WorldWideScience

Sample records for public healthcare systems

  1. Accounting System in Croatian Public Healthcare Organizations: an Empirical Analysis

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    Davor VAŠIČEK

    2010-06-01

    Full Text Available In considering the adequacy of adopting accruals and IPSASs, this paper tests the appropriateness of existing modified accrual accounting and financial reporting system in Croatian public healthcare sector. The paper indicates that accounting information system contains discrepancies and constraints in assuring true and fair view of organization’s financial position and performance. Our statistics confirms low level of cost and managerial accounting methods development, and external and internal financial reporting convergence.Having in mind its specificities, we argue that Croatian public healthcare sector represents a segmental accounting subsystem within the integral public sector accounting framework, where accruals implementation might prove justifiable.

  2. Public trust in the healthcare system in a developing country.

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    Peters, Dexnell; Youssef, Farid F

    2016-04-01

    Broadly defined, trust in the healthcare system is concerned with how the public perceives the system and the actors therein as it pertains to their ability to both deliver services and seek the best interests of their clientele. Trust is important because it impacts upon a range of health behaviors including compliance and ultimately affects the ability of the healthcare system to meet its goals. While several studies exist on public trust within the developed world, few studies have explored this issue in developing countries. This paper therefore assesses public trust in the healthcare system of a developing small island nation, Trinidad and Tobago. A cross-sectional survey of adults was conducted using a questionnaire that has been successfully used across Europe. We report that trust levels in the healthcare system in Trinidad and Tobago are relatively low with less than 50% of persons indicating fair trust in the healthcare system. In addition, individual health professionals also did not score highly with lowest scores found for nurses and complementary therapists. Results on four out of five dimensions of trust also demonstrated scores significantly lower than those reported in more developed nations. Open-ended comments supported these findings with the majority of persons indicating a lack of confidence in the healthcare system. These results may reflect the reality in the wider developing world, and we suggest that bolstering trust is a needed area of focus in the delivery of healthcare services throughout the nation. Copyright © 2014 John Wiley & Sons, Ltd. Copyright © 2014 John Wiley & Sons, Ltd.

  3. Socioeconomic Status and Satisfaction with Public Healthcare System in Iran.

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    Maharlouei, Najmeh; Akbari, Mojtaba; Akbari, Maryam; Lankarani, Kamran B

    2017-01-01

    The users' satisfaction is a method for evaluating the efficacy of healthcare system. We aimed to evaluate the association between the users' socioeconomic status (SES) and satisfaction with the healthcare system in Shiraz, Iran. This cross-sectional study was conducted from December, 2013 to March, 2014, in Shiraz, Iran. 3400 households were recruited by multi-stage cluster random sampling. Information about demographic, insurance status, and users' satisfaction was derived from face-to-face interviews. Satisfaction with healthcare system was assessed by using 5-point Likert scale statements, which ranged from "very dissatisfied" to "very satisfied". All statistical analyses were performed using SPSS-21. Overall, 1.6% (55) of the respondents were very satisfied, while 6% (203) were very dissatisfied with healthcare system. Participants were classified into high SES (26.3%), middle SES (47.9%) and low SES (25.8%). It was discovered that the better the SES, the more frequent were the respondents dissatisfied with healthcare system (Psystem (P=0.005). Also, dissatisfied respondents had significantly a higher level of education than satisfied ones (Psystem. This study demonstrated that users' sex, age, educational level, and SES were related to dissatisfaction with healthcare system. Meanwhile, clients' age, SES, insurance status and marital status were recognized as determinant factors.

  4. Funding New Zealand's public healthcare system: time for an honest appraisal and public debate.

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    Keene, Lyndon; Bagshaw, Philip; Nicholls, M Gary; Rosenberg, Bill; Frampton, Christopher M; Powell, Ian

    2016-05-27

    Successive New Zealand governments have claimed that the cost of funding the country's public healthcare services is excessive and unsustainable. We contest that these claims are based on a misrepresentation of healthcare spending. Using data from the New Zealand Treasury and the Organisation for Economic Cooperation and Development (OECD), we show how government spending as a whole is low compared with most other OECD countries and is falling as a proportion of GDP. New Zealand has a modest level of health spending overall, but government health spending is also falling as a proportion of GDP. Together, the data indicate the New Zealand Government can afford to spend more on healthcare. We identify compelling reasons why it should do so, including forecast growing health need, signs of increasing unmet need, and the fact that if health needs are not met the costs still have to be borne by the economy. The evidence further suggests it is economically and socially beneficial to meet health needs through a public health system. An honest appraisal and public debate is needed to determine more appropriate levels of healthcare spending.

  5. Business Intelligence and its Applications in the Public Healthcare System

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    Puangrat JINPON

    2011-06-01

    Full Text Available Business intelligence (BI has been known as a popular tool in business management and decision support systems. BI helps to transform raw data into smart information. There are many BI tools such as extract transform and load (ETL, data warehouse, online analytical processing (OLAP, and dashboard. BI tools are usually used in public health fields for financial and administrative purposes. Now BI is also helping public health organisations with diagnosing and treating patients with long term conditions and evaluating alternative treatments based on outcomes analyses. BI is composed of four steps: integration, storage, analysis, and presentation. BI usually uses a dashboard in the presentation step to deliver the information to end users. The development an effective dashboard is still a challenge.Graphical abstract

  6. [Public health stewardship and governance regarding the Colombian healthcare system, 2012-2013].

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    Roth-Deubel, André N; Molina-Marín, Gloria

    2013-01-01

    Analysing decision-making concerning public health issues regarding the Colombian healthcare system from a market economy-based approach. This study involved applying Glaser and Strauss's grounded theory in six Colombian cities during 2012: Bogotá, Barranquilla, Bucaramanga, Leticia, Medellin and Pasto. 120 individual interviews were conducted with professionals involved in decision-making, running public healthcare programmes and making policy within public and private institutions. Fourteen focus groups were held with community organisation leaders. The findings suggested national and municipal health authorities' weak stewardship and ineffective governance regarding public healthcare policy and programmes, related to a lack of staff trained in public health management issues. In turn, this was related to political parties' interference and private insurers' particular interests and the structural fragmentation of functions and actors within the health system, thereby limiting public health development. A new axiology is necessary for achieving effective governance (I.e. cooperation between Colombian Healthcare Social Security System actors) to overcome current incompetence and financial self-interest predominating within the Colombian healthcare system.

  7. Perceptions of dental students regarding dentistry, the job market and the public healthcare system.

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    Costa, Simone de Melo; Silveira, Marise Fagundes; Durães, Sarah Jane Alves; Abreu, Mauro Henrique Nogueira Guimarães de; Bonan, Paulo Rogério Ferreti

    2012-05-01

    The scope was to analyze the perceptions of dentistry students at the State University of Montes Claros, Brazil, regarding dentistry, the job market and the public healthcare system. For this, a triangulation method was employed, using a self-administered questionnaire and interviews. The quantitative data were submitted to univariate and multivariate analysis, using Poisson regression, where pdentistry course prepares students for this market as the curriculum integrates both teaching and service, reported being in favor of greater experience in the public healthcare system and said they would not take classes in Public Health if they were optional. Contact with the social context through teaching/service integration in the advanced semesters of the dentistry course appears to contribute to the development of new professional skills for working in the public sector. However, the students' perceptions revealed contradictions, considering the low value they attributed to the classes on Public Health and their perception of the public system as a residual job option.

  8. PUBLIC FINANCING OF HEALTHCARE SERVICES

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    Agnieszka Bem

    2013-10-01

    Full Text Available Healthcare in Poland is mainly financed by public sector entities, among them the National Health Fund (NFZ, state budget and local government budgets. The task of the National Health Fund, as the main payer in the system, is chiefly currently financing the services. The state budget plays a complementary role in the system, and finances selected groups of services, health insurance premiums and investments in healthcare infrastructure. The basic role of the local governments is to ensure access to the services, mostly by performing ownership functions towards healthcare institutions.

  9. PARTICIPATORY GOVERNANCE IN THE PUBLIC HEALTHCARE SYSTEMS OF THE SCANDINAVIAN AND BALTIC COUNTRIES

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    Stefanescu Aurelia

    2011-12-01

    Full Text Available The diminished trust of citizens in the public sector, the increased complexity of policy issues and the reforms in accordance with the new public management principles generate the need of focusing more extensively on participatory governance. Participatory governance can be defined as the genuine engagement of citizens and other organizations in the formulation of policies and strategies, in the decision-making process from the public sector and in the implementation of the decisions. The present paper's objectives are to define the concept of participatory governance, to argue in favor of implementing it in the public sector and to find to what extent public healthcare institutions from Scandinavian and Baltic countries publish information on participatory governance and how they perceive community engagement. The research findings are that the information on participatory governance disclosed on the websites of relevant institutions from within the Scandinavian and Baltic public healthcare systems is scarce. The countries with the greatest concern for community engagement are Denmark and Sweden. It is argued that there should be a shift in focus within the public sector in general and within the healthcare system in particular, so that citizens are genuinely involved in the relevant processes and their satisfaction is indeed at an adequate level.

  10. Toward a Nationwide Mobile-Based Public Healthcare Service System with Wireless Sensor Networks

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    Chien-wen Shen

    2016-01-01

    Full Text Available This paper describes the development of a nationwide public healthcare service system with the integration of cloud technology, wireless sensor networks, and mobile technology to provide citizens with convenient and professional healthcare services. The basic framework of the system includes the architectures for the user end of wireless physiological examinations, for the regional healthcare cloud, and for national public healthcare service system. Citizens with chronic conditions or elderly people who are living alone can use the wireless physiological sensing devices to keep track of their health conditions and get warning if the system detects abnormal signals. Through mobile devices, citizens are able to get real-time health advice, prompt warning, health information, feedback, personalized support, and intervention ubiquitously. With the long-term tracking data for physiological sensing, reliable prediction models for epidemic diseases and chronic diseases can be developed for the government to respond to and control diseases immediately. Besides, such a nationwide approach enables government to have a holistic understanding of the public health information in real time, which is helpful to establish effective policies or strategies to prevent epidemic diseases or chronic diseases.

  11. Bedside rationing by general practitioners: a postal survey in the Danish public healthcare system

    DEFF Research Database (Denmark)

    Lauridsen, Sigurd; Norup, Michael; Rossel, Peter

    2008-01-01

    ABSTRACT: BACKGROUND: It is ethically controversial whether medical doctors are morally permitted to ration the care of their patients at the bedside. To explore whether general practitioners in fact do ration in this manner we conducted a study within primary care in the Danish public healthcare...... of the study were twofold: an assessment of the proportion of GPs who, in a mainly hypothetical setting, would consider cost-quality trade-offs relevant to their clinical decision-making given their economic impact on the healthcare system; and a measure of the extent to which they would disclose...... this information to patients. RESULTS: In the hypothetical setting 95% of GPs considered cost-quality trade-offs relevant to their clinical decision-making given the economic impact of such trade-offs on the healthcare system. In all 90% stated that this consideration had been relevant in clinical decision...

  12. A web-based information system for a regional public mental healthcare service network in Brazil.

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    Yoshiura, Vinicius Tohoru; de Azevedo-Marques, João Mazzoncini; Rzewuska, Magdalena; Vinci, André Luiz Teixeira; Sasso, Ariane Morassi; Miyoshi, Newton Shydeo Brandão; Furegato, Antonia Regina Ferreira; Rijo, Rui Pedro Charters Lopes; Del-Ben, Cristina Marta; Alves, Domingos

    2017-01-01

    Regional networking between services that provide mental health care in Brazil's decentralized public health system is challenging, partly due to the simultaneous existence of services managed by municipal and state authorities and a lack of efficient and transparent mechanisms for continuous and updated communication between them. Since 2011, the Ribeirao Preto Medical School and the XIII Regional Health Department of the Sao Paulo state, Brazil, have been developing and implementing a web-based information system to facilitate an integrated care throughout a public regional mental health care network. After a profound on-site analysis, the structure of the network was identified and a web-based information system for psychiatric admissions and discharges was developed and implemented using a socio-technical approach. An information technology team liaised with mental health professionals, health-service managers, municipal and state health secretariats and judicial authorities. Primary care, specialized community services, general emergency and psychiatric wards services, that comprise the regional mental healthcare network, were identified and the system flow was delineated. The web-based system overcame the fragmentation of the healthcare system and addressed service specific needs, enabling: detailed patient information sharing; active coordination of the processes of psychiatric admissions and discharges; real-time monitoring; the patients' status reports; the evaluation of the performance of each service and the whole network. During a 2-year period of operation, it registered 137 services, 480 health care professionals and 4271 patients, with a mean number of 2835 accesses per month. To date the system is successfully operating and further expanding. We have successfully developed and implemented an acceptable, useful and transparent web-based information system for a regional mental healthcare service network in a medium-income country with a decentralized

  13. Physician density planning in a public healthcare system: Complexities, threats and opportunities-The case of the Israeli healthcare system.

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    Gamzu, Ronni; Kaidar, Nir; Afek, Arnon; Horev, Tuvia

    2016-08-01

    Human-resource planning in healthcare is one of the most significant challenges that healthcare systems worldwide face. Among all healthcare professions, the planning of physician supply is the most complex of all due to physicians' lengthy training and many specialties. Forecasts showing a disturbing downward trend in the ratio of physicians to population in Israel prompted the Israeli Government in 2010 to establish a committee mandated to predict demand for physicians and recommend steps to adjust supply to it. The committee analyzed numerous variables that affect physician supply and demand and recommended measures that in greater part were implemented. The article discusses the methodology of the committee, its recommendations, and their implementation such as a 52% increase in the number of first-year medical students between 2010 and 2012. Its analysis of the current situation shows that the implementation of the recommendations successfully stemmed the decrease in physician density and attained the committee's other long-term objectives: physician density of 2.9 per 1000 of population and an increase (32.5%) in the number of physicians who began training in targeted specialties. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  14. Factors influencing the role of primary care providers as gatekeepers in the Malaysian public healthcare system.

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    Ang, K T; Ho, B K; Mimi, O; Salmah, N; Salmiah, M S; Noridah, M S

    2014-01-01

    Primary care providers play an important gatekeeping role in ensuring appropriate referrals to secondary care facilities. This cross-sectional study aimed to determine the level, pattern and rate of referrals from health clinics to hospitals in the public sector, and whether the placement of resident family medicine specialist (FMS) had made a significant difference. The study was carried out between March and April in 2012, involving 28 public primary care clinics. It showed that the average referral rate was 1.56% for clinics with resident FMS and 1.94% for those without resident FMS, but it was not statistically significant. Majority of referred cases were considered appropriate (96.1%). Results of the multivariate analysis showed that no prior consultation with senior healthcare provider and illnesses that were not severe and complex were independently associated with inappropriate referrals. Severity, complexity or uncertain diagnosis of patients' illness or injury significantly contributed to unavoidable referrals. Adequate facilities or having more experienced doctors could have avoided 14.5% of the referrals. The low referral rate and very high level of appropriate referrals could indicate that primary care providers in the public sector played an effective role as gatekeepers in the Malaysian public healthcare system.

  15. [Responsibility for the loss of opportunity in malignant cancer care in the Spanish public healthcare system].

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    Sardinero-García, Carlos; Santiago-Sáez, Andrés; Bravo, M Del Carmen; Perea-Pérez, Bernardo; Albarrán-Juan, M Elena; Labajo-González, Elena; Benito-León, Julián

    The loss of chance in healthcare has been forcibly introduced in the adjudications pronounced in recent years. Our objective was to analyse the verdicts of guilt resulting from the loss of chance ordered by the Contentious-Administrative Court (i.e., in the public healthcare system), in which both the origin of the disease to be treated and the sequelae were oncological processes. We analysed 137 cancer-related court judgments from the Contentious-Administrative Court, which referred to the concept of loss of chance, issued in Spain up to May 2014. Of the 137 sentences, 119 (86.9%), were pronounced due to diagnostic error and 14 (10.2%) due to inadequate treatment. Since 2010, 100 sentences have been passed (73.0%), representing an increase of more than 170% with respect to the 37 (27.0%) ordered in the first six years of the study (from 2004 to 2009). Most of the patients (68.6%) died, predominantly from breast cancer and gynaecological cancer (24.1%), and gastrointestinal cancers (21.1%). These malignancies were the ones most often involved in the sentences. The litigant activity due to loss of chance in oncological processes in the public health care has significantly increased in the last years. The judgments were mainly given because of diagnostic error or inadequate treatment. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

  16. Public-Privat e Partnership in the System of Regional Healthcare Financing

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    Margarita Yur’evna Molchanova

    2016-05-01

    Full Text Available Healthcare financing reform in the Russian Federation, besides its positive consequences, has led to the emergence of several major organizational and economic problems that hinder the expansion of financing sources for this sphere, which also involves public-private partnership (PPP. The paper highlights the regional specifics of such healthcare projects compared to similar projects of other spheres of the national economy. The author describes the problems of PPP projects implementation in healthcare; they include the insufficiency of substantiation of public-private partnership application in healthcare, and the absence of typical models for establishment of relations between PPP participants. The paper presents the healthcare priorities put forward by the author; these priorities are based on the theory of the life cycle of a service. The author presents her own model for organizing a regional concession, which is the most common form of public-private partnership in healthcare so far. The cluster brings together on a voluntary basis the legally independent organizations that are interested in improving the quality and increasing the accessibility of health services. These can include medical institutions of various forms of ownership located in the region, clinics, facilities, institutions that train healthcare workers, authorities, etc. The author shows that a favorable environment for the formation and implementation of PPP projects can be created under the cluster approach to the organization of healthcare. When establishing the medical cluster, the main task is to organize interaction between all its subjects in the interest of the overall development of healthcare in the region and the implementation of one’s own interests

  17. Daas: A Web-based System for User-specific Dietary Analysis and Advice for the Public Healthcare Domain

    Institute of Scientific and Technical Information of China (English)

    Deirdre Nugent; Kudakwashe Dube; Wu Bing

    2003-01-01

    This paper presents a Dietary Analysis and Advice System (DAAS), a web-based system for providing, within the public healthcare domain, user-specific diet advice based on a preliminary analysis of current diet or eating habits and lifestyle, using knowledge from domain expertise and experts' interpretation of national dietary guidelines.

  18. The utilization of mobile devices for telemedicine services in a South African public healthcare system.

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    Hartmann, André; Van Dyk, Liezl

    2014-01-01

    The purpose of this study is to develop an understanding in the use of mobile devices in administering telemedicine services within the public health care sector of South Africa. An online questionnaire was developed and distributed amongst medical officers, specialists, students and medical staff of one of the health districts of South Africa. This paper describes the design of the questionnaire as well as the most significant outcomes. Results are presented in terms of reasons why healthcare workers use mobile devices, as well as perceptions in terms of transmission security and quality of transmitted information.

