Using Smartphones and Health Apps to Change and Manage Health Behaviors: A Population-Based Survey.

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Ernsting, Clemens; Dombrowski, Stephan U; Oedekoven, Monika; O Sullivan, Julie L; Kanzler, Melanie; Kuhlmey, Adelheid; Gellert, Paul

2017-04-05

Chronic conditions are an increasing challenge for individuals and the health care system. Smartphones and health apps are potentially promising tools to change health-related behaviors and manage chronic conditions. The aim of this study was to explore (1) the extent of smartphone and health app use, (2) sociodemographic, medical, and behavioral correlates of smartphone and health app use, and (3) associations of the use of apps and app characteristics with actual health behaviors. A population-based survey (N=4144) among Germans, aged 35 years and older, was conducted. Sociodemographics, presence of chronic conditions, health behaviors, quality of life, and health literacy, as well as the use of the Internet, smartphone, and health apps were assessed by questionnaire at home visit. Binary logistic regression models were applied. It was found that 61.25% (2538/4144) of participants used a smartphone. Compared with nonusers, smartphone users were younger, did more research on the Internet, were more likely to work full-time and more likely to have a university degree, engaged more in physical activity, and less in low fat diet, and had a higher health-related quality of life and health literacy. Among smartphone users, 20.53% (521/2538) used health apps. App users were younger, less likely to be native German speakers, did more research on the Internet, were more likely to report chronic conditions, engaged more in physical activity, and low fat diet, and were more health literate compared with nonusers who had a smartphone. Health apps focused on smoking cessation (232/521, 44.5%), healthy diet (201/521, 38.6%), and weight loss (121/521, 23.2%). The most common app characteristics were planning (264/521, 50.7%), reminding (188/521, 36.1%), prompting motivation (179/521 34.4%), and the provision of information (175/521, 33.6%). Significant associations were found between planning and the health behavior physical activity, between feedback or monitoring and physical

Wealth from Health: an incentive program for disease and population management: a 12-year project.

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Ratner, D; Louria, D; Sheffet, A; Fain, R; Curran, J; Saed, N; Bhaskar, S; Quereshi, M; Cable, G

2001-01-01

The future of healthcare is linked with its ability to face the challenges of consumerism. Disease and population management will represent the dominant style of healthcare delivery in the future. This article describes the Wealth from Health programs which utilize current and future technologies to help the healthcare system become a leader in healthcare delivery and to assist many communities at an affordable cost.

Developing Staffing Models to Support Population Health Management And Quality Oucomes in Ambulatory Care Settings.

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Haas, Sheila A; Vlasses, Frances; Havey, Julia

2016-01-01

There are multiple demands and challenges inherent in establishing staffing models in ambulatory heath care settings today. If health care administrators establish a supportive physical and interpersonal health care environment, and develop high-performing interprofessional teams and staffing models and electronic documentation systems that track performance, patients will have more opportunities to receive safe, high-quality evidence-based care that encourages patient participation in decision making, as well as provision of their care. The health care organization must be aligned and responsive to the community within which it resides, fully invested in population health management, and continuously scanning the environment for competitive, regulatory, and external environmental risks. All of these challenges require highly competent providers willing to change attitudes and culture such as movement toward collaborative practice among the interprofessional team including the patient.

Impact of a Population Health Management Intervention on Disparities in Cardiovascular Disease Control.

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James, Aisha; Berkowitz, Seth A; Ashburner, Jeffrey M; Chang, Yuchiao; Horn, Daniel M; O'Keefe, Sandra M; Atlas, Steven J

2018-04-01

Healthcare systems use population health management programs to improve the quality of cardiovascular disease care. Adding a dedicated population health coordinator (PHC) who identifies and reaches out to patients not meeting cardiovascular care goals to these programs may help reduce disparities in cardiovascular care. To determine whether a program that used PHCs decreased racial/ethnic disparities in LDL cholesterol and blood pressure (BP) control. Retrospective difference-in-difference analysis. Twelve thousdand five hundred fifty-five primary care patients with cardiovascular disease (cohort for LDL analysis) and 41,183 with hypertension (cohort for BP analysis). From July 1, 2014-December 31, 2014, 18 practices used an information technology (IT) system to identify patients not meeting LDL and BP goals; 8 practices also received a PHC. We examined whether having the PHC plus IT system, compared with having the IT system alone, decreased racial/ethnic disparities, using difference-in-difference analysis of data collected before and after program implementation. Meeting guideline concordant LDL and BP goals. At baseline, there were racial/ethnic disparities in meeting LDL (p = 0.007) and BP (p = 0.0003) goals. Comparing practices with and without a PHC, and accounting for pre-intervention LDL control, non-Hispanic white patients in PHC practices had improved odds of LDL control (OR 1.20 95% CI 1.09-1.32) compared with those in non-PHC practices. Non-Hispanic black (OR 1.15 95% CI 0.80-1.65) and Hispanic (OR 1.29 95% CI 0.66-2.53) patients saw similar, but non-significant, improvements in LDL control. For BP control, non-Hispanic white patients in PHC practices (versus non-PHC) improved (OR 1.13 95% CI 1.05-1.22). Non-Hispanic black patients (OR 1.17 95% CI 0.94-1.45) saw similar, but non-statistically significant, improvements in BP control, but Hispanic (OR 0.90 95% CI 0.59-1.36) patients did not. Interaction testing confirmed that disparities did not

Clinical reasoning and population health: decision making for an emerging paradigm of health care.

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Edwards, Ian; Richardson, Barbara

2008-01-01

Chronic conditions now provide the major disease and disability burden facing humanity. This development has necessitated a reorientation in the practice skills of health care professions away from hospital-based inpatient and outpatient care toward community-based management of patients with chronic conditions. Part of this reorientation toward community-based management of chronic conditions involves practitioners' understanding and adoption of a concept of population health management based on appropriate theoretical models of health care. Drawing on recent studies of expertise in physiotherapy, this article proposes a clinical reasoning and decision-making framework to meet these challenges. The challenge of population and community-based management of chronic conditions also provides an opportunity for physiotherapists to further clarify a professional epistemology of practice that embraces the kinds of knowledge and clinical reasoning processes used in physiotherapy practice. Three case studies related to the management of chronic musculoskeletal pain in different populations are used to exemplify the range of epistemological perspectives that underpin community-based practice. They illustrate the link between conceptualizations of practice problems and knowledge sources that are used as a basis for clinical reasoning and decision making as practitioners are increasingly required to move between the clinic and the community.

Effective public health management: The Nigerian experience | Abe ...

African Journals Online (AJOL)

Public health management in Nigeria is the process of mobilizing and deploying resources for the provision of effective public health services. To ensure an effective public health, population based strategies would need to be put in place and this would require proper management to yield desired results. This paper ...

A randomized controlled open trial of population-based disease and case management in a Medicare Plus Choice health maintenance organization.

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Martin, David C; Berger, Marc L; Anstatt, David T; Wofford, Jonathan; Warfel, DeAnn; Turpin, Robin S; Cannuscio, Carolyn C; Teutsch, Steven M; Mansheim, Bernard J

2004-10-01

The object of this study was to examine the effect of population-based disease management and case management on resource use, self-reported health status, and member satisfaction with and retention in a Medicare Plus Choice health maintenance organization (HMO). Study design consisted of a prospective, randomized controlled open trial of 18 months' duration. Participants were 8504 Medicare beneficiaries aged 65 and older who had been continuously enrolled for at least 12 months in a network model Medicare Plus Choice HMO serving a contiguous nine-county metropolitan area. Members were care managed with an expert clinical information system and frequent telephone contact. Main outcomes included self-reported health status measured by the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36), resource use measured by admission rates and bed-days per thousand per year, member satisfaction, and costs measured by paid claims. More favorable outcomes occurred in the intervention group for satisfaction with the health plan (P management and case management led to improved self-reported satisfaction and social function but not to a global net decrease in resource use or improved member retention.

National Surveys of Population Health: Big Data Analytics for Mobile Health Monitors.

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Schatz, Bruce R

2015-12-01

At the core of the healthcare crisis is fundamental lack of actionable data. Such data could stratify individuals within populations to predict which persons have which outcomes. If baselines existed for all variations of all conditions, then managing health could be improved by matching the measuring of individuals to their cohort in the population. The scale required for complete baselines involves effective National Surveys of Population Health (NSPH). Traditionally, these have been focused upon acute medicine, measuring people to contain the spread of epidemics. In recent decades, the focus has moved to chronic conditions as well, which require smaller measures over longer times. NSPH have long utilized quality of life questionnaires. Mobile Health Monitors, where computing technologies eliminate manual administration, provide richer data sets for health measurement. Older technologies of telephone interviews will be replaced by newer technologies of smartphone sensors to provide deeper individual measures at more frequent timings across larger-sized populations. Such continuous data can provide personal health records, supporting treatment guidelines specialized for population cohorts. Evidence-based medicine will become feasible by leveraging hundreds of millions of persons carrying mobile devices interacting with Internet-scale services for Big Data Analytics.

Population health management as a strategy for creation of optimal healing environments in worksite and corporate settings.

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Chapman, Larry S; Pelletier, Kenneth R

2004-01-01

This paper provides an (OHE) overview of a population health management (PHM) approach to the creation of optimal healing environments (OHEs) in worksite and corporate settings. It presents a framework for consideration as the context for potential research projects to examine the health, well-being, and economic effects of a set of newer "virtual" prevention interventions operating in an integrated manner in worksite settings. The main topics discussed are the fundamentals of PHM with basic terminology and core principles, a description of PHM core technology and implications of a PHM approach to creating OHEs.

Implementation of a novel population panel management curriculum among interprofessional health care trainees.

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Kaminetzky, Catherine P; Beste, Lauren A; Poppe, Anne P; Doan, Daniel B; Mun, Howard K; Woods, Nancy Fugate; Wipf, Joyce E

2017-12-22

Gaps in chronic disease management have led to calls for novel methods of interprofessional, team-based care. Population panel management (PPM), the process of continuous quality improvement across groups of patients, is rarely included in health professions training for physicians, nurses, or pharmacists. The feasibility and acceptance of such training across different healthcare professions is unknown. We developed and implemented a novel, interprofessional PPM curriculum targeted to diverse health professions trainees. The curriculum was implemented annually among internal medicine residents, nurse practitioner students and residents, and pharmacy residents co-located in a large, academic primary care site. Small groups of interprofessional trainees participated in supervised quarterly seminars focusing on chronic disease management (e.g., diabetes mellitus, hypertension, or chronic obstructive pulmonary disease) or processes of care (e.g., emergency department utilization for nonacute conditions or chronic opioid management). Following brief didactic presentations, trainees self-assessed their clinic performance using patient-level chart review, presented individual cases to interprofessional staff and faculty, and implemented subsequent feedback with their clinic team. We report data from 2011 to 2015. Program evaluation included post-session participant surveys regarding attitudes, knowledge and confidence towards PPM, ability to identify patients for referral to interprofessional team members, and major learning points from the session. Directed content analysis was performed on an open-ended survey question. Trainees (n = 168) completed 122 evaluation assessments. Trainees overwhelmingly reported increased confidence in using PPM and increased knowledge about managing their patient panel. Trainees reported improved ability to identify patients who would benefit from multidisciplinary care or referral to another team member. Directed content analysis

Multinational Population-Based Health Surveys Linked to Outcome Data: An Untapped Resource

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Stacey Fisher

2017-04-01

This study provides initial support for the methodological feasibility of pooling linked population health surveys however, challenges introduced by dissimilarities will require the use of innovative methodologies, and discussions regarding how to manage jurisdictional data restrictions and privacy issues are needed. Pooled population health data has the potential to improve national and international health surveillance and public health.

Population-based worksite obesity management interventions: a qualitative case study.

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Romney, Martha C; Thomson, Erin; Kash, Kathryn

2011-06-01

Due to the increased prevalence of obesity and associated direct and indirect costs to employers, weight management programs have become an integral component of employer and insurer benefits plans. The programs vary in foci, scope, breadth, and implementation. The aim of this study was to explore promising employer-sponsored population-based obesity management programs. A case study that utilized a telephonic semi-structured questionnaire was conducted with small and large organizations located in different regions of the United States that had been recruited to participate. Eight employers and 1 health care advocacy coalition who met the inclusion criteria were interviewed about features of their weight management programs. The case study revealed a number of themes consistent with reports in the literature and reflecting cited best practices. Key findings include confirmation that weight management is a significant component of the wellness strategy in all participating organizations because employers are invested in population health programs and cost savings. Based upon their experience and knowledge, occupational health specialists are responsible for designing, implementing, managing, and evaluating employee health programs. Almost all employers utilize electronic media as a prominent component of wellness and disease management initiatives. Experience has shown that incentives-both financial and nonmonetary-are effective motivators for employee engagement and outcomes. However, while employers report success, favorable outcomes have been difficult to quantify.

Estimating small area health-related characteristics of populations: a methodological review

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Azizur Rahman

2017-05-01

Full Text Available Estimation of health-related characteristics at a fine local geographic level is vital for effective health promotion programmes, provision of better health services and population-specific health planning and management. Lack of a micro-dataset readily available for attributes of individuals at small areas negatively impacts the ability of local and national agencies to manage serious health issues and related risks in the community. A solution to this challenge would be to develop a method that simulates reliable small-area statistics. This paper provides a significant appraisal of the methodologies for estimating health-related characteristics of populations at geographical limited areas. Findings reveal that a range of methodologies are in use, which can be classified as three distinct set of approaches: i indirect standardisation and individual level modelling; ii multilevel statistical modelling; and iii micro-simulation modelling. Although each approach has its own strengths and weaknesses, it appears that microsimulation- based spatial models have significant robustness over the other methods and also represent a more precise means of estimating health-related population characteristics over small areas.

Population Health Management and the Second Golden Age of Arab Medicine: Promoting Health, Localizing Knowledge Industries, and Diversifying Economies in the GCC Countries.

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Mattke, Soeren; Hunter, Lauren E; Magnuson, Madeline; Arifkhanova, Aziza

2015-07-15

Over the past half-century, the Gulf Cooperation Council (GCC) countries-Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates-have experienced rapid economic growth and, with it, dramatic lifestyle changes. Low levels of physical activity and calorie-dense diets have led to an increase in the prevalence of chronic disease, most prominently diabetes. After having successfully controlled communicable diseases and made advanced acute care accessible locally, the GCC countries now face the challenge of orienting their health care systems toward prevention and treatment of chronic diseases. In this study, Dr. Mattke and his colleagues argue that this challenge presents GCC countries with a historic opportunity to reestablish the thought leadership role that Arab medicine had in the Islamic Golden Age. They propose that GCC countries could apply their considerable wealth to design and implement innovative health care systems based on population health management principles and sophisticated health information technology. Taking this path would not only improve prevention and management of chronic disease in the GCC countries but also contribute to the diversification of their economies and localization of knowledge industries.

Assessing return on investment of defined-population disease management interventions.

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Wilson, Thomas W; Gruen, Jeff; William, Thar; Fetterolf, Donald; Minalkumar, Patel; Popiel, Richard G; Lewis, Al; Nash, David B

2004-11-01

Strategies to reduce health expenditures through the improvement of health and quality of care are in high demand. A group of experts formed a nonpartisan, independent work group, under the sponsorship of the National Managed Health Care Congress. Its goal was to establish a list of easy-to-understand, actionable, and usable recommendations to enable disease management program advocates to conduct basic-level evaluations. The work group made recommendations concerning identification of reference and intervention population, population definitions, quantitative methods and data quality, confounding and bias, and stakeholder agreements/contracting. A case study was created to quantitatively illustrate some of the major issues raised by the work group. Five typical errors were simulated by applying different rules to the intervention population than to the reference population: differential inclusion (high versus low risk), differential exclusion (high versus low risk) and differential claims run-out. Compared with the true impact, four of the five errors resulted in a bias toward "intervention effect," while one (differential inclusion of high-risk patients) was biased against the "intervention effect." The direction and magnitude of the bias in natural settings will not necessarily follow this pattern.

Targeting Environmental Quality to Improve Population Health ...

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Key goals of health care reform are to stimulate innovative approaches to improve healthcare quality and clinical outcomes while holding down costs. To achieve these goals value-based payment places the needs of the patient first and encourages multi-stakeholder cooperation. Yet, the stakeholders are typically all within the healthcare system, e.g. the Accountable Care Organization or Patient-Centered Medical Home, leaving important contributors to the health of the population such as the public health and environmental health systems absent. And rarely is the quality of the environment regarded as a modifiable factor capable of imparting a health benefit. Underscoring this point, a PubMed search of the search terms “environmental quality” with “value-based payment”, “value-based healthcare” or “value-based reimbursement” returned no relevant articles, providing further evidence that the healthcare industry largely disregards the quality of the environment as a significant determinant of wellbeing and an actionable risk factor for clinical disease management and population health intervention. Yet, the quality of the environment is unequivocally related to indicators of population health including all-cause mortality. The EPA’s Environmental Quality Index (EQI) composed of five different domains (air, land use, water, built environment and social) has provided new estimates of the associations between environmental quality and health stat

Integration of priority population, health and nutrition interventions into health systems: systematic review

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Adeyi Olusoji

2011-10-01

Full Text Available Abstract Background Objective of the study was to assess the effects of strategies to integrate targeted priority population, health and nutrition interventions into health systems on patient health outcomes and health system effectiveness and thus to compare integrated and non-integrated health programmes. Methods Systematic review using Cochrane methodology of analysing randomised trials, controlled before-and-after and interrupted time series studies. We defined specific strategies to search PubMed, CENTRAL and the Cochrane Effective Practice and Organisation of Care Group register, considered studies published from January 1998 until September 2008, and tracked references and citations. Two reviewers independently agreed on eligibility, with an additional arbiter as needed, and extracted information on outcomes: primary (improved health, financial protection, and user satisfaction and secondary (improved population coverage, access to health services, efficiency, and quality using standardised, pre-piloted forms. Two reviewers in the final stage of selection jointly assessed quality of all selected studies using the GRADE criteria. Results Of 8,274 citations identified 12 studies met inclusion criteria. Four studies compared the benefits of Integrated Management of Childhood Illnesses in Tanzania and Bangladesh, showing improved care management and higher utilisation of health facilities at no additional cost. Eight studies focused on integrated delivery of mental health and substance abuse services in the United Kingdom and United States of America. Integrated service delivery resulted in better clinical outcomes and greater reduction of substance abuse in specific sub-groups of patients, with no significant difference found overall. Quality of care, patient satisfaction, and treatment engagement were higher in integrated delivery models. Conclusions Targeted priority population health interventions we identified led to improved health

Integration of priority population, health and nutrition interventions into health systems: systematic review.

Science.gov (United States)

Atun, Rifat; de Jongh, Thyra E; Secci, Federica V; Ohiri, Kelechi; Adeyi, Olusoji; Car, Josip

2011-10-10

Objective of the study was to assess the effects of strategies to integrate targeted priority population, health and nutrition interventions into health systems on patient health outcomes and health system effectiveness and thus to compare integrated and non-integrated health programmes. Systematic review using Cochrane methodology of analysing randomised trials, controlled before-and-after and interrupted time series studies. We defined specific strategies to search PubMed, CENTRAL and the Cochrane Effective Practice and Organisation of Care Group register, considered studies published from January 1998 until September 2008, and tracked references and citations. Two reviewers independently agreed on eligibility, with an additional arbiter as needed, and extracted information on outcomes: primary (improved health, financial protection, and user satisfaction) and secondary (improved population coverage, access to health services, efficiency, and quality) using standardised, pre-piloted forms. Two reviewers in the final stage of selection jointly assessed quality of all selected studies using the GRADE criteria. Of 8,274 citations identified 12 studies met inclusion criteria. Four studies compared the benefits of Integrated Management of Childhood Illnesses in Tanzania and Bangladesh, showing improved care management and higher utilisation of health facilities at no additional cost. Eight studies focused on integrated delivery of mental health and substance abuse services in the United Kingdom and United States of America. Integrated service delivery resulted in better clinical outcomes and greater reduction of substance abuse in specific sub-groups of patients, with no significant difference found overall. Quality of care, patient satisfaction, and treatment engagement were higher in integrated delivery models. Targeted priority population health interventions we identified led to improved health outcomes, quality of care, patient satisfaction and access to care

Targeted population health management can help a hospital grow market share.

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Olson, Gary; Talbert, Pearson

2012-06-01

In 2005, St. Luke's Hospital in Chesterfield, Mo., launched the "Passport to Wellness" program to help employers reduce preventable illnesses by providing access to screenings, health education, health coaching, disease management, and healthy lifestyle programs. The program was designed to influence consumer choice of hospitals and physicians and influence health insurance purchasing decisions. St. Luke's program also met goals created by local businesses, including identifying health risks of each employer's workforce and reducing health-related costs.

Using the collaborative intervention planning framework to adapt a health-care manager intervention to a new population and provider group to improve the health of people with serious mental illness.

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Cabassa, Leopoldo J; Gomes, Arminda P; Meyreles, Quisqueya; Capitelli, Lucia; Younge, Richard; Dragatsi, Dianna; Alvarez, Juana; Manrique, Yamira; Lewis-Fernández, Roberto

2014-11-30

Health-care manager interventions improve the physical health of people with serious mental illness (SMI) and could be widely implemented in public mental health clinics. Local adaptations and customization may be needed to increase the reach of these interventions in the public mental health system and across different racial and ethnic communities. In this study, we describe how we used the collaborative intervention planning framework to customize an existing health-care manager intervention to a new patient population (Hispanics with SMI) and provider group (social workers) to increase its fit with our local community. The study was conducted in partnership with a public mental health clinic that serves predominantly Hispanic clients. A community advisory board (CAB) composed of researchers and potential implementers (e.g., social workers, primary care physicians) used the collaborative intervention planning framework, an approach that combines community-based participatory research principles and intervention mapping (IM) procedures, to inform intervention adaptations. The adaptation process included four steps: fostering collaborations between CAB members; understanding the needs of the local population through a mixed-methods needs assessment, literature reviews, and group discussions; reviewing intervention objectives to identify targets for adaptation; and developing the adapted intervention. The application of this approach enabled the CAB to identify a series of cultural and provider level-adaptations without compromising the core elements of the original health-care manager intervention. Reducing health disparities in people with SMI requires community engagement, particularly when preparing existing interventions to be used with new communities, provider groups, and practice settings. Our study illustrates one approach that can be used to involve community stakeholders in the intervention adaptation process from the very beginning to enhance the

Retention of health workers in Malawi: perspectives of health workers and district management.

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Manafa, Ogenna; McAuliffe, Eilish; Maseko, Fresier; Bowie, Cameron; MacLachlan, Malcolm; Normand, Charles

2009-07-28

Shortage of human resources is a major problem facing Malawi, where more than 50% of the population lives in rural areas. Most of the district health services are provided by clinical health officers specially trained to provide services that would normally be provided by fully qualified doctors or specialists. As this cadre and the cadre of enrolled nurses are the mainstay of the Malawian health service at the district level, it is important that they are supported and motivated to deliver a good standard of service to the population. This study explores how these cadres are managed and motivated and the impact this has on their performance. A quantitative survey measured health workers' job satisfaction, perceptions of the work environment and sense of justice in the workplace, and was reported elsewhere. It emerged that health workers were particularly dissatisfied with what they perceived as unfair access to continuous education and career advancement opportunities, as well as inadequate supervision. These issues and their contribution to demotivation, from the perspective of both management and health workers, were further explored by means of qualitative techniques.Focus group discussions were held with health workers, and key-informant interviews were conducted with members of district health management teams and human resource officers in the Ministry of Health. The focus groups used convenience sampling that included all the different cadres of health workers available and willing to participate on the day the research team visited the health facility. The interviews targeted district health management teams in three districts and the human resources personnel in the Ministry of Health, also sampling those who were available and agreed to participate. The results showed that health workers consider continuous education and career progression strategies to be inadequate. Standard human resource management practices such as performance appraisal and the

Retention of health workers in Malawi: perspectives of health workers and district management

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MacLachlan Malcolm

2009-07-01

Full Text Available Abstract Background Shortage of human resources is a major problem facing Malawi, where more than 50% of the population lives in rural areas. Most of the district health services are provided by clinical health officers specially trained to provide services that would normally be provided by fully qualified doctors or specialists. As this cadre and the cadre of enrolled nurses are the mainstay of the Malawian health service at the district level, it is important that they are supported and motivated to deliver a good standard of service to the population. This study explores how these cadres are managed and motivated and the impact this has on their performance. Methods A quantitative survey measured health workers' job satisfaction, perceptions of the work environment and sense of justice in the workplace, and was reported elsewhere. It emerged that health workers were particularly dissatisfied with what they perceived as unfair access to continuous education and career advancement opportunities, as well as inadequate supervision. These issues and their contribution to demotivation, from the perspective of both management and health workers, were further explored by means of qualitative techniques. Focus group discussions were held with health workers, and key-informant interviews were conducted with members of district health management teams and human resource officers in the Ministry of Health. The focus groups used convenience sampling that included all the different cadres of health workers available and willing to participate on the day the research team visited the health facility. The interviews targeted district health management teams in three districts and the human resources personnel in the Ministry of Health, also sampling those who were available and agreed to participate. Results The results showed that health workers consider continuous education and career progression strategies to be inadequate. Standard human resource

Population preferences for health care in liberia: insights for rebuilding a health system.

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Kruk, Margaret E; Rockers, Peter C; Tornorlah Varpilah, S; Macauley, Rose

2011-12-01

OBJECTIVE. To quantify the influence of health system attributes, particularly quality of care, on preferences for health clinics in Liberia, a country with a high burden of disease that is rebuilding its health system after 14 years of civil war. DATA SOURCES/STUDY SETTING. Informed by focus group discussions, a discrete choice experiment (DCE) was designed to assess preferences for structure and process of care at health clinics. The DCE was fielded in rural, northern Liberia as part of a 2008 population-based survey on health care utilization. DATA COLLECTION. The survey response rate was 98 percent with DCE data available for 1,431 respondents. Mixed logit models were used to estimate the influence of six attributes on choice of hypothetical clinics for a future illness. PRINCIPAL FINDINGS. Participants' choice of clinic was most influenced by provision of a thorough physical exam and consistent availability of medicines. Respectful treatment and government (versus NGO) management marginally increased utility, whereas waiting time was not significant. CONCLUSIONS. Liberians value technical quality of care over convenience, courtesy, and public management in selecting clinics for curative care. This suggests that investments in improved competence of providers and availability of medicines may increase population utilization of essential services as well as promote better clinical outcomes. © Health Research and Educational Trust.

Measuring population health in Moldova: health expectancies

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Cristina Avram

2018-05-01

Full Text Available Health measures are decisive for the development and implementation of population health policies. Monitoring health indicators can lead to improvements in health and decrease in the inequalities among subpopulations. The life expectancy at birth for the Moldovan population did not increase considerably during the last decades, due to the social and economic crisis which led to high mortality and poor health. In Moldova, no aggregated health indicators are utilized for health monitoring. Therefore, the authors calculated health indicators to assess the population health and argue their importance. Mortality and subjective data on self-perceived health and self-rated morbidity from the Household Budget Survey was used for constructing period morbidity-mortality tables. Thus, the authors applied Sullivan’s method to calculate the life expectancy in very good/good/fair health and the life expectancy without chronic morbidity for the period 2006 - 2015. The life expectancies in very good/good/fair health showed a compression of morbidity in the older ages for both sexes, and for rural and urban types of residence. The life expectancies without chronic morbidity for males and for urban dwellers demonstrated an expansion of morbidity. Although the life expectancy is slowly increasing, the trends in population health are contradictory, depending on the applied measures. The health expectancy indicators, based on self-perceived health, depict the actual situation in the population health. These indicators are becoming more essential with the ageing process and can be used for the tailoring of social and health policies and services to the real needs of the population.

Gesundes Kinzigtal Integrated Care: improving population health by a shared health gain approach and a shared savings contract

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H. Hildebrandt

2010-06-01

Full Text Available Introduction: Integrated care solutions need supportive financial incentives. In this paper we describe the financial architecture and operative details of the integrated pilot Gesundes Kinzigtal.Description of integrated care case: Located in Southwest Germany, Gesundes Kinzigtal is one of the few population-based integrated care approaches in Germany, organising care across all health service sectors and indications. The system serving around half of the population of the region is run by a regional health management company (Gesundes Kinzigtal GmbH in coope­ration with the physicians' network in the region (MQNK, a German health care management company with a background in medical sociology and health economics (OptiMedis AG and with two statutory health insurers (among them is the biggest health insurer in Southwest Germany: AOK Baden-Württemberg.Discussion and (preliminary conclusion: The shared savings contract between Gesundes Kinzigtal GmbH and the two health insurers, providing financial incentives for managers and health care providers to realize a sub­stantial efficiency gain, could be an appropriate contractual base of Gesundes Kinzigtal's population health gain approach. This approach is based on the assumption that a more effective trans-sector organisation of Germany's health care system and increased investments in well-designed preventive programmes will lead to a reduction in  morbidity, and in particular to a reduced incidence and prevalence of chronic diseases. This, in turn, is to lead to a comparative reduction in health care cost. Although the comparative cost in the Kinzigtal region has been reduced from the onset of Gesundes Kinzigtal Integrated Care, only future research will have to demonstrate whether - and to what extent - cost reduction may be attributed to a real population health gain.

Gesundes Kinzigtal Integrated Care: improving population health by a shared health gain approach and a shared savings contract

Directory of Open Access Journals (Sweden)

H. Hildebrandt

2010-06-01

Full Text Available Introduction: Integrated care solutions need supportive financial incentives. In this paper we describe the financial architecture and operative details of the integrated pilot 'Gesundes Kinzigtal'. Description of integrated care case: Located in Southwest Germany, 'Gesundes Kinzigtal' is one of the few population-based integrated care approaches in Germany, organising care across all health service sectors and indications. The system serving around half of the population of the region is run by a regional health management company (Gesundes Kinzigtal GmbH in coope­ration with the physicians' network in the region (MQNK, a German health care management company with a background in medical sociology and health economics (OptiMedis AG and with two statutory health insurers (among them is the biggest health insurer in Southwest Germany: AOK Baden-Württemberg. Discussion and (preliminary conclusion: The shared savings contract between Gesundes Kinzigtal GmbH and the two health insurers, providing financial incentives for managers and health care providers to realize a sub­stantial efficiency gain, could be an appropriate contractual base of Gesundes Kinzigtal's population health gain approach. This approach is based on the assumption that a more effective trans-sector organisation of Germany's health care system and increased investments in well-designed preventive programmes will lead to a reduction in  morbidity, and in particular to a reduced incidence and prevalence of chronic diseases. This, in turn, is to lead to a comparative reduction in health care cost. Although the comparative cost in the Kinzigtal region has been reduced from the onset of Gesundes Kinzigtal Integrated Care, only future research will have to demonstrate whether - and to what extent - cost reduction may be attributed to a real population health gain.

Integral control for population management.

Science.gov (United States)

Guiver, Chris; Logemann, Hartmut; Rebarber, Richard; Bill, Adam; Tenhumberg, Brigitte; Hodgson, Dave; Townley, Stuart

2015-04-01

We present a novel management methodology for restocking a declining population. The strategy uses integral control, a concept ubiquitous in control theory which has not been applied to population dynamics. Integral control is based on dynamic feedback-using measurements of the population to inform management strategies and is robust to model uncertainty, an important consideration for ecological models. We demonstrate from first principles why such an approach to population management is suitable via theory and examples.

Patient credentialing as a population health management strategy: a diabetes case study.

Science.gov (United States)

Watson, Lindsay L; Bluml, Benjamin M; Skoufalos, Alexandria

2015-06-01

When given the opportunity to become actively involved in the decision-making process, patients can positively impact their health outcomes. Understanding how to empower patients to become informed consumers of health care services is an important strategy for addressing disparities and variability in care. Patient credentialing identifies people who have a certain diagnosis and have achieved certain levels of competency in understanding and managing their disease. Patient credentialing was developed to meet 3 core purposes: (1) enhance patient engagement by increasing personal accountability for health outcomes, (2) create a mass customization strategy for providers to deliver high-quality, patient-centered collaborative care, and (3) provide payers with a foundation for properly aligning health benefit incentives. The Patient Self-Management Credential for Diabetes, a first-of-its-kind, psychometrically validated tool, has been deployed within 3 practice-based research initiatives as a component of innovative diabetes care. Results from these projects show improved clinical outcomes, reduced health care costs, and a relationship between credential achievement levels and clinical markers of diabetes. Implementing patient credentialing as part of collaborative care delivered within various settings across the health care system may be an effective way to reduce disparities, improve access to care and appropriate treatments, incentivize patient engagement in managing their health, and expend time and resources in a customized way to meet individual needs.

Connecting Patients to mHealth Applications to Enhance Self-care Management.

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Conroy, Meghan K

2015-09-01

Smartphone use and the desire to use mHealth are growing in the population of patients who most commonly use home healthcare (HHC) services, a population with chronic conditions and complex healthcare management needs. HHC nurses are positioned to connect HHC patients with mHealth Apps to access health-related information, engage in interactive monitoring, and manage self-care activities. The challenge of finding reputable Apps is discussed and resources are presented to overcome this challenge at the business orindividual level.

[Research program for the Brazilian Unified Health System (SUS): the contribution to health management and services in Paraiba State, Brazil].

Science.gov (United States)

Celino, Suely Deysny de Matos; Costa, Gabriela Maria Cavalcanti; França, Inácia Sátiro Xavier de; Araújo, Ednaldo Cavalcante de

2013-01-01

The shared management in health of the Research Program for the Unified Health System (PPSUS) has the purpose of funding research in priority areas for the health of the Brazilian population. The scope of this qualitative study is to understand the researchers' perception of the contribution of research funded by the PPSUS invitations to bid in the State of Paraiba, for resolving the priority health problems of the Paraiba population, for reducing regional inequalities in health and for bolstering the management of SUS. A documentary survey of the bids and final reports of research and a semi-structured interview with 28 coordinators of these studies was conducted. Triangulation strategy of data was used and subsequently subjected to content analysis, which converged with the categories: solving the health problems; reducing regional inequalities; contribution to management. Paraiba state needs adjustments such that the PPSUS can be fully implemented, ensuring that the knowledge generated can be converted into health policies and actions, since the research funded respond to the health needs of the population and difficulties in SUS management.

Aligning smoke management with ecological and public health goals

Science.gov (United States)

Jonathan W. Long; Leland W. Tarnay; Malcolm P. North

2017-01-01

Past and current forest management affects wildland fire smoke impacts on downwind human populations. However, mismatches between the scale of benefits and risks make it difficult to proactively manage wildland fires to promote both ecological and public health. Building on recent literature and advances in modeling smoke and health effects, we outline a framework to...

Population Preferences for Health Care in Liberia: Insights for Rebuilding a Health System

Science.gov (United States)

Kruk, Margaret E; Rockers, Peter C; Tornorlah Varpilah, S; Macauley, Rose

2011-01-01

Objective To quantify the influence of health system attributes, particularly quality of care, on preferences for health clinics in Liberia, a country with a high burden of disease that is rebuilding its health system after 14 years of civil war. Data Sources/Study Setting Informed by focus group discussions, a discrete choice experiment (DCE) was designed to assess preferences for structure and process of care at health clinics. The DCE was fielded in rural, northern Liberia as part of a 2008 population-based survey on health care utilization. Data Collection The survey response rate was 98 percent with DCE data available for 1,431 respondents. Mixed logit models were used to estimate the influence of six attributes on choice of hypothetical clinics for a future illness. Principal Findings Participants' choice of clinic was most influenced by provision of a thorough physical exam and consistent availability of medicines. Respectful treatment and government (versus NGO) management marginally increased utility, whereas waiting time was not significant. Conclusions Liberians value technical quality of care over convenience, courtesy, and public management in selecting clinics for curative care. This suggests that investments in improved competence of providers and availability of medicines may increase population utilization of essential services as well as promote better clinical outcomes. PMID:21517835

[Consolidation of international guidelines for the management of canine populations in urban areas and proposal of performance indicators].

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Garcia, Rita de Cassia Maria; Calderón, Néstor; Ferreira, Fernando

2012-08-01

The objective of this study is to propose a generic program for the management of urban canine populations with suggestion of performance indicators. The following international guidelines on canine population management were revised and consolidated: World Health Organization, World Organisation for Animal Health, World Society for the Protection of Animals, International Companion Animal Management Coalition, and the Food and Agriculture Organization. Management programs should cover: situation diagnosis, including estimates of population size; social participation with involvement of various sectors in the planning and execution of strategies; educational actions to promote humane values, animal welfare, community health, and responsible ownership (through purchase or adoption); environmental and waste management to eliminate sources of food and shelter; registration and identification of animals; animal health care, reproductive control; prevention and control of zoonoses; control of animal commerce; management of animal behavior and adequate solutions for abandoned animals; and laws regulating responsible ownership, prevention of abandonment and zoonoses. To monitor these actions, four groups of indicators are suggested: animal population indicators, human/animal interaction indicators, public service indicators, and zoonosis indicators. The management of stray canine populations requires political, sanitary, ethologic, ecologic, and humanitarian strategies that are socially acceptable and environmentally sustainable. Such measures must also include the control of zoonoses such as rabies and leishmaniasis, considering the concept of "one health," which benefits both the animals and people in the community.

[The role of management in health care].

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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.

Population Health and Occupational Therapy.

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Braveman, Brent

2016-01-01

Occupational therapy practitioners play an important role in improving the health of populations through the development of occupational therapy interventions at the population level and through advocacy to address occupational participation and the multiple determinants of health. This article defines and explores population health as a concept and describes the appropriateness of occupational therapy practice in population health. Support of population health practice as evidenced in the official documents of the American Occupational Therapy Association and the relevance of population health for occupational therapy as a profession are reviewed. Recommendations and directions for the future are included related to celebration of the achievements of occupational therapy practitioners in the area of population health, changes to the Occupational Therapy Practice Framework and educational accreditation standards, and the importance of supporting, recognizing, rewarding, and valuing occupational therapy practitioners who assume roles in which direct care is not their primary function. Copyright © 2016 by the American Occupational Therapy Association, Inc.

Population health intervention research training: the value of public health internships and mentorship.

Science.gov (United States)

Hamelin, Anne-Marie; Paradis, Gilles

2018-01-01

Better alignment between academia and public health practice and policies are critical to improve public health actions. Training of future researchers to address complex issues and to conduct transdisciplinary and collaborative research will help improve this alignment. In this paper, we describe the role of internship placements and mentorship for trainees' skills development in population health intervention research and the benefits of embedding research trainees within public health organizations. This qualitative descriptive study assessed the perceptions of the role and benefits of internships and mentorship for population health intervention research training among former doctoral and postdoctoral students, public health mentors, and senior public health managers who participated in the 4P Program, a research training program which bridges academic training and the public health system in Quebec, Canada. Two types of interviews were conducted: telephone semi-structured interviews by an external evaluator and face-to-face trainee "exit" interviews by the Program co-director. Semi-annual evaluation reports from each trainee were also reviewed. Qualitative data were subjected to a thematic analysis. Internships provided trainees with a working knowledge of the public health system and the context in which decisions and public health interventions are implemented. It was an opportunity for trainees to interact with knowledge-user partners and assess the gap between research and practice. Effective mentorship was key to help trainees interpret the public health reality and develop population health intervention research skills. Trainees learned to ask the "how" questions that are critical for in-depth understanding of complex interventions and the conditions under which they can be best implemented. Conditions of success of internships and mentorship for population health intervention research included the alignment of the interests between the trainee, the

Family physicians' ability to perform population management is associated with adoption of other aspects of the patient-centered medical home.

