprises and people. We further aim to identify a number of current problems and link...

  4. Relationship marketing in health care.

    Science.gov (United States)

    Wagner, H C; Fleming, D; Mangold, W G; LaForge, R W

    1994-01-01

    Building relationships with patients is critical to the success of many health care organizations. The authors profile the relationship marketing program for a hospital's cardiac center and discuss the key strategic aspects that account for its success: a focus on a specific hospital service, an integrated marketing communication strategy, a specially designed database, and the continuous tracking of results.

  5. Reengineering health care materials management.

    Science.gov (United States)

    Connor, L R

    1998-01-01

    Health care executives across the country, faced with intense competition, are being forced to consider drastic cost cutting measures as a matter of survival. The entire health care industry is under siege from boards of directors, management and others who encourage health care systems to take actions ranging from strategic acquisitions and mergers to simple "downsizing" or "rightsizing," to improve their perceived competitive positions in terms of costs, revenues and market share. In some cases, management is poorly prepared to work within this new competitive paradigm and turns to consultants who promise that following their methodologies can result in competitive advantage. One favored methodology is reengineering. Frequently, cost cutting attention is focused on the materials management budget because it is relatively large and is viewed as being comprised mostly of controllable expenses. Also, materials management is seldom considered a core competency for the health care system and the organization performing these activities does not occupy a strongly defensible position. This paper focuses on the application of a reengineering methodology to healthcare materials management.

  6. Intercultural Health Care and Welfare

    DEFF Research Database (Denmark)

    Nielsen, Ben

    2014-01-01

    Artiklen har fokus på undervisning, planlægning, udvikling og evaluering af et internationalt tværfagligt valgfag Intercultural Health Care and Welfare, der udbydes på Det Sundhedsfaglige og Teknologiske Fakultet på Professionshøjskolen Metropol. Ifølge den tysk-amerikanske professor Iris Varner og...

  7. Health care insolvency and bankruptcy.

    Science.gov (United States)

    Handelsman, L; Speiser, M; Maltz, A; Kirpalani, S

    1998-08-01

    Bankruptcy is an event that is often considered a business' worst nightmare. Debt, lawyers, and the U.S. government can lead to the eventual destruction of a business. This article shows how declaring bankruptcy can be a helpful instrument in continuing a successful venture in the health care marketplace.

  8. Lower Costs, Better Care- Reforming Our Health Care Delivery

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Affordable Care Act includes tools to improve the quality of health care that can also lower costs for taxpayers and patients. This means avoiding costly...

  9. Social justice issues related to uneven distribution of resources.

    Science.gov (United States)

    Ervin, Naomi E; Bell, Sue Ellen

    2004-01-01

    This article examines the social justice issues resulting from the uneven distribution of resources. In this article, justice theories are discussed in relation to two of these issues: lack of adequate food and shelter and inequitable access to an appropriate continuum of health care. Public health nurses have the obligation to deal with the results of poverty and the uneven distribution of resources, which pose a threat to the common good in the United States and throughout the global community.

  10. Managed consumerism in health care.

    Science.gov (United States)

    Robinson, James C

    2005-01-01

    The future of market-oriented health policy and practice lies in "managed consumerism," a blend of the patient-centric focus of consumer-driven health care and the provider-centric focus of managed competition. The optimal locus of incentives will vary among health services according to the nature of the illness, the clinical technology, and the extent of discretion in utilization. A competitive market will manifest a variety of comprehensive and limited benefit designs, broad and narrow contractual networks, and single-and multispecialty provider organizations.

  11. Health care technology as a policy issue

    NARCIS (Netherlands)

    Banta, H.D.

    1994-01-01

    Health care technology has become an increasingly visible issue in many countries, primarily because of the rising costs of health care. In addition, many questions concerning quality of care are being raised. Health care technology assessment has been seen as an aid in addressing questions

  12. Improving eye care in the primary health care setting

    Directory of Open Access Journals (Sweden)

    M de Wet

    2000-09-01

    Full Text Available One of the challenges facing primary health care in South Africa is the delivery of quality eye care to all South Africans. In this regard the role of the primary health care worker, as the first point of contact, is crucial. This paper reports on the problems primary health care workers experience in providing quality eye care in Region B of the Free State. Problems identified by those involved in the study include the cumbersome referral system, the unavailability of appropriate medicine at clinics, the insufficient knowledge of primary health care workers regarding eye conditions and the lack of communication between the various eye care service providers. Suggestions to address the problems identified included more in-service training of primary health care workers regarding eye conditions, liaison with NGO’s providing eye care, decentralisation of services and the establishment of an eye care committee in the region.

  13. Oral Health Care Delivery Within the Accountable Care Organization.

    Science.gov (United States)

    Blue, Christine; Riggs, Sheila

    2016-06-01

    The accountable care organization (ACO) provides an opportunity to strategically design a comprehensive health system in which oral health works within primary care. A dental hygienist/therapist within the ACO represents value-based health care in action. Inspired by health care reform efforts in Minnesota, a vision of an accountable care organization that integrates oral health into primary health care was developed. Dental hygienists and dental therapists can help accelerate the integration of oral health into primary care, particularly in light of the compelling evidence confirming the cost-effectiveness of care delivered by an allied workforce. A dental insurance Chief Operating Officer and a dental hygiene educator used their unique perspectives and experience to describe the potential of an interdisciplinary team-based approach to individual and population health, including oral health, via an accountable care community. The principles of the patient-centered medical home and the vision for accountable care communities present a paradigm shift from a curative system of care to a prevention-based system that encompasses the behavioral, social, nutritional, economic, and environmental factors that impact health and well-being. Oral health measures embedded in the spectrum of general health care have the potential to ensure a truly comprehensive healthcare system. Published by Elsevier Inc.

  14. Epidemiological Criminology: Contextualization of HIV/AIDS Health Care for Female Inmates.

    Science.gov (United States)

    Lanier, Mark M; Zaitzow, Barbara H; Farrell, C Thomas

    2015-04-01

    Worldwide, women are increasingly being incarcerated. One unintended consequence is the increase in unhealthy female offenders. Among the more serious health concerns are HIV and AIDS. Challenges associated with caring for women with HIV/AIDS impacts not only disease management and infection control within correctional facilities but also the prisoners' home communities where they will need health care, drug and alcohol rehabilitation, housing assistance, and employment opportunities. No bridging theory has been presented that links prison and community health concerns with criminal justice policy. This article not only presents recommendations for effective HIV/AIDS policy but also suggests epidemiological criminology as a means of explicit merging of health with justice issues and consequently provides a bridging framework. © The Author(s) 2015.

  15. Financing the health care Internet.

    Science.gov (United States)

    Robinson, J C

    2000-01-01

    Internet-related health care firms have accelerated through the life cycle of capital finance and organizational destiny, including venture capital funding, public stock offerings, and consolidation, in the wake of heightened competition and earnings disappointments. Venture capital flooded into the e-health sector, rising from $3 million in the first quarter of 1998 to $335 million two years later. Twenty-six e-health firms went public in eighteen months, raising $1.53 billion at initial public offering (IPO) and with post-IPO share price appreciation greater than 100 percent for eighteen firms. The technology-sector crash hit the e-health sector especially hard, driving share prices down by more than 80 percent for twenty-one firms. The industry now faces an extended period of consolidation between e-health and conventional firms.

  16. The case of Scott Ortiz: a clash between criminal justice and public health

    Directory of Open Access Journals (Sweden)

    Tobia Maria S

    2006-07-01

    Full Text Available Abstract The criminal justice system creates particular challenges for persons with HIV and Hepatitis C, many of whom have a history of injection drug use. The case of Scott Ortiz, taken from public trial and sentencing transcripts, reveals the manner in which incarceration may delay learning of important health problems such as Hepatitis C infection. In addition, the case of Mr. Ortiz suggests the bias in sentencing that a former injection drug user may face. Collaboration between the Montefiore Medical Center residency in Social Medicine and a Bronx legal services agency, Bronx Defenders, yielded the discovery that a decade after diagnosis with HIV and after long term incarceration, Mr. Ortiz was infected with Hepatitis C. Mr. Ortiz only became aware of his advanced Hepatitis C and liver damage during his trial. The second important aspect of this case centers on the justification for lengthy sentence for a burglary conviction. The presiding Judge in Mr. Ortiz's case acknowledged that because of his advanced illness, Mr. Ortiz posed no threat to society as a burglar (the crime for which he was convicted. But the Judge elected to use his discretion to sentence Mr. Ortiz to a term of 15 years to life (as opposed to a minimum of two to four years based on the idea that the public health would be served by preventing Mr. Ortiz from returning to the life of a street addict, sharing dirty needles with others. Mr. Ortiz reports distant injection drug use, no evidence of current or recent drug use was presented during Mr. Ortiz's trial and he reports no injection drug use for over a decade. In this case, bias against a former injection drug user, masquerading as concern for public health, is used to justify a lengthier sentence. Mr. Ortiz's lack of awareness of his Hepatitis C infection despite long term incarceration, combined with the justification for his dramatically increased sentence, provide examples of how persons within the criminal justice

  17. Economic Justice: Necessary Condition for Human Rights.

    Science.gov (United States)

    Cloud, Fred

    1993-01-01

    Economic justice means taking the personhood of poor people into account; respecting their needs, personal ambitions, rights, and dignity; and affording equal opportunity and equal access to education, health care, housing, and jobs. Examples of injustice to minority groups are provided, citing the Universal Declaration of Human Rights. (SLD)

  18. The Impact of Health Insurance on Health Care Provision in ...

    African Journals Online (AJOL)

    This study assesses the impact of the NHIS scheme in promoting access to health care. It identifies a need for all stakeholders to engage in the active promotion of awareness on health insurance as option of health care provisioning. It argues that health insurance can make health care more accessible to a wider segment ...

  19. Attending Unintended Transformations of Health Care Infrastructure

    DEFF Research Database (Denmark)

    Wentzer, Helle; Bygholm, Ann

    2007-01-01

    Introduction: Western health care is under pressure from growing demands on quality and efficiency. The development and implementation of information technology, IT is a key mean of health care authorities to improve on health care infrastructure. Theory and methods: Against a background of theor......Introduction: Western health care is under pressure from growing demands on quality and efficiency. The development and implementation of information technology, IT is a key mean of health care authorities to improve on health care infrastructure. Theory and methods: Against a background...

  20. What is the health care product?

    Science.gov (United States)

    France, K R; Grover, R

    1992-06-01

    Because of the current competitive environment, health care providers (hospitals, HMOs, physicians, and others) are constantly searching for better products and better means for delivering them. The health care product is often loosely defined as a service. The authors develop a more precise definition of the health care product, product line, and product mix. A bundle-of-elements concept is presented for the health care product. These conceptualizations help to address how health care providers can segment their market and position, promote, and price their products. Though the authors focus on hospitals, the concepts and procedures developed are applicable to other health care organizations.

  1. Transitional Justice

    DEFF Research Database (Denmark)

    Gissel, Line Engbo

    This presentation builds on an earlier published article, 'Contemporary Transitional Justice: Normalising a Politics of Exception'. It argues that the field of transitional justice has undergone a shift in conceptualisation and hence practice. Transitional justice is presently understood to be th...... to be the provision of ordinary criminal justice in contexts of exceptional political transition.......This presentation builds on an earlier published article, 'Contemporary Transitional Justice: Normalising a Politics of Exception'. It argues that the field of transitional justice has undergone a shift in conceptualisation and hence practice. Transitional justice is presently understood...

  2. [Increased financial risks for health insurers: a challenge for providers of mental health care in the Netherlands].

    Science.gov (United States)

    Daansen, P J; van Schilt, J

    2014-01-01

    As from 2014 Dutch health insurance companies will bear the full financial risk for their clients in mental health care. Over the next years the existing risk settlement shared between insurance companies will gradually be brought to a close. Municipalities and the Ministry of Justice are already responsible for or will soon become responsible for financing health care for adolescents, patients with severe psychiatric disorders and forensic psychiatric patients. As a result, the health insurance companies are beginning to impose ever stricter conditions regarding the care 'product' they are 'buying'. To study the possible consequences, for mental health care institutions, of the increased risk to be borne by health care insurers. Use was made of relevant marketing literature and literature relating to mental health care. Studies of Dutch mental health care literature indicate that in the future the purchasing procedure will no longer consider the immediate treatment outcome as the sole performance indicator but will also take into account additional factors such as long-term improvements in patients' health, customer satisfaction and degree of patient participation, patient empowerment and autonomy. In formulating the details of their health products and business strategies, health care providers will now have to take into account not only the efficacy of the treatment they provide but also the purchasing policy and strategy of the health insurance companies.

  3. Justicia y racionamiento sanitario en el Plan AUGE: dilemas bioéticos asociados a la distribución de recursos escasos Justiça e fundamentação sanitária no Plano AUGE: dilemas bioéticos associados à distribuição de recursos escassos Justice and health care rationing in AUGE: bioethical dilemmas associated to the distribution of scarce resources

    Directory of Open Access Journals (Sweden)

    Alejandra Zúñiga Fajuri

    2011-06-01

    Full Text Available Los criterios de racionamiento en materia sanitaria establecidos por el Plan AUGE en Chile, se fundan principalmente en máximas de eficiencia que son contrarias a los principios de equidad que debieran sustentar las políticas sanitarias de las sociedades democráticas. Para la aplicación y justificación de las técnicas de racionamiento sanitario se requiere no sólo una reflexión desde la ciencia médica y la economía de la salud, sino que también desde la filosofía moral y la bioética. El estudio de las teorías de la justicia distributiva sanitaria permite valorar críticamente los criterios de racionamiento sanitarios utilizados por las Guías Clínicas de cada una de las patologías GES/AUGE que resultan contrarios al principio de equidad.Os critérios de fundamentação em matéria sanitária estabelecidos pelo Plano AUGE, no Chile, se fundam, principalmente, em máximas de eficiência que são contrárias aos princípios de equidade que deveriam sustentar as políticas sanitárias ds sociedades democráticas. Para a aplicação e justificação das técnicas de racionamento sanitário se requer não só uma reflexão a partir da ciência médica e da economia da saúde, mas, também, a partir da filosofia moral e da bioética. O estudo das teorias da justiça distributiva sanitária permite valorar criticamente os critérios de racionamento sanitário utilizados pelas Guias Clínicas de cada uma das patologias GES/AUGE que resultam contrários ao princípio da equidade.Rationing criteria in health care establish by AUGE, in Chile, are based, mainly, in maximum efficiency, contrary to the equity principle, which should sustain health care policies in democratic societies. For the application and justification of health care rationing techniques is required not only a medical science and health care economy reflection, but a moral philosophy and bioethical reflection as well. The study of health care distributive justice theories

  4. Mandatory influenza immunization for health care workers--an ethical discussion.

    Science.gov (United States)

    Steckel, Cynthia M

    2007-01-01

    Influenza is a serious vaccine-preventable disease affecting 20% of the U.S. population each year. Vaccination of high-risk groups has been called the single most important influenza control measure by the Centers for Disease Control and Prevention. Studies show that vaccination can lead to decreases in flu-related illness and absenteeism among health care workers, as well as fewer acute care outbreaks and reduced patient mortality in long-term care settings. However, to date, voluntary programs have achieved only a 40% vaccination rate among health care workers, causing concern among government and infectious disease organizations. This article addresses the ethical justification for mandating influenza vaccination for health care workers. Health care workers' attitudes toward vaccination are presented, as well as historical and legal perspectives on compulsory measures. The ethical principles of effectiveness, beneficence, necessity, autonomy, justice, and transparency are discussed.

  5. Internet in Continuous Health Care

    Czech Academy of Sciences Publication Activity Database

    Zvárová, Jana; Hanzlíček, Petr

    2005-01-01

    Roč. 13, č. 5 (2005), s. 451-452 ISSN 0928-7329. [MedNet 2005. World Congress on the Internet in Medicine /10./. 04.12.2005-07.12.2005, Prague] R&D Projects: GA AV ČR 1ET200300413 Institutional research plan: CEZ:AV0Z10300504 Keywords : Internet * health care * technology Subject RIV: BD - Theory of Information

  6. Reflexive Research Ethics for Environmental Health and Justice: Academics and Movement-Building

    Science.gov (United States)

    Cordner, Alissa; Ciplet, David; Brown, Phil; Morello-Frosch, Rachel

    2012-01-01

    Community-engaged research on environmental problems has reshaped researcher-participant relationships, academic-community interaction, and the role of community partners in human subjects protection and ethical oversight. We draw on our own and others’ research collaborations with environmental health and justice social movement organizations to discuss the ethical concerns that emerge in community-engaged research. In this paper we introduce the concept of reflexive research ethics: ethical guidelines and decision-making principles that depend on continual reflexivity concerning the relationships between researchers and participants. Seeing ethics in this way can help scientists conduct research that simultaneously achieves a high level of professional conduct and protects the rights, well-being, and autonomy of both researchers and the multiple publics affected by research. We highlight our research with community-based organizations in Massachusetts, California, and Alaska, and discuss the potential impacts of the community or social movement on the research process and the potential impacts of research on community or social movement goals. We conclude by discussing ways in which the ethical concerns that surface in community-engaged research have led to advances in ethical research practices. This type of work raises ethical questions whose answers are broadly relevant for social movement, environmental, and public health scholars. PMID:22690133

  7. Oncology in primary health care

    International Nuclear Information System (INIS)

    Mendoza del Pino, Mario Valentín

    2009-01-01

    The book O ncology in the primary health care , constitutes an important contribution to the prevention and treatment of cancer, from a very comprehensive assessment. It's a disease that is the second leading cause of death in our country, to much pain and suffering is for the patient and their family. The book has a very useful for basic health equipment approach, since it emphasizes that cancer can be prevented if achieved in the population changes in lifestyle. The book is valued not correct food as responsible for one third of all cancers. Currently important research being developed in relation to psiconeuroinmuno-Endocrinology, who is studying the association between psychological factors and the development of cancer valuing that kept stress and depression reduces the antitumor activity of the immune system; that made programs with encouraging results where the treatment of cancer has joined elements of psychotherapy, immunotherapy and the use of the biotherapy. The focus of the book fills an important place in the primary health care and is an indispensable guide for professionals at this level of care (author)

  8. Allocating health care: cost-utility analysis, informed democratic decision making, or the veil of ignorance?

    Science.gov (United States)

    Goold, S D

    1996-01-01

    Assuming that rationing health care is unavoidable, and that it requires moral reasoning, how should we allocate limited health care resources? This question is difficult because our pluralistic, liberal society has no consensus on a conception of distributive justice. In this article I focus on an alternative: Who shall decide how to ration health care, and how shall this be done to respect autonomy, pluralism, liberalism, and fairness? I explore three processes for making rationing decisions: cost-utility analysis, informed democratic decision making, and applications of the veil of ignorance. I evaluate these processes as examples of procedural justice, assuming that there is no outcome considered the most just. I use consent as a criterion to judge competing processes so that rationing decisions are, to some extent, self-imposed. I also examine the processes' feasibility in our current health care system. Cost-utility analysis does not meet criteria for actual or presumed consent, even if costs and health-related utility could be measured perfectly. Existing structures of government cannot creditably assimilate the information required for sound rationing decisions, and grassroots efforts are not representative. Applications of the veil of ignorance are more useful for identifying principles relevant to health care rationing than for making concrete rationing decisions. I outline a process of decision making, specifically for health care, that relies on substantive, selected representation, respects pluralism, liberalism, and deliberative democracy, and could be implemented at the community or organizational level.

  9. Empowering women and health care.

    Science.gov (United States)

    Shiva, M

    1993-02-01

    Women health workers have made great contributions to the health of their community for many years. In India, women physicians have established some hospitals, e.g., Christian Medical Colleges in Ludhiana and Vellore. Some such hospitals operate in remote areas to serve the poor and the suffering. Women health workers of Jamkhed, Deen Bandhu of Pachod, have proved that village women can improve the health status of their community, particularly that of women and children, if they receive encouragement to learn health care skills In India, community health care lies mainly with women (e.g., nursing personnel and in rural areas). Yet, despite their competence and experience, few become physicians, health project directors, and administrators because the society continues to be patriarchal and discriminates against females. Women need to become empowered to ensure equal opportunities for training and promotion and equal wages for equal work. In Bangladesh, use of bicycles to visit houses allows women paramedical workers from Gonasasthya Kendra, Sawar, freedom and imparts confidence. People must identify customs, practices, laws, attitudes, religious misrepresentations, and policies that discriminate against women and then oppose them. They should set these changes in motion at home, in villages, and from district to national, and even global levels. In India, society blames the mother for having a girl, but the man donates the chromosome determining sex. In Gandhigram, a woman physician and her peers have effected an apparent change in attitude toward the birth of a girl. Now the people confer equal happiness to her birth as they do to a boy's birth. Yet, female infanticides still occur in some villages of Salem District of Tamil Nadu. Sex determination tests often lead to abortion of female fetuses. Once a woman marries she has no right to her maternal home and often suffers from domestic violence. Many people resist legislation to grant women more rights, e

  10. Community health clinical education in Canada: part 2--developing competencies to address social justice, equity, and the social determinants of health.