  19. Trends in treatment of anterior cruciate ligament injuries of the knee in the public and private healthcare systems of Brazil

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    Diego Costa Astur

    Full Text Available CONTEXT AND OBJECTIVE Orthopedic surgery implies high costs for both public and private healthcare. The aim of this study was to better understand the differences between the public and private sectors regarding treatment of a damaged anterior cruciate ligament, which is a common knee injury. DESIGN AND SETTING Descriptive cross-sectional study conducted during the Brazilian Orthopedics Congress in Brasília. METHODS We applied questionnaires during the 2010 Brazilian Orthopedics Congress, with participation by 241 knee surgeons from 24 Brazilian states. This was followed by statistical analysis on the data that were obtained. RESULTS The orthopedic surgeons who were evaluated used different approaches and treatment options in different Brazilian states, comparing between the public and private systems. CONCLUSION Both in the public and in the private systems in Brazil, because of non-medical issues surrounding the treatment, the best medical decision is not always made. This may be harmful both to patients and to physicians.

  20. Comparative performance of private and public healthcare systems in low- and middle-income countries: a systematic review.

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    Sanjay Basu

    Full Text Available INTRODUCTION: Private sector healthcare delivery in low- and middle-income countries is sometimes argued to be more efficient, accountable, and sustainable than public sector delivery. Conversely, the public sector is often regarded as providing more equitable and evidence-based care. We performed a systematic review of research studies investigating the performance of private and public sector delivery in low- and middle-income countries. METHODS AND FINDINGS: Peer-reviewed studies including case studies, meta-analyses, reviews, and case-control analyses, as well as reports published by non-governmental organizations and international agencies, were systematically collected through large database searches, filtered through methodological inclusion criteria, and organized into six World Health Organization health system themes: accessibility and responsiveness; quality; outcomes; accountability, transparency, and regulation; fairness and equity; and efficiency. Of 1,178 potentially relevant unique citations, data were obtained from 102 articles describing studies conducted in low- and middle-income countries. Comparative cohort and cross-sectional studies suggested that providers in the private sector more frequently violated medical standards of practice and had poorer patient outcomes, but had greater reported timeliness and hospitality to patients. Reported efficiency tended to be lower in the private than in the public sector, resulting in part from perverse incentives for unnecessary testing and treatment. Public sector services experienced more limited availability of equipment, medications, and trained healthcare workers. When the definition of "private sector" included unlicensed and uncertified providers such as drug shop owners, most patients appeared to access care in the private sector; however, when unlicensed healthcare providers were excluded from the analysis, the majority of people accessed public sector care. "Competitive

  1. Comparative performance of private and public healthcare systems in low- and middle-income countries: a systematic review.

    Science.gov (United States)

    Basu, Sanjay; Andrews, Jason; Kishore, Sandeep; Panjabi, Rajesh; Stuckler, David

    2012-01-01

    Private sector healthcare delivery in low- and middle-income countries is sometimes argued to be more efficient, accountable, and sustainable than public sector delivery. Conversely, the public sector is often regarded as providing more equitable and evidence-based care. We performed a systematic review of research studies investigating the performance of private and public sector delivery in low- and middle-income countries. Peer-reviewed studies including case studies, meta-analyses, reviews, and case-control analyses, as well as reports published by non-governmental organizations and international agencies, were systematically collected through large database searches, filtered through methodological inclusion criteria, and organized into six World Health Organization health system themes: accessibility and responsiveness; quality; outcomes; accountability, transparency, and regulation; fairness and equity; and efficiency. Of 1,178 potentially relevant unique citations, data were obtained from 102 articles describing studies conducted in low- and middle-income countries. Comparative cohort and cross-sectional studies suggested that providers in the private sector more frequently violated medical standards of practice and had poorer patient outcomes, but had greater reported timeliness and hospitality to patients. Reported efficiency tended to be lower in the private than in the public sector, resulting in part from perverse incentives for unnecessary testing and treatment. Public sector services experienced more limited availability of equipment, medications, and trained healthcare workers. When the definition of "private sector" included unlicensed and uncertified providers such as drug shop owners, most patients appeared to access care in the private sector; however, when unlicensed healthcare providers were excluded from the analysis, the majority of people accessed public sector care. "Competitive dynamics" for funding appeared between the two sectors, such

  2. Benchmarking management practices in Australian public healthcare.

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    Agarwal, Renu; Green, Roy; Agarwal, Neeru; Randhawa, Krithika

    2016-01-01

    The purpose of this paper is to investigate the quality of management practices of public hospitals in the Australian healthcare system, specifically those in the state-managed health systems of Queensland and New South Wales (NSW). Further, the authors assess the management practices of Queensland and NSW public hospitals jointly and globally benchmark against those in the health systems of seven other countries, namely, USA, UK, Sweden, France, Germany, Italy and Canada. In this study, the authors adapt the unique and globally deployed Bloom et al. (2009) survey instrument that uses a "double blind, double scored" methodology and an interview-based scoring grid to measure and internationally benchmark the management practices in Queensland and NSW public hospitals based on 21 management dimensions across four broad areas of management - operations, performance monitoring, targets and people management. The findings reveal the areas of strength and potential areas of improvement in the Queensland and NSW Health hospital management practices when compared with public hospitals in seven countries, namely, USA, UK, Sweden, France, Germany, Italy and Canada. Together, Queensland and NSW Health hospitals perform best in operations management followed by performance monitoring. While target management presents scope for improvement, people management is the sphere where these Australian hospitals lag the most. This paper is of interest to both hospital administrators and health care policy-makers aiming to lift management quality at the hospital level as well as at the institutional level, as a vehicle to consistently deliver sustainable high-quality health services. This study provides the first internationally comparable robust measure of management capability in Australian public hospitals, where hospitals are run independently by the state-run healthcare systems. Additionally, this research study contributes to the empirical evidence base on the quality of

  3. Barriers to healthcare coordination in market-based and decentralized public health systems: a qualitative study in healthcare networks of Colombia and Brazil.

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    Vargas, Ingrid; Mogollón-Pérez, Amparo Susana; De Paepe, Pierre; Ferreira da Silva, Maria Rejane; Unger, Jean-Pierre; Vázquez, María-Luisa

    2016-07-01

    Although integrated healthcare networks (IHNs) are promoted in Latin America in response to health system fragmentation, few analyses on the coordination of care across levels in these networks have been conducted in the region. The aim is to analyse the existence of healthcare coordination across levels of care and the factors influencing it from the health personnel' perspective in healthcare networks of two countries with different health systems: Colombia, with a social security system based on managed competition and Brazil, with a decentralized national health system. A qualitative, exploratory and descriptive-interpretative study was conducted, based on a case study of healthcare networks in four municipalities. Individual semi-structured interviews were conducted with a three stage theoretical sample of (a) health (112) and administrative (66) professionals of different care levels, and (b) managers of providers (42) and insurers (14). A thematic content analysis was conducted, segmented by cases, informant groups and themes. The results reveal poor clinical information transfer between healthcare levels in all networks analysed, with added deficiencies in Brazil in the coordination of access and clinical management. The obstacles to care coordination are related to the organization of both the health system and the healthcare networks. In the health system, there is the existence of economic incentives to compete (exacerbated in Brazil by partisan political interests), the fragmentation and instability of networks in Colombia and weak planning and evaluation in Brazil. In the healthcare networks, there are inadequate working conditions (temporary and/or part-time contracts) which hinder the use of coordination mechanisms, and inadequate professional training for implementing a healthcare model in which primary care should act as coordinator in patient care. Reforms are needed in these health systems and networks in order to modify incentives, strengthen

  4. Walking and health care expenditures among adult users of the Brazilian public healthcare system: retrospective cross-sectional study.

    Science.gov (United States)

    Turi, Bruna Camilo; Codogno, Jamile Sanches; Fernandes, Rômulo Araújo; Monteiro, Henrique Luiz

    2015-11-01

    Physical inactivity is a major public health challenge due to its association with chronic diseases and the resulting economic impact on the public healthcare system. However, walking can help alleviate these problems. Aim To verify associations between walking during leisure-time, risk factors and health care expenditure among users of the Brazilian public health care system. Methods The sample consisted of 963 adults. Walking was evaluated using the Baecke questionnaire. The total expenditure per year was evaluated through the demand for health care services, verified in the medical records of each participant. Results Walking was reported as a physical activity during leisure-time by 64.4% of the participants. The group with the highest engagement in walking was younger and presented lower values for BMI, WC and expenditure on medication. Participants inserted in the category of higher involvement in walking were 41% less likely to be inserted into the group with higher total expenditure (OR = 0:59; 95% CI 0.39-0.89). Conclusion It was found that walking was the most frequent leisure-time physical activity reported by users of the Brazilian health care system and was associated with lower total and medication expenditure.

  5. Environmental sustainability in European public healthcare.

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    Chiarini, Andrea; Vagnoni, Emidia

    2016-01-01

    Purpose - The purpose of this paper is to enlarge the debate concerning the influence of leadership on environmental sustainability implementation in European public healthcare organisations. Design/methodology/approach - This paper is a viewpoint. It is based on preliminary analysis of European standards dedicated to environmental sustainability and their spread across Europe in public healthcare organisations. Viewpoints concerning leadership are then discussed and asserted. Findings - This paper found a limited implementation of standards such as Green Public Procurement criteria, Eco-Management and Audit Scheme and ISO 14001 in public healthcare. Some clues indicate that the lack of implementation is related to leadership and management commitment. Originality/value - For the first time, this paper investigates relationships between leadership and environmental sustainability in European public healthcare opening further avenues of research on the subject.

  6. Value Creation from Public Healthcare IS

    DEFF Research Database (Denmark)

    Schlichter, Bjarne Rerup; Svejvig, Per; Andersen, Povl Erik Rostgaard

    2014-01-01

    value. During the project, specific key performance indicators (KPIs) were identified and a baseline was established for the stroke process. The outcome is a framework for measuring IS public value as: professional, organizational, patient-perceived and employee-perceived quality as well as learning....... Selected non-financial measures for each dimension and their development are presented, e.g., a decrease in mortality.......The obtainment of value from IT is a recurring theme that has diffused into healthcare information systems (HIS). Having completed the implementation of an integrated HIS, the Faroese Health Service (FHS) has started discussions regarding the obtainment of value from its IT investment which...

  7. Artificial Intelligence and Public Healthcare Service Innovation

    DEFF Research Database (Denmark)

    Sun, Tara Qian; Medaglia, Rony

    Public healthcare ecosystems are complex networks of diverse actors that are subject to pressures to innovate, also a result of technological advancements. Artificial Intelligence (AI), in particular, has the potential to transform the way hospitals, doctors, patients, government agencies...

  8. Legitimate Allocation of Public Healthcare

    DEFF Research Database (Denmark)

    Lippert-Rasmussen, Kasper; Lauridsen, Sigurd

    2009-01-01

    governing priorities among groups of patients. The Accountability for Reasonableness (A4R) framework suggests an ingenious solution to this problem of moral disagreement. Rather than advocating any substantive distributive principle, its advocates propose a feasible set of conditions, which, if met......Citizens' consent to political decisions is often regarded as a necessary condition of political legitimacy. Consequently, legitimate allocation of healthcare has seemed almost unattainable in contemporary pluralistic societies. The problem is that citizens do not agree on any single principle...

  9. Integrated healthcare information systems.

    Science.gov (United States)

    Miller, J

    1995-01-01

    When it comes to electronic data processing in healthcare, we offer a guarded, but hopeful, prognosis. To be sure, the age of electronic information processing has hit healthcare. Employers, insurance companies, hospitals, physicians and a host of ancillary service providers are all being ushered into a world of high speed, high tech electronic information. Some are even predicting that the health information business will grow from $20 billion to over $100 billion in a decade. Yet, out industry lags behind other industries in its overall movement to the paperless world. Selecting and installing the most advanced integrated information system isn't a simple task, as we've seen. As in life, compromises can produce less than optimal results. Nevertheless, integrated healthcare systems simply won't achieve their goals without systems designed to support the operation of a continuum of services. That's the reality! It is difficult to read about the wonderful advances in other sectors, while realizing that many trees still fall each year in the name of the health care industry. Yes, there are some outstanding examples of organizations pushing the envelop in a variety of areas. Yet from a very practical standpoint, many (like our physician's office) are still struggling or are on the sidelines wondering what to do. Given the competitive marketplace, organizations without effective systems may not have long to wonder and wait.

  10. Systems Architecture for a Nationwide Healthcare System.

    Science.gov (United States)

    Abin, Jorge; Nemeth, Horacio; Friedmann, Ignacio

    2015-01-01

    From a national level to give Internet technology support, the Nationwide Integrated Healthcare System in Uruguay requires a model of Information Systems Architecture. This system has multiple healthcare providers (public and private), and a strong component of supplementary services. Thus, the data processing system should have an architecture that considers this fact, while integrating the central services provided by the Ministry of Public Health. The national electronic health record, as well as other related data processing systems, should be based on this architecture. The architecture model described here conceptualizes a federated framework of electronic health record systems, according to the IHE affinity model, HL7 standards, local standards on interoperability and security, as well as technical advice provided by AGESIC. It is the outcome of the research done by AGESIC and Systems Integration Laboratory (LINS) on the development and use of the e-Government Platform since 2008, as well as the research done by the team Salud.uy since 2013.

  11. Rotavirus vaccines contribute towards universal health coverage in a mixed public-private healthcare system.

    Science.gov (United States)

    Loganathan, Tharani; Jit, Mark; Hutubessy, Raymond; Ng, Chiu-Wan; Lee, Way-Seah; Verguet, Stéphane

    2016-11-01

    To evaluate rotavirus vaccination in Malaysia from the household's perspective. The extended cost-effectiveness analysis (ECEA) framework quantifies the broader value of universal vaccination starting with non-health benefits such as financial risk protection and equity. These dimensions better enable decision-makers to evaluate policy on the public finance of health programmes. The incidence, health service utilisation and household expenditure related to rotavirus gastroenteritis according to national income quintiles were obtained from local data sources. Multiple birth cohorts were distributed into income quintiles and followed from birth over the first five years of life in a multicohort, static model. We found that the rich pay more out of pocket (OOP) than the poor, as the rich use more expensive private care. OOP payments among the poorest although small are high as a proportion of household income. Rotavirus vaccination results in substantial reduction in rotavirus episodes and expenditure and provides financial risk protection to all income groups. Poverty reduction benefits are concentrated amongst the poorest two income quintiles. We propose that universal vaccination complements health financing reforms in strengthening Universal Health Coverage (UHC). ECEA provides an important tool to understand the implications of vaccination for UHC, beyond traditional considerations of economic efficiency. © 2016 John Wiley & Sons Ltd.

  12. The setting of healthcare priorities through public engagement.

    Science.gov (United States)

    Meetoo, Danny

    Global fiscal constraints mean that the UK healthcare system of the 21st century can no longer provide all possible services and treatment for all the people it serves. Currently, more than ever, there is a need to set priorities in terms of resources. The allocation of scarce healthcare resources will result in some care programmes being supported while others are not. Decision makers are increasingly engaging the public in policy making and priority-setting processes. Advocates of increased public engagement argue that public services are paid for by the people and, therefore, should be shaped more extensively by them, preferably by a fully representative sample. Central to the concept of public engagement is a desire for open dialogue and debate between groups that might not ordinarily have the channels to understand or speak to one another. Public engagement activities aim to link the healthcare community with the general public, community groups, civil society organisations and any other groups or communities in the outside world where healthcare decision-making gains its relevance. This article, therefore, aims to discuss the importance of promoting public engagement.

  13. The Cuban National Healthcare System: Characterization of primary healthcare services.

    Directory of Open Access Journals (Sweden)

    Keli Regina DAL PRÁ

    2015-10-01

    Full Text Available This article presents a report on the experience of healthcare professionals in Florianópolis, who took the course La Atención Primaria de Salud y la Medicina Familiar en Cuba [Primary Healthcare and Family Medicine in Cuba], in 2014. The purpose of the study is to characterize the healthcare units and services provided by the Cuban National Healthcare System (SNS and to reflect on this experience/immersion, particularly on Cuba’s Primary Healthcare Service. The results found that in comparison with Brazil’s Single Healthcare System (SUS Cuba’s SNS Family Healthcare (SF service is the central organizing element of the Primary Healthcare Service. The number of SF teams per inhabitant is different than in Brazil; the programs given priority in the APS are similar to those in Brazil and the intersectorial nature and scope of the services prove to be effective in the resolution of healthcare problems.

  14. Childhood Injuries in Singapore: Can Local Physicians and the Healthcare System Do More to Confront This Public Health Concern?

    Directory of Open Access Journals (Sweden)

    Alvin Cong Wei Ong

    2016-07-01

    Full Text Available Childhood injury is one of the leading causes of death globally. Singapore is no exception to this tragic fact, with childhood injuries accounting up to 37% of Emergency Department visits. Hence, it is important to understand the epidemiology and risk factors of childhood injuries locally. A search for relevant articles published from 1996–2016 was performed on PubMed, Cochrane Library and Google Scholar using keywords relating to childhood injury in Singapore. The epidemiology, mechanisms of injury, risk factors and recommended prevention strategies of unintentional childhood injuries were reviewed and described. Epidemiological studies have shown that childhood injury is a common, preventable and significant public health concern in Singapore. Home injuries and falls are responsible for majority of the injuries. Injuries related to childcare products, playground and road traffic accidents are also important causes. Healthcare professionals and legislators play an important role in raising awareness and reducing the incidence of childhood injuries in Singapore. For example, despite legislative requirements for many years, the low usage of child restraint seats in Singapore is worrisome. Thus, greater efforts in public health education in understanding childhood injuries, coupled with more research studies to evaluate the effectiveness and deficiencies of current prevention strategies will be necessary.

  15. Childhood Injuries in Singapore: Can Local Physicians and the Healthcare System Do More to Confront This Public Health Concern?

    Science.gov (United States)

    Ong, Alvin Cong Wei; Low, Sher Guan; Vasanwala, Farhad Fakhrudin

    2016-07-16

    Childhood injury is one of the leading causes of death globally. Singapore is no exception to this tragic fact, with childhood injuries accounting up to 37% of Emergency Department visits. Hence, it is important to understand the epidemiology and risk factors of childhood injuries locally. A search for relevant articles published from 1996-2016 was performed on PubMed, Cochrane Library and Google Scholar using keywords relating to childhood injury in Singapore. The epidemiology, mechanisms of injury, risk factors and recommended prevention strategies of unintentional childhood injuries were reviewed and described. Epidemiological studies have shown that childhood injury is a common, preventable and significant public health concern in Singapore. Home injuries and falls are responsible for majority of the injuries. Injuries related to childcare products, playground and road traffic accidents are also important causes. Healthcare professionals and legislators play an important role in raising awareness and reducing the incidence of childhood injuries in Singapore. For example, despite legislative requirements for many years, the low usage of child restraint seats in Singapore is worrisome. Thus, greater efforts in public health education in understanding childhood injuries, coupled with more research studies to evaluate the effectiveness and deficiencies of current prevention strategies will be necessary.