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Ottmar, Jessica; Blackburn, Brenna; Phillips, Robert L; Peterson, Lars E; Jaén, Carlos Roberto

2015-04-01

The patient-centered medical home (PCMH) model is considered a promising approach to improving population health, but how elements of these advanced practice models relate to population health capability is unknown. To measure associations between family physicians' performance of population management with PCMH components, a cross-sectional survey was conducted with physicians accessing the American Board of Family Medicine Web site in 2011. Bivariate analysis and logistic regression tested associations between physician and practice demographics and specific PCMH features. The primary outcome was performance of population management. The final sample included 3855 physicians, 37.3% of whom reported performing population management. Demographic characteristics significantly associated with greater use of population management were female sex and graduation from an international medical school. PCMH components that remained associated with population management after adjustment were access to clinical case managers (odds ratio [OR]=2.01, 95% confidence interval [95% CI]: 1.69, 2.39), behavioral health collaboration (OR=1.49, 95% CI: 1.26, 1.77), having an electronic health record that supports meaningful use (OR=1.47, 95% CI: 1.25, 1.74), recent participation in a quality improvement project (OR=2.47, 95% CI: 2.12, 2.89), and routine measurement of patient difficulty securing an appointment (OR=2.87, 95% CI: 2.45, 3.37). Performance of population management was associated with several PCMH elements and resources not present in traditional primary care offices. Attention to these elements likely will enhance delivery of population management services in primary care.

[Development of technologies of population health management in Kazakhstan based on an integrated assessment of the combined exposure to environmental factors].

Science.gov (United States)

Sraubaev, E N; Serik, B

2013-01-01

At present there is overdue necessity of an integral approach to the assessment of health status and the impact of environmental factors on it, in the development of science-based management decisions and programs on improvement of the health status of the population of Kazakhstan and in the increase in life expectancy from the birth and healthy life expectancy. The purpose of the proposed program--improving health and increasing life expectancy from the birth and healthy life expectancy of the population of Kazakhstan. Based on a meta-analysis to justify the target age group in which an implementation of complex of preventive measures will increase both the life expectancy from the birth and healthy life expectancy, to perform a comprehensive health screening for the basic classes of diseases and behavioral characteristics of the target group in the course of a multicentre studies to give a comprehensive hygienic characteristics of the ecological status of the studied regions and to develop the Health Passport of the region, to develop a model of the combined effects of environmental factors on health; to create a theoretical model for the calculation of life expectancy from the birth and healthy life expectancy, taking into account the limits of modifiability of factors that affect them, and justify a comprehensive program of management decisions on modification of factors, to carry out pilot studies on the development and validation technological (managemental) solutions to control modifiable factors that affect life expectancy from the birth and healthy life expectancy.

[The Utilization of Health-Related Applications in Chronic Disease Self-Management].

Science.gov (United States)

Kao, Chi-Wen; Chuang, Hui-Wan; Chen, Ting-Yu

2017-08-01

The dramatic increase in smartphone usage has spurred the development of many health-related mobile applications (apps). On the other hand, population aging and the associated rise in the incidence of chronic disease is increasing the demand for long-term care. Effective chronic disease self-management has been shown to help patients improve their health condition. Numerous smartphone applications currently support patient self-management of chronic disease, facilitating health management and health promotion. The purpose of the present article was to introduce the definition, contents, and types of health-related apps; to discuss the effectiveness of self-management health-related apps in promoting chronic disease management; and to assess and evaluate these apps. We hope that the present article helps give to healthcare professionals and patients who are willing to manage their diseases a general understanding of health-related apps and their potential to facilitate the self-management of chronic diseases.

Toward population management in an integrated care model.

Science.gov (United States)

Maddux, Franklin W; McMurray, Stephen; Nissenson, Allen R

2013-01-01

Under the Patient Protection and Affordable Care Act of 2010, accountable care organizations (ACOs) will be the primary mechanism for achieving the dual goals of high-quality patient care at managed per capita costs. To achieve these goals in the newly emerging health care environment, the nephrology community must plan for and direct integrated delivery and coordination of renal care, focusing on population management. Even though the ESRD patient population is a complex group with comorbid conditions that may confound integration of care, the nephrology community has unique experience providing integrated care through ACO-like programs. Specifically, the recent ESRD Management Demonstration Project sponsored by the Centers for Medicare & Medicaid Services and the current ESRD Prospective Payment System with it Quality Incentive Program have demonstrated that integrated delivery of renal care can be accomplished in a manner that provides improved clinical outcomes with some financial margin of savings. Moving forward, integrated renal care will probably be linked to provider performance and quality outcomes measures, and clinical integration initiatives will share several common elements, namely performance-based payment models, coordination of communication via health care information technology, and development of best practices for care coordination and resource utilization. Integration initiatives must be designed to be measured and evaluated, and, consistent with principles of continuous quality improvement, each initiative will provide for iterative improvements of the initiative. © 2013 S. Karger AG, Basel.

Managing the Social Determinants of Health: Part I: Fundamental Knowledge for Professional Case Management.

Science.gov (United States)

Fink-Samnick, Ellen

PRIMARY PRACTICE SETTING(S):: Applicable to health and behavioral health settings, wherever case management is practiced. The SDH pose major challenges to the health care workforce in terms of effective resource provision, health and behavioral health treatment planning plus adherence, and overall coordination of care. Obstacles and variances to needed interventions easily lead to less than optimal outcomes for case managers and their health care organizations. Possessing sound knowledge and clear understanding of each SDH, the historical perspectives, main theories, and integral dynamics, as well as creative resource solutions, all support a higher level of intentional and effective professional case management practice. Those persons and communities impacted most by the SDH comprise every case management practice setting. These clients can be among the most vulnerable and disenfranchised members of society, which can easily engender biases on the part of the interprofessional workforce. They are also among the costliest to care for with 50% of costs for only 5% of the population. Critical attention to knowledge about managing the SDH leverages and informs case management practice, evolves more effective programming, and enhances operational outcomes across practice settings.

Measuring Population Health Outcomes

OpenAIRE

Parrish, R. Gibson

2010-01-01

An ideal population health outcome metric should reflect a population's dynamic state of physical, mental, and social well-being. Positive health outcomes include being alive; functioning well mentally, physically, and socially; and having a sense of well-being. Negative outcomes include death, loss of function, and lack of well-being. In contrast to these health outcomes, diseases and injuries are intermediate factors that influence the likelihood of achieving a state of health. On the basis...

Exploring factors related to the adoption and acceptance of an internet-based electronic personal health management tool (EPHMT) in a low income, special needs population of people living with HIV and AIDS in New York City.

Science.gov (United States)

Odlum, Michelle; Gordon, Peter; Camhi, Eli; Valdez, Esmerlin; Bakken, Suzanne

2014-01-01

Access to personal health information assists efforts to improve health outcomes and creates a population of active and informed health consumers. Understanding this significance, Healthy People 2020 retained, as a Focus Area, the need for improved interactive Health Communication and HIT. Attainment of this goal includes increasing the use of Internet-based electronic personal health management tools (EPHMT). Health information management, essential for favorable health outcomes, can be problematic in low income, special needs populations with complex chronic illnesses such as HIV/AIDS. Furthermore, barriers to the adoption and acceptance of an EPHMT in such populations have not been well explored. The current study seeks to explore the usability of an EPHMT entitled MyHealthProfile and to identify perceived health information needs in a vulnerable population of people living with HIV and AIDS (PLWH) that have access to an EPHMT through their Medicaid Special Needs Plan.

The effect of community-based health management on the health of the elderly: a randomized controlled trial from China

Directory of Open Access Journals (Sweden)

Chao Jianqian

2012-12-01

Full Text Available Abstract Background An aging population poses significant challenges to health care in China. Health management has been implemented to reduce the costs of care, raise health service utilization, increase health knowledge and improve quality of life. Several studies have tried to verify the effectiveness of health management in achieving these goals worldwide. However, there have been insufficient randomized control trials (RCTs to draw reliable conclusions. The few small-scale studies conducted in China include mostly the general population rather than the elderly. Our study is designed to evaluate the impact of community-based health management on the health of the elderly through an RCT in Nanjing, China. Methods Two thousand four hundred participants, aged 60 or older and who gave informed consent, were randomly allocated 1:1 into management and control groups, the randomization schedule was concealed from community health service center staff until allocation. Community-based health management was applied in the former while the latter was only given usual care. After 18 months, three categories of variables (subjective grading health indices, objective health indices and health service utilization were measured based on a questionnaire, clinical monitoring and diagnostic measurements. Differences between the two groups were assessed before and after the intervention and analyzed with t-test, χ2-test, and multiple regression analysis. Results Compared with the control group, the management group demonstrated improvement on the following variables (P Conclusion Community-based health management improved both subjective grading health indices, objective health indices and decreased the number of outpatient clinic visits, demonstrating effectiveness in improving elderly health. Trial registration ChiCTR-OCH-11001716

SARS and Population Health Technology

OpenAIRE

Eysenbach, Gunther

2003-01-01

The recent global outbreak of SARS (severe acute respiratory syndrome) provides an opportunity to study the use and impact of public health informatics and population health technology to detect and fight a global epidemic. Population health technology is the umbrella term for technology applications that have a population focus and the potential to improve public health. This includes the Internet, but also other technologies such as wireless devices, mobile phones, smart appliances, or smar...

Strategic management of population programs

OpenAIRE

Bernhart, Michael H.

1992-01-01

Formal strategic planning and management appear to contribute to organizational effectiveness. The author surveys the literature on strategic management in private/for-profit organizations and applies lessons from that literature to population programs. Few would argue that population programs would not benefit from strategic planning and management, but it would be inadvisable to initiate the process when the organization is faced with a short-term crisis; during or immediately before a chan...

Health care waste management practice in a hospital.

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Paudel, R; Pradhan, B

2010-10-01

Health-care waste is a by-product of health care. Its poor management exposes health-care workers, waste handlers and the community to infections, toxic effects and injuries including damage of the environment. It also creates opportunities for the collection of disposable medical equipment, its re-sale and potential re-use without sterilization, which causes an important burden of disease worldwide. The purpose of this study was to find out health care waste management practice in hospital. A cross-sectional study was conducted in Narayani Sub-Regional Hospital, Birgunj from May to October 2006 using both qualitative and quantitative methods. Study population was four different departments of the hospital (Medical/Paediatric, Surgical/Ortho, Gynae/Obstetric and Emergency), Medical Superintendent, In-charges of four different departments and all sweepers. Data was collected using interview, group discussion, observation and measurement by weight and volume. Total health-care waste generated was 128.4 kg per day while 0.8 kg per patient per day. The composition of health care waste was found to be 96.8 kg (75.4%) general waste, 24.1 kg (8.8%) hazardous waste and 7.5 kg (5.8%) sharps per day by weight. Health staffs and sweepers were not practicing the waste segregation. Occupational health and safety was not given due attention. Majority of the sweepers were unaware of waste management and need of safety measures to protect their own health. Health care waste management practice in the hospital was unsatisfactory because of the lack of waste management plan and carelessness of patients, visitors and staffs. Therefore the hospital should develop the waste management plan and strictly follow the National Health Care Waste Management Guideline.

Partnerships in Health Systems: Social Organization as limits and possibilities in the Family Health Strategy Management.

Science.gov (United States)

Silva, Vanessa Costa E; Barbosa, Pedro Ribeiro; Hortale, Virgínia Alonso

2016-05-01

This is a case study in the municipality of Rio de Janeiro about management in the Family Health Strategy based on the Social Organizations model. The aims were to characterize and analyze aspects of the governance system adopted by the Rio de Janeiro Municipal Health Department and identify limits and possibilities of this model as a management option in Brazil's Unified Health System. A qualitative study was performed based on a literature review, document analysisand interviews with key informants. This management model facilitated the expansion of access to primary healthcare through the Family Health Strategy in Rio - where the population covered increased from 7.2% of the population in 2008 to 45.5% in 2015. The results showthat some practices in the contractual logic need to be improved, including negotiation and accountability with autonomywith the service suppliers. Evaluation and control has focus on processes, not results, and there has not been an increase in transparency and social control. The system of performance incentives has been reported as inducing improvements in the work process of the health teams. It is concluded that the regulatory capacity of the municipal management would need to be improved. On the other hand, there is an important and significant process of learning in progress.

A Novel Mobile App and Population Management System to Manage Rheumatoid Arthritis Flares: Protocol for a Randomized Controlled Trial.

Science.gov (United States)

Wang, Penny; Luo, Dee; Lu, Fengxin; Elias, Josephine S; Landman, Adam B; Michaud, Kaleb D; Lee, Yvonne C

2018-04-11

Rheumatoid arthritis flares have a profound effect on patients, causing pain and disability. However, flares often occur between regularly scheduled health care provider visits and are, therefore, difficult to monitor and manage. We sought to develop a mobile phone app combined with a population management system to help track RA flares between visits. The objective of this study is to implement the mobile app plus the population management system to monitor rheumatoid arthritis disease activity between scheduled health care provider visits over a period of 6 months. This is a randomized controlled trial that lasts for 6 months for each participant. We aim to recruit 190 patients, randomized 50:50 to the intervention group versus the control group. The intervention group will be assigned the mobile app and be prompted to answer daily questionnaires sent to their mobile devices. Both groups will be assigned a population manager, who will communicate with the participants via telephone at 6 weeks and 18 weeks. The population manager will also communicate with the participants in the intervention group if their responses indicate a sustained increase in rheumatoid arthritis disease activity. To assess patient satisfaction, the primary outcomes will be scores on the Treatment Satisfaction Questionnaire for Medication as well as the Perceived Efficacy in Patient-Physician Interactions questionnaire at 6 months. To determine the effect of the mobile app on rheumatoid arthritis disease activity, the primary outcome will be the Clinical Disease Activity Index at 6 months. The trial started in November 2016, and an estimated 2.5 years will be necessary to complete the study. Study results are expected to be published by the end of 2019. The completion of this study will provide important data regarding the following: (1) the assessment of validated outcome measures to assess rheumatoid arthritis disease activity with a mobile app between routinely scheduled health care

Choropampa case: mercury spilland damage to health in rural exppsed population

OpenAIRE

Arana-Zegarra, Marco; Teólogo. Máster en Sociología. Diplomado en Agua y Saneamiento. Diplomado en Gerencia Social. Miembro del Consejo Directivo de la Red Muqui y ex Director de la ONG Grupo de formación e Intervención para el Desarrollo Sostenible. Cajamarca, Perú.

2009-01-01

In 2000, a spill of metallic mercury is evaporated into the atmosphere, and it affected the health of over a thousand peasants, who, eight years later, still are suffering the consequences on their health. Modern mining does not guarantee an adequate management, control and mitigation of environmental impacts and public authority does not grant the right to health of populations in environments which miners from the point of view of the right to environmental health should be sites consid...

Population pressure and health risks in urban market environment: a ...

African Journals Online (AJOL)

Population pressure and health risks in urban market environment: a study of Bodija market, Ibadan, Nigeria. ... International Journal of Development and Management Review ... This study was directed at permanent sellers in Bodija Market, (men and women) and people who frequent the market to make purchases.

Health Information Management System for Elderly Health Sector: A Qualitative Study in Iran.

Science.gov (United States)

Sadoughi, Farahnaz; Shahi, Mehraban; Ahmadi, Maryam; Davaridolatabadi, Nasrin

2016-02-01

There are increasing change and development of information in healthcare systems. Given the increase in aging population, managers are in need of true and timely information when making decision. The aim of this study was to investigate the current status of the health information management system for the elderly health sector in Iran. This qualitative study was conducted in two steps. In the first step, required documents for administrative managers were collected using the data gathering form and observed and reviewed by the researcher. In the second step, using an interview guide, the required information was gathered through interviewing experts and faculty members. The convenience, purposeful and snowball sampling methods were applied to select interviewees and the sampling continued until reaching the data saturation point. Finally, notes and interviews were transcribed and content analysis was used to analyze them. The results of the study showed that there was a health information management system for the elderly health sector in Iran. However, in all primary health care centers the documentation of data was done manually; the data flow was not automated; and the analysis and reporting of data are also manually. Eventually, decision makers are provided with delayed information. It is suggested that the steward of health in Iran, the ministry of health, develops an appropriate infrastructure and finally puts a high priority on the implementation of the health information management system for elderly health sector in Iran.

A population approach to disease management: hepatitis C direct-acting antiviral use in a large health care system.

Science.gov (United States)

Belperio, Pamela S; Backus, Lisa I; Ross, David; Neuhauser, Melinda M; Mole, Larry A

2014-06-01

months earlier. By facility, the median proportion of veterans with MPR ≥ 0.95 remained 80% for those prescribed boceprevir; for telaprevir, the median proportion was 75% and improved to 80% 6 months later. Nonconcordance with VA medication guidance was as follows: receipt of an ESA without dose reducing ribavirin, 30% boceprevir, 45% telaprevir; ESA initiated with a hemoglobin greater than 10 g/dL, 42% boceprevir, 25% telaprevir; receipt of GCSF with absolute neutrophil count above the criteria threshold, 84%. This clinically focused, comprehensive, population-based medication management approach affected real-time change in health services, practice, and outcomes evidenced by widespread and rapid DAA uptake, improved HCV RNA monitoring, attention to adherence, and more appropriate management of DAA-related anemia. Timely outcome sharing provided decision makers and clinicians evidence to support current HCV practices.

An obesity/cardiometabolic risk reduction disease management program: a population-based approach.

Science.gov (United States)

Villagra, Victor G

2009-04-01

Obesity is a critical health concern that has captured the attention of public and private healthcare payers who are interested in controlling costs and mitigating the long-term economic consequences of the obesity epidemic. Population-based approaches to obesity management have been proposed that take advantage of a chronic care model (CCM), including patient self-care, the use of community-based resources, and the realization of care continuity through ongoing communications with patients, information technology, and public policy changes. Payer-sponsored disease management programs represent an important conduit to delivering population-based care founded on similar CCM concepts. Disease management is founded on population-based disease identification, evidence-based care protocols, and collaborative practices between clinicians. While substantial clinician training, technology infrastructure commitments, and financial support at the payer level will be needed for the success of disease management programs in obesity and cardiometabolic risk reduction, these barriers can be overcome with the proper commitment. Disease management programs represent an important tool to combat the growing societal risks of overweight and obesity.

A Measure of the Potential Impact of Hospital Community Health Activities on Population Health and Equity.

Science.gov (United States)

Begun, James W; Kahn, Linda M; Cunningham, Brooke A; Malcolm, Jan K; Potthoff, Sandra

2017-12-13

Many hospitals in the United States are exploring greater investment in community health activities that address upstream causes of poor health. Develop and apply a measure to categorize and estimate the potential impact of hospitals' community health activities on population health and equity. We propose a scale of potential impact on population health and equity, based on the cliff analogy developed by Jones and colleagues. The scale is applied to the 317 activities reported in the community health needs assessment implementation plan reports of 23 health care organizations in the Minneapolis-St Paul, Minnesota metropolitan area in 2015. Using a 5-point ordinal scale, we assigned a score of potential impact on population health and equity to each community health activity. A majority (50.2%) of health care organizations' community health activities are classified as addressing social determinants of health (level 4 on the 5-point scale), though very few (5.4%) address structural causes of health equity (level 5 on the 5-point scale). Activities that score highest on potential impact fall into the topic categories of "community health and connectedness" and "healthy lifestyles and wellness." Lower-scoring activities focus on sick or at-risk individuals, such as the topic category of "chronic disease prevention, management, and screening." Health care organizations in the Minneapolis-St Paul metropolitan area vary substantially in the potential impact of their aggregated community health activities. Hospitals can be significant contributors to investment in upstream community health programs. This article provides a scale that can be used not only by hospitals but by other health care and public health organizations to better align their community health strategies, investments, and partnerships with programming and policies that address the foundational causes of population health and equity within the communities they serve.

Financial coping strategies of mental health consumers: managing social benefits.

Science.gov (United States)

Caplan, Mary Ager

2014-05-01

Mental health consumers depend on social benefits in the forms of supplemental security income and social security disability insurance for their livelihood. Although these programs pay meager benefits, little research has been undertaken into how this population makes ends meet. Using a qualitative approach, this study asks what are the financial coping strategies of mental health consumers? Seven approaches were identified: subsidies, cost-effective shopping, budgeting, prioritizing, technology, debt management, and saving money. Results illustrate the resourcefulness of mental health consumers in managing meager social benefits and highlight the need to strengthen community mental health efforts with financial capabilities education.

Health and Stress Management and Mental-health Disability Claims.

Science.gov (United States)

Marchand, Alain; Haines, Victor Y; Harvey, Steve; Dextras-Gauthier, Julie; Durand, Pierre

2016-12-01

This study examines the associations between health and stress management (HSM) practices and mental-health disability claims. Data from the Salveo study was collected during 2009-2012 within 60 workplaces nested in 37 companies located in Canada (Quebec) and insured by a large insurance company. In each company, 1 h interviews were conducted with human resources managers in order to obtain data on 63 HSM practices. Companies and workplaces were sorted into the low-claims and high-claims groups according to the median rate of the population of the insurer's corporate clients. Logistic regression adjusted for design effect and multidimensional scaling was used to analyse the data. After controlling for company size and economic sector, task design, demands control, gratifications, physical activity and work-family balance were associated with low mental-health disability claims rates. Further analyses revealed three company profiles that were qualified as laissez-faire, integrated and partially integrated approaches to HSM. Of the three, the integrated profile was associated with low mental-health disability claims rates. The results of this study provide evidence-based guidance for a better control of mental-health disability claims. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

Social Determinants of Health in Managed Care Payment Formulas.

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Ash, Arlene S; Mick, Eric O; Ellis, Randall P; Kiefe, Catarina I; Allison, Jeroan J; Clark, Melissa A

2017-10-01

Managed care payment formulas commonly allocate more money for medically complex populations, but ignore most social determinants of health (SDH). To add SDH variables to a diagnosis-based payment formula that allocates funds to managed care plans and accountable care organizations. Using data from MassHealth, the Massachusetts Medicaid and Children's Health Insurance Program, we estimated regression models predicting Medicaid spending using a diagnosis-based and SDH-expanded model, and compared the accuracy of their cost predictions overall and for vulnerable populations. MassHealth members enrolled for at least 6 months in 2013 in fee-for-service (FFS) programs (n = 357 660) or managed care organizations (MCOs) (n = 524 607). We built cost prediction models from a fee-for-service program. Predictors in the diagnosis-based model are age, sex, and diagnoses from claims. The SDH model adds predictors describing housing instability, behavioral health issues, disability, and neighborhood-level stressors. Overall model explanatory power and overpayments and underpayments for subgroups of interest for all Medicaid-reimbursable expenditures excepting long-term support services (mean annual cost = $5590 per member). We studied 357 660 people who were FFS participants and 524 607 enrolled in MCOs with a combined 806 889 person-years of experience. The FFS program experience included more men (49.6% vs 43.6%), older patients (mean age of 26.1 years vs 21.6 years), and sicker patients (mean morbidity score of 1.16 vs 0.89) than MCOs. Overall, the SDH model performed well, but only slightly better than the diagnosis-based model, explaining most of the spending variation in the managed care population (validated R2 = 62.4) and reducing underpayments for several vulnerable populations. For example, raw costs for the quintile of people living in the most stressed neighborhoods were 9.6% ($537 per member per year) higher than average. Since greater

ESRD in the geriatric population: the crisis of managed care and the opportunity of disease management.

Science.gov (United States)

Steinman, Theodore I

2002-01-01

The geriatric population with end-stage renal disease (ESRD) is placed at risk with regards to the quality and extent of medical coverage because of the rapidly changing financial environment. Managed care organizations (MCOs) are generally for-profit companies that must focus on the bottom line. While the verbal commitment to quality care is voiced, the financial pressures on MCOs have led to a decrease in coverage of many services and outright denial for some necessary treatments. While denying services, the MCOs have also reduced payments to providers for services rendered. The coverage crisis is compounded by health maintenance organizations (HMOs) quitting Medicare because the reimbursement from the Health Care Financing Administration (HCFA) is less than their costs. Because of the above issues which can potentially impact on the quality of care delivered to the ESRD geriatric population, a new approach to disease management has created the opportunity to improve total patient care to a level not yet achieved in the United States. Disease management encompasses integrated care across all disciplines. Every component of care can be tracked by a dedicated information system. Improvement in outcomes has far exceeded the U.S. Renal Data System (USRDS) benchmark performance measurements with a disease management model approach. The key to success is the health service coordinator (HSC), a senior nurse with many years of ESRD experience. This individual coordinates care across all disciplines and expedites necessary referrals. With rapid attention to patient needs there has been a significant reduction in hospital admissions, hospital length of stay, and emergency room visits. Patient care will steadily improve as the disease management system matures as a consequence of understanding the patients total physical and psychosocial needs.

Assessment of management capacity to improve the value of health-care systems: a survey

OpenAIRE

Rebecca L Weintraub, MD; Keri Wachter, BA; Jennifer Goldsmith, MS; Marie J Teichman, BA; Eda Algur; Julie D Rosenberg, MPH

2017-01-01

Background: Strong management is important for high-value health-care systems if returns on global health investments are to be delivered and the Sustainable Development Goals met by 2030. Managers are responsible for care delivery systems and strategies, making sure that health services benefit the population they intend to serve. Most managers in resource-limited settings work at the district level and below, with little training in non-clinical skills. They are often health care providers ...

The impact of Telephonic Health Coaching on Health Outcomes in a High-risk Population.

Science.gov (United States)

Lawson, Karen L; Jonk, Yvonne; O'Connor, Heidi; Riise, Kirsten Sundgaard; Eisenberg, David M; Kreitzer, Mary Jo

2013-05-01

Health coaching is a client-centric process to increase motivation and self-efficacy that supports sustainable lifestyle behavior changes and active management of health conditions. This study describes an intervention offered as a benefit to health plan members and examines health and behavioral outcomes of participants. High-risk health plan enrollees were invited to participate in a telephonic health coaching intervention addressing the whole person and focusing on motivating health behavior changes. Outcomes of self-reported lifestyle behaviors, perceived health, stress levels, quality of life, readiness to make changes, and patient activation levels were reported at baseline and upon program completion. Retrospectively, these data were extracted from administrative and health coaching records of participants during the first 2 full years of the program. Less than 7% of the 114 615 potential candidates self-selected to actively participate in health coaching, those with the highest chronic disease load being the most likely to participate. Of 6940 active participants, 1082 fully completed health inventories, with 570 completing Patient Activation Measure (PAM). The conditions most often represented in the active participants were depression, congestive heart failure, diabetes, hyperlipidemia, hypertension, osteoporosis, asthma, and low back pain. In 6 months or less, 89% of participants met at least one goal. Significant improvements occurred in stress levels, healthy eating, exercise levels, and physical and emotional health, as well as in readiness to make change and PAM scores. The types of client-selected goals most often met were physical activity, eating habits, stress management, emotional health, sleep, and pain management, resulting in improved overall quality of life regardless of condition. Positive shifts in activation levels and readiness to change suggest that health coaching is an intervention deserving of future prospective research studies to

Population growth, poverty and health.

Science.gov (United States)

Kibirige, J S

1997-07-01

One of the most popular explanations for the many problems that face Africa is population growth. Africa's population has doubled since 1960. Africa has the highest fertility rate in the world and the rate of population growth is higher than in any other region. At the same time, Africa faces a social and economic situation that is viewed by many as alarming. Among the problems that devastate Africa is that of persistent poor health. Africa has lower life expectancy, higher mortality rates and is affected by more disease and illness conditions than any other region. Focusing on sub-Saharan Africa, this paper examines the relationship between population growth, poverty and poor health. While most analyses have focused on population growth as an original cause of poverty and underdevelopment, this paper argues that while both population growth and poor health play a significant role in exacerbating the problem of poverty, they are themselves primary consequences of poverty rather than its cause.

Many Mobile Health Apps Target High-Need, High-Cost Populations, But Gaps Remain.

Science.gov (United States)

Singh, Karandeep; Drouin, Kaitlin; Newmark, Lisa P; Lee, JaeHo; Faxvaag, Arild; Rozenblum, Ronen; Pabo, Erika A; Landman, Adam; Klinger, Elissa; Bates, David W

2016-12-01

With rising smartphone ownership, mobile health applications (mHealth apps) have the potential to support high-need, high-cost populations in managing their health. While the number of available mHealth apps has grown substantially, no clear strategy has emerged on how providers should evaluate and recommend such apps to patients. Key stakeholders, including medical professional societies, insurers, and policy makers, have largely avoided formally recommending apps, which forces patients to obtain recommendations from other sources. To help stakeholders overcome barriers to reviewing and recommending apps, we evaluated 137 patient-facing mHealth apps-those intended for use by patients to manage their health-that were highly rated by consumers and recommended by experts and that targeted high-need, high-cost populations. We found that there is a wide variety of apps in the marketplace but that few apps address the needs of the patients who could benefit the most. We also found that consumers' ratings were poor indications of apps' clinical utility or usability and that most apps did not respond appropriately when a user entered potentially dangerous health information. Going forward, data privacy and security will continue to be major concerns in the dissemination of mHealth apps. Project HOPE—The People-to-People Health Foundation, Inc.

Query Health: standards-based, cross-platform population health surveillance.

Science.gov (United States)

Klann, Jeffrey G; Buck, Michael D; Brown, Jeffrey; Hadley, Marc; Elmore, Richard; Weber, Griffin M; Murphy, Shawn N

2014-01-01

Understanding population-level health trends is essential to effectively monitor and improve public health. The Office of the National Coordinator for Health Information Technology (ONC) Query Health initiative is a collaboration to develop a national architecture for distributed, population-level health queries across diverse clinical systems with disparate data models. Here we review Query Health activities, including a standards-based methodology, an open-source reference implementation, and three pilot projects. Query Health defined a standards-based approach for distributed population health queries, using an ontology based on the Quality Data Model and Consolidated Clinical Document Architecture, Health Quality Measures Format (HQMF) as the query language, the Query Envelope as the secure transport layer, and the Quality Reporting Document Architecture as the result language. We implemented this approach using Informatics for Integrating Biology and the Bedside (i2b2) and hQuery for data analytics and PopMedNet for access control, secure query distribution, and response. We deployed the reference implementation at three pilot sites: two public health departments (New York City and Massachusetts) and one pilot designed to support Food and Drug Administration post-market safety surveillance activities. The pilots were successful, although improved cross-platform data normalization is needed. This initiative resulted in a standards-based methodology for population health queries, a reference implementation, and revision of the HQMF standard. It also informed future directions regarding interoperability and data access for ONC's Data Access Framework initiative. Query Health was a test of the learning health system that supplied a functional methodology and reference implementation for distributed population health queries that has been validated at three sites. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under

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

Science.gov (United States)

Purcell, Rachael; McGirr, Joe

2018-02-01

To determine health service managers' (HSMs) recommendations on strengthening the health service response to climate change. Self-administered survey in paper or electronic format. Rural south-west of New South Wales. Health service managers working in rural remote metropolitan areas 3-7. Proportion of respondents identifying preferred strategies for preparation of rural health services for climate change. There were 43 participants (53% response rate). Most respondents agreed that there is scepticism regarding climate change among health professionals (70%, n = 30) and community members (72%, n = 31). Over 90% thought that climate change would impact the health of rural populations in the future with regard to heat-related illnesses, mental health, skin cancer and water security. Health professionals and government were identified as having key leadership roles on climate change and health in rural communities. Over 90% of the respondents believed that staff and community in local health districts (LHDs) should be educated about the health impacts of climate change. Public health education facilitated by State or Federal Government was the preferred method of educating community members, and education facilitated by the LHD was the preferred method for educating health professionals. Health service managers hold important health leadership roles within rural communities and their health services. The study highlights the scepticism towards climate change among health professionals and community members in rural Australia. It identifies the important role of rural health services in education and advocacy on the health impacts of climate change and identifies recommended methods of public health education for community members and health professionals. © 2017 National Rural Health Alliance Inc.

An evaluation of the Well at Dell health management program: health risk change and financial return on investment.

Science.gov (United States)

Musich, Shirley; McCalister, Tre'; Wang, Sara; Hawkins, Kevin

2015-01-01

To investigate the effectiveness of the Well at Dell comprehensive health management program in delivering health care and productivity cost savings relative to program investment (i.e., return on investment). A quasi-experimental design was used to quantify the financial impact of the program and nonexperimental pre-post design to evaluate change in health risks. Ongoing worksite health management program implemented across multiple U.S. locations. Subjects were 24,651 employees with continuous medical enrollment in 2010-2011 who were eligible for 2011 health management programming. Incentive-driven, outcomes-based multicomponent corporate health management program including health risk appraisal (HRA)/wellness, lifestyle management, and disease management coaching programs. Medical, pharmacy, and short-term disability pre/post expenditure trends adjusted for demographics, health status, and baseline costs. Self-reported health risks from repeat HRA completers. Analysis: Propensity score-weighted and multivariate regression-adjusted comparison of baseline to post trends in health care expenditures and productivity costs for program participants and nonparticipants (i.e., difference in difference) relative to programmatic investment. The Well at Dell program achieved an overall return on investment of 2.48 in 2011. Most of the savings were realized from the HRA/wellness component of the program. Cost savings were supported with high participation and significant health risk improvement. An incentive-driven, well-managed comprehensive corporate health management program can continue to achieve significant health improvement while promoting health care and productivity cost savings in an employee population.

Health services management modalities in the Brazilian Unified National Health System: a narrative review of research production in Public Health (2005-2016).

Science.gov (United States)

Ravioli, Antonio Franco; Soárez, Patrícia Coelho De; Scheffer, Mário César

2018-01-01

The current study aimed to systematically analyze trends and priorities in the theoretical and conceptual approaches and empirical studies on specific health services management modalities in the Brazilian Unified National Health System. A narrative review of the literature identified, in 33 publications, the location and nature of services, management models, methodological procedures, and study outcomes. The research deals mainly with the models' conceptual and legal characteristics and management practices, in addition to addressing contracts, procurement, human resources, financing, and control mechanisms. In conclusion, the literature is limited and concentrated in the State of São Paulo, showing little theoretical diversity and methodological weaknesses, while it is nonconclusive as to the superiority of one management model over another. New evaluation studies are needed that are capable of comparing different models and assessing their performance and their effects on the quality of health services' provision, the population's health, and the health system's organization.

Use of Stakeholder Focus Groups to Define the Mission and Scope of a new Department of Population Health.

Science.gov (United States)

Tierney, William M

2018-04-09

The focus and funding of US healthcare is evolving from volume to value-based, and healthcare leaders, managers, payers, and researchers are increasingly focusing on managing populations of patients. Simultaneously, there is increasing interest in getting "upstream" from disease management to promote health and prevent disease. Hence, the term "population health" has both clinical and community-based connotations relevant to the tripartite mission of US medical schools. To seek broad input for the strategic development of the Department of Population Health in a new medical school at a tier 1 research university. Focus groups with facilitated consensus development. Eighty-one persons representing the Dell Medical School and other schools at the University of Texas at Austin, city/county government, community nonprofit organizations, and faculty from other local university schools along with selected national academic leaders. Focus groups with subsequent consensus development of emphases identified premeeting by participants by e-mail exchanges. The resulting departmental strategic plan included scope of work, desired characteristics of leaders, and early impact activities in seven areas of interest: community engagement and health equity, primary care and value-based health, occupational and environment medicine, medical education, health services and community-based research, health informatics and data analysis, and global health. Medical schools should have a primary focus in population, most effectively at the departmental level. Engaging relevant academic and community stakeholders is an effective model for developing this emerging discipline in US medical schools.

Population Neuroscience: Dementia Epidemiology Serving Precision Medicine and Population Health.

Science.gov (United States)

Ganguli, Mary; Albanese, Emiliano; Seshadri, Sudha; Bennett, David A; Lyketsos, Constantine; Kukull, Walter A; Skoog, Ingmar; Hendrie, Hugh C

2018-01-01

Over recent decades, epidemiology has made significant contributions to our understanding of dementia, translating scientific discoveries into population health. Here, we propose reframing dementia epidemiology as "population neuroscience," blending techniques and models from contemporary neuroscience with those of epidemiology and biostatistics. On the basis of emerging evidence and newer paradigms and methods, population neuroscience will minimize the bias typical of traditional clinical research, identify the relatively homogenous subgroups that comprise the general population, and investigate broader and denser phenotypes of dementia and cognitive impairment. Long-term follow-up of sufficiently large study cohorts will allow the identification of cohort effects and critical windows of exposure. Molecular epidemiology and omics will allow us to unravel the key distinctions within and among subgroups and better understand individuals' risk profiles. Interventional epidemiology will allow us to identify the different subgroups that respond to different treatment/prevention strategies. These strategies will inform precision medicine. In addition, insights into interactions between disease biology, personal and environmental factors, and social determinants of health will allow us to measure and track disease in communities and improve population health. By placing neuroscience within a real-world context, population neuroscience can fulfill its potential to serve both precision medicine and population health.

Optimal management of non-Markovian biological populations

Science.gov (United States)

Williams, B.K.

2007-01-01

Wildlife populations typically are described by Markovian models, with population dynamics influenced at each point in time by current but not previous population levels. Considerable work has been done on identifying optimal management strategies under the Markovian assumption. In this paper we generalize this work to non-Markovian systems, for which population responses to management are influenced by lagged as well as current status and/or controls. We use the maximum principle of optimal control theory to derive conditions for the optimal management such a system, and illustrate the effects of lags on the structure of optimal habitat strategies for a predator-prey system.

Population health and medicine: Policy and financial drivers.

Science.gov (United States)

Lavigne, Jill E; Brown, Jack; Matzke, Gary R

2017-09-15

The financial and policy levers of population health and potential opportunities for pharmacists are described. Three long-standing problems drive the focus on population health: (1) the United States suffers far worse population health outcomes compared with those of other developed nations that spend significantly less on healthcare, (2) the U.S. healthcare system's focus on "sick care" fails to address upstream prevention and population health improvement, and (3) financial incentives for healthcare delivery are poorly aligned with improvements in population health outcomes. The Patient Protection and Affordable Care Act of 2010 (ACA) was arguably the first major healthcare legislation since 1965 and had 3 main strategies for improving population health: expand health insurance coverage, control healthcare costs, and improve the healthcare delivery system. Federal and state legislation as well as Medicare and Medicaid financing strategies have designated mechanisms to reward advances in population outcomes since the passage of the ACA. States are responsible for many of the factors that affect population health, and a bipartisan effort that builds upon state and federal collaboration will likely be needed to implement the necessary health policy initiative. Population health issues affect productivity in the United States; conversely, improvements in population health may increase productivity, helping to offset the rising federal debt. Employers are in a position to improve population health and consequently help reduce the federal debt by addressing lifestyle, chronic disease, poverty, and inequality. National pharmacy organizations, regulatory bodies, and journal editors need to collectively agree to a threshold of quality and rigor for publication and endorsement. Knowledge of the policy and financial drivers of population health may both support pharmacists' efforts to improve population outcomes and identify opportunities for professional advancement

What would it take? Stakeholders' views and preferences for implementing a health care manager program in community mental health clinics under health care reform.

Science.gov (United States)

Cabassa, Leopoldo J; Gomes, Arminda P; Lewis-Fernández, Roberto

2015-02-01

Health care manager interventions can improve the physical health of people with serious mental illness (SMI). In this study, we used concepts from the theory of diffusion of innovations, the consolidated framework for implementation research and a taxonomy of implementation strategies to examine stakeholders' recommendations for implementing a health care manager intervention in public mental health clinics serving Hispanics with SMI. A purposive sample of 20 stakeholders was recruited from mental health agencies, primary care clinics, and consumer advocacy organizations. We presented participants a vignette describing a health care manager intervention and used semistructured qualitative interviews to examine their views and recommendations for implementing this program. Interviews were recorded, professionally transcribed, and content analyzed. We found that a blend of implementation strategies that demonstrates local relative advantage, addresses cost concerns, and enhances compatibility to organizations and the client population is critical for moving health care manager interventions into practice. © The Author(s) 2014.

Open source electronic health records and chronic disease management.

Science.gov (United States)

Goldwater, Jason C; Kwon, Nancy J; Nathanson, Ashley; Muckle, Alison E; Brown, Alexa; Cornejo, Kerri

2014-02-01

To study and report on the use of open source electronic health records (EHR) to assist with chronic care management within safety net medical settings, such as community health centers (CHC). The study was conducted by NORC at the University of Chicago from April to September 2010. The NORC team undertook a comprehensive environmental scan, including a literature review, a dozen key informant interviews using a semistructured protocol, and a series of site visits to CHC that currently use an open source EHR. Two of the sites chosen by NORC were actively using an open source EHR to assist in the redesign of their care delivery system to support more effective chronic disease management. This included incorporating the chronic care model into an CHC and using the EHR to help facilitate its elements, such as care teams for patients, in addition to maintaining health records on indigent populations, such as tuberculosis status on homeless patients. The ability to modify the open-source EHR to adapt to the CHC environment and leverage the ecosystem of providers and users to assist in this process provided significant advantages in chronic care management. Improvements in diabetes management, controlled hypertension and increases in tuberculosis vaccinations were assisted through the use of these open source systems. The flexibility and adaptability of open source EHR demonstrated its utility and viability in the provision of necessary and needed chronic disease care among populations served by CHC.