    Science.gov (United States)

    Cohen, Benita E; Gregory, David

    2009-01-01

    Recently, several Canadian professional nursing associations have highlighted the expectations that community health nurses (CHNs) should address the social determinants of health and promote social justice and equity. These developments have important implications for (pre-licensure) CHN clinical education. This article reports the findings of a qualitative descriptive study that explored how baccalaureate nursing programs in Canada address the development of competencies related to social justice, equity, and the social determinants of health in their community health clinical courses. Focus group interviews were held with community health clinical course leaders in selected Canadian baccalaureate nursing programs. The findings foster understanding of key enablers and challenges when providing students with clinical opportunities to develop the CHN role related to social injustice, inequity, and the social determinants of health. The findings may also have implications for nursing programs internationally that are addressing these concepts in their community health clinical courses.

  11. An Integrative Behavioral Health Care Model Using Automated SBIRT and Care Coordination in Community Health Care.

    Science.gov (United States)

    Dwinnells, Ronald; Misik, Lauren

    2017-10-01

    Efficient and effective integration of behavioral health programs in a community health care practice emphasizes patient-centered medical home principles to improve quality of care. A prospective, 3-period, interrupted time series study was used to explore which of 3 different integrative behavioral health care screening and management processes were the most efficient and effective in prompting behavioral health screening, identification, interventions, and referrals in a community health practice. A total of 99.5% ( P < .001) of medical patients completed behavioral health screenings; brief intervention rates nearly doubled to 83% ( P < .001) and 100% ( P < .001) of identified at-risk patients had referrals made using a combination of electronic tablets, electronic medical record, and behavioral health care coordination.

  12. Consumer Attitudes toward Health and Health Care: A Differential Perspective.

    Science.gov (United States)

    Gould, Stephen J.

    1988-01-01

    Questionnaires returned by 343 out of 350 subjects measured health attitudes and health status. Results suggest that some consumers take a more scientific approach to health care and prevention. Demographic factors, health status, and health consciousness are partial predictors of consumer attitudes and approach to health care. (SK)

  13. Managed care: employers' influence on the health care system.

    Science.gov (United States)

    Corder, K T; Phoon, J; Barter, M

    1996-01-01

    Health care reform is a complex issue involving many key sectors including providers, consumers, insurers, employers, and the government. System changes must involve all sectors for reform to be effective. Each sector has a responsibility to understand not only its own role in the health care system, but the roles of others as well. The role of business employers is often not apparent to health care providers, especially nurses. Understanding the influence employers have on the health care system is vital if providers want to be proactive change agents ensuring quality care.

  14. How to achieve care coordination inside health care organizations

    DEFF Research Database (Denmark)

    Prætorius, Thim; C. Becker, Markus

    2015-01-01

    Understanding how health care organizations can achieve care coordination internally is essential because it is difficult to achieve, but essential for high quality and efficient health care delivery. This article offers an answer by providing a synthesis of knowledge about coordination from...

  15. Teamwork or interdepartmental cooperation: which is more important in the health care setting?

    Science.gov (United States)

    Carson, K D; Carson, P P; Yallapragada, R; Roe, C W

    2001-06-01

    A survey of 75 nursing department employees was conducted to assess the relative importance of across-department and within-team cooperation on workplace outcomes. As compared with within-team cooperation, across-department cooperation is more positively associated with procedural justice, interpersonal justice, satisfaction with supervisor feedback, supervisory rating, job satisfaction, and organizational commitment. Across-department cooperation is more negatively associated with role ambiguity, role conflict, role overload, job tension, and job withdrawal intentions. No significant correlational differences are noted for either distributive justice or politics. Type of cooperation also was analyzed using hierarchical regression, and more variance was explained in across-department cooperation than within-team cooperation by organizational variables. Based on these results, it may be more important for the health care manager to attend to issues of interdepartmental cooperation rather than to internal team dynamics.

  16. Technology in health care logistics

    DEFF Research Database (Denmark)

    Jørgensen, Pelle; Wallin, Michael

    In most of the developed countries hospitals are facing a major challenge – they have to provide more health care using the same resources. Due to the demographic trend and the increasing share of the population being in a more health-demanding age, the hospitals will have to deal with more...... patients in the future. It is therefore essential that the hospitals are more efficient in order to meet the requirement of providing more health for the same or less resources. Studies have shown that more than 30% of hospital expenditures are related to various logistics cost, making the logistics...... papers presented at scientific conferences, and three articles submitted to scientific journals. In addition to the results, the thesis presents a detailed description of the scientific approach taken, as well as considerations in relation to the scientific approach and the achieved results....

  17. [Equity in health? Health inequalities, ethics, and theories of distributive justice].

    Science.gov (United States)

    Buyx, A M

    2010-01-01

    It is well-documented that the socio-economic status has an important influence on health. In all developed countries, health is closely correlated with income, education, and type of employment, as well as with several other social determinants. While data on this socio-economic health gradient have been available for decades, the moral questions surrounding social health inequalities have only recently been addressed within the field of public health ethics. The present article offers a brief overview of relevant data on social health inequalities and on some explanatory models from epidemiology, social medicine and related disciplines. The main part explores three influential normative accounts addressing the issue of health inequalities. Finally, an agenda for future work in the field of public health ethics and health inequalities is sketched, with particular attention to the German context.

  18. Teaching Health Care in Introductory Economics

    Science.gov (United States)

    Cutler, David M.

    2017-01-01

    Health care is one of the economy's biggest industries, so it is natural that the health care industry should play some role in the teaching of introductory economics. There are many ways that health care can appear in such a context: in the teaching of microeconomics, as a macroeconomic issue, to learn about social welfare, and even to learn how…

  19. Women's health care: from whom and why?

    NARCIS (Netherlands)

    Brink-Muinen, A. van den

    1997-01-01

    Differences are investigated between female practice populations of female general practitioners providing women's health care and of women and men general practitioners providing regular health care. Women's health care in the Netherlands is provided in the general practice "Aletta" and is based

  20. Rationalising health care in india : Challenges & strategies

    Directory of Open Access Journals (Sweden)

    K I Mathai

    2014-01-01

    Full Text Available An overview of health care delivery in India is essential, if we are to plan and to improve health care delivery and the indices of health in the coming decades. The health sector in India is a mix of private and government services. While some health care indices appear dismal, several others, including life expectancy are heartening. A balance between regulation and free enterprise is possibly the best option. In this paper we provide a glimpse of health and health related statistics & a n overview of the public health care delivery systems. In the end, we offer suggestion on rationalisation of health care delivery to provide maximum services for the majority of our population within the budget of an optimal health care system outlay

  1. Child Welfare, Juvenile Justice, Mental Health, and Education Providers' Conceptualizations of Trauma-Informed Practice.

    Science.gov (United States)

    Donisch, Katelyn; Bray, Chris; Gewirtz, Abigail

    2016-05-01

    This study systematically examined child-service providers' conceptualizations of trauma-informed practice (TIP) across service systems, including child welfare, juvenile justice, mental health, and education. Eleven focus groups and nine individual interviews were conducted, totaling 126 child-service providers. Conventional content analysis was used to analyze the qualitative data with interrater reliability analyses indicating near perfect agreement between coders. Qualitative analysis revealed that child-service providers identified traumatic stress as an important common theme among children and families served as well as the interest in TIP in their service systems. At the same time, child-service providers generally felt knowledgeable about what they define TIP to be, although they articulated wide variations in the degree to which they are taught skills and strategies to respond to their traumatized clients. The results of this study suggest a need for a common lexicon and metric with which to advance TIP within and across child-service systems. © The Author(s) 2016.

  2. Remote Health Care Provision in Care Homes.

    Science.gov (United States)

    Newbould, Louise; Mountain, Gail; Hawley, Mark; Ariss, Steve

    2017-01-01

    A survey was developed to map provision, knowledge, attitudes and views towards videoconferencing in care homes in Yorkshire and The Humber. The survey was sent to 859 care homes, with a 14% response rate. Twelve homes reported using videoconferencing. Non-users appeared skeptical, managers using the system reported improvements in outcomes.

  3. Let's put "care" back into health care.

    Science.gov (United States)

    Wesolowski, C E

    1990-01-01

    Organizations that clearly demonstrate they care about their people reap the benefits of a positive self-image, higher productivity and financial gains. Consider the effects that a demoralized, unappreciated staff have on productivity, recruitment and retention, public relations, marketing, customer satisfaction and the resulting financial repercussions. Can we afford not to care?

  4. Climate Justice in Rural Southeastern United States: A Review of Climate Change Impacts and Effects on Human Health

    OpenAIRE

    Gutierrez, Kristie S.; LePrevost, Catherine E.

    2016-01-01

    Climate justice is a local, national, and global movement to protect at-risk populations who are disproportionately affected by climate change. The social context for this review is the Southeastern region of the United States, which is particularly susceptible to climate change because of the geography of the area and the vulnerabilities of the inhabiting populations. Negative human health effects on variable and vulnerable populations within the Southeast region due to changing climate are ...

  5. Work motivation in health care: a scoping literature review.

    Science.gov (United States)

    Perreira, Tyrone A; Innis, Jennifer; Berta, Whitney

    2016-12-01

    The aim of this scoping literature review was to examine and summarize the factors, context, and processes that influence work motivation of health care workers. A scoping literature review was done to answer the question: What is known from the existing empirical literature about factors, context, and processes that influence work motivation of health care workers? This scoping review used the Arksey and O'Malley framework to describe and summarize findings. Inclusion and exclusion criteria were developed to screen studies. Relevant studies published between January 2005 and May 2016 were identified using five electronic databases. Study abstracts were screened for eligibility by two reviewers. Following this screening process, full-text articles were reviewed to determine the eligibility of the studies. Eligible studies were then evaluated by coding findings with descriptive labels to distinguish elements that appeared pertinent to this review. Coding was used to form groups, and these groups led to the development of themes. Twenty-five studies met the eligibility criteria for this literature review. The themes identified were work performance, organizational justice, pay, status, personal characteristics, work relationships (including bullying), autonomy, organizational identification, training, and meaningfulness of work. Most of the research involved the use of surveys. There is a need for more qualitative research and for the use of case studies to examine work motivation in health care organizations. All of the studies were cross-sectional. Longitudinal research would provide insight into how work motivation changes, and how it can be influenced and shaped. Several implications for practice were identified. There is a need to ensure that health care workers have access to training opportunities, and that autonomy is optimized. To improve work motivation, there is a need to address bullying and hostile behaviours in the workplace. Addressing the factors that

  6. Gender-based violence against female sex workers in Cameroon: prevalence and associations with sexual HIV risk and access to health services and justice.

    Science.gov (United States)

    Decker, Michele R; Lyons, Carrie; Billong, Serge Clotaire; Njindam, Iliassou Mfochive; Grosso, Ashley; Nunez, Gnilane Turpin; Tumasang, Florence; LeBreton, Matthew; Tamoufe, Ubald; Baral, Stefan

    2016-12-01

    Female sex workers (FSWs) are at risk for HIV and physical and sexual gender-based violence (GBV). We describe the prevalence of lifetime GBV and its associations with HIV risk behaviour, access to health services and barriers in accessing justice among FSWs in Cameroon. FSWs (n=1817) were recruited for a cross-sectional study through snowball sampling in seven cities in Cameroon. We examined associations of lifetime GBV with key outcomes via adjusted logistic regression models. Overall, 60% (1098/1817) had experienced physical or sexual violence in their lifetime. GBV was associated with inconsistent condom use with clients (adjusted OR (AOR) 1.49, 95% CI 1.18 to 1.87), being offered more money for condomless sex (AOR 2.09, 95% CI 1.56 to 2.79), having had a condom slip or break (AOR 1.53, 95% CI 1.25 to 1.87) and difficulty suggesting condoms with non-paying partners (AOR 1.47, 95% CI 1.16 to 1.87). Violence was also associated with fear of health services (AOR 2.25, 95% CI 1.61 to 3.16) and mistreatment in a health centre (AOR 1.66, 95% CI 1.01 to 2.73). Access to justice was constrained for FSWs with a GBV history, specifically feeling that police did not protect them (AOR 1.41, 95% CI 1.12 to 1.78). Among FSWs in Cameroon, violence is prevalent and undermines HIV prevention and access to healthcare and justice. Violence is highly relevant to FSWs' ability to successfully negotiate condom use and engage in healthcare. In this setting of criminalised sex work, an integrated, multisectoral GBV-HIV strategy that attends to structural risk is needed to enhance safety, HIV prevention and access to care and justice. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  7. Social Determinants of Health in Environmental Justice Communities: Examining Cumulative Risk in Terms of Environmental Exposures and Social Determinants of Health

    OpenAIRE

    Prochaska, John D.; Nolen, Alexandra B.; Kelley, Hilton; Sexton, Ken; Linder, Stephen H.; Sullivan, John

    2014-01-01

    Residents of environmental justice (EJ) communities may bear a disproportionate burden of environmental health risk, and often face additional burdens from social determinants of health. Accounting for cumulative risk should include measures of risk from both environmental sources and social determinants. This study sought to better understand cumulative health risk from both social and environmental sources in a disadvantaged community in Texas. Key outcomes were determining what data are cu...

  8. Inequities in health and healthcare viewed through the ethical lens of critical social justice: contextual knowledge for the global priorities ahead.

    Science.gov (United States)

    Anderson, Joan M; Rodney, Patricia; Reimer-Kirkham, Sheryl; Browne, Annette J; Khan, Koushambhi Basu; Lynam, M Judith

    2009-01-01

    The authors use the backdrop of the Healthy People 2010 initiative to contribute to a discussion encompassing social justice from local to national to global contexts. Drawing on findings from their programs of research, they explore the concept of critical social justice as a powerful ethical lens through which to view inequities in health and in healthcare access. They examine the kind of knowledge needed to move toward the ideal of social justice and point to strategies for engaging in dialogue about knowledge and actions to promote more equitable health and healthcare from local to global levels.

  9. Key Considerations in Providing a Free Appropriate Public Education for Youth with Disabilities in Juvenile Justice Secure Care Facilities. Issue Brief

    Science.gov (United States)

    Gagnon, Joseph C.; Read, Nicholas W.; Gonsoulin, Simon

    2015-01-01

    Access to high-quality education for youth is critical to their long-term success as adults. Youth in juvenile justice secure care facilities, however, too often do not have access to the high-quality education and related supports and services that they need, particularly youth with disabilities residing in such facilities. This brief discusses…

  10. Hospitals and health care establishments

    International Nuclear Information System (INIS)

    1999-01-01

    These guidelines have been drown up to assist all those involved in the management and maintenance of hospitals and health care establishments. Compliance with this guidance should minimise the risk of pollution occurring. The guidelines are jointly produced by the Environment Agency for England and Wales, the Scottish Environment Protection Agency and the Environment and Heritage Service for Northern Ireland, referred to as the Agency or Agencies. It includes guidelines on site drainage, sewage and waste water disposal, treatment of surface water drainage and waste management

  11. Integrating human health into environmental impact assessment: an unrealized opportunity for environmental health and justice.

    Science.gov (United States)

    Bhatia, Rajiv; Wernham, Aaron

    2008-08-01

    The National Environmental Policy Act and related state laws require many public agencies to analyze and disclose potentially significant environmental effects of agency actions, including effects on human health. In this paper we review the purpose and procedures of environmental impact assessment (EIA), existing regulatory requirements for health effects analysis, and potential barriers to and opportunities for improving integration of human health concerns within the EIA process. We use statutes, regulations, guidelines, court opinions, and empirical research on EIA along with recent case examples of integrated health impact assessment (HIA)/EIA at both the state and federal level. We extract lessons and recommendations for integrated HIA/EIA practice from both existing practices as well as case studies. The case studies demonstrate the adequacy, scope, and power of existing statutory requirements for health analysis within EIA. The following support the success of integrated HIA/EIA: a proponent recognizing EIA as an available regulatory strategy for public health; the openness of the agency conducting the EIA; involvement of public health institutions; and complementary objectives among community stakeholders and health practitioners. We recommend greater collaboration among institutions responsible for EIA, public health institutions, and affected stakeholders along with guidance, resources, and training for integrated HIA/EIA practice.

  12. Solidarity, justice, and recognition of the other.

    Science.gov (United States)

    Ter Meulen, Ruud

    2016-12-01

    Solidarity has for a long time been referred to as the core value underpinning European health and welfare systems. But there has been debate in recent years about whether solidarity, with its alleged communitarian content, can be reconciled with the emphasis on individual freedom and personal autonomy. One may wonder whether there is still a place for solidarity, and whether the concept of justice should be embraced to analyse the moral issues regarding access to health care. In this article, I will answer this question by analysing the normative foundations of the concept of justice, followed by a deeper examination of the concept of solidarity in continental philosophy. More specifically, I will compare the philosophical traditions rooted in Kant (with emphasis on autonomy and individual rights) to approaches rooted in Hegel (with emphasis on individual relations of recognition). In addition, I will present the work of Avishai Margalit on the decent society to criticize a predominantly liberal approach to access to health care. The importance of solidarity lies particularly in its emphasis on relational aspects and the role of recognition in care practices, which are usually ignored in liberal approaches to justice. However, the article will argue that solidarity is not an alternative to a rights-based concept of justice, but must be considered as a necessary complement to it.

  13. Managing Cancer Care - Finding Health Care Services

    Science.gov (United States)

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

  14. Integrated occupational health care at sea

    DEFF Research Database (Denmark)

    Jensen, Olaf Chresten

    2011-01-01

    exposures during life at sea and work place health promotion. SEAHEALTH and some of the shipping companies have already added workplace health promotion to occupational health care programs. The purpose of this article is to reinforce this trend by adding some international perspectives and by providing......Workplace Health Promotion is the combined efforts of employers, employees and society to improve the health and well-being of people at work. Integrated maritime health care can be defined as the total maritime health care function that includes the prevention of health risks from harmful...

  15. Environmental justice and health practices: understanding how health inequities arise at the local level.

    Science.gov (United States)

    Frohlich, Katherine L; Abel, Thomas

    2014-02-01

    While empirical evidence continues to show that people living in low socio-economic status neighbourhoods are less likely to engage in health-enhancing behaviour, our understanding of why this is so remains less than clear. We suggest that two changes could take place to move from description to understanding in this field; (i) a move away from the established concept of individual health behaviour to a contextualised understanding of health practices; and (ii) a switch from focusing on health inequalities in outcomes to health inequities in conditions. We apply Pierre Bourdieu's theory on capital interaction but find it insufficient with regard to the role of agency for structural change. We therefore introduce Amartya Sen's capability approach as a useful link between capital interaction theory and action to reduce social inequities in health-related practices. Sen's capability theory also elucidates the importance of discussing unequal chances in terms of inequity, rather than inequality, in order to underscore the moral nature of inequalities. We draw on the discussion in social geography on environmental injustice, which also underscores the moral nature of the spatial distribution of opportunities. The article ends by applying this approach to the 'Interdisciplinary study of inequalities in smoking' framework. © 2013 The Authors. Sociology of Health & Illness © 2013 Foundation for the Sociology of Health & Illness/John Wiley & Sons Ltd.

  16. Controversies in faith and health care.

    Science.gov (United States)

    Tomkins, Andrew; Duff, Jean; Fitzgibbon, Atallah; Karam, Azza; Mills, Edward J; Munnings, Keith; Smith, Sally; Seshadri, Shreelata Rao; Steinberg, Avraham; Vitillo, Robert; Yugi, Philemon

    2015-10-31

    Differences in religious faith-based viewpoints (controversies) on the sanctity of human life, acceptable behaviour, health-care technologies and health-care services contribute to the widespread variations in health care worldwide. Faith-linked controversies include family planning, child protection (especially child marriage, female genital mutilation, and immunisation), stigma and harm reduction, violence against women, sexual and reproductive health and HIV, gender, end-of-life issues, and faith activities including prayer. Buddhism, Christianity, Hinduism, Islam, Judaism, and traditional beliefs have similarities and differences in their viewpoints. Improved understanding by health-care providers of the heterogeneity of viewpoints, both within and between faiths, and their effect on health care is important for clinical medicine, public-health programmes, and health-care policy. Increased appreciation in faith leaders of the effect of their teachings on health care is also crucial. This Series paper outlines some faith-related controversies, describes how they influence health-care provision and uptake, and identifies opportunities for research and increased interaction between faith leaders and health-care providers to improve health care. Copyright © 2015 Elsevier Ltd. All rights reserved.