  16. HEALTHCARE: A COMPLEX SERVICE SYSTEM

    Institute of Scientific and Technical Information of China (English)

    James M. TIEN; Pascal J. GOLDSCHMIDT-CLERMONT

    2009-01-01

    Healthcare is indeed a complex service system, one requiring the technobiology approach of systems engineering to underpin its development as an integrated and adaptive system. In general, healthcare services are carried out with knowledge-intensive agents or components which work together as providers and consumers to create or co-produce value. Indeed, the engineering design of a healthcare system must recognize the fact that it is actually a complex integration of human-centered activities that is increasingly dependent on information technology and knowledge. Like any service system, healthcare can be considered to be a combination or recombination of three essential components-people (characterized by behaviors, values, knowledge, etc.), processes (characterized by collaboration, customization, etc.) and products (characterized by software, hardware, infrastructures, etc.). Thus, a healthcare system is an integrated and adaptive set of people, processes and products. It is, in essence, a system of systems which objectives are to enhance its efficiency (leading to greater interdependency) and effectiveness (leading to improved health). Integration occurs over the physical, temporal, organizational and functional dimensions, while adaptation occurs over the monitoring, feedback, cybernetic and learning dimensions. In sum, such service systems as healthcare are indeed complex, especially due to the uncertainties associated with the human-centered aspects of these systems. Moreover, the system complexities can only be dealt with methods that enhance system integration and adaptation.

  17. Public Healthcare Organizations: Leadership or Management?

    Directory of Open Access Journals (Sweden)

    Maite Martínez-Gonzalez

    2016-11-01

    Full Text Available This article studies the type of leadership that managers are currently exercising in the Catalan health system in Catalonia. A questionnaire (MQL-5X was sent to 120 people occupying management positions in healthcare centers and hospitals as well as 14 others who also hold such positions in these healthcare centers and hospitals, were interviewed. The mixed methods research design attests that the Catalan health system is managed through a structure of simultaneous transformational and transactional leadership. However, the efficacy of this system is conditioned purely by the communicative competence that a manager may or may not possess, as the system itself makes no effort to encourage transformational leadership. Transformation leadership inspires positive change, conveys a clear vision and enhances morale, motivation and job performance. It galvanizes a team into changing their expectations and perceptions and motivates them to work towards common goals.

  18. Healthcare public key infrastructure (HPKI) and non-profit organization (NPO): essentials for healthcare data exchange.

    Science.gov (United States)

    Takeda, Hiroshi; Matsumura, Yasushi; Nakagawa, Katsuhiko; Teratani, Tadamasa; Qiyan, Zhang; Kusuoka, Hideo; Matsuoka, Masami

    2004-01-01

    To share healthcare information and to promote cooperation among healthcare providers and customers (patients) under computerized network environment, a non-profit organization (NPO), named as OCHIS, was established at Osaka, Japan in 2003. Since security and confidentiality issues on the Internet have been major concerns in the OCHIS, the system has been based on healthcare public key infrastructure (HPKI), and found that there remained problems to be solved technically and operationally. An experimental study was conducted to elucidate the central and the local function in terms of a registration authority and a time stamp authority by contracting with the Ministry of Economics and Trading Industries in 2003. This paper describes the experimental design with NPO and the results of the study concerning message security and HPKI. The developed system has been operated practically in Osaka urban area.

  19. Education of healthcare professionals and the public.

    Science.gov (United States)

    McNulty, Cliodna A M; Cookson, Barry D; Lewis, Michael A O

    2012-07-01

    In the winter of 2007-08 a new public-facing antimicrobial campaign was agreed by the Advisory Committee on Antimicrobial Resistance and Healthcare-Associated Infection (ARHAI) Education sub-Group (later divided into subgroups for professional and public education): it comprised posters with a positive message on how the public could help themselves when they had a cold. However, the poster campaign, used in isolation in England, did not improve antibiotic use; therefore, the Public Education sub-Group took forward educational approaches to change the behaviour of the public and health professionals. Professionals have been encouraged to give patients clear information about the likely duration of symptoms, self-care, and benefits and harms of antibiotics, reinforcing the public poster campaigns in surgeries, hospitals and pharmacies. Since 2008, campaigns have been launched in England to coincide with European Antibiotic Awareness Day (EAAD) on 18 November, using Department of Health and EAAD materials. Professional education has been facilitated by the 2008 National Institute for Health and Clinical Excellence respiratory tract infection delayed prescribing guidance for general practitioners. A toolkit of materials for medicines management teams, to facilitate good antimicrobial stewardship in primary care (ASPIC), is being taken forward by the Public Education sub-Group and professional societies. After advice from ARHAI, in 2009 the General Medical Council requested that all postgraduate deans and Royal Colleges ensure infection prevention and control and antimicrobial prescribing become standard practice implemented in all clinical settings, and that they are emphasized strongly in undergraduate and postgraduate medical training. ARHAI has also taken a keen interest in reviewing, advising and leading on a number of European Union initiatives dealing with professional education.

  20. Systems design for remote healthcare

    CERN Document Server

    Bonfiglio, Silvio

    2014-01-01

    This book provides a multidisciplinary overview of the design and implementation of systems for remote patient monitoring and healthcare. Readers are guided step-by-step through the components of such a system and shown how they could be integrated in a coherent framework for deployment in practice. The authors explain planning from subsystem design to complete integration and deployment, given particular application constraints. Readers will benefit from descriptions of the clinical requirements underpinning the entire application scenario, physiological parameter sensing techniques, information processing approaches and overall, application dependent system integration. Each chapter ends with a discussion of practical design challenges and two case studies are included to provide practical examples and design methods for two remote healthcare systems with different needs. ·         Provides a multi-disciplinary overview of next-generation mobile healthcare system design; ·         Includes...

  1. [Healthcare value chain: a model for the Brazilian healthcare system].

    Science.gov (United States)

    Pedroso, Marcelo Caldeira; Malik, Ana Maria

    2012-10-01

    This article presents a model of the healthcare value chain which consists of a schematic representation of the Brazilian healthcare system. The proposed model is adapted for the Brazilian reality and has the scope and flexibility for use in academic activities and analysis of the healthcare sector in Brazil. It places emphasis on three components: the main activities of the value chain, grouped in vertical and horizontal links; the mission of each link and the main value chain flows. The proposed model consists of six vertical and three horizontal links, amounting to nine. These are: knowledge development; supply of products and technologies; healthcare services; financial intermediation; healthcare financing; healthcare consumption; regulation; distribution of healthcare products; and complementary and support services. Four flows can be used to analyze the value chain: knowledge and innovation; products and services; financial; and information.

  2. Mobile Healthcare System using NFC Technology

    OpenAIRE

    A Devendran; T Bhuvaneswari; Arun Kumar Krishnan

    2012-01-01

    Although primary care physicians are increasingly interested in adopting electronic medical record (EMR) systems, few use such systems in practice. Mobile devices offer new ways for users to access health care data and services in a secure and user-friendly environment. Mobile healthcare (m-healthcare) systems are regarded as a solution to healthcare costs without reducing the quality of patient care. We are developing a basic architecture for m-healthcare services using Near Field Communicat...

  3. Healthy workplaces and teamwork for healthcare workers need public engagement.

    Science.gov (United States)

    Matthews, Sue; Macdonald-Rencz, Sandra

    2007-01-01

    This response challenges the healthcare system to take full responsibility for the work environments created for health human resources. While the need for healthy work environments and teamwork in healthcare are inarguable, the fact is they are not a reality in today's health system. The authors suggest strategies to address this issue and identify the person or groups that should take responsibility, including governments, organizations, individuals and the public. Strategies include ensuring that policies do not contradict one another and holding each level responsible for the outcomes of a healthy work environment - retention and recruitment of health human resources, better patient/client outcomes and healthcare costs. The need for strong and appropriate leadership for health human resources with "content knowledge" is discussed, along with recommendations for measuring the performance and success of healthy work environments and teamwork. The authors conclude that collaboration at the micro, meso and macro levels is required to facilitate the true change that is needed to improve the work environments of health human resources.

  4. Integrating buprenorphine treatment into a public healthcare system: the San Francisco Department of Public Health's office-based Buprenorphine Pilot Program.

    Science.gov (United States)

    Hersh, David; Little, Sherri L; Gleghorn, Alice

    2011-01-01

    Despite well-documented efficacy, US physicians have been relatively slow to embrace the use of buprenorphine for the treatment of opioid dependence. In order to introduce and support the use of buprenorphine across the San Francisco Department of Public Health system of care, the Buprenorphine Pilot Program was initiated in 2003. Program treatment sites included a centralized buprenorphine induction clinic and program pharmacy, and three community-based treatment sites; two primary care clinics and a private dual diagnosis group practice. The target patient population consisted of opioid-dependent patients typically seen in an urban, public health setting, including individuals experiencing extreme poverty, homelessness/unstable housing, unemployment, polysubstance abuse/dependence, coexisting mental health disorders, and/or little psychosocial support. This program evaluation reviews patient characteristics, treatment retention, substance use over time, patient impressions, and provider practices for the 57 patients admitted between 9/1/03 and 8/31/05. At baseline, over 80% of patients were injecting heroin, over 40% were homeless, and over one-third were using cocaine. Outcomes included an overall one-year retention rate of 61%, a rapid and dramatic decline in opioid use, very positive patient impressions of the program and of buprenorphine, and significant shifts in provider practices over time.

  5. Public/private information sharing in healthcare fraud investigations.

    Science.gov (United States)

    Sheehan, J G

    1999-01-01

    Private insurers have good reason, both in their private interest and in the public interest, for pursuing and rooting out fraud in the healthcare system; moreover, they often have sophisticated data systems, substantial investigative information, and management expertise that can be useful to prosecutors. It makes sense, as a public policy matter, to undertake steps to encourage insurers to be aggressive in pursuing legitimate fraud cases, and to provide a framework for effective cooperation and information sharing with law enforcement. At the same time, prosecutors are responsible for enforcing equal justice under the law; thus, any such relationship must be handled in an appropriate manner, with safeguards to protect privacy and the reputation of investigative subjects. While the courts have not yet explored many of the relevant legal and factual issues in this area, the author surveys existing guidance under governing laws and policies applicable to state and federal prosecutors, and suggests techniques to prevent inappropriate communication or use of such information.

  6. Healthcare Firms and the ERP Systems

    OpenAIRE

    A. Garefalakis; G. Mantalis; E. Vourgourakis; K. Spinthiropoulos; Ch. Lemonakis

    2016-01-01

    With the continuous and drastic changes due to the economic crisis, along with the increasing market demands, major reforms are initiated in the healthcare sector in order to improve the quality of healthcare and operational efficiency, while reducing costs and optimizing back-end operations. ERP systems have been the basic technological infrastructure to many sectors as well as healthcare. The main objective of this study is to discuss how the adoption of ERP systems in healthcar...

  7. Markets and Public Values in Healthcare

    NARCIS (Netherlands)

    T. Zuiderent-Jerak (Teun); K.J. Grit (Kor); T.E.D. van der Grinten (Tom)

    2010-01-01

    textabstractAbstract: Discussions on the role of markets in healthcare easily lead to political and unfruitful polarized positions. Actors arguing in favour of markets as a solution for the quality/cost conundrum entrench themselves against others pointing out the risk of markets for the delivery a

  8. Mobile Healthcare System using NFC Technology

    Directory of Open Access Journals (Sweden)

    A Devendran

    2012-05-01

    Full Text Available Although primary care physicians are increasingly interested in adopting electronic medical record (EMR systems, few use such systems in practice. Mobile devices offer new ways for users to access health care data and services in a secure and user-friendly environment. Mobile healthcare (m-healthcare systems are regarded as a solution to healthcare costs without reducing the quality of patient care. We are developing a basic architecture for m-healthcare services using Near Field Communication (NFC to facilitate the provisioning of healthcare to people anywhere, anytime using mobile devices that are connected through wireless communication technologies.

  9. [Prenatal care and management of hypertension in pregnant women in the public healthcare system in Rio de Janeiro, Brazil].

    Science.gov (United States)

    Vettore, Marcelo Vianna; Dias, Marcos; Domingues, Rosa Maria Soares Madeira; Vettore, Mario Vianna; Leal, Maria do Carmo

    2011-05-01

    The aim of this study was to assess the adequacy of prenatal care for pregnant women with hypertension as compared to those at low risk. Adequate management of hypertension and associated factors were also investigated. A cross-sectional study was conducted with 1,947 women, 187 of whom with hypertension, in public prenatal care units in Rio de Janeiro, Brazil, in 2007-2008. Demographic and socioeconomic data, obstetric history, and information on adequacy of prenatal care were collected using interviews and prenatal care cards. Adequacy of management of hypertension was evaluated according to performance of health professionals and health services and women's individual characteristics. Chi-square and multivariate logistic regression were used to compare groups and identify factors associated with management of hypertension. Adequacy of prenatal care was 79% and did not differ between groups. Only 27% of pregnant women with hypertension received appropriate management, with poor professional performance. Hypertensive pregnant women with better prenatal care were those with previous neonatal deaths and/or stillbirths and those with 35 years of age and older. Despite adequate use of prenatal care, management of hypertension in pregnant women was inadequate.

  10. Approaches to organizing public relations functions in healthcare.

    Science.gov (United States)

    Guy, Bonnie; Williams, David R; Aldridge, Alicia; Roggenkamp, Susan D

    2007-01-01

    This article provides health care audiences with a framework for understanding different perspectives of the role and functions of public relations in healthcare organizations and the resultant alternatives for organizing and enacting public relations functions. Using an example of a current issue receiving much attention in US healthcare (improving rates of organ donation), the article provides examples of how these different perspectives influence public relations goals and objectives, definitions of 'public', activities undertaken, who undertakes them and where they fit into the organizational hierarchy.

  11. Healthcare system responsiveness in Jiangsu Province, China.

    Science.gov (United States)

    Chao, Jianqian; Lu, Boyang; Zhang, Hua; Zhu, Liguo; Jin, Hui; Liu, Pei

    2017-01-13

    The perceived responsiveness of a healthcare system reflects its ability to satisfy reasonable expectations of the public with respect to non-medical services. Recently, there has been increasing attention paid to responsiveness in evaluating the performance of a healthcare system in a variety of service settings. However, the factors that affect the responsiveness have been inconclusive so far and measures of improved responsiveness have not always thoroughly considered the factors. The aim of this study was to evaluate both the responsiveness of the healthcare system in Jiangsu Province, China, the factors that influence responsiveness and the measures of improved responsiveness considering it, as determined by a responsiveness survey. A multistage, stratified random sampling method was used to select 1938 adult residents of Jiangsu Province in 2011. Face-to-face interviews were conducted using a self-designed questionnaire modeled on the World Health Organization proposal. The final analysis was based on 1783 (92%) valid questionnaires. Canonical correlation analysis was used to assess the factors that affect responsiveness. The average score of all responsiveness-related domains in the surveyed healthcare system was satisfactory (7.50 out of a maximum 10.0). The two highest scoring domains were dignity and confidentiality, and the two lowest scoring domains choice and prompt attention. The factors affecting responsiveness were age, regional economic development level, and geographic area (urban vs. rural). The responsiveness regarding basic amenities was rated worse by the elderly than by younger respondents. Responsiveness ranked better by those with a poorer economic status. Choice in cities was better than in rural regions. The responsiveness of the Jiangsu healthcare system was considered to be satisfactory but could be improved by offering greater choice and providing more prompt attention. Perceptions of healthcare system responsiveness differ with age

  12. Recognition of the Concept of Publicness in Healthcare: a Content Analysis of Korean Newspapers

    Science.gov (United States)

    2017-01-01

    The traditional boundaries between public and private sectors has been blurred, and questions raised regarding how publicness could be conceptualized. The empirical study on the concept of publicness can reveal greatly diversified views on publicness, and help to reduce confusion over publicness. For the content analysis, 750 news articles of 8 national Korean newspapers were retrieved from the Korea Integrated News Database System. The articles were coded by the inductive category for the topic of the paragraph, the concept related to publicness, and the overall tone toward publicness. Publicness was addressed in a number of different issues, and diverse and specific statuses or actions were associated with the realization of publicness. The most frequent concept was “government,” which represented the main agent of healthcare provision and the owner of institutions for “the vulnerable.” Issues of industrialization of healthcare/healthcare industry and reform of the national healthcare system mentioned publicness in a normative sense, which laid stress on “not-for-profit” service and the right of “universal access” to service for publicness. Articles of health/disease information or global health regarded “the population/public” as the main targets or beneficiaries of healthcare services. Occasionally, publicness was not related to specific concepts, being used unclearly or as a routine. The fulfillment of the specific actions or status may lead to the enhancement of publicness. However, publicness itself could not be reduced to the specific concepts suggested. The use of publicness in healthcare delivered only its normative sense without substantive meaning. PMID:28145640

  13. Communication with the public in the health-care system: a descriptive study of the use of social media in local health authorities and public hospitals in Italy.

    Science.gov (United States)

    Vanzetta, Marina; Vellone, Ercole; Dal Molin, Alberto; Rocco, Gennaro; De Marinis, Maria Grazia; Rosaria, Alvaro

    2014-01-01

    In 2010 the Italian Ministry of Health set out recommendations for the use of social technology and Web 2.0, inviting organisations within the Italian national health service (Servizio Sanitario Nazionale, SSN) to equip themselves with instruments. 1. to ascertain how many local health authorities (Aziende Sanitarie Locali, ASL) and public hospitals have a presence on the most widely used social media websites in Italy: Facebook, Twitter and YouTube; 2. to find out how well the Facebook, Twitter and YouTube pages of ASLs and public hospitals are known among the general population; 3. to find out how ASLs and public hospitals engage with the general public on social media sites. The websites of all ASLs and public hospitals across the country were visited to look for the icons of the social media sites under examination. The data considered were publicly available upon access. A total of 245 websites were analysed. 7.34% ASLs and hospitals had social media accounts. 8 organisations had an account on all three of the social media sites considered in the study. The results show a low presence of ASLs and hospitals on social media. Other studies are needed in this field.

  14. Communication with the public in the health-care system: a descriptive study of the use of social media in Local Health Authorities and public hospitals in Italy

    Directory of Open Access Journals (Sweden)

    Marina Vanzetta

    2014-06-01

    Full Text Available INTRODUCTION. In 2010 the Italian Ministry of Health set out recommendations for the use of social technology and Web 2.0, inviting organisations within the Italian national health service (Servizio Sanitario Nazionale, SSN to equip themselves with instruments. Objectives. 1. to ascertain how many local health authorities (Aziende Sanitarie Locali, ASL and public hospitals have a presence on the most widely used social media websites in Italy: Facebook, Twitter and YouTube; 2. to find out how well the Facebook, Twitter and YouTube pages of ASLs and public hospitals are known among the general population; 3. to find out how ASLs and public hospitals engage with the general public on social media sites. MATERIALS AND METHODS. The websites of all ASLs and public hospitals across the country were visited to look for the icons of the social media sites under examination. The data considered were publicly available upon access. RESULTS. A total of 245 websites were analysed. 7.34% ASLs and hospitals had social media accounts. 8 organisations had an account on all three of the social media sites considered in the study. CONCLUSIONS. The results show a low presence of ASLs and hospitals on social media. Other studies are needed in this field.