The population health approach in historical perspective.

Science.gov (United States)

Szreter, Simon

2003-03-01

The origin of the population health approach is an historic debate over the relationship between economic growth and human health. In Britain and France, the Industrial Revolution disrupted population health and stimulated pioneering epidemiological studies, informing the early preventive public health movement. A century-long process of political adjustment between the forces of liberal democracy and propertied interests ensued. The 20th-century welfare states resulted as complex political mechanisms for converting economic growth into enhanced population health. However, the rise of a "neoliberal" agenda, denigrating the role of government, has once again brought to the fore the importance of prevention and a population health approach to map and publicize the health impacts of this new phase of "global" economic growth.

Meeting baccalaureate public/community health nursing education competencies in nurse-managed wellness centers.

Science.gov (United States)

Thompson, Cheryl W; Bucher, Julia A

2013-01-01

The purpose of this article is to describe how community health competencies for baccalaureate nursing education have been met by locating clinical experiences in nurse-managed wellness centers. Such centers are an ideal setting for students to integrate theoretical concepts into clinical practice while building on previous learning. Students are able to develop skills in community health nursing practice at individual, family, and population level. In addition, the practice setting provides other advantages. Clients who represent a vulnerable population group receive valuable health services. Students gain learning opportunities that are broader than community health competencies, and faculty are provided clinical practice, research, and scholarship opportunities. The challenges to year-round sustainability of nurse-managed centers are burdensome; however, the benefits outweigh the difficulty of those challenges. Copyright © 2013 Elsevier Inc. All rights reserved.

A mismatch between population health literacy and the complexity of health information

DEFF Research Database (Denmark)

Rowlands, Gillian; Protheroe, Joanne; Winkley, John

2015-01-01

skills in relation to these. DESIGN AND SETTING: An English observational study comparing health materials with national working-age population skills. METHOD: Health materials were sampled using a health literacy framework. Competency thresholds to understand and use the materials were identified......BACKGROUND: Low health literacy is associated with poorer health and higher mortality. Complex health materials are a barrier to health. AIM: To assess the literacy and numeracy skills required to understand and use commonly used English health information materials, and to describe population...... of health materials and the skills of the English adult working-age population. Those most in need of health information have the least access to it. Efficacious strategies are building population skills, improving health professionals' communication, and improving written health information....

A survey of the health needs of hospital staff: implications for health care managers.

Science.gov (United States)

Jinks, Annette M; Lawson, Valerie; Daniels, Ruth

2003-09-01

Developing strategies to address the health needs of the National Health Services (NHS) workforce are of concern to many health care managers. Focal to the development of such strategies are of being in receipt of baseline information about employees expressed health needs and concerns. This article addresses obtaining such baseline information and presents the findings of a health needs survey of acute hospital staff in a trust in North Wales. The total population of trust employees were surveyed (n = 2300) and a 44% (n = 1021) response rate was achieved. A number of positive findings are given. Included are that the majority of those surveyed stated that their current health status is good, are motivated to improve their health further, do not smoke and their alcohol consumption is within recommended levels. There appears, however, to be a number of areas where trust managers can help its staff improve their health. Included are trust initiatives that focus on weight control and taking more exercise. In addition, there appears to be a reported lack of knowledge and positive health behaviour amongst the male respondents surveyed that would imply the trust needs to be more effective in promoting well man type issues. Finally there appears to be a general lack of pride in working for the trust and a pervasive feeling that the trust does not care about its employees that needs to be addressed. It is concluded that the findings of this survey have implications for management practices in the trust where the survey was conducted and also wider applicability to the management of health care professionals. For example, addressing work-related psychological and physical problems of employees are of importance to all health care managers. This is especially so when considering recruitment and retention issues.

Population health improvement: a community health business model that engages partners in all sectors.

Science.gov (United States)

Kindig, David A; Isham, George

2014-01-01

Because population health improvement requires action on multiple determinants--including medical care, health behaviors, and the social and physical environments--no single entity can be held accountable for achieving improved outcomes. Medical organizations, government, schools, businesses, and community organizations all need to make substantial changes in how they approach health and how they allocate resources. To this end, we suggest the development of multisectoral community health business partnership models. Such collaborative efforts are needed by sectors and actors not accustomed to working together. Healthcare executives can play important leadership roles in fostering or supporting such partnerships in local and national arenas where they have influence. In this article, we develop the following components of this argument: defining a community health business model; defining population health and the Triple Aim concept; reaching beyond core mission to help create the model; discussing the shift for care delivery beyond healthcare organizations to other community sectors; examining who should lead in developing the community business model; discussing where the resources for a community business model might come from; identifying that better evidence is needed to inform where to make cost-effective investments; and proposing some next steps. The approach we have outlined is a departure from much current policy and management practice. But new models are needed as a road map to drive action--not just thinking--to address the enormous challenge of improving population health. While we applaud continuing calls to improve health and reduce disparities, progress will require more robust incentives, strategies, and action than have been in practice to date. Our hope is that ideas presented here will help to catalyze a collective, multisectoral response to this critical social and economic challenge.

Seven Foundational Principles of Population Health Policy.

Science.gov (United States)

Bhattacharya, Dru; Bhatt, Jay

2017-10-01

In 2016, Keyes and Galea issued 9 foundational principles of population health science and invited further deliberations by specialists to advance the field. This article presents 7 foundational principles of population health policy whose intersection with health care, public health, preventive medicine, and now population health, presents unique challenges. These principles are in response to a number of overarching questions that have arisen in over a decade of the authors' collective practice in the public and private sectors, and having taught policy within programs of medicine, law, nursing, and public health at the graduate and executive levels. The principles address an audience of practitioners and policy makers, mindful of the pressing health care challenges of our time, including: rising health-related expenditures, an aging population, workforce shortages, health disparities, and a backdrop of inequities rooted in social determinants that have not been adequately translated into formal policies or practices among the key stakeholders in population health. These principles are meant to empower stakeholders-whether it is the planner or the practitioner, the decision maker or the dedicated caregiver-and inform the development of practical tools, research, and education.

Mental Health Consultation Among Ontario's Immigrant Populations.

Science.gov (United States)

Islam, Farah; Khanlou, Nazilla; Macpherson, Alison; Tamim, Hala

2017-11-16

To determine the prevalence rates and characteristics of past-year mental health consultation for Ontario's adult (18 + years old) immigrant populations. The Canadian Community Health Survey (CCHS) 2012 was used to calculate the prevalence rates of past-year mental health consultation by service provider type. Characteristics associated with mental health consultation were determined by carrying out multivariable logistic regression analysis on merged CCHS 2008-2012 data. Adult immigrant populations in Ontario (n = 3995) had lower estimated prevalence rates of past-year mental health consultation across all service provider types compared to Canadian-born populations (n = 14,644). Amongst those who reported past-year mental health consultation, 57.89% of Ontario immigrants contacted their primary care physician, which was significantly higher than the proportion who consulted their family doctor from Canadian-born populations (45.31%). The factors of gender, age, racial/ethnic background, education level, working status, food insecurity status, self-perceived health status, smoking status, alcohol drinking status, years since immigration, and age at time of immigration were significantly associated with past-year mental health consultation for immigrant populations. Ontario's adult immigrant populations most commonly consult their family doctor for mental health care. Potential exists for expanding the mental health care role of primary care physicians as well as efforts to increase accessibility of specialized mental health services. Integrated, coordinated care where primary care physicians, specialized mental health professionals, social workers, and community educators, etc. working together in a sort of "one-stop-shop" may be the most effective way to mitigate gaps in the mental health care system. In order to effectively tailor mental health policy, programming, and promotion to suit the needs of immigrant populations initiatives that focus on

Assessing the whole person: case managers take a holistic approach to physical and mental health.

Science.gov (United States)

Carter, Jolynne Jo; Zawalski, Sandra; Sminkey, Patrice V; Christopherson, Bruce

2015-01-01

Given the prevalence of mental health issues, particularly depressive disorders, in the U.S. population, professional case managers should increase their sensitivity to and awareness of mental illnesses, as well as their impact on physical health. Throughout the case management process, case managers frequently observe behaviors and symptoms such as those associated with depressive disorders. Case managers need to have, at a minimum, a working knowledge of mental and behavioral health issues and be familiar with basic screening tools. This will enable them to become more attuned to symptoms and behaviors that indicate that the individual should be further assessed and diagnosed by a physician. Across the case management spectrum, including acute care, accountable care organizations, patient-centered medical homes, physician practices, clinics, occupational health clinics, workers' compensation, and other settings in which case managers work with individuals (clients who receive case management services) and their families/support systems. With more than one quarter of the U.S. population affected by a depressive disorder, professional case managers who practice holistically bring together the mental and physical aspects of health. This is particularly important in a health care system and among payer sources that continue to divide the two. Case managers elevate their practice by demonstrating a greater understanding of the interconnectedness of mental and physical health and can positively influence the transdisciplinary care team to take a person-centered approach to address all health issues, in pursuit of the individual's health goals. Professional case managers must increase their understanding of mental health, becoming more aware of "red flags" that may necessitate a further evaluation and assessment by a mental health professional. They should also hone their communication skills, particularly the use of motivational interviewing techniques, to encourage

Future directions in population health.

Science.gov (United States)

Hancock, T

1999-01-01

The long-term health of the population will be influenced by a number of major forces in the next century. In this brief review, particular emphasis is placed on environmental and economic forces. Major global environmental changes include climate change and global warming, resource depletion, ecotoxicity and reduced biodiversity. We do not yet know the impact on longevity of lifetime exposure to a mix of persistent toxic chemicals in our environment, since it has only been widespread in the past 40-50 years. The health impacts of global warming are only just beginning to be understood and could be profound. But perhaps the most profound threat to population health is economic growth, to the extent that it undermines environmental and social sustainability. We need a new form of capitalism, one that simultaneously increases environmental, social, economic and human capital, if population health is to be maintained in the 21st century.

Strategies for expanding health insurance coverage in vulnerable populations.

Science.gov (United States)

Jia, Liying; Yuan, Beibei; Huang, Fei; Lu, Ying; Garner, Paul; Meng, Qingyue

2014-11-26

evaluated the effects of strategies on increasing health insurance coverage for vulnerable populations. We defined strategies as measures to improve the enrolment of vulnerable populations into health insurance schemes. Two categories and six specified strategies were identified as the interventions. At least two review authors independently extracted data and assessed the risk of bias. We undertook a structured synthesis. We included two studies, both from the United States. People offered health insurance information and application support by community-based case managers were probably more likely to enrol their children into health insurance programmes (risk ratio (RR) 1.68, 95% confidence interval (CI) 1.44 to 1.96, moderate quality evidence) and were probably more likely to continue insuring their children (RR 2.59, 95% CI 1.95 to 3.44, moderate quality evidence). Of all the children that were insured, those in the intervention group may have been insured quicker (47.3 fewer days, 95% CI 20.6 to 74.0 fewer days, low quality evidence) and parents may have been more satisfied on average (satisfaction score average difference 1.07, 95% CI 0.72 to 1.42, low quality evidence).In the second study applications were handed out in emergency departments at hospitals, compared to not handing out applications, and may have had an effect on enrolment (RR 1.5, 95% CI 1.03 to 2.18, low quality evidence). Community-based case managers who provide health insurance information, application support, and negotiate with the insurer probably increase enrolment of children in health insurance schemes. However, the transferability of this intervention to other populations or other settings is uncertain. Handing out insurance application materials in hospital emergency departments may help increase the enrolment of children in health insurance schemes. Further studies evaluating the effectiveness of different strategies for expanding health insurance coverage in vulnerable population are

How Academic Health Systems Can Achieve Population Health in Vulnerable Populations Through Value-Based Care: The Critical Importance of Establishing Trusted Agency.

Science.gov (United States)

Wesson, Donald E; Kitzman, Heather E

2018-01-16

Improving population health may require health systems to proactively engage patient populations as partners in the implementation of healthy behaviors as a shared value using strategies that incentivize healthy outcomes for the population as a whole. The current reactive health care model, which focuses on restoring the health of individuals after it has been lost, will not achieve the goal of improved population health. To achieve this goal, health systems must proactively engage in partnerships with the populations they serve. Health systems will need the help of community entities and individuals who have the trust of the population being served to act on behalf of the health system if they are to achieve this effective working partnership. The need for these trusted agents is particularly pertinent for vulnerable and historically underserved segments of the population. In this Invited Commentary, the authors discuss ways by which health systems might identify, engage, and leverage trusted agents to improve the health of the population through value-based care.

[HADASSAH MEDICAL ORGANIZATION - A PIONEER IN POPULATION HEALTH].

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Calderon-Margalit, Ronit; Levine, Hagai; Israeli, Avi; Paltiel, Ora

2018-03-01

Population health is a term encompassing "the health outcomes of a group of individuals, including the distribution of such outcomes within the group." Only recently have hospitals viewed themselves as focal points for promoting health in a community, involving themselves with population health. Hadassah Medical Organization (HMO), however, has been in the business of population health since its founding. Its early programs, promoting and delivering nutritional support, maternal-child health and other services to the Yishuv's inhabitants, showed that the HMO defined its community broadly. Hospital care came later. The HMO was established together with the Hebrew University Israel's first School of Public Health and Community Medicine in the 1960's, contributing >1200 Israeli alumni, and exposing thousands of medical students to population health. The School's founders developed Community-Oriented Primary Care, aimed at assessing and addressing health determinants and outcomes at the community level implemented in many centers worldwide. Reaching beyond Israel's borders, the School has trained a global public health workforce through its International Masters in Public Health with >820 graduates from 92 countries. HMO's researchers have made important contributions in the fields of epidemiology, health economics and policy and population health methodology as well as hospital and community quality of care. This article reviews HMO's contribution to population health at local, municipal, national and international levels. We will demonstrate the unique circumstances in Hadassah, Jerusalem and Israel which have enabled world-class research and training in population health, identifying important contributions to policy and service provision, as well as addressing future population health challenges.

Assessing service use for mental health by Indigenous populations in Australia, Canada, New Zealand and the United States of America: a rapid review of population surveys.

Science.gov (United States)

McIntyre, Cecily; Harris, Meredith G; Baxter, Amanda J; Leske, Stuart; Diminic, Sandra; Gone, Joseph P; Hunter, Ernest; Whiteford, Harvey

2017-08-04

Indigenous people in Australia, Canada, New Zealand and the United States of America experience disproportionately poor mental health compared to their non-Indigenous counterparts. To optimally allocate resources, health planners require information about the services Indigenous people use for mental health, their unmet treatment needs and the barriers to care. We reviewed population surveys of Indigenous people to determine whether the information needed to guide service development is being collected. We sought national- or state-level epidemiological surveys of Indigenous populations conducted in each of the four selected countries since 1990 that asked about service use for mental health. Surveys were identified from literature reviews and web searches. We developed a framework for categorising the content of each survey. Using this framework, we compared the service use content of the surveys of Indigenous people to each other and to general population mental health surveys. We focused on identifying gaps in information coverage and topics that may require Indigenous-specific questions or response options. Nine surveys met our inclusion criteria. More than half of these included questions about health professionals consulted, barriers to care, perceived need for care, medications taken, number, duration, location and payment of health professional visits or use of support services or self-management. Less than half included questions about interventions received, hospital admissions or treatment dropout. Indigenous-specific content was most common in questions regarding use of support services or self-management, types of health professionals consulted, barriers to care and interventions received. Epidemiological surveys measuring service use for mental health among Indigenous populations have been less comprehensive and less standardised than surveys of the general population, despite having assessed similar content. To better understand the gaps in mental

Population health metrics: crucial inputs to the development of evidence for health policy

Directory of Open Access Journals (Sweden)

Salomon Joshua A

2003-04-01

Full Text Available Abstract Valid, reliable and comparable measures of the health states of individuals and of the health status of populations are critical components of the evidence base for health policy. We need to develop population health measurement strategies that coherently address the relationships between epidemiological measures (such as risk exposures, incidence, and mortality rates and multi-domain measures of population health status, while ensuring validity and cross-population comparability. Studies reporting on descriptive epidemiology of major diseases, injuries and risk factors, and on the measurement of health at the population level – either for monitoring trends in health levels or inequalities or for measuring broad outcomes of health systems and social interventions – are not well-represented in traditional epidemiology journals, which tend to concentrate on causal studies and on quasi-experimental design. In particular, key methodological issues relating to the clear conceptualisation of, and the validity and comparability of measures of population health are currently not addressed coherently by any discipline, and cross-disciplinary debate is fragmented and often conducted in mutually incomprehensible language or paradigms. Population health measurement potentially bridges a range of currently disjoint fields of inquiry relating to health: biology, demography, epidemiology, health economics, and broader social science disciplines relevant to assessment of health determinants, health state valuations and health inequalities. This new journal will focus on the importance of a population based approach to measurement as a way to characterize the complexity of people's health, the diseases and risks that affect it, its distribution, and its valuation, and will attempt to provide a forum for innovative work and debate that bridge the many fields of inquiry relevant to population health in order to contribute to the development of valid

Adoption of online health management tools among healthy older adults: An exploratory study.

Science.gov (United States)

Zettel-Watson, Laura; Tsukerman, Dmitry

2016-06-01

As the population ages and chronic diseases abound, overburdened healthcare systems will increasingly require individuals to manage their own health. Online health management tools, quickly increasing in popularity, have the potential to diminish or even replace in-person contact with health professionals, but overall efficacy and usage trends are unknown. The current study explored perceptions and usage patterns among users of online health management tools, and identified barriers and barrier-breakers among non-users. An online survey was completed by 169 computer users (aged 50+). Analyses revealed that a sizable minority (37%) of participants use online health management tools and most users (89%) are satisfied with these tools, but a limited range of tools are being used and usage occurs in relatively limited domains. Improved awareness and education for online health management tools could enhance people's abilities to remain at home as they age, reducing the financial burden on formal assistance programs. © The Author(s) 2014.

Case manager satisfaction in public health.

Science.gov (United States)

Schutt, Russell K; Fawcett, Jacqueline; Gall, Gail B; Harrow, Brooke; Woodford, Mary Lou

2010-01-01

The purpose of this study was to examine correlates of case managers' satisfaction with their work, services, and service network and to identify connections to service performance and service costs. A decentralized public health program that exemplifies the trend toward more diverse clients and networked services. A mixed method design with 34 case managers. As hypothesized, the case managers' experiences with clients and the service network, and their service effectiveness, were associated with their satisfaction with their jobs and the services they provide. Satisfaction was also positively associated with more timely service delivery. These associations were explained in part by case managers' education and training. Case managers can achieve high levels of job and service satisfaction in outreach programs serving a diverse client population in a decentralized service network. Case managers' job and service satisfaction improves with reduced service problems and service delays and when case managers can devise work-arounds for persistent service problems. Using advanced practice nurses (APN) and providing more on-the-job training may increase case manager satisfaction with their jobs and the services they provide. Special efforts may be needed to prevent a decline in job satisfaction with years of experience.

FastStats: Health of Mexican American Population

Science.gov (United States)

... Submit Button NCHS Home Health of Mexican American Population Recommend on Facebook Tweet Share Compartir Data are ... Source: Summary Health Statistics Tables for the U.S. Population: National Health Interview Survey, 2015, Table P-1c [ ...

ORGANIZATIONAL PHILOSOPHY IN THE MANAGEMENT OF HEALTH IN MISIONES

Directory of Open Access Journals (Sweden)

Gloria Beatriz, Orzuza

2011-01-01

Full Text Available The passage of time brings us new knowledge, science advances in all its aspects, which translates to all areas of the organization, of management.Health care is undergoing marked changes, the welfare model, which serves as a function of demand is gradually adapting to the actions recommended by the sanitary model that acts more intensely with the communities and the environment, promoting health and preventing disease.The aim of this paper is to reflect the change that occurred in the organizational philosophy of the health system of Misiones. To this end, we first know the concepts of Newtonian and quantum organizations, focused from its philosophical origins. Second, we will refer to the legal framework of the management expenses of the Province government. Third, we analyze the socioeconomic status of the population of Misiones. Fourth, we will refer to the new health paradigm. To finish off highlighting the definitive implementation of a holistic approach, in the health system.

Population health state

International Nuclear Information System (INIS)

1993-01-01

General conception on the Chernobyl accident effect on the human health (persons took part in the emergency response, children and adults in the Chernobyl region as a whole) is given. Pattern of population disease incidence in the whole region was compared with that of contaminated regions in Russia. New method for assessment of population disease incidence in the contaminated zones due to the Chernobyl accident is proposed taking into account low dose radiation effects, territory ecological difference, medical-demographic unhomogeneity of the population and personal instability. Methods of complex mathematical analysis were used. Data on the Tula region are presented as an example. 17 figs.; 6 tabs

Political economy and population health: is Australia exceptional?

Science.gov (United States)

Boxall, Anne-marie; Short, Stephanie D

2006-06-01

It is accepted knowledge that social and economic conditions--like education and income--affect population health. What remains uncertain is whether the degree of inequality in these conditions influences population health and if so, how. Some researchers who argue that inequalities are important, say there is a relationship between political economy, inequality and population health. Their evidence comes from comparative studies showing that countries with neo-liberal political economies generally have poorer population health outcomes than those with social or Christian democratic political economies. According to these researchers, neo-liberal political economies adopt labour market and welfare state policies that lead to greater levels of inequality and poorer population health outcomes for us all. Australia has experienced considerable social and economic reforms over the last 20 years, with both major political parties increasingly adopting neo-liberal policies. Despite these reforms, population health outcomes are amongst the best in the world. Australia appears to contest theories suggesting a link between political economy and population health. To progress our understanding, researchers need to concentrate on policy areas outside health--such as welfare, economics and industrial relations. We need to do longitudinal studies on how reforms in these areas affect levels of social and economic inequality, as well population health. We need to draw on social scientific methods, especially concerning case selection, to advance our understanding of casual relationships in policy studies. It is important to find out if, and why, Australia has resisted the affects of neo-liberalism on population health so we ensure our high standards are maintained in the future.

Navigating from the heights of technical rigour to the swampy reality: Lessons from New Zealand in population health outcomes monitoring

Directory of Open Access Journals (Sweden)

John Wren

2008-06-01

Full Text Available

Background: The objective of this paper is to describe and discuss two documents produced by the New Zealand Ministry of Health concerning the monitoring of outcomes of public health programs. The New Zealand Government is increasingly expecting planners and managers of publicly funded services to shift their focus from the delivery of ‘outputs’ towards achievement of ‘outcomes’. Intervention logic models and outcomes monitoring are promoted by central government agencies as suitable management methods for implementing the change. [1-3]

Methods: To help managers design and implement comprehensive, effective and measurable population health programmes the Ministry of Health recently published two guidance documents. The first document provided guidance about how to plan programmes using a generic logic model approach.[4] The second set out in detail a process on how to monitor population health programmes.[5] The intent of the documents was to help managers navigate between the heights of technical rigour and the swamps of reality in the delivery of population health programmes.[6]

Results: A number of issues and implications for how population health programmes are planned monitored and performance assessed have been identified by the guidance documents. Issues include the problem of small numbers, understanding the difference between outcomes monitoring and traditional forms of evaluation, and outcomes monitoring being seen as a tool for punitive performance management rather than ‘continuous programme improvement’. Implications include more time spent on the design of programmes. Planners will need to focus upon better sequencing of activities, setting more specific and time limited goals, and to be more informed about how to use research to inform the selection of interventions.

Conclusions: The guidance documents promoted by

Holistic self-management education and support: a proposed public health model for improving women's health in Zimbabwe.

Science.gov (United States)

Kanchense, Jane Handina Murigwa

2006-08-01

The primary health care model of public health has been implemented in many countries around the globe since the Declaration of Alma Ata in 1978, without pilot testing the primary health care model. Therefore, many public health researchers have sought methods of improving primary health care by creating evidence-based models. Many of these researchers recognize the role of behavioral models in public health. These offshoots of primary health care include the ecological, care, central human capabilities, and the SPECIES models. Holistic self-management education and support is a capacity-building philosophy that ensures active involvement of consumers of health care in the planning and implementation and evaluation of health care services. It helps consumers of health care to achieve the desired improved quality of health and life in managing and sustaining their health at the grassroots level. The care model addresses disease management ideals of the in the original primary health care model. The SPECIES model addresses those aspects of the primary health care model that include the cultural and social factors, as well as individual health education and support in the original primary health care model. The ecological model offers an improvement of the socioeconomic ideal in the original primary health care model. Improving the health of individuals will prevent illness, thereby reducing health care costs and lessening the current strain on an overburdened health care system in Zimbabwe. Holistic self-management education and support links health care delivery systems with social processes. It is a best practices model that could better serve Zimbabwean girls and women by contributing positively to the national challenges in health care, thereby meeting the Zimbabwean primary health care and safe motherhood goals. It is here recommended that holistic self-management education and support must be pilot tested before being adopted as the most appropriate model for

SARS and population health technology.

Science.gov (United States)

Eysenbach, Gunther

2003-01-01

The recent global outbreak of SARS (severe acute respiratory syndrome) provides an opportunity to study the use and impact of public health informatics and population health technology to detect and fight a global epidemic. Population health technology is the umbrella term for technology applications that have a population focus and the potential to improve public health. This includes the Internet, but also other technologies such as wireless devices, mobile phones, smart appliances, or smart homes. In the context of an outbreak or bioterrorism attack, such technologies may help to gather intelligence and detect diseases early, and communicate and exchange information electronically worldwide. Some of the technologies brought forward during the SARS epidemic may have been primarily motivated by marketing efforts, or were more directed towards reassuring people that "something is being done," ie, fighting an "epidemic of fear." To understand "fear epidemiology" is important because early warning systems monitoring data from a large number of people may not be able to discriminate between a biological epidemic and an epidemic of fear. The need for critical evaluation of all of these technologies is stressed.

Health Applications for Corporate Health Management.

Science.gov (United States)

Steigner, Guido; Doarn, Charles R; Schütte, Michael; Matusiewicz, David; Thielscher, Christian

2017-05-01

Many corporate organizations around the world are looking at new ways to improve the health and well-being of their employees. Many have begun to use m-health approaches and unique applications (apps) to provide assistance. In Germany, both m-health and occupational health management (OHM) are growing quickly. Therefore, we hypothesized that the combination-apps usage in OHM-is growing as well. We studied the usage of health apps in large corporations for health management of employed individuals. To understand the environment in Germany, a two-part study was conducted. First, an extensive literature search was done and second, interviews were conducted with 12 of the 20 biggest companies' health management representatives. Using key search terms, 5,445 peer-reviewed journal articles traced with German databases and on PubMed were reviewed. Interestingly and somewhat surprising to the authors, none of them covered our specific topic. Interviews were conducted with 60% of the companies indicated. Only 3 out of 12 companies use apps. Four companies are piloting apps. With one exception, apps cover well-known areas such as food coaching, physical motion, smoking cessation, stress prevention, and other health-related subjects. One app used sensors in work clothing to prevent unhealthy motion. With a few exceptions, there has been no evaluation of the utility and utilization of apps. Current app usage in corporate health management in Germany is surprisingly low. Apps need to be better evaluated. Main obstacles-which could be resolved in the future-are legal restrictions (especially on data security), the lack of company-owned smart phones, misfit of apps and corporate health strategy, a lack of app evaluation, and high app prices.

Pathways to health in a deprived population: relationships between smoking, mental health & physical health

OpenAIRE

Kemp, Kim

2011-01-01

Introduction: Recently there has been increasing interest in understanding and addressing health inequalities and enhancing the well-being of the population as a whole through anticipatory care and better health care delivery. The current study aimed to investigate the predictive relationships between smoking behaviour, physical health, and mental health in a deprived population using models of mediation. Method: Participants had attended a Keep Well health check, a natio...

Conceptualizing ORGANIZATIONAL HEALTH - Public health management and leadership perspectives

OpenAIRE

Orvik, Arne

2016-01-01

The thesis introduces a new conceptual model of organizational health and discusses its implications for public health management and leadership. It is developed with reference to organizational theories and ideologies, including New Public Management, the use of which has coincided with increasing workplace health problems in health care organizations. The model is based on empirical research and theories in the fields of public health, health care organization and management, and institutio...

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.

Strategic management of health care information systems: nurse managers' perceptions.

Science.gov (United States)

Lammintakanen, Johanna; Kivinen, Tuula; Saranto, Kaija; Kinnunen, Juha

2009-01-01

The aim of this study is to describe nurse managers' perceptions of the strategic management of information systems in health care. Lack of strategic thinking is a typical feature in health care and this may also concern information systems. The data for this study was collected by eight focus group interviews including altogether 48 nurse managers from primary and specialised health care. Five main categories described the strategic management of information systems in health care; IT as an emphasis of strategy; lack of strategic management of information systems; the importance of management; problems in privacy protection; and costs of IT. Although IT was emphasised in the strategies of many health care organisations, a typical feature was a lack of strategic management of information systems. This was seen both as an underutilisation of IT opportunities in health care organisations and as increased workload from nurse managers' perspective. Furthermore, the nurse managers reported that implementation of IT strengthened their managerial roles but also required stronger management. In conclusion, strategic management of information systems needs to be strengthened in health care and nurse managers should be more involved in this process.

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.

Evidence based practice in population health: a regional survey to inform workforce development and organisational change.

Science.gov (United States)

Adily, A; Ward, J

2004-06-01

To assess current capacity to implement evidence based practice (EBP) in population health. Postal survey of a regional population health workforce in Sydney, Australia. Division of Population Health, South Western Sydney Area Health Service. 104 population health staff (response rate: 73%). In the sample of regional population health practitioners, views about the current promotion of EBP were positive. Non-medical respondents with less that Masters degree were more likely to report "high self assessed need" to increase their capacity in EBP (p = 0.022). Confidence in understanding of EBP terminology was not associated with seniority but with highest level of education reached (pskills" or "need to increase their capacity in EBP" in their current position. The proportion of participants "strongly" supporting implementation of a colorectal cancer screening programme whose benefit was expressed as relative risk reduction was greater than that so supporting a programme whose benefit was expressed as number needed to screen (p = 0.008). Most respondents referred to their immediate managers when seeking support for EBP. The findings provide a quantitative baseline for capacity building through workplace programmes. Managerial commitment has been increased and performance development is now underway.

Occupational Therapy and Management of Multiple Chronic Conditions in the Context of Health Care Reform

Science.gov (United States)

Fogelberg, Donald J.; Halle, Ashley D.; Mroz, Tracy M.

2017-01-01

One in four individuals living in the United States has multiple chronic conditions (MCCs), and the already high prevalence of MCCs continues to grow. This population has high rates of health care utilization yet poor outcomes, leading to elevated concerns about fragmented, low-quality care provided within the current health care system. Several national initiatives endeavor to improve care for the population with MCCs, and occupational therapy is uniquely positioned to contribute to these efforts for more efficient, effective, client-centered management of care. By integrating findings from the literature with current policy and practice, we aim to highlight the potential role for occupational therapy in managing MCCs within the evolving health care system. PMID:28027031

Investigating the Perceptions of Care Coordinators on Using Behavior Theory-Based Mobile Health Technology With Medicaid Populations: A Grounded Theory Study.

Science.gov (United States)

Sigler, Brittany Erika

2017-03-21

Medicaid populations are less engaged in their health care than the rest of the population, translating to worse health outcomes and increased health care costs. Since theory-based mobile health (mHealth) interventions have been shown to increase patient engagement, mobile phones may be an optimal strategy to reach this population. With increased development of theory-based mHealth technology, these interventions must now be evaluated with these medically underserved populations in a real-world setting. The aim of our study was to investigate care coordinators' perceived value of using a health behavior theory-based mHealth platform with Medicaid clients. In particular, attention was paid to the perceived impact on patient engagement. This research was conducted using the patient-provider text messaging (short message service, SMS) platform, Sense Health (now Wellpass), which integrates the transtheoretical model (TTM), also called the stages of change model; social cognitive theory (SCT); supportive accountability; and motivational interviewing (MI). Interviews based in grounded theory methodology were conducted with 10 care managers to understand perceptions of the relationship between mHealth and patient engagement. The interviews with care managers yielded a foundation for a grounded theory model, presenting themes that suggested 4 intertwined correlative relationships revolving around patient engagement: (1) A text messaging (short message service, SMS) platform supplements the client-care manager dynamic, which is grounded in high quality, reciprocal-communication to increase patient engagement; (2) Texting enhances the relationship between literacy and access to care for Medicaid patients, increasing low-literacy patients' agency to access services; (3) Texting enhances communication, providing care managers with a new means to support their clients; and (4) Reminders augment client accountability, leading to both increased motivation and readiness to change

Survival models for harvest management of mourning dove populations

Science.gov (United States)

Otis, D.L.

2002-01-01

Quantitative models of the relationship between annual survival and harvest rate of migratory game-bird populations are essential to science-based harvest management strategies. I used the best available band-recovery and harvest data for mourning doves (Zenaida macroura) to build a set of models based on different assumptions about compensatory harvest mortality. Although these models suffer from lack of contemporary data, they can be used in development of an initial set of population models that synthesize existing demographic data on a management-unit scale, and serve as a tool for prioritization of population demographic information needs. Credible harvest management plans for mourning dove populations will require a long-term commitment to population monitoring and iterative population analysis.

Population mental health: evidence, policy, and public health practice

National Research Council Canada - National Science Library

Cohen, Neal L; Galea, Sandro

2011-01-01

... on population mental health with public mental health policy and practice. Issues covered in the book include the influence of mental health policies on the care and well-­ being of individuals with mental illness, the interconnectedness of physical and mental disorders, the obstacles to adopting a public health orientation to mental health/mental ill...

Population health management guiding principles to stimulate collaboration and improve pharmaceutical care.

Science.gov (United States)

Steenkamer, Betty; Baan, Caroline; Putters, Kim; van Oers, Hans; Drewes, Hanneke

2018-04-09

Purpose A range of strategies to improve pharmaceutical care has been implemented by population health management (PHM) initiatives. However, which strategies generate the desired outcomes is largely unknown. The purpose of this paper is to identify guiding principles underlying collaborative strategies to improve pharmaceutical care and the contextual factors and mechanisms through which these principles operate. Design/methodology/approach The evaluation was informed by a realist methodology examining the links between PHM strategies, their outcomes and the contexts and mechanisms by which these strategies operate. Guiding principles were identified by grouping context-specific strategies with specific outcomes. Findings In total, ten guiding principles were identified: create agreement and commitment based on a long-term vision; foster cooperation and representation at the board level; use layered governance structures; create awareness at all levels; enable interpersonal links at all levels; create learning environments; organize shared responsibility; adjust financial strategies to market contexts; organize mutual gains; and align regional agreements with national policies and regulations. Contextual factors such as shared savings influenced the effectiveness of the guiding principles. Mechanisms by which these guiding principles operate were, for instance, fostering trust and creating a shared sense of the problem. Practical implications The guiding principles highlight how collaboration can be stimulated to improve pharmaceutical care while taking into account local constraints and possibilities. The interdependency of these principles necessitates effectuating them together in order to realize the best possible improvements and outcomes. Originality/value This is the first study using a realist approach to understand the guiding principles underlying collaboration to improve pharmaceutical care.

[The hospital perspective: disease management and integrated health care].

Science.gov (United States)

Schrappe, Matthias

2003-06-01

Disease Management is a transsectoral, population-based form of health care, which addresses groups of patients with particular clinical entities and risk factors. It refers both to an evidence-based knowledge base and corresponding guidelines, evaluates outcome as a continuous quality improvement process and usually includes active participation of patients. In Germany, the implementation of disease management is associated with financial transactions for risk adjustment between health care assurances [para. 137 f, Book V of Social Code (SGB V)] and represents the second kind of transsectoral care, besides a program designed as integrated health care according to para. 140 a ff f of Book V of Social Code. While in the USA and other countries disease management programs are made available by several institutions involved in health care, in Germany these programs are offered by health care insurers. Assessment of disease management from the hospital perspective will have to consider three questions: How large is the risk to compensate inadequate quality in outpatient care? Are there synergies in internal organisational development? Can the risk of inadequate funding of the global "integrated" budget be tolerated? Transsectoral quality assurance by valid performance indicators and implementation of a quality improvement process are essential. Internal organisational changes can be supported, particularly in the case of DRG introduction. The economic risk and financial output depends on the kind of disease being focussed by the disease management program. In assessing the underlying scientific evidence of their cost effectiveness, societal costs will have to be precisely differentiated from hospital-associated costs.

Development and Implementation of Team-Based Panel Management Tools: Filling the Gap between Patient and Population Information Systems.

Science.gov (United States)

Watts, Brook; Lawrence, Renée H; Drawz, Paul; Carter, Cameron; Shumaker, Amy Hirsch; Kern, Elizabeth F

2016-08-01

Effective team-based models of care, such as the Patient-Centered Medical Home, require electronic tools to support proactive population management strategies that emphasize care coordination and quality improvement. Despite the spread of electronic health records (EHRs) and vendors marketing population health tools, clinical practices still may lack the ability to have: (1) local control over types of data collected/reports generated, (2) timely data (eg, up-to-date data, not several months old), and accordingly (3) the ability to efficiently monitor and improve patient outcomes. This article describes a quality improvement project at the hospital system level to develop and implement a flexible panel management (PM) tool to improve care of subpopulations of patients (eg, panels of patients with diabetes) by clinical teams. An in-depth case analysis approach is used to explore barriers and facilitators in building a PM registry tool for team-based management needs using standard data elements (eg, laboratory values, pharmacy records) found in EHRs. Also described are factors that may contribute to sustainability; to date the tool has been adapted to 6 disease-focused subpopulations encompassing more than 200,000 patients. Two key lessons emerged from this initiative: (1) though challenging, team-based clinical end users and information technology needed to work together consistently to refine the product, and (2) locally developed population management tools can provide efficient data tracking for frontline clinical teams and leadership. The preliminary work identified critical gaps that were successfully addressed by building local PM registry tools from EHR-derived data and offers lessons learned for others engaged in similar work. (Population Health Management 2016;19:232-239).

Connected health and integrated care: Toward new models for chronic disease management.

Science.gov (United States)

Chouvarda, Ioanna G; Goulis, Dimitrios G; Lambrinoudaki, Irene; Maglaveras, Nicos

2015-09-01

The increasingly aging population in Europe and worldwide brings up the need for the restructuring of healthcare. Technological advancements in electronic health can be a driving force for new health management models, especially in chronic care. In a patient-centered e-health management model, communication and coordination between patient, healthcare professionals in primary care and hospitals can be facilitated, and medical decisions can be made timely and easily communicated. Bringing the right information to the right person at the right time is what connected health aims at, and this may set the basis for the investigation and deployment of the integrated care models. In this framework, an overview of the main technological axes and challenges around connected health technologies in chronic disease management are presented and discussed. A central concept is personal health system for the patient/citizen and three main application areas are identified. The connected health ecosystem is making progress, already shows benefits in (a) new biosensors, (b) data management, (c) data analytics, integration and feedback. Examples are illustrated in each case, while open issues and challenges for further research and development are pinpointed. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Quality, risk management and governance in mental health: an overview.

Science.gov (United States)

Callaly, Tom; Arya, Dinesh; Minas, Harry

2005-03-01

To consider the origin, current emphasis and relevance of the concepts of quality, risk management and clinical governance in mental health. Increasingly, health service boards and management teams are required to give attention to clinical governance rather than corporate governance alone. Clinical governance is a unifying quality concept that aims to produce a structure and systems to assure and improve the quality of clinical services by promoting an integrated and organization-wide approach towards continuous quality improvement. Many psychiatrists will find the reduction in clinical autonomy, the need to consider the welfare of the whole population as well as the individual patient for whom they are responsible, and the requirement that they play a part in a complex systems approach to quality improvement to be a challenge. Avoiding or ignoring this challenge will potentially lead to conflict with modern management approaches and increased loss of influence on future developments in mental health services.