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

    African Journals Online (AJOL)

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

  18. Access to justice: evaluating law, health and human rights programmes in Kenya.

    Science.gov (United States)

    Gruskin, Sofia; Safreed-Harmon, Kelly; Ezer, Tamar; Gathumbi, Anne; Cohen, Jonathan; Kameri-Mbote, Patricia

    2013-11-13

    In Kenya, human rights violations have a marked impact on the health of people living with HIV. Integrating legal literacy and legal services into healthcare appears to be an effective strategy to empower vulnerable groups and address underlying determinants of health. We carried out an evaluation to collect evidence about the impact of legal empowerment programmes on health and human rights. The evaluation focused on Open Society Foundation-supported legal integration activities at four sites: the Academic Model of Providing Access to Healthcare (AMPATH) facility, where the Legal Aid Centre of Eldoret (LACE) operates, in Eldoret; Kenyatta National Hospital's Gender-based Violence Recovery Centre, which hosts the COVAW legal integration program; and Christian Health Association of Kenya (CHAK) facilities in Mombasa and Naivasha. In consultation with the organizations implementing the programs, we designed a conceptual logic model grounded in human rights principles, identified relevant indicators and then coded structure, process and outcome indicators for the rights-related principles they reflect. The evaluation included a resource assessment questionnaire, a review of program records and routine data, and semi-structured interviews and focus group discussions with clients and service providers. Data were collected in May-August 2010 and April-June 2011. Clients showed a notable increase in practical knowledge and awareness about how to access legal aid and claim their rights, as well as an enhanced ability to communicate with healthcare providers and to improve their access to healthcare and justice. In turn, providers became more adept at identifying human rights violations and other legal difficulties, which enabled them to give clients basic information about their rights, refer them to legal aid and assist them in accessing needed support. Methodological challenges in evaluating such activities point to the need to strengthen rights-oriented evaluation

  19. [Restorative Justice: Neither care nor repression? The case study of Louis, a multi-recidivist, neither "dangerous" nor "sick"].

    Science.gov (United States)

    Dieu, E; Vandevoorde, J; Hirschelmann, A

    2017-05-01

    acts presented similarities marked by auto-punitive tendencies. For example, he remained on site until being arrested and joked with the police. The case Louis revealed what neither the care nor repression succeeded to reach, namely the quality of the relationship which can in itself confine or on the contrary repair. Relational Justice, by seeking neither to "suppress" nor to "care", allows the participants to reconstruct and understand the other with empathy, and strengthened the protective factors. Mediation as a method or purpose held a prominent place in the reconstruction process of the participants as it allowed us to act on both the "frame" (scenario of the problem-situation) and the "drama" ((non)-effectiveness of cognitive strategies and experienced emotions) of the original problem-situation. So the restorative program was an alternative to the socio-judicial measures inducing potential therapeutic effects on the future path of the participant. If the question of the relevance of direct, or perhaps better indirect, confrontations between the author and the victim still remains the (psycho-)criminological diagnosis of the penal couple's - author and victim - relationship investigates the psychosocial and delinquent process in terms of motivation. A satisfaction survey at the end of the program helps to analyse the future prospects of the participants. Based on dynamic and structured methods, the PARIS relational Justice program offers a Third Way between care and punishment: restoration of existential and relational links. Copyright © 2016 L’Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.

  20. The Obama health care plan: what it means for mental health care of older adults.

    Science.gov (United States)

    Sorrell, Jeanne M

    2009-01-01

    Health care was an important issue for both the Obama and McCain election campaigns. Now that Barack Obama is poised to serve as the 44th President of the United States, many health care providers are focused on what Obama's administration will mean for new health care initiatives. This article focuses specifically on aspects of the Obama and Biden health care plan that affects mental health care for older adults.

  1. Delegation within municipal health care.

    Science.gov (United States)

    Bystedt, Maria; Eriksson, Maria; Wilde-Larsson, Bodil

    2011-05-01

    To describe how registered nurses (RNs) perceive delegation to unlicensed personnel (UP) in a municipal healthcare context in Sweden. Within municipal health care RNs often delegate tasks to UP. The latter have practical training, but lack formal competence. Twelve RNs were interviewed and the material was analysed using a phenomenographic approach. Owing to a shortage of RNs, delegation is seen as a prerequisite for a functioning organization. This necessity also involves a number of perceived contradictions in three areas: (1) the work situation of RNs - facilitation and relief vs. lack of control, powerlessness, vagueness regarding responsibility, and resignation; (2) the relationship with unlicensed personnel - stimulation, possibility for mentoring, use of UP competence and the creation of fairness vs. questioning UP competence; and (3) The patients - increase in continuity, quicker treatment, and increased security vs. insecurity (with respect to, for example, the handling of medicine). Registered nurses perceptions of delegation within municipal healthcare involve their own work situation, the UP and the patients. Registered nurses who delegate to UP must be given time for mentoring such that the nursing care is safe care of high quality. © 2011 The Authors. Journal compilation © 2011 Blackwell Publishing Ltd.

  2. Health Care Information System (HCIS) Data File

    Data.gov (United States)

    U.S. Department of Health & Human Services — The data was derived from the Health Care Information System (HCIS), which contains Medicare Part A (Inpatient, Skilled Nursing Facility, Home Health Agency (Part A...

  3. Reforming health care in Hungary.

    Science.gov (United States)

    Császi, L; Kullberg, P

    1985-01-01

    Over the past two decades Hungary has initiated a series of social and economic reforms which have emphasized decentralization of control and the reintroduction of market mechanisms into the socialized economy. These reforms both reflect and reinforce a changing social structure, in particular the growing influence of upper class special interest groups. Market reforms are an expression of concurrent ideological shifts in Hungarian society. We examined the political significance of three recent proposals to reform health services against the backdrop of broader social and economic changes taking place. The first proposes a bureaucratic reorganization, the second, patient co-payments, and the third, a voucher system. The problems each proposal identifies, as well as the constituency each represents, reveal a trend toward consolidation of class structure in Hungary. Only one of these proposals has any potential to democratize the control and management of the heath care system. Moreover, despite a governmental push toward decentralization, two of these proposals would actually increase centralized bureaucratic control. Two of the reforms incorporate market logic into their arguments, an indication that the philosophical premises of capitalism are re-emerging as an important component of the Hungarian world-view. In Hungary, as well as in other countries, social analysis of proposed health care reforms can effectively illuminate the social and political dynamics of the larger society.

  4. [Teletransmission, health care and deontology].

    Science.gov (United States)

    Lousson, J P

    1995-01-01

    EDI is the technique the most frequently used by Chemists to relay their daily orders to their suppliers. Three out of four Chemists in France are computerised using various forms of computer hardware and software. The Health Care organisations propose that Chemists use the EDI to relay to the CETELIC all the items of information concerning their invoicing. This means handing over administrative information identifying the patient, the doctor ... as well as financial and confidential data such as the CIP code of the prescribed and delivered medicine. The law of the 4th January 1993 was instigated to control the rising expenses of the Health Care organisations and it mandates the Caisse Primaire d'Assurance Maladie (the French social security organisations) to retrieve and analyse the information thus gathered from all of the medical professionals involved. However, the accumulation of all these items of computerised information constitutes in effect a confidential medical file on each patient. This raises the following issues: Who does this confidential data belong to? Who should the Chemists give it to? What is to be done with it? Who will be responsible for its analysis in respect of the confidentiality problem? (Another medical professional bound by oath?) And how can we insure against subsequent abuse of this material?

  5. Latex allergy in health care

    Directory of Open Access Journals (Sweden)

    Tina Virtič

    2012-11-01

    Full Text Available The increasing use of natural rubber latex medical gloves in the last three decades has caused an increase in latex allergy. The majority of risk groups for allergy development include health care workers, workers in the rubber industry, atopic individuals and children with congenital malformations. Three types of pathological reactions can occur in people using latex medical gloves: irritant contact dermatitis, allergic contact dermatitis and immediate hypersensitivity. The latex allergy is caused by constituent components of latex gloves and added powders; there are also numerous latex allergens involved in cross-reactivity between latex and fruits and vegetables, the so-called latex-fruit syndrome. The diagnosis is based on an accurate history of exposure, clinical presentation and confirmatory in vivo and in vitro tests. Prevention is the easiest, most effective and least expensive way to avoid latex allergy. Powder-free latex gloves with reduced levels of proteins and chemicals, and synthetic gloves for allergic workers must be provided in the work environment. There are already many health care institutions around the world where all latex products have been replaced by synthetic material products.

  6. Collaborative HIV care in primary health care: nurses' views.

    Science.gov (United States)

    Ngunyulu, R N; Peu, M D; Mulaudzi, F M; Mataboge, M L S; Phiri, S S

    2017-12-01

    Collaborative HIV care between the nurses and traditional health practitioners is an important strategy to improve health care of people living with HIV. To explore and describe the views of nurses regarding collaborative HIV care in primary healthcare services in the City of Tshwane, South Africa. A qualitative, descriptive design was used to explore and describe the views of nurses who met the study's inclusion criteria. In-depth individual interviews were conducted to collect data from purposively selected nurses. Content analysis was used to analyse data. Two main categories were developed during the data analysis stage. The views of nurses and health system challenges regarding collaborative HIV care. The study findings revealed that there was inadequate collaborative HIV care between the nurses and the traditional health practitioners. It is evident that there is inadequate policy implementation, monitoring and evaluation regarding collaboration in HIV care. The study findings might influence policymakers to consider the importance of collaborative HIV care, and improve the quality of care by strengthening the referral system and follow-up of people living with HIV and AIDS, as a result the health outcomes as implied in the Sustainable Development Goals 2030 might be improved. Training and involvement of traditional health practitioners in the nursing and health policy should be considered to enhance and build a trustworthy working relationship between the nurses and the traditional health practitioners in HIV care. © 2017 International Council of Nurses.

  7. A change of direction in the Dutch health care system?

    Science.gov (United States)

    Lapré, R M

    1988-08-01

    The Dutch health care system seems to be undergoing a clear change of direction. The publication of the Report of the Committee of the Structure and Financing of the Health Care System is a prominent document which marks the emergence of a new trend. After an analysis of the characteristics of the Dutch health care system in the periods 1960-1975 and 1975-1985, an account is given of the most important proposals of the committee. The proposals clearly alter the trend towards more governmental involvement. They envisage a more market-oriented approach and freedom of operation while at the same time paying attention to aspects such as solidarity and social justice. The Committee's suggestions include the introduction of a basic insurance scheme for every citizen with a coverage determined by law, and in addition a voluntary supplementary insurance scheme in which the insured can decide what coverage he requires and that the insurer is obliged to accept him. The fact that there is a certain amount of agreement, at least over the direction that the strategy for change should take, justifies the expectation that many of the committee's proposals will be implemented.

  8. Home Health Care: Services and Cost

    Science.gov (United States)

    Widmer, Geraldine; And Others

    1978-01-01

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

  9. Incentives of Health Care Expenditure

    Directory of Open Access Journals (Sweden)

    Eero Siljander

    2012-12-01

    Full Text Available The incentives of health care expenditure (HCE have been a topic of discussion in the USA (Obama reforms and in Europe (adjustment to debt crisis. There are competing views of institutional versus GDP (unit income elasticity and productivity related factors of growth of expenditure. However ageing of populations, technology change and economic incentives related to institutions are also key drivers of growth according to the OECD and EU’s AWG committee. Simulation models have been developed to forecast the growth of social expenditure (including HCEs to 2050. In this article we take a historical perspective to look at the institutional structures and their relationship to HCE growth. When controlling for age structure, price developments, doctor density and in-patient and public shares of expenditures, we find that fee-for-service in primary care, is according to the results, in at least 20 percent more costly than capitation or salary remuneration. Capitation and salary (or wage remuneration are at same cost levels in primary care. However we did not find the cost lowering effect for gatekeeping which could have been expected based on previous literature. Global budgeting 30 (partly DRG based percent less costly in specialized care than other reimbursement schemes like open contracting or volume based reimbursement. However the public integration of purchaser and provider cost seems to result to about 20 higher than public reimbursement or public contracting. Increasing the number of doctors or public financing share results in increased HCEs. Therefore expanding public reimbursement share of health services seems to lead to higher HCE. On the contrary, the in-patient share reduced expenditures. Compared to the previous literature, the finding on institutional dummies is in line with similar modeling papers. However the results for public expansion of services is a contrary one to previous works on the subject. The median lag length of

  10. Using appreciative inquiry to transform health care.

    Science.gov (United States)

    Trajkovski, Suza; Schmied, Virginia; Vickers, Margaret; Jackson, Debra

    2013-08-01

    Amid tremendous changes in contemporary health care stimulated by shifts in social, economic and political environments, health care managers are challenged to provide new structures and processes to continually improve health service delivery. The general public and the media are becoming less tolerant of poor levels of health care, and health care professionals need to be involved and supported to bring about positive change in health care. Appreciative inquiry (AI) is a philosophy and method for promoting transformational change, shifting from a traditional problem-based orientation to a more strength-based approach to change, that focuses on affirmation, appreciation and positive dialog. This paper discusses how an innovative participatory approach such as AI may be used to promote workforce engagement and organizational learning, and facilitate positive organizational change in a health care context.

  11. Dual Loyalty in Prison Health Care

    Science.gov (United States)

    Stöver, Heino; Wolff, Hans

    2012-01-01

    Despite the dissemination of principles of medical ethics in prisons, formulated and advocated by numerous international organizations, health care professionals in prisons all over the world continue to infringe these principles because of perceived or real dual loyalty to patients and prison authorities. Health care professionals and nonmedical prison staff need greater awareness of and training in medical ethics and prisoner human rights. All parties should accept integration of prison health services with public health services. Health care workers in prison should act exclusively as caregivers, and medical tasks required by the prosecution, court, or security system should be carried out by medical professionals not involved in the care of prisoners. PMID:22390510

  12. Integrated primary health care in Australia

    Directory of Open Access Journals (Sweden)

    Gawaine Powell Davies

    2009-10-01

    Full Text Available Introduction: To fulfil its role of coordinating health care, primary health care needs to be well integrated, internally and with other health and related services. In Australia, primary health care services are divided between public and private sectors, are responsible to different levels of government and work under a variety of funding arrangements, with no overarching policy to provide a common frame of reference for their activities. Description of policy: Over the past decade, coordination of service provision has been improved by changes to the funding of private medical and allied health services for chronic conditions, by the development in some states of voluntary networks of services and by local initiatives, although these have had little impact on coordination of planning. Integrated primary health care centres are being established nationally and in some states, but these are too recent for their impact to be assessed. Reforms being considered by the federal government include bringing primary health care under one level of government with a national primary health care policy, establishing regional organisations to coordinate health planning, trialling voluntary registration of patients with general practices and reforming funding systems. If adopted, these could greatly improve integration within primary health care. Discussion: Careful change management and realistic expectations will be needed. Also other challenges remain, in particular the need for developing a more population and community oriented primary health care.

  13. Integrated primary health care in Australia.

    Science.gov (United States)

    Davies, Gawaine Powell; Perkins, David; McDonald, Julie; Williams, Anna

    2009-10-14

    To fulfil its role of coordinating health care, primary health care needs to be well integrated, internally and with other health and related services. In Australia, primary health care services are divided between public and private sectors, are responsible to different levels of government and work under a variety of funding arrangements, with no overarching policy to provide a common frame of reference for their activities. Over the past decade, coordination of service provision has been improved by changes to the funding of private medical and allied health services for chronic conditions, by the development in some states of voluntary networks of services and by local initiatives, although these have had little impact on coordination of planning. Integrated primary health care centres are being established nationally and in some states, but these are too recent for their impact to be assessed. Reforms being considered by the federal government include bringing primary health care under one level of government with a national primary health care policy, establishing regional organisations to coordinate health planning, trialling voluntary registration of patients with general practices and reforming funding systems. If adopted, these could greatly improve integration within primary health care. Careful change management and realistic expectations will be needed. Also other challenges remain, in particular the need for developing a more population and community oriented primary health care.

  14. Health care of youth aging out of foster care.

    Science.gov (United States)

    2012-12-01

    Youth transitioning out of foster care face significant medical and mental health care needs. Unfortunately, these youth rarely receive the services they need because of lack of health insurance. Through many policies and programs, the federal government has taken steps to support older youth in foster care and those aging out. The Fostering Connections to Success and Increasing Adoptions Act of 2008 (Pub L No. 110-354) requires states to work with youth to develop a transition plan that addresses issues such as health insurance. In addition, beginning in 2014, the Patient Protection and Affordable Care Act of 2010 (Pub L No. 111-148) makes youth aging out of foster care eligible for Medicaid coverage until age 26 years, regardless of income. Pediatricians can support youth aging out of foster care by working collaboratively with the child welfare agency in their state to ensure that the ongoing health needs of transitioning youth are met.

  15. Personal vis-a-vis social responsibility for disparities in health status: An issue of justice.

    Science.gov (United States)

    Jha, Ayan; Dobe, Madhumita

    2016-01-01

    Health inequities are disparities which can be avoided through rational actions on the part of policymakers. Such inequalities are unnecessary and unjust and may exist between and within nations, societies, and population groups. Social determinants such as wealth, income, occupation, education, gender, and racial/ethnic groups are the principal drivers of this inequality since they determine the health risks and preventive behaviors, access to, and affordability of health care. Within this framework, there is a debate on assigning a personal responsibility factor over and above societal responsibility to issues of ill health. One school of philosophy argues that when individuals are worse-off than others for no fault of their own, it is unjust, as opposed to health disparities that arise due to avoidable personal choices such as smoking and drug addiction for which there should (can) be a personal responsibility. Opposing thoughts have pointed out that the relative socioeconomic position of an individual dictates how his/her life may progress from education to working conditions and aging, susceptibility to diseases and infirmity, and the consequences thereof. The existence of a social gradient in health outcomes across populations throughout the world is a testimony to this truth. It has been emphasized that assuming personal responsibility for health in public policy-making can only have a peripheral place. Instead, the concept of individual responsibility should be promoted as a positive concept of enabling people to gain control over the determinants of health through conscious, informed, and healthy choices.

  16. Health systems as defences against the consequences of poverty: equity in health as social justice.

    Science.gov (United States)

    Mburu, F M

    1983-01-01

    The main development problems in the Third World are known to be gross socioeconomic inequality, widespread poor health status accompanied by high fertility and infant mortality rates, low life expectancy, mass illiteracy and mass poverty. In most of these countries governments invest a great deal of scarce resources toward the consequences of poverty rather than it causes. The paucity of resources for such social services is exacerbated by continuously increasing demands and needs which have to be satisfied. Unmet needs tend to cause apathy in the population. For purposes of controlling poverty and its consequences, these must be clearly formulated and relevant policies, a commitment to implement such policies, adequate administrative capacity and reasonably adequate resources. In the case of the health services system, the same requirements apply. Above all, the health system has to be directed toward the greatest needs of the population. This must involve policy makers, implementors and the consumer community. This paper argues that health systems cannot be an effective weapon against the consequences of poverty unless the above kinds of policy exist and are implemented.

  17. Understanding the failure of health-care exceptionalism in the Supreme Court's Obamacare decision.

    Science.gov (United States)

    Moncrieff, Abigail R

    2012-09-01

    On June 28, 2012, a mere century after the first presidential proposal for national health insurance, the Supreme Court issued a resounding victory for President Obama and for health-care reform generally, upholding the Patient Protection and Affordable Care Act against a serious constitutional challenge. Nevertheless, the Court also struck a potential blow to future health-care reform efforts in refusing to accept the solicitor general's argument that health care is a unique market with unique regulatory needs that justify special constitutional treatment. The failure of health-care exceptionalism in the Court's opinion might render future reform efforts more difficult than they would have been if the solicitor general's argument had carried the day. This commentary seeks to shed light on the Court's hesitation to recognize the uniqueness of health insurance and health care, noting that market-based exceptionalism in constitutional law has a long, dark history that the Court was understandably loath to repeat. Although the result of Chief Justice John Roberts' one-size-fits-all approach to constitutional analysis in this case is an odd holding that elides some genuine uniqueness of American health care, the alternative of health-care exceptionalism might have been much worse for our overall constitutional system.