  15. Romanian healthcare system at a glance

    Directory of Open Access Journals (Sweden)

    Christiana Balan

    2013-04-01

    Full Text Available The Romanian healthcare system is facing constant challenges to produce high quality care with low costs. Objectives The paper aims to analyze the efficiency of the Romanian healthcare system in terms of resources allocation. The evaluation and the dimension of healthcare system efficiency are important for identifying a balance between the resources required and the health outcomes. Prior Work Previous studies describe the Romanian healthcare system as a system in transition. This study focuses on the relationship between the inputs and outputs of the system. Approach In order to assess the efficiency of the Romanian healthcare system we use Data Envelopment Analysis approach. Both input and output healthcare indicators are observed for the period 1999-2010 and the years when healthcare inputs have been used efficiently are identified. Results The results show that human, financial, and technological resources have been used at maximum capacity in 1999, 2003, 2004, 2007 and 2010. Implications Though efficiency is defined differently by diverse stakeholders, healthcare policies should focus on rising the responsibility of communities and individuals for better treatments and services and better access to information on healthcare providers. Value The paper is an empirically based study of the healthcare resources allocation in Romania.

  16. Metadata Management System for Healthcare Information Systems

    OpenAIRE

    Patil, Ketan Shripat

    2011-01-01

    The Utah Department of Health (UDOH) uses multiple and diverse healthcare information systems for managing, maintaining, and sharing the health information. To keep track of the important details about these information systems such as the operational details, data semantics, data exchange standards, and personnel responsible for maintaining and managing it is a monumental task, with several limitations. This report describes the design and implementation of the Metadata Management System (MD...

  17. [Cost analysis of18F-FDG PET-CT from the perspective of the Brazilian Unified National Health System as healthcare provider: a study in a public healthcare center in Rio de Janeiro, Brazil].

    Science.gov (United States)

    Caetano, Rosângela; Schluckebier, Luciene Fontes; Bastos, Cláudia Regina Garcia; Silva, Rondineli Mendes da; Carneiro, Michel Pontes; Silva, Jorge Wagner Esteves da; Biz, Aline Navega

    2014-02-01

    Positron emission tomography (PET) has been introduced recently in Brazil and requires costs analysis to support economic evaluation studies on its use. The current study analyzed the use of 18 F-FDG PET-CT and estimated its costs from the perspective of a public healthcare provider. The micro-costing technique was used, identifying, quantifying, and valuing all the inputs used to perform the procedure. Cost estimates considered 85 tests performed at the Brazilian National Cancer Institute from March to June 2012. Reference cases were defined as adult cancer patients, output of five tests per day, and one dose of 18 F-FDG per patient. Unit cost for the procedure was BRL 3,150.30 based on career wages under the Ministry of Science and Technology and BRL 2,927.19 based on Ministry of Health career wages. The factor with the heaviest cost impact was daily output of tests. Other factors that could impact the test's cost in public healthcare institutions were also examined.

  18. Healthcare Systems and Other Applications

    NARCIS (Netherlands)

    van Kasteren, T.L.M.; Kröse, B.J.A.

    2007-01-01

    This Works in Progress department discusses eight projects related to healthcare. The first project aims to aid people with mild dementia. The second project plans to simplify the delivery of healthcare services to the elderly and cognitively disabled, while the third project is developing models fo

  19. Healthcare Systems and Other Applications

    NARCIS (Netherlands)

    van Kasteren, T.L.M.; Kröse, B.J.A.

    2007-01-01

    This Works in Progress department discusses eight projects related to healthcare. The first project aims to aid people with mild dementia. The second project plans to simplify the delivery of healthcare services to the elderly and cognitively disabled, while the third project is developing models

  20. Performance management of the public healthcare services in Ireland: a review.

    Science.gov (United States)

    Mesabbah, Mohammed; Arisha, Amr

    2016-01-01

    Performance Management (PM) processes have become a potent part of strategic and service quality decisions in healthcare organisations. In 2005, the management of public healthcare in Ireland was amalgamated into a single integrated management body, named the Health Service Executive (HSE). Since then, the HSE has come up with a range of strategies for healthcare developments and reforms, and has developed a PM system as part of its strategic planning. The purpose of this paper is to review the application of PM in the Irish Healthcare system, with a particular focus on Irish Hospitals and Emergency Services. An extensive review of relevant HSE's publications from 2005 to 2013 is conducted. Studies of the relevant literature related to the application of PM and of international best practices in healthcare performance systems are also presented. PM and performance measurement systems used by the HSE include many performance reports designed to monitor performance trends and strategic goals. Issues in the current PM system include inconsistency of measures and performance reporting, unclear strategy alignment, and deficiencies in reporting (e.g. feedback and corrective actions). Furthermore, PM processes have not been linked adequately into Irish public hospitals' management systems. The HSE delivers several services such as mental health, social inclusion, etc. This study focuses on the HSE's PM framework, with a particular interest in acute hospitals and emergency services. This is the first comprehensive review of Irish healthcare PM since the introduction of the HSE. A critical analysis of the HSE reports identifies the shortcomings in its current PM system.

  1. Guest editorial. Integrated healthcare information systems.

    Science.gov (United States)

    Li, Ling; Ge, Ri-Li; Zhou, Shang-Ming; Valerdi, Ricardo

    2012-07-01

    The use of integrated information systems for healthcare has been started more than a decade ago. In recent years, rapid advances in information integration methods have spurred tremendous growth in the use of integrated information systems in healthcare delivery. Various techniques have been used for probing such integrated systems. These techniques include service-oriented architecture (SOA), EAI, workflow management, grid computing, and others. Many applications require a combination of these techniques, which gives rise to the emergence of enterprise systems in healthcare. Development of the techniques originated from different disciplines has the potential to significantly improve the performance of enterprise systems in healthcare. This editorial paper briefly introduces the enterprise systems in the perspective of healthcare informatics.

  2. Tailor-made quality systems in healthcare

    NARCIS (Netherlands)

    van der Bij, JD; Broekhuis, H

    2000-01-01

    At present many healthcare organizations are being pressed by national governments or client groups to develop and implement quality systems. Unfortunately, not much is known about the development and implementation of these systems in healthcare organizations. There still are definition questions t

  3. Healthcare Firms and the ERP Systems

    Directory of Open Access Journals (Sweden)

    A. Garefalakis

    2016-04-01

    Full Text Available With the continuous and drastic changes due to the economic crisis, along with the increasing market demands, major reforms are initiated in the healthcare sector in order to improve the quality of healthcare and operational efficiency, while reducing costs and optimizing back-end operations. ERP systems have been the basic technological infrastructure to many sectors as well as healthcare. The main objective of this study is to discuss how the adoption of ERP systems in healthcare organizations improves their functionality, simplifies their business processes, assure the quality of care services and helps their management accounting and controlling. This study presents also the stages required for the implementation of ERP system in healthcare organizations. This study utilizes a literature review in order to reach the research conclusions. Specifically, through related case studies and research, it examines how ERP systems are used to evaluate the better functionality of the healthcare organizations, addressing in parallel important problems, and possible malfunctions. The implementation of ERP systems in healthcare organizations promises to evolve and align strictly to the organizations’ corporate objectives and high-levels of healthcare quality. In order to accomplish this goal, the right decisions should be made by the managers of the healthcare organization regarding the choice of the appropriate ERP system following its installation and its application. Limited research exists on the significance ERP systems implementation in healthcare organizations, while possible dysfunctions and challenges during its installation and implementation are recorded. Therefore, new evidence in the significance of ERP systems in healthcare organization is provided.

  4. Impact of healthcare reforms on out-of-pocket health expenditures in Turkey for public insurees.

    Science.gov (United States)

    Erus, Burcay; Aktakke, Nazli

    2012-06-01

    The Turkish healthcare system has been subject to major reforms since 2003. During the reform process, access to public healthcare providers was eased and private providers were included in the insurance package for public insurees. This study analyzes data on out-of-pocket (OOP) healthcare expenditures to look into the impact of reforms on the size of OOP health expenditures for premium-based public insurees. The study uses Household Budget Surveys that provide a range of individual- and household-level data as well as healthcare expenditures for the years 2003, before the reforms, and 2006, after the reforms. Results show that with the reforms ratio of households with non-zero OOP expenditure has increased. Share and level of OOP expenditures have decreased. The impact varies across income levels. A semi-parametric analysis shows that wealthier individuals benefited more in terms of the decrease in OOP health expenditures.

  5. 77 FR 26281 - National Advisory Council for Healthcare Research and Quality: Request for Nominations for Public...

    Science.gov (United States)

    2012-05-03

    ... of health care economics, information systems, law, ethics, business, or public policy; and, (7) in... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND... Research and Quality: Request for Nominations for Public Members AGENCY: Agency for Healthcare Research and...

  6. 76 FR 18765 - National Advisory Council for Healthcare Research and Quality: Request for Nominations for Public...

    Science.gov (United States)

    2011-04-05

    ... of health care economics, information systems, law, ethics, business, or public policy; and, (7) in... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND... Research and Quality: Request for Nominations for Public Members AGENCY: Agency for Healthcare Research and...

  7. 78 FR 26638 - National Advisory Council for Healthcare Research and Quality: Request for Nominations for Public...

    Science.gov (United States)

    2013-05-07

    ... of health care economics, information systems, law, ethics, business, or public policy; and, (7) in... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND... Research and Quality: Request for Nominations for Public Members AGENCY: Agency for Healthcare Research and...

  8. Concepts and trends in healthcare information systems

    CERN Document Server

    Koutsouris, Dionysios-Dimitrios

    2014-01-01

    ​Concepts and Trends in Healthcare Information Systems covers the latest research topics in the field from leading researchers and practitioners. This book offers theory-driven research that explores the role of Information Systems in the delivery of healthcare in its diverse organizational and regulatory settings. In addition to the embedded role of Information Technology (IT) in clinical and diagnostics equipment, Information Systems are uniquely positioned to capture, store, process, and communicate timely information to decision makers for better coordination of healthcare at both the individual and population levels. For example, data mining and decision support capabilities can identify potential adverse events for an individual patient while also contributing to the population's health by providing insights into the causes of disease complications. Information systems have great potential to reduce healthcare costs and improve outcomes. The healthcare delivery systems share similar characteristics w...

  9. Requirements for Interoperability in Healthcare Information Systems

    Directory of Open Access Journals (Sweden)

    Rita Noumeir

    2012-01-01

    Full Text Available Interoperability is a requirement for the successful deployment of Electronic Health Records (EHR. EHR improves the quality of healthcare by enabling access to all relevant information at the diagnostic decision moment, regardless of location. It is a system that results from the cooperation of several heterogeneous distributed subsystems that need to successfully exchange information relative to a specific healthcare process. This paper analyzes interoperability impediments in healthcare by first defining them and providing concrete healthcare examples, followed by discussion of how specifications can be defined and how verification can be conducted to eliminate those impediments and ensure interoperability in healthcare. This paper also analyzes how Integrating the Healthcare Enterprise (IHE has been successful in enabling interoperability, and identifies some neglected aspects that need attention.

  10. Engineering the system of healthcare delivery

    National Research Council Canada - National Science Library

    Rouse, William B; Cortese, Denis A

    2010-01-01

    "As the United States continues to debate reform of its healthcare system, this book argues that providing health insurance for all without improving the delivery system will not improve the current...

  11. The Italian health-care system.

    Science.gov (United States)

    France, George; Taroni, Francesco; Donatini, Andrea

    2005-09-01

    Italy's national health service is statutorily required to guarantee the uniform provision of comprehensive care throughout the country. However, this is complicated by the fact that, constitutionally, responsibility for health care is shared between the central government and the 20 regions. There are large and growing differences in regional health service organisation and provision. Public health-care expenditure has absorbed a relatively low share of gross domestic product, although in the last 25 years it has consistently exceeded central government forecasts. Changes in payment systems, particularly for hospital care, have helped to encourage organisational appropriateness and may have contributed to containing expenditure. Tax sources used to finance the Servizio Sanitario Nazionale (SSN) have become somewhat more regressive. The limited evidence on vertical equity suggests that the SSN ensures equal access to primary care but lower income groups face barriers to specialist care. The health status of Italians has improved and compares favourably with that in other countries, although regional disparities persist.

  12. The political economy of healthcare reform in China: negotiating public and private.

    Science.gov (United States)

    Daemmrich, Arthur

    2013-01-01

    China's healthcare system is experiencing significant growth from expanded government-backed insurance, greater public-sector spending on hospitals, and the introduction of private insurance and for-profit clinics. An incremental reform process has sought to develop market incentives for medical innovation and liberalize physician compensation and hospital finance while continuing to keep basic care affordable to a large population that pays for many components of care out-of-pocket. Additional changes presently under consideration by policymakers are likely to further restructure insurance and the delivery of care and will alter competitive dynamics in major healthcare industries, notably pharmaceuticals, medical devices, and diagnostic testing. This article describes the institutional history of China's healthcare system and identifies dilemmas emerging as the country negotiates divisions between public and private in healthcare. Building on this analysis, the article considers opportunities for public-private partnerships and greater systems integration to reconcile otherwise incommensurable approaches to rewarding innovation and improving access. The article concludes with observations on the public function of health insurance and its significance to further development of China's healthcare system.

  13. Unequal access to public healthcare facilities: theory and measurement revisited

    Directory of Open Access Journals (Sweden)

    Stefano Mainardi

    2007-12-01

    Full Text Available Adequate coverage and efficiency of public health services are high priorities for sustainable growth and development. In many countries, public healthcare continues to fall short of demand, and remains unevenly distributed among the population. As in other areas of project appraisal, studies on social equity and access to public utilities are fraught with theoretical and empirical questions. Based on the concepts of marginal disutility with respect to distance, safety thresholds and `equally distributed equivalent' distance, the paper first reassesses utility theory assumptions supporting the rationale for functional re-specifications. Partly drawing on these theoretical refinements, the analysis formulates a stochastic cost frontier hurdle model with an endogenously determined hospital distance threshold. For illustrative purposes, this model is applied to pooled biennial communal data for Chile. Healthcare accessibility in terms of travel cost/time is proxied by distances of administrative centres from the nearest emergency hospitals over the period 2000-2003.

  14. Healthcare and healthcare systems: inspiring progress and future prospects.

    Science.gov (United States)

    Durrani, Hammad

    2016-01-01

    Healthcare systems globally have experienced intensive changes, reforms, developments, and improvement over the past 30 years. Multiple actors (governmental and non-governmental) and countries have played their part in the reformation of the global healthcare system. New opportunities are presenting themselves while multiple challenges still remain especially in developing countries. Better way to proceed would be to learn from historical patterns while we plan for the future in a technology-driven society with dynamic demographic, epidemiological and economic uncertainties. A structured review of both peer-reviewed and gray literature on the topic was carried out. On the whole, people are healthier, doing better financially and live longer today than 30 years ago. The number of under-5 mortality worldwide has declined from 12.7 million in 1990 to 6.3 million in 2013. Infant and maternal mortality rates have also been reduced. However, both rates are still considered high in Africa and some Asian countries. The world's population nearly doubled in these 30 years, from 4.8 billion in 1985 to 7.2 billion in 2015. The majority of the increasing population was coming from the least developed countries, i.e., 3.66 to 5.33 billion. The world will be short of 12.9 million health-care workers by 2035; today, that figure stands at 7.2 million. Health care expenditures among countries also show sharp differences. In high income countries, per person health expenditure is over USD 3,000 on average, while in poor countries, it is as low as USD 12, WHO estimate of minimum spending per person per year needed to provide basic, life-saving services is USD 44. The challenges faced by the global health system over the past 30 years have been increased in population and urbanization, behavioral changes, rise in chronic diseases, traumatic injuries, infectious diseases, specific regional conflicts and healthcare delivery security. Over the next 30 years, most of the world population

  15. Surveillance Systems from Public Health Institutions and Scientific Societies for Antimicrobial Resistance and Healthcare-Associated Infections in Europe (SUSPIRE): protocol for a systematic review

    Science.gov (United States)

    Núñez-Núñez, María; Navarro, María Dolores; Gkolia, Panagiota; Babu Rajendran, Nithya; del Toro, María Dolores; Voss, Andreas; Sharland, Mike; Sifakis, Frangiscos; Tacconelli, Evelina; Rodríguez-Baño, Jesús

    2017-01-01

    Introduction The worldwide spread of antimicrobial resistance is now recognised as a global public health threat. Owing to the geographical heterogeneity, complexity and continuously evolving dynamics of resistant organisms and genes, surveillance is a key tool for understanding, measuring and informing actions in the fight against this problem. To date there is no harmonisation of key indicators or of methodologies used to obtain them. Methods and analysis The main objective of this project is to systematically review and analyse the current publicly available surveillance activities on antimicrobial resistance and healthcare-associated infections in Europe. Eligible activities are those endorsed by regional, national or transnational health organisations and scientific societies providing data on a periodic basis. Grey and peer-reviewed literature will be searched with no language restrictions. Three independent reviewers will perform a two-step selection process using a previously piloted, tailored electronic data extraction form. Descriptive summaries and tables of all relevant findings will be performed and reported according to PRISMA guidelines. Ethics and dissemination We did not seek ethical approval for this study because the data to be collected are not linked to individuals. Data will be presented at international conferences and published in peer-reviewed journals. Trial registration number CRD42016033867. PMID:28348192

  16. Utilizing Health Information Technology to Support Universal Healthcare Delivery: Experience of a National Healthcare System.

    Science.gov (United States)

    Syed-Abdul, Shabbir; Hsu, Min-Huei; Iqbal, Usman; Scholl, Jeremiah; Huang, Chih-Wei; Nguyen, Phung Anh; Lee, Peisan; García-Romero, Maria Teresa; Li, Yu-Chuan Jack; Jian, Wen-Shan

    2015-09-01

    Recent discussions have focused on using health information technology (HIT) to support goals related to universal healthcare delivery. These discussions have generally not reflected on the experience of countries with a large amount of experience using HIT to support universal healthcare on a national level. HIT was compared globally by using data from the Ministry of the Interior, Republic of China (Taiwan). Taiwan has been providing universal healthcare since 1995 and began to strategically implement HIT on a national level at that time. Today the national-level HIT system is more extensive in Taiwan than in many other countries and is used to aid administration, clinical care, and public health. The experience of Taiwan thus can provide an illustration of how HIT can be used to support universal healthcare delivery. In this article we present an overview of some key historical developments and successes in the adoption of HIT in Taiwan over a 17-year period, as well as some more recent developments. We use this experience to offer some strategic perspectives on how it can aid in the adoption of large-scale HIT systems and on how HIT can be used to support universal healthcare delivery.