Conceptualizing ORGANIZATIONAL HEALTH - Public health management and leadership perspectives

DEFF Research Database (Denmark)

Orvik, Arne

The thesis introduces a new conceptual model of organizational health and discusses its implications for public health management and leadership. It is developed with reference to organizational theories and ideologies, including New Public Management, the use of which has coincided with increasing...... as the disintegration of such values. Possible implications for public health management and leadership include four different forms. The application of the conceptual model can potentially draw attention to value conflicts and help to clarify contradictory, institutional logics. It can also potentially support health...... workplace health problems in health care organizations. The model is based on empirical research and theories in the fields of public health, health care organization and management, and institutional theory. It includes five dimensions and defines organizational health in terms of how an organization...

On Management Matters: Why We Must Improve Public Health Management Through Action: Comment on "Management Matters: A Leverage Point for Health Systems Strengthening in Global Health".

Science.gov (United States)

Willacy, Erika; Bratton, Shelly

2015-09-30

Public health management is a pillar of public health practice. Only through effective management can research, theory, and scientific innovation be translated into successful public health action. With this in mind, the U.S. Centers for Disease Control and Prevention (CDC) has developed an innovative program called Improving Public Health Management for Action (IMPACT) which aims to address this critical need by building an effective cadre of public health managers to work alongside scientists to prepare for and respond to disease threats and to effectively implement public health programs. IMPACT is a 2-year, experiential learning program that provides fellows with the management tools and opportunities to apply their new knowledge in the field, all while continuing to serve the Ministry of Health (MoH). IMPACT will launch in 2016 in 2 countries with the intent of expanding to additional countries in future years resulting in a well-trained cadre of public health managers around the world. © 2016 by Kerman University of Medical Sciences.

NGO management and health care financing approaches in the Eastern Democratic Republic of the Congo.

Science.gov (United States)

Dijkzeul, D; Lynch, C A

2006-01-01

The role of cost-sharing in health care is a crucial, yet contentious issue. In conflict situations, cost-sharing becomes even more controversial as health and other institutions are failing. In such situations, NGOs manage health programmes which aim to aid populations in crisis and improve or at least sustain a deteriorating health system. This study looks at the issue of cost-sharing in the wider context of utilization rates and management approaches of three NGOs in the chronic, high-mortality crisis of the eastern DRC. Approaches to increase access to health care were found to exist, yet cost-recovery, even on the basis of maximum utilization rates, would only partially sustain the health system in the eastern DRC. Factors external to the direct management of NGO health programs, such as the wider economic and security situation, local management structures, and international donor policies, need to be taken into account for establishing more integrated management and financing approaches.

Application of PACE Principles for Population Health Management of Frail Older Adults.

Science.gov (United States)

Stefanacci, Richard G; Reich, Shelley; Casiano, Alex

2015-10-01

To determine which practices would have the most impact on reducing hospital and emergency department admissions and nursing home placement among older adults with multiple comorbid conditions, a literature search and survey were conducted to identify and prioritize comprehensive care principles as practiced in the Program of All-inclusive Care for the Elderly (PACE). PACE medical directors and members of the PACE interdisciplinary team (IDT) were surveyed to gain their insights on the most impactful practices, which were identified as: End-of-Life Management, Caregiver Support, Management of Red Flags, Medication Management, Participant and Caregiver Health Care System Literacy, and Care Coordination. In addition, this research evaluated measures that could be used to assess an organization's level of success with regard to each of the 6 PACE practices identified. The results reported in this article, found through a survey with PACE medical directors and IDT members concerning effective interventions, can be viewed as strategies to improve care for older adults, enabling them to maintain their independence in the community, avoid the expense of facility-based care, and enhance their quality of life.

A "Mental-Health-at-the-Workplace" Educational Workshop Reduces Managers' Stigma Toward Depression.

Science.gov (United States)

Hamann, Johannes; Mendel, Rosmarie; Reichhart, Tatjana; Rummel-Kluge, Christine; Kissling, Werner

2016-01-01

Stigma and discrimination are important factors hindering people with mental health conditions to stay employed or successfully make their careers. We surveyed 580 German managers before and after visiting a "mental-health-at-the-workplace" educational workshop using the Depression Stigma Scale. The workshop significantly reduced stigma toward depression. Managers at baseline already exhibited lower stigma toward depression compared with the general population. In addition, female gender and higher education predicted lower stigma, which is in line with findings from other studies. We conclude that an educational workshop giving practical guidance regarding "mental-health-at-the-workplace" reduces managers' stigma toward depression and improves knowledge regarding depression, its course, and its treatment.

Evaluating Performance of Safety Management and Occupational Health Using Total Quality Safety Management Model (TQSM

Directory of Open Access Journals (Sweden)

E Mohammadfam

2015-11-01

Full Text Available Introduction: All organizations, whether public or private, necessitate performance evaluation systems in regard with growth, stability, and development in the competitive fields. One of the existing models for performance evaluation of occupational health and safety management is Total Quality Safety Management model (TQSM. Therefore, the present study aimed to evaluate performance of safety management and occupational health utilizing TQSM model. Methods: In this descriptive-analytic study, the population consisted of 16 individuals, including managers, supervisors, and members of technical protection and work health committee. Then the participants were asked to respond to TQSM questionnaire before and after the implementation of Occupational Health & Safety Advisory Services 18001 (OHSAS18001. Ultimately, the level of each program as well as the TQSM status were determined before and after the implementation of OHSAS18001. Results: The study results showed that the scores obtained by the company before OHSAS 18001’s implementation, was 43.7 out of 312. After implementing OHSAS 18001 in the company and receiving the related certificate, the total score of safety program that company could obtain was 127.12 out of 312 demonstrating a rise of 83.42 scores (26.8%. The paired t-test revealed that mean difference of TQSM scores before and after OHSAS 18001 implementation was proved to be significant (p> 0.05. Conclusion: The study findings demonstrated that TQSM can be regarded as an appropriate model in order to monitor the performance of safety management system and occupational health, since it possesses the ability to quantitatively evaluate the system performance.

Identification of management units using population genetic data

NARCIS (Netherlands)

Palsboll, Per J.; Berube, Martine; Allendorf, Fred W.

The identification of management units (MUs) is central to the management of natural populations and is crucial for monitoring the effects of human activity upon species abundance. Here, we propose that the identification of MUs from population genetic data should be based upon the amount of genetic

Lessons Learned in Promoting Evidence-Based Public Health: Perspectives from Managers in State Public Health Departments.

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Allen, Peg; Jacob, Rebekah R; Lakshman, Meenakshi; Best, Leslie A; Bass, Kathryn; Brownson, Ross C

2018-03-02

Evidence-based public health (EBPH) practice, also called evidence-informed public health, can improve population health and reduce disease burden in populations. Organizational structures and processes can facilitate capacity-building for EBPH in public health agencies. This study involved 51 structured interviews with leaders and program managers in 12 state health department chronic disease prevention units to identify factors that facilitate the implementation of EBPH. Verbatim transcripts of the de-identified interviews were consensus coded in NVIVO qualitative software. Content analyses of coded texts were used to identify themes and illustrative quotes. Facilitator themes included leadership support within the chronic disease prevention unit and division, unit processes to enhance information sharing across program areas and recruitment and retention of qualified personnel, training and technical assistance to build skills, and the ability to provide support to external partners. Chronic disease prevention leaders' role modeling of EBPH processes and expectations for staff to justify proposed plans and approaches were key aspects of leadership support. Leaders protected staff time in order to identify and digest evidence to address the common barrier of lack of time for EBPH. Funding uncertainties or budget cuts, lack of political will for EBPH, and staff turnover remained challenges. In conclusion, leadership support is a key facilitator of EBPH capacity building and practice. Section and division leaders in public health agencies with authority and skills can institute management practices to help staff learn and apply EBPH processes and spread EBPH with partners.

Understanding and estimating effective population size for practical application in marine species management.

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Hare, Matthew P; Nunney, Leonard; Schwartz, Michael K; Ruzzante, Daniel E; Burford, Martha; Waples, Robin S; Ruegg, Kristen; Palstra, Friso

2011-06-01

Effective population size (N(e)) determines the strength of genetic drift in a population and has long been recognized as an important parameter for evaluating conservation status and threats to genetic health of populations. Specifically, an estimate of N(e) is crucial to management because it integrates genetic effects with the life history of the species, allowing for predictions of a population's current and future viability. Nevertheless, compared with ecological and demographic parameters, N(e) has had limited influence on species management, beyond its application in very small populations. Recent developments have substantially improved N(e) estimation; however, some obstacles remain for the practical application of N(e) estimates. For example, the need to define the spatial and temporal scale of measurement makes the concept complex and sometimes difficult to interpret. We reviewed approaches to estimation of N(e) over both long-term and contemporary time frames, clarifying their interpretations with respect to local populations and the global metapopulation. We describe multiple experimental factors affecting robustness of contemporary N(e) estimates and suggest that different sampling designs can be combined to compare largely independent measures of N(e) for improved confidence in the result. Large populations with moderate gene flow pose the greatest challenges to robust estimation of contemporary N(e) and require careful consideration of sampling and analysis to minimize estimator bias. We emphasize the practical utility of estimating N(e) by highlighting its relevance to the adaptive potential of a population and describing applications in management of marine populations, where the focus is not always on critically endangered populations. Two cases discussed include the mechanisms generating N(e) estimates many orders of magnitude lower than census N in harvested marine fishes and the predicted reduction in N(e) from hatchery-based population

Strategies for expanding health insurance coverage in vulnerable populations

Science.gov (United States)

Jia, Liying; Yuan, Beibei; Huang, Fei; Lu, Ying; Garner, Paul; Meng, Qingyue

2014-01-01

) studies and Interrupted time series (ITS) studies that evaluated the effects of strategies on increasing health insurance coverage for vulnerable populations. We defined strategies as measures to improve the enrolment of vulnerable populations into health insurance schemes. Two categories and six specified strategies were identified as the interventions. Data collection and analysis At least two review authors independently extracted data and assessed the risk of bias. We undertook a structured synthesis. Main results We included two studies, both from the United States. People offered health insurance information and application support by community-based case managers were probably more likely to enrol their children into health insurance programmes (risk ratio (RR) 1.68, 95% confidence interval (CI) 1.44 to 1.96, moderate quality evidence) and were probably more likely to continue insuring their children (RR 2.59, 95% CI 1.95 to 3.44, moderate quality evidence). Of all the children that were insured, those in the intervention group may have been insured quicker (47.3 fewer days, 95% CI 20.6 to 74.0 fewer days, low quality evidence) and parents may have been more satisfied on average (satisfaction score average difference 1.07, 95% CI 0.72 to 1.42, low quality evidence). In the second study applications were handed out in emergency departments at hospitals, compared to not handing out applications, and may have had an effect on enrolment (RR 1.5, 95% CI 1.03 to 2.18, low quality evidence). Authors' conclusions Community-based case managers who provide health insurance information, application support, and negotiate with the insurer probably increase enrolment of children in health insurance schemes. However, the transferability of this intervention to other populations or other settings is uncertain. Handing out insurance application materials in hospital emergency departments may help increase the enrolment of children in health insurance schemes. Further studies

Forest management under uncertainty for multiple bird population objectives

Science.gov (United States)

Moore, C.T.; Plummer, W.T.; Conroy, M.J.; Ralph, C. John; Rich, Terrell D.

2005-01-01

We advocate adaptive programs of decision making and monitoring for the management of forest birds when responses by populations to management, and particularly management trade-offs among populations, are uncertain. Models are necessary components of adaptive management. Under this approach, uncertainty about the behavior of a managed system is explicitly captured in a set of alternative models. The models generate testable predictions about the response of populations to management, and monitoring data provide the basis for assessing these predictions and informing future management decisions. To illustrate these principles, we examine forest management at the Piedmont National Wildlife Refuge, where management attention is focused on the recovery of the Red-cockaded Woodpecker (Picoides borealis) population. However, managers are also sensitive to the habitat needs of many non-target organisms, including Wood Thrushes (Hylocichla mustelina) and other forest interior Neotropical migratory birds. By simulating several management policies on a set of-alternative forest and bird models, we found a decision policy that maximized a composite response by woodpeckers and Wood Thrushes despite our complete uncertainty regarding system behavior. Furthermore, we used monitoring data to update our measure of belief in each alternative model following one cycle of forest management. This reduction of uncertainty translates into a reallocation of model influence on the choice of optimal decision action at the next decision opportunity.

Health management of radiation workers

International Nuclear Information System (INIS)

Kunugita, Naoki; Igari, Kazuyuki

2013-01-01

People in Japan have expressed great anxiety about possible radiation and radioactivity after the accident at the Fukushima Daiichi Nuclear Power Plant of Tokyo Electric Power Company's (TEPCO), due to the great earthquake and tsunami in eastern Japan on 11 March 2011. A large number of workers were engaged in response and recovery operations, and they were possibly exposed to high doses of radiation as compared to the general population. In the accident at the Chernobyl Nuclear Power Plant in 1986, high doses of radiation to 134 plant staff and emergency personnel resulted in acute radiation syndrome (ARS), which proved fatal for 28 of them. In the Fukushima accident, six workers were exposed to more than 250 mSv of radiation during the initial response phase, but no one showed ARS. It is necessary to continue registration of radiation doses for all workers who were exposed to radiation to facilitate suitable healthcare management in the future. In addition to radiation exposure, a group of workers were also exposed to other health hazards. Frequent occurrence of heat disorders has been a concern for the workers wearing protective clothing with poor ventilation. A comprehensive program to prevent heat illness was implemented by TEPCO under the guidance of the Ministry of Health, Labour, and Welfare. It is important to provide effective systems not only for prevention of radiation exposure but also for general management of other health risks including heat disorders and infection. (author)

Effects of Community-Based Health Worker Interventions to Improve Chronic Disease Management and Care Among Vulnerable Populations: A Systematic Review.

Science.gov (United States)

Kim, Kyounghae; Choi, Janet S; Choi, Eunsuk; Nieman, Carrie L; Joo, Jin Hui; Lin, Frank R; Gitlin, Laura N; Han, Hae-Ra

2016-04-01

��= 21), case management (n = 4), social services (n = 7), and social support (n = 18). Fifty-three studies provided information regarding CBHW training, yet CBHW competency evaluation (n = 9) and supervision procedures (n = 24) were largely underreported. The length and duration of CBHW training ranged from 4 hours to 240 hours with an average of 41.3 hours (median: 16.5 hours) in 24 studies that reported length of training. Eight studies reported the frequency of supervision, which ranged from weekly to monthly. There was a trend toward improvements in cancer prevention (n = 21) and cardiovascular risk reduction (n = 16). Eight articles documented cost analyses and found that integrating CBHWs into the health care delivery system was associated with cost-effective and sustainable care. Interventions by CBHWs appear to be effective when compared with alternatives and also cost-effective for certain health conditions, particularly when partnering with low-income, underserved, and racial and ethnic minority communities. Future research is warranted to fully incorporate CBHWs into the health care system to promote noncommunicable health outcomes among vulnerable populations.

The Value of Community Health Workers in Diabetes Management in Low-Income Populations: A Qualitative Study.

Science.gov (United States)

Silverman, Julie; Krieger, James; Sayre, George; Nelson, Karin

2018-03-01

To describe community health workers (CHWs) roles in a diabetes self-management intervention. Retrospective qualitative inductive analysis of open text home visit encounter form from Peer Support for Achieving Independence in Diabetes (Peer AID), a randomized controlled trial in which low-income individuals with poorly controlled diabetes received either CHW home visits or usual care. Following visits, CHWs completed encounter forms documenting the health goal of the visit, the self-management strategies discussed and participant concerns. 634 encounter reports were completed for the 145 intervention participants. CHW notes revealed three main obstacles to optimal disease control: gaps in diabetes knowledge and self-management skills; socioeconomic conditions; and the complexity of the healthcare system. CHWs helped participants overcome these obstacles through extensive, hands-on education, connecting participants to community resources, and assistance navigating the medical system. In addition, the CHWs offered uncomplicated accessibility and availability to their clients. CHWs can be a valuable asset for low-income patients with chronic health conditions who may require more support than what can provided in a typical primary care visit.

[A framework to support action in population mental health].

Science.gov (United States)

Mantoura, Pascale; Roberge, Marie-Claude; Fournier, Louise

In Quebec, like elsewhere in the world, we are witnessing a growing concern for the population's mental health and for the importance of concentrating efforts on prevention and promotion. In this context, public health actors are invited to adopt a leadership role in advancing mental health promotion and mental disorder prevention goals, and establish the required partnerships with actors from the health and social services and from other sectors who are indispensable to the population mental health agenda. In Canada, public heath actors are not yet sufficiently supported in this role. They express the need to access structuring frameworks which can clarify their action in mental health. This article first presents the momentum for change at the policy level within the field of mental health. A framework to support population mental health action is then presented. The framework identifies the various dimensions underlying the promotion of population mental health as well as the reduction of mental health inequalities. The article finally illustrates how the application of a populational (the application of a populational responsibility perspective) responsibility perspective, as it is defined in the context of Quebec, facilitates the implementation of the various elements of this framework. In the end, public health actors are better equipped to situate their practice in favour of the population's mental health.

Data Analytic Process of a Nationwide Population-Based Study Using National Health Information Database Established by National Health Insurance Service

Directory of Open Access Journals (Sweden)

Yong-ho Lee

2016-02-01

Full Text Available In 2014, the National Health Insurance Service (NHIS signed a memorandum of understanding with the Korean Diabetes Association to provide limited open access to its databases for investigating the past and current status of diabetes and its management. NHIS databases include the entire Korean population; therefore, it can be used as a population-based nationwide study for various diseases, including diabetes and its complications. This report presents how we established the analytic system of nation-wide population-based studies using the NHIS database as follows: the selection of database study population and its distribution and operational definition of diabetes and patients of currently ongoing collaboration projects.

[Time based management in health care system: the chosen aspects].

Science.gov (United States)

Kobza, Joanna; Syrkiewicz-Świtała, Magdalena

2014-01-01

Time-based management (TBM) is the key element of the whole management process. For many years in health care systems of highly developed countries modern and effective methods of time-based management have been implemented in both primary health care and hospitals (emergency departments and operating rooms). Over the past two decades a systematic review of Polish literature (since 1990) and peer reviewed articles published in international journals based on PubMed/Medline (2001-2011) have been carried out. The collected results indicate that the demographic and health changes in the populations are one of the main challenges facing general practitioners in the nearest future. Time-based management needs new and effective tools and skills, i.e., identification of priorities, well designed planning, delegation of the tasks, proper coordination, and creation of primary care teams that include additional members and human resources management. Proper reimbursement of health services, development of IT in health care system, better collection, storage, processing, analysis and exchange of information and research findings will also be needed. The use of innovative technologies, like telemedicine consultations, provides the possibility of reducing waiting time for diagnosis and treatment and in some cases could be applied in terms of secondary care. To improve the efficiency of operating rooms it is necessary to introduce different solutions, such as operating room coordinator involvement, application of automation to guide decision-making or use of robotic tools to assist surgical procedures. Overcrowded emergency departments have a major detrimental effect on the quality of hospital functions, therefore, efforts should be made to reduce them. Time-based management training among physicians and health care management in Poland, as well as the implementation of practice-based solutions still applied in highly developed countries seem to be necessary.

Time based management in health care system: The chosen aspects

Directory of Open Access Journals (Sweden)

Joanna Kobza

2014-08-01

Full Text Available Time-based management (TBM is the key element of the whole management process. For many years in health care systems of highly developed countries modern and effective methods of time-based management have been implemented in both primary health care and hospitals (emergency departments and operating rooms. Over the past two decades a systematic review of Polish literature (since 1990 and peer reviewed articles published in international journals based on PubMed/Medline (2001–2011 have been carried out. The collected results indicate that the demographic and health changes in the populations are one of the main challenges facing general practitioners in the nearest future. Time-based management needs new and effective tools and skills, i.e., identification of priorities, well designed planning, delegation of the tasks, proper coordination, and creation of primary care teams that include additional members and human resources management. Proper reimbursement of health services, development of IT in health care system, better collection, storage, processing, analysis and exchange of information and research findings will also be needed. The use of innovative technologies, like telemedicine consultations, provides the possibility of reducing waiting time for diagnosis and treatment and in some cases could be applied in terms of secondary care. To improve the efficiency of operating rooms it is necessary to introduce different solutions, such as operating room coordinator involvement, application of automation to guide decision-making or use of robotic tools to assist surgical procedures. Overcrowded emergency departments have a major detrimental effect on the quality of hospital functions, therefore, efforts should be made to reduce them. Time-based management training among physicians and health care management in Poland, as well as the implementation of practice-based solutions still applied in highly developed countries seem to be necessary

X-33/RLV System Health Management/Vehicle Health Management

Science.gov (United States)

Mouyos, William; Wangu, Srimal

1998-01-01

To reduce operations costs, Reusable Launch Vehicles (RLVS) must include highly reliable robust subsystems which are designed for simple repair access with a simplified servicing infrastructure, and which incorporate expedited decision-making about faults and anomalies. A key component for the Single Stage To Orbit (SSTO) RLV system used to meet these objectives is System Health Management (SHM). SHM incorporates Vehicle Health Management (VHM), ground processing associated with the vehicle fleet (GVHM), and Ground Infrastructure Health Management (GIHM). The primary objective of SHM is to provide an automated and paperless health decision, maintenance, and logistics system. Sanders, a Lockheed Martin Company, is leading the design, development, and integration of the SHM system for RLV and for X-33 (a sub-scale, sub-orbit Advanced Technology Demonstrator). Many critical technologies are necessary to make SHM (and more specifically VHM) practical, reliable, and cost effective. This paper will present the X-33 SHM design which forms the baseline for the RLV SHM, and it will discuss applications of advanced technologies to future RLVs. In addition, this paper will describe a Virtual Design Environment (VDE) which is being developed for RLV. This VDE will allow for system design engineering, as well as program management teams, to accurately and efficiently evaluate system designs, analyze the behavior of current systems, and predict the feasibility of making smooth and cost-efficient transitions from older technologies to newer ones. The RLV SHM design methodology will reduce program costs, decrease total program life-cycle time, and ultimately increase mission success.

Access to general health care services by a New Zealand population with serious mental illness.

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Wheeler A

2014-03-01

Full Text Available INTRODUCTION: Literature suggests that good quality health care access can have a positive impact on the health of people with serious mental illness (SMI, but literature relating to patterns of access by this group is equivocal. AIM: This study was designed to explore health care access patterns in a group of people with SMI and to compare them with a general New Zealand population group, in order for health providers to understand how they might contribute to positive health outcomes for this group. METHODS: The study surveyed 404 mental health consumers aged 18-65 years receiving care from one district health board in Auckland about their patterns of health care access. Results were compared with those from the New Zealand Health Survey of the general population. RESULTS: Findings suggest that the SMI consumer respondents had poorer physical health than the general population respondents, accessed health care services in more complex ways and were more particular about who they accessed for their care than the general population respondents. There was some concern from SMI consumers around discrimination from health care providers. The study also suggested that some proactive management with SMI consumers for conditions such as metabolic syndrome was occurring within the health care community. DISCUSSION: The first point of access for SMI consumers with general health problems is not always the family general practitioner and so other health professionals may sometimes need to consider the mental and physical health of such consumers in a wider context than their own specialism.

Laypeoples' preferred sources of health information on the emergency management of tooth avulsion.

Science.gov (United States)

Al-Sane, Mona; Bourisly, Nibal; Almulla, Taghreed; Andersson, Lars

2011-12-01

When planning nationwide information campaigns on the emergency management of tooth avulsion, the populations' preference to different modes of information delivery should be taken into consideration. We currently lack information on that. The aim of this study was, therefore, to assess laypeoples' preferred sources of information on the emergency management of tooth avulsion. This was a joint study undertaken by experts in media and experts in dental traumatology. Interview-assisted questionnaires were conducted on a sample of 579 adults from Kuwait. Subjects were asked to choose their three preferred sources of information on the emergency management of tooth avulsion. Subjects' responses and sociodemographic data were registered. The data were descriptively analyzed, and a chi-square test was used to assess the relation of the subjects' preferences to their registered demographics. The Internet, health care professionals, and TV were the three most preferred sources of information on the emergency management of tooth avulsion across all groups, regardless of the sociodemographic characteristics. Younger adults, singles and subjects with higher education significantly preferred the Internet. Older adults preferred TV. Family was a preferred source in geographic districts populated with extended families, while friends were a preferred source in geographic districts populated by expatriates. Younger people and those with higher education can be effectively targeted through the Internet, while it is more effective to target older people through TV. Information, on tooth avulsion management, given by health care professionals is preferred across all population segments. © 2011 John Wiley & Sons A/S.

A knowledge management tool for public health: health-evidence.ca

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Dobbins Maureen

2010-08-01

Full Text Available Abstract Background The ultimate goal of knowledge translation and exchange (KTE activities is to facilitate incorporation of research knowledge into program and policy development decision making. Evidence-informed decision making involves translation of the best available evidence from a systematically collected, appraised, and analyzed body of knowledge. Knowledge management (KM is emerging as a key factor contributing to the realization of evidence-informed public health decision making. The goal of health-evidence.ca is to promote evidence-informed public health decision making through facilitation of decision maker access to, retrieval, and use of the best available synthesized research evidence evaluating the effectiveness of public health interventions. Methods The systematic reviews that populate health evidence.ca are identified through an extensive search (1985-present of 7 electronic databases: MEDLINE, EMBASE, CINAHL, PsycINFO, Sociological Abstracts, BIOSIS, and SportDiscus; handsearching of over 20 journals; and reference list searches of all relevant reviews. Reviews are assessed for relevance and quality by two independent reviewers. Commonly-used public health terms are used to assign key words to each review, and project staff members compose short summaries highlighting results and implications for policy and practice. Results As of June 2010, there are 1913 reviews in the health-evidence.ca registry in 21 public health and health promotion topic areas. Of these, 78% have been assessed as being of strong or moderate methodological quality. Health-evidence.ca receives approximately 35,000 visits per year, 20,596 of which are unique visitors, representing approximately 100 visits per day. Just under half of all visitors return to the site, with the average user spending six minutes and visiting seven pages per visit. Public health nurses, program managers, health promotion workers, researchers, and program coordinators are

[METHODICAL APPROACHES, EXPERIENCE AND PERSPECTIVES OF THE IMPLEMENTATION OF THE RISK MODEL OF SURVEILLANCE ACTIVITIES IN THE SPHERE OF THE ASSURANCE OF SANITARY AND EPIDEMIOLOGICAL WELFARE OF POPULATION, POPULATION'S HEALTH RISK MANAGEMENT AND THE CONSUMER RIGHTS PROTECTION].

Science.gov (United States)

Gurvich, V B; Kuz'min, S V; Dikonskaia, O V; Gileva, M A; Boiarskiĭ, A P

2015-01-01

Control and supervision measures--one of the main technologies of Federal Service for Supervision of Consumer Rights protection and Human Welfare in the overall system of risk management for public health and damage to property consumers, aimed at the solution of the prior tasks in the field of assurance of the sanitary and epidemiological welfare of the population and consumer rights protection. The effectiveness of this technology depends on the correct choice of priority objects of supervision, which form the main problems in the sanitary and epidemiological situation and in the consumer market. The application of is approach has led to more effective oversight activity and the improvement of a number of indices characterizing the achievement of the objectives in the common system of risk management for public health and property of consumers.

Evaluation of a complex, population-based injury claims management intervention for improving injury outcomes: study protocol

Science.gov (United States)

Collie, Alex; Gabbe, Belinda; Fitzharris, Michael

2015-01-01

Introduction Injuries resulting from road traffic crashes are a substantial cause of disability and death worldwide. Injured persons receiving compensation have poorer recovery and return to work than those with non-compensable injury. Case or claims management is a critical component of injury compensation systems, and there is now evidence that claims management can have powerful positive impacts on recovery, but can also impede recovery or exacerbate mental health concerns in some injured people. This study seeks to evaluate the impact of a population-based injury claims management intervention in the State of Victoria, Australia, on the health of those injured in motor vehicle crashes, their experience of the compensation process, and the financial viability of the compensation system. Methods and analysis Evaluation of this complex intervention involves a series of linked but stand-alone research projects to assess the anticipated process changes, impacts and outcomes of the intervention over a 5-year time frame. Linkage and analysis of routine administrative and health system data is supplemented with a series of primary studies collecting new information. Additionally, a series of ‘action’ research projects will be undertaken to inform the implementation of the intervention. A program logic model designed by the state government Transport Accident Commission in conjunction with the research team provides the evaluation framework. Ethics and dissemination Relatively few studies have comprehensively examined the impact of compensation system processes on the health of injured persons, their satisfaction with systems processes, and impacts on the financial performance of the compensation scheme itself. The wholesale, population-based transformation of an injury claims management model is a rare opportunity to document impacts of system-level policy change on outcomes of injured persons. Findings will contribute to the evidence base of information on the

Assessment of time management attitudes among health managers.

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Sarp, Nilgun; Yarpuzlu, Aysegul Akbay; Mostame, Fariba

2005-01-01

These days, working people are finding it difficult to manage their time, get more done at work, and find some balance in their work and personal lives. Successful time management is often suggested to be a product of organizing skills, however, what works for one person may not work for others. Context current competence assessment formats for physicians, health professionals, and managers during their training years reliably test core knowledge and basic skills. However, they may underemphasize some important domains of professional medical practice. Thus, in addition to assessments of basic skills, new formats that assess clinical reasoning, expert judgment, management of ambiguity, professionalism, time management, learning strategies, and teamwork to promise a multidimensional assessment while maintaining adequate reliability and validity in classic health education and health care institutional settings are needed to be worked on. It should be kept in mind that institutional support, reflection, and mentoring must accompany the development of assessment programs. This study was designed to describe the main factors that consume time, effective hours of work, time management opportunities, and attitudes and behaviors of health professionals and managers on time management concept through assessment by the assessment tool Time Management Inquiry Form (TMIQ-F). The study was conducted at the State Hospital, Social Security Hospital, and University Hospital at Kirikkale, Turkey between October 1999 and January 2000, including 143 subjects defined as medical managers and medical specialists. According to the results, a manager should give priority to the concept of planning, which may be counted among the efficient time management techniques, and educate him/herself on time management.

[Methods for health impact assessment of policies for municipal solid waste management: the SESPIR Project].

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Parmagnani, Federica; Ranzi, Andrea; Ancona, Carla; Angelini, Paola; Chiusolo, Monica; Cadum, Ennio; Lauriola, Paolo; Forastiere, Francesco

2014-01-01

The Project Epidemiological Surveillance of Health Status of Resident Population Around the Waste Treatment Plants (SESPIR) included five Italian regions (Emilia-Romagna, Piedmont, Lazio, Campania, and Sicily) and the National Institute of Health in the period 2010-2013. SESPIR was funded by the Ministry of Health as part of the National centre for diseases prevention and control (CCM) programme of 2010 with the general objective to provide methods and operational tools for the implementation of surveillance systems for waste and health, aimed at assessing the impact of the municipal solid waste (MSW) treatment cycle on the health of the population. The specific objective was to assess health impacts resulting from the presence of disposal facilities related to different regional scenarios of waste management. Suitable tools for analysis of integrated assessment of environmental and health impact were developed and applied, using current demographic, environmental and health data. In this article, the methodology used for the quantitative estimation of the impact on the health of populations living nearby incinerators, landfills and mechanical biological treatment plants is showed, as well as the analysis of three different temporal scenarios: the first related to the existing plants in the period 2008-2009 (baseline), the second based on regional plans, the latter referring to MSW virtuous policy management based on reduction of produced waste and an intense recovery policy.

Chronic disease management in rural and underserved populations: innovation and system improvement help lead to success.

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Bolin, Jane; Gamm, Larry; Kash, Bita; Peck, Mitchell

2005-03-01

Successful implementation of disease management (DM) is based on the ability of an organization to overcome a variety of barriers to deliver timely, appropriate care of chronic illnesses. Such programs initiate DM services to patient populations while initiating self-management education among medication-resistant patients who are chronically ill. Despite formidable challenges, rural health care providers have been successful in initiating DM programs and have discovered several ways in which these programs benefit their organizations. This research reports on six DM programs that serve large rural and underserved populations and have demonstrated that DM can be successfully implemented in such areas.

Improving Chronic Disease Self-Management by Older Home Health Patients through Community Health Coaching

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Cheryl Dye

2018-04-01

Full Text Available The purpose of the study was to pilot test a model to reduce hospital readmissions and emergency department use of rural, older adults with chronic diseases discharged from home health services (HHS through the use of volunteers. The study’s priority population consistently experiences poorer health outcomes than their urban counterparts due in part to lower socioeconomic status, reduced access to health services, and incidence of chronic diseases. When they are hospitalized for complications due to poorly managed chronic diseases, they are frequently readmitted for the same conditions. This pilot study examines the use of volunteer community members who were trained as Health Coaches to mentor discharged HHS patients in following the self-care plan developed by their HHS RN; improving chronic disease self-management behaviors; reducing risk of falls, pneumonia, and flu; and accessing community resources. Program participants increased their ability to monitor and track their chronic health conditions, make positive lifestyle changes, and reduce incidents of falls, pneumonia and flu. Although differences in the ED and hospital admission rates after discharge from HHS between the treatment and comparison group (matched for gender, age, and chronic condition were not statistically significant, the treatment group’s rate was less than the comparison group thus suggesting a promising impact of the HC program (90 day: 263 comparison vs. 129 treatment; p = 0.65; 180 day 666.67 vs. 290.32; p = 0.19. The community health coach model offers a potential approach for improving the ability of discharged older home health patients to manage chronic conditions and ultimately reduce emergent care.

Occupational health management: an audit tool.

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Shelmerdine, L; Williams, N

2003-03-01

Organizations must manage occupational health risks in the workplace and the UK Health & Safety Executive (HSE) has published guidance on successful health and safety management. This paper describes a method of using the published guidance to audit the management of occupational health and safety, first at an organizational level and, secondly, to audit an occupational health service provider's role in the management of health risks. The paper outlines the legal framework in the UK for health risk management and describes the development and use of a tool for qualitative auditing of the efficiency, effectiveness and reliability of occupational health service provision within an organization. The audit tool is presented as a question set and the paper concludes with discussion of the strengths and weaknesses of using this tool, and recommendations on its use.

Cyanobacterial toxins: risk management for health protection

International Nuclear Information System (INIS)

Codd, Geoffrey A.; Morrison, Louise F.; Metcalf, James S.

2005-01-01

This paper reviews the occurrence and properties of cyanobacterial toxins, with reference to the recognition and management of the human health risks which they may present. Mass populations of toxin-producing cyanobacteria in natural and controlled waterbodies include blooms and scums of planktonic species, and mats and biofilms of benthic species. Toxic cyanobacterial populations have been reported in freshwaters in over 45 countries, and in numerous brackish, coastal, and marine environments. The principal toxigenic genera are listed. Known sources of the families of cyanobacterial toxins (hepato-, neuro-, and cytotoxins, irritants, and gastrointestinal toxins) are briefly discussed. Key procedures in the risk management of cyanobacterial toxins and cells are reviewed, including derivations (where sufficient data are available) of tolerable daily intakes (TDIs) and guideline values (GVs) with reference to the toxins in drinking water, and guideline levels for toxigenic cyanobacteria in bathing waters. Uncertainties and some gaps in knowledge are also discussed, including the importance of exposure media (animal and plant foods), in addition to potable and recreational waters. Finally, we present an outline of steps to develop and implement risk management strategies for cyanobacterial cells and toxins in waterbodies, with recent applications and the integration of Hazard Assessment Critical Control Point (HACCP) principles

Understanding Medicaid Managed Care Investments in Members' Social Determinants of Health.

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Gottlieb, Laura; Ackerman, Sara; Wing, Holly; Manchanda, Rishi

2017-08-01

Despite widespread interest in addressing social determinants of health (SDH) as a means to improve health and to reduce health care spending, little information is available about how to develop, sustain, and scale nonmedical interventions in diverse payer environments, including Medicaid Managed Care. This study aimed to explore how Medicaid Managed Care Organization (MMCO) leaders interpret their roles and responsibilities around SDH, how they garner resources to develop and sustain interventions to address SDH, and how they perceive the influences of external organizations on related activities. Semistructured qualitative key informant interviews were conducted with a purposive sample of 26 Medicaid Managed Care corporate executives. Data were analyzed with an iterative coding, thematic development and interpretation process. MMCO leaders' interests and activities around interventions to address SDH are described, as well as their perceptions of existing and potential incentives and barriers to expanding these interventions. Despite significant experimentation and programmatic diversity of interventions addressing social determinants, MMCO leaders struggle with clinical integration, financing, and evaluation efforts that could promote sustainability. Though their efforts are nascent, MMCO leaders are investing in tackling social determinants to improve health and to decrease health care spending in managed care settings that serve low-income populations. Results highlight both opportunities and concerns about sustaining and scaling clinical interventions addressing SDH.

[Input on monitoring and evaluation practices of government management of Brazilian Municipal Health Departments].

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Miranda, Alcides Silva de; Carvalho, André Luis Bonifácio de; Cavalcante, Caio Garcia Correia Sá

2012-04-01

What do the leaders of the Municipal Health Service (SMS) report and say about the systematic monitoring and evaluation of their own government management? The purpose of this paper is to provide input for the formulation of plausible hypotheses about such institutional processes and practices based on information produced in an exploratory study. This is a multiple case study with quantitative and qualitative analysis of answers to a semi-structured questionnaire given to government officials of a systematic sample of 577 Municipal Health Services (10.4% of the total in Brazil). They were selected and stratified by proportional distribution among states and by the population size of municipalities. In general, it shows that approximately half of the respondents use information from Health Monitoring Evaluations to orient decision-making, planning and other management approaches. This proportion tends to decrease in cities with smaller populations. There are specific and significant gaps in financial, personnel and crisis management. The evidence from the hypotheses highlights the fact that these processes are still at an early stage.

Barriers and facilitators to diabetes self-management: perspectives of older community dwellers and health professionals in China.

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Shen, Huixia; Edwards, Helen; Courtney, Mary; McDowell, Jan; Wei, Juan

2013-12-01

Little is known about self-management among people with Type 2 diabetes living in mainland China. Understanding the experiences of this target population is needed to provide socioculturally relevant education to effectively promote self-management. The aim of this study was to explore perceived barriers and facilitators to diabetes self-management for both older community dwellers and health professionals in China. Four focus groups, two for older people with diabetes and two for health professionals, were conducted. All participants were purposively sampled from two communities in Shanghai, China. Six barriers were identified: overdependence on but dislike of western medicine, family role expectations, cuisine culture, lack of trustworthy information sources, deficits in communication between clients and health professionals, and restriction of reimbursement regulations. Facilitators included family and peer support, good relationships with health professionals, simple and practical instruction and a favourable community environment. The findings provide valuable information for diabetes self-management intervention development in China, and have implications for programmes tailored to populations in similar sociocultural circumstances. © 2013 Wiley Publishing Asia Pty Ltd.

Stress Managment and Health Promotion

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Asghar Dadkhah

2004-09-01

Full Text Available Health promotion approach is utilized to address the prevention, management and early intervention for stress management and also to promote positive mental and psychological health. Stress affects everyone and must be managed effectively to reduce its chronic and deleterious effects this study consists of two sections: in first section the principals of health promotion in different human existence levels, prevention of disease related to stress, the effect of stress on human well-being, and stress management were discussed. In second section the role of rehabilitation specialists (Medical technologist, nurses, occupational therapists, physiotherapists, respiratory therapists, and social workers in stress management were counted.

Effectiveness of the mHealth technology in improvement of healthy behaviors in an elderly population-a systematic review.