  18. Distributed leadership in health care

    DEFF Research Database (Denmark)

    Günzel-Jensen, Franziska; Jain, Ajay K.; Kjeldsen, Anne Mette

    2018-01-01

    Management and health care literature is increasingly preoccupied with leadership as a collective social process, and related leadership concepts such as distributed leadership have therefore recently gained momentum. This paper investigates how formal, i.e. transformational, transactional...... and empowering, leadership styles affect employees’ perceived agency in distributed leadership, and whether these associations are mediated by employees’ perceived organizational efficacy. Based on large-scale survey data from a study at one of Scandinavia’s largest public hospitals (N = 1,147), our results show...... that all leadership styles had a significant positive impact on employees’ perceived agency in distributed leadership. Further, organizational efficacy related negatively to employees’ perceived agency in distributed leadership; however a mediatory impact of this on the formal leadership styles...

  19. Medical and health care sector

    International Nuclear Information System (INIS)

    Ainul Hayati Daud; Hazmimi Kasim

    2010-01-01

    The medical and health care sector in general supplies products and provides services that can be categorized as diagnostic radiology, therapeutic application and nuclear medicine (both, diagnostic and/ or therapeutic). The institutions offer different categories of services. Some provide only one category of service, for example, diagnostic radiology. Others may provide more than one categories, for example, diagnostic nuclear medicine and therapeutic nuclear medicine services. A total of 90 entities comprising 65 public agencies and 34 private companies were selected in this study for this sector. The majority of the entities, 75.6 %, operate in Peninsular Malaysia. The remainders operate in Sabah and Sarawak. The findings of the study on both public agencies and private companies are presented in subsequent sections of this chapter. (author)

  20. Managing Home Health Care (For Parents)

    Science.gov (United States)

    ... this topic for: Parents Kids Teens Palliative Care Electronic Health Records When Your Child's in the Pediatric Intensive Care ... Us Contact Us Partners Editorial Policy Permissions Guidelines Privacy Policy & Terms of Use Notice of Nondiscrimination Visit ...

  1. 8 ways to cut health care costs

    Science.gov (United States)

    ... care include strep throat, bladder infection, or a dog bite. You will save both time and money ... health services. www.healthcare.gov/coverage/preventive-care-benefits . Accessed October 18, 2016. U.S. Preventive Services Taskforce ...

  2. The Phelophepa Health Care Train: a pharmacoepidemiological ...

    African Journals Online (AJOL)

    2009-11-19

    Nov 19, 2009 ... Background: The Phelophepa Health Care Train is the only primary healthcare train in the world. Phelophepa is an ... history of caring.3. The Phelophepa .... Skin conditions were, according to the pharmacists, common in the ...

  3. Targeting health visitor care: lessons from Starting Well.

    Science.gov (United States)

    Wright, C M; Jeffrey, S K; Ross, M K; Wallis, L; Wood, R

    2009-01-01

    UK child health promotion guidelines expect health visitors to assess family needs before new babies are aged 4 months and offer targeted care on that basis thereafter. Data from an intensive family support programme were used to assess how accurately family needs can be predicted at this stage. A population based cohort of 1202 families with new babies receiving an intensive health visiting programme. Analysis of routinely recorded data. Starting Well project, Glasgow, UK. Health visitor rating of family needs. Families receiving high visiting rates or referred to social work services. Of 302 families rated high need, only 143 (47%) were identified by age 4 months. Visiting rates in the first year for those initially rated high need were nearly double those for the remainder, but around two thirds of those with high contact rates/referred to social work were not initially rated high need. Six family characteristics (no income, baby born preterm, multiple pregnancy, South Asian, prior social work/criminal justice involvement, either parent in care as a child) were identified as the commonest/strongest predictors of contact rates; 1003 (83%) families had one such characteristics and/or lived in a highly deprived area, including 228 (93%) of those with high contact rates and 157 (96%) of those referred to social work. Most families at risk will not be identified on an individual basis in the early weeks. Most families in deprived areas need continued input if the most vulnerable families are to be reliably identified.

  4. Effect of Health Care Professionals' Continuing Education ...

    African Journals Online (AJOL)

    Purpose: To evaluate the impact of educational intervention by health care providers on clinical outcomes in type 2 diabetes patients in a Yemeni health facility. Methods: A prospective, one-group and pre- and post-test design to assess the effects of health care providers' education on clinical patient outcomes was ...

  5. Health Care Access among Deaf People

    Science.gov (United States)

    Kuenburg, Alexa; Fellinger, Paul; Fellinger, Johannes

    2016-01-01

    Access to health care without barriers is a clearly defined right of people with disabilities as stated by the UN Convention on the Rights of People with Disabilities. The present study reviews literature from 2000 to 2015 on access to health care for deaf people and reveals significant challenges in communication with health providers and gaps in…

  6. Predictors of Adolescent Health Care Utilization

    Science.gov (United States)

    Vingilis, Evelyn; Wade, Terrance; Seeley, Jane

    2007-01-01

    This study, using Andersen's health care utilization model, examined how predisposing characteristics, enabling resources, need, personal health practices, and psychological factors influence health care utilization using a nationally representative, longitudinal sample of Canadian adolescents. Second, this study examined whether this process…

  7. Competition in the Dutch Health Care Sector

    NARCIS (Netherlands)

    F.T. Schut (Erik)

    1995-01-01

    textabstractFor more than two decades, Dutch health policy has been marked by a search for a suitable market order in health care. Suitable in the sense of maintaining universal access, containing the growth of health care expenditure and improving the technical and allocative efficiency of

  8. Health care: economic impact of caring for geriatric patients.

    Science.gov (United States)

    Rich, Preston B; Adams, Sasha D

    2015-02-01

    National health care expenditures constitute a continuously expanding component of the US economy. Health care resources are distributed unequally among the population, and geriatric patients are disproportionately represented. Characterizing this group of individuals that accounts for the largest percentage of US health spending may facilitate the introduction of targeted interventions in key high-impact areas. Changing demographics, an increasing incidence of chronic disease and progressive disability, rapid technological advances, and systemic market failures in the health care sector combine to drive cost. A multidisciplinary approach will become increasingly necessary to balance the delicate relationship between our constrained supply and increasing demand. Copyright © 2015 Elsevier Inc. All rights reserved.

  9. Costs of health care across primary care models in Ontario

    OpenAIRE

    Laberge, Maude; Wodchis, Walter P; Barnsley, Jan; Laporte, Audrey

    2017-01-01

    Background The purpose of this study is to analyze the relationship between newly introduced primary care models in Ontario, Canada, and patients? primary care and total health care costs. A specific focus is on the payment mechanisms for primary care physicians, i.e. fee-for-service (FFS), enhanced-FFS, and blended capitation, and whether providers practiced as part of a multidisciplinary team. Methods Utilization data for a one year period was measured using administrative databases for a 1...

  10. Discrimination against older women in health care.

    Science.gov (United States)

    Belgrave, L L

    1993-01-01

    Growing awareness of apparent gaps in health care received by women and men raises concern over possible discrimination. This literature review examines this issue for elderly women, whose health care is obtained in a system that also may be permeated with age discrimination. Physicians tend to spend more time with women and older patients, suggesting that discrimination may not be an issue in the physician-patient relationship or may work in favor of older women. However, this may simply reflect elderly women's poorer health. Gender and age disparities in medical treatments received provide a more compelling argument that the health care system is a source of discrimination against older women, who are less likely than others to receive available treatments for cardiac, renal, and other conditions. The history of medical treatment of menopause suggests that stereotypes of older women have been advantageous for segments of the health care system. Finally, in addition to discrimination that has its source within the health care system itself, societal-wide inequities, particularly economic, are extremely detrimental to older women's health care. As we respond to the health care crisis, we must be alert to the potential to rectify those structures and tendencies that can lead to discrimination against women and the aged. Health care reform presents a unique opportunity to ensure health care equity.

  11. Understanding a Value Chain in Health Care.

    Science.gov (United States)

    Sharan, Alok D; Schroeder, Gregory D; West, Michael E; Vaccaro, Alexander R

    2015-10-01

    As the US health care system transitions toward a value-based system, providers and health care organizations will have to closely scrutinize their current processes of care. To do this, a value chain analysis can be performed to ensure that only the most efficient steps are followed in patient care. Ultimately this will produce a higher quality or equal quality product for less cost by eliminating wasteful steps along the way.

  12. Depressive Disorders in Primary Health Care

    OpenAIRE

    Vuorilehto, Maria

    2008-01-01

    The Vantaa Primary Care Depression Study (PC-VDS) is a naturalistic and prospective cohort study concerning primary care patients with depressive disorders. It forms a collaborative research project between the Department of Mental and Alcohol Research of the National Public Health Institute, and the Primary Health Care Organization of the City of Vantaa. The aim is to obtain a comprehensive view on clinically significant depression in primary care, and to compare depressive patients in prima...

  13. Health incentive research and social justice: does the risk of long term harms to systematically disadvantaged groups bear consideration?

    Science.gov (United States)

    Wild, Verina; Pratt, Bridget

    2017-03-01

    The ethics of health incentive research-a form of public health research-are not well developed, and concerns of justice have been least examined. In this paper, we explore what potential long term harms in relation to justice may occur as a result of such research and whether they should be considered as part of its ethical evaluation. 'Long term harms' are defined as harms that contribute to existing systematic patterns of disadvantage for groups. Their effects are experienced on a long term basis, persisting even once an incentive research project ends. We will first establish that three categories of such harms potentially arise as a result of health incentive interventions. We then argue that the risk of these harms also constitutes a morally relevant consideration for health incentive research and suggest who may be responsible for assessing and mitigating these risks. We propose that responsibility should be assigned on the basis of who initiates health incentive research projects. Finally, we briefly describe possible strategies to prevent or mitigate the risk of long term harms to members of disadvantaged groups, which can be employed during the design, conduct and dissemination of research projects. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  14. Health care and equity in India.

    Science.gov (United States)

    Balarajan, Y; Selvaraj, S; Subramanian, S V

    2011-02-05

    In India, despite improvements in access to health care, inequalities are related to socioeconomic status, geography, and gender, and are compounded by high out-of-pocket expenditures, with more than three-quarters of the increasing financial burden of health care being met by households. Health-care expenditures exacerbate poverty, with about 39 million additional people falling into poverty every year as a result of such expenditures. We identify key challenges for the achievement of equity in service provision, and equity in financing and financial risk protection in India. These challenges include an imbalance in resource allocation, inadequate physical access to high-quality health services and human resources for health, high out-of-pocket health expenditures, inflation in health spending, and behavioural factors that affect the demand for appropriate health care. Use of equity metrics in monitoring, assessment, and strategic planning; investment in development of a rigorous knowledge base of health-systems research; development of a refined equity-focused process of deliberative decision making in health reform; and redefinition of the specific responsibilities and accountabilities of key actors are needed to try to achieve equity in health care in India. The implementation of these principles with strengthened public health and primary-care services will help to ensure a more equitable health care for India's population. Copyright © 2011 Elsevier Ltd. All rights reserved.

  15. Roles and responsibilities of health care professionals in combating environmental degradation and social injustice: education and activism.

    Science.gov (United States)

    Donohoe, Martin

    2008-01-01

    This article describes the causes and health consequences of environmental degradation and social injustice. These issues, which impact primarily on the poor and underserved (both in the United States and internationally) are rarely or inadequately covered in the curriculums of traditional health care professions. The discussion offers ways for health care professionals to promote equality and justice and uses the example of Rudolph Virchow's social activism to illustrate how one physician can lead society toward major public health gains. There is also an examination of the roles of institutions and organisations in enhancing environmental preservation and promoting social justice. Specific curricular suggestions from history and the humanities are offered for those teaching and mentoring new health professionals.

  16. Attending unintended transformations of health care infrastructure

    Directory of Open Access Journals (Sweden)

    Helle Wentzer

    2007-11-01

    Full Text Available Introduction: Western health care is under pressure from growing demands on quality and efficiency. The development and implementation of information technology, IT is a key mean of health care authorities to improve on health care infrastructure. Theory and methods: Against a background of theories on human-computer interaction and IT-mediated communication, different empirical studies of IT implementation in health care are analyzed. The outcome is an analytical discernment between different relations of communication and levels of interaction with IT in health care infrastructure. These relations and levels are synthesized into a framework for identifying tensions and potential problems in the mediation of health care with the IT system. These problems are also known as unexpected adverse consequences, UACs, from IT implementation into clinical health care practices. Results: This paper develops a conceptual framework for addressing transformations of communication and workflow in health care as a result of implementing IT. Conclusion and discussion: The purpose of the conceptual framework is to support the attention to and continuous screening for errors and unintended consequences of IT implementation into health care practices and outcomes.

  17. Celiac Disease Testing (for Health Care Professionals)

    Science.gov (United States)

    ... Series Urinary Tract Imaging Urodynamic Testing Virtual Colonoscopy Celiac Disease Testing (for Health Care Professionals) Serologic tests for celiac disease provide an effective first step in identifying candidates ...

  18. Cross-cultural barriers to health care.

    Science.gov (United States)

    Vidaeff, Alex C; Kerrigan, Anthony J; Monga, Manju

    2015-01-01

    Culturally sensitive health care represents a real ethical and practical need in a Western healthcare system increasingly serving a multiethnic society. This review focuses on cross-cultural barriers to health care and incongruent aspects from a cultural perspective in the provision of health care. To overcome difficulties in culturally dissimilar interactions and eventually remove cross-cultural barriers to health care, a culturally sensitive physician considers his or her own identity, values, and beliefs; recognizes the similarities and differences among cultures; understands what those similarities and differences mean; and is able to bridge the differences to accomplish clear and effective communication.

  19. Care of children with disabilities in Primary Health Care

    Directory of Open Access Journals (Sweden)

    Thaís Giudice Schultz

    2016-07-01

    Full Text Available Objective: This article describes an experience report that aimed to present perceptions on the care of children with disabilities in the Family Health Strategy (FHS, showing its limits and potentials based on the experience of participation in the program ‘PET-Saúde’. Method: Data were collected from field notes which recorded the monitoring of the care process offered to children with disabilities by the FHS teams. The study was conducted in a health facility in the city of Rio de Janeiro for one year. Results: Content analysis results listed the two main themes that composed the issues of concern for child care in this experience: the coordination of health care and the family and community orientation as the core for child care in the FHS. Conclusion: Despite the weakness in compliance with these categories, which are principles and fundamentals of the FHS, this is a privileged space with regard to care practices for children with disabilities.

  20. Police custody health care: a review of health morbidity, models of care and innovations within police custody in the UK, with international comparisons

    Directory of Open Access Journals (Sweden)

    McKinnon IG

    2016-09-01

    , timely access to mental health services, the protection of the rights of mentally disordered detainees, and the diversion of mentally disordered persons from the criminal justice system into appropriate health and social care interventions. There is a lack of rigorous research relating to interventions for physical health problems, protecting those at risk of substance withdrawal, and detainees with preexisting or peri-arrest injures. Research to improve the health of police custody detainees requires greater priority, focusing on case identification and service redesign to address high levels of morbidity and to facilitate health promotion and prevention activities. Keywords: police, vulnerable detainees, criminal justice system, deaths in custody, mentally disordered offenders, police health care innovations

  1. The Child Health Care System in Italy.

    Science.gov (United States)

    Corsello, Giovanni; Ferrara, Pietro; Chiamenti, Gianpietro; Nigri, Luigi; Campanozzi, Angelo; Pettoello-Mantovani, Massimo

    2016-10-01

    Pediatric care in Italy has been based during the last 40 years on the increased awareness of the importance of meeting the psychosocial and developmental needs of children and of the role of families in promoting the health and well-being of their children. The pediatric health care system in Italy is part of the national health system. It is made up of 3 main levels of intervention: first access/primary care, secondary care/hospital care, and tertiary care based on specialty hospital care. This overview will also include a brief report on neonatal care, pediatric preventive health care, health service accreditation programs, and postgraduate training in pediatrics. The quality of the Italian child health care system is now considered to be in serious danger because of the restriction of investments in public health caused both by the 2008 global and national economic crisis and by a reduction of the pediatric workforce as a result of progressively insufficient replacement of specialists in pediatrics. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Effect of Health Care Professionals' Continuing Education ...

    African Journals Online (AJOL)

    Purpose: To evaluate the impact of educational intervention by health care providers on clinical outcomes in type 2 diabetes patients in a Yemeni health facility. Methods: A .... compliance, exercise and diets recommended for diabetes patients.

  3. Policy challenges in modern health care

    National Research Council Canada - National Science Library

    Mechanic, David

    2005-01-01

    ... for the Obesity Epidemic KENNETH E. WARNER 99 8 Patterns and Causes of Disparities in Health DAVID R. WILLIAMS 115 9 Addressing Racial Inequality in Health Care SARA ROSENBAUM AND JOEL TEITELBAU...

  4. Acute mental health care according to recent mental health ...

    African Journals Online (AJOL)

    acute care, treatment and rehabilitation as a 72-hour assessment unit in a .... resemble prisons, such as unnecessary bars on windows and one-way glass. ..... model to consider design solutions for other acute mental health care settings.

  5. global health strategies versus local primary health care priorities

    African Journals Online (AJOL)

    CARE PRIORITIES - A CASE STUDY. OF NATIONAL ... development of comprehensive primary health care (pHC). The routine ..... on injection safety will be sustainable. On the negative side, ... This is mainly at management level, where time ...

  6. eHealth and quality in health care: implementation time

    NARCIS (Netherlands)

    Ossebaard, Hans Cornelis; van Gemert-Pijnen, Julia E.W.C.

    2016-01-01

    The use of information and communication technologies in health and health care could improve healthcare quality in many ways. Today's evidence base demonstrates the (cost-)effectiveness of online education, self-management support and tele-monitoring in several domains of health and care. While new

  7. The ethics of everyday practice in primary medical care: responding to social health inequities

    Science.gov (United States)

    2010-01-01

    Background Social and structural inequities shape health and illness; they are an everyday presence within the doctor-patient encounter yet, there is limited ethical guidance on what individual physicians should do. This paper draws on a study that explored how doctors and their professional associations ought to respond to the issue of social health inequities. Results Some see doctors as bound by a notion of care that is blind to a patient's social position, while others respond to this issue through invoking notions of justice and human rights where access to care is a prime focus. Both care and justice orientations however conceal important tensions linked to the presence of bioethical principles underpinning these. Other normative ethical theories like deontology, virtue ethics and utilitarianism do not provide adequate guidance on the problem of social health inequities either. Conclusion This paper explores if Bauman's notion of "forms of togetherness" provides the basis of a relational ethical theory that can help to develop a response to social health inequities of relevance to individual physicians. This theory goes beyond silence on the influence of social position of health and avoids amoral regulatory approaches to monitoring equity of care provision. PMID:20438627

  8. The ethics of everyday practice in primary medical care: responding to social health inequities

    Directory of Open Access Journals (Sweden)

    Palmer Victoria J

    2010-05-01

    Full Text Available Abstract Background Social and structural inequities shape health and illness; they are an everyday presence within the doctor-patient encounter yet, there is limited ethical guidance on what individual physicians should do. This paper draws on a study that explored how doctors and their professional associations ought to respond to the issue of social health inequities. Results Some see doctors as bound by a notion of care that is blind to a patient's social position, while others respond to this issue through invoking notions of justice and human rights where access to care is a prime focus. Both care and justice orientations however conceal important tensions linked to the presence of bioethical principles underpinning these. Other normative ethical theories like deontology, virtue ethics and utilitarianism do not provide adequate guidance on the problem of social health inequities either. Conclusion This paper explores if Bauman's notion of "forms of togetherness" provides the basis of a relational ethical theory that can help to develop a response to social health inequities of relevance to individual physicians. This theory goes beyond silence on the influence of social position of health and avoids amoral regulatory approaches to monitoring equity of care provision.

  9. The ethics of everyday practice in primary medical care: responding to social health inequities.

    Science.gov (United States)

    Furler, John S; Palmer, Victoria J

    2010-05-03

    Social and structural inequities shape health and illness; they are an everyday presence within the doctor-patient encounter yet, there is limited ethical guidance on what individual physicians should do. This paper draws on a study that explored how doctors and their professional associations ought to respond to the issue of social health inequities. Some see doctors as bound by a notion of care that is blind to a patient's social position, while others respond to this issue through invoking notions of justice and human rights where access to care is a prime focus. Both care and justice orientations however conceal important tensions linked to the presence of bioethical principles underpinning these. Other normative ethical theories like deontology, virtue ethics and utilitarianism do not provide adequate guidance on the problem of social health inequities either. This paper explores if Bauman's notion of "forms of togetherness" provides the basis of a relational ethical theory that can help to develop a response to social health inequities of relevance to individual physicians. This theory goes beyond silence on the influence of social position of health and avoids amoral regulatory approaches to monitoring equity of care provision.