  17. Engineering healthcare as a service system.

    Science.gov (United States)

    Tien, James M; Goldschmidt-Clermont, Pascal J

    2010-01-01

    Engineering has and will continue to have a critical impact on healthcare; the application of technology-based techniques to biological problems can be defined to be technobiology applications. This paper is primarily focused on applying the technobiology approach of systems engineering to the development of a healthcare service system that is both integrated and adaptive. In general, healthcare services are carried out with knowledge-intensive agents or components which work together as providers and consumers to create or co-produce value. Indeed, the engineering design of a healthcare system must recognize the fact that it is actually a complex integration of human-centered activities that is increasingly dependent on information technology and knowledge. Like any service system, healthcare can be considered to be a combination or recombination of three essential components - people (characterized by behaviors, values, knowledge, etc.), processes (characterized by collaboration, customization, etc.) and products (characterized by software, hardware, infrastructures, etc.). Thus, a healthcare system is an integrated and adaptive set of people, processes and products. It is, in essence, a system of systems which objectives are to enhance its efficiency (leading to greater interdependency) and effectiveness (leading to improved health). Integration occurs over the physical, temporal, organizational and functional dimensions, while adaptation occurs over the monitoring, feedback, cybernetic and learning dimensions. In sum, such service systems as healthcare are indeed complex, especially due to the uncertainties associated with the human-centered aspects of these systems. Moreover, the system complexities can only be dealt with methods that enhance system integration and adaptation.

  18. Behavioral Reference Model for Pervasive Healthcare Systems.

    Science.gov (United States)

    Tahmasbi, Arezoo; Adabi, Sahar; Rezaee, Ali

    2016-12-01

    The emergence of mobile healthcare systems is an important outcome of application of pervasive computing concepts for medical care purposes. These systems provide the facilities and infrastructure required for automatic and ubiquitous sharing of medical information. Healthcare systems have a dynamic structure and configuration, therefore having an architecture is essential for future development of these systems. The need for increased response rate, problem limited storage, accelerated processing and etc. the tendency toward creating a new generation of healthcare system architecture highlight the need for further focus on cloud-based solutions for transfer data and data processing challenges. Integrity and reliability of healthcare systems are of critical importance, as even the slightest error may put the patients' lives in danger; therefore acquiring a behavioral model for these systems and developing the tools required to model their behaviors are of significant importance. The high-level designs may contain some flaws, therefor the system must be fully examined for different scenarios and conditions. This paper presents a software architecture for development of healthcare systems based on pervasive computing concepts, and then models the behavior of described system. A set of solutions are then proposed to improve the design's qualitative characteristics including, availability, interoperability and performance.

  19. Cyberterrorism: is the U.S. healthcare system safe?

    Science.gov (United States)

    Harries, David; Yellowlees, Peter M

    2013-01-01

    The Internet has brought with it many benefits; key among them has been its ability to allow the expansion of communication and transfer of all kinds of information throughout the U.S. healthcare system. As a consequence, healthcare has become increasingly dependent on the activities carried out in that environment. It is this very dependence that increases the likelihood of individuals or organizations conducting activities through the Internet that will cause physical and/or psychological harm. These activities have become known by the term "cyberterrorism." In the healthcare landscape this can appear in a variety of forms, such as bringing down a hospital computer system or publicly revealing private medical records. Whatever shape it takes, the general effects are the same: patient care is compromised, and trust in the health system is diminished. Fortunately no significant cyber attack has been successfully launched against a U.S. healthcare organization to date. However, there is evidence to suggest that cyber threats are increasing and that much of the U.S. healthcare system is ill equipped to deal with them. Securing cyberspace is not an easy proposition as the threats are constantly changing, and recognizing that cyberterrorism should be part of a broader information technology risk management strategy, there are several"best practices" that can be adopted by healthcare organizations to protect themselves against cyber attacks.

  20. Teaching at primary healthcare services within the Brazilian national health system (SUS in Brazilian healthcare professionals' training

    Directory of Open Access Journals (Sweden)

    Ramona Fernanda Ceriotti Toassi

    2013-06-01

    Full Text Available The aim of this study was to analyze the role of teaching at primary healthcare services within the Brazilian National Health System (SUS in dentists' training, at a public university in the south of Brazil. A qualitative methodological approach (case study was used. Interviews were conducted with 12 dentistry students, six dentists who were preceptors working in public primary healthcare services and three teachers connected with this curricular training. Our findings showed that the curricular training in SUS primary healthcare services had an impact on the dentists' education through establishment of bonds, autonomy in problem-solving and multiprofessional teamwork. It was seen that they learned about how healthcare services function, about healthcare and about development of cultural competence. There is a need to maintain constant questioning regarding these practices, and to ensure the presence of infrastructure and qualified professionals for teaching at these services.

  1. Infrastructuring Multicultural Healthcare Information Systems.

    Science.gov (United States)

    Dreessen, Katrien; Huybrechts, Liesbeth; Grönvall, Erik; Hendriks, Niels

    2017-01-01

    This paper stresses the need for more research in the field of Participatory Design (PD) and in particular into how to design Health Information Technology (HIT) together with care providers and -receivers in multicultural settings. We contribute to this research by describing a case study, the 'Health-Cultures' project, in which we designed HIT for the context of home care of older people with a migration background. The Health-Cultures project is located in the city of Genk, Belgium, which is known for its multicultural population, formed by three historical migration waves of people coming to work in the nowadays closed coal mines. Via a PD approach, we studied existing means of dialogue and designed HIT that both care receivers and care providers in Genk can use in their daily exchanges between cultures in home care contexts. In discussing relevant literature as well as the results of this study, we point to the need and the ways of taking spatio-historical aspects of a specific healthcare situation into account in the PD of HIT to support multicultural perspectives on healthcare.

  2. Securing U-Healthcare Sensor Networks using Public Key Based Scheme

    CERN Document Server

    Haque, Md Mokammel; Hong, Choong Seon

    2008-01-01

    Recent emergence of electronic culture uplifts healthcare facilities to a new era with the aid of wireless sensor network (WSN) technology. Due to the sensitiveness of medical data, austere privacy and security are inevitable for all parts of healthcare systems. However, the constantly evolving nature and constrained resources of sensors in WSN inflict unavailability of a lucid line of defense to ensure perfect security. In order to provide holistic security, protections must be incorporated in every component of healthcare sensor networks. This paper proposes an efficient security scheme for healthcare applications of WSN which uses the notion of public key cryptosystem. Our entire security scheme comprises basically of two parts; a key handshaking scheme based on simple linear operations and the derivation of decryption key by a receiver node for a particular sender in the network. Our architecture allows both base station to node or node to base station secure communications, and node-to-node secure commun...

  3. The orthopaedist's role in healthcare system governance.

    Science.gov (United States)

    Probe, Robert A

    2013-06-01

    Historically, physicians as participants in healthcare governance were shunned because of perceived potential for conflict of interest. This maxim is being revisited as health systems begin to appreciate the value presented by physician leaders. This overview of the orthopaedist's role in healthcare governance will be addressed in three sections: first to identify the need for change in American healthcare, second to examine the role that physicians should play in governing over this inevitable change, and third to outline strategies for effective participation for those physicians wishing to play a role in healthcare governance. The PubMed data set was queried applying the search commands "governance AND (healthcare OR hospital) AND (doctor OR physician OR surgeon)" for the time period 1969 to 2012. In addition, the bibliographies of relevant articles were reviewed. This search strategy returned 404 titles. Abstract and article review identified 19 relevant to the topic. Bibliographic review identified five more articles of relevance forming the foundation for this review. The delivery of American health care will require change to face current economic realities. Organizations that embrace this change guided by the insight of physician governors are well positioned to recognize the simultaneous improvement in value and quality. Although few physicians are formally trained for these roles, multiple paths to becoming effective governors are available. In this environment of rapid change in healthcare delivery, the medical insight of physician leadership will prove invaluable. Governing bodies should reach out to talented physicians and administratively talented physicians should rise to this challenge.

  4. The Dutch Healthcare System in International Perspective

    NARCIS (Netherlands)

    Mikkers, Misja

    2016-01-01

    In this address, important aspects of the Dutch system of managed competition are discussed from the economic perspective, highlighting both its merits and the major challenges posed by the development of this system. Reasons for government intervention in healthcare markets are provided, and the ou

  5. The Dutch Healthcare System in International Perspective

    NARCIS (Netherlands)

    Mikkers, Misja

    2016-01-01

    In this address, important aspects of the Dutch system of managed competition are discussed from the economic perspective, highlighting both its merits and the major challenges posed by the development of this system. Reasons for government intervention in healthcare markets are provided, and the ou

  6. [Fraud in the health-care system from the perspective of the public health insurance companies. Empirical findings on the work of anti-fraud agencies].

    Science.gov (United States)

    Meier, B D; Homann, D

    2010-07-01

    The article summarises the results of a study on the activities of the German public health insurance companies to fight fraudulent behaviour in the system. The study is based on the analysis of 140 activity reports of the years 2004 and 2005 which the companies had to deliver to the Federal Social Insurance Authority as well as on the results of an additional survey. The article deals with the number of cases, the phenomenology of the delinquent acts, the referral of the suspicious cases to the law enforcement agencies, and the cooperation with other insurance companies. Finally, the article presents some considerations on an improved prevention of fraud in the public health care system. Copyright Georg Thieme Verlag KG Stuttgart . New York.

  7. Emotional predictors of consumer's satisfaction with healthcare public services.

    Science.gov (United States)

    Vinagre, Helena; Neves, José

    2010-01-01

    The aim of this paper is to test empirically a framework that contributes to the understanding of patients' satisfaction by estimating the relationships between the satisfaction of particular types of customers with their emotions and perceived justice. The study was developed in two segments. First, an exploratory analysis was conducted to find a factor structure and to test the psychometric properties of satisfaction and perceived justice scales. After that the hypothesized model was tested through an empirical study, with a sample of 520 patients from six Portuguese public healthcare services, using structural equation modelling. The results show that the scales are psychometrically sound and confirm that satisfaction results from a complex cognitive and affective mechanism, thus highlighting the interactive characteristics of the services. Further research is needed to confirm these findings and to find if there is any possible conditioning factors that would interfere with these variables and change their effects on satisfaction. Patients' satisfaction is an important issue for improving the provided healthcare services. The paper offers empirical evidence about the complementary effect of emotions and perceived justice on the satisfaction with healthcare services. Findings also provide a model of analysis with valid and reliable measures.

  8. The Incidence of Public Spending on Healthcare: Comparative Evidence from Asia

    NARCIS (Netherlands)

    O.A. O'Donnell (Owen); E.K.A. van Doorslaer (Eddy); R.P. Rannan-Eliya (Ravi)

    2007-01-01

    textabstractThe article compares the incidence of public healthcare across 11 Asian countries and provinces, testing the dominance of healthcare concentration curves against an equal distribution and Lorenz curves and across countries. The analysis reveals that the distribution of public healthcare

  9. The Incidence of Public Spending on Healthcare: Comparative Evidence from Asia

    NARCIS (Netherlands)

    O.A. O'Donnell (Owen); E.K.A. van Doorslaer (Eddy); R.P. Rannan-Eliya (Ravi)

    2007-01-01

    textabstractThe article compares the incidence of public healthcare across 11 Asian countries and provinces, testing the dominance of healthcare concentration curves against an equal distribution and Lorenz curves and across countries. The analysis reveals that the distribution of public healthcare

  10. System Interoperability Study for Healthcare Information System with Web Services

    Directory of Open Access Journals (Sweden)

    J. K. Zhang

    2007-01-01

    Full Text Available This paper describes the use of a new distributed middleware technology ‘Web Services’ in the proposed Healthcare Information System (HIS to address the issue of system interoperability raised from existing Healthcare Information systems. With the development of HISs, hospitals and healthcare institutes have been building their own HISs for processing massive healthcare data, such as, systems built up for hospitals under the NHS (National Health Service to manage patients’ records. Nowadays many healthcare providers are willing to integrate their systems’ functions and data for information sharing. This has raised concerns in data transmission, data security and network limitation. Among these issues, system and language interoperability are one of most obvious issues since data and application integration is not an easy task due to differences in programming languages, system platforms, Database Management Systems (DBMS used within different systems. As a new distributed middleware technology, Web service brings an ideal solution to the issue of system and language interoperability. Web service has been approved to be very successful in many commercial applications (e.g. Amazon.com, Dell computer, etc., however it is different to healthcare information system. As the result, Web Service-based Integrated Healthcare Information System (WSIHIS is proposed to address the interoperability issue of existing HISs but also to introduce this new technology into the healthcare environment.

  11. Do senior management cultures affect performance? Evidence from Italian public healthcare organizations.

    Science.gov (United States)

    Prenestini, Anna; Lega, Federico

    2013-01-01

    Healthcare organizations are often characterized by diffuse power, ambiguous goals, and a plurality of actors. In this complex and pluralistic context, senior healthcare managers are expected to provide strategic direction and lead their organizations toward their goals and performance targets. The present work explores the relationship between senior management team culture and performance by investigating Italian public healthcare organizations in the Tuscany region. Our assessment of senior management culture was accomplished through the use of an established framework and a corresponding tool, the competing values framework, which supports the idea that specific aspects of performance are related to a dominant management culture. Organizational performance was assessed using a wide range of measures collected by a multidimensional performance evaluation system, which was developed in Tuscany to measure the performance of its 12 local health authorities (LHAs) and four teaching hospitals (THs). Usable responses were received from 80 senior managers of 11 different healthcare organizations (two THs and nine LHAs). Our findings show that Tuscan healthcare organizations are characterized by various dominant cultures: developmental, clan, rational, and hierarchical. These variations in dominant culture were associated with performance measures. The implications for management theory, professional practice, and public policy are discussed.

  12. Integration of advanced practice providers into the Israeli healthcare system.

    Science.gov (United States)

    Aaron, Eliana Marcus; Andrews, Caryn Scheinberg

    2016-01-01

    Many countries around the world have integrated various types of Advanced Practice Providers (APPs) into their healthcare systems. The main motivating factors for recognizing and developing APPs worldwide include physician shortages and the need for improved access or delivery (US, France, Belgium, Scotland, Switzerland), reduced residency hours (US, UK), shortages in underserved regions (US, Canada, Finland, Australia), and cost containment (Germany, Netherlands, UK, US). Israel is experiencing a shortage of physicians in peripheral geographic regions and in critical medical specialties. Recent by-laws approved by the Knesset (Parliament), combined with Israel Ministry of Health (MOH) policies, have thus far been unable to fully address the shortages. To understand the potential contribution of APPs in Israel, we evaluated the international historical foundations and development of APP roles. We assessed how APPs have impacted healthcare in other countries by analyzing public data and published international research about APP education, safety, quality of care, motivators, barriers, and impact. We found that APPs are recognized in dozens of countries, and have similar scopes of practice, graduate level education requirements (in developed countries), and clinical training. At the same time, there is wide variability among countries in the actual function and independence of the advanced practice nurse (APN), particularly the nurse practitioner (NP). APPs have been established as cost effective, safe healthcare providers who improve healthcare access. Israel has begun to introduce APPs, specifically NPs, in a variety of fields, including geriatrics, palliative care and diabetic care. We recommend a rapid expansion of existing and new APP roles into the Israeli healthcare system based on evidence and the recommendations of international evaluations by non-government organizations. By shifting the education to a university setting, mirroring successful, evidence

  13. Personal healthcare system using cloud computing.

    Science.gov (United States)

    Takeuchi, Hiroshi; Mayuzumi, Yuuki; Kodama, Naoki; Sato, Keiichi

    2013-01-01

    A personal healthcare system used with cloud computing has been developed. It enables a daily time-series of personal health and lifestyle data to be stored in the cloud through mobile devices. The cloud automatically extracts personally useful information, such as rules and patterns concerning lifestyle and health conditions embedded in the personal big data, by using a data mining technology. The system provides three editions (Diet, Lite, and Pro) corresponding to users' needs.

  14. Implementing chronic disease management in the public healthcare sector in Singapore: the role of hospitals.

    Science.gov (United States)

    Cheah, J; Heng, B H

    2001-01-01

    The public health care delivery system in Singapore faces the challenges of a rapidly ageing population, an increasing chronic disease burden, increasing healthcare cost, rising expectations and demand for better health services, and shortage of resources. It is also fragmented, resulting in duplication and lack of coordination between institutions. A disease management approach has been adopted by the National Healthcare Group (NHG) as a critical strategy to provide holistic, cost-effective, seamless and well-coordinated care across the continuum. The framework in the development of the disease management plan included identifying the diseases and defining the target population, organizing a multi-disciplinary team lead by a clinician champion, defining the core components, treatment protocols and evaluation methods, defining the goals, and measuring and managing the outcomes. As disease management and case management for chronic diseases are new approaches adopted in the healthcare delivery system, there is a lack of understanding by healthcare professionals. The leadership and participation of hospital physicians was sought in the planning, design and outcomes monitoring to ensure their 'buy-in' and the successful implementation and effectiveness of the program. The episodic diagnosis related group (DRG)-based framework of funding and subvention for healthcare, and the shortage of step-care care facilities, have been recognized by the Ministry of Health as an impediments to the implementation, and these are currently being addressed.

  15. Public release of performance data in changing the behaviour of healthcare consumers, professionals or organisations.

    Science.gov (United States)

    Ketelaar, Nicole A B M; Faber, Marjan J; Flottorp, Signe; Rygh, Liv Helen; Deane, Katherine H O; Eccles, Martin P

    2011-11-09

    Systems information on health plan choice in a Medicaid population. One interrupted time series study found a small positive effect of the publishing of data on patient volumes for coronary bypass surgery and low-complication outliers for lumbar discectomy, but these effects did not persist longer than two months after each public release. No effects on patient volumes for acute myocardial infarction were found.One cluster-randomised controlled trial, conducted in Canada, studied improvement changes in care after the public release of performance data for patients with acute myocardial infarction and congestive heart failure. No effects for the composite process-of-care indicators for either condition were found, but there were some improvements in the individual process-of-care indicators. There was an effect on the mortality rates for acute myocardial infarction. More quality improvement activities were initiated in response to the publicly-released report cards. No secondary outcomes were reported. The small body of evidence available provides no consistent evidence that the public release of performance data changes consumer behaviour or improves care. Evidence that the public release of performance data may have an impact on the behaviour of healthcare professionals or organisations is lacking.

  16. Public Value Creation Enabled by Healthcare IS Projects – a resource-based-view

    DEFF Research Database (Denmark)

    Schlichter, Bjarne Rerup; Svejvig, Per; Laursen, Markus

    in a public HIS setting to create value. The framework consists of Professional- , Organisational-, Patient Perceived- and Employee Perceived-Value dimensions. HIS is partly overlooked in the public management literature and the aspect of emergence and (personal as well as organisational) learning plays......Creation of value from IT projects is a recurring theme that has diffused into healthcare information sys-tems (HIS). By applying a resource-based-view on findings from a study on the optimisation project of an integrated health information system (HIS) we develop a framework of capabilities needed...... an important role in the creation value in HIS-projects....