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Changizi, Maryam; Kaveh, Mohammad H

2017-01-01

Demographic changes in the 21st century, increased population of the elderly and high prevalence of related diseases call for new healthcare strategies that can change the behavior and lifestyle of elderly individuals. Innovative information and communication technology, such as mobile health (mHealth), can play a significant role. The present study was conducted aiming to assess the effectiveness of mHealth in improving health behaviors among an elderly population. This paper presents a systematic review involving a search of PubMed, Web of Science (ISI), Scopus, Science Direct and Embase databases from [2012-2016]. Our search resulted after initial evaluations 12 articles. Inclusion criteria mostly revolved around interventional studies, other studies were excluded because of their methodology, non-elderly target groups and irrelevant to the subject. Findings showed that mHealth can improve care, self-management, self-efficacy, behavior promotion (quality of sleep, diet, physical activity mental health) and medication adherence. The mHealth technology has proven effective for disease prevention, lifestyle changes, management of cardiovascular disease and diabetes, and is a suitable tool for elderly people. In conclusion, it seems that mHealth can facilitate behavioral changes; although, further research is necessary in this regard.

A Community Health Worker Intervention for Diabetes Self-Management Among the Tz'utujil Maya of Guatemala.

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Micikas, Mary; Foster, Jennifer; Weis, Allison; Lopez-Salm, Alyse; Lungelow, Danielle; Mendez, Pedro; Micikas, Ashley

2015-07-01

Despite the high prevalence of diabetes in rural Guatemala, there is little education in diabetes self-management, particularly among the indigenous population. To address this need, a culturally relevant education intervention for diabetic patients was developed and implemented in two rural communities in Guatemala. An evaluative research project was designed to investigate if the structured, community-led diabetes self-management intervention improved selected health outcomes for participants. A one-group, pretest-posttest design was used to evaluate the effectiveness of the educational intervention by comparing measures of health, knowledge, and behavior in patients pre- and postintervention. A survey instrument assessed health beliefs and practices and hemoglobin A1c (HgA1c) measured blood glucose levels at baseline and 4 months post initiation of intervention (n = 52). There was a significant decrease (1.2%) in the main outcome measure, mean HgA1c from baseline (10.1%) and follow-up (8.9%; p = .001). Other survey findings were not statistically significant. This study illustrates that a culturally specific, diabetes self-management program led by community health workers may reduce HgA1c levels in rural populations of Guatemala. However, as a random sample was not feasible for this study, this finding should be interpreted with caution. Limitations unique to the setting and patient population are discussed in this article. © 2014 Society for Public Health Education.

Public health evaluation of waste management plan of urban areas of Florence

International Nuclear Information System (INIS)

Corti, Andrea; Lombardi, Lidia; Carpentieri, Matteo; Buiatti, Eva; Bartolacci, Simone; Bianchi, Fabrizio; Linzalone, Nunzia; Minichilli, Fabrizio; Mancuso, Stefano

2005-01-01

Public health evaluation impact for solid municipal waste management of Florence urban areas is considered. In this case study the evaluation step of screening show the environmental analysis of pollutants in the urban areas and epidemiologic study of exposed population in the area

NHS health checks through general practice: randomised trial of population cardiovascular risk reduction

Directory of Open Access Journals (Sweden)

Cochrane Thomas

2012-11-01

Full Text Available Abstract Background The global burden of the major vascular diseases is projected to rise and to remain the dominant non-communicable disease cluster well into the twenty first century. The Department of Health in England has developed the NHS Health Check service as a policy initiative to reduce population vascular disease risk. The aims of this study were to monitor population changes in cardiovascular disease (CVD risk factors over the first year of the new service and to assess the value of tailored lifestyle support, including motivational interview with ongoing support and referral to other services. Methods Randomised trial comparing NHS Health Check service only with NHS Health Check service plus additional lifestyle support in Stoke on Trent, England. Thirty eight general practices and 601 (365 usual care, 236 additional lifestyle support patients were recruited and randomised independently between September 2009 and February 2010. Changes in population CVD risk between baseline and one year follow-up were compared, using intention-to-treat analysis. The primary outcome was the Framingham 10 year CVD risk score. Secondary outcomes included individual modifiable risk measures and prevalence of individual risk categories. Additional lifestyle support included referral to a lifestyle coach and free sessions as needed for: weight management, physical activity, cook and eat and positive thinking. Results Average population CVD risk decreased from 32.9% to 29.4% (p Conclusions The NHS Health Check service in Stoke on Trent resulted in significant reduction in estimated population CVD risk. There was no evidence of further benefit of the additional lifestyle support services in terms of absolute CVD risk reduction.

Emerging health issues: the widening challenge for population health promotion.

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McMichael, Anthony J; Butler, Colin D

2006-12-01

The spectrum of tasks for health promotion has widened since the Ottawa Charter was signed. In 1986, infectious diseases still seemed in retreat, the potential extent of HIV/AIDS was unrecognized, the Green Revolution was at its height and global poverty appeared less intractable. Global climate change had not yet emerged as a major threat to development and health. Most economists forecast continuous improvement, and chronic diseases were broadly anticipated as the next major health issue. Today, although many broadly averaged measures of population health have improved, many of the determinants of global health have faltered. Many infectious diseases have emerged; others have unexpectedly reappeared. Reasons include urban crowding, environmental changes, altered sexual relations, intensified food production and increased mobility and trade. Foremost, however, is the persistence of poverty and the exacerbation of regional and global inequality. Life expectancy has unexpectedly declined in several countries. Rather than being a faint echo from an earlier time of hardship, these declines could signify the future. Relatedly, the demographic and epidemiological transitions have faltered. In some regions, declining fertility has overshot that needed for optimal age structure, whereas elsewhere mortality increases have reduced population growth rates, despite continuing high fertility. Few, if any, Millennium Development Goals (MDG), including those for health and sustainability, seem achievable. Policy-makers generally misunderstand the link between environmental sustainability (MDG #7) and health. Many health workers also fail to realize that social cohesion and sustainability--maintenance of the Earth's ecological and geophysical systems--is a necessary basis for health. In sum, these issues present an enormous challenge to health. Health promotion must address population health influences that transcend national boundaries and generations and engage with the

New public management in Iran's health complex: a management framework for primary health care system.

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Tabrizi, Jafar Sadegh; HaghGoshayie, Elaheh; Doshmangir, Leila; Yousefi, Mahmood

2018-05-01

New public management (NPM) was developed as a management reform to improve the efficiency and effectiveness in public organizations, especially in health sector. Using the features of private sector management, the managers of health organizations may try to implement the elements of NPM with the hope to improve the performance of their systems.AimsOur aim in the present study was to identify the elements and infrastructures suitable for implementing NPM in the Iranian health complex. In this qualitative study with conventional content analysis approach, we tried to explore the NPM elements and infrastructures in Iranian public health sector. A series of semi-structured interviews (n=48) were conducted in 2016 with a managers in public and private health complex. Three focus group discussions with nine faculty members were also conducted. A data collection form was used to collect the demographic characteristics and perspectives of the participants.FindingsFrom the perspective of managers, managerialism, decentralization, using market mechanism, performance management, customer orientation and performance budgeting were the main elements of NPM in the Iranian context. The most important infrastructures for implementing this reform were as follows: education and training, information technology, the proper use of human resources, decision support systems, top management commitment, organizational culture, flexibility of rules, rehabilitating of the aging infrastructures, and expanding the coverage of services. The NPM was generally identified to be an effective replacement for the traditional administration method. These reforms may be helpful in strengthening the public health complex and the management capacity, as well. NPM also seems to be useful in interacting the public health sector with the private sector in terms of personnel and resources, performance, reward structure, and methods of doing business.

Change management in an environment of ongoing primary health care system reform: A case study of Australian primary health care services.

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Javanparast, Sara; Maddern, Janny; Baum, Fran; Freeman, Toby; Lawless, Angela; Labonté, Ronald; Sanders, David

2018-01-01

Globally, health reforms continue to be high on the health policy agenda to respond to the increasing health care costs and managing the emerging complex health conditions. Many countries have emphasised PHC to prevent high cost of hospital care and improve population health and equity. The existing tension in PHC philosophies and complexity of PHC setting make the implementation and management of these changes more difficult. This paper presents an Australian case study of PHC restructuring and how these changes have been managed from the viewpoint of practitioners and middle managers. As part of a 5-year project, we interviewed PHC practitioners and managers of services in 7 Australian PHC services. Our findings revealed a policy shift away from the principles of comprehensive PHC including health promotion and action on social determinants of health to one-to-one disease management during the course of study. Analysis of the process of change shows that overall, rapid, and top-down radical reforms of policies and directions were the main characteristic of changes with minimal communication with practitioners and service managers. The study showed that services with community-controlled model of governance had more autonomy to use an emergent model of change and to maintain their comprehensive PHC services. Change is an inevitable feature of PHC systems continually trying to respond to health care demand and cost pressures. The implementation of change in complex settings such as PHC requires appropriate change management strategies to ensure that the proposed reforms are understood, accepted, and implemented successfully. Copyright © 2017 John Wiley & Sons, Ltd.

South Asian populations in Canada: migration and mental health

Science.gov (United States)

2014-01-01

Background South Asian populations are the largest visible minority group in Canada; however, there is very little information on the mental health of these populations. The objective of this study was to determine the prevalence rates and characteristics of mental health outcomes for South Asian first-generation immigrant and second-generation Canadian-born populations. Methods The Canadian Community Health Survey (CCHS) 2011 was used to calculate the estimated prevalence rates of the following mental health outcomes: mood disorders, anxiety disorders, fair-poor self-perceived mental health status, and extremely stressful life stress. The characteristics associated with these four mental health outcomes were determined through multivariate logistic regression analysis of merged CCHS 2007–2011 data. Results South Asian Canadian-born (3.5%, 95% CI 3.4-3.6%) and South Asian immigrant populations (3.5%, 95% CI 3.5-3.5%) did not vary significantly in estimated prevalence rates of mood disorders. However, South Asian immigrants experienced higher estimated prevalence rates of diagnosed anxiety disorders (3.4%, 95% CI 3.4-3.5 vs. 1.1%, 95% CI 1.1-1.1%) and self-reported extremely stressful life stress (2.6%, 95% CI 2.6-2.7% vs. 2.4%, 95% CI 2.3-2.4%) compared to their Canadian-born counterparts. Lastly, South Asian Canadian-born populations had a higher estimated prevalence rate of poor-fair self-perceived mental health status (4.4%, 95% CI 4.3-4.5%) compared to their immigrant counterparts (3.4%, 95% CI 3.3-3.4%). Different profiles of mental health determinants emerged for South Asian Canadian-born and immigrant populations. Female gender, having no children under the age of 12 in the household, food insecurity, poor-fair self-rated health status, being a current smoker, immigrating to Canada before adulthood, and taking the CCHS survey in either English or French was associated with greater risk of negative mental health outcomes for South Asian immigrant

Analyzing best practices in employee health management: how age, sex, and program components relate to employee engagement and health outcomes.

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Terry, Paul E; Grossmeier, Jessica; Mangen, David J; Gingerich, Stefan B

2013-04-01

Examine the influence of employee health management (EHM) best practices on registration, participation, and health behavior change in telephone-based coaching programs. Individual health assessment data, EHM program data, and health coaching participation data were analyzed for associations with coaching program enrollment, active participation, and risk reduction. Multivariate analyses occurred at the individual (n = 205,672) and company levels (n = 55). Considerable differences were found in how age and sex impacted typical EHM evaluation metrics. Cash incentives for the health assessment were associated with more risk reduction for men than for women. Providing either a noncash or a benefits-integrated incentive for completing the health assessment, or a noncash incentive for lifestyle management, strengthened the relationship between age and risk reduction. In EHM programs, one size does not fit all. These results can help employers tailor engagement strategies for their specific population.

MD Anderson's Population Health Approaches to Cancer Prevention.

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Foxhall, Lewis; Moreno, Mark; Hawk, Ernest

2018-02-01

Texas's size and unique population demographics present challenges to addressing the state's cancer burden. The University of Texas MD Anderson Cancer Center is one of 69 National Cancer Institute-designated cancer centers across the United States. While these centers traditionally have focused on research, education and training, and providing research-driven patient care, they are in a unique position to collaboratively advance population health through cancer control. Unlike the traditional academic model of a three-legged stool representing research, education, and patient care, MD Anderson's mission includes a fourth leg that incorporates population health approaches. MD Anderson has leveraged state- and national-level data and freely available resources to develop population-health priorities and a set of evidence-based actions across policy, public and professional education, and community-based clinical service domains to address these priorities. Population health approaches complement dissemination and implementation research and treatment, and will be increasingly needed to address the growing cancer burden in Texas and the nation.

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

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Szilagyi, Peter G.

1998-01-01

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

Income inequality and population health in Islamic countries.

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Esmaeili, A; Mansouri, S; Moshavash, M

2011-09-01

To undertake a fresh examination of the relationship between income inequality and population health for a group of Islamic countries using recent information derived from data resource sites from the World Bank and Islamic countries. Cross-sectional data on different measures of income distribution (prosperity, health care, women's role and environment) and indicators of population health were used to illuminate this issue. The relationship between income inequality and population health for a group of Islamic countries was tested using recent information derived from data resource sites from the World Bank and Islamic countries. After consideration of previous studies, seven dependent variables were determined and tested in six equation formats. According to the equations, the urban population percentage and gross domestic product are the most important significant variables that affect life expectancy and the infant mortality rate in Islamic countries. The income distribution coefficient, regardless of the type of measure, was almost insignificant in all equations. In selected Islamic countries, income level has a positive effect on population health, but the level of income distribution is not significant. Among the other dependent variables (e.g. different measures of income distribution, health care, role of women and environment), only environment and education had significant effects. Most of the Islamic countries studied are considered to be poorly developed. Copyright © 2011 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Burden, Determinants, and Pharmacological Management of Hypertension in HIV-Positive Patients and Populations: A Systematic Narrative Review.

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Nguyen, Kim Anh; Peer, Nasheeta; Mills, Edward J; Kengne, Andre Pascal

2015-01-01

Hypertension among HIV-positive populations has emerged as a new threat to the health and well being of people living with HIV, particularly among those receiving antiretroviral therapy. We reviewed the global evidence on the burden of disease (including prevalence and incidence), determinants of hypertension among HIV-positive populations, and the pharmacological management of hypertension in HIV-positive patients. We systematically searched PubMed-MEDLINE and EMBASE from January 2000 through February 2015 for relevant studies and traced their citations through the ISI Web of Science. We also searched the websites of the World Health Organisation, the International Society of Hypertension, and the International AIDS Society and constructed a narrative data synthesis. Hypertension is common in HIV-positive populations, with prevalence estimates ranging from 4.7 to 54.4% in high-income countries, and from 8.7 to 45.9% in low- and middle-income countries. The role of HIV-specific factors including disease severity, duration of disease, and treatments on the presence of hypertension in HIV-positive patients is reported, but patterns remain unclear. The clinical management of hypertension in HIV-positive patients is similar to those with hypertension in the general population; however, additional considerations should be given to potential drug interactions between antihypertensive agents and antiretroviral drugs to inform the clinician's selection of these therapies. Hypertension is common in HIV-positive populations and remains an important comorbidity affecting mortality outcomes. Further research examining the development of hypertension and its associated care in HIV-positive patients is required to optimize management of the dual conditions.

Impact of Health Behaviors and Health Management on Employment After SCI: Psychological Health and Health Management.

Science.gov (United States)

Reed, Karla S; Meade, Michelle A; Krause, James S

2016-01-01

Objective: The purpose of this study was to examine the relationship between employment and psychological health and health management as described by individuals with spinal cord injury (SCI) who were employed at least once following injury. Methods: A qualitative approach used 6 focus groups at 2 sites with 44 participants who were at least 10 years post SCI. All had been employed at some point since injury. Heterogeneous and homogeneous groups were delineated based on specific characteristics, such as education, gender, or race. Group sessions followed a semi-structured interview format with questions about personal, environmental, and policy related factors influencing employment following SCI. All group sessions were recorded, transcribed, and coded into conceptual categories to identify topics, themes, and patterns. Inferences were drawn about their meaning. NVivo 10 software using the constant comparative method was used for data analysis. Results: Narratives discussed the relationship between employment and psychological and emotional health and health management. Four themes were identified: (1) adjustment and dealing with emotional reactions, (2) gaining self-confidence, (3) preventing burnout, and (4) attitudes and perspectives. Most themes reflected issues that varied based on severity of injury as well as stage of employment. Conclusions: Individuals with SCI who are successful in working following injury must determine how to perform the behaviors necessary to manage their health and prevent emotional or physical complications. The emotional consequences of SCI must be recognized and addressed and specific behaviors enacted in order to optimize employment outcomes.

Making it local: Beacon Communities use health information technology to optimize care management.

Science.gov (United States)

Allen, Amy; Des Jardins, Terrisca R; Heider, Arvela; Kanger, Chatrian R; Lobach, David F; McWilliams, Lee; Polello, Jennifer M; Rein, Alison L; Schachter, Abigail A; Singh, Ranjit; Sorondo, Barbara; Tulikangas, Megan C; Turske, Scott A

2014-06-01

Care management aims to provide cost-effective, coordinated, non-duplicative care to improve care quality, population health, and reduce costs. The 17 communities receiving funding from the Office of the National Coordinator for Health Information Technology through the Beacon Community Cooperative Agreement Program are leaders in building and strengthening their health information technology (health IT) infrastructure to provide more effective and efficient care management. This article profiles 6 Beacon Communities' health IT-enabled care management programs, highlighting the influence of local context on program strategy and design, and describing challenges, lessons learned, and policy implications for care delivery and payment reform. The unique needs (eg, disease burden, demographics), community partnerships, and existing resources and infrastructure all exerted significant influence on the overall priorities and design of each community's care management program. Though each Beacon Community needed to engage in a similar set of care management tasks--including patient identification, stratification, and prioritization; intervention; patient engagement; and evaluation--the contextual factors helped shape the specific strategies and tools used to carry out these tasks and achieve their objectives. Although providers across the country are striving to deliver standardized, high-quality care, the diverse contexts in which this care is delivered significantly influence the priorities, strategies, and design of community-based care management interventions. Gaps and challenges in implementing effective community-based care management programs include: optimizing allocation of care management services; lack of available technology tailored to care management needs; lack of standards and interoperability; integrating care management into care settings; evaluating impact; and funding and sustainability.

Mental health in war-affected populations

NARCIS (Netherlands)

Scholte, W.F.

2013-01-01

This book addresses mental health problems in populations in nonwestern war-affected regions, and methods to mitigate these problems through interventions focusing on social reintegration. It describes a number of studies among war-affected populations in widely different areas: refugees from the

Population Consultation: A Powerful Means to Ensure that Health Strategies are Oriented Towards Universal Health Coverage.

Science.gov (United States)

Rohrer, Katja; Rajan, Dheepa; Schmets, Gerard

2017-01-01

We seek to highlight why population consultations need to be promoted more strongly as a powerful means to move health reforms towards Universal Health Coverage (UHC). However, despite this increasing recognition that the "population" is the key factor of successful health planning and high-quality service delivery, there has been very little systematic reflection and only limited (international) attention brought to the idea of specifically consulting the population to improve the quality and soundness of health policies and strategies and to strengthen the national health planning process and implementation. So far, research has done little to assess the significance of population consultations for the health sector and its importance for strategic planning and implementation processes; in addition, there has been insufficient evaluation of population consultations in the health sector or health-related areas. We drew on ongoing programmatic work of World Health Organization (WHO) offices worldwide, as most population consultations are not well-documented. In addition, we analyzed any existing documentation available on population consultations in health. We then elaborate on the potential benefits of bringing the population's voice into national health planning. We briefly mention the key methods used for population consultations, and we put forward recent country examples showing that population consultation is an effective way of assessing the population's needs and expectations, and should be more widely used in strategizing health. Giving the voice to the population is a means to strengthen accountability, to reinforce the commitment of policy makers, decision-makers and influencers (media, political parties, academics, etc.) to the health policy objectives of UHC, and, in the specific case of donor-dependent countries, to sensitize donors' engagement and alignment with national health strategies. The consequence of the current low international interest for

A review of waste management practices and their impact on human health

International Nuclear Information System (INIS)

Giusti, L.

2009-01-01

This work reviews (i) the most recent information on waste arisings and waste disposal options in the world, in the European Union (EU), in Organisation for Economic Co-operation and Development (OEDC) countries, and in some developing countries (notably China) and (ii) the potential direct and indirect impact of waste management activities on health. Though the main focus is primarily on municipal solid waste (MSW), exposure to bioaerosols from composting facilities and to pathogens from sewage treatment plants are considered. The reported effects of radioactive waste are also briefly reviewed. Hundreds of epidemiological studies reported on the incidence of a wide range of possible illnesses on employees of waste facilities and on the resident population. The main conclusion of the overall assessment of the literature is that the evidence of adverse health outcomes for the general population living near landfill sites, incinerators, composting facilities and nuclear installations is usually insufficient and inconclusive. There is convincing evidence of a high risk of gastrointestinal problems associated with pathogens originating at sewage treatment plants. In order to improve the quality and usefulness of epidemiological studies applied to populations residing in areas where waste management facilities are located or planned, preference should be given to prospective cohort studies of sufficient statistical power, with access to direct human exposure measurements, and supported by data on health effect biomarkers and susceptibility biomarkers.

Cardiovascular health promotion in aging women: validating a population health approach.

Science.gov (United States)

Sawatzky, Jo-Ann V; Naimark, Barbara J

2005-01-01

Although cardiovascular disease is the leading cause of death in North American women, most cardiovascular research has focused on men. In addition, while there has been a recent trend toward population health promotion (PHP) and a consequent focus on the broad determinants of health, there is still a dearth of research evidence related to the promotion of cardiovascular health within this context. The purpose of this study was to explore and describe the interrelationships between the determinants of health and individual cardiovascular health/risk behaviors in healthy women, within the context of a framework for PHP. A comprehensive inventory of factors affecting the cardiovascular health of women was operationalized in a survey questionnaire, the Cardiovascular Health Promotion Profile. Physical measures were also taken on each participant (n = 206). The multivariate analyses support significant interrelationships between the population health determinants and multiple individual cardiovascular health/risk behaviors in this cohort (p PHP framework, is central to building on the body of knowledge in this area.

Understanding and managing organizational change: implications for public health management.

Science.gov (United States)

Thompson, Jon M

2010-01-01

Managing organizational change has become a significant responsibility of managers. Managing the change process within public health organizations is important because appropriately and systematically managing change is linked to improved organizational performance. However, change is difficult and the change process poses formidable challenges for managers. Managers themselves face increased pressure to respond to environmental influences and provide the necessary leadership to their organizations in the change process. In fact, managing organizational change has become a key competency for healthcare managers. This article addresses the important topic of organizational change in public health organizations. It provides a conceptual foundation for understanding organizational change and its relationship to healthcare organizational performance, and then discusses the types and nature of change, using some examples and evidence from those organizations that have successfully managed change. A framework for guiding public health managers in the change management process is provided. The article concludes with suggested management competencies to establish a change-oriented organization with the culture and capacity for change.

[The operation of the health program SICALIDAD: the role of managers in primary care and hospitals].

Science.gov (United States)

Granados-Cosme, José Arturo; Tetelboin-Henrion, Carolina; Torres-Cruz, César; Pineda-Pérez, Dayana; Villa-Contreras, Blanca Margarita

2011-01-01

To characterize the role of quality managers in health care units and health districts, identifying the constraints they experience in their performance. An interview guide and a questionnaire were carried out and were applied to quality managers in nine states as well as in Mexico City´s Health Services, in a Reference Federal Hospital and in a National Institute of Health. These instruments were analyzed using SPSS and Atlas.ti software. The activities done by the managers depend on the organizational level of services, which can be a care unit or the health jurisdiction. For each of these, we identified different order constraints that affect the performance of the role of management in the strategies to improve the quality of the services for population without social insurance, which together make up the government program called Integrated Quality Health System. Jurisdictional managers are the link between care units and state authorities in the management of information, while the medical units' managers drive operational strategies to improve the quality. Although the health program is implemented with the personal and infrastructure of the health system, it requires a greater institutionalization and strengthening of its structure and integration, as well as greater human and material resources.

Building research and evaluation capacity in population health: the NSW Health approach.

Science.gov (United States)

Edwards, Barry; Stickney, Beth; Milat, Andrew; Campbell, Danielle; Thackway, Sarah

2016-02-01

Issue addressed An organisational culture that values and uses research and evaluation (R&E) evidence to inform policy and practice is fundamental to improving health outcomes. The 2016 NSW Government Program Evaluation Guidelines recommend investment in training and development to improve evaluation capacity. The purpose of this paper is to outline the approaches taken by the NSW Ministry of Health to develop R&E capacity and assess these against existing models of practice. Method The Ministry of Health's Centre for Epidemiology and Evidence (CEE) takes an evidence-based approach to building R&E capacity in population health. Strategies are informed by: the NSW Population Health Research Strategy, R&E communities of practice across the Ministry and health Pillar agencies and a review of the published evidence on evaluation capacity building (ECB). An internal survey is conducted biennially to monitor research activity within the Ministry's Population and Public Health Division. One representative from each of the six centres that make up the Division coordinates completion of the survey by relevant staff members for their centre. Results The review identified several ECB success factors including: implementing a tailored multifaceted approach; an organisational commitment to R&E; and offering experiential training and ongoing technical support to the workforce. The survey of research activity found that the Division funded a mix of research assets, research funding schemes, research centres and commissioned R&E projects. CEE provides technical advice and support services for staff involved in R&E and in 2015, 22 program evaluations were supported. R&E capacity building also includes a series of guides to assist policy makers, practitioners and researchers to commission, undertake and use policy-relevant R&E. Staff training includes workshops on critical appraisal, program logic and evaluation methods. From January 2013 to June 2014 divisional staff published 84

Using Population Dose to Evaluate Community-level Health Initiatives.

Science.gov (United States)

Harner, Lisa T; Kuo, Elena S; Cheadle, Allen; Rauzon, Suzanne; Schwartz, Pamela M; Parnell, Barbara; Kelly, Cheryl; Solomon, Loel

2018-05-01

Successful community-level health initiatives require implementing an effective portfolio of strategies and understanding their impact on population health. These factors are complicated by the heterogeneity of overlapping multicomponent strategies and availability of population-level data that align with the initiatives. To address these complexities, the population dose methodology was developed for planning and evaluating multicomponent community initiatives. Building on the population dose methodology previously developed, this paper operationalizes dose estimates of one initiative targeting youth physical activity as part of the Kaiser Permanente Community Health Initiative, a multicomponent community-level obesity prevention initiative. The technical details needed to operationalize the population dose method are explained, and the use of population dose as an interim proxy for population-level survey data is introduced. The alignment of the estimated impact from strategy-level data analysis using the dose methodology and the data from the population-level survey suggest that dose is useful for conducting real-time evaluation of multiple heterogeneous strategies, and as a viable proxy for existing population-level surveys when robust strategy-level evaluation data are collected. This article is part of a supplement entitled Building Thriving Communities Through Comprehensive Community Health Initiatives, which is sponsored by Kaiser Permanente, Community Health. Copyright © 2018 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

BRIC Health Systems and Big Pharma: A Challenge for Health Policy and Management.

Science.gov (United States)

Rodwin, Victor G; Fabre, Guilhem; Ayoub, Rafael F

2018-01-02

BRIC nations - Brazil, Russia, India, and China - represent 40% of the world's population, including a growing aging population and middle class with an increasing prevalence of chronic disease. Their healthcare systems increasingly rely on prescription drugs, but they differ from most other healthcare systems because healthcare expenditures in BRIC nations have exhibited the highest revenue growth rates for pharmaceutical multinational corporations (MNCs), Big Pharma. The response of BRIC nations to Big Pharma presents contrasting cases of how governments manage the tensions posed by rising public expectations and limited resources to satisfy them. Understanding these tensions represents an emerging area of research and an important challenge for all those who work in the field of health policy and management (HPAM). © 2018 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

A new axiomatic approach to the evaluation of population health

DEFF Research Database (Denmark)

Hougaard, Jens Leth; Moreno-Ternero, Juan D.; Østerdal, Lars Peter Raahave

2013-01-01

In this paper we explore the implications of normative principles for the evaluation of population health. We formalize those principles as axioms for social preferences over distributions of health for a given population. We single out several focal population health evaluation functions, which...

The Copenhagen Oral Health Senior Cohort: design, population and dental health

DEFF Research Database (Denmark)

Heegaard, Karen M; Holm-Pedersen, Poul; Jensen, Allan Bardow

2011-01-01

Gerodontology 2010; doi: 10.1111/j.1741-2358.2010.00383.x The Copenhagen Oral Health Senior Cohort: design, population and dental health Background: In order to study the way old age influence oral health, the Copenhagen Oral Health Senior Cohort (COHS) has been established. Objectives: To describe...

Texting for Health: An Evaluation of a Population Approach to Type 2 Diabetes Risk Reduction With a Personalized Message.

Science.gov (United States)

Khurshid, Anjum; Brown, Lisanne; Mukherjee, Snigdha; Abebe, Nebeyou; Kulick, David

2015-11-01

txt4health is an innovative, 14-week, interactive, population-based mobile health program for individuals at risk of type 2 diabetes, developed under the Beacon Community Program in the Greater New Orleans, La., area. A comprehensive social marketing campaign sought to enroll hard-to-reach, at-risk populations using a combination of mass media and face-to-face engagement in faith-based and retail environments. Little is known about the effectiveness of social marketing for mobile technology application in the general population. A systematic evaluation of the campaign identified successes and barriers to implementing a population-based mobile health program. Face-to-face engagement helped increase program enrollment after the initial launch; otherwise, enrollment leveled off over time. Results show positive trends in reaching target populations and in the use of mobile phones to record personal health information and set goals for reducing the risk of type 2 diabetes. The lessons from the txt4health campaign can help inform the development and programmatic strategies to provide a person-level intervention using a population-level approach for individuals at risk for diabetes as well as aid in chronic disease management.

Crisis management teams in health organisations.

Science.gov (United States)

Canyon, Deon V

2012-01-01

Crisis management teams (CMT) are necessary to ensure adequate and appropriate crisis management planning and response to unforeseen, adverse events. This study investigated the existence of CMTs, the membership of CMTs, and the degree of training received by CMTs in Australian health and allied health organisations. This cross-sectional study draws on data provided by executive decision makers in a broad selection of health and allied health organisations. Crisis management teams were found in 44.2 per cent of the health-related organisations surveyed, which is ten per cent lower than the figure for business organisations. Membership of these CMTs was not ideal and did not conform to standard CMT membership profiles. Similarly, the extent of crisis management training in health-related organisations is 20 per cent lower than the figure for business organisations. If organisations do not become pro-active in their crisis management practices, the onus is on government to improve the situation through regulation and the provision of more physical, monetary and skill resources to ensure that the health services of Australia are sufficiently prepared to respond to adverse events.

Effective behavioral intervention strategies using mobile health applications for chronic disease management: a systematic review.

Science.gov (United States)

Lee, Jung-Ah; Choi, Mona; Lee, Sang A; Jiang, Natalie

2018-02-20

Mobile health (mHealth) has continuously been used as a method in behavioral research to improve self-management in patients with chronic diseases. However, the evidence of its effectiveness in chronic disease management in the adult population is still lacking. We conducted a systematic review to examine the effectiveness of mHealth interventions on process measures as well as health outcomes in randomized controlled trials (RCTs) to improve chronic disease management. Relevant randomized controlled studies that were published between January 2005 and March 2016 were searched in six databases: PubMed, CINAHL, EMBASE, the Cochrane Library, PsycINFO, and Web of Science. The inclusion criteria were RCTs that conducted an intervention using mobile devices such as smartphones or tablets for adult patients with chronic diseases to examine disease management or health promotion. Of the 12 RCTs reviewed, 10 of the mHealth interventions demonstrated statistically significant improvement in some health outcomes. The most common features of mHealth systems used in the reviewed RCTs were real-time or regular basis symptom assessments, pre-programed reminders, or feedbacks tailored specifically to the data provided by participants via mHealth devices. Most studies developed their own mHealth systems including mobile apps. Training of mHealth systems was provided to participants in person or through paper-based instructions. None of the studies reported the relationship between health outcomes and patient engagement levels on the mHealth system. Findings from mHealth intervention studies for chronic disease management have shown promising aspects, particularly in improving self-management and some health outcomes.

Quantifying the detrimental impacts of land-use and management change on European forest bird populations.

Directory of Open Access Journals (Sweden)

Amy S I Wade

Full Text Available The ecological impacts of changing forest management practices in Europe are poorly understood despite European forests being highly managed. Furthermore, the effects of potential drivers of forest biodiversity decline are rarely considered in concert, thus limiting effective conservation or sustainable forest management. We present a trait-based framework that we use to assess the detrimental impact of multiple land-use and management changes in forests on bird populations across Europe. Major changes to forest habitats occurring in recent decades, and their impact on resource availability for birds were identified. Risk associated with these changes for 52 species of forest birds, defined as the proportion of each species' key resources detrimentally affected through changes in abundance and/or availability, was quantified and compared to their pan-European population growth rates between 1980 and 2009. Relationships between risk and population growth were found to be significantly negative, indicating that resource loss in European forests is an important driver of decline for both resident and migrant birds. Our results demonstrate that coarse quantification of resource use and ecological change can be valuable in understanding causes of biodiversity decline, and thus in informing conservation strategy and policy. Such an approach has good potential to be extended for predictive use in assessing the impact of possible future changes to forest management and to develop more precise indicators of forest health.

Health infrastructural challenges to health management information ...

African Journals Online (AJOL)

Aim: This study aims to assess health management information systems at the ... workers' ability to practice and use the health data generated at their Primary Health ... Only 2 (5.7%) of the health centres surveyed were capable of operating the ... The government at all levels should ensure collective effort and political will to ...

Waste management, informal recycling, environmental pollution and public health.

Science.gov (United States)

Yang, Hong; Ma, Mingguo; Thompson, Julian R; Flower, Roger J

2018-03-01

With rapid population growth, especially in low-income and middle-income countries, the generation of waste is increasing at an unprecedented rate. For example, annual global waste arising from waste electrical and electronic equipment alone will have increased from 33.8 to 49.8 million tonnes between 2010 and 2018. Despite incineration and other waste treatment techniques, landfill still dominates waste disposal in low-income and middle-income countries. There is usually insufficient funding for adequate waste management in these countries and uptake of more advanced waste treatment technologies is poor. Without proper management, many landfills represent serious hazards as typified by the landslide in Shenzhen, China on 20 December 2015. In addition to formal waste recycling systems, approximately 15million people around the world are involved in informal waste recycling, mainly for plastics, metals, glass and paper. This review examines emerging public health challenges, in particular within low-income and middle-income countries, associated with the informal sector. While informal recyclers contribute to waste recycling and reuse, the relatively primitive techniques they employ, combined with improper management of secondary pollutants, exacerbate environmental pollution of air, soil and water. Even worse, insufficient occupational health measures expose informal waste workers to a range of pollutants, injuries, respiratory and dermatological problems, infections and other serious health issues that contribute to low life expectancy. Integration of the informal sector with its formal counterparts could improve waste management while addressing these serious health and livelihood issues. Progress in this direction has already been made notably in several Latin American countries where integrating the informal and formal sectors has had a positive influence on both waste management and poverty alleviation. © Article author(s) (or their employer(s) unless

Design and Construction for Community Health Service Precision Fund Appropriation System Based on Performance Management.

Science.gov (United States)

Gao, Xing; He, Yao; Hu, Hongpu

2017-01-01

Allowing for the differences in economy development, informatization degree and characteristic of population served and so on among different community health service organizations, community health service precision fund appropriation system based on performance management is designed, which can provide support for the government to appropriate financial funds scientifically and rationally for primary care. The system has the characteristic of flexibility and practicability, in which there are five subsystems including data acquisition, parameter setting, fund appropriation, statistical analysis system and user management.

Managing Health Information System | Campbell | Nigerian ...

African Journals Online (AJOL)

The effective planning, management monitoring and evaluation of health services, health resources and indeed the health system requires a wealth of health information, with its simultaneous effective and efficient management. It is an instrument used to help policy-making, decision making and day to day actions in the ...

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.

Management of health-care waste in Izmir, Turkey

Directory of Open Access Journals (Sweden)

Ahmet Soysal

2010-01-01

Full Text Available The aim of this study was to evaluate health-care waste in the 18 districts of metropolitan municipality of the third biggest city in Turkey. This cross-sectional study was carried out with 825 health institutions established in the 18 districts of Izmir metropolitan municipality, in 2007. The total amount of health-care waste collected was 4841 tons and 621 kilograms per patient's bed in 2007. Most of the medical wastes were collected from Konak, Karsiyaka and Bornova districts and were 2308, 272 and 1020 tons, respectively. Regarding to overpopulation, the number of health institutions in these districts are more than the number of health institutions in the other administrative districts. There was a statistically significant, positive correlation between the amount of health-care waste collected and population of the 18 districts (r = 0.79, p < 0.001, and number of beds/patients (r = 0.83, p < 0.001. To provide a safe health-care waste management metropolitan municipality must provide hazardous waste separation in health institutions, establish sterilization units for infectious waste, and provide the last storage of medical waste in completely different, safe and special areas apart from the municipal waste storage areas.

Difference in Health Inequity between Two Population Groups due to a Social Determinant of Health

Science.gov (United States)

Moonesinghe, Ramal; Bouye, Karen; Penman-Aguilar, Ana

2014-01-01

The World Health Organization defines social determinants of health as “complex, integrated, and overlapping social structures and economic systems” that are responsible for most health inequities. Similar to the individual-level risk factors such as behavioral and biological risk factors that influence disease, we consider social determinants of health such as the distribution of income, wealth, influence and power as risk factors for risk of disease. We operationally define health inequity in a disease within a population due to a risk factor that is unfair and avoidable as the difference between the disease outcome with and without the risk factor in the population. We derive expressions for difference in health inequity between two populations due to a risk factor that is unfair and avoidable for a given disease. The difference in heath inequity between two population groups due to a risk factor increases with increasing difference in relative risks and the difference in prevalence of the risk factor in the two populations. The difference in health inequity could be larger than the difference in health outcomes between the two populations in some situations. Compared to health disparities which are typically measured and monitored using absolute or relative disparities of health outcomes, the methods presented in this manuscript provide a different, yet complementary, picture because they parse out the contributions of unfair and avoidable risk factors. PMID:25522048

Self-reported oral health of a metropolitan homeless population in Australia: comparisons with population-level data.

Science.gov (United States)

Parker, E J; Jamieson, L M; Steffens, M A; Cathro, P; Logan, R M

2011-09-01

There is limited information on self-perceived oral health of homeless populations. This study quantified self-reported oral health among a metropolitan homeless adult population and compared against a representative sample of the metropolitan adult population obtained from the National Survey of Adult Oral Health. A total of 248 homeless participants (age range 17-78 years, 79% male) completed a self-report questionnaire. Data for an age-matched, representative sample of metropolitan-dwelling adults were obtained from Australia's second National Survey of Adult Oral Health. Percentage responses and 95% confidence intervals were calculated, with non-overlapping 95% confidence intervals used to identify statistically significant differences between the two groups. Homeless adults reported poorer oral health than their age-matched general population counterparts. Twice as many homeless adults reported visiting a dentist more than a year ago and that their usual reason for dental attendance was for a dental problem. The proportion of homeless adults with a perceived need for fillings or extractions was also twice that of their age-matched general population counterparts. Three times as many homeless adults rated their oral health as 'fair' or 'poor'. A significantly greater proportion of homeless adults in an Australian metropolitan location reported poorer oral health compared with the general metropolitan adult population. © 2011 Australian Dental Association.

Information Technologies as Health Management Tools: Urban Elders' Interest and Ability in Using the Internet

Science.gov (United States)

Cresci, M. Kay; Novak, Julie M.

2012-01-01

Older adults represent an increasing percentage of both the whole U.S. population and persons living with one or more chronic health conditions. However, extant research has largely overlooked older adults when examining current Internet users and the potential for the Internet as a health management resource. In this study, the researchers…

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

Mental Health and the Transgender Population.