  10. The Future of Home Health Care

    Science.gov (United States)

    Landers, Steven; Madigan, Elizabeth; Leff, Bruce; Rosati, Robert J.; McCann, Barbara A.; Hornbake, Rodney; MacMillan, Richard; Jones, Kate; Bowles, Kathryn; Dowding, Dawn; Lee, Teresa; Moorhead, Tracey; Rodriguez, Sally; Breese, Erica

    2016-01-01

    The Future of Home Health project sought to support transformation of home health and home-based care to meet the needs of patients in the evolving U.S. health care system. Interviews with key thought leaders and stakeholders resulted in key themes about the future of home health care. By synthesizing this qualitative research, a literature review, case studies, and the themes from a 2014 Institute of Medicine and National Research Council workshop on “The Future of Home Health Care,” the authors articulate a vision for home-based care and recommend a bold framework for the Medicare-certified home health agency of the future. The authors also identify challenges and recommendations for achievement of this framework. PMID:27746670

  11. The authoritarian reign in American health care.

    Science.gov (United States)

    Ballou, Kathryn A; Landreneau, Kandace J

    2010-02-01

    The aim of this article is to increase understanding of the mechanisms of the continuation of elite hegemonic control of a highly valued social system--American health care. White, male physicians and administrators achieved control of the health care industry and its workers, including nurses, at the start of the 20th century. Using critical theorists' work on authoritarianism and incorporating gender analysis, the authors describe the health care system from a critical social- psychological perspective. The authors discuss the meaning and presence of authoritarian hierarchy and gender effects in today's health system through a critical analysis of the profession of medicine, the profession of nursing, corporate and bureaucratic health care, and patients or consumers. It is concluded that the social-psychological behavior of the American health care system has profound implications that must be taken into account in any recommendations for change.

  12. [The role of management in health care].

    Science.gov (United States)

    Güntert, Bernhard J

    2007-01-01

    The situation in the health care sector is affected by a shortage of public funds on the one hand and, on the other hand, by rapid developments in medicine and nursing with an enormous expansion of both diagnostic and therapeutic possibilities. This and the aging population are generating a steadily increasing demand for health care services. The result is an increased cost consciousness in society calling for more professional management in health care organizations. However, the traditional administration of health care organizations, which is closely aligned with health professionals and production processes, was not able to cope with these dynamics or did so only unsatisfactorily. An improved management would surely lead to an optimization of health care delivery processes and a more effective use of resources. The question, however, is whether the effectiveness of the total system can be improved and whether patients' and society's needs can actually be met by classical management approaches.

  13. Ethics and values in health care practice: philosophical, educational, and political considerations.

    Science.gov (United States)

    Carvalho, Vilma de

    2011-12-01

    This paper presents philosophical, pedagogical and political considerations on Ethics and Values in Professional Health Care Practice. The current changes and crises in the world, intensified by economic turmoil, have affected social justice issues affecting health and education. to clarify nurses' role in the context of the art to take care of clients both as individuals and community; to urge nurses for attention to laws and codes/norms as established in the profession; and to suggest the application of basic laws of the Philosophy of Art to nursing care. The study presents critical analysis on ethics and values involved in nursing actions and may affect the art of learning-to-be and becoming an expert professional in nursing care. The author's epistemological position is presented to build competencies in the nursing as a health science.

  14. [The ethics of health care organization].

    Science.gov (United States)

    Goic, Alejandro

    2004-03-01

    Health care organization is not only a technical issue. Ethics gives meaning to the medical profession's declared intent of preserving the health and life of the people while honoring their intelligence, dignity and intimacy. It also induces physicians to apply their knowledge, intellect and skills for the benefit of the patient. In a health care system, it is important that people have insurance coverage for health contingencies and that the quality of the services provided be satisfactory. People tend to judge the medical profession according to the experience they have in their personal encounter with physicians, health care workers, hospitals and clinics. Society and its political leaders must decide upon the particular model that will ensure the right of citizens to a satisfactory health care. Any health care organization not founded on humanitarian and ethical values is doomed tofailure. The strict adherence of physicians to Hippocratic values and to the norms of good clinical practice as well as to an altruistic cooperative attitude will improve the efficiency of the health care sector and reduce its costs. It is incumbent upon society to generate the conditions where by the ethical roots of medical care can be brought to bear upon the workings of the health care system. Every country must strive to provide not only technically efficient medical services, but also the social mechanisms that make possible a humanitarian interaction between professionals and patients where kindness and respect prevail.

  15. Toward a 21st-century health care system: Recommendations for health care reform

    NARCIS (Netherlands)

    K. Arrow (Kenneth); A. Auerbach (Alan); J. Bertko (John); L.P. Casalino (Lawrence Peter); F.J. Crosson (Francis); A. Enthoven (Alain); E. Falcone; R.C. Feldman; V.R. Fuchs (Victor); A.M. Garber (Alan); M.R. Gold (Marthe Rachel); D.A. Goldman; G.K. Hadfield (Gillian); M.A. Hall (Mark Ann); R.I. Horwitz (Ralph); M. Hooven; P.D. Jacobson (Peter); T.S. Jost (Timothy Stoltzfus); L.J. Kotlikoff; J. Levin (Jonathan); S. Levine (Sharon); R. Levy; K. Linscott; H.S. Luft; R. Mashal; D. McFadden (Daniel); D. Mechanic (David); D. Meltzer (David); J.P. Newhouse (Joseph); R.G. Noll (Roger); J.B. Pietzsch (Jan Benjamin); P. Pizzo (Philip); R.D. Reischauer (Robert); S. Rosenbaum (Sara); W. Sage (William); L.D. Schaeffer (Leonard Daniel); E. Sheen; B.N. Silber (Bernie Michael); J. Skinner (Jonathan Robert); S.M. Shortell (Stephen); S.O. Thier (Samuel); S. Tunis (Sean); L. Wulsin Jr.; P. Yock (Paul); G.B. Nun; S. Bryan (Stirling); O. Luxenburg (Osnat); W.P.M.M. van de Ven (Wynand); J. Cooper (Jim)

    2009-01-01

    textabstractThe coverage, cost, and quality problems of the U.S. health care system are evident. Sustainable health care reform must go beyond financing expanded access to care to substantially changing the organization and delivery of care. The FRESH-Thinking Project (www.fresh-thinking.org) held a

  16. Justice delayed is justice denied: Protecting Miners against ...

    African Journals Online (AJOL)

    Justice delayed is justice denied: Protecting Miners against Occupational ... of section 35 of Compensation for Occupational Injuries and Diseases Act 130 of ... of the Mankayi case for the system of occupational health and safety in South Africa. ... KEYWORDS: Occupational health; diseases; injuries; employees; protection; ...

  17. Health federalism: the role of health care professionals in Nepal.

    Science.gov (United States)

    Dulal, R K

    2009-01-01

    Nepal has entered from its unitary system into a new "Federal Democratic Republic State". The current constitution presents basic health care services as a fundamental right. The Ministry for Health and Population has been providing resources to meet health demands, but managers are wrestling to meet these demands. Persistent disparities between rural and urban and across regions resulted inferior health outcomes, e.g., life expectancy in an urban district like Bhaktapur is 71 years, whereas in the rural district of Mugu it is 44 years. The poor health and poor access to health care in the past systems prompted people to seek a different model. Ultimately, all political parties except one have agreed on federalism. The exact number of federal states that are going to be created is unknown. In federalism, all federated states have to assume certain relationships between the locality, the region, and the nation that apply not only in politics but in health care too. Managing changes in health care organization during the transitional period and after restructuring the unitary Nepal into federal states should be carefully planned. In case, if new system also fails to deliver necessary health care services, the possibility of igniting of dissatisfaction, public unrest and even disintegration cannot be ignored. In order to outline a structure and give life to a health care system under federalism, health care professionals need to engage themselves seriously.

  18. Legislating health care coverage for the unemployed.

    Science.gov (United States)

    Palley, H A; Feldman, G; Gallner, I; Tysor, M

    1985-01-01

    Because the unemployed and their families are often likely to develop stress-related health problems, ensuring them access to health care is a public health issue. Congressional efforts thus far to legislate health coverage for the unemployed have proposed a system that recognizes people's basic need for coverage but has several limitations.

  19. High and rising health care costs.

    Science.gov (United States)

    Ginsburg, Paul B

    2008-10-01

    The U.S. is spending a growing share of the GDP on health care, outpacing other industrialized countries. This synthesis examines why costs are higher in the U.S. and what is driving their growth. Key findings include: health care inefficiency, medical technology and health status (particularly obesity) are the primary drivers of rising U.S. health care costs. Health payer systems that reward inefficiencies and preempt competition have impeded productivity gains in the health care sector. The best evidence indicates medical technology accounts for one-half to two-thirds of spending growth. While medical malpractice insurance and defensive medicine contribute to health costs, they are not large enough factors to significantly contribute to a rise in spending. Research is consistent that demographics will not be a significant factor in driving spending despite the aging baby boomers.

  20. Implementing the learning health care system.

    NARCIS (Netherlands)

    Verheij, R.; Barten, D.J.; Hek, K.; Nielen, M.; Prins, M.; Zwaanswijk, M.; Bakker, D. de

    2014-01-01

    Background: As computerisation of primary care facilities is rapidly increasing, a wealth of data is created in routinely recorded electronic health records (EHRs). This data can be used to create a true learning health care system, in which routinely available data are processed and analysed in

  1. Online Health Care Communication in Denmark

    DEFF Research Database (Denmark)

    Andersen, Kim Normann; Agger Nielsen, Jeppe; Kim, Soonhee

    2013-01-01

    This paper brings forward five propositions on the use of online communication in health care, its potential impacts on efficiency and effectiveness in health care, and which role government should play in moving forward the use of online communication. In the paper, each of the five propositions...

  2. Quality systems in Dutch health care institutions.

    NARCIS (Netherlands)

    Casparie, A.F.; Sluijs, E.M.; Wagner, C.; Bakker, D.H. de

    1997-01-01

    The implementation of quality systems in Dutch health care was supervised by a national committee during 1990-1995. To monitor the progress of implementation a large survey was conducted in the beginning of 1995. The survey enclosed all subsectors in health care. A postal questionnaire-derived

  3. Future health care technology and the hospital

    NARCIS (Netherlands)

    Banta, H.D.

    1990-01-01

    The past decades have been a time of rapid technological change in health care, but technological change will probably accelerate during the next decade or so. This will bring problems, but it will also present certain opportunities. In particular, the health care system is faced with the need to

  4. Gender and communication style in general practice: differences between women's health care and regular health care.

    NARCIS (Netherlands)

    Brink-Muinen, A. van den; Bensing, J.M.; Kerssens, J.J.

    1998-01-01

    Objectives: differences were investigated between general practitioners providing women's health care (4 women) and general practitioners providing regular health care (8 women and 8 men). Expectations were formulated on the basis of the principles of women's health care and literature about gender

  5. Changing trends in health care tourism.

    Science.gov (United States)

    Karuppan, Corinne M; Karuppan, Muthu

    2010-01-01

    Despite much coverage in the popular press, only anecdotal evidence is available on medical tourists. At first sight, they seemed confined to small and narrowly defined consumer segments: individuals seeking bargains in cosmetic surgery or uninsured and financially distressed individuals in desperate need of medical care. The study reported in this article is the first empirical investigation of the medical tourism consumer market. It provides the demographic profile, motivations, and value perceptions of health care consumers who traveled abroad specifically to receive medical care. The findings suggest a much broader market of educated and savvy health care consumers than previously thought. In the backdrop of the health care reform, the article concludes with implications for health care providers.

  6. Integrating Community Health Workers (CHWs) into Health Care Organizations.

    Science.gov (United States)

    Payne, Julianne; Razi, Sima; Emery, Kyle; Quattrone, Westleigh; Tardif-Douglin, Miriam

    2017-10-01

    Health care organizations increasingly employ community health workers (CHWs) to help address growing provider shortages, improve patient outcomes, and increase access to culturally sensitive care among traditionally inaccessible or disenfranchised patient populations. Scholarly interest in CHWs has grown in recent decades, but researchers tend to focus on how CHWs affect patient outcomes rather than whether and how CHWs fit into the existing health care workforce. This paper focuses on the factors that facilitate and impede the integration of the CHWs into health care organizations, and strategies that organizations and their staff develop to overcome barriers to CHW integration. We use qualitative evaluation data from 13 awardees that received Health Care Innovation Awards from the Centers of Medicare and Medicaid Innovation to enhance the quality of health care, improve health outcomes, and reduce the cost of care using programs involving CHWs. We find that organizational capacity, support for CHWs, clarity about health care roles, and clinical workflow drive CHW integration. We conclude with practical recommendations for health care organizations interested in employing CHWs.

  7. Cognitive systems engineering in health care

    CERN Document Server

    Bisantz, Ann M; Fairbanks, Rollin J

    2014-01-01

    Cognitive Engineering for Better Health Care Systems, Ann M. Bisantz, Rollin J. Fairbanks, and Catherine M. BurnsThe Role of Cognitive Engineering in Improving Clinical Decision Support, Anne Miller and Laura MilitelloTeam Cognitive Work Analysis as an Approach for Understanding Teamwork in Health Care, Catherine M. BurnsCognitive Engineering Design of an Emergency Department Information System, Theresa K. Guarrera, Nicolette M. McGeorge, Lindsey N. Clark, David T. LaVergne, Zachary A. Hettinger, Rollin J. Fairbanks, and Ann M. BisantzDisplays for Health Care Teams: A Conceptual Framework and Design Methodology, Avi ParushInformation Modeling for Cognitive Work in a Health Care System, Priyadarshini R. PennathurSupport for ICU Clinician Cognitive Work through CSE, Christopher Nemeth, Shilo Anders, Jeffrey Brown, Anna Grome, Beth Crandall, and Jeremy PamplinMatching Cognitive Aids and the "Real Work" of Health Care in Support of Surgical Microsystem Teamwork, Sarah Henrickson Parker and Shawna J. PerryEngageme...

  8. Health care employee perceptions of patient-centered care.

    Science.gov (United States)

    Balbale, Salva Najib; Turcios, Stephanie; LaVela, Sherri L

    2015-03-01

    Given the importance of health care employees in the delivery of patient-centered care, understanding their unique perspectives is essential for quality improvement. The purpose of this study was to use photovoice to evaluate perceptions and experiences around patient-centered care among U.S. Veterans Affairs (VA) health care employees. We asked participants to take photographs of salient features in their environment related to patient-centered care. We used the photographs to facilitate dialogue during follow-up interviews. Twelve VA health care employees across two VA sites participated in the project. Although most participants felt satisfied with their work environment and experiences at the VA, they identified several areas for improvement. These included a need for more employee health and wellness initiatives and a need for enhanced opportunities for training and professional growth. Application of photovoice enabled us to learn about employees' unique perspectives around patient-centered care while engaging them in an evaluation of care delivery. © The Author(s) 2014.

  9. Transition care for children with special health care needs.

    Science.gov (United States)

    Davis, Alaina M; Brown, Rebekah F; Taylor, Julie Lounds; Epstein, Richard A; McPheeters, Melissa L

    2014-11-01

    Approximately 750,000 children in the United States with special health care needs will transition from pediatric to adult care annually. Fewer than half receive adequate transition care. We had conversations with key informants representing clinicians who provide transition care, pediatric and adult providers of services for individuals with special health care needs, policy experts, and researchers; searched online sources for information about currently available programs and resources; and conducted a literature search to identify research on the effectiveness of transition programs. We identified 25 studies evaluating transition care programs. Most (n = 8) were conducted in populations with diabetes, with a smaller literature (n = 5) on transplant patients. We identified an additional 12 studies on a range of conditions, with no more than 2 studies on the same condition. Common components of care included use of a transition coordinator, a special clinic for young adults in transition, and provision of educational materials. The issue of how to provide transition care for children with special health care needs warrants further attention. Research needs are wide ranging, including both substantive and methodologic concerns. Although there is widespread agreement on the need for adequate transition programs, there is no accepted way to measure transition success. It will be essential to establish consistent goals to build an adequate body of literature to affect practice. Copyright © 2014 by the American Academy of Pediatrics.

  10. Quality Improvement in Athletic Health Care.

    Science.gov (United States)

    Lopes Sauers, Andrea D; Sauers, Eric L; Valier, Alison R Snyder

    2017-11-01

      Quality improvement (QI) is a health care concept that ensures patients receive high-quality (safe, timely, effective, efficient, equitable, patient-centered) and affordable care. Despite its importance, the application of QI in athletic health care has been limited.   To describe the need for and define QI in health care, to describe how to measure quality in health care, and to present a QI case in athletic training.   As the athletic training profession continues to grow, a widespread engagement in QI efforts is necessary to establish the value of athletic training services for the patients that we serve. A review of the importance of QI in health care, historical perspectives of QI, tools to drive QI efforts, and examples of common QI initiatives is presented to assist clinicians in better understanding the value of QI for advancing athletic health care and the profession. Clinical and Research Advantages:  By engaging clinicians in strategies to measure outcomes and improve their patient care services, QI practice can help athletic trainers provide high-quality and affordable care to patients.

  11. The 21st Century Cures Act Implications for the Reduction of Racial Health Disparities in the US Criminal Justice System: a Public Health Approach.

    Science.gov (United States)

    Cole, Donna M; Thomas, Dawna Marie; Field, Kelsi; Wool, Amelia; Lipiner, Taryn; Massenberg, Natalie; Guthrie, Barbara J

    2017-11-09

    Past drug epidemics have disproportionately criminalized drug addiction among African Americans, leading to disparate health outcomes, increased rates of HIV/AIDS, and mass incarceration. Conversely, the current opioid addiction crisis in the USA focuses primarily on white communities and is being addressed as a public health problem. The 21st Century Cures Act has the potential to reduce racial health disparities in the criminal justice system through the Act's public health approach to addiction and mental health issues. The 21st Century Cures Act is a progressive step in the right direction; however, given the historical context of segregation and the criminalization of drug addiction among African Americans, the goals of health equity are at risk of being compromised. This paper discusses the implications of this landmark legislation and its potential to decrease racial health disparities, highlighting the importance of ensuring that access to treatment and alternatives to incarceration must include communities of color. In this paper, the authors explain the key components of the 21st Century Cures Act that are specific to criminal justice reform, including a key objective, which is treatment over incarceration. We suggest that without proper attention to how, and where, funding mechanisms are distributed, the 21st Century Cures Act has the potential to increase racial health disparities rather than alleviate them.

  12. Health Literacy and Communication Quality in Health Care Organizations

    Science.gov (United States)

    Wynia, Matthew K.; Osborn, Chandra Y.

    2011-01-01

    The relationship between limited health literacy and poor health may be due to poor communication quality within health care delivery organizations. We explored the relationship between health literacy status and receiving patient-centered communication in clinics and hospitals serving communication-vulnerable patient populations. Thirteen health care organizations nationwide distributed a survey to 5,929 patients. All patients completed seven items assessing patient-centered communication. One third also completed three items assessing health literacy. The majority of patients had self-reported health literacy challenges, reporting problems learning about their medical condition because of difficulty understanding written information (53%), a lack of confidence in completing medical forms by themselves (61%), and needing someone to help them read hospital/clinic materials (57%). Logistic regression models showed that, after adjustment for patient demographic characteristics and health care organization type, patients with limited health literacy were 28–79% less likely than those with adequate health literacy to report their health care organization “always” provides patient-centered communication across seven communication items. Using a scaled composite of these items, limited health literacy remained associated with lower reported communication quality. These results suggest that improving communication quality in health care organizations might help to address the challenges facing patients with limited health literacy. They also highlight that efforts to address the needs of patients with limited health literacy should be sensitive to the range of communication challenges confronting these patients and their caregivers. PMID:20845197

  13. Implementing shared decision making in routine mental health care.

    Science.gov (United States)

    Slade, Mike

    2017-06-01

    Shared decision making (SDM) in mental health care involves clinicians and patients working together to make decisions. The key elements of SDM have been identified, decision support tools have been developed, and SDM has been recommended in mental health at policy level. Yet implementation remains limited. Two justifications are typically advanced in support of SDM. The clinical justification is that SDM leads to improved outcome, yet the available empirical evidence base is inconclusive. The ethical justification is that SDM is a right, but clinicians need to balance the biomedical ethical principles of autonomy and justice with beneficence and non-maleficence. It is argued that SDM is "polyvalent", a sociological concept which describes an idea commanding superficial but not deep agreement between disparate stakeholders. Implementing SDM in routine mental health services is as much a cultural as a technical problem. Three challenges are identified: creating widespread access to high-quality decision support tools; integrating SDM with other recovery-supporting interventions; and responding to cultural changes as patients develop the normal expectations of citizenship. Two approaches which may inform responses in the mental health system to these cultural changes - social marketing and the hospitality industry - are identified. © 2017 World Psychiatric Association.