  17. Nottingham Trent University and Makerere University School of Public Health partnership: experiences of co-learning and supporting the healthcare system in Uganda.

    Science.gov (United States)

    Musoke, David; Gibson, Linda; Mukama, Trasias; Khalil, Yesmean; Ssempebwa, John C

    2016-03-28

    Partnerships between developed and developing country institutions are increasingly becoming important in addressing contemporary global health challenges faced by health systems. Inter-university health collaboration such as the Nottingham Trent University (UK) and Makerere University School of Public Health (Uganda) partnership provide opportunities for working together in training, research and service delivery while strengthening health systems. This paper shares the experiences, achievements and opportunities of this partnership in co-learning and supporting the health system in Uganda. This includes a project being implemented to strengthen the training, supervision and motivation of community health workers in rural Uganda. Training and research are a key focus of the partnership and have involved both staff and students of both institutions including guest lectures, seminars and conference presentations. The partnership's collaboration with stakeholders such as the Ministry of Health (Uganda) and local health authorities has ensured participation necessary in supporting implementation of sustainable interventions. The partnership uses several channels such as email, telephone, Skype, Dropbox and WhatsApp which have been useful in maintaining constant and effective communication. The challenges faced by the partnership include lack of funding to support student mobility, and varying academic schedules of the two institutions. The experiences and prospects of this growing partnership can inform other collaborations in similar settings.

  18. Understanding healthcare innovation systems: the Stockholm region case.

    Science.gov (United States)

    Larisch, Lisa-Marie; Amer-Wåhlin, Isis; Hidefjäll, Patrik

    2016-11-21

    Purpose There is an increasing interest in understanding how innovation processes can address current challenges in healthcare. The purpose of this paper is to analyze the wider socio-economic context and conditions for such innovation processes in the Stockholm region, using the functional dynamics approach to innovation systems (ISs). Design/methodology/approach The analysis is based on triangulation using data from 16 in-depth interviews, two workshops, and additional documents. Using the functional dynamics approach, critical structural and functional components of the healthcare IS were analyzed. Findings The analysis revealed several mechanisms blocking innovation processes such as fragmentation, lack of clear leadership, as well as insufficient involvement of patients and healthcare professionals. Furthermore, innovation is expected to occur linearly as a result of research. Restrictive rules for collaboration with industry, reimbursement, and procurement mechanisms limit entrepreneurial experimentation, commercialization, and spread of innovations. Research limitations/implications In this study, the authors analyzed how certain functions of the functional dynamics approach to ISs related to each other. The authors grouped knowledge creation, resource mobilization, and legitimacy as they jointly constitute conditions for needs articulation and entrepreneurial experimentation. The economic effects of entrepreneurial experimentation and needs articulation are mainly determined by the stage of market formation and existence of positive externalities. Social implications Stronger user involvement; a joint innovation strategy for healthcare, academia, and industry; and institutional reform are necessary to remove blocking mechanisms that today prevent innovation from occurring. Originality/value This study is the first to provide an analysis of the system of innovation in healthcare using a functional dynamics approach, which has evolved as a tool for public

  19. Smart Cards Applications in the Healthcare System

    Directory of Open Access Journals (Sweden)

    Claudiu Oltean

    2011-06-01

    Full Text Available Current medical system based on medical records and health books is outdated and no longer meets the new requirements. Essential information security in terms of data privacy, integrity and authenticity, is not assured. Healthcare fraud with medical records is quite easy, because there is no security features to prevent this. Obtaining prescription drugs is slowly, the patient is forced in most cases, to go to the pharmacy staff to get their prescription. Another issue is data portability because each clinic can use a proprietary format of medical records, which is not always standardized. Modern and efficient healthcare system can be achieved by introducing smart cards and related software. Their introduction in addition to the portability and data security, reduce costs for both patient and medical institutions. The result will be increase confidence and patient satisfaction in medical institutions. Developed software package includes software applications which manage medical archive to smartcard, in a secure form and a software module which can be used for e-commerce transactions. All developed software application meets current standards for data security. Implementation of such solutions in practice would significantly reduce current costs in healthcare system.

  20. Human factors systems approach to healthcare quality and patient safety

    Science.gov (United States)

    Carayon, Pascale; Wetterneck, Tosha B.; Rivera-Rodriguez, A. Joy; Hundt, Ann Schoofs; Hoonakker, Peter; Holden, Richard; Gurses, Ayse P.

    2013-01-01

    Human factors systems approaches are critical for improving healthcare quality and patient safety. The SEIPS (Systems Engineering Initiative for Patient Safety) model of work system and patient safety is a human factors systems approach that has been successfully applied in healthcare research and practice. Several research and practical applications of the SEIPS model are described. Important implications of the SEIPS model for healthcare system and process redesign are highlighted. Principles for redesigning healthcare systems using the SEIPS model are described. Balancing the work system and encouraging the active and adaptive role of workers are key principles for improving healthcare quality and patient safety. PMID:23845724

  1. The public/private debate in the funding, administration and delivery of healthcare in Canada.

    Science.gov (United States)

    Marchildon, Gregory P

    2004-01-01

    To help clarify the confusing debate concerning the public-private divide in Canada and the respective positions of the Romanow and Kirby reports, a new approach is proposed. The funding, administration and delivery of the healthcare "system" is split into distinct analytical categories and then applied to three major coverage groupings: universal public (Canada Health Act) coverage for medically necessary/required services; mixed coverage for drug care, home and long-term care; and private health goods and services. While there were no fundamental differences between Romanow and Kirby concerning the funding of public healthcare in Canada, there were some important differences on issues of administration. In particular, the Romanow report recommended that home mental healthcare services become universally covered under the Canada Health Act as well as fundamental changes to the regulation and administration of prescription drug care. The reports also differed in terms of framing the private delivery question, with the Romanow report questioning whether the evidence justified private-for-profit delivery replacing current private not-for-profit or public arm's length delivery modes.

  2. Assessment of general public satisfaction with public healthcare services in Kedah, Malaysia.

    Science.gov (United States)

    Hassali, Mohammed Azmi; Alrasheedy, Alian A; Ab Razak, Basyirah Afifah; Al-Tamimi, Saleh Karamah; Saleem, Fahad; Ul Haq, Noman; Aljadhey, Hisham

    2014-01-01

    Patient satisfaction is considered an essential component of healthcare services evaluation and an additional indicator of the quality of healthcare. Moreover, patient satisfaction may also predict health-related behaviours of patients such as adherence to treatment and recommendations. The study aimed to assess patients' level of satisfaction with public healthcare services and to explore the association between socio-demographic and other study variables and patient satisfaction level. A cross-sectional study was conducted using selfadministered questionnaires distributed to a convenience sample of the general public in Kedah, Malaysia. A total of 435 out of 500 people invited to participate in the study agreed to take part, giving a response rate of 87 per cent. In this study, only approximately half of the participants (n=198, 45.5 per cent) were fully satisfied with the current healthcare services. The majority of the participants agreed that doctors had given enough information about their state of health (n=222, 51 per cent) and were competent and sympathetic (n=231, 53.1 per cent). Almost half of the participants (n=215, 49.5 per cent) agreed that the doctors took their problems seriously. Only 174 (40 per cent) participants agreed that doctors had spent enough time on their consultation session. Some respondents (n=266, 61.2 per cent) agreed that healthcare professionals in the public health sector were highly skilled. The majority of the respondents described amenities, accessibility and facilities available in the public healthcare sector as good or better. In this study, waiting time was significantly associated with patient satisfaction as the results showed that those who waited longer than two hours were less satisfied with the services than those who waited under two hours. The study findings showed that approximately half of the respondents were fully satisfied with current healthcare services. In this study, waiting time was the main factor that

  3. Principles for Health System Capacity Planning: Insights for Healthcare Leaders.

    Science.gov (United States)

    Shaw, James; Wong, Ivy; Griffin, Bailey; Robertson, Michael; Bhatia, R Sacha

    2017-01-01

    Jurisdictions across Canada and around the world face the challenge of planning high-performing and sustainable health systems in response to growing healthcare demands. In this paper, we report on the process of developing principles for health system capacity planning by the Ministry of Health and Long-Term Care in Ontario. Integrating the results of a literature review on health system planning and a symposium with representatives from local health integration networks, we describe the following six principles in detail: (1) develop an aspirational vision, (2) establish clear leadership, (3) commit to stakeholder engagement, (4) engage patients and the public, (5) build analytics infrastructure and (6) revise policy when necessary.

  4. Expert consensus (SBC/SBHCI) on the use of drug-eluting stents: recommendations of the Brazilian society of interventional cardiology/ Brazilian society of cardiology for the Brazilian public single healthcare system.

    Science.gov (United States)

    Lima, Valter C; Mattos, Luiz Alberto P; Caramori, Paulo R A; Perin, Marco A; Mangione, José A; Machado, Bruno M; Coelho, Wilson M C; Bueno, Ronaldo R L

    2006-10-01

    The authors review percutaneous coronary intervention (PCI) evolution and its growing application in myocardial revascularization for patients with coronary heart disease in Brazil and worldwide. PCI was introduced in 1977 using only the catheter balloon. Limitations of this method (acute occlusion and coronary restenosis) led to the adoption of coronary stents and more recently the advent of drug-eluting stents2, which were developed to drastically reduce restenosis rates. These developments allowed the exponential growth of percutaneous coronary intervention (PCI) procedures in Brazil which have replaced many bypass surgery procedures and have become the gold standard for the majority of symptomatic patients suffering from coronary artery disease. The preference for this procedure gained new dimensions in 2000 when the Brazilian Public Healthcare System (SUS) began reimbursing for stent procedures. This measure exemplified the importance of the Public Healthcare System's participation in incorporating medical advances and offering a high standard of cardiovascular treatment to a large portion of the Brazilian population. It is emphasized that prevention of in-stent restenosis is complex due to its unpredictable and ubiquitous occurrence. Control of this condition improves quality of life and reduces the recurrence of angina pectoris, the need to perform new revascularization procedures and hospital readmissions. The overall success of the drug-eluting stents has proven to be reliable and consistent in overcoming restenosis and has some beneficial impact for all clinical and angiographic conditions. This paper discusses the adoption and criteria for the use of drug-eluting stents in other countries as well as the recommendations established by the Brazilian Society of Interventional Cardiology for their reimbursement by SUS. The incorporation of new healthcare technology involves two distinct stages. During the first stage, the product is registered with the

  5. Public Health Risks from Mismanagement of Healthcare Wastes in Shinyanga Municipality Health Facilities, Tanzania

    OpenAIRE

    Kizito Kuchibanda; Mayo, Aloyce W.

    2015-01-01

    The increase of healthcare facilities in Shinyanga municipality has resulted in an increase of healthcare wastes, which poses serious threats to the environment, health workers, and the general public. This research was conducted to investigate management practices of healthcare wastes in Shinyanga municipality with a view of assessing health risks to health workers and the general public. The study, which was carried out in three hospitals, involved the use of questionnaires, in-depth interv...

  6. The healthcare system and provision of oral healthcare in European Union member states. Part 4: Greece.

    Science.gov (United States)

    Damaskinos, P; Koletsi-Kounari, H; Economou, C; Eaton, K A; Widström, E

    2016-03-11

    This paper presents a description of the healthcare system and how oral healthcare is organised and provided in Greece, a country in a deep economic and social crisis. The national health system is underfunded, with severe gaps in staffing levels and the country has a large private healthcare sector. Oral healthcare has been largely provided in the private sector. Most people are struggling to survive and have no money to spend on general and oral healthcare. Unemployment is rising and access to healthcare services is more difficult than ever. Additionally, there has been an overproduction of dentists and no development of team dentistry. This has led to under or unemployment of dentists in Greece and their migration to other European Union member states, such as the United Kingdom, where over 600 Greek dentists are currently working.

  7. Reforming primary healthcare: from public policy to organizational change.

    Science.gov (United States)

    Gilbert, Frédéric; Denis, Jean-Louis; Lamothe, Lise; Beaulieu, Marie-Dominique; D'amour, Danielle; Goudreau, Johanne

    2015-01-01

    Governments everywhere are implementing reform to improve primary care. However, the existence of a high degree of professional autonomy makes large-scale change difficult to achieve. The purpose of this paper is to elucidate the change dynamics and the involvement of professionals in a primary healthcare reform initiative carried out in the Canadian province of Quebec. An empirical approach was used to investigate change processes from the inception of a public policy to the execution of changes in professional practices. The data were analysed from a multi-level, combined contextualist-processual perspective. Results are based on a longitudinal multiple-case study of five family medicine groups, which was informed by over 100 interviews, questionnaires, and documentary analysis. The results illustrate the multiple processes observed with the introduction of planned large-scale change in primary care services. The analysis of change content revealed that similar post-change states concealed variations between groups in the scale of their respective changes. The analysis also demonstrated more precisely how change evolved through the introduction of "intermediate change" and how cycles of prescribed and emergent mechanisms distinctively drove change process and change content, from the emergence of the public policy to the change in primary care service delivery. This research was conducted among a limited number of early policy adopters. However, given the international interest in turning to the medical profession to improve primary care, the results offer avenues for both policy development and implementation. The findings offer practical insights for those studying and managing large-scale transformations. They provide a better understanding of how deliberate reforms coexist with professional autonomy through an intertwining of change content and processes. This research is one of few studies to examine a primary care reform from emergence to implementation

  8. Understanding safety in healthcare: the system evolution, erosion and enhancement model.

    Science.gov (United States)

    Carthey, Jane

    2013-12-01

    The paper summarises previous theories of accident causation, human error, foresight, resilience and system migration. Five lessons from these theories are used as the foundation for a new model which describes how patient safety emerges in complex systems like healthcare: the System Evolution Erosion and Enhancement model. It is concluded that to improve patient safety, healthcare organisations need to understand how system evolution both enhances and erodes patient safety. Significance for public healthThe article identifies lessons from previous theories of human error and accident causation, foresight, resilience engineering and system migration and introduces a new framework for understanding patient safety in healthcare; the System Evolution, Erosion and Enhancement (SEEE) model. The article is significant for public health because healthcare organizations around the world need to understand how safety evolves and erodes to develop and implement interventions to reduce patient harm.

  9. The major medical ethical challenges facing the public and healthcare providers in Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Abdulaziz F Alkabba

    2012-01-01

    Full Text Available Background: Despite the relatively high expenditure on healthcare in Saudi Arabia, its health system remains highly centralized in the main cities with its primary focus on secondary and tertiary care rather than primary care. This has led to numerous ethical challenges for the healthcare providers. This article reports the results of a study conducted with a panel of practitioners, and non-clinicians, in Saudi Arabia, in order to identify the top ten ethical challenges for healthcare providers, patients, and their families. Materials and Methods: The study design was a cross-sectional, descriptive, and qualitative one. The participants were asked the question: "What top ten ethical challenges are Saudis likely to face in health care?" The participants were asked to rank the top ten ethical challenges throughout a modified Delphi process, using a ranking Scale. A consensus was reached after three rounds of questions and an experts′ meeting. Results: The major 10 ethical issues, as perceived by the participants in order of their importance, were: (1 Patients′ Rights, (2 Equity of resources, (3 Confidentiality of the patients, (4 Patient Safety, (5 Conflict of Interests, (6 Ethics of privatization, (7 Informed Consent, (8 Dealing with the opposite sex, (9 Beginning and end of life, and (10 Healthcare team ethics. Conclusion: Although many of the challenges listed by the participants have received significant public and specialized attention worldwide, scant attention has been paid to these top challenges in Saudi Arabia. We propose several possible steps to help address these key challenges.

  10. Security threats categories in healthcare information systems.

    Science.gov (United States)

    Samy, Ganthan Narayana; Ahmad, Rabiah; Ismail, Zuraini

    2010-09-01

    This article attempts to investigate the various types of threats that exist in healthcare information systems (HIS). A study has been carried out in one of the government-supported hospitals in Malaysia.The hospital has been equipped with a Total Hospital Information System (THIS). The data collected were from three different departments, namely the Information Technology Department (ITD), the Medical Record Department (MRD), and the X-Ray Department, using in-depth structured interviews. The study identified 22 types of threats according to major threat categories based on ISO/IEC 27002 (ISO 27799:2008). The results show that the most critical threat for the THIS is power failure followed by acts of human error or failure and other technological factors. This research holds significant value in terms of providing a complete taxonomy of threat categories in HIS and also an important component in the risk analysis stage.

  11. Personalized biomedical devices & systems for healthcare applications

    Science.gov (United States)

    Chen, I.-Ming; Phee, Soo Jay; Luo, Zhiqiang; Lim, Chee Kian

    2011-03-01

    With the advancement in micro- and nanotechnology, electromechanical components and systems are getting smaller and smaller and gradually can be applied to the human as portable, mobile and even wearable devices. Healthcare industry have started to benefit from this technology trend by providing more and more miniature biomedical devices for personalized medical treatments in order to obtain better and more accurate outcome. This article introduces some recent development in non-intrusive and intrusive biomedical devices resulted from the advancement of niche miniature sensors and actuators, namely, wearable biomedical sensors, wearable haptic devices, and ingestible medical capsules. The development of these devices requires carful integration of knowledge and people from many different disciplines like medicine, electronics, mechanics, and design. Furthermore, designing affordable devices and systems to benefit all mankind is a great challenge ahead. The multi-disciplinary nature of the R&D effort in this area provides a new perspective for the future mechanical engineers.

  12. What is the evidence base for public involvement in health-care policy?: results of a systematic scoping review.

    Science.gov (United States)

    Conklin, Annalijn; Morris, Zoë; Nolte, Ellen

    2015-04-01

    Public involvement in health-care policy has been advocated as a means to enhance health system responsiveness, yet evidence for its impact has been difficult to ascertain. To review the peer-reviewed empirical evidence on outcomes of public involvement in health-care policy. We systematically searched PsychINFO and PubMed from November 2000 to April 2010 for empirical studies that reported on original research only; studies in languages other than English, German or French were excluded. Data were extracted using a standardized evidence table with a priori determined headings. Nineteen studies were identified as eligible for inclusion in our review. We found that sound empirical evidence of the outcomes of public involvement activities in health care remains underdeveloped. The concept and the indicators used to examine and determine outcomes remain poorly specified and inconsistent, as does the reporting of the evidence. There was some evidence for the developmental role of public involvement, such as enhancing awareness, understanding and competencies among lay participants. Evidence for instrumental benefits of public involvement initiatives was less well documented. Despite the growing body of work on public involvement in health-care policy, evidence of its impact remains scarce; thus, firm conclusions about involvement activities that are appropriate and effective for policy development are difficult to draw. However, focus on outcomes risks missing the normative argument that involving the public in the health-care policy process may be seen to be of intrinsic value. © 2012 John Wiley & Sons Ltd.