Science.gov (United States)

Carmel, Tamar C; Erickson-Schroth, Laura

2016-12-01

Although research into the physical and mental health disparities faced by transgender and gender nonconforming (TGNC) populations is becoming more popular, historically it has been limited. It is now recognized that TGNC people experience disproportionate rates of negative mental health outcomes relative to both their gender-normative, heterosexual peers, as well as their gender-normative lesbian, gay, and bisexual (LGB) peers. The theoretical basis of current transgender mental health research is rooted in the Minority Stress Model, which postulates that we live in a hetero-centric, gender-normative society that stigmatizes and discriminates against lesbian, gay, bisexual, and transgender (LGBT) people, subjecting them to chronic stress (Hendricks & Testa, 2012; Meyer, 1995). This chronic, potentially compounding stress, is responsible for the increased risk of negative mental health outcomes in LGBT populations. TGNC people, in particular, may experience more adverse outcomes than their LGB peers due to rejection and discrimination within society at large as well as within the LGB community. [Journal of Psychosocial Nursing and Mental Health Services, 54(12), 44-48.]. Copyright 2016, SLACK Incorporated.

A population-based study on health-related quality of life among urban community residents in Shenyang, Northeast of China.

Science.gov (United States)

Song, Tian; Ding, Yan-wei; Sun, Yan; He, Yi-Ni; Qi, Dian-Jun; Wu, Ying; Wu, Bin; Lang, Lang; Yu, Kai; Zhao, Xin; Zhu, Liang-liang; Wang, Shuang; Yu, Xiao-Song

2015-09-19

Due to the rising standard of living environment and advances in public health and medical care in China, it has been a tendency in recent years that health-related quality of life (HRQoL) has been increasingly acknowledged in community health management. However, large-scale population-based study on evaluating HQRoL in northeast of China was not conducted. This article aims to investigate the HRQoL in community residents in Northeast China and explore the associated factors. Stratified multiple-stage sampling method was used in the cross-sectional survey to investigate HRQoL of community residents in northeast of China. Univariate analysis and multiple linear regressions were used to analyze the factors associated to HRQoL of the community residents. The results were confirmed that HRQoL in general population was well performed for the first time in northeast of China in a large scale population. Community residents had better mental health than physical health. The factors influencing HRQoL included gender, age, educational level, marital status, ethnic group, chronic disease status, having breakfast frequency weekly and sleep quality. However, drinking and smoking habits did not affect residents' HRQoL. In this study, the result of the large-scale survey was satisfactory in northeast of China, providing HRQoL status of community residents. Policies on specific health management in community public health would emphasize on lifestyle behaviors especially eating habits in order to improving HRQoL.

An economic assessment of population health risk in region

Directory of Open Access Journals (Sweden)

Nina Vladimirovna Zaytseva

2012-06-01

Full Text Available This paper proposes a method of economic assessment of population health risk as a tool of life qualitymanagement and qualityof labor resources in the region (as factors of a region’s economic security. The technique is based on the cost of reducing the period of disability in the implementation of population health risk and takes into account the effects of risk prevention on levels of the budgetary system of the Russian Federation. The method intends to support making decisions on planning measures to reduce population health risk at the level of regions, territories and separate objects to assess their cost-performance, optimization of investment and operating costs to reduce the population health risk and sustainable development of the territory

Experts' Perspectives Toward a Population Health Approach for Children With Medical Complexity.

Science.gov (United States)

Barnert, Elizabeth S; Coller, Ryan J; Nelson, Bergen B; Thompson, Lindsey R; Chan, Vincent; Padilla, Cesar; Klitzner, Thomas S; Szilagyi, Moira; Chung, Paul J

2017-08-01

Because children with medical complexity (CMC) display very different health trajectories, needs, and resource utilization than other children, it is unclear how well traditional conceptions of population health apply to CMC. We sought to identify key health outcome domains for CMC as a step toward determining core health metrics for this distinct population of children. We conducted and analyzed interviews with 23 diverse national experts on CMC to better understand population health for CMC. Interviewees included child and family advocates, health and social service providers, and research, health systems, and policy leaders. We performed thematic content analyses to identify emergent themes regarding population health for CMC. Overall, interviewees conveyed that defining and measuring population health for CMC is an achievable, worthwhile goal. Qualitative themes from interviews included: 1) CMC share unifying characteristics that could serve as the basis for population health outcomes; 2) optimal health for CMC is child specific and dynamic; 3) health of CMC is intertwined with health of families; 4) social determinants of health are especially important for CMC; and 5) measuring population health for CMC faces serious conceptual and logistical challenges. Experts have taken initial steps in defining the population health of CMC. Population health for CMC involves a dynamic concept of health that is attuned to individual, health-related goals for each child. We propose a framework that can guide the identification and development of population health metrics for CMC. Copyright © 2017 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Attitudes and preferences on the use of mobile health technology and health games for self-management: interviews with older adults on anticoagulation therapy.

Science.gov (United States)

Lee, Jung-Ah; Nguyen, Annie Lu; Berg, Jill; Amin, Alpesh; Bachman, Mark; Guo, Yuqing; Evangelista, Lorraine

2014-07-23

management. They also expressed the need for family support in the use of health technology devices. Moreover, the participants discussed concerns and challenges to use health technology and health games, and provided suggestions on ways to make mHealth technology and health games elder-friendly. These findings indicate that our older adults on warfarin therapy are interested in mHealth technology specific to warfarin medication management and health games. Further research needs to be done to validate these findings. Elder-friendly designs, technology support, and physical safety using mHealth technology may be useful in this population. These findings can be used to inform a larger study to design and test an elder-centered mHealth technology in this target population.

Primary Health Care Software-A Computer Based Data Management System

Directory of Open Access Journals (Sweden)

Tuli K

1990-01-01

Full Text Available Realising the duplication and time consumption in the usual manual system of data collection necessitated experimentation with computer based management system for primary health care in the primary health centers. The details of the population as available in the existing manual system were used for computerizing the data. Software was designed for data entry and analysis. It was written in Dbase III plus language. It was so designed that a person with no knowledge about computer could use it, A cost analysis was done and the computer system was found more cost effective than the usual manual system.

Management Matters: A Leverage Point for Health Systems Strengthening in Global Health

Directory of Open Access Journals (Sweden)

Elizabeth H. Bradley

2015-07-01

Full Text Available Despite a renewed focus in the field of global health on strengthening health systems, inadequate attention has been directed to a key ingredient of high-performing health systems: management. We aimed to develop the argument that management – defined here as the process of achieving predetermined objectives through human, financial, and technical resources – is a cross-cutting function necessary for success in all World Health Organization (WHO building blocks of health systems strengthening. Management within health systems is particularly critical in low-income settings where the efficient use of scarce resources is paramount to attaining health goals. More generally, investments in management capacity may be viewed as a key leverage point in grand strategy, as strong management enables the achievement of large ends with limited means. We also sought to delineate a set of core competencies and identify key roles to be targeted for management capacity building efforts. Several effective examples of management interventions have been described in the research literature. Together, the existing evidence underscores the importance of country ownership of management capacity building efforts, which often challenge the status quo and thus need country leadership to sustain despite inevitable friction. The literature also recognizes that management capacity efforts, as a key ingredient of effective systems change, take time to embed, as new protocols and ways of working become habitual and integrated as standard operating procedures. Despite these challenges, the field of health management as part of global health system strengthening efforts holds promise as a fundamental leverage point for achieving health system performance goals with existing human, technical, and financial resources. The evidence base consistently supports the role of management in performance improvement but would benefit from additional research with improved

Chronic care case management for the frail elderly population in the United States: normative, funding and organizational aspects

Directory of Open Access Journals (Sweden)

Antonio Giulio de Belvis

2004-12-01

Full Text Available

In the most developed countries, it is necessary to bring about significant changes to health care delivery through the strengthening of prevention, rehabilitation and the integration of the social and healthcare dimensions.

This means moving the policy focus from “treating” to “taking care” of the sick in a broader and more integrated way, one which is more closely linked to the World Health Organization’s definition of health as physical, psychological and social well-being. This change involves the delivery of care for the elderly. Developed countries are confronting this issue by using different community-based programs to integrate acute and long-term care services for frail elderly individuals with complex health needs.

The objective of this health policy article is to give an overview of the most recent initiatives on long-term care management for the elderly including normative, funding and organizational issues in the USA, as their public health system largely differs from those of the Western European countries.

Particular attention is given to the PACE (Program of All Inclusive Care for the Elderly, which applies a comprehensive approach to managing the care of the frail elderly population and would represent a new framework in geriatric care. By incorporating a central core care team to manage the needs of each elderly individual, this approach recognizes the contributing factors that non-traditional health related functions play in the overall health of the individual.

Although there is a little knowledge of this program, as it covers a very small percentage of the eligible individuals, and it may be difficult to extrapolate to other sectors of the population, PACE offers many lessons that could be applied to more effective integration of care for individuals and lead to better health outcomes.

Stigma as a Fundamental Cause of Population Health Inequalities

Science.gov (United States)

Phelan, Jo C.

2013-01-01

Bodies of research pertaining to specific stigmatized statuses have typically developed in separate domains and have focused on single outcomes at 1 level of analysis, thereby obscuring the full significance of stigma as a fundamental driver of population health. Here we provide illustrative evidence on the health consequences of stigma and present a conceptual framework describing the psychological and structural pathways through which stigma influences health. Because of its pervasiveness, its disruption of multiple life domains (e.g., resources, social relationships, and coping behaviors), and its corrosive impact on the health of populations, stigma should be considered alongside the other major organizing concepts for research on social determinants of population health. PMID:23488505

Population Health Science: A Core Element of Health Science Education in Sub-Saharan Africa.

Science.gov (United States)

Hiatt, Robert A; Engmann, Natalie J; Ahmed, Mushtaq; Amarsi, Yasmin; Macharia, William M; Macfarlane, Sarah B; Ngugi, Anthony K; Rabbani, Fauziah; Walraven, Gijs; Armstrong, Robert W

2017-04-01

Sub-Saharan Africa suffers an inordinate burden of disease and does not have the numbers of suitably trained health care workers to address this challenge. New concepts in health sciences education are needed to offer alternatives to current training approaches.A perspective of integrated training in population health for undergraduate medical and nursing education is advanced, rather than continuing to take separate approaches for clinical and public health education. Population health science educates students in the social and environmental origins of disease, thus complementing disease-specific training and providing opportunities for learners to take the perspective of the community as a critical part of their education.Many of the recent initiatives in health science education in sub-Saharan Africa are reviewed, and two case studies of innovative change in undergraduate medical education are presented that begin to incorporate such population health thinking. The focus is on East Africa, one of the most rapidly growing economies in sub-Saharan Africa where opportunities for change in health science education are opening. The authors conclude that a focus on population health is a timely and effective way for enhancing training of health care professionals to reduce the burden of disease in sub-Saharan Africa.

A Population-Level Data Analytics Portal for Self-Administered Lifestyle and Mental Health Screening.

Science.gov (United States)

Zhang, Xindi; Warren, Jim; Corter, Arden; Goodyear-Smith, Felicity

2016-01-01

This paper describes development of a prototype data analytics portal for analysis of accumulated screening results from eCHAT (electronic Case-finding and Help Assessment Tool). eCHAT allows individuals to conduct a self-administered lifestyle and mental health screening assessment, with usage to date chiefly in the context of primary care waiting rooms. The intention is for wide roll-out to primary care clinics, including secondary school based clinics, resulting in the accumulation of population-level data. Data from a field trial of eCHAT with sexual health questions tailored to youth were used to support design of a data analytics portal for population-level data. The design process included user personas and scenarios, screen prototyping and a simulator for generating large-scale data sets. The prototype demonstrates the promise of wide-scale self-administered screening data to support a range of users including practice managers, clinical directors and health policy analysts.

An XML-based framework for personalized health management.

Science.gov (United States)

Lee, Hiye-Ja; Park, Seung-Hun; Jeong, Byeong-Soo

2006-01-01

This paper proposes a framework for personalized health management. In this framework, XML technology is used for representing and managing the health information and knowledge. Major components of the framework are Health Management Prescription (HMP) Expert System and Health Information Repository. The HMP Expert System generates a HMP efficiently by using XML-based templates. Health Information Repository provides integrated health information and knowledge for personalized health management by using XML and relational database together.

International collaboration in health promotion and disease management: implications of U.S. health promotion efforts on Japan's health care system.

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Pelletier, Kenneth R

2005-01-01

For more than 25 years, health promotion and disease management interventions have been conducted by large employers in the United States. Today there are more than 100 studies of such multifactorial, comprehensive interventions that all demonstrate positive clinical outcomes. For those interventions that have also been evaluated for return on investment, all but one have demonstrated cost-effectiveness. This article is an evidence-based overview of the clinical and cost outcomes research to elaborate on the insights gained from this research in the areas of implementation and evaluation of such programs; integration of health promotion and disease management programs into conventional, occupational medicine; accessing difficult to reach populations, such as mobile workers, retirees, and/or dependents; areas of potential conflict of interest and privacy/confidentiality issues; health consequences of downsizing and job strain; and, finally, recommendations for improved integration and evaluation of such programs for both clinical and cost outcomes. With medical costs rapidly escalating again on a global scale, these interventions with evidence of both clinical and cost outcomes can provide the foundation to improve the health, performance, and productivity of both individuals and their corporations.

Value-Driven Population Health: An Emerging Focus for Improving Stakeholder Role Performance.

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Allen, Harris; Burton, Wayne N; Fabius, Raymond

2017-12-01

Health and health care in the United States are being jeopardized by top-end spending whose share of the gross domestic product continues to increase even as aggregate health outcomes remain mediocre. This paper focuses on a new approach for improving stakeholder role performance in the marketplace, value-driven population health (VDPH SM ). Devoted to maximizing the value of every dollar spent on population health, VDPH holds much promise for ameliorating this dilemma and exerting a constructive influence on the reshaping of the Affordable Care Act. This paper introduces VDPH and differentiates the science underlying it from the management that serves to make good on its potential. To highlight what VDPH brings to the table, comparisons are made with 3 like-minded approaches to health reform. Next, 2 areas are highlighted, workplace wellness and the quality and cost of health care, where without necessarily being recognized as such, VDPH has gained real traction among 2 groups: leading employers and, more recently, leading providers. Key findings with respect to workplace wellness are assessed in terms of psychometric performance to evaluate workplace wellness and to point out how VDPH can help direct future employer initiatives toward firmer scientific footing. Then, insights gleaned from the employer experience are applied to illustrate how VDPH can help guide future provider efforts to build on the model developed. This paper concludes with a framework for the use of VDPH by each of 5 stakeholder groups. The discussion centers on how VDPH transcends and differentiates these groups. Implications for health reform in the recently altered political landscape are explored.

A mismatch between population health literacy and the complexity of health information: an observational study.

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Rowlands, Gillian; Protheroe, Joanne; Winkley, John; Richardson, Marty; Seed, Paul T; Rudd, Rima

2015-06-01

Low health literacy is associated with poorer health and higher mortality. Complex health materials are a barrier to health. To assess the literacy and numeracy skills required to understand and use commonly used English health information materials, and to describe population skills in relation to these. An English observational study comparing health materials with national working-age population skills. Health materials were sampled using a health literacy framework. Competency thresholds to understand and use the materials were identified. The proportion of the population above and below these thresholds, and the sociodemographic variables associated with a greater risk of being below the thresholds, were described. Sixty-four health materials were sampled. Two competency thresholds were identified: text (literacy) only, and text + numeracy; 2515/5795 participants (43%) were below the text-only threshold, while 2905/4767 (61%) were below the text + numeracy threshold. Univariable analyses of social determinants of health showed that those groups more at risk of socioeconomic deprivation had higher odds of being below the health literacy competency threshold than those at lower risk of deprivation. Multivariable analysis resulted in some variables becoming non-significant or reduced in effect. Levels of low health literacy mirror those found in other industrialised countries, with a mismatch between the complexity of health materials and the skills of the English adult working-age population. Those most in need of health information have the least access to it. Efficacious strategies are building population skills, improving health professionals' communication, and improving written health information. © British Journal of General Practice 2015.

Primary care and public health: exploring integration to improve population health

National Research Council Canada - National Science Library

Committee on Integrating Primary Care and Public Health; Board on Population Health and Public Health Practice; Institute of Medicine

...; and the provision of timely, effective, and coordinated health care. Achieving substantial and lasting improvements in population health will require a concerted effort from all these entities, aligned with a common goal...

Future preparation of occupational health nurse managers.

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Scalzi, C C; Wilson, D L; Ebert, R

1991-03-01

This article presents the results of a national survey of job activities of corporate level occupational health nurse managers. The survey was designed to identify the relative amount of time spent and importance attributed to specific areas of their current job. In general this sample tended to have more management experience and educational preparation than previously cited studies: over 50% had completed a graduate degree. The scores for importance and time spent were highly correlated. That is, occupational health corporate nurse managers seemed to allocate their time to job responsibilities they considered most important. Management activities related to policy, practice standards, quality assurance, staff development, and systems for client care delivery appear to represent the core responsibilities of occupational health nursing management. Curriculum recommendations for management positions in occupational health include: health policy, program planning, and evaluation; business strategy; applications of management information systems; quality assurance; and marketing.

Health plans' disease management programs: extending across the medical and behavioral health spectrum?

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Merrick, Elizabeth Levy; Horgan, Constance M; Garnick, Deborah W; Hodgkin, Dominic; Morley, Melissa

2008-01-01

Although the disease management industry has expanded rapidly, there is little nationally representative data regarding medical and behavioral health disease management programs at the health plan level. National estimates from a survey of private health plans indicate that 90% of health plan products offered disease management for general medical conditions such as diabetes but only 37% had depression programs. The frequency of specific depression disease management activities varied widely. Program adoption was significantly related to product type and behavioral health contracting. In health plans, disease management has penetrated more slowly into behavioral health and depression program characteristics are highly variable.

Challenges and Opportunities with Empowering Baby Boomers for Personal Health Information Management Using Consumer Health Information Technologies: an Ecological Perspective.

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LeRouge, Cynthia M; Tao, Donghua; Ohs, Jennifer; Lach, Helen W; Jupka, Keri; Wray, Ricardo

2014-01-01

"Baby Boomers" (adults born between the years of 1946 and 1964) make up the largest segment of the population in many countries, including the United States (about 78 million Americans) [1]. As Baby Boomers reach retirement age and beyond, many will have increasing medical needs and thus demand more health care resources that will challenge the healthcare system. Baby Boomers will likely accelerate the movement toward patient self-management and prevention efforts. Consumer Health Information Technologies (CHIT) hold promise for empowering health consumers to take an active role in health maintenance and disease management, and thus, have the potential to address Baby Boomers' health needs. Such innovations require changes in health care practice and processes that take into account Baby Boomers' personal health needs, preferences, health culture, and abilities to use these technologies. Without foundational knowledge of barriers and opportunities, Baby Boomers may not realize the potential of these innovations for improving self-management of health and health outcomes. However, research to date has not adequately explored the degree to which Baby Boomers are ready to embrace consumer health information technology and how their unique subcultures affect adoption and diffusion. This position paper describes an ecological conceptual framework for understanding and studying CHIT aimed at satisfying the personal health needs of Baby Boomers. We explore existing literature to provide a detailed depiction of our proposed conceptual framework, which focuses characteristics influencing Baby Boomers and their Personal Health Information Management (PHIM) and potential information problems. Using our ecological framework as a backdrop, we provide insight and implications for future research based on literature and underlying theories represented in our model.

A review of health leadership and management capacity in the Solomon Islands.

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Asante, Augustine; Roberts, Graham; Hall, John

2012-04-01

and to Ministry of Finance and Public Service Division regulations. The delineation of central and provincial health authorities' responsibilities requires guidelines in a changing system, where both population-based and targeted vertical programs are implemented at local levels. NUMBER AND DISTRIBUTION OF MANAGERS: Nine of the 10 positions of Provincial Health Director have experienced high turnover, which reportedly occurs without adequate handover to incoming appointees, most of whom are recent clinical graduates. Health services in the Honiara urban area are provided through the Honiara City Council. Church health services are staffed by government employees. COMPETENCE OF DISTRICT HEALTH MANAGERS: Management skills are reportedly weak at the provincial level. The Regional Assistance Mission to Solomon Islands provides governance training inputs to provincial government staff. Provincial health departments have limited financial and human resource management capacity. They also have clinical backgrounds and no training in public health planning or health services management, other than that provided by donors, the Regional Assistance Mission itself and the MHMS. MANAGEMENT WORKING ENVIRONMENT: Provincial health directors have limited control over health staff. Little supportive supervision in management is provided to new provincial health directors. No performance management systems are in place to ensure that staff are properly assessed and supported to do their best Large numbers of non-government organisations working at the provincial level in youth and women's programs require coordination by Provincial health directors to avoid duplication or implementation of programs that will require ongoing funding, but this is not done. FUNCTIONING OF MANAGEMENT SUPPORT SYSTEMS: Management support systems for budgeting and finance, management information and procurement and supply do not function adequately to support provincial health directors to manage effectively

TeamSTEPPS for health care risk managers: Improving teamwork and communication.

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Cooke, Marcia

2016-07-01

Ineffective communication among the health care team is a leading cause of errors in the patient care setting. Studies assessing training related to communication and teamwork in the clinical team are prevalent, however, teamwork training at the administrative level is lacking. This includes individuals in leadership positions such as health care risk managers. The purpose was to determine the impact of an educational intervention on the knowledge and attitudes related to communication and teamwork in the health care risk management population. The educational intervention was an adaptation of a national teamwork training program and incorporated didactic content as well as video vignettes and small group activities. Measurement of knowledge and attitudes were used to determine the impact of the education program. Knowledge and attitudes were assessed pre- and postcourse. Findings indicate that teamwork education tailored to the needs of the specific audience resulted in knowledge gained and improved attitudes toward the components of teamwork. The attitudes that most significantly improved were related to team structure and situation monitoring. There was no improvement in participants' attitudes toward leadership, mutual support, and communication. Team training has been shown to improve safety culture, patient satisfaction, and clinical outcomes. Including risk managers in training on teamwork, communication, and collaboration can serve to foster a common language among clinicians and management. In addition, a measurement related to implementation in the health care setting may yield insight into the impact of training. Qualitative measurement may allow the researcher to delve deeper into how these health care facilities are using team training interventions. © 2016 American Society for Healthcare Risk Management of the American Hospital Association.

Chronic kidney disease in an Aboriginal population: A nurse practitioner-led approach to management.

Science.gov (United States)

Barrett, Elizabeth; Salem, Lesley; Wilson, Sue; O'Neill, Claire; Davis, Kathleen; Bagnulo, Sharif

2015-12-01

Chronic kidney disease (CKD) is a significant health problem impacting Australia's Aboriginal and Torres Strait Islander population. After age adjustment, the prevalence of kidney disease is 3.7 times higher in Aboriginal people and 7.3 times higher for end-stage kidney disease compared with the wider population. Yet at an Aboriginal Community Controlled Health Service (ACCHS) with a significant patient population, fewer than expected numbers of Aboriginal patients were identified with CKD. The ACCHS engaged a nurse practitioner to lead a systematic approach to the identification and treatment of CKD. This nurse practitioner-led approach to CKD was developed and implemented at a rural NSW ACCHS, with the support of a partnership formed between the nurse practitioner, the ACCHS, a nephrologist from a referral hospital and a statewide NGO. The primary measure for improvement has been to identify and stage patients with CKD and establish management plans as appropriate. This nurse-led project was established to: (i) identify patients with CKD; (ii) provide access for CKD patients to appropriate services; (iii) commence pharmacological and non-pharmacological strategies that enable remission or regression of CKD; and (iv) educate practice GPs and other staff members on CKD clinical guidelines and best practice. The CKD project has improved access to essential health care for vulnerable and at-risk populations, with 187 patients to date having been identified with kidney disease and staged for its severity. The need for strong multi-disciplinary teamwork has been demonstrated with good communication strategies implemented. © 2015 National Rural Health Alliance Inc.

Public health financial management competencies.

Science.gov (United States)

Honoré, Peggy A; Costich, Julia F

2009-01-01

The absence of appropriate financial management competencies has impeded progress in advancing the field of public health finance. It also inhibits the ability to professionalize this sector of the workforce. Financial managers should play a critical role by providing information relevant to decision making. The lack of fundamental financial management knowledge and skills is a barrier to fulfilling this role. A national expert committee was convened to examine this issue. The committee reviewed standards related to financial and business management practices within public health and closely related areas. Alignments were made with national standards such as those established for government chief financial officers. On the basis of this analysis, a comprehensive set of public health financial management competencies was identified and examined further by a review panel. At a minimum, the competencies can be used to define job descriptions, assess job performance, identify critical gaps in financial analysis, create career paths, and design educational programs.

Dissemination research: the University of Wisconsin Population Health Institute.

Science.gov (United States)

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

2009-08-01

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

Socioeconomic Inequalities in Mental Health of Adult Population: Serbian National Health Survey.

Science.gov (United States)

Santric-Milicevic, Milena; Jankovic, Janko; Trajkovic, Goran; Terzic-Supic, Zorica; Babic, Uros; Petrovic, Marija

2016-01-01

The global burden of mental disorders is rising. In Serbia, anxiety is the leading cause of disability-adjusted life years. Serbia has no mental health survey at the population level. The information on prevalence of mental disorders and related socioeconomic inequalities are valuable for mental care improvement. To explore the prevalence of mental health disorders and socioeconomic inequalities in mental health of adult Serbian population, and to explore whether age years and employment status interact with mental health in urban and rural settlements. Cross-sectional study. This study is an additional analysis of Serbian Health Survey 2006 that was carried out with standardized household questionnaires at the representative sample of 7673 randomly selected households - 15563 adults. The response rate was 93%. A multivariate logistic regression modeling highlighted the predictors of the 5 item Mental Health Inventory (MHI-5), and of chronic anxiety or depression within eight independent variables (age, gender, type of settlement, marital status and self-perceived health, education, employment status and Wealth Index). The significance level in descriptive statistics, chi square analysis and bivariate and multivariate logistic regressions was set at pinequalities contributed by differences in age, education, employment, marriage and the wealth status of the adult population.

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

Science.gov (United States)

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

2018-03-20

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

The Health of America's Aging Prison Population.

Science.gov (United States)

Skarupski, Kimberly A; Gross, Alden; Schrack, Jennifer A; Deal, Jennifer A; Eber, Gabriel B

2018-03-23

Older incarcerated individuals comprise the fastest growing demographic in the US prison system. Unhealthy lifestyles among incarcerated individuals and inadequate health care lead to earlier onset and more rapid progression of many chronic conditions that are prevalent among community-living older adults. There are limited peer-reviewed epidemiologic data in this area; however, there is growing interest in identifying strategies for housing aging incarcerated individuals, delivering appropriate health care in prisons, and coordinating after-release health care. In this systematic review, we summarize the epidemiologic evidence of the health challenges facing the aging US prison population. Our comprehensive literature search focused on health outcomes, including diseases, comorbid conditions, mental health, cognition, and mobility. From 12,486 articles identified from the literature search, we reviewed 21 studies published between 2007 and 2017. All the studies were observational and cross-sectional, and most (n = 17) were based on regional samples. Sample sizes varied widely, ranging from 25 to 14,499 incarcerated people (median, 258). In general, compared with their younger counterparts, older incarcerated individuals reported high rates of diabetes mellitus, cardiovascular conditions, and liver disease. Mental health problems were common, especially anxiety, fear of desire for death or suicide, and depression. Activities of daily living were challenging for up to one-fifth of the population. We found no empirical data on cognition among older incarcerated individuals. The findings of this review reveal few empirical data in this area and highlight the need for new data to drive policy and practice patterns that address critical health issues related to the aging prison population.

The Oral Health Care Manager in a Patient-Centered Health Facility.

Science.gov (United States)

Theile, Cheryl Westphal; Strauss, Shiela M; Northridge, Mary Evelyn; Birenz, Shirley

2016-06-01

The dental hygienist team member has an opportunity to coordinate care within an interprofessional practice as an oral health care manager. Although dental hygienists are currently practicing within interprofessional teams in settings such as pediatric offices, hospitals, nursing homes, schools, and federally qualified health centers, they often still assume traditional responsibilities rather than practicing to the full extent of their training and licenses. This article explains the opportunity for the dental hygiene professional to embrace patient-centered care as an oral health care manager who can facilitate integration of oral and primary care in a variety of health care settings. Based on an innovative model of collaboration between a college of dentistry and a college of nursing, an idea emerged among several faculty members for a new management method for realizing continuity and coordination of comprehensive patient care. Involved faculty members began working on the development of an approach to interprofessional practice with the dental hygienist serving as an oral health care manager who would address both oral health care and a patient's related primary care issues through appropriate referrals and follow-up. This approach is explained in this article, along with the results of several pilot studies that begin to evaluate the feasibility of a dental hygienist as an oral health care manager. A health care provider with management skills and leadership qualities is required to coordinate the interprofessional provision of comprehensive health care. The dental hygienist has the opportunity to lead closer integration of oral and primary care as an oral health care manager, by coordinating the team of providers needed to implement comprehensive, patient-centered care. Copyright © 2016 Elsevier Inc. All rights reserved.

Solid waste integrated management proposal in Churuguara and Maparari population axis, Federacion municipality Falcon State, Venezuela

International Nuclear Information System (INIS)

Reyes Torres, Magly; Melendez, Angelica; Sanchez, Angel

2009-01-01

This research shows a solid waste integrated management proposal in Churuguara and Maparari axis population, Federation municipality Falcon State. The inadequate arrangement of solid waste in these populations lacks of any type of control. It has caused environmental pollution problems that affect public health. For this reason, a diagnosis of the situation was made to classify the solid waste, an optimal way of processing and storing them was shown; the fleet that will offer the service, the routes of collection, the frequency and timetable of them, the waste to recycle and the design of a semi-mechanized landfill site were measured as a technical and economical alternative for the government. In this proposal, there are established strategies to increase the quality of life of the inhabitants of this region that allow to reform, improve and transform the solid waste management within a valid legal frame. Since, this is one of the most important services and it has direct consequences in people's health. It is necessary the community and governmental entities participation in the managerial process of these kinds of waste. (author)

[The role of county health center in the management of patients with acute coronary syndrome].

Science.gov (United States)

Krcmar, Nevenka; Pristas, Ivan; Stevanović, Ranko

2009-02-01

Health emergency service teams play an important role in the management of patients with acute coronary syndrome. They have to be educated, equipped, skilful and supported by the entire health care system. The role of county health center in the management of patients with acute coronary syndrome is illustrated in the article, based on the experience acquired at Medimurje County Health Center from Cakovec. The reformed Health Center activities including organization, coordination and linking of teams, population health monitoring at the local level, epidemiologic surveillance, education (active and passive, on both sides of college chair), joint diagnostic and other services, and quality control are discussed in detail. In contrast to a bureaucratic and formal one, a real and innovative reform should take account of necessary changes in the management and organization, not just in standards, rights and obligations. The management protocol for acute coronary syndrome patients is described: setting the main objective (acute coronary disease morbidity and mortality reduction), setting short-term and long-term specific goals, adoption of strategy based on the main objective (education, completion and particular programs pursuit, connecting, collaboration, quality assurance through clinical guidelines and protocols) and other elements, including dignity, leadership, teamwork, adoption and implementation of patient management protocols.

FastStats: Health of American Indian or Alaska Native Population

Science.gov (United States)

... Home Health of American Indian or Alaska Native Population Recommend on Facebook Tweet Share Compartir Data are ... Source: Summary Health Statistics Tables for the U.S. Population: National Health Interview Survey, 2015, Table P-1c [ ...

Accessibility to health services in the prison population in Colombia: a public health challenge

Directory of Open Access Journals (Sweden)

Luz Mery Mejía O

2010-08-01

Full Text Available This article is the result of a product of a study elaborated with the aim of systematizing the available information related to the accessibility to the health services of the prison population in the penitentiary centers. To this end, we reviewed the literature and systematic collection of the academic available material in the principal university libraries in the city of Medellin, scientific databases and the web pages of national and international organizations that have dealt with this topic. The information was systematized considering some historical references to prisons and health, the record of experiences in some countries and the current regulations for health care in the prison population in the Colombian case. We conclude that although significant progress has been made to ensure health care for the prison population, in the prison there are still obstacles and limitations that infringe the right to health of this population. Likewise, it is evidenced that it has not been considered a public health problem in the country, which it is considered a challenge to incorporate it as such.

Populations protection and territories management in nuclear emergency and post-accident situation

International Nuclear Information System (INIS)

Bourrel, M.; Calmon, Ph.; Calvez, M.; Chambrette, V.; Champion, D.; Devin, P.; Godino, O.; Lombard, J.; Rzepka, J.P.; Schneider, Th.; Verhaeghe, B.; Cogez, E.; Kayser, O.; Guenon, C.; Jourdain, J.R.; Bouchot, E.; Murith, Ch.; Lochard, J.; Cluchier, A.; Vandecasteele, Ch.; Pectorin, X.; Dubiau, Ph.; Gerphagnon, O.; Roche, H.; Cessac, B.; Cochard, A.; Machenaud, G.; Jourdain, J.R.; Pirard, Ph.; Leger, M.; Bouchot, E.; Demet, M.; Charre, J.P.; Poumadere, M.; Cogez, E.

2010-01-01

for the management of post-accident consequences: agricultural activities and exit of the emergency stage (B. Cessac); 18 - presentation of the operational means of the GIE Groupe Intra (A. Cochard); 19 - synthetical presentation of the studies of post-accident management conditions in the milk industry (G. Machenaud); 20 - reconstruction of doses received by exposed populations (J.R. Jourdain); 21 - organisation of the health monitoring of populations after a radiological accident - presentation taken from the recommendations of the Codirpa's working group 'health stakes' (P. Pirard); 22 - losses indemnification in case of nuclear accident (M. Leger); 23 - post nuclear accident communication - reflections of the Codirpa's working group 'communication' (E. Bouchot); 24 - the ANCCLI's permanent group 'territories - post-accident' (M. Demet); 25 - experience feedback from the local information commission (CLI) 'Marcoule-Gard' in the management of a post-accident situation (J.P. Charre); 26 - commitment of intervening parties in the preparation to accident and post-accident situations: European experiences (T. Schneider); 27 - socio-cognitive exposure and risk assessment - the radio waves case (M. Poumadere). (J.S.)

Information support for health information management in regional Sri Lanka: health managers' perspectives.

Science.gov (United States)

Ranasinghe, Kaduruwane Indika; Chan, Taizan; Yaralagadda, Prasad

Good management, supported by accurate, timely and reliable health information, is vital for increasing the effectiveness of Health Information Systems (HIS). When it comes to managing the under-resourced health systems of developing countries, information-based decision making is particularly important. This paper reports findings of a self-report survey that investigated perceptions of local health managers (HMs) of their own regional HIS in Sri Lanka. Data were collected through a validated, pre-tested postal questionnaire, and distributed among a selected group of HMs to elicit their perceptions of the current HIS in relation to information generation, acquisition and use, required reforms to the information system and application of information and communication technology (ICT). Results based on descriptive statistics indicated that the regional HIS was poorly organised and in need of reform; that management support for the system was unsatisfactory in terms of relevance, accuracy, timeliness and accessibility; that political pressure and community and donor requests took precedence over vital health information when management decisions were made; and use of ICT was unsatisfactory. HIS strengths included user-friendly paper formats, a centralised planning system and an efficient disease notification system; weaknesses were lack of comprehensiveness, inaccuracy, and lack of a feedback system. Responses of participants indicated that HIS would be improved by adopting an internationally accepted framework and introducing ICT applications. Perceived barriers to such improvements were high initial cost of educating staff to improve computer literacy, introduction of ICTs, and HIS restructure. We concluded that the regional HIS of Central Province, Sri Lanka had failed to provide much-needed information support to HMs. These findings are consistent with similar research in other developing countries and reinforce the need for further research to verify causes of

Low literacy self-care management patient education for a multi-lingual heart failure population: Results of a pilot study.

Science.gov (United States)

Dickson, Victoria Vaughan; Chyun, Deborah; Caridi, Cristina; Gregory, Jill K; Katz, Stuart

2016-02-01

The purpose of this pilot study was to test the impact of language-free, low literacy self-care management patient education materials in an ethnically diverse multilingual heart failure (HF) population. A one group pre-test-post-test design measured changes in self-care, knowledge and health-related quality of life (HRQL) after a 1 month intervention using language-free, low literacy self-care management patient education materials and delivered by a health educator. The ethnically diverse sample (n=21) was predominately male (72%), 48% Black, 42% Hispanic, and 28% marginal/inadequate literacy. There were significant improvements in self-care and knowledge but not HRQL. Language-free, low literacy self-care patient education may facilitate improved self-care and knowledge in diverse populations who are at risk for poor HF outcomes. Copyright © 2015 Elsevier Inc. All rights reserved.

[The efficacy of e-health management on weight control in adolescents: a systematic review].

Science.gov (United States)

Su, Mei-Chen; Lin, Chia-Ling; Tsao, Lee-Ing

2014-02-01

Advances during the past decade have made it feasible to apply e-health methods to chronic disease management. Researchers have recently begun applying these methods to weight control. The application of e-health management methods to weight control in adolescents has yet to be investigated empirically. This study conducted a systematic review of reports discussing the weight-control effects of e-health management in adolescents. Researchers searched 6 electronic databases for relevant articles published between 1995 and April 2013. Data were collected using inclusion and exclusion criteria. A modified Jadad Scale was used to evaluate the quality of the identified articles. Seven studies met the inclusion criterion of targeting adolescent subject populations. A total of 3728 adolescents and 1394 parents participated in these studies. The majority of participants were overweight girls and median participant ages ranged from 12.52 (SD = 3.15) to 15.31 (SD = 0.69). All studies reported that e-health management reduced body mass index and body fat percentage. Four studies indicate that e-health management may improve physical activity knowledge and skills. However, diet control outcomes among the seven studies varied. Empirical results demonstrate that e-health management significantly affects weight control. However, the effectiveness of log-in versus primary outcome indicators was inconclusive. Future studies should consider the use of incentives, reminder systems, and other strategies to enhance website usage. The development of an Internet-based, computer-tailored weight-management intervention for overweight adolescents and the development of an appropriate care model are recommended.

Patient safety is not enough: targeting quality improvements to optimize the health of the population.

Science.gov (United States)

Woolf, Steven H

2004-01-06

Ensuring patient safety is essential for better health care, but preoccupation with niches of medicine, such as patient safety, can inadvertently compromise outcomes if it distracts from other problems that pose a greater threat to health. The greatest benefit for the population comes from a comprehensive view of population needs and making improvements in proportion with their potential effect on public health; anything less subjects an excess of people to morbidity and death. Patient safety, in context, is a subset of health problems affecting Americans. Safety is a subcategory of medical errors, which also includes mistakes in health promotion and chronic disease management that cost lives but do not affect "safety." These errors are a subset of lapses in quality, which result not only from errors but also from systemic problems, such as lack of access, inequity, and flawed system designs. Lapses in quality are a subset of deficient caring, which encompasses gaps in therapeutics, respect, and compassion that are undetected by normative quality indicators. These larger problems arguably cost hundreds of thousands more lives than do lapses in safety, and the system redesigns to correct them should receive proportionately greater emphasis. Ensuring such rational prioritization requires policy and medical leaders to eschew parochialism and take a global perspective in gauging health problems. The public's well-being requires policymakers to view the system as a whole and consider the potential effect on overall population health when prioritizing care improvements and system redesigns.

Medical Waste Management in Community Health Centers.

Science.gov (United States)

Tabrizi, Jafar Sadegh; Rezapour, Ramin; Saadati, Mohammad; Seifi, Samira; Amini, Behnam; Varmazyar, Farahnaz

2018-02-01

Non-standard management of medical waste leads to irreparable side effects. This issue is of double importance in health care centers in a city which are the most extensive system for providing Primary Health Care (PHC) across Iran cities. This study investigated the medical waste management standards observation in Tabriz community health care centers, northwestern Iran. In this triangulated cross-sectional study (qualitative-quantitative), data collecting tool was a valid checklist of waste management process developed based on Iranian medical waste management standards. The data were collected in 2015 through process observation and interviews with the health center's staff. The average rate of waste management standards observance in Tabriz community health centers, Tabriz, Iran was 29.8%. This case was 22.8% in dimension of management and training, 27.3% in separating and collecting, 31.2% in transport and temporary storage, and 42.9% in sterilization and disposal. Lack of principal separation of wastes, inappropriate collecting and disposal cycle of waste and disregarding safety tips (fertilizer device performance monitoring, microbial cultures and so on) were among the observed defects in health care centers supported by quantitative data. Medical waste management was not in a desirable situation in Tabriz community health centers. The expansion of community health centers in different regions and non-observance of standards could predispose to incidence the risks resulted from medical wastes. So it is necessary to adopt appropriate policies to promote waste management situation.