  14. Organizational Justice

    Science.gov (United States)

    Burns, Travis

    2013-01-01

    Helping principals understand the importance of organizational justice is the first step in enhancing learning outcomes for all learners, regardless of their social class, race, abilities, sex, or gender. In schools, organizational justice may be defined as teachers' perceptions of fairness, respect, and equity that relate to their interactions…

  15. Justice Globalism

    NARCIS (Netherlands)

    Wilson, Erin; Steger, Manfred; Siracusa, Joseph; Battersby, Paul

    2014-01-01

    The pursuit of a global order founded on universal rules extends beyond economics into the normative spheres of law, politics and justice. Justice globalists claim universal principles applicable to all societies irrespective of religion or ideology. This view privileges human rights, democracy and

  16. Education and Health Care Policies in Ghana

    Directory of Open Access Journals (Sweden)

    Ziblim Abukari

    2015-10-01

    Full Text Available Education and health care policies in Ghana since independence have been universalist in approach providing free universal health care and free basic and tertiary education until the early 1980s. Precipitated primarily by a severe drought, stagnant economic growth, mismanagement, and political instability, Ghana undertook major economic reforms with prodding from the World Bank and International Monetary Fund in a bid to salvage the economy. These economic measures included cost recovery and cutback spending in education and health sectors. However, in recent years, purposive targeted interventions have been pursued to address inequalities in education and health care. These new programs include the Education Capitation Grant, school feeding program, and the National Health Insurance Scheme (NHIS, which are propelling Ghana toward the achievement of the Millennium Development Goals. The prospects of these programs in addressing disparities in access to education and health care in the country and recommendations for improved delivery are discussed.

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

    Science.gov (United States)

    Caicedo, Carmen

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

  18. Health Literacy and Access to Care

    Science.gov (United States)

    Janke, Alex

    2016-01-01

    Despite well-documented links between low health literacy, low rates of health insurance coverage, and poor health outcomes, there has been almost no research on the relationship between low health literacy and self-reported access to care. This study analyzed a large, nationally representative sample of community-dwelling adults ages 50 and older to estimate the relationship between low health literacy and self-reported difficulty obtaining care. We found that individuals with low health literacy were significantly more likely than individuals with adequate health literacy to delay or forego needed care or to report difficulty finding a provider, even after controlling for other factors including health insurance coverage, employment, race/ethnicity, poverty, and general cognitive function. They were also more likely to lack a usual source of care, although this result was only marginally significant after controlling for other factors. The results show that in addition to any obstacles that low health literacy creates within the context of the clinical encounter, low health literacy also reduces the probability that people get in the door of the health care system in a timely way. PMID:27043757

  19. Holistic health care: Patients' experiences of health care provided by an Advanced Practice Nurse.

    Science.gov (United States)

    Eriksson, Irene; Lindblad, Monica; Möller, Ulrika; Gillsjö, Catharina

    2018-02-01

    Advanced Practice Nurse (APN) is a fairly new role in the Swedish health care system. To describe patients' experiences of health care provided by an APN in primary health care. An inductive, descriptive qualitative approach with qualitative open-ended interviews was chosen to obtain descriptions from 10 participants regarding their experiences of health care provided by an APN. The data were collected during the spring 2012, and a qualitative approach was used for analyze. The APNs had knowledge and skills to provide safe and secure individual and holistic health care with high quality, and a respectful and flexible approach. The APNs conveyed trust and safety and provided health care that satisfied the patients' needs of accessibility and appropriateness in level of care. The APNs way of providing health care and promoting health seems beneficial in many ways for the patients. The individual and holistic approach that characterizes the health care provided by the APNs is a key aspect in the prevailing change of health care practice. The transfer of care and the increasing number of older adults, often with a variety of complex health problems, call for development of the new role in this context. © 2017 The Authors. International Journal of Nursing Practice Published by John Wiley & Sons Australia, Ltd.

  20. Point-of-Care Ultrasound: A Trend in Health Care.

    Science.gov (United States)

    Buerger, Anita M; Clark, Kevin R

    2017-11-01

    To discuss the current and growing use of point-of-care (POC) ultrasound in the management and care of patients. Several electronic research databases were searched to find articles that emphasized the use of POC ultrasound by health care providers who manage and treat critically ill or injured patients. Thirty-five relevant peer-reviewed journal articles were selected for this literature review. Common themes identified in the literature included the use of POC ultrasound in emergency medicine, military medicine, and remote care; comparison of POC ultrasound to other medical imaging modalities; investigation of the education and training required for nonimaging health care professionals who perform POC ultrasound in their practices; and discussion of the financial implications and limitations of POC ultrasound. POC ultrasound provides clinicians with real-time information to better manage and treat critically ill or injured patients in emergency medicine, military medicine, and remote care. In addition to providing immediate bedside diagnostic information, use of POC ultrasound has increased because of concerns regarding radiation protection. Finally, the expansion of POC ultrasound to other specialty areas requires nonimaging health care professionals to perform bedside ultrasound examinations and interpret the resulting images. Because POC ultrasound is user-dependent, adequate training is essential for all who perform and interpret the examinations. Research involving POC ultrasound will continue as innovations and confidence in ultrasound applications advance. Future research should continue to examine the broad use of POC ultrasound in patient care and management. ©2017 American Society of Radiologic Technologists.

  1. Organizational Learning in Health Care Organizations

    Directory of Open Access Journals (Sweden)

    Savithiri Ratnapalan

    2014-02-01

    Full Text Available The process of collective education in an organization that has the capacity to impact an organization’s operations, performance and outcomes is called organizational learning. In health care organizations, patient care is provided through one or more visible and invisible teams. These teams are composed of experts and novices from diverse backgrounds working together to provide coordinated care. The number of teams involved in providing care and the possibility of breakdowns in communication and coordinated care increases in direct proportion to sophisticated technology and treatment strategies of complex disease processes. Safe patient care is facilitated by individual professional learning; inter-professional team learning and system based organizational learning, which encompass modified context specific learning by multiple teams and team members in a health care organization. Organizational learning in health care systems is central to managing the learning requirements in complex interconnected dynamic systems where all have to know common background knowledge along with shared meta-knowledge of roles and responsibilities to execute their assigned functions, communicate and transfer the flow of pertinent information and collectively provide safe patient care. Organizational learning in health care is not a onetime intervention, but a continuing organizational phenomenon that occurs through formal and informal learning which has reciprocal association with organizational change. As such, organizational changes elicit organizational learning and organizational learning implements new knowledge and practices to create organizational changes.

  2. COMMUNITY MEDICINE & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    ajiboro

    2Department of Community Medicine & Primary Care, Faculty of Clinical Sciences, ... It may result from road traffic accident, near saving basic principles in emergency care that even drowning, electric ... (4.3%) at place of work, 8 (11.4%) at.

  3. Health care and equity in India

    Science.gov (United States)

    Balarajan, Yarlini; Selvaraj, S; Subramanian, S V

    2011-01-01

    India’s health system faces the ongoing challenge of responding to the needs of the most disadvantaged members of Indian society. Despite progress in improving access to health care, inequalities by socioeconomic status, geography and gender continue to persist. This is compounded by high out-of-pocket expenditures, with the rising financial burden of health care falling overwhelming on private households, which account for more than three-quarter of health spending in India. Health expenditures are responsible for more than half of Indian households falling into poverty; the impact of this has been increasing pushing around 39 million Indians into poverty each year. In this paper, we identify key challenges to equity in service delivery, and equity in financing and financial risk protection in India. These include imbalanced resource allocation, limited physical access to quality health services and inadequate human resources for health; high out-of-pocket health expenditures, health spending inflation, and behavioral factors that affect the demand for appropriate health care. Complementing other paper in this Series, we argue for the application of certain principles in the pursuit of equity in health care in India. These are the adoption of equity metrics in monitoring, evaluation and strategic planning, investment in developing a rigorous knowledge-base of health systems research; development of more equity-focused process of deliberative decision-making in health reform, and redefinition of the specific responsibilities and accountabilities of key actors. The implementation of these principles, together with strengthening of public health and primary care services, provide an approach for ensuring more equitable health care for India’s population. PMID:21227492

  4. Rural health care bypass behavior: how community and spatial characteristics affect primary health care selection.

    Science.gov (United States)

    Sanders, Scott R; Erickson, Lance D; Call, Vaughn R A; McKnight, Matthew L; Hedges, Dawson W

    2015-01-01

    (1) To assess the prevalence of rural primary care physician (PCP) bypass, a behavior in which residents travel farther than necessary to obtain health care, (2) To examine the role of community and non-health-care-related characteristics on bypass behavior, and (3) To analyze spatial bypass patterns to determine which rural communities are most affected by bypass. Data came from the Montana Health Matters survey, which gathered self-reported information from Montana residents on their health care utilization, satisfaction with health care services, and community and demographic characteristics. Logistic regression and spatial analysis were used to examine the probability and spatial patterns of bypass. Overall, 39% of respondents bypass local health care. Similar to previous studies, dissatisfaction with local health care was found to increase the likelihood of bypass. Dissatisfaction with local shopping also increases the likelihood of bypass, while the number of friends in a community, and commonality with community reduce the likelihood of bypass. Other significant factors associated with bypass include age, income, health, and living in a highly rural community or one with high commuting flows. Our results suggest that outshopping theory, in which patients bundle services and shopping for added convenience, extends to primary health care selection. This implies that rural health care selection is multifaceted, and that in addition to perceived satisfaction with local health care, the quality of local shopping and levels of community attachment also influence bypass behavior. © 2014 National Rural Health Association.

  5. Acute mental health care and South African mental health legislation

    African Journals Online (AJOL)

    information on mental health care outcome, to do a cost analysis and to establish a quality assurance cycle that may facilitate a cost ... clinical record reviews of mental health service delivery, training ... (d) describe the demographic and clinical profile of HIV positive ..... accommodate the differentiated but integrated care of.

  6. Acute mental health care according to recent mental health ...

    African Journals Online (AJOL)

    Objective: This is the third of three reports on the follow-up review of mental health care at Helen Joseph Hospital (HJH). The study reviewed existing South African standards for mental health care facilities. Architectural principles and implications for the use of space were deducted from recent legislation. Objectives were to ...

  7. Acute mental health care and South African mental health legislation ...

    African Journals Online (AJOL)

    Objective: This is the first of three reports on a follow-up review of mental health care at Helen Joseph Hospital (HJH). In this first part, qualitative and quantitative descriptions were made of the services and of demographic and clinical data on acute mental health care users managed at HJH, in a retrospective review of ...

  8. The French prescription for health care reform.

    Science.gov (United States)

    Segouin, C; Thayer, C

    1999-01-01

    In 1996, the French government introduced a wide-ranging health care reform which aimed to resolve the problems of rising health expenditure and a levelling off in health sector income. Changes in the regulation of the health care system sought to strengthen quality while improving professional practice. At the same time the changes were intended to encourage greater synergy both between professionals and between the different parts of the system, thus promoting greater cost-effectiveness. The tools designed to achieve these results included: the creation of new regional hospital agencies, the introduction of cash-limited budgets at national and regional level, the launching of a contracting procedure between health authorities and hospitals and the setting up of a new health care accreditation agency. With some signs of improvement in the overall health insurance budgetary situation, the Jospin government seems to be supporting the broad lines of the reform introduced by its predecessor.

  9. [Aspects of economic responsibility in health care].

    Science.gov (United States)

    Hauke, Eugen

    2007-01-01

    According to the final consensus of a panel of intense discussions, the health care system should/can not be excluded from the economic laws of efficiency. Appropriate adaptation of various methods and instruments of economics make these tools applicable for use in the health care system. Due to errors in the implementation of economic methods, though, the question arises who is economically responsible in the health care system. The answer is found at three different levels of the health care system. The physician plays a leading role, both personally and professionally, in being primarily responsible for the direct medical treatment of the patient. The physician's dependence, however, on the health care system reduces his independence, which markedly affects his decision-making and treatment. Management of and in health care institutions is largely independent of the profession learned. Managers and physicians acting as managers must be appropriately and duly educated in the necessary specific talents and knowledge. The organisation of a health care system should also be reserved for trained specialists where the physicians as well as other professionals are obliged to acquire the skills necessary.

  10. Promoting coordination in Norwegian health care

    Directory of Open Access Journals (Sweden)

    Tor I. Romøren

    2011-10-01

    Full Text Available   Introduction: The Norwegian health care system is well organized within its two main sectors - primary health and long term care on the one hand, and hospitals and specialist services on the other. However, the relation between them lacks mediating structures.Policy practice: Enhancing coordination between primary and secondary health care has been central in Norwegian health care policy the last decade. In 2003 a committee was appointed to identify coordination problems and proposed a lot of practical and organisational recommendations. It relied on an approach challenging primary and secondary health care in shared geographical regions to take action. However, these proposals were not implemented. In 2008 a new Minister of Health and Care worked out plans under the key term "Coordination Reform". These reform plans superseded and expanded the previous policy initiatives concerning cooperation, but represented also a shift in focus to a regulative and centralised strategy, including new health legislation, structural reforms and use of economic incentives that are now about to be implemented.Discussion: The article analyses the perspectives and proposals of the previous and the recent reform initiatives in Norway and discusses them in relation to integrated care measures implemented in Denmark and Sweden.

  11. Nigerian health care: A quick appraisal

    Directory of Open Access Journals (Sweden)

    Yau Zakari Lawal

    2017-01-01

    Full Text Available Qualitative health care is a fundamental right of all citizens of a given country. How this health care is delivered depends significantly on the economy, dedication, and quality of the health-care providers and the political will of the government of the country. Health care may be public run or organized by private health-care providers. We can also have an intercalated program where there is public–private partnership. Whichever way this basic fundamental human right is delivered, sustainability, affordability, and accessibility are vital to its success. The Nigerian health-care delivery can be broadly classified into two; the hitherto existing traditional medicine and the modern orthodox medicine which came to our shores with the arrival of the European colonialists. The traditional system is still patronized by most Nigerians and is known by different linguistic terminologies such as the “Wanzami” or Barber in Hausa and the “Babalawo” in Yoruba language. Traditional birth attendants also exist in all communities in Nigeria complemented by herbalist and spiritualists of different shades and callings. It is our aim to give a brief account of our observations on the Nigerian health-care system with a view to correcting the challenges by the government and the public in general.

  12. Corporate moral responsibility in health care.

    Science.gov (United States)

    Wilmot, S

    2000-01-01

    The question of corporate moral responsibility--of whether it makes sense to hold an organisation corporately morally responsible for its actions, rather than holding responsible the individuals who contributed to that action--has been debated over a number of years in the business ethics literature. However, it has had little attention in the world of health care ethics. Health care in the United Kingdom (UK) is becoming an increasingly corporate responsibility, so the issue is increasingly relevant in the health care context, and it is worth considering whether the specific nature of health care raises special questions around corporate moral responsibility. For instance, corporate responsibility has usually been considered in the context of private corporations, and the organisations of health care in the UK are mainly state bodies. However, there is enough similarity in relevant respects between state organisations and private corporations, for the question of corporate responsibility to be equally applicable. Also, health care is characterised by professions with their own systems of ethical regulation. However, this feature does not seriously diminish the importance of the corporate responsibility issue, and the importance of the latter is enhanced by recent developments. But there is one major area of difference. Health care, as an activity with an intrinsically moral goal, differs importantly from commercial activities that are essentially amoral, in that it narrows the range of opportunities for corporate wrongdoing, and also makes such organisations more difficult to punish.

  13. Ethical thinking and discrimination in health care

    Directory of Open Access Journals (Sweden)

    Aleksander Mlinšek

    2012-02-01

    Full Text Available RQ: Personal excellence of nursing focusing on self-transcendence and achievements is crucial for achieving excellence in health care. The question is whether there is unequal treatment of patients despite high ethical standards placed in health care.Purpose: Professional nurses code is a guide in assessing their ethical performance. People are different amongst each other, but have the same rights in the health system, which should be provided by health care services. The need to overcome inequalities has become a cornerstone of excellence in health care.Method: A small quantitative survey of nurses was conducted in one of the departments in a Slovenian hospital. To analyse the results, we used frequency statistics, Spearman's rank correlation test and chi-square test. Results: Providers of health care services are aware of the importance of ethics in its formation. Professional Code is relatively well known; 8.4 % of the respondents were not sure if they clearly define the principles of respect for equality. Discrimination, caused by providers of health care, is of a less extent. Ethical awareness among health care providers does not affect identification with the profession. The education level ofnursing personnel and the perception of discrimination based on religious affiliation influenced one another. Education has no influence on the perception of discrimination based on other circumstances.Organization: Health care organizations should integrate hygieneethical thinking among its strategic goals. Quality is not only quantifying the data. Personal excellence of health care providers, which is difficult to measure, is the basic building block of organizational excellence and patient satisfaction.Originality: There are not many research studies on perceptionsof discrimination in health care. The article raises the sensitive issue that we should talk more about.Limitations: The survey was conducted on a small sample size. Further research

  14. How Health Care Complexity Leads to Cooperation and Affects the Autonomy of Health Care Professionals

    NARCIS (Netherlands)

    Molleman, Eric; Broekhuis, Manda; Stoffels, Renee; Jaspers, Frans

    2008-01-01

    Health professionals increasingly face patients with complex health problems and this pressurizes them to cooperate. The authors have analyzed how the complexity of health care problems relates to two types of cooperation: consultation and multidisciplinary teamwork (MTW). Moreover, they have

  15. Bioethical responsibilities of the health authority in health care and biomedical research

    Directory of Open Access Journals (Sweden)

    Rodrigo A. Salinas

    2015-01-01

    Full Text Available The reflection on bioethical contents of health policies and their effects on the demands for social justice has been a preferred concern of those who have driven the health reforms that were behind the creation of the National Health Service and, more recently, the regime of health guarantees. In the course of the years, the concern for the vindication of individual rights in the context of health care and research has joined to citizen demands for equitable access to health actions. For this purpose, in 2006 and 2012, specific laws addressing these matters were enacted and in the last year, regulations that make them operative emerged and are being implemented. The wording of the articles of both laws, in the effort to rescue individual rights, raises an imbalance in some respects, with regard to the social impact of their implementation. In certain subjects, its provisions run counter to existing codes of professional ethics in the country and in others; its implementation allows the privatization of the process of ethical review of pharmacological research, which was restricted to public health services. The absence of starting up of the National Bioethics Commission, pending since 2006, has prevented the creation of a pluralistic spaTce for deliberation on these issues and others as provided by law.

  16. [Health care for migrant patients: primary care or specialized medicine?].

    Science.gov (United States)

    Durieux-Paillard, S; Dao, M Dominicé; Perron, N Junod

    2007-09-26

    When consulting with migrant patients, general practitioners should pay special attention to the quality of their communication, because language barriers and cultural differences may arise. They must also be aware that life events experienced in the home country, during transit and in the host country can impact negatively on their patients' health, and thus a detailed history must be carefully obtained. Finally, they must be conscious that the migratory policies of the host country can influence the delivery of health care to migrant patients as well as their health status.

  17. Toward More Equitable Primary Health Care in Argentina and Latin ...

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

    Intersectoral efforts in the healthcare industry are projects and programs involving multiple sectors working together to improve health and well-being. This requires collaboration and coordination between the formal health sector and other sectors such as social welfare, education, environment, transportation, justice, ...

  18. Towards safe information technology in health care

    NARCIS (Netherlands)

    J.E.C.M. Aarts (Jos)

    2011-01-01

    textabstractHealth information technology is widely accepted to increase patient safety and reduce medical errors. The widespread implementation makes evident that health information technology has become of a complex sociotechnical system that is health care. Design and implementation may result in

  19. A Message to Health Care Professionals

    Centers for Disease Control (CDC) Podcasts

    2011-10-11

    This podcast features teens who urge US health care professionals to talk to teen patients about pregnancy and contraception.  Created: 10/11/2011 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Division of Reproductive Health (DRH).   Date Released: 10/11/2011.

  20. What Are the Professional, Political, and Ethical Challenges of Co-Creating Health Care Systems?

    Science.gov (United States)

    Singh, Guddi; Owens, John; Cribb, Alan

    2017-11-01

    Co-creation is seen by many as a means of meeting the multiple challenges facing contemporary health care systems by involving institutions, professionals, patients, and stakeholders in new roles, relationships, and collaborative practices. While co-creation has the potential to positively transform health care systems, it generates a number of political and ethical challenges that should not be overlooked. We suggest that those involved in envisioning and implementing co-creation initiatives pay close attention to significant questions of equity, power, and justice and to the fundamental challenge of securing a common vision of the aims of and agendas for health care systems. While such initiatives present significant opportunities for improvement, they need to be viewed in light of their accompanying professional, political, and ethical challenges. © 2017 American Medical Association. All Rights Reserved.