  13. Awareness of the healthcare system and rights to healthcare in the Colombian population.

    Science.gov (United States)

    Delgado Gallego, María Eugenia; Vázquez-Navarrete, María Luisa

    2013-01-01

    To analyze changes in users' awareness of the healthcare system and of their rights to healthcare in Colombia in the last 10 years, as well as the factors that influence users' awareness. We carried out a descriptive study to compare the results of two cross-sectional studies based on two surveys of users of the Colombian healthcare system. The first survey was performed in 2000 and the second in 2010. The municipalities of Tuluá (urban area) and Palmira (rural area) were surveyed. In both surveys, a stratified, multistage probability sample was selected. There were 1497 users in the first sample and 1405 in the second. Changes in awareness of the healthcare system and associated factors in each year were assessed through multivariate logistic regressions. Users' awareness of the healthcare system was limited in 2000 and was significantly lower in 2010, except for that relating to health insurers and providers. In contrast, more than 90% of users in both surveys perceived themselves as having healthcare rights. The factors consistently associated with greater awareness were belonging to a high socioeconomic stratum and having higher education. The most underprivileged users were less likely to be aware of the healthcare system, hampering their ability to make informed decisions and to exercise their health rights. To correct this situation, health institutions and the government should act decisively to reduce social inequalities. Copyright © 2012 SESPAS. Published by Elsevier Espana. All rights reserved.

  14. Healthcare system information at language schools for newly arrived immigrants

    DEFF Research Database (Denmark)

    Tynell, Lena Lyngholt; Wimmelmann, Camilla Lawaetz; Jervelund, Signe Smith

    2017-01-01

    Objective: In most European countries, immigrants do not systematically learn about the host countries’ healthcare system when arriving. This study investigated how newly arrived immigrants perceived the information they received about the Danish healthcare system. Method: Immigrants attending...... a language school in Copenhagen in 2012 received either a course or written information on the Danish healthcare system and subsequently evaluated this quantitatively. Results: The evaluation revealed a positive appraisal of the course/information provided. Conclusion: In times of austerity, incorporating...

  15. System integrational and migrational concepts and methods within healthcare

    DEFF Research Database (Denmark)

    Endsleff, F; Loubjerg, P

    1997-01-01

    In this paper an overview and comparison of the basic concepts and methods behind different system integrational implementations is given, including the DHE, which is based on the coming Healthcare Information Systems Architecture pre-standard HISA, developed by CEN TC251. This standard and the DHE...... (Distributed Healthcare Environment) not only provides highly relevant standards, but also provides an efficient and well structured platform for Healthcare IT Systems....

  16. The Appliance Pervasive of Internet of Things in Healthcare Systems

    Directory of Open Access Journals (Sweden)

    Mir Sajjad Hussain Talpur

    2013-01-01

    Full Text Available In fact, information systems are the foundation of new productivity sources, medical organizational forms, and erection of a global economy. IoT based healthcare systems play a significant role in ICT and have contribution in growth of medical information systems, which are underpinning of recent medical and economic development strategies. However, to take advantages of IoT, it is essential that medical enterprises and community should trust the IoT systems in terms of performance, security, privacy, reliability and return-on-investment, which are open challenges of current IoT systems. For heightening of healthcare system; tracking, tracing and monitoring of patients and medical objects are more essential. But due to the inadequate healthcare situation, medical environment, medical technologies and the unique requirements of some healthcare applications, the obtainable tools cannot meet them accurately. The tracking, tracing and monitoring of patients and healthcare actors activities in healthcare system are challenging research directions for IoT researchers. State-of-the-art IoT based healthcare system should be developed which ensure the safety of patients and other healthcare activities. With this manuscript, we elaborate the essential role of IoT in healthcare systems; immense prospects of Internet of things in healthcare systems; extensive aspect of the use of IoT is dissimilar among different healthcare components and finally the participation of IoT between the useful research and present realistic applications. IoT and few other modern technologies are still in underpinning stage; mainly in the healthcare system.

  17. Pervasive mobile healthcare systems for chronic disease monitoring.

    Science.gov (United States)

    Huzooree, Geshwaree; Kumar Khedo, Kavi; Joonas, Noorjehan

    2017-05-01

    Pervasive mobile healthcare system has the potential to improve healthcare and the quality of life of chronic disease patients through continuous monitoring. Recently, many articles related to pervasive mobile healthcare system focusing on health monitoring using wireless technologies have been published. The main aim of this review is to evaluate the state-of-the-art pervasive mobile healthcare systems to identify major technical requirements and design challenges associated with the realization of a pervasive mobile healthcare system. A systematic literature review was conducted over IEEE Xplore Digital Library to evaluate 20 pervasive mobile healthcare systems out of 683 articles from 2011 to 2016. The classification of the pervasive mobile healthcare systems and other important factors are discussed. Potential opportunities and challenges are pointed out for the further deployment of effective pervasive mobile healthcare systems. This article helps researchers in health informatics to have a holistic view toward understanding pervasive mobile healthcare systems and points out new technological trends and design challenges that researchers have to consider when designing such systems for better adoption, usability, and seamless integration.

  18. A Complex Systems Science Approach to Healthcare Costs and Quality

    CERN Document Server

    Bar-Yam, Yaneer Bar-Yam with Shlomiya; Cohen, Nancy; Gard-Murray, Alexander S; Harte, Helen P; Leykum, Luci

    2012-01-01

    There is a mounting crisis in delivering affordable healthcare in the US. For decades, key decision makers in the public and private sectors have considered cost-effectiveness in healthcare a top priority. Their actions have focused on putting a limit on fees, services, or care options. However, they have met with limited success as costs have increased rapidly while the quality isn't commensurate with the high costs. A new approach is needed. Here we provide eight scientifically-based steps for improving the healthcare system. The core of the approach is promoting the best use of resources by matching the people and organization to the tasks they are good at, and providing the right incentive structure. Harnessing costs need not mean sacrificing quality. Quality service and low costs can be achieved by making sure the right people and the right organizations deliver services. As an example, the frequent use of emergency rooms for non-emergency care demonstrates the waste of resources of highly capable indivi...

  19. PALLIATIVE CARE – ITS ROLE IN HEALTHCARE SYSTEMS

    Directory of Open Access Journals (Sweden)

    Urška Lunder

    2003-11-01

    Full Text Available Background. In the last decades a palliative care has been well established in the majority of West European countries. However, majority of these countries are not able to follow needs for palliative care because of demographic changes (older population, changes of morbidity pattern (increase of chronic progressive diseases and social changes (disability of families to care for their relatives at their homes. Research is showing evidence on palliative care effectiveness at end of life and in bereavement. There is still a great need for healthcare professionals’ change in their attitudes, knowledge and skills. In many National strategic plans (United Kingdom, Ireland, Sweden, Australia, New Zealand and Canada palliative care becomes a priority in the national public health. New organizational planning supports establishement of palliative care departments in hospitals and other healthcare settings and consultant teams at all levels of healthcare system. Hospices, caritative and independent organizations, will remain as a source of good clinical practice and philosophy of care at the end of life also in the future.

  20. Regionalization in the Brazilian Healthcare System, SUS: a critical review.

    Science.gov (United States)

    Fernandes, Fernando Manuel Bessa

    2017-04-01

    to review the output and the use of the data to support managers in making decisions on the healthcare system, and analyze academic output on the theme. An online search of the SciELO database for articles using 'regionalization' and 'health/healthcare' as the keywords, and all indices as the 'scope of the study'. We found a total of 102 references, and after analyzing the abstracts selected 70 articles that effectively discuss regionalization of health/healthcare in Brazil. We also found four articles in non-health related journals. the institutional criteria (journal, theme area, date of publication, scope and number of authors), and the analytical criteria created by author - Type 1 - "Exploratory Studies" (26), "Evaluation Studies" (6), "Comparison Studies" (3); and "Reports of Experience" (5), Type 2 - "Theoretical-Analytical" papers (20) and "Historical-Conceptual Reviews" (4), and Type 3 - "Editorials (3) and "Book Reviews" (3). regionalization has become more important in journals published since 2010. Most of the articles fall in the Type 1 category.

  1. Management practices in Australian healthcare: can NSW public hospitals do better?

    Science.gov (United States)

    Agarwal, Renu; Green, Roy; Agarwal, Neeru; Randhawa, Krithika

    2016-05-16

    Purpose - The purpose of this paper is to investigate the determinants of best management practices in an Australian state-run healthcare system, namely New South Wales (NSW), and studies the impact of a range of hospital factors in driving best management practices as a means of enhancing healthcare delivery. Design/methodology/approach - This study adapts a unique survey instrument globally tested to quantify the multi-dimensional nature of hospital management practices in 42 acute care public hospitals of NSW. The authors then analysed the role of hospital-specific characteristics in driving best management practices, namely hospital size (measured by the number of hospital beds, employees and doctors), level of skill and education, degree of hospital manager autonomy and organisational hierarchy. Findings - The findings of this study show the areas of strength and potential areas of improvement in NSW hospitals. The authors find a positive association between the adoption of better management practices and hospital size (measured by the number of hospital beds and employees), level of skills and education, degree of hospital manager autonomy and organisational hierarchy. However, hospital size as measured by the number of doctors did not have a statistically significant relationship. Practical implications - This paper is of interest to both hospital administrators, clinical doctors and healthcare policy-makers who want to improve and develop strategies for better management in the healthcare sector. Originality/value - This study provides an internationally comparable robust measure of management capability in public hospitals, and contributes to the evidence-base of management practices and performance in hospitals.

  2. Department of Defense Healthcare Management System Modernization (DHMSM)

    Science.gov (United States)

    2016-03-01

    2016 Major Automated Information System Annual Report Department of Defense Healthcare Management System Modernization (DHMSM) Defense...Secretary of Defense PB - President’s Budget RDT&E - Research, Development, Test, and Evaluation SAE - Service Acquisition Executive TBD - To Be...DSN Fax: Date Assigned: November 16, 2015 Program Information Program Name Department of Defense Healthcare Management System Modernization

  3. Building a middle-range theory of free public healthcare seeking in sub-Saharan Africa: a realist review.

    Science.gov (United States)

    Robert, Emilie; Samb, Oumar Mallé; Marchal, Bruno; Ridde, Valéry

    2017-09-01

    Realist reviews are a new form of knowledge synthesis aimed at providing middle-range theories (MRTs) that specify how interventions work, for which populations, and under what circumstances. This approach opens the 'black box' of an intervention by showing how it triggers mechanisms in specific contexts to produce outcomes. We conducted a realist review of health user fee exemption policies (UFEPs) in sub-Saharan Africa (SSA). This article presents how we developed both the intervention theory (IT) of UFEPs and a MRT of free public healthcare seeking in SSA, building on Sen's capability approach. Over the course of this iterative process, we explored theoretical writings on healthcare access, services use, and healthcare seeking behaviour. We also analysed empirical studies on UFEPs and healthcare access in free care contexts. According to the IT, free care at the point of delivery is a resource allowing users to make choices about their use of public healthcare services, choices previously not generally available to them. Users' ability to choose to seek free care is influenced by structural, local, and individual conversion factors. We tested this IT on 69 empirical studies selected on the basis of their scientific rigor and relevance to the theory. From that analysis, we formulated a MRT on seeking free public healthcare in SSA. It highlights three key mechanisms in users' choice to seek free public healthcare: trust, risk awareness and acceptability. Contextual elements that influence both users' ability and choice to seek free care include: availability of and control over resources at the individual level; characteristics of users' and providers' communities at the local level; and health system organization, governance and policies at the structural level. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

  4. Accounting Information Systems in Healthcare: A Review of the Literature.

    Science.gov (United States)

    Hammour, Hadal; Househ, Mowafa; Razzak, Hira Abdul

    2017-01-01

    As information technology progresses in Saudi Arabia, the manual accounting systems have become graduallyinadequate for decision needs. Subsequently, private and public healthcare divisions in Saudi Arabia perceive Computerized accounting information system (CAIS) as a vehicle to safeguard efficient and effective flow of information during the analysis, processes, and recording of financial data. Efficient and effective flow of information improvesthe decision making of staff, thereby improving the capability of health care sectors to reduce cost of the medical services.In this paper, we define computerized accounting systems from the point of view of health informatics. Also, the challenges and benefits of supporting CAIS applications in hospitals of Saudi Arabia. With these elements, we conclude that CAIS in Saudi Arabia can serve as a valuable tool for evaluating and controlling the cost of medical services in healthcare sectors. Supplementary education on the significance of having systems of computerized accounting within hospitals for nurses, doctors, and accountants with other health care staff is warranted in future.

  5. The healthcare system and the provision of oral healthcare in European Union member states: Part 5: Romania.

    Science.gov (United States)

    Oancea, R; Amariei, C; Eaton, K A; Widström, E

    2016-04-01

    Romania is one of the newest member states of the European Union (EU). It has 13 dental schools, 14,841 dentists and 2,935 dental technicians providing oral health care for a population, at 31 December 2014, of 21.3 million. The shift from a communist system to a democratic or capitalist society has contributed to an enormous change in the proportion of public and private sector oral health services. The lack of public funds during the post-communist years has contributed to a dependency on private oral healthcare rather than the government financed public provision. Affordability and social awareness have together established a mixed economy for oral health care costs and oral healthcare is growing slowly compared with other developed EU member states. At the same time, there has been overproduction of new dentists (currently 1500 graduate annually). This has led to un and under-employment and emigration of dentists to other EU member states. This paper explains the current oral healthcare system in Romania and changes in recent years.

  6. Value Chains of Public and Private Health-care Services in a Small EU Island State: A SWOT Analysis

    Science.gov (United States)

    Buttigieg, Sandra C.; Schuetz, Marcus; Bezzina, Frank

    2016-01-01

    The global financial and macroeconomic crisis of 2008/2009 and the ensuing recessions obliged policy makers to maximize use of resources and cut down on waste. Specifically, in health care, governments started to explore ways of establishing collaborations between the public and private health-care sectors. This is essential so as to ensure the best use of available resources, while securing quality of delivery of care as well as health systems sustainability and resilience. This qualitative study explores complementary and mutual attributes in the value creation process to patients by the public and private health-care systems in Malta, a small European Union island state. A workshop was conducted with 28 professionals from both sectors to generate two separate value chains, and this was followed by an analysis of strengths, weaknesses, opportunities, and threats (SWOT). The latter revealed several strengths and opportunities, which can better equip health-policy makers in the quest to maximize provision of health-care services. Moreover, the analysis also highlighted areas of weaknesses in both sectors as well as current threats of the external environment that, unless addressed, may threaten the state’s health-care system sustainability and resilience to macroeconomic shocks. The study goes on to provide feasible recommendations aimed at maximizing provision of health-care services in Malta. PMID:27683658

  7. Value Chains of Public and Private Health-care Services in a Small EU Island State: A SWOT Analysis.

    Science.gov (United States)

    Buttigieg, Sandra C; Schuetz, Marcus; Bezzina, Frank

    2016-01-01

    The global financial and macroeconomic crisis of 2008/2009 and the ensuing recessions obliged policy makers to maximize use of resources and cut down on waste. Specifically, in health care, governments started to explore ways of establishing collaborations between the public and private health-care sectors. This is essential so as to ensure the best use of available resources, while securing quality of delivery of care as well as health systems sustainability and resilience. This qualitative study explores complementary and mutual attributes in the value creation process to patients by the public and private health-care systems in Malta, a small European Union island state. A workshop was conducted with 28 professionals from both sectors to generate two separate value chains, and this was followed by an analysis of strengths, weaknesses, opportunities, and threats (SWOT). The latter revealed several strengths and opportunities, which can better equip health-policy makers in the quest to maximize provision of health-care services. Moreover, the analysis also highlighted areas of weaknesses in both sectors as well as current threats of the external environment that, unless addressed, may threaten the state's health-care system sustainability and resilience to macroeconomic shocks. The study goes on to provide feasible recommendations aimed at maximizing provision of health-care services in Malta.

  8. Software engineering principles applied to large healthcare information systems--a case report.

    Science.gov (United States)

    Nardon, Fabiane Bizinella; de A Moura, Lincoln

    2007-01-01

    São Paulo is the largest city in Brazil and one of the largest cities in the world. In 2004, São Paulo City Department of Health decided to implement a Healthcare Information System to support managing healthcare services and provide an ambulatory health record. The resulting information system is one of the largest public healthcare information systems ever built, with more than 2 million lines of code. Although statistics shows that most software projects fail, and the risks for the São Paulo initiative were enormous, the information system was completed on-time and on-budget. In this paper, we discuss the software engineering principles adopted that allowed to accomplish that project's goals, hoping that sharing the experience of this project will help other healthcare information systems initiatives to succeed.

  9. Outpatient parenteral antimicrobial therapy for orthopedic infections - a successful public healthcare experience in Brazil.

    Science.gov (United States)

    Oliveira, Priscila Rosalba; Felix, Cassia da Silva; Carvalho, Vladimir Cordeiro de; Giovani, Arlete Mazzini; Reis, Rosangela Suarti Dos; Beraldo, Marisa; Albuquerque, Edmir Peralta; Ferreira, Walter Cintra; Silva, Jorge Dos Santos; Lima, Ana Lucia Lei

    2016-01-01

    Treatment of orthopedic infections usually requires prolonged antimicrobial therapy, ranging from 14 days up to 6 months. Nowadays, rising levels of antimicrobial resistance demands parenteral therapy for many patients. Outpatient parenteral antimicrobial therapy (OPAT) is a modality that allows treatment out of hospital in these situations. In Brazil, where a public universal healthcare system allows full coverage for all citizens, implantation and dissemination of OPAT programs would be beneficial for patients and for the system, because it would allow a better allocation of health resources. The Instituto de Ortopedia e Traumatologia do Hospital das Clínicas da Faculdade de Medicina da USP (IOT) started, in July 2013, a partnership with municipal health authorities in Sao Paulo, Brazil, in order to initiate an OPAT program in which patients discharged from that hospital would be able to continue antimicrobial therapy at primary care facilities. When necessary, patients could also receive their therapy at the day-hospital located at IOT. Primary care nursing and physician staff were trained about antimicrobial infusion and peripherally inserted central catheter manipulation. An OPAT specific antimicrobial protocol was designed and a special reference and counter-reference organized. As a result, 450 primary healthcare professionals were trained. In the first year of this program, 116 patients were discharged for OPAT. Chronic and acute osteomyelitis were most frequent diagnosis. Teicoplanin, ertapenem and tigecycline were the most used drugs. Duration of treatment varied from 10 to 180 days (average 101, median 42). Total sum of days in OPAT regimen was 11,698. Only 3 patients presented adverse effects. Partnership between services of different levels of complexity allowed implantation of a safe and effective public healthcare OPAT program for treatment of orthopedic infections. This program can serve as a model for developing similar strategies in other regions

  10. Public assessment of key performance indicators of healthcare in a Canadian province: the effect of age and chronic health problems.