Roads to health : multi-state modelling of population health and resource use

NARCIS (Netherlands)

Niessen, Louis Wilhelmus

2002-01-01

The book has described the dynamics of disease occurrence in populations and gives an overview of the major known health determinants of mortality decline, health risk factors and health services, and studies the health interventions options in two example diseases i.e. diabetes and stroke. We

Managing individual nests promotes population recovery of a top predator

Science.gov (United States)

Cruz, Jennyffer; Windels, Steve K.; Thogmartin, Wayne E.; Crimmins, Shawn M.; Grim, Leland; Zuckerberg, Benjamin

2018-01-01

Threatened species are managed using diverse conservation tactics implemented at multiple scales ranging from protecting individuals, to populations, to entire species. Individual protection strives to promote recovery at the population‐ or species‐level, although this is seldom evaluated.After decades of widespread declines, bald eagles, Haliaeetus leucocephalus, are recovering throughout their range due to legal protection and pesticide bans. However, like other raptors, their recovery remains threatened by human activities. Bald eagle nests are commonly managed using buffer zones to minimize human disturbance, but the benefits of this practice remain unquantified.Within Voyageurs National Park (VNP), Minnesota, USA, managers have monitored bald eagle populations for over 40 years, and since 1991, have protected at‐risk nests from human disturbance using buffer zones (200 and 400 m radius). We aimed to (1) quantify the recovery of bald eagles in VNP (1973–2016), and (2) provide a first‐ever evaluation of the individual‐ and population‐level effects of managing individual nests. To do so, we developed Bayesian Integrated Population Models combining observations of nest occupancy and reproductive output (metrics commonly collected for raptors) to estimate nest‐level probabilities of occupancy, nest success, and high productivity (producing ≥2 nestlings), as well as population‐level estimates of abundance and growth.The breeding population of bald eagles at VNP increased steadily from management significantly improved occupancy and success. At the population‐level, management led to 8% and 13% increases in nest success and productivity rates, respectively, resulting in a 37% increase in breeding pair abundance.Synthesis and applications. There is a clear need to evaluate how management approaches at multiple scales assist in species recovery. Our study uses an Integrated Population Model to reveal the population‐level benefits of a widely

Intelligent Integrated System Health Management

Science.gov (United States)

Figueroa, Fernando

2012-01-01

Intelligent Integrated System Health Management (ISHM) is the management of data, information, and knowledge (DIaK) with the purposeful objective of determining the health of a system (Management: storage, distribution, sharing, maintenance, processing, reasoning, and presentation). Presentation discusses: (1) ISHM Capability Development. (1a) ISHM Knowledge Model. (1b) Standards for ISHM Implementation. (1c) ISHM Domain Models (ISHM-DM's). (1d) Intelligent Sensors and Components. (2) ISHM in Systems Design, Engineering, and Integration. (3) Intelligent Control for ISHM-Enabled Systems

mHealth technologies in the management of obesity: a narrative review

Directory of Open Access Journals (Sweden)

Allman-Farinelli M

2017-07-01

Full Text Available Margaret Allman-Farinelli, Juliana Chen School of Life and Environmental Science, Charles Perkins Centre, The University of Sydney, Camperdown, NSW, Australia Abstract: The global pandemic of obesity requires an urgent response. Obesity results in increased risk of type 2 diabetes, cardiovascular disease and cancer. The need to provide cost-effective treatment to the millions affected is evident but traditional repeated individual face-to-face management would clearly exhaust available health care services. It is for this reason that the use of mobile health (mHealth to improve population health, diet, and physical activity has become an active area of research. The aim of this review is to give a perspective of where this field of research currently stands using examples from the published literature. Smartphones provide a medium for the delivery of health information, personal coaching, monitoring of eating and physical activity behaviors and to integrate outputs from other sensors. Health and computer researchers have been developing and evaluating mHealth for the management of obesity but their efforts are relatively small. Text messaging, applications (apps and a number of multicomponent mHealth programs utilizing a variety of Smartphone functions indicate some success in weight management but the results are mixed. Apart from the ubiquitous nature of Smartphones and devices, the real-time delivery of output data provides the potential for continuous adjustment of interventions according to the changes an individual is making after each message they receive from the mHealth program. This ability to optimize interventions for individual weight management in a timely fashion is the big challenge for researchers. Personalized heath advice is the preferred option of individuals, and cooperation between computer scientists, behavioral scientists, dietitians, exercise physiologists and medical practitioners will be needed to meaningfully

Epidemiology, Characteristics, and Outcomes of ICU-Managed Homeless Patients: A Population-Based Study

Directory of Open Access Journals (Sweden)

Lavi Oud

2018-01-01

Full Text Available Background. The population-level demand for critical care services among the homeless (H remains unknown, with only sparse data on the characteristics and outcomes of those managed in the ICU. Methods. The Texas Inpatient Public Use Data File and annual federal reports were used to identify H hospitalizations and annual estimates of the H population between 2007 and 2014. The incidence of ICU admissions in the H population, the characteristics of ICU-managed H, and factors associated with their short-term mortality were examined. Results. Among 52,206 H hospitalizations 15,553 (29.8% were admitted to ICU. The incidence of ICU admission among state H population rose between 2007 and 2014 from 28.0 to 96.6/1,000 (p<0.0001, respectively. Adults aged ≥ 45 years and minorities accounted for 70.2% and 57.6%, respectively, of the growth in volume of ICU admissions. Short-term mortality was 3.2%, with odds of death increased with age, comorbidity burden, and number of failing organs. Conclusions. The demand for critical care services was increasingly high among the H and was contrasted by low short-term mortality among ICU admissions. These findings, coupled with the persistent health disparities among minority H, underscore the need to effectively address homelessness and reduce barriers to longitudinal appropriate prehospital care among the H.

Adult height, nutrition, and population health

Science.gov (United States)

Perkins, Jessica M.; Subramanian, S.V.; Davey Smith, George

2016-01-01

In this review, the potential causes and consequences of adult height, a measure of cumulative net nutrition, in modern populations are summarized. The mechanisms linking adult height and health are examined, with a focus on the role of potential confounders. Evidence across studies indicates that short adult height (reflecting growth retardation) in low- and middle-income countries is driven by environmental conditions, especially net nutrition during early years. Some of the associations of height with health and social outcomes potentially reflect the association between these environmental factors and such outcomes. These conditions are manifested in the substantial differences in adult height that exist between and within countries and over time. This review suggests that adult height is a useful marker of variation in cumulative net nutrition, biological deprivation, and standard of living between and within populations and should be routinely measured. Linkages between adult height and health, within and across generations, suggest that adult height may be a potential tool for monitoring health conditions and that programs focused on offspring outcomes may consider maternal height as a potentially important influence. PMID:26928678

Macroeconomic conditions and population health in Iceland

Directory of Open Access Journals (Sweden)

Kristín Helga Birgisdóttir

2017-09-01

Full Text Available Background: Results from recent research on the impact of economic cycles and population health have been mixed, with results appearing to be context-sensitive. Objective: We examine the long-term relationship between economic conditions and population health in Iceland, which has experienced some economically turbulent times in the last years and decades. Methods: We use aggregate annual data for 1981‒2014. We use three aggregate indicators of economic activity to proxy the economic cycle: unemployment rate, real GDP per capita, and real GDP. Life expectancy at birth, infant mortality, and total mortality as well as four cause-specific mortality rates were used as outcome measures. Results: Our results do not suggest a statistically significant relationship between economic conditions and total mortality, infant mortality, or life expectancy. Different responses between causes of death are found, and in some instances between genders, although statistical significance is low. We do, however, find a consistent and statistically significant relationship for females aged 45‒64, where economic downturns are associated with lower all-cause mortality. Conclusions: For the time period studied we do not find a significant relationship between economic cycles and population health, where health is proxied by mortality rates, life expectancy at birth, and infant mortality. Further studies using less extreme health outcomes, such as morbidity rates, are warranted. Contribution: This type of study has not been performed using Icelandic data before and provides a comparison to research from other countries where the relationship has been explored more. Additionally, one of the contributions of this paper is to use a variety of economic indicators as proxies for economic cycles in a study examining their relationship with population health.

The influence of management and environment on local health department organizational structure and adaptation: a longitudinal network analysis.

Science.gov (United States)

Keeling, Jonathan W; Pryde, Julie A; Merrill, Jacqueline A

2013-01-01

The nation's 2862 local health departments (LHDs) are the primary means for assuring public health services for all populations. The objective of this study is to assess the effect of organizational network analysis on management decisions in LHDs and to demonstrate the technique's ability to detect organizational adaptation over time. We conducted a longitudinal network analysis in a full-service LHD with 113 employees serving about 187,000 persons. Network survey data were collected from employees at 3 times: months 0, 8, and 34. At time 1 the initial analysis was presented to LHD managers as an intervention with information on evidence-based management strategies to address the findings. At times 2 and 3 interviews documented managers' decision making and events in the task environment. Response rates for the 3 network analyses were 90%, 97%, and 83%. Postintervention (time 2) results showed beneficial changes in network measures of communication and integration. Screening and case identification increased for chlamydia and for gonorrhea. Outbreak mitigation was accelerated by cross-divisional teaming. Network measurements at time 3 showed LHD adaptation to H1N1 and budget constraints with increased centralization. Task redundancy increased dramatically after National Incident Management System training. Organizational network analysis supports LHD management with empirical evidence that can be translated into strategic decisions about communication, allocation of resources, and addressing knowledge gaps. Specific population health outcomes were traced directly to management decisions based on network evidence. The technique can help managers improve how LHDs function as organizations and contribute to our understanding of public health systems.

The effectiveness of health care cost management strategies: a review of the evidence.

Science.gov (United States)

Fronstin, P

1994-10-01

This Issue Brief discusses the evolution of the health care delivery and financing systems and its effects on health care cost management and describes the changes in the health care delivery system as they pertain to managed care. It presents empirical evidence on the effectiveness of managed care and concludes with an analysis of the potential of future health care reform to influence the evolution of the health care delivery system and affect health care costs. Between 1987 and 1993, total enrollment in health maintenance organizations (HMOs) increased from 28.6 million to 39.8 million, representing an additional 11.2 million individuals, or 4 percent of the U.S. population. At the same time, new forms of managed care organizations emerged. Enrollment in preferred provider organizations increased from 12.2 million individuals in 1987 to 58 million in 1992, and enrollment in point-of-service plans increased from virtually none in 1987 to 2.3 million individuals in 1992. In addition, the percentage of traditional fee-for-service plans with some form of utilization review increased to 95 percent in 1990 from 41 percent in 1987. Measuring the effects of the changing delivery system on the costs and quality of health care services has been a difficult task, resulting in considerable disagreement as to whether or not costs have been affected. In a recent report, the Congressional Budget Office recognizes two new major findings. First, managed care can provide cost-effective health care at a level of quality comparable with the care typically provided by a fee-for-service plan. Second, independent practice associations can be as effective as group- or staff-model HMOs under certain conditions. In the future, we are likely to see a continued movement of Americans into managed care arrangements, an increase in the number of physicians forming networks, a reduction in the number of insurers, an increase in the number of employers joining coalitions to purchase health care

Analysis of Workplace Health Education Performed by Occupational Health Managers in Korea

Directory of Open Access Journals (Sweden)

Yeon-Ha Kim, RN, PhD

2016-09-01

Conclusions: “Analysis and planning” skill is priority training area for healthcare professionals and occupational health managers who managed nonmanufacturing industry. It is necessary to develop a training curriculum for occupational health managers that include improving analysis of worksites and plans for a health education program.

Genetic wealth, population health: Major histocompatibility complex variation in captive and wild ring-tailed lemurs (Lemur catta).

Science.gov (United States)

Grogan, Kathleen E; Sauther, Michelle L; Cuozzo, Frank P; Drea, Christine M

2017-10-01

Across species, diversity at the major histocompatibility complex (MHC) is critical to individual disease resistance and, hence, to population health; however, MHC diversity can be reduced in small, fragmented, or isolated populations. Given the need for comparative studies of functional genetic diversity, we investigated whether MHC diversity differs between populations which are open, that is experiencing gene flow, versus populations which are closed, that is isolated from other populations. Using the endangered ring-tailed lemur ( Lemur catta ) as a model, we compared two populations under long-term study: a relatively "open," wild population ( n  = 180) derived from Bezà Mahafaly Special Reserve, Madagascar (2003-2013) and a "closed," captive population ( n  = 121) derived from the Duke Lemur Center (DLC, 1980-2013) and from the Indianapolis and Cincinnati Zoos (2012). For all animals, we assessed MHC-DRB diversity and, across populations, we compared the number of unique MHC-DRB alleles and their distributions. Wild individuals possessed more MHC-DRB alleles than did captive individuals, and overall, the wild population had more unique MHC-DRB alleles that were more evenly distributed than did the captive population. Despite management efforts to maintain or increase genetic diversity in the DLC population, MHC diversity remained static from 1980 to 2010. Since 2010, however, captive-breeding efforts resulted in the MHC diversity of offspring increasing to a level commensurate with that found in wild individuals. Therefore, loss of genetic diversity in lemurs, owing to small founder populations or reduced gene flow, can be mitigated by managed breeding efforts. Quantifying MHC diversity within individuals and between populations is the necessary first step to identifying potential improvements to captive management and conservation plans.

Leadership and management in mental health nursing.

Science.gov (United States)

Blegen, Nina Elisabeth; Severinsson, Elisabeth

2011-05-01

Mental health nurses are agents of change, and their leadership, management role and characteristics exist at many levels in health care. Previous research presents a picture of mental health nurses as subordinate and passive recipients of the leader's influence and regard leadership and management as distinct from the nurses' practical work. The aim was to provide a synthesis of the studies conducted and to discuss the relationship between nursing leadership and nursing management in the context of mental health nursing. A literature search was conducted using EBSCO-host, Academic Search Premier, Science Direct, CINAHL and PubMed for the period January 1995-July 2010. Leadership and management in the context of mental health nursing are human activities that imply entering into mutual relationships. Mental health nurses' leadership, management and transformational leadership are positively related in terms of effectiveness and nurses' skills. It is important to consider mental health nurses' management as a form of leadership similar to or as a natural consequence of transformational leadership (TL) and that ethical concerns must be constantly prioritized throughout every level of the organization. © 2011 The Authors. Journal compilation © 2011 Blackwell Publishing Ltd.

Development and validation of health service management competencies.

Science.gov (United States)

Liang, Zhanming; Howard, Peter F; Leggat, Sandra; Bartram, Timothy

2018-04-09

Purpose The importance of managerial competencies in monitoring and improving the performance of organisational leaders and managers is well accepted. Different processes have been used to identify and develop competency frameworks or models for healthcare managers around the world to meet different contextual needs. The purpose of the paper is to introduce a validated process in management competency identification and development applied in Australia - a process leading to a management competency framework with associated behavioural items that can be used to measure core management competencies of health service managers. Design/methodology/approach The management competency framework development study incorporated both qualitative and quantitative methods, implemented in four stages, including job description analysis, focus group discussions and online surveys. Findings The study confirmed that the four-stage process could identify management competencies and the framework developed is considered reliable and valid for developing a management competency assessment tool that can measure management competence amongst managers in health organisations. In addition, supervisors of health service managers could use the framework to distinguish perceived superior and average performers among managers in health organisations. Practical implications Developing the core competencies of health service managers is important for management performance improvement and talent management. The six core management competencies identified can be used to guide the design professional development activities for health service managers. Originality/value The validated management competency identification and development process can be applied in other countries and different industrial contexts to identify core management competency requirements.

Management Options for Women at Risk for Inherited Breast Cancer in a Multi-ethnic Health Plan Population: A Randomized Control Trial

National Research Council Canada - National Science Library

Schaefer, Catherine

1998-01-01

...-to-moderate risk women from minority populations. Resulting strategies will be usefully applied in the large, ethnically and economically diverse populations of health maintenance organizations from which increasing...

Management Options for Women at Risk for Inherited Breast Cancer in a Multi-ethnic Health Plan Population: A Randomized Control Trial

National Research Council Canada - National Science Library

Hiatt, Robert

1997-01-01

...-to-moderate risk women from minority populations. Resulting stategies will be usefully applied in the large, ethnically and economically diverse populations of health maintenance organizations from which increasing...

[Role of "Health" National project in improvement of health parameters in working population].

Science.gov (United States)

Bykovskaia, T Iu

2011-01-01

The author analyzed results of "Health" National project accomplishment in Rostov region over 2006-2009. Findings are that quality of primary medical care has improved, material and technical basis of municipal health care institutions has progressed, salary of primary health care division specialists has increased. Over this period, infant mortality and mortality among able-bodied population in the region has decreased, birth rate has increased, coefficient of natural loss of population has reduced, life expectancy has increased.

Characteristics of effective health care managers.

Science.gov (United States)

Johnson, Sherryl W

2005-01-01

This article provides an overview of traditional and contemporary management theories. Concerns, characteristics, and skills of effective managers are also presented. Further, a self-assessment (survey) of 7 highly effective health care managers in a South Georgia community was conducted to determine their ratings on 6 management indices. The assessment or Scale of Transformational Leadership uses a Likert-type scale to allow for the evaluation of managers. The scale contains 6 management elements for assessment: attention, meaning, trust, self, vision, and feeling. Individual ratings and group summary skills rating are presented. Findings revealed the order of managerial importance of the elements as follows (from highest to lowest): Management of Trust, Management of Attention, Management of Self, Management of Feeling, Management of Meaning, and Management of Risk. As a second tier, the final ratings are corroborated by health care management interns.

MARKETING RESEARCHES OF THE POPULATIONS HEALTH STATE AS A FACTOR OF DEMAND FORMATION IN THE MARKET OF PAID MEDICAL SERVICES

Directory of Open Access Journals (Sweden)

Nataliia Hrechanyk

2017-08-01

Full Text Available The state of health of the population is one of the most important indicators of the well-being of the nation. Important directions of health care reform are optimization of management, rational distribution of limited financial resources, efficient use of material resources, introduction of health insurance, restructuring of treatment and preventive care to the people. Marketing of medical services market is one of the most complex types of marketing. Because it is medical services that are connected with the protection and maintenance of the most important values ​​of a person - life and health. The market for medical services is a combination of socio-economic relations in the healthcare sector. The most important components of the analysis of any market, including the market of medical services, are marketing research, which is a systematic collection, processing, analysis of data and information in order to formulate proposals for effective activities on it. In the field of public health, marketing can be defined as a complex process of planning, economic substantiation and management of the process of provision of medical services, the formation of a pricing policy of the medical-preventive process, ensuring effective communication with patients. The purpose of the study is to identify the health of the population and determine the demand factors for paid health services and their demand. The main task set before market research on the health of the population is the formation and provision of benefits to consumers that meet their needs for qualified medical care and quality of life. The research methods used in the work are based on probabilistic, stratified, quota, representative samples for the entire population of Ivano-Frankivsk and Ivano-Frankivsk region. The obtained results allow us to give a realistic assessment of the main trends and allow us to assess the potential of socio-economic adaptation of the population in the

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.

Is population flow an unintended consequence of alcohol management plans?

Science.gov (United States)

Usher, Kim; Woods, Cindy; Lynch, Paul; Pointing, Shane Boris; Budden, Lea; Barker, Ruth; Catchpoole, Jesani; Clough, Alan

2017-03-01

The aim of this study was to gauge whether, and to what extent, population flow occurred as a result of the implementation of alcohol management plans in Indigenous communities. Alcohol management plans involving carriage limits and dry places were introduced into 15 Queensland Indigenous communities between 2002-2004. Controls on alcohol availability were further tightened between 2008-2010, seeing the closure of eight mainly remote community taverns/canteens. A retrospective observational study was undertaken using data from the Queensland Injury Surveillance Unit. Population flow was measured by changing patterns of alcohol-related injuries in a mining region near dry Indigenous communities following the introduction of alcohol management plans and a control mining region distant from Indigenous communities with alcohol management plans. Data were analysed using descriptive and inferential statistics. Logistic regression was used for the comparison of the characteristics between the emergency department presentations. The rates of alcohol-related injury presentations per 1000/population were calculated and age-standardised to the Australian population. Between the five-year periods 2003-2007 and 2008-2012, alcohol-related injury presentations to the Mount Isa emergency department trebled from an age-adjusted average annual rate of 9·5/1000 in the region's population to 27·1/1000 population. In the control region, alcohol-related emergency department injury presentations did not increase to the same degree with age-adjusted average annual rates of 1·42/1000 and 2·21/1000, respectively. The 10-year pattern of emergency department presentations for alcohol-related injuries increased significantly in the Mount Isa region compared with the control region. Further research should investigate the impacts of population flow related to Indigenous community alcohol management plans. Although initiatives such as alcohol management plans have been implemented to reduce

Employee Health Behaviors, Self-Reported Health Status, and Association With Absenteeism: Comparison With the General Population.

Science.gov (United States)

Yun, Young Ho; Sim, Jin Ah; Park, Eun-Gee; Park, June Dong; Noh, Dong-Young

2016-09-01

To perform a comparison between health behaviors and health status of employees with those of the general population, to evaluate the association between employee health behaviors, health status, and absenteeism. Cross-sectional study enrolled 2433 employees from 16 Korean companies in 2014, and recruited 1000 general population randomly in 2012. The distribution of employee health behaviors, health status, and association with absenteeism were assessed. Employees had significantly worse health status and low rates of health behaviors maintenance compared with the general population. Multiple logistic regression model revealed that regular exercise, smoking cessation, work life balance, proactive living, religious practice, and good physical health status were associated with lower absenteeism. Maintaining health behaviors and having good health status were associated with less absenteeism. This study suggests investment of multidimensional health approach in workplace health and wellness (WHW) programs.

The Thai-Australian Health Alliance: developing health management capacity and sustainability for primary health care services.

Science.gov (United States)

Briggs, D S; Tejativaddhana, P; Cruickshank, M; Fraser, J; Campbell, S

2010-11-01

There have been recent calls for a renewed worldwide focus on primary health care. The Thai-Australian Health Alliance addresses this call by developing health care management capability in primary health care professionals in rural Thailand. This paper describes the history and current activities of the Thai-Australian Health Alliance and its approaches to developing health care management capacity for primary care services through international collaborations in research, education and training over a sustained time period. The Alliance's approach is described herein as a distributed network of practices with access to shared knowledge through collaboration. Its research and education approaches involve action research, multi-methods projects, and evaluative studies in the context of workshops and field studies. WHO principles underpin this approach, with countries sharing practical experiences and outcomes, encouraging leadership and management resource networks, creating clearing houses/knowledge centres, and harmonising and aligning partners with their country's health systems. Various evaluations of the Alliance's activities have demonstrated that a capacity building approach that aligns researchers, educators and health practitioners in comparative and reflective activities can be effective in transferring knowledge and skills among a collaboration's partners. Project participants, including primary health care practitioners, health policy makers and academics embraced the need to acquire management skills to sustain primary care units. Participants believe that the approaches described herein were crucial to developing the management skills needed of health care professionals for rural and remote primary health care. The implementation of this initiative was challenged by pre-existing low opinions of the importance of the management role in health care, but with time the Alliance's activities highlighted for all the importance of health care management

Evaluation of an electronic health record-supported obesity management protocol implemented in a community health center: a cautionary note.

Science.gov (United States)

Steglitz, Jeremy; Sommers, Mary; Talen, Mary R; Thornton, Louise K; Spring, Bonnie

2015-07-01

Primary care clinicians are well-positioned to intervene in the obesity epidemic. We studied whether implementation of an obesity intake protocol and electronic health record (EHR) form to guide behavior modification would facilitate identification and management of adult obesity in a Federally Qualified Health Center serving low-income, Hispanic patients. In three studies, we examined clinician and patient outcomes before and after the addition of the weight management protocol and form. In the Clinician Study, 12 clinicians self-reported obesity management practices. In the Population Study, BMI and order data from 5000 patients and all 40 clinicians in the practice were extracted from the EHR preintervention and postintervention. In the Exposure Study, EHR-documented outcomes for a sub-sample of 46 patients actually exposed to the obesity management form were compared to matched controls. Clinicians reported that the intake protocol and form increased their performance of obesity-related assessments and their confidence in managing obesity. However, no improvement in obesity management practices or patient weight-loss was evident in EHR records for the overall clinic population. Further analysis revealed that only 55 patients were exposed to the form. Exposed patients were twice as likely to receive weight-loss counseling following the intervention, as compared to before, and more likely than matched controls. However, their obesity outcomes did not differ. Results suggest that an obesity intake protocol and EHR-based weight management form may facilitate clinician weight-loss counseling among those exposed to the form. Significant implementation barriers can limit exposure, however, and need to be addressed. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Applying e-health to case management.

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Adams, J M

2000-01-01

The healthcare industry is only beginning to understand e-health. E-health can be defined as the use of technology to directly improve healthcare delivery-affording patients the opportunity to participate in their own healthcare management, provider, and institution. The market is changing rapidly, and innovations, partnerships, and mergers are taking place daily. For healthcare institutions, setting a long-term, yet adaptable e-health strategy is of vital importance for the continued success of the organization. For clinicians, an understanding of and familiarity with technologies can significantly improve workflow, organization, and patient interaction. For the patient, technology can be leveraged as a means to take initiative and responsibility for his/her own health. This article defines e-health and explains the implications and benefits of e-health to nurses and their patients. The article also identifies unique opportunities e-health/e-commerce can provide case managers in promoting patient connectivity, care management, and economy in cost of care.

The match between motivation and performance management of health sector workers in Mali

Directory of Open Access Journals (Sweden)

Touré Hamadassalia

2006-02-01

Full Text Available Abstract Human resources for health (HRH play a central role in improving accessibility to services and quality of care. Their motivation influences this. In Mali, operational research was conducted to identify the match between motivation and the range and use of performance management activities. Objectives To describe the factors motivating and demotivating health workers in Mali and match the motivators with the implementation of performance management. Methods First an exploratory qualitative study was conducted: 28 interviews and eight group discussions were held. This was followed by a cross-sectional survey, during which 370 health workers were interviewed. The study population consisted of health workers of eight professional groups. The following issues were investigated: • motivating and demotivating factors; • experiences with performance management, including: job descriptions, continuous education, supervision, performance appraisal and career development. Findings The study showed that the main motivators of health workers were related to responsibility, training and recognition, next to salary. These can be influenced by performance management (job descriptions, supervisions, continuous education and performance appraisal. Performance management is not optimally implemented in Mali, as job descriptions were not present or were inappropriate; only 13% of interviewees received 4× per year supervision, and training needs were not analysed. Some 48% of the interviewees knew their performance had been appraised in the last two years; the appraisals were perceived as subjective. No other methods were in place to show recognition. The results enabled the research team to propose adaptations or improvements upon existing performance management. Conclusion The results showed the importance of adapting or improving upon performance management strategies to influence staff motivation. This can be done by matching performance management

"Community vital signs": incorporating geocoded social determinants into electronic records to promote patient and population health.

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Bazemore, Andrew W; Cottrell, Erika K; Gold, Rachel; Hughes, Lauren S; Phillips, Robert L; Angier, Heather; Burdick, Timothy E; Carrozza, Mark A; DeVoe, Jennifer E

2016-03-01

Social determinants of health significantly impact morbidity and mortality; however, physicians lack ready access to this information in patient care and population management. Just as traditional vital signs give providers a biometric assessment of any patient, "community vital signs" (Community VS) can provide an aggregated overview of the social and environmental factors impacting patient health. Knowing Community VS could inform clinical recommendations for individual patients, facilitate referrals to community services, and expand understanding of factors impacting treatment adherence and health outcomes. This information could also help care teams target disease prevention initiatives and other health improvement efforts for clinic panels and populations. Given the proliferation of big data, geospatial technologies, and democratization of data, the time has come to integrate Community VS into the electronic health record (EHR). Here, the authors describe (i) historical precedent for this concept, (ii) opportunities to expand upon these historical foundations, and (iii) a novel approach to EHR integration. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

A guide to performance management for the Health Information Manager.

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Leggat, Sandra G

This paper provides a summary of human resource management practices that have been identified as being associated with better outcomes in performance management. In general, essential practices include transformational leadership and a coherent program of goal setting, performance monitoring and feedback. Some Health Information Managers may feel they require training assistance to develop the necessary skills in the establishment of meaningful work performance goals for staff and the provision of useful and timely feedback. This paper provides useful information to assist Health Information Managers enhance the performance of their staff.

Health Literacy Assessment in an Otolaryngology Clinic Population.

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Megwalu, Uchechukwu C; Lee, Jennifer Y

2016-12-01

To assess health literacy in an adult tertiary care otolaryngology clinic population and to explore potential determinants of inadequate health literacy. Cross-sectional study. Tertiary care otolaryngology clinic. The study population included all adult patients treated at 3 of Stanford University's adult otolaryngology clinic sites between March 1 and 11, 2016. Data were collected via an anonymous questionnaire. Health literacy was assessed with the Brief Health Literacy Screen. Ten percent of patients had inadequate health literacy. White race (odds ratio [OR], 0.23) and having English as the primary language (OR, 0.12) were associated with adequate health literacy, while high school or lower level of education (OR, 3.2) was associated with inadequate health literacy. Age, sex, and Hispanic ethnicity were not associated with health literacy. Our study highlights the need for health literacy screening in the otolaryngology clinic setting and identifies sociodemographic risk factors for inadequate health literacy. Further studies are needed to assess the impact of health literacy on patient outcomes and to test specific interventions to address health literacy and health outcomes. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.

Relationships between nurse- and physician-to-population ratios and state health rankings.

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Bigbee, Jeri L

2008-01-01

To evaluate the relationship between nurse-to-population ratios and population health, as indicated by state health ranking, and to compare the findings with physician-to-population ratios. Secondary analysis correlational design. The sample consisted of all 50 states in the United States. Data sources included the United Health Foundation's 2006 state health rankings, the 2004 National Sample Survey for Registered Nurses, and the U.S. Health Workforce Profile from the New York Center for Health Workforce Studies. Significant relationships between nurse-to-population ratio and overall state health ranking (rho=-.446, p tf?>=.001) and 11 of the 18 components of that ranking were found. Significant components included motor vehicle death rate, high school graduation rate, violent crime rate, infectious disease rate, percentage of children in poverty, percentage of uninsured residents, immunization rate, adequacy of prenatal care, number of poor mental health days, number of poor physical health days, and premature death rate, with higher nurse-to-population ratios associated with higher health rankings. Specialty (public health and school) nurse-to-population ratios were not as strongly related to state health ranking. Physician-to-population ratios were also significantly related to state health ranking, but were associated with different components than nurses. These findings suggest that greater nurses per capita may be uniquely associated with healthier communities; however, further multivariate research is needed.

[Health problems of working-age population in the Russian Federation].

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Izmerov, N F; Tikhonova, G I

2010-01-01

The paper deals with health problems of working-age population in the Russian Federation. According to foreign and domestic experts reduction of the able-bodied population and its fraction in the general population will be accompanied by ageing of labour force in the nearest two decades. Despite the growth of life expectancy in 2006-2007 demonstrated by disability, mortality and life expectancy indices for the age group of interest, its health status is considered to be critical. Mathematical simulation of mortality rates allowed for the assessment of potential years of life lost (PYLL) from leading causes of death among active working population. The data obtained provide a basis for the elaboration of medical and social programs aimed at increasing life expectancy. The most essential role in current negative tendencies in the health of active working population belongs to the deterioration of work conditions and safety at industrial enterprises coupled to low efficiency of occupational health prevention system accounting for the significantly reduced accessibility of health services. Restoration of occupational health system in Russia is of crucial importance. Experts of the Institute of Occupational Health have elaborated a draft National Action Plan designed to improve health protection of labour force in this country; its implementation would help to solve demographic problems and increase the amount and quality of labour force.

Digital divide: Use of electronic personal health record by different population groups.

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Kim, Eung-Hun; Kim, Yongmin

2010-01-01

Personal Health Record (PHR) has been increasingly recognized and actively promoted by the federal government, experts and industry as an important tool for improving healthcare in the U.S. However, the PHR use by patients and its utility have not been studied well. We have evaluated a web-based PHR in multiple locations covering diverse population groups. The study sites included a surgical specialty clinic, a medical specialty clinic, and a mental health clinic at the University of Washington, and a low-income elderly housing facility near Seattle in the state of Washington. The PHR use by the low-income elderly was limited due to poor technical skills and low physical/cognitive abilities. On the other hand, the younger and affluent populations used the web-based PHR much easily and efficiently compared to the older and low-income group. They regarded managing personal health information easy while the older group struggled. As more computer literate individuals age, the next-generation elderly are certain to be more technically skilled than the current generation. Although the reduced physical/cognitive abilities due to aging would still be a challenge, more elderly people will be able to not only use a PHR system but also use it to the full extent to get the maximum benefit.

An online education approach to population health in a global society.

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Utley-Smith, Queen

2017-07-01

Health professions education content must keep pace with the ever-evolving and changing health care system. Population-based health care is advocated as a way to improve health outcomes, particularly in a technologically advanced health system like the United States. At the same time, global health knowledge is increasingly valued in health professions education, including nursing. This article describes the design and implementation of an online population health course with a global viewpoint intended to accommodate the need for improved knowledge and skill application for graduate nurses. Attention was also given to faculty efficiency during the process of design and implementation. This population-global health course was piloted in a renovated master's curriculum for two semesters. Administering a Course Improvement Survey after initial course offerings assisted faculty to assess and target essential course changes. Data were collected from 106 registered nurse graduate students. Population and global health course objectives were met and students identified areas for course enhancement. Students (90%-94%) reported achieving increased knowledge of population health and global health. Like other creative works, the first rendition of a course requires pedagogical adjustments and editing. Formal student input, when built into the design and implementation of a course can assist faculty to be efficient when crafting essential course changes for subsequent semesters. Data from the survey showed that major population and global subject matter was being grasped by students, the data also revealed that tweaking specific online strategies like making all course content mobile would enhance the course. The course development process and course improvement evaluation for this Population Health in a Global Society course proved valuable in the education of nurses, and helped maintain faculty work efficiency. © 2017 Wiley Periodicals, Inc.

Health literacy among Saudi population: a cross-sectional study.

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Abdel-Latif, Mohamed M M; Saad, Sherif Y

2017-09-12

Health literacy is a major problem worldwide and adversely affects an individual's health. The aim of the present study was to assess health literacy level among Saudi population. A cross-sectional study was conducted among a randomly selected population (n = 500) in Saudi Arabia. The questionnaire comprised of questions pertaining to demographic characteristics, health literacy and health information. Health literacy was measured by REALM-R test. Internal reliability was determined using Cronbach's alpha coefficient. The majority of the respondents had intermediate (43.8%) and basic (34.4%) health literacy levels. A higher percentage among men had intermediate (59.8%) and basic (70.93%) health literacy levels compared with women. About 30% of respondents had difficulty in understanding health screening tests and disease treatment. More than half of participants (52.4%) had difficulty in finding health information. The REALM-R test revealed that about 42.6% of individuals with score of >6 had adequate health literacy compared with 57.4% with score of ≤6 had inadequate health literacy. The present study demonstrated that a majority of Saudi individuals had inadequate health literacy that associated with poor knowledge of health information. Our findings highlighted the importance of understanding the status of health literacy among Saudis and the need for educational programs to raise the health literacy awareness among Saudi population. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

[Public spending on health and population health in Algeria: an econometric analysis].

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Messaili, Moussa; Kaïd Tlilane, Nouara

2017-07-10

Objective: The objective of this study was to estimate the impact of public spending on health, among other determinants of health, on the health of the population in Algeria, using life expectancy (men and women) and infant mortality rates as indicators of health status. Methods: We conducted a longitudinal study over the period from 1974 to 2010 using the ARDL (Autoregressive Distributed Lags) approach to co-integration to estimate the short-term and long-term relationship. Results: Public spending on health has a positive, but not statistically significant impact, in the long and short term, on life expectancy (men and women). However, public spending significantly reduces the infant mortality rate. The long-term impact of the number of hospital beds is significant for the life expectancy of men, but not for women and infant mortality, but is significant for all indicators in the short-term relationship. The most important variables in improving the health of the population are real GDP per capita and fertility rate.

Population health and social governance: analyzing the mainstream incorporation of ethnography.

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O'Byrne, Patrick

2012-06-01

Recently, health care workers (researchers, academics, policy writers, clinicians) have begun to view ethnography as an acceptable research methodology for informing public health work. This corresponds with a change in public health practice toward population health, wherein identifiable groups are examined to identify the group-level and contextual factors that affect their health statuses. Although population health-based methodological and outcomes-focused examinations have already occurred regarding ethnography, no extant literature scrutinizes the incorporation of ethnography into mainstream public and population health work from a sociopolitical viewpoint. Consequently, such an investigation occurs here using Foucault's concepts of discipline and Lupton's advancement of Foucault's ideas about the imperative of health. The outcome of this investigation is the assertion that ethnography is a strategic method for disciplining populations that do not respect the imperative of health. In other words, ethnography helps generate the data that can be used to normalize large groups of people.

Economic stress and well-being: Does population health context matter?

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Probst, Tahira M; Sinclair, Robert R; Sears, Lindsay E; Gailey, Nicholas J; Black, Kristen Jennings; Cheung, Janelle H

2018-05-07

The purpose of this study was to investigate the role of county-level population health determinants in predicting individual employee reactions to economic stress. Using multilevel modeling and a population health perspective, we tested a model linking nationally representative individual-level data (N = 100,968) on exposure to economic stressors and county-level population health determinants (N = 3,026) to responses on a composite measure of individual well-being that included the facets of purpose, community, physical, and social well-being, as well as life satisfaction. Results indicate that higher income- and employment-related economic stress were significantly related to poorer well-being. Additionally, living in a county with more positive population health determinants was significantly predictive of individual well-being. Finally, the Level-1 relationship between income-related stress and well-being was significantly attenuated for individuals living in counties with more positive population health determinants. In contrast, employment-related stress had a stronger negative relationship with well-being for individuals who lived in counties with more positive population health determinants. We discuss these findings in light of conservation of resources and relative deprivation theories, as well as how they may extend the scientific foundation for evidence-based social policy and evidence-based intervention programs aimed at lessening the effects of economic stress on individual well-being. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Predicting the impact of the 2011 conflict in Libya on population mental health: PTSD and depression prevalence and mental health service requirements.