  1. Child Health Care Services in Austria.

    Science.gov (United States)

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

    2016-10-01

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

  2. COMMUNITY MEDICINE & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    ajiboro

    Management Sciences for Health (MSH) defined ... Poor supply chains, weak stock ... pharmacies and patent medicine stores for their ACT supply. ..... Global Health Observatory (GHO); program. ... logistics of supply and distribution is yet to be.

  3. COMMUNITY MEDICINE & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    ajiboro

    did not statistically affect it. (p>0.05). Conclusion ... and irritability) with concomitant memory .... associated with other health related effects though believe that it will affect the self- image and ego of .... attitude toward andropause among health.

  4. COMMUNITY MEDICINE & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    ajiboro

    Work Profile of Community Health Extension Workers in Cross. River State and ... reasons. In some countries they were to meet shortages in health manpower. In other ... Life expectancy is 51 years; maternal mortality and workers were ...

  5. & PRIMARY HEALTH CARE COMMUNITY MEDICINE

    African Journals Online (AJOL)

    Background: Physical exercise is important for good health. Moderate ... Conclusion: Public education is needed to improve physical activity and curb the menace of health ..... Geriatrics 53(10):46-62. ... Recreation Therapy, 2005; 4(1): 21-30.

  6. COMMUNITY MEDICINE & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    Background:Community Based Health Insurance Scheme is a social service organized at community level. It is a mutual health ... As part of her corporate social responsibility. Shell in .... Schmidt J. The benefits and challenges of shows the ...

  7. Digital health and perioperative care.

    Science.gov (United States)

    Fotis, Theofanis

    2017-06-01

    According to the U.S. Food and Drug Administration 'the broad scope of digital health includes categories such as mobile health (mHealth), health information technology (IT), wearable devices, telehealth and telemedicine, and personalised medicine, and is used by providers and other stakeholders in their efforts to reduce inefficiencies, improve access, reduce costs, increase quality, and make medicine more personalised for patients (FDA 2016). More recently, Paul Sonier, a digital health strategist and founder of the Linkedin digital health group with more than 40,000 members, defined digital health as 'the convergence of the digital and genomic revolutions with health, healthcare, living, and society' (storyofdigitalhealth.com 2016). Copyright the Association for Perioperative Practice.

  8. [External and internal financing in health care].

    Science.gov (United States)

    Henke, Klaus-Dirk

    2007-05-15

    The objective of this contribution is to characterize the functional and institutional features of the German health-care system. This takes place after a short introduction and examination of the ongoing debate on health care in Germany. External funding describes the form of revenue generation. Regarding external funding of the German health care system, one of the favored alternatives in the current debate is the possibility of introducing per capita payments. After a short introduction to the capitation option, focus is on the so-called health fund that is currently debated on and being made ready for implementation in Germany, actually a mixed system of capitation and contributions based on income. On the other hand, internal funding is the method of how different health-care services are purchased or reimbursed. This becomes a rather hot topic in light of new trends for integrated and networked care to patients and different types of budgeting. Another dominating question in the German health-care system is the liberalization of the contractual law, with its "joint and uniform" regulations that have to be loosened for competition gains. After a discussion of the consequences of diagnosis-related groups (DRGs) in Germany, the article is concluded by a note on the political rationality of the current health-care reform for increased competition within the Statutory Health Insurance and its players as exemplified by the health fund. To sum up, it has to be said that the complexity and specific features of how the German system is financed seem to require ongoing reform considerations even after realization of the currently debated health-care reform law which, unfortunately, is dominated by political rationalities rather than objective thoughts.

  9. Traveling technologies and transformations in health care

    DEFF Research Database (Denmark)

    Juul, Annegrete

    2010-01-01

    light, its chances of influencing those it would like bear down on is bound to be minimal. For a health care program to have an effect it must be able to travel or move between practices. Some health care programs successfully accomplish this task. They come to be widely adopted, apparently having...... global relevance, as for example the Chronic Disease Self-Management Program, which has been adopted by countries as diverse as Japan, Australia and Denmark. But how does this happen and which effects does traveling have on a health care program and its place of arrival? This question is the starting...... point for the following text....

  10. Robots and service innovation in health care.

    Science.gov (United States)

    Oborn, Eivor; Barrett, Michael; Darzi, Ara

    2011-01-01

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

  11. Health care evaluation, utilitarianism and distortionary taxes.

    Science.gov (United States)

    Calcott, P

    2000-09-01

    Cost Utility Analysis (CUA) and Cost Benefit Analysis (CBA) are methods to evaluate allocations of health care resources. Problems are raised for both methods when income taxes do not meet the first best optimum. This paper explores the implications of three ways that taxes may fall short of this ideal. First, taxes may be distortionary. Second, they may be designed and administered without reference to information that is used by providers of health care. Finally, the share of tax revenue that is devoted to health care may be suboptimal. The two methods are amended to account for these factors.

  12. Simulation modeling for the health care manager.

    Science.gov (United States)

    Kennedy, Michael H

    2009-01-01

    This article addresses the use of simulation software to solve administrative problems faced by health care managers. Spreadsheet add-ins, process simulation software, and discrete event simulation software are available at a range of costs and complexity. All use the Monte Carlo method to realistically integrate probability distributions into models of the health care environment. Problems typically addressed by health care simulation modeling are facility planning, resource allocation, staffing, patient flow and wait time, routing and transportation, supply chain management, and process improvement.

  13. mHealth in Cardiovascular Health Care.

    Science.gov (United States)

    Chow, Clara K; Ariyarathna, Nilshan; Islam, Sheikh Mohammed Shariful; Thiagalingam, Aravinda; Redfern, Julie

    2016-08-01

    Mobile health (mHealth) has been defined as medical and public health practice supported by mobile devices, such as mobile phones, patient monitoring devices and personal digital assistants. Cardiovascular mHealth is, arguably, leading the mHealth space, through innovation, research and implementation, and especially in the areas of prevention, cardiac rehabilitation and education. mHealth includes simple strategies, such as the use of short message service (SMS) or text messages in successful short-term smoking-cessation, weight loss and diabetes management programs. The recent Australian Tobacco, Exercise and Diet Messages (TEXT ME) randomised clinical trial addressed multiple cardiovascular risk factors. mHealth can also involve more complex strategies, such as smart phone applications (apps), global positioning systems (GPS) and Bluetooth technologies. Although many apps could be considered suitable for primary prevention, they are largely unregulated and most are not evidence-based. Some have been well-developed, such as the Food Switch app and an iPhone electrocardiogram (ECG) system. The "explosion" of apps has driven initiatives such as the Mobile Applications Rating Scale (MARS). More recently, the use of sensors to monitor and provide feedback to patients and healthcare providers is being explored. With almost two billion people currently owning a Smartphone, and 50% of adults (globally) predicted to own one by 2018, mHealth provides the prospect of delivering efficient, affordable healthcare services to widespread populations both locally and globally. In particular, it has the potential to reduce socioeconomic disparity and alleviate the burden of cardiovascular disease. There is now a need to rethink traditional health service structures and bioengineering capacity, to ensure mHealth systems are also safe, secure and robust. Copyright © 2016 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of

  14. Finding Common Ground: Environmental Ethics, Social Justice, and a Sustainable Path for Nature-Based Health Promotion.

    Science.gov (United States)

    Jennings, Viniece; Yun, Jessica; Larson, Lincoln

    2016-08-25

    Decades of research have documented continuous tension between anthropocentric needs and the environment's capacity to accommodate those needs and support basic human welfare. The way in which society perceives, manages, and ultimately utilizes natural resources can be influenced by underlying environmental ethics, or the moral relationship that humans share with the natural world. This discourse often centers on the complex interplay between the tangible and intangible benefits associated with nonhuman nature (e.g., green space), both of which are relevant to public health. When ecosystem degradation is coupled with socio-demographic transitions, additional concerns related to distributional equity and justice can arise. In this commentary, we explore how environmental ethics can inform the connection between the ecosystem services from green space and socially just strategies of health promotion.

  15. Poultry litter incineration as a source of energy: reviewing the potential for impacts on environmental health and justice.

    Science.gov (United States)

    Stingone, Jeanette A; Wing, Steve

    2011-01-01

    Legislation in North Carolina has mandated obtaining renewable energy from the incineration of poultry waste, resulting in proposals for three poultry-litter-fueled power plants statewide. This article summarizes environmental health and environmental justice issues associated with incineration of poultry waste for the generation of electric power. Emissions from poultry waste incineration include particulate matter, dioxins, arsenic, bioaerosols and other toxins; various components are associated with cardiovascular disease, cancer, respiratory illness, and other diseases. Industrial farm animal production tends to be concentrated in low-income, rural communities, where residents may be more vulnerable to air pollutants due to pre-existing diseases, other exposures and stressors, and poor access to medical services. These communities lack the political clout to prevent citing of polluting facilities or to pressure industry and government to follow and enforce regulations. Policies intended to reduce reliance on fossil fuels have the potential to increase environmental injustices and threats to environmental health.

  16. The carbon footprint of Australian health care.

    Science.gov (United States)

    Malik, Arunima; Lenzen, Manfred; McAlister, Scott; McGain, Forbes

    2018-01-01

    Carbon footprints stemming from health care have been found to be variable, from 3% of the total national CO 2 equivalent (CO 2 e) emissions in England to 10% of the national CO 2 e emissions in the USA. We aimed to measure the carbon footprint of Australia's health-care system. We did an observational economic input-output lifecycle assessment of Australia's health-care system. All expenditure data were obtained from the 15 sectors of the Australian Institute of Health and Welfare for the financial year 2014-15. The Australian Industrial Ecology Virtual Laboratory (IELab) data were used to obtain CO 2 e emissions per AUS$ spent on health care. In 2014-15 Australia spent $161·6 billion on health care that led to CO 2 e emissions of about 35 772 (68% CI 25 398-46 146) kilotonnes. Australia's total CO 2 e emissions in 2014-15 were 494 930 kilotonnes, thus health care represented 35 772 (7%) of 494 930 kilotonnes total CO 2 e emissions in Australia. The five most important sectors within health care in decreasing order of total CO 2 e emissions were: public hospitals (12 295 [34%] of 35 772 kilotonnes CO 2 e), private hospitals (3635 kilotonnes [10%]), other medications (3347 kilotonnes [9%]), benefit-paid drugs (3257 kilotonnes [9%]), and capital expenditure for buildings (2776 kilotonnes [8%]). The carbon footprint attributed to health care was 7% of Australia's total; with hospitals and pharmaceuticals the major contributors. We quantified Australian carbon footprint attributed to health care and identified health-care sectors that could be ameliorated. Our results suggest the need for carbon-efficient procedures, including greater public health measures, to lower the impact of health-care services on the environment. None. Copyright © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.

  17. Challenges in mental health care in the Family Health Strategy

    Directory of Open Access Journals (Sweden)

    Consuelo Helena Aires de Freitas

    2011-06-01

    Full Text Available Objective: To discuss the practice of mental health care performed by healthcare professionals from the Family Health Strategy in Fortaleza-CE, Brazil. Methods: This is a critical and reflective study conducted in six Basic Health Units in Fortaleza-Ce. The study subjects were 12 health workers of the following professions: doctor, nurse, community health agents and technical and/or nursing assistant. Semi-structured interviews, systematic observationand questionnaire were used for data collection. The empirical analysis was based on an understanding of the discourses through critical hermeneutics. Results: It was evident that the mental health services are developed by some health workers in the ESF, such as, matrix support, relational technologies, home visits and community group therapy. However, there is still deficiency in training/coaching by most professionals in primary care, due to anenduring model of pathological or curative health care. Conclusion: Mental health care is still occasionally held by some workers in primary care. However, some progresses are already present as matrix support, relational technologies in health care, home visits andcommunity therapy.

  18. [Rethinking ethics with Paul Ricœur. Nursing: between responsibility, care and justice].

    Science.gov (United States)

    Svandra, Philippe

    2016-03-01

    In this article, the purpose is less praising Paul Ricoeur's work than enlightening how the reader may actually find some practical, even operative help in this philosophical thought. This is particularly true regarding the fields of medicine and care. Paul Ricœur is now worldwide renowned as a major philosophical figure of the 20th century, and with books such as "Oneself as another", he occupies a very peculiar place at the crossroads of phenomenology and hermeneutics. Through both these philosophical traditions, Paul Ricœur offers some narrative ethics which may greatly sustain caregivers in their reflexion. Yet, the aim of this article is to focus on this philosopher who invites us to inhabit and play a role in this world. The goal is also to bring out the pragmatic ethics that this thinker developed, based on Aristotelian and Kantian traditions. Then, this piece seeks to demonstrate how the three stages of Ricoeur's "petite éthique" (his "small ethics"), which are the self's aim "for the good life with and for others in just institutions" can shed some light on the ethical consideration of politicals and caregivers.

  19. Leadership research in business and health care.

    Science.gov (United States)

    Vance, Connie; Larson, Elaine

    2002-01-01

    To summarize research on leadership in the health care and business literature and to identify the outcomes of leadership on individuals, groups, and organizations. A computerized search and review of research studies was conducted in the health care and business literature from 1970-1999. Studies were categorized and analyzed according to participants, design, primary topic area, and effects or outcomes of leadership. Most of the health care and business literature on leadership consisted of anecdotal or theoretical discussion. Only 4.4% (n = 290) of 6,628 articles reviewed were data-based. Further, the largest proportion of the research (120/290, 41.4%) was purely descriptive of the demographic characteristics or personality traits of leaders. Other studies showed the influence of leadership on subordinates (27.9%). Only 15 (5.2%) of 290 research articles include correlations of qualities or styles of leadership with measurable outcomes on the recipients of services or positive changes in organizations. Research on leadership in the health care and business literature to date has been primarily descriptive. Although work in the social sciences indicates that leadership styles can have a major influence on performance and outcomes, minimal transfer of this work to the health care system is evident. Limited research on leadership and health care outcomes exists, such as changes in patient care or improvements in organizational outputs. In this era of evidence-based practice, such research, although difficult to conduct, is urgently needed.

  20. Health promotion in connection to the health care students

    Directory of Open Access Journals (Sweden)

    S. Kyuchukova

    2017-09-01

    Full Text Available The activities of health promotion for the students in health care specialties is organized and managed by the teacher process. During the training communication skills are acquired. It is the time for preparing students for work in counseling and patient education, collecting and providing health information - promotive function in the process of care (1. We assumed that these opportunities could be used in our work with children deprived of parental care. We set a goal to explore experiences, attitudes and ideas about students’ participation in health care in health promotion in the community of children and individuals. The study found that students are aware of the social importance of the knowledge acquired during the training and are convinced of the need to support adolescents to develop a responsible attitude towards their own health.

  1. Professional values, technology and future health care: The view of health care professionals in The Netherlands

    NARCIS (Netherlands)

    M.E. Nieboer; A.M. van Hout; Joost van Hoof; Sil Aarts; Eveline Wouters

    2014-01-01

    Perceptions and values of care professionals are critical in successfully implementing technology in health care. The aim of this study was threefold: (1) to explore the main values of health care professionals, (2) to investigate the perceived influence of the technologies regarding these values,

  2. Dealing with Health and Health Care System Challenges in China: assessing health determinants and health care reforms

    NARCIS (Netherlands)

    H. Zhang (Hao)

    2017-01-01

    markdownabstractThis dissertation investigates the challenges faced by China around 2010 in two domains – population health and the health care system. Specifically, chapters 2 and 3 are devoted to health challenges, explaining the female health disadvantage in later life and assessing the effect

  3. An Australian hospital's training program and referral pathway within a multi-disciplinary health-justice partnership addressing family violence.

    Science.gov (United States)

    Forsdike, Kirsty; Humphreys, Cathy; Diemer, Kristin; Ross, Stuart; Gyorki, Linda; Maher, Helena; Vye, Penelope; Llewelyn, Fleur; Hegarty, Kelsey

    2018-06-01

    An innovative health-justice partnership was established to deliver legal assistance to women experiencing family violence who attended an Australian hospital. This paper reports on a multifaceted response to build capacity and willingness of health professionals to identify signs of family violence and engage with referral pathways to on-site legal assistance. A Realistic Evaluation analysed health professionals' knowledge and attitudes towards identification, response and referral for family violence before and after training; and use of referral pathways. Of 123 health professionals participating in training, 67 completed baseline and follow-up surveys. Training improved health professionals' self-reported knowledge of, and confidence in, responding to family violence and understanding of lawyers' roles in hospitals. Belief that patients should be referred to on-site legal services increased. Training did not correspond to actual increased referrals to legal assistance. The program built capacity and willingness of health professionals to identify signs of, and respond to, family violence. Increase in referral rates to legal assistance was not shown. Potential improvements include better data capture and greater availability of legal services. Implications for public health: Strong hospital system supports and reliable recording of family violence referrals need to be in place before introducing such partnerships to other hospitals. © 2017 The Authors.

  4. Challenges to Native American health care.

    Science.gov (United States)

    Noren, J; Kindig, D; Sprenger, A

    1998-01-01

    Native American health care programs face complex and unprecedented challenges resulting from the increased assumption of clinical operations by tribal authorities, shortfalls in Federal funding, modifications in state and Federal health and welfare programs, and intensifying involvement with managed care organizations. These challenges are further complicated by service populations that are increasing at a faster rate than the growth in funding. The authors conducted onsite surveys of 39 Native American health programs in 10 states in order to assess the organizational and management problems they faced. The trend toward transfer of health programs from the Indian Health Service to tribal operation seems likely to continue and accelerate. The survey results indicate that in order for programs to be effective in the long run, they will need to be guided by skilled managers able to adapt to these powerful changes in the health care environment.

  5. Health care in the 21st Century.

    Science.gov (United States)

    Kaiser, L R

    1996-01-01

    Our primary agenda for the 21st Century is the reinvention of America. We must reinvent democracy, capitalism, entrepreneurism, and community. Indeed, we must recreate all of our major social institutions. This includes health care. A design for a new society requires a new design for health care. In fact, health care enjoys a special privilege in this regard. It is the gateway to total societal redesign. Health is the common denominator in any society. If you loose your health you cannot work, you cannot play, you cannot study; and, if you lose it sufficiently, you cannot even pray. Health and well-being create the foundation for all other constructive human endeavors. Therefore, the design of healthy communities is the necessary first step in the redesign of total human habitats. This massive redesign effort will take a century. However, it will be launched in the next few years.

  6. [Calculation of workers' health care costs].

    Science.gov (United States)

    Rydlewska-Liszkowska, Izabela

    2006-01-01

    In different health care systems, there are different schemes of organization and principles of financing activities aimed at ensuring the working population health and safety. Regardless of the scheme and the range of health care provided, economists strive for rationalization of costs (including their reduction). This applies to both employers who include workers' health care costs into indirect costs of the market product manufacture and health care institutions, which provide health care services. In practice, new methods of setting costs of workers' health care facilitate regular cost control, acquisition of detailed information about costs, and better adjustment of information to planning and control needs in individual health care institutions. For economic institutions and institutions specialized in workers' health care, a traditional cost-effect calculation focused on setting costs of individual products (services) is useful only if costs are relatively low and the output of simple products is not very high. But when products form aggregates of numerous actions like those involved in occupational medicine services, the method of activity based costing (ABC), representing the process approach, is much more useful. According to this approach costs are attributed to the product according to resources used during different activities involved in its production. The calculation of costs proceeds through allocation of all direct costs for specific processes in a given institution. Indirect costs are settled on the basis of resources used during the implementation of individual tasks involved in the process of making a new product. In this method, so called map of processes/actions consisted in the manufactured product and their interrelations are of particular importance. Advancements in the cost-effect for the management of health care institutions depend on their managerial needs. Current trends in this regard primarily depend on treating all cost reference

  7. Health Problems and Health Care Seeking Behaviour of Rohingya Refugees

    OpenAIRE

    Masud, Abdullah Al; Ahmed, Md. Shahoriar; Sultana, Mst. Rebeka; Alam, S. M. Iftekhar; Kabir, Russell; Arafat, S. M. Yasir; Papadopoulos, Konstantinos

    2017-01-01

    Abstract Background: Rohingya refugees are one of the most vulnerable group due to lack of health care system, personal hygiene, shelter, sanitation and violence. Aim: The present study aims to find out the health problems and health care seeking behavior of rohingya refugee peoples, to identify the socio-demographic information for such exposure group in relation to age, sex, occupation, living areas, to explore the patient's physical, emotional, perceptions, attitudes and environmen...

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

    Science.gov (United States)

    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

  9. [Managed care. Its impact on health care in the USA, especially on anesthesia and intensive care].

    Science.gov (United States)

    Bauer, M; Bach, A

    1998-06-01

    Managed care, i.e., the integration of health insurance and delivery of care under the direction of one organization, is gaining importance in the USA health market. The initial effects consisted of a decrease in insurance premiums, a very attractive feature for employers. Managed care promises to contain expenditures for health care. Given the shrinking public resources in Germany, managed care seems attractive for the German health system, too. In this review the development of managed care, the principal elements, forms of organisation and practical tools are outlined. The regulation of the delivery of care by means of controlling and financial incentives threatens the autonomy of physicians: the physician must act as a "double agent", caring for the interest for the individual patient and being restricted by the contract with the managed care organisation. Cost containment by managed care was achieved by reducing the fees for physicians and hospitals (and partly by restricting care for patients). Only a fraction of this cost reduction was handed over to the enrollee or employer, and most of the money was returned with profit to the shareholders of the managed care organisations. The preeminent role of primary care physicians as gatekeepers of the health network led to a reduced demand for specialist services in general and for university hospitals and anesthesiologists in particular. The paradigm of managed care, i.e., to guide the patient and the care giver through the health care system in order to achieve cost-effective and high quality care, seems very attractive. The stress on cost minimization by any means in the daily practice of managed care makes it doubtful if managed care should be an option for the German health system, in particular because there are a number of restrictions on it in German law.

  10. The Shifting Landscape of Health Care: Toward a Model of Health Care Empowerment

    Science.gov (United States)

    2011-01-01

    In a rapidly changing world of health care information access and patients’ rights, there is limited conceptual infrastructure available to understand how people approach and engage in treatment of medical conditions. The construct of health care empowerment is defined as the process and state of being engaged, informed, collaborative, committed, and tolerant of uncertainty regarding health care. I present a model in which health care empowerment is influenced by an interplay of cultural, social, and environmental factors; personal resources; and intrapersonal factors. The model offers a framework to understand patient and provider roles in facilitating health care empowerment and presents opportunities for investigation into the role of health care empowerment in multiple outcomes across populations and settings, including inquiries into the sources and consequences of health disparities. PMID:21164096

  11. Petroleum and Health Care: Evaluating and Managing Health Care's Vulnerability to Petroleum Supply Shifts

    Science.gov (United States)

    Bednarz, Daniel; Bae, Jaeyong; Pierce, Jessica

    2011-01-01

    Petroleum is used widely in health care—primarily as a transport fuel and feedstock for pharmaceuticals, plastics, and medical supplies—and few substitutes for it are available. This dependence theoretically makes health care vulnerable to petroleum supply shifts, but this vulnerability has not been empirically assessed. We quantify key aspects of petroleum use in health care and explore historical associations between petroleum supply shocks and health care prices. These analyses confirm that petroleum products are intrinsic to modern health care and that petroleum supply shifts can affect health care prices. In anticipation of future supply contractions lasting longer than previous shifts and potentially disrupting health care delivery, we propose an adaptive management approach and outline its application to the example of emergency medical services. PMID:21778473

  12. Community mental health care in India.

    Science.gov (United States)

    Padmavati, R

    2005-04-01

    Recent times are witnessing methods in the various forms of community care for the mentally ill in India. Non-governmental organizations (NGO) play a pivotal role in filling the gap in the existing mental health services in India and the substantial need for these services. Various strategies that have been employed in community care have attempted to utilize existing community resources for implementation. Informal manpower resources incorporated with specialist psychiatric care and integrated with existing health care facilities have been general strategies. While the feasibility and cost-effectiveness of the NGO operated community outreach programs for the mentally ill have been demonstrated, various factors are seen to influence the planning and execution of such programs. This paper elucidates some critical factors that would need to be considered in community mental health care in India.

  13. Modeling Health Care Expenditures and Use.

    Science.gov (United States)

    Deb, Partha; Norton, Edward C

    2018-04-01

    Health care expenditures and use are challenging to model because these dependent variables typically have distributions that are skewed with a large mass at zero. In this article, we describe estimation and interpretation of the effects of a natural experiment using two classes of nonlinear statistical models: one for health care expenditures and the other for counts of health care use. We extend prior analyses to test the effect of the ACA's young adult expansion on three different outcomes: total health care expenditures, office-based visits, and emergency department visits. Modeling the outcomes with a two-part or hurdle model, instead of a single-equation model, reveals that the ACA policy increased the number of office-based visits but decreased emergency department visits and overall spending.

  14. Equity versus humanity in health care

    African Journals Online (AJOL)

    Discussions of the economic aspects of health care often blur the distinction ... occupation with the treatment of economic symptoms rather than causes. ..... New York: Basic Books,. 1974. 14. ... Harvard University Press, 1971. 21. Benatar SR.

  15. CDC Vital Signs: Making Health Care Safer

    Science.gov (United States)

    ... of Page What Can Be Done The Federal government is Implementing activities across all government agencies to ... Making Health Care Safer [PSA – 0:60 seconds] Digital Press Kit: CDC Modeling Predicts Growth of Drug- ...

  16. Coverage matters: insurance and health care

    National Research Council Canada - National Science Library

    Board on Health Care Services Staff; Institute of Medicine Staff; Institute of Medicine; National Academy of Sciences

    2001-01-01

    ...: Insurance and Health Care , explores the myths and realities of who is uninsured, identifies social, economic, and policy factors that contribute to the situation, and describes the likelihood faced...

  17. Reshaping Health Care in Latin America

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

    Reform In Mexico — Silvia Tamez and Nancy Molina ... This book assesses the health care reforms of the past decade in Argentina, Brazil and Mexico. ...... prevention and control of pulmonary tuberculosis; prevention and control of high blood ...

  18. Who pays for health care in Asia?

    Science.gov (United States)

    O'Donnell, Owen; van Doorslaer, Eddy; Rannan-Eliya, Ravi P; Somanathan, Aparnaa; Adhikari, Shiva Raj; Akkazieva, Baktygul; Harbianto, Deni; Garg, Charu C; Hanvoravongchai, Piya; Herrin, Alejandro N; Huq, Mohammed N; Ibragimova, Shamsia; Karan, Anup; Kwon, Soon-man; Leung, Gabriel M; Lu, Jui-fen Rachel; Ohkusa, Yasushi; Pande, Badri Raj; Racelis, Rachel; Tin, Keith; Tisayaticom, Kanjana; Trisnantoro, Laksono; Wan, Quan; Yang, Bong-Min; Zhao, Yuxin

    2008-03-01

    We estimate the distributional incidence of health care financing in 13 Asian territories that account for 55% of the Asian population. In all territories, higher-income households contribute more to the financing of health care. The better-off contribute more as a proportion of ability to pay in most low- and lower-middle-income territories. Health care financing is slightly regressive in three high-income economies with universal social insurance. Direct taxation is the most progressive source of finance and is most so in poorer economies. In universal systems, social insurance is proportional to regressive. In high-income economies, the out-of-pocket (OOP) payments are proportional or regressive while in low-income economies the better-off spend relatively more OOP. But in most low-/middle-income countries, the better-off not only pay more, they also get more health care.

  19. Inequalities in South African health care

    African Journals Online (AJOL)

    the other to the population as cliemele of that system. Recently the ... divides from which inequalities in this sector emanate are those of .... power for private health care, and fewer srill are insured .... Nurses are mainly employed in public sector.

  20. Illuminating collaboration in emergency health care situations

    DEFF Research Database (Denmark)

    Sonnenwald, Diane H.; Söderholm, Hanna Maurin; Welch, Gregory F.

    2014-01-01

    reported the technology would require additional training, changes to existing financial models used in emergency health care, and increased access to physicians. Conclusions. Teaching collaboration skills and strategies to physicians and paramedics could benefit their collaboration today, and increase...

  1. Making Health Care Safer PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    This 60 second public service announcement is based on the March 2013 CDC Vital Signs report, which discusses lethal infections from carbapenem-resistant Enterobacteriaceae, or CRE, germs and ways health care providers can help stop CRE infections.

  2. [Communication in health care - legal aspects].

    Science.gov (United States)

    Mina, András

    2016-04-24

    This paper is focusing on the legal aspects of communication in health care, especially on doctor-patient relationship, responsibility for information, communication of adverse events, and legal declarations.

  3. Mental Health Care: Who's Who

    Science.gov (United States)

    ... Healthy Living Healthy Living Healthy Living Nutrition Fitness Sports Oral Health Emotional Wellness Growing Healthy Sleep Safety & Prevention Safety & Prevention Safety and Prevention Immunizations ...

  4. Chiropractic care and public health

    DEFF Research Database (Denmark)

    Johnson, Claire; Rubinstein, Sidney M; Côté, Pierre

    2012-01-01

    The purpose of this collaborative summary is to document current chiropractic involvement in the public health movement, reflect on social ecological levels of influence as a profession, and summarize the relationship of chiropractic to the current public health topics of: safety, health issues...... disorders? How can chiropractic use cognitive behavioral therapy to address chronic low back pain as a public health problem? What opportunities exist for doctors of chiropractic to more effectively serve the aging population? What is the role of ethics and the contribution of the chiropractic profession...

  5. Is organizational justice climate at the workplace associated with individual-level quality of care and organizational affective commitment? A multi-level, cross-sectional study on dentistry in Sweden.

    Science.gov (United States)

    Berthelsen, Hanne; Conway, Paul Maurice; Clausen, Thomas

    2018-02-01

    The aim of this study is to investigate whether organizational justice climate at the workplace level is associated with individual staff members' perceptions of care quality and affective commitment to the workplace. The study adopts a cross-sectional multi-level design. Data were collected using an electronic survey and a response rate of 75% was obtained. Organizational justice climate and affective commitment to the workplace were measured by items from Copenhagen Psychosocial Questionnaire and quality of care by three self-developed items. Non-managerial staff working at dental clinics with at least five respondents (n = 900 from 68 units) was included in analyses. A set of Level-2 random intercept models were built to predict individual-level organizational affective commitment and perceived quality of care from unit-level organizational justice climate, controlling for potential confounding by group size, gender, age, and occupation. The results of the empty model showed substantial between-unit variation for both affective commitment (ICC-1 = 0.17) and quality of care (ICC-1 = 0.12). The overall results showed that the shared perception of organizational justice climate at the clinical unit level was significantly associated with perceived quality of care and affective commitment to the organization (p Organizational justice climate at work unit level explained all variation in affective commitment among dental clinics and was associated with both the individual staff members' affective commitment and perceived quality of care. These findings suggest a potential for that addressing organizational justice climate may be a way to promote quality of care and enhancing affective commitment. However, longitudinal studies are needed to support causality in the examined relationships. Intervention research is also recommended to probe the effectiveness of actions increasing unit-level organizational justice climate and test their impact on quality of care

  6. Promoting oral health care among people living in residential aged care facilities: Perceptions of care staff.

    Science.gov (United States)

    Villarosa, Amy R; Clark, Sally; Villarosa, Ariana C; Patterson Norrie, Tiffany; Macdonald, Susan; Anlezark, Jennifer; Srinivas, Ravi; George, Ajesh

    2018-04-23

    This study aimed to look at the practices and perspectives of residential aged care facility (RACF) care staff regarding the provision of oral health care in RACFs. Emphasis has been placed on the provision of adequate oral health care in RACFs through the Better Oral Health in Residential Aged Care programme. Endorsed by the Australian government, this programme provided oral health education and training for aged care staff. However, recent evidence suggests that nearly five years after the implementation of this programme, the provision of oral care in RACFs in NSW remains inadequate. This project utilised an exploratory qualitative design which involved a focus group with 12 RACF care staff. Participants were asked to discuss the current oral health practices in their facility, and their perceived barriers to providing oral health care. The key findings demonstrated current oral health practices and challenges among care staff. Most care staff had received oral health training and demonstrated positive attitudes towards providing dental care. However, some participants identified that ongoing and regular training was necessary to inform practice and raise awareness among residents. Organisational constraints and access to dental services also limited provision of dental care while a lack of standardised guidelines created confusion in defining their role as oral healthcare providers in the RACF. This study highlighted the need for research and strategies that focus on capacity building care staff in oral health care and improving access of aged care residents to dental services. © 2018 John Wiley & Sons A/S and The Gerodontology Association. Published by John Wiley & Sons Ltd.

  7. Inequalities in South African health care

    African Journals Online (AJOL)

    address inequalities in health care should commence at the root causes .... sion and disrribution, bear in mind rhat rhere are also rhose mecha- nism and .... gle body is evidem in borh nawmal heallh service syscems and socialised heallh care ...

  8. Vertical Integration Spurs American Health Care Revolution.

    Science.gov (United States)

    Phillips, Richard C.

    1986-01-01

    Under new "managed health care systems," the classical functional separation of risk taker, claims payor, and provider are vertically integrated into a common entity. This evolution should produce a competitive environment with medical care rendered to all Americans on a more cost-effective basis. (CJH)

  9. Future of Military Health Care Final Report

    Science.gov (United States)

    2007-12-20

    AND+third. 15 Ibid. 16 Ibid. 17 32 C.F.R. §199.17(p)(5)(ii) (2005). 18 See http://mytoc.tma.osd.mil/AccessToCare/ TOC /ATC.htm. 19 File name...responsible sexual behavior; mental health; injury and violence; environmental quality; immunization; and access to care.11 Responsibility The Assistant

  10. Integrating mental health into primary care: a global perspective

    National Research Council Canada - National Science Library

    Funk, Michelle

    2008-01-01

    ... for mental disorders is enormous 4. Primary care for mental health enhances access 5. Primary care for mental health promotes respect of human rights 6. Primary care for mental health is affordab...

  11. The valuation of health care intangible assets.

    Science.gov (United States)

    Reilly, R F; Rabe, J R

    1997-01-01

    Health care entities (and especially medical practices) are valued for a number of reasons: sale transaction pricing and structuring, merger formation and dissolution, taxation and regulatory compliance, and litigation support and dispute resolution. The identification and quantification of the entity's intangible assets are often the most important aspects of the valuation. This article illustrates the generally accepted methods for valuing health care-related intangible assets.

  12. The English and Swedish health care reforms.

    Science.gov (United States)

    Glennerster, H; Matsaganis, M

    1994-01-01

    England and Sweden have two of the most advanced systems of universal access to health care in the world. Both have begun major reforms based on similar principles. Universal access and finance from taxation are retained, but a measure of competition between providers of health care is introduced. The reforms therefore show a movement toward the kind of approach advocated by some in the United States. This article traces the origins and early results of the two countries' reform efforts.

  13. Health care delivery: strength in numbers.

    Science.gov (United States)

    DeVries, R A

    1978-03-16

    The number and types of multi-institutional arrangements among health care facilities are on the increase, and the days of the completely autonomous, independent hospital are coming to a close. Although by themselves hospital systems are no panacea in dealing with the challenges facing hospitals today, many such arrangements offer more opportunities than problems in coping with the rapid changes currently facing the health care industry. The pros and cons of seven arrangements are discussed in detail.

  14. Emerging trends in health care finance.

    Science.gov (United States)

    Sterns, J B

    1994-01-01

    Access to capital will become more difficult. Capital access is dependent on ability to repay debt, which, in turn, is dependent on internally generated cash flows. Under any health care reform proposal, revenue inflows will be slowed. The use of corporate finance techniques to limit financial risk and lower cost will be a permanent response to fundamental changes to the health care system. These changes will result in greater balance sheet management, centralized capital allocation, and alternative sources of capital.

  15. [Information security in health care].

    Science.gov (United States)

    Ködmön, József; Csajbók, Zoltán Ernő

    2015-07-05

    Doctors, nurses and other medical professionals are spending more and more time in front of the computer, using applications developed for general practitioners, specialized care, or perhaps an integrated hospital system. The data they handle during healing and patient care are mostly sensitive data and, therefore, their management is strictly regulated. Finding our way in the jungle of laws, regulations and policies is not simple. Notwithstanding, our lack of information does not waive our responsibility. This study summarizes the most important points of international recommendations, standards and legal regulations of the field, as well as giving practical advices for managing medical and patient data securely and in compliance with the current legal regulations.

  16. Crossing borders: a critical review of the role of the European Court of Justice in EU health policy.

    Science.gov (United States)

    Brooks, Eleanor

    2012-04-01

    Over the last two decades, the European Union (EU) has steadily increased its involvement in the health policies of its member states, with considerable support from the European Court of Justice (ECJ). However, much of the literature examining the Court's role has focused upon the intersection between internal market law and the health services sector; the majority of studies have failed to examine the potential role for the Court in public health policy. Observers such as Greer have seen the development of healthcare as a clear case of neofunctional spillover, a view supported but qualified by Wasserfallen and others, who present a more detailed account of the mechanics of the process. Alternative analyses have focused upon the new modes of governance, soft law and other factors - this article reviews the current state of research in the field and the extent to which it should concern health policy actors and non-specialists in EU policy alike. It concludes that the Court has played and continues to play a crucial role in the development of EU public health policy, as well as in health services and broader social policy, where its influence has already been well documented. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  17. Health Care Reform, Care Coordination, and Transformational Leadership.

    Science.gov (United States)

    Steaban, Robin Lea

    2016-01-01

    This article is meant to spur debate on the role of the professional nurse in care coordination as well as the role of nursing leaders for defining and leading to a future state. This work highlights the opportunity and benefits associated with transformation of professional nursing practice in response to the mandates of the Affordable Care Act of 2010. An understanding of core concepts and the work of care coordination are used to propose a model of care coordination based on the population health pyramid. This maximizes the roles of nurses across the continuum as transformational leaders in the patient/family and nursing relationship. The author explores the role of the nurse in a transactional versus transformational relationship with patients, leading to actualization of the nurse in care coordination. Focusing on the role of the nurse leader, the challenges and necessary actions for optimization of the professional nurse role are explored, using principles of transformational leadership.

  18. The construction of a governable health care

    DEFF Research Database (Denmark)

    Peyton, Margit Malmmose

    Many studies have been conducted on the issue of New Public Management (NPM) and health care, not always quoting directly the philosophies of NPM, but using methods deriving from it. This study seeks to explore the development of studies on NPM in health care since the 1970s. The following resear...... construction of the governable person” as a theoretical framework, all academic articles from AA journals on the issues of NPM, health care and/or hospitals are analyzed.......Many studies have been conducted on the issue of New Public Management (NPM) and health care, not always quoting directly the philosophies of NPM, but using methods deriving from it. This study seeks to explore the development of studies on NPM in health care since the 1970s. The following research...... questions will be addressed: What types of studies are conducted on NPM in health care and how do these studies relate to the construction of the governable person? What are the changes in these relations and is the acceptance of this nationally dependent? Using Miller and O’Leary’s (1987), “The...

  19. Health Care Ergonomics: Contributions of Thomas Waters.

    Science.gov (United States)

    Poole Wilson, Tiffany; Davis, Kermit G

    2016-08-01

    The aim of this study was to assess the contributions of Thomas Waters's work in the field of health care ergonomics and beyond. Waters's research of safe patient handling with a focus on reducing musculoskeletal disorders (MSDs) in health care workers contributed to current studies and prevention strategies. He worked with several groups to share his research and assist in developing safe patient handling guidelines and curriculum for nursing students and health care workers. The citations of articles that were published by Waters in health care ergonomics were evaluated for quality and themes of conclusions. Quality was assessed using the Mixed Methods Appraisal Tool and centrality to original research rating. Themes were documented by the type of population the citing articles were investigating. In total, 266 articles that referenced the top seven cited articles were evaluated. More than 95% of them were rated either medium or high quality. The important themes of these citing articles were as follows: (a) Safe patient handling is effective in reducing MSDs in health care workers. (b) Shift work has negative impact on nurses. (c) There is no safe way to manually lift a patient. (d) Nurse curriculums should contain safe patient handling. The research of Waters has contributed significantly to the health care ergonomics and beyond. His work, in combination with other pioneers in the field, has generated multiple initiatives, such as a standard safe patient-handling curriculum and safe patient-handling programs. © 2016, Human Factors and Ergonomics Society.

  20. Juvenile Justice

    OpenAIRE

    International Child Development Centre

    1998-01-01

    The third Innocenti Digest deals with the main issues connected with children and young people coming into conflict with the law and contact with the justice system. It looks at standards and problems from arrest through to the court hearing and sentencing, use of custodial measures and ways of avoiding the child’s unnecessary and counter-productive involvement with the formal justice system. It also covers prevention questions. Like previous publications in the series, it contains practical ...