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Fiona J Charlson

Full Text Available BACKGROUND: Mental disorders are likely to be elevated in the Libyan population during the post-conflict period. We estimated cases of severe PTSD and depression and related health service requirements using modelling from existing epidemiological data and current recommended mental health service targets in low and middle income countries (LMIC's. METHODS: Post-conflict prevalence estimates were derived from models based on a previously conducted systematic review and meta-regression analysis of mental health among populations living in conflict. Political terror ratings and intensity of exposure to traumatic events were used in predictive models. Prevalence of severe cases was applied to chosen populations along with uncertainty ranges. Six populations deemed to be affected by the conflict were chosen for modelling: Misrata (population of 444,812, Benghazi (pop. 674,094, Zintan (pop. 40,000, displaced people within Tripoli/Zlitan (pop. 49,000, displaced people within Misrata (pop. 25,000 and Ras Jdir camps (pop. 3,700. Proposed targets for service coverage, resource utilisation and full-time equivalent staffing for management of severe cases of major depression and post-traumatic stress disorder (PTSD are based on a published model for LMIC's. FINDINGS: Severe PTSD prevalence in populations exposed to a high level of political terror and traumatic events was estimated at 12.4% (95%CI 8.5-16.7 and was 19.8% (95%CI 14.0-26.3 for severe depression. Across all six populations (total population 1,236,600, the conflict could be associated with 123,200 (71,600-182,400 cases of severe PTSD and 228,100 (134,000-344,200 cases of severe depression; 50% of PTSD cases were estimated to co-occur with severe depression. Based upon service coverage targets, approximately 154 full-time equivalent staff would be required to respond to these cases sufficiently which is substantially below the current level of resource estimates for these regions. DISCUSSION

LEGAL STATUS AND MANAGEMENT OF THE DINARIC LYNX POPULATION

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Magda Sindičić

2013-09-01

Full Text Available Reintroduction of the Eurasian lynx (Lynx lynx to the Dinaric Mountains in 1973 is one of the rare examples of successful reintroduction of a large predator. Today, Dinaric lynx population includes all lynx in Slovenia south of highway Ljubljana – Trieste, lynx in Croatia as well as lynx in western Bosnia and Herzegovina. It is considered that the population consists of mostly 130 individuals. Being small and endangered, the most important threats for its survival are poaching, depletion of prey, and possible consequences of reduced genetic diversity. In Slovenia, Croatia and the Federation of Bosnia and Herzegovina, the lynx is a protected species, while the current legislation of the Republic of Srpska does not refer to the lynx at all. Slovenia and Croatia have coordinated their monitoring and management activities, while no organized monitoring system is present in Bosnia and Herzegovina. The goal is to establish bilateral cooperation between Croatia and Slovenia as a basis for the management of the entire lynx population in this part of Europe, including primarily Bosnia and Herzegovina but also Austria and Italy.Key words: Eurasian lynx, Lynx lynx, Dinaric population, legal status, management

A psychoanalytic investigation of transference management in the Irish adult public mental health services

OpenAIRE

Moore, Gerard

2012-01-01

Mental health is a pressing issue for society with approximately 700,000 of the Irish population being affected by a mental health problem over the course of their lives. Despite the extensive demand and the national reformation agenda recent reports indicate that patients are unsatisfied and readmission rates remain consistently high indicating that services do not enable recovery. Psychoanalysis has demonstrated that to enable positive change it is essential to manage trans...

Concept Development for Software Health Management

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Riecks, Jung; Storm, Walter; Hollingsworth, Mark

2011-01-01

This report documents the work performed by Lockheed Martin Aeronautics (LM Aero) under NASA contract NNL06AA08B, delivery order NNL07AB06T. The Concept Development for Software Health Management (CDSHM) program was a NASA funded effort sponsored by the Integrated Vehicle Health Management Project, one of the four pillars of the NASA Aviation Safety Program. The CD-SHM program focused on defining a structured approach to software health management (SHM) through the development of a comprehensive failure taxonomy that is used to characterize the fundamental failure modes of safety-critical software.

Which Triple Aim related measures are being used to evaluate population management initiatives? An international comparative analysis.

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Hendrikx, Roy J P; Drewes, Hanneke W; Spreeuwenberg, Marieke; Ruwaard, Dirk; Struijs, Jeroen N; Baan, Caroline A

2016-05-01

Population management (PM) initiatives are introduced in order to create sustainable health care systems. These initiatives should focus on the continuum of health and well-being of a population by introducing interventions that integrate various services. To be successful they should pursue the Triple Aim, i.e. simultaneously improve population health and quality of care while reducing costs per capita. This study explores how PM initiatives measure the Triple Aim in practice. An exploratory search was combined with expert consultations to identify relevant PM initiatives. These were analyzed based on general characteristics, utilized measures and related selection criteria. In total 865 measures were used by 20 PM initiatives. All quality of care domains were included by at least 11 PM initiatives, while most domains of population health and costs were included by less than 7 PM initiatives. Although their goals showed substantial overlap, the measures applied showed few similarities between PM initiatives and were predominantly selected based on local priority areas and data availability. Most PM initiatives do not measure the full scope of the Triple Aim. Additionally, variety between measures limits comparability between PM initiatives. Consensus on the coverage of Triple Aim domains and a set of standardized measures could further both the inclusion of the various domains as well as the comparability between PM initiatives. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Gamification and geospatial health management

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Wortley, David

2014-06-01

Sensor and Measurement technologies are rapidly developing for many consumer applications which have the potential to make a major impact on business and society. One of the most important areas for building a sustainable future is in health management. This opportunity arises because of the growing popularity of lifestyle monitoring devices such as the Jawbone UP bracelet, Nike Fuelband and Samsung Galaxy GEAR. These devices measure physical activity and calorie consumption and, when visualised on mobile and portable devices, enable users to take more responsibility for their personal health. This presentation looks at how the process of gamification can be applied to develop important geospatial health management applications that could not only improve the health of nations but also significantly address some of the issues in global health such as the ageing society and obesity.

Gamification and geospatial health management

International Nuclear Information System (INIS)

Wortley, David

2014-01-01

Sensor and Measurement technologies are rapidly developing for many consumer applications which have the potential to make a major impact on business and society. One of the most important areas for building a sustainable future is in health management. This opportunity arises because of the growing popularity of lifestyle monitoring devices such as the Jawbone UP bracelet, Nike Fuelband and Samsung Galaxy GEAR. These devices measure physical activity and calorie consumption and, when visualised on mobile and portable devices, enable users to take more responsibility for their personal health. This presentation looks at how the process of gamification can be applied to develop important geospatial health management applications that could not only improve the health of nations but also significantly address some of the issues in global health such as the ageing society and obesity

Assessment of implementation of the health management ...

African Journals Online (AJOL)

Background Despite Malawi's introduction of a health management information system (HMIS) in 1999, the country's health sector still lacks accurate, reliable, complete, consistent and timely health data to inform effective planning and resource management. Methods A cross-sectional survey was conducted wherein ...

Dual-Use Aspects of System Health Management

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Owens, P. R.; Jambor, B. J.; Eger, G. W.; Clark, W. A.

1994-01-01

System Health Management functionality is an essential part of any space launch system. Health management functionality is an integral part of mission reliability, since it is needed to verify the reliability before the mission starts. Health Management is also a key factor in life cycle cost reduction and in increasing system availability. The degree of coverage needed by the system and the degree of coverage made available at a reasonable cost are critical parameters of a successful design. These problems are not unique to the launch vehicle world. In particular, the Intelligent Vehicle Highway System, commercial aircraft systems, train systems, and many types of industrial production facilities require various degrees of system health management. In all of these applications, too, the designers must balance the benefits and costs of health management in order to optimize costs. The importance of an integrated system is emphasized. That is, we present the case for considering health management as an integral part of system design, rather than functionality to be added on at the end of the design process. The importance of maintaining the system viewpoint is discussed in making hardware and software tradeoffs and in arriving at design decisions. We describe an approach to determine the parameters to be monitored in any system health management application. This approach is based on Design of Experiments (DOE), prototyping, failure modes and effects analyses, cost modeling and discrete event simulation. The various computer-based tools that facilitate the approach are discussed. The approach described originally was used to develop a fault tolerant avionics architecture for launch vehicles that incorporated health management as an integral part of the system. Finally, we discuss generalizing the technique to apply it to other domains. Several illustrations are presented.

New technology and illness self-management: Potential relevance for resource-poor populations in Asia.

Science.gov (United States)

Lucas, Henry

2015-11-01

Advances in technology have made it possible for many standard diagnostic and health monitoring procedures, traditionally carried out by qualified personnel within medical facilities, to be reliably undertaken by patients or carers in their own homes with a minimum of basic training. There has also been a dramatic increase in the number and diversity of both sources of information on health issues and the possibilities for sharing information and experiences over ICT-based social networks. It has been suggested that these developments have the potential to 'empower' patients, reducing their dependence on providers and possibly improving their quality of care by increasing the volume and timeliness of diagnostic data and encouraging active self-management of their condition, for example through lifestyle changes. Perhaps more significantly, it is also seen by many economies with ageing populations as a way to contain high and ever rising healthcare costs. It has also been suggested that a move to greater self-management supported by expert networks and smart phone technology could improve the treatment of many millions of patients with chronic diseases in low and middle income economies that are also confronting the potential cost implications of epidemiological and demographic transitions, combined with the higher expectations of a more educated and knowledgeable population. There is now limited evidence that some fairly basic e- and mHealth interventions, for example in the areas of MNCH, malaria and HIV/AIDS can have a positive impact, even in resource-poor contexts. The aim here is to explore the extent to which further investment in technology could play a role in the development of an effective and affordable health sector strategy for at least some developing economies. It is suggested that the effectiveness of the approach may be highly dependent on the specific health conditions addressed, the nature of existing health systems and the overall socio

Demographic, epidemiological, and health transitions: are they relevant to population health patterns in Africa?

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Kuate Defo, Barthélémy

2014-01-01

Studies of trends in population changes and epidemiological profiles in the developing world have overwhelmingly relied upon the concepts of demographic, epidemiological, and health transitions, even though their usefulness in describing and understanding population and health trends in developing countries has been repeatedly called into question. The issue is particularly relevant for the study of population health patterns in Africa and sub-Saharan Africa, as the history and experience there differs substantially from that of Western Europe and North America, for which these concepts were originally developed. The aim of this study is two-fold: to review and clarify any distinction between the concepts of demographic transition, epidemiological transition and health transition and to identify summary indicators of population health to test how well these concepts apply in Africa. Notwithstanding the characteristically diverse African context, Africa is a continent of uncertainties and emergencies where discontinuities and interruptions of health, disease, and mortality trends reflect the enduring fragility and instability of countries and the vulnerabilities of individuals and populations in the continent. Africa as a whole remains the furthest behind the world's regions in terms of health improvements and longevity, as do its sub-Saharan African regions and societies specifically. This study documents: 1) theoretically and empirically the similarities and differences between the demographic transition, epidemiological transition, and health transition; 2) simple summary indicators that can be used to evaluate their descriptive and predictive features; 3) marked disparities in the onset and pace of variations and divergent trends in health, disease, and mortality patterns as well as fertility and life expectancy trajectories among African countries and regions over the past 60 years; 4) the rapid decline in infant mortality and gains in life expectancy from the

ROMANIAN FOOD CONSUMPTION AND ITS EFFECTS ON POPULATION'S HEALTH CONDITION

Directory of Open Access Journals (Sweden)

Mihaela CONSTANDACHE

2014-04-01

Full Text Available Public health is a top priority for the European Union. The main factor in ensuring population health is food consumption and in particular food quality. The present paper aims at analyzing Romanian population food consumption during the 1990-2012 periods, its evolution in time; it identifies its main features and their effects on population health. Amid the economic crisis the purchasing power of population is impaired leading to insufficient consumption of fresh fruits and vegetables and a low intake of vitamins, calcium, phosphorous and iron (especially in children, women and elderly people, which could be an important risk factor in the development of chronic diseases.

Politics, welfare regimes, and population health: controversies and evidence.

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Muntaner, Carles; Borrell, Carme; Ng, Edwin; Chung, Haejoo; Espelt, Albert; Rodriguez-Sanz, Maica; Benach, Joan; O'Campo, Patricia

2011-09-01

In recent years, a research area has emerged within social determinants of health that examines the role of politics, expressed as political traditions/parties and welfare state characteristics, on population health. To better understand and synthesise this growing body of evidence, the present literature review, informed by a political economy of health and welfare regimes framework, located 73 empirical and comparative studies on politics and health, meeting our inclusion criteria in three databases: PubMed (1948-), Sociological Abstracts (1953-), and ISI Web of Science (1900-). We identified two major research programmes, welfare regimes and democracy, and two emerging programmes, political tradition and globalisation. Primary findings include: (1) left and egalitarian political traditions on population health are the most salutary, consistent, and substantial; (2) the health impacts of advanced and liberal democracies are also positive and large; (3) welfare regime studies, primarily conducted among wealthy countries, find that social democratic regimes tend to fare best with absolute health outcomes yet consistently in terms of relative health inequalities; and (4) globalisation defined as dependency indicators such as trade, foreign investment, and national debt is negatively associated with population health. We end by discussing epistemological, theoretical, and methodological issues for consideration for future research. © 2011 The Authors. Sociology of Health & Illness © 2011 Foundation for the Sociology of Health & Illness/Blackwell Publishing Ltd.

Comparing population health in the United States and Canada

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Huguet Nathalie

2010-04-01

Full Text Available Abstract Background The objective of the paper is to compare population health in the United States (US and Canada. Although the two countries are very similar in many ways, there are potentially important differences in the levels of social and economic inequality and the organization and financing of and access to health care in the two countries. Methods Data are from the Joint Canada/United States Survey of Health 2002/03. The Health Utilities Index Mark 3 (HUI3 was used to measure overall health-related quality of life (HRQL. Mean HUI3 scores were compared, adjusting for major determinants of health, including body mass index, smoking, education, gender, race, and income. In addition, estimates of life expectancy were compared. Finally, mean HUI3 scores by age and gender and Canadian and US life tables were used to estimate health-adjusted life expectancy (HALE. Results Life expectancy in Canada is higher than in the US. For those Conclusions The population of Canada appears to be substantially healthier than the US population with respect to life expectancy, HRQL, and HALE. Factors that account for the difference may include access to health care over the full life span (universal health insurance and lower levels of social and economic inequality, especially among the elderly.

Medical cost savings for participants and nonparticipants in health risk assessments, lifestyle management, disease management, depression management, and nurseline in a large financial services corporation.

Science.gov (United States)

Serxner, Seth; Alberti, Angela; Weinberger, Sarah

2012-01-01

To compare changes in medical costs between participants and nonparticipants in five different health and productivity management (HPM) programs. Quasi-experimental pre/post intervention study. A large financial services corporation. A cohort population of employees enrolled in medical plans (n  =  49,723) [corrected]. A comprehensive HPM program, which addressed health risks, acute and chronic conditions, and psychosocial disorders from 2005 to 2007. Incentives were used to encourage health risk assessment participation in years 2 and 3. Program participation and medical claims data were collected for members at the end of each program year to assess the change in total costs from the baseline period. Analysis . Multivariate analyses for participation categories were conducted comparing baseline versus program year cost differences, controlling for demographics. All participation categories yielded a lower cost increase compared to nonparticipation and a positive return on investment (ROI) for years 2 and 3, resulting in a 2.45∶1 ROI for the combined program years. Medical cost savings exceeded program costs in a wide variety of health and productivity management programs by the second year.

Integrating genetic data and population viability analyses for the identification of harbour seal (Phoca vitulina) populations and management units

DEFF Research Database (Denmark)

Olsen, Morten Tange; Andersen, Liselotte Wesley; Dietz, Rune

2014-01-01

present a novel approach, integrating genetic, life-history and demographic data to identify populations and management units in southern Scandinavian harbour seals. First, 15 microsatellite markers and model- and distance-based genetic clustering methods were used to determine the population genetic...... structure in harbour seals. Second, we used harbour seal demographic and life-history data to conduct population viability analyses (PVAs) in the VORTEX simulation model in order to determine whether the inferred genetic units could be classified as management units according to Lowe and Allendorf's (2010......, and that the combined use of genetic data and PVAs constitute a promising approach for delineating populations and management units. This article is protected by copyright. All rights reserved....

FastStats: Health of Black or African American non-Hispanic Population

Science.gov (United States)

... Health of Black or African American non-Hispanic Population Recommend on Facebook Tweet Share Compartir Data are ... Source: Summary Health Statistics Tables for the U.S. Population: National Health Interview Survey, 2015, Table P-1c [ ...

A Social Work Approach to Policy: Implications for Population Health.

Science.gov (United States)

Miller, Daniel P; Bazzi, Angela R; Allen, Heidi L; Martinson, Melissa L; Salas-Wright, Christopher P; Jantz, Kathryn; Crevi, Katherine; Rosenbloom, David L

2017-12-01

The substantial disparities in health and poorer outcomes in the United States relative to peer nations suggest the need to refocus health policy. Through direct contact with the most vulnerable segments of the population, social workers have developed an approach to policy that recognizes the importance of the social environment, the value of social relationships, and the significance of value-driven policymaking. This approach could be used to reorient health, health care, and social policies. Accordingly, social workers can be allies to public health professionals in efforts to eliminate disparities and improve population health.

Quality management in Irish health care.

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Ennis, K; Harrington, D

1999-01-01

This paper reports on the findings from a quantitative research study of quality management in the Irish health-care sector. The study findings suggest that quality management is what hospitals require to become more cost-effective and efficient. The research also shows that the culture of health-care institutions must change to one where employees experience pride in their work and where all are involved and committed to continuous quality improvement. It is recommended that a shift is required from the traditional management structures to a more participative approach. Furthermore, all managers whether from a clinical or an administration background must understand one another's role in the organisation. Finally, for quality to succeed in the health-care sector, strong committed leadership is required to overcome tensions in quality implementation.

Changes in chronic disease management among community health centers (CHCs) in China: Has health reform improved CHC ability?

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Wang, Zhaoxin; Shi, Jianwei; Wu, Zhigui; Xie, Huiling; Yu, Yifan; Li, Ping; Liu, Rui; Jing, Limei

2017-07-01

Since the 1980s, China has been criticized for its mode of chronic disease management (CDM) that passively provides treatment in secondary and tertiary hospitals but lacks active prevention in community health centers (CHCs). Since there are few systematic evaluations of the CHCs' methods for CDM, this study aimed to analyze their abilities. On the macroperspective, we searched the literature in China's largest and most authoritative databases and the official websites of health departments. Literature was used to analyze the government's efforts in improving CHCs' abilities to perform CDM. At the microlevel, we examined the CHCs' longitudinal data after the New Health Reform in 2009, including financial investment, facilities, professional capacities, and the conducted CDM activities. A policy analysis showed that there was an increasing tendency towards government efforts in developing CDM, and the peak appeared in 2009. By evaluating the reform at CHCs, we found that there was an obvious increase in fiscal and public health subsidies, large-scale equipment, general practitioners, and public health physicians. The benefited vulnerable population in this area also rose significantly. However, rural centers were inferior in their CDM abilities compared with urban ones, and the referral system is still not effective in China. This study showed that CHCs are increasingly valued in managing chronic diseases, especially after the New Health Reform in 2009. However, we still need to improve collaborative management for chronic diseases in the community and strengthen the abilities of CHCs, especially in rural areas. Copyright © 2017 John Wiley & Sons, Ltd.

Socioeconomic characteristics of the population living in Roma settlements and their association with health and health-related behaviour.

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Gecková, Andrea Madarasová; Babinská, Ingrid; Bobáková, Daniela; Veselská, Zuzana Dankulincová; Bosáková, Lucia; Kolarcik, Peter; Jarcuska, Peter; Pella, Daniel; Halánová, Monika

2014-03-01

The aim of this study was to compare socioeconomic characteristics of the Roma population living in Roma settlements with the majority population. Moreover, it was aimed to assess socioeconomic differences in health and health-related behaviour within the population living in Roma settlements. Data from the cross-sectional HepaMeta study conducted in Slovakia in 2011 were used. The sample consisted of 452 Roma (mean age = 34.7; 35.2% men) and 403 non-Roma (mean age = 33.5; 45.9% men) respondents. Roma in selected settlements were recruited by local Roma community workers. Respondents from the major population were randomly selected from a list of patients from general practitioners. Data were collected via questionnaire, anthropometric measures and analysed blood samples. Differences in socioeconomic characteristics between the population living in Roma settlements and the majority population were tested using the chi-square test. The contribution of selected socioeconomic characteristics on health and health-related behaviour of the population living in Roma settlements was assessed by logistic regression models adjusted for age and gender. The population living in Roma settlements is characterised by significantly lower socioeconomic standards, and the living conditions are significantly worse compared with the majority. With few exceptions, the study did not confirm any significant association between socioeconomic indicators and health and health-related behaviour within the population living in Roma settlements. The deteriorating effect of living in Roma settlement on health and health-related behaviour seems to be immense regardless differences in socioeconomic characteristics or living condition within the settlement population.

Managing the health of the elite athlete: a new integrated performance health management and coaching model.

Science.gov (United States)

Dijkstra, H Paul; Pollock, N; Chakraverty, R; Alonso, J M

2014-04-01

Elite athletes endeavour to train and compete even when ill or injured. Their motivation may be intrinsic or due to coach and team pressures. The sports medicine physician plays an important role to risk-manage the health of the competing athlete in partnership with the coach and other members of the support team. The sports medicine physician needs to strike the right ethical and operational balance between health management and optimising performance. It is necessary to revisit the popular delivery model of sports medicine and science services to elite athletes based on the current reductionist multispecialist system lacking in practice an integrated approach and effective communication. Athlete and coach in isolation or with a member of the multidisciplinary support team, often not qualified or experienced to do so, decide on the utilisation of services and how to apply the recommendations. We propose a new Integrated Performance Health Management and Coaching model based on the UK Athletics experience in preparation for the London Olympic and Paralympic Games. The Medical and Coaching Teams are managed by qualified and experienced individuals operating in synergy towards a common performance goal, accountable to a Performance Director and ultimately to the Board of Directors. We describe the systems, processes and implementation strategies to assist the athlete, coach and support teams to continuously monitor and manage athlete health and performance. These systems facilitate a balanced approach to training and competing decisions, especially while the athlete is ill or injured. They take into account the best medical advice and athlete preference. This Integrated Performance Health Management and Coaching model underpinned the Track and Field Gold Medal performances at the London Olympic and Paralympic Games.

European organic dairy farmers' preference for animal health management within the farm management system.

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van Soest, F J S; Mourits, M C M; Hogeveen, H

2015-11-01

The expertise and knowledge of veterinary advisors on improving animal health management is key towards a better herd health status. However, veterinary advisors are not always aware of the goals and priorities of dairy farmers. To dairy farmers animal health is only one aspect of farm management and resources may be allocated to other more preferred areas. Veterinary advisors may experience this as non-compliant with their advice. To explore the preferences of European Union (EU) organic dairy farmers for improved animal health management relative to other farm management areas an adaptive conjoint analysis (ACA) was performed. A total of 215 farmers participated originating from organic dairy farms in France (n = 70), Germany (n = 60), Spain (n = 28) and Sweden (n = 57). The management areas udder health and claw health represented animal health management whereas barn, calf and pasture management represented potential conflicting management areas. Results indicate that EU organic dairy farmers differ in their preferences for improved animal health management within the farming system. In general, improved calf management was the most preferred area and improved claw health management was found to be least preferred, the remaining areas were of intermediate interest. Cluster analyses on claw health measures and udder health measures resulted in respectively seven and nine distinct preference profiles. The results indicate a high degree of variation in farmers' preference, which cannot be explained by the typical herd characteristics. With the individual preferences revealed by ACA, a veterinary advisor can now find out whether his intended advice is directed at a favourable or unfavourable management area of the farmer. If the latter is the case the veterinarian should first create awareness of the problem to the farmer. Insights in individual farmers preferences will allow veterinary advisors to better understand why farmers were incompliant with their advice

Nutrition training improves health workers' nutrition knowledge and competence to manage child undernutrition: a systematic review.

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Sunguya, Bruno F; Poudel, Krishna C; Mlunde, Linda B; Urassa, David P; Yasuoka, Junko; Jimba, Masamine

2013-09-24

Medical and nursing education lack adequate practical nutrition training to fit the clinical reality that health workers face in their practices. Such a deficit creates health workers with poor nutrition knowledge and child undernutrition management practices. In-service nutrition training can help to fill this gap. However, no systematic review has examined its collective effectiveness. We thus conducted this study to examine the effectiveness of in-service nutrition training on health workers' nutrition knowledge, counseling skills, and child undernutrition management practices. We conducted a literature search on nutrition interventions from PubMed/MEDLINE, CINAHL, EMBASE, ISI Web of Knowledge, and World Health Organization regional databases. The outcome variables were nutrition knowledge, nutrition-counseling skills, and undernutrition management practices of health workers. Due to heterogeneity, we conducted only descriptive analyses. Out of 3910 retrieved articles, 25 were selected as eligible for the final analysis. A total of 18 studies evaluated health workers' nutrition knowledge and showed improvement after training. A total of 12 studies with nutrition counseling as the outcome variable also showed improvement among the trained health workers. Sixteen studies evaluated health workers' child undernutrition management practices. In all such studies, child undernutrition management practices and competence of health workers improved after the nutrition training intervention. In-service nutrition training improves quality of health workers by rendering them more knowledge and competence to manage nutrition-related conditions, especially child undernutrition. In-service nutrition training interventions can help to fill the gap created by the lack of adequate nutrition training in the existing medical and nursing education system. In this way, steps can be taken toward improving the overall nutritional status of the child population.

Moving Upstream in U.S. Hospital Care Toward Investments in Population Health.

Science.gov (United States)

Begun, James W; Potthoff, Sandra

The root causes for most health outcomes are often collectively referred to as the social determinants of health. Hospitals and health systems now must decide how much to "move upstream," or invest in programs that directly affect the social determinants of health. Moving upstream in healthcare delivery requires an acceptance of responsibility for the health of populations. We examine responses of 950 nonfederal, general hospitals in the United States to the 2015 American Hospital Association Population Health Survey to identify characteristics that distinguish those hospitals that are most aligned with population health and most engaged in addressing social determinants of health. Those "upstream" hospitals are significantly more likely to be large, not-for-profit, metropolitan, teaching-affiliated, and members of systems. Internally, the more upstream hospitals are more likely to organize their population health activities with strong executive-level involvement, full-time-equivalent support, and coordination at the system level.The characteristics differentiating hospitals strongly involved in population health and upstream activity are not unlike those characteristics associated with diffusion of many innovations in hospitals. These hospitals may be the early adopters in a diffusion process that will eventually include most hospitals or, at least, most not-for-profit hospitals. Alternatively, the population health and social determinants movements could be transient or could be limited to a small portion of hospitals such as those identified here, with distinctive patient populations, missions, and resources.

[Hospital governance: between crisis management and implementation of public health policy].

Science.gov (United States)

Bréchat, Pierre-Henri; Antoine, Leenhardt; Mathieu-Grenouilleau, Marie-Christine; Rymer, Roland; Matisse, François; Baraille, Denis; Beaufils, Philippe

2010-01-01

The implementation of the recent act to amend the law on hospitals, patient health and territories (HPST Law) completes the reform of the organization and governance of health facilities, which was announced in 2002 by the "Hospital 2007" plan. What kind of assessments and perspectives can be considered and envisaged for these Hospital Activity Poles? We compared our experience with a review of the professional and scientific literature in order to stimulate answers to these questions for advocacy purposes prior to the Act's implementation. The hospital's cluster of activities should reinforce--not call into question the core activities and the financial stability of the facility, while respecting the contract on agreed objectives and the necessary means and resources to meet the health needs of the catchment population as well as national priorities. Although significant, but limited, successes exist, five obstacles to hospital reorganization can be identified. These include, for example: lack of delegation of management and centralization of decisions, the heterogeneity of numerous Hospital Activity Poles or problems related to timing. These obstacles may cause strain, or put the Hospital Activity Poles and the health facilities in a difficult situation with respect to their dynamics. This may show that the State and social health insurance should steer and direct public health policy and that the delegation of management roles and responsibilities to the Hospital Activity Poles should be addressed.

A systematic review of population health interventions and Scheduled Tribes in India

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Labonté Ronald

2010-07-01

Full Text Available Abstract Background Despite India's recent economic growth, health and human development indicators of Scheduled Tribes (ST or Adivasi (India's indigenous populations lag behind national averages. The aim of this review was to identify the public health interventions or components of these interventions that are effective in reducing morbidity or mortality rates and reducing risks of ill health among ST populations in India, in order to inform policy and to identify important research gaps. Methods We systematically searched and assessed peer-reviewed literature on evaluations or intervention studies of a population health intervention undertaken with an ST population or in a tribal area, with a population health outcome(s, and involving primary data collection. Results The evidence compiled in this review revealed three issues that promote effective public health interventions with STs: (1 to develop and implement interventions that are low-cost, give rapid results and can be easily administered, (2: a multi-pronged approach, and (3: involve ST populations in the intervention. Conclusion While there is a growing body of knowledge on the health needs of STs, there is a paucity of data on how we can address these needs. We provide suggestions on how to undertake future population health intervention research with ST populations and offer priority research avenues that will help to address our knowledge gap in this area.

[Health services utilization by the immigrant population in Spain].

Science.gov (United States)

Regidor, Enrique; Sanz, Belén; Pascual, Cruz; Lostao, Lourdes; Sánchez, Elisabeth; Díaz Olalla, José Manuel

2009-12-01

To compare health services utilization between the immigrant and indigenous populations in Spain. We used information provided by the following four health surveys carried out around 2005: Catalonia 2005; city of Madrid 2005, Canary Islands 2004 and the Autonomous Community of Valencia 2005. The health services studied were general practice, specialist services, emergency services, hospitalization, and two preventive services: pap smear test and mammography. In general, most health services were less frequently used by the immigrant population than by the Spanish population. The health services showing the least differences between the two populations were general practice and hospitalization, while the greatest differences were found in the use of specialist and preventive services. The most heterogeneous results were found in general practice and hospitalization, since some immigrant groups showed a relatively high frequency of use in some geographical areas and a relatively low frequency in other areas. The results of the present study reproduce those found in other studies carried out in countries with similar social and economic characteristics to Spain. Like previous results, the present results are difficult to explain. Future research should aim to use other study designs and to test hypotheses not put forward by the scientific community to date.

Population Health Vulnerabilities to Vector-borne Diseases ...

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

Damming, irrigation and other forms of water management are also creating new habitats ... adaptation, particularly to improve the resilience of vulnerable populations. ... Linking research to urban planning at the ICLEI World Congress 2018.

Women as managers in the health services

Directory of Open Access Journals (Sweden)

Jocelyne Kane Berman

1989-09-01

Full Text Available Despite their numerical superiority women do not occupy positions o f power and authority in the health services generally. This is perceived as being due to a variety of factors which prevent women from realising their ful l potential as managers. In other parts of the world, as well as in South Africa, middle class white males have dominated health services, since medicine became a form al science, usurping the traditional role of women healers. Some research indicates that women are inclined to practice “feminine " management styles. It is suggested that the femine I masculine dichotomy is artificial and that qualities which ensure effective management should not be regarded as genderlinked. Leaders in the health services should strive for interdisciplinary, mixed-gender education and training at all levels. Identification and development of management potential in women health-care professionals, role-modelling and sponsor-mentor relationships should be encouraged to allow women to acquire the full range of management skills and to achieve positions of power and authority in the health services.

Exploring the relationship between population density and maternal health coverage

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Hanlon Michael

2012-11-01

Full Text Available Abstract Background Delivering health services to dense populations is more practical than to dispersed populations, other factors constant. This engenders the hypothesis that population density positively affects coverage rates of health services. This hypothesis has been tested indirectly for some services at a local level, but not at a national level. Methods We use cross-sectional data to conduct cross-country, OLS regressions at the national level to estimate the relationship between population density and maternal health coverage. We separately estimate the effect of two measures of density on three population-level coverage rates (6 tests in total. Our coverage indicators are the fraction of the maternal population completing four antenatal care visits and the utilization rates of both skilled birth attendants and in-facility delivery. The first density metric we use is the percentage of a population living in an urban area. The second metric, which we denote as a density score, is a relative ranking of countries by population density. The score’s calculation discounts a nation’s uninhabited territory under the assumption those areas are irrelevant to service delivery. Results We find significantly positive relationships between our maternal health indicators and density measures. On average, a one-unit increase in our density score is equivalent to a 0.2% increase in coverage rates. Conclusions Countries with dispersed populations face higher burdens to achieve multinational coverage targets such as the United Nations’ Millennial Development Goals.

Health and disease in unacculturated Amerindian populations

Energy Technology Data Exchange (ETDEWEB)

Neel, J V

1977-08-01

The stereotype of uncontacted tribal populations is that they must reproduce at near capacity to maintain or slightly increase their numbers. This paper argues that the health of minimally contacted Amerindians, as judged by the results of physical examinations and life tables for the Yanomama of Southern Venezuela and Northern Brazil, is relatively good, with population control a feature of the Indian culture. It is further argued that the usual deterioration in health with contacts with western culture probably does not result so much from special innate susceptibilities to certain epidemic diseases and to the diets and ''stresses'' of civilization as from the epidemiological characteristics of newly contacted peoples.

Crisis Management in the Health Sector: Qualities and characteristics of health crisis managers

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Manwlidou Zacharoula

2009-01-01

Full Text Available The rapidly evolving nature of today’s health systems and the need to adapt to modern demands,require that these systems are staffed with skilled health crisis managers. Based on that scenario, crisis managerswith good knowledge and training, adequate experience, as well as virtues of excellent organizational skills,operational planning, mental power and social sensitivity, can play a key role in dealing successfully with crisesin the health sector.

Assessing the population coverage of a health demographic surveillance system using satellite imagery and crowd-sourcing.

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Aurelio Di Pasquale

Full Text Available Remotely sensed data can serve as an independent source of information about the location of residential structures in areas under demographic and health surveillance. We report on results obtained combining satellite imagery, imported from Bing, with location data routinely collected using the built-in GPS sensors of tablet computers, to assess completeness of population coverage in a Health and Demographic Surveillance System in Malawi. The Majete Malaria Project Health and Demographic Surveillance System, in Malawi, started in 2014 to support a project with the aim of studying the reduction of malaria using an integrated control approach by rolling out insecticide treated nets and improved case management supplemented with house improvement and larval source management. In order to support the monitoring of the trial a Health and Demographic Surveillance System was established in the area that surrounds the Majete Wildlife Reserve (1600 km2, using the OpenHDS data system. We compared house locations obtained using GPS recordings on mobile devices during the demographic surveillance census round with those acquired from satellite imagery. Volunteers were recruited through the crowdcrafting.org platform to identify building structures on the images, which enabled the compilation of a database with coordinates of potential residences. For every building identified on these satellite images by the volunteers (11,046 buildings identified of which 3424 (ca. 30% were part of the censused area, we calculated the distance to the nearest house enumerated on the ground by fieldworkers during the census round of the HDSS. A random sample of buildings (85 structures identified on satellite images without a nearby location enrolled in the census were visited by a fieldworker to determine how many were missed during the baseline census survey, if any were missed. The findings from this ground-truthing effort suggest that a high population coverage was

Demographic, epidemiological, and health transitions: are they relevant to population health patterns in Africa?

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Barthélémy Kuate Defo

2014-05-01

Full Text Available Background: Studies of trends in population changes and epidemiological profiles in the developing world have overwhelmingly relied upon the concepts of demographic, epidemiological, and health transitions, even though their usefulness in describing and understanding population and health trends in developing countries has been repeatedly called into question. The issue is particularly relevant for the study of population health patterns in Africa and sub-Saharan Africa, as the history and experience there differs substantially from that of Western Europe and North America, for which these concepts were originally developed. Objective: The aim of this study is two-fold: to review and clarify any distinction between the concepts of demographic transition, epidemiological transition and health transition and to identify summary indicators of population health to test how well these concepts apply in Africa. Results: Notwithstanding the characteristically diverse African context, Africa is a continent of uncertainties and emergencies where discontinuities and interruptions of health, disease, and mortality trends reflect the enduring fragility and instability of countries and the vulnerabilities of individuals and populations in the continent. Africa as a whole remains the furthest behind the world's regions in terms of health improvements and longevity, as do its sub-Saharan African regions and societies specifically. This study documents: 1 theoretically and empirically the similarities and differences between the demographic transition, epidemiological transition, and health transition; 2 simple summary indicators that can be used to evaluate their descriptive and predictive features; 3 marked disparities in the onset and pace of variations and divergent trends in health, disease, and mortality patterns as well as fertility and life expectancy trajectories among African countries and regions over the past 60 years; 4 the rapid decline in infant

Demographic, epidemiological, and health transitions: are they relevant to population health patterns in Africa?

Science.gov (United States)

Kuate Defo, Barthélémy

2014-01-01

Background Studies of trends in population changes and epidemiological profiles in the developing world have overwhelmingly relied upon the concepts of demographic, epidemiological, and health transitions, even though their usefulness in describing and understanding population and health trends in developing countries has been repeatedly called into question. The issue is particularly relevant for the study of population health patterns in Africa and sub-Saharan Africa, as the history and experience there differs substantially from that of Western Europe and North America, for which these concepts were originally developed. Objective The aim of this study is two-fold: to review and clarify any distinction between the concepts of demographic transition, epidemiological transition and health transition and to identify summary indicators of population health to test how well these concepts apply in Africa. Results Notwithstanding the characteristically diverse African context, Africa is a continent of uncertainties and emergencies where discontinuities and interruptions of health, disease, and mortality trends reflect the enduring fragility and instability of countries and the vulnerabilities of individuals and populations in the continent. Africa as a whole remains the furthest behind the world's regions in terms of health improvements and longevity, as do its sub-Saharan African regions and societies specifically. This study documents: 1) theoretically and empirically the similarities and differences between the demographic transition, epidemiological transition, and health transition; 2) simple summary indicators that can be used to evaluate their descriptive and predictive features; 3) marked disparities in the onset and pace of variations and divergent trends in health, disease, and mortality patterns as well as fertility and life expectancy trajectories among African countries and regions over the past 60 years; 4) the rapid decline in infant mortality and gains

Health care units and human resources management trends.

Science.gov (United States)

André, Adriana Maria; Ciampone, Maria Helena Trench; Santelle, Odete

2013-02-01

To identify factors producing new trends in basic health care unit management and changes in management models. This was a prospective study with ten health care unit managers and ten specialists in the field of Health in São Paulo, Southeastern Brazil, in 2010. The Delphi methodology was adopted. There were four stages of data collection, three quantitative and the fourth qualitative. The first three rounds dealt with changing trends in management models, manager profiles and required competencies, and the Mann-Whitney test was used in the analysis. The fourth round took the form of a panel of those involved, using thematic analysis. The main factors which are driving change in basic health care units were identified, as were changes in management models. There was consensus that this process is influenced by the difficulties in managing teams and by politics. The managers were found to be up-to-date with trends in the wider context, with the arrival of social health organizations, but they are not yet anticipating these within the institutions. Not only the content, but the professional development aspect of training courses in this area should be reviewed. Selection and recruitment, training and assessment of these professionals should be guided by these competencies aligned to the health service mission, vision, values and management models.

A Social Work Approach to Policy: Implications for Population Health

Science.gov (United States)

Bazzi, Angela R.; Allen, Heidi L.; Martinson, Melissa L.; Salas-Wright, Christopher P.; Jantz, Kathryn; Crevi, Katherine; Rosenbloom, David L.

2017-01-01

The substantial disparities in health and poorer outcomes in the United States relative to peer nations suggest the need to refocus health policy. Through direct contact with the most vulnerable segments of the population, social workers have developed an approach to policy that recognizes the importance of the social environment, the value of social relationships, and the significance of value-driven policymaking. This approach could be used to reorient health, health care, and social policies. Accordingly, social workers can be allies to public health professionals in efforts to eliminate disparities and improve population health. PMID:29236535

ASSESSMENT OF LOGISTICS MANAGEMENT IN GHANA HEALTH SERVICE

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john frimpong manso

2013-08-01

Full Text Available Ghana Public Health Sector runs a three-tier system of managing health commodities. Suppliers, the Central Medical Store, The Regional Medical Store, Service Delivery Points and the transportation system form the supply chain.  Ghana Health Service logistics system is centralized and the health care delivery system is decentralized. Logistics management in the health system is crucial. This is because there are instances where medicines and health commodities are not available at the Central Medical Stores and the Regional Medical Stores. Consequently, there is no commodity security at the service delivery points. Upon this backdrop the study seeks to assess the logistics management system in order to bring efficiency in the system. The study adopts a multi-case study approach to assess the practices of logistics management, the causes of inadequacy of logistics and the strengths and weaknesses in Ghana Health Service logistics system.  Two categories of participants that is, the key players of health logistics management and end-users were involved in the study.  Four variables; finance for procurement of health commodities, evenly distribution of health commodities, effective supervision and constant monitoring and evaluation were found crucial in effective and efficient logistics management. Moreover, it was found that poor procurement planning and budgeting, lack of financial resources for procurement, poor quantification and forecasting, delay in procurement process and order processing, and delay in receiving insurance claims are some of the causes of inadequacy of logistics in the health systems. It is recommended that Ghana Health Service logistics or supply system must receive constant monitoring and evaluation. Further, Ghana Health Service must ensure that there is effective top-down supervision in the system to bring up efficiency. Again, Ghana Health Service and Ministry of Health must ensure enough funds are secured from the

Health promotion in Swedish schools: school managers' views.