    Science.gov (United States)

    Nurullah, Abu Sadat; Northcott, Herbert C; Harvey, Michael D

    2014-01-15

    This study explores the effect of age and chronic conditions on public perceptions of the health system, as measured by the Key Performance Indicators (KPIs) of healthcare, in the province of Alberta in Canada. Drawing from data collected by Government of Alberta's Department of Health and Wellness, this research examines two key questions: (1) Do people in the 65+ age group rate the KPIs of healthcare (i.e., availability, accessibility, quality, outcome, and satisfaction) more favorably compared to people in younger age groups in Alberta? (2) Does the rating of KPIs of healthcare in Alberta vary with different chronic conditions (i.e., no chronic problem, chronic illnesses without pain, and chronic pain)? The findings indicate that people in the older age group tend to rate the KPIs of healthcare more favorably compared to younger age groups in Alberta, net of socio-demographic factors, self-reported health status, and knowledge and utilization of health services. However, people experiencing chronic pain are less likely to rate the KPIs of healthcare favorably compared to people with no chronic health problem in Alberta. Discussion includes implications of the findings for the healthcare system in the province.

  11. Healthcare system factors and colorectal cancer screening.

    Science.gov (United States)

    Zapka, Jane G; Puleo, Elaine; Vickers-Lahti, Maureen; Luckmann, Roger

    2002-07-01

    Developing effective programs to promote colorectal cancer (CRC) screening requires understanding of the effect of healthcare system factors on access to screening and adherence to guidelines. This study assessed the role of insurance status, type of plan, the frequency of preventive health visits, and provider recommendation on utilization of CRC screening tests using a cross-sectional, random-digit-dial survey of 1002 Massachusetts residents aged > or =50. A broad definition of CRC screening status included colonoscopy or barium enema (screening or diagnostic) within 10 years, flexible sigmoidoscopy (FSIG) within 5 years, and fecal occult blood testing (FOBT) in the past year as options; 51.7% of subjects aged 50 to 64 and 61.5% of older subjects were current. The uninsured had the lowest current testing rate. Among insured participants, type of insurance had little impact on CRC testing; older subjects enrolled in HMOs had marginally higher rates, although not statistically significant. Increased frequency of preventive health visits and ever receiving a physician's recommendation for FSIG or ever receiving FOBT cards were associated with higher rates of CRC screening among both age groups. Even when broad criteria are used to define current CRC screening status, a substantial proportion of the age-eligible population remains underscreened. Obtaining regular preventive care and receiving a physician's recommendation for screening appear to be potent facilitators of screening that should be considered in designing promotional efforts.

  12. Public Health Risks from Mismanagement of Healthcare Wastes in Shinyanga Municipality Health Facilities, Tanzania.

    Science.gov (United States)

    Kuchibanda, Kizito; Mayo, Aloyce W

    2015-01-01

    The increase of healthcare facilities in Shinyanga municipality has resulted in an increase of healthcare wastes, which poses serious threats to the environment, health workers, and the general public. This research was conducted to investigate management practices of healthcare wastes in Shinyanga municipality with a view of assessing health risks to health workers and the general public. The study, which was carried out in three hospitals, involved the use of questionnaires, in-depth interview, and observation checklist. The results revealed that healthcare wastes are not quantified or segregated in all the three hospitals. Healthcare wastes at the Shinyanga Regional Referral Hospital are disposed of by on-site incineration and burning and some wastes are disposed off-site. At Kolandoto DDH only on-site burning and land disposal are practiced, while at Kambarage UHC healthcare solid wastes are incinerated, disposed of on land disposal, and burned. Waste management workers do not have formal training in waste management techniques and the hospital administrations pay very little attention to appropriate management of healthcare wastes. In light of this, it is evident that management of healthcare solid wastes is not practiced in accordance with the national and WHO's recommended standards.

  13. Public Health Risks from Mismanagement of Healthcare Wastes in Shinyanga Municipality Health Facilities, Tanzania

    Directory of Open Access Journals (Sweden)

    Kizito Kuchibanda

    2015-01-01

    Full Text Available The increase of healthcare facilities in Shinyanga municipality has resulted in an increase of healthcare wastes, which poses serious threats to the environment, health workers, and the general public. This research was conducted to investigate management practices of healthcare wastes in Shinyanga municipality with a view of assessing health risks to health workers and the general public. The study, which was carried out in three hospitals, involved the use of questionnaires, in-depth interview, and observation checklist. The results revealed that healthcare wastes are not quantified or segregated in all the three hospitals. Healthcare wastes at the Shinyanga Regional Referral Hospital are disposed of by on-site incineration and burning and some wastes are disposed off-site. At Kolandoto DDH only on-site burning and land disposal are practiced, while at Kambarage UHC healthcare solid wastes are incinerated, disposed of on land disposal, and burned. Waste management workers do not have formal training in waste management techniques and the hospital administrations pay very little attention to appropriate management of healthcare wastes. In light of this, it is evident that management of healthcare solid wastes is not practiced in accordance with the national and WHO’s recommended standards.

  14. Why screening rates vary between Korea and Japan--differences between two national healthcare systems.

    Science.gov (United States)

    Goto, Rei; Hamashima, Chisato; Mun, Sunghyun; Lee, Won-Chul

    2015-01-01

    Both Japan and Korea provide population-based screening programs. However, screening rates are much higher in Korea than in Japan. To clarify the possible factors explaining the differences between these two countries, we analyzed the current status of the cancer screening and background healthcare systems. Population- based cancer screening in Korea is coordinated well with social health insurance under a unified insurer system. In Japan, there are over 3,000 insurers and coordinating a comprehensive strategy for cancer screening promotion has been very difficult. The public healthcare system also has influence over cancer screening. In Korea, public healthcare does not cover a wide range of services. Almost free cancer screening and subsidization for medical cost for cancers detected in population-screening provides high incentive to participation. In Japan, on the other hand, a larger coverage of medical services, low co-payment, and a lenient medical audit enables people to have cancer screening under public health insurance as well as the broad range of cancer screening. The implementation of evidence-based cancer screening programs may be largely dependent on the background healthcare system. It is important to understand the impacts of each healthcare system as a whole and to match the characteristics of a particular health system when designing an efficient cancer screening system.

  15. A comparison of outpatient healthcare expenditures between public and private medical institutions in urban China: an instrumental variable approach.

    Science.gov (United States)

    Xu, Judy; Liu, Gordon; Deng, Guoying; Li, Lin; Xiong, Xianjun; Basu, Kisalaya

    2015-03-01

    The growth of healthcare expenditure provokes constant comments and discussions, as countries battle the issues on cost containment and cost effectiveness. Prior to 1978, medical institutions in China were either state-owned or were collective public hospitals. Since 1978, China has been trying to rebuild its healthcare system, which was destroyed during the 'cultural revolution', allowing private medical institutions to deliver healthcare services. As a result, private medical institutions have grown from 0% to 28.57% between 1978 and 2010. In this context, we compare outpatient healthcare expenditures between public and private medical institutions. The central problem of this comparison is that the choice of medical institution is endogenous. So we apply an instrumental variable (IV) framework utilizing geographic information (whether the closest medical institution is private) as the instrument while controlling for severity of health and other relevant confounding factors. Using China's Urban Resident Basic Medical Insurance Survey 2008-2010, we found that there is no difference in expenditure between public and private medical institutions when IV framework is used. Our econometric tests suggest that our IV model is specified appropriately. However, the ordinary least square model, which is inconsistent in the presence of endogenous regressor(s), reveals that public medical institutions are more expensive. Copyright © 2013 John Wiley & Sons, Ltd.

  16. Expanding public health in China: an empirical analysis of healthcare inputs and outputs.

    Science.gov (United States)

    Deng, F; Lv, J H; Wang, H L; Gao, J M; Zhou, Z L

    2017-01-01

    obtained from the 2015 China Statistical Yearbook. From 2009 to 2014, China's healthcare human resources were distributed primarily in hospitals that focus on providing treatment. By 2014, 62.5% of the health professionals and technical personnel were distributed in hospitals. From 2009, the Chinese Government spent more money on health care than previously, with approximately 67% spent on disease treatment and 14.19% spent on disease prevention. However, the 2-week prevalence of illness increased by 5.2 percentage points, and the prevalence of chronic diseases increased by 9 percentage points. Meanwhile, residents' out-of-pocket payments for health care were as high as 50.61% of the total healthcare expenditure and were particularly high in rural areas. China should adjust the direction of its health reform as soon as possible to focus on improving health status rather than treatment of disease. In the future, as China's population ageing trend intensifies, China must take effective measures or the country's non-communicable disease rates will continue to increase. To meet this challenge, China's health reform should take effective measures to control the rising trend of the incidence of non-communicable diseases. First, China should focus on the core goal of its health reform policy, which is disease prevention. Second, China should focus on strengthening public health systems to effectively prevent and control key epidemic diseases. Third, China should increase the number of public health personnel, improve the level of education and training of public health personnel and increase the input of funds into the field of public health as soon as possible. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  17. LIFE CYCLE ASSESSMENT IN HEALTHCARE SYSTEM OPTIMIZATION. INTRODUCTION

    Directory of Open Access Journals (Sweden)

    V. Sarancha

    2015-03-01

    Full Text Available Article describes the life cycle assessment method and introduces opportunities for method performance in healthcare system settings. LSA draws attention to careful use of resources, environmental, human and social responsibility. Modelling of environmental and technological inputs allows optimizing performance of the system. Various factors and parameters that may influence effectiveness of different sectors in healthcare system are detected. Performance optimization of detected parameters could lead to better system functioning, higher patient safety, economic sustainability and reduce resources consumption.

  18. Understanding how orthopaedic surgery practices generate value for healthcare systems.

    Science.gov (United States)

    Olson, Steven A; Mather, Richard C

    2013-06-01

    Orthopaedic surgery practices can provide substantial value to healthcare systems. Increasingly, healthcare administrators are speaking of the need for alignment between physicians and healthcare systems. However, physicians often do not understand what healthcare administrators value and therefore have difficulty articulating the value they create in discussions with their hospital or healthcare organization. Many health systems and hospitals use service lines as an organizational structure to track the relevant data and manage the resources associated with a particular type of care, such as musculoskeletal care. Understanding service lines and their management can be useful for orthopaedic surgeons interested in interacting with their hospital systems. We provide an overview of two basic types of value orthopaedic surgeons create for healthcare systems: financial or volume-driven benefits and nonfinancial quality or value-driven patient care benefits. We performed a search of PubMed from 1965 to 2012 using the term "service line." Of the 351 citations identified, 18 citations specifically involved the use of service lines to improve patient care in both nursing and medical journals. A service line is a structure used in healthcare organizations to enable management of a subset of activities or resources in a focused area of patient care delivery. There is not a consistent definition of what resources are managed within a service line from hospital to hospital. Physicians can positively impact patient care through engaging in service line management. There is increasing pressure for healthcare systems and hospitals to partner with orthopaedic surgeons. The peer-reviewed literature demonstrates there are limited resources for physicians to understand the value they create when attempting to negotiate with their hospital or healthcare organization. To effectively negotiate for resources to provide the best care for patients, orthopaedic surgeons need to claim and

  19. The public's voice about healthcare quality regulation policies. A population-based survey

    NARCIS (Netherlands)

    R. Bouwman (Renée); M. Bomhoff (Manja); J.D. De Jong (Judith D.); P.B.M. Robben (Paul); R.D. Friele (Roland)

    2015-01-01

    textabstractBackground: In the wake of various high-profile incidents in a number of countries, regulators of healthcare quality have been criticised for their 'soft' approach. In politics, concerns were expressed about public confidence. It was claimed that there are discrepancies between public

  20. The contact network of patients in a regional healthcare system

    CERN Document Server

    Liljeros, Fredrik; Giesecke, Johan

    2007-01-01

    Yet in spite of advances in hospital treatment, hospitals continue to be a breeding ground for several airborne diseases and for diseases that are transmitted through close contacts like SARS, methicillin-resistant Staphylococcus aureus (MRSA), norovirus infections and tuberculosis (TB). Here we extract contact networks for up to 295,108 inpatients for durations up to two years from a database used for administrating a local public healthcare system serving a population of 1.9 million individuals. Structural and dynamical properties of the network of importance for the transmission of contagious diseases are then analyzed by methods from network epidemiology. The contact networks are found to be very much determined by an extreme (age independent) variation in duration of hospital stays and the hospital structure. We find that that the structure of contacts between in-patients exhibit structural properties, such as a high level of transitivity, assortativity and variation in number of contacts, that are likel...

  1. Qualidade do serviço oftalmológico prestado aos pacientes ambulatoriais do Sistema Único de Saúde - SUS Ophthalmological service quality offered to outpatients of the Public Healthcare System

    Directory of Open Access Journals (Sweden)

    Benigno Vicente Santos Hercos

    2006-04-01

    Full Text Available OBJETIVOS: Identificar a percepção da qualidade dos serviços oftalmológicos prestados aos pacientes ambulatoriais do Sistema Único de Saúde - SUS - e detectar quais ações são percebidas como necessárias e prioritárias para melhorar a sua qualidade. MÉTODOS: Foi realizado estudo descritivo quantitativo de 100 pacientes ambulatoriais do SUS, submetidos a exame oftalmológico na Fundação Hilton Rocha, em Belo Horizonte - MG, no período de 1 de junho a 30 de julho de 2004. Realizaram-se entrevistas pessoais, mediante a aplicação de dois questionários estruturados adaptados da escala SERVQUAL modificada. Essa escala foi adaptada à realidade da instituição estudada. RESULTADOS: A escala SERVQUAL adaptada foi submetida à validação estatística apresentando adequado índice de consistência interna. Em termos gerais, detectou-se ligeira insatisfação geral com a qualidade do atendimento oftalmológico. Os entrevistados deram maior importância à segurança e à confiabilidade. Detectou-se o maior grau de insatisfação na confiabilidade, principalmente em relação ao cumprimento das atividades nos horários marcados e em relação à execução dos serviços no prazo prometido. CONCLUSÕES: A instituição deve planejar e executar ações que levem a melhora geral da satisfação de seus pacientes com a qualidade do serviço recebido, principalmente no aspecto confiabilidade. A monitorização da qualidade do serviço pelo emprego periódico da escala SERVQUAL permitiria não só planejar estratégias precisas de intervenção de alta efetividade neste e em outros serviços de saúde, como também permitiria monitorizar a resposta a essas ações, contribuindo, dessa forma, para a melhora da qualidade do serviço no sistema como um todo.PURPOSE: To identify the perception of the ophthalmic service quality provided for outpatients of the public healthcare system as well as to detect which actions should be considered necessary

  2. The influence of power in the Canadian healthcare system.

    Science.gov (United States)

    Seenandan-Sookdeo, Kendra-Ann I

    2012-01-01

    This article presents a review of the literature as it relates to the influence of the word power in the context of the Canadian healthcare system. The concept of power is used to explore issues of gender and the evolution of advanced nurse practice in the development of the Canadian healthcare system. Furthermore, issues related to the call for interprofessional collaboration are addressed. Healthcare workers, in particular nurses, are trusted in a society that seeks, promotes, and aspires for power and control. In addition, societal norms continue to shape our healthcare reform. As a consequence, the discussion centers on a call for true collaboration among our healthcare providers and concludes with implications for nursing.

  3. Sourcing Strategy and Supply Chain Risk Management in the Healthcare Sector: A Case Study of Malawi¡¯s Public Healthcare Delivery Supply Chain

    OpenAIRE

    Kizito Elijah Kanyoma; James Kamwachale Khomba; Eric James Sankhulani; Rabiya Hanif

    2013-01-01

    The study primarily investigated the role of single sourcing strategy in either exacerbating or mitigating persistent supply failure in Malawi¡¯s public healthcare delivery supply chain. It also investigated the role of the single supplier in recurrent drug stockouts in the country¡¯s public hospitals. The study was conducted at five public healthcare delivery centres in southern Malawi. Data was collected using two sets of self administered questionnaires to, hospital managers and procuremen...

  4. Building a Healthcare System's Innovation Program.

    Science.gov (United States)

    Conger, Michelle D

    2016-01-01

    OSF HealthCare, based in Peoria, Illinois, has developed an innovative strategy to adapt to the changes and forces disrupting the healthcare environment. This strategy evolved organically from the performance improvement efforts we began more than 15 years ago, as well as from the lessons we learned from years of research into the innovative practices and platforms of other healthcare institutions and of companies in other industries. More important, the strategy reflects our mission "to serve persons with the greatest care and love."The OSF innovation model has three components: internal innovations, partnering with external entities, and validating innovations through simulation. OSF has an ongoing and comprehensive commitment to innovation. Examples include our initiative to transform our model of care in primary care clinics by expanding access, reducing costs, and increasing efficiency; our partnerships with outside entities to find revolutionary solutions and products in which we can invest; and our establishment of a world-class simulation and education center.OSF HealthCare could not do any of this if it lacked the support of its people. To that end, we continue to work on embedding a culture of innovation across all of our facilities. Ours is a culture in which everyone is encouraged to voice creative ideas and no one is afraid to fail-all for the betterment of our organization and the patients we serve.

  5. Virtual video prototyping of pervasive healthcare systems

    DEFF Research Database (Denmark)

    Bardram, Jakob; Bossen, Claus; Lykke-Olesen, Andreas

    2002-01-01

    . In this article we report our initial experience in the domain of pervasive healthcare with producing virtual video prototypes and using them in a design workshop. Our experience has been predominantly favourable. The production of a virtual video prototype forces the designers to decide very concrete design...

  6. Virtual Video Prototyping for Healthcare Systems

    DEFF Research Database (Denmark)

    Bardram, Jakob Eyvind; Bossen, Claus; Lykke-Olesen, Andreas

    2002-01-01

    . In this article we report our initial experience in the domain of pervasive healthcare with producing virtual video prototypes and using them in a design workshop. Our experience has been predominantly favourable. The production of a virtual video prototype forces the designers to decide very concrete design...

  7. Building an Ontology for Identity Resolution in Healthcare and Public Health.

    Science.gov (United States)

    Duncan, Jeffrey; Eilbeck, Karen; Narus, Scott P; Clyde, Stephen; Thornton, Sidney; Staes, Catherine

    2015-01-01

    Integration of disparate information from electronic health records, clinical data warehouses, birth certificate registries and other public health information systems offers great potential for clinical care, public health practice, and research. Such integration, however, depends on correctly matching patient-specific records using demographic identifiers. Without standards for these identifiers, record linkage is complicated by issues of structural and semantic heterogeneity. Our objectives were to develop and validate an ontology to: 1) identify components of identity and events subsequent to birth that result in creation, change, or sharing of identity information; 2) develop an ontology to facilitate data integration from multiple healthcare and public health sources; and 3) validate the ontology's ability to model identity-changing events over time. We interviewed domain experts in area hospitals and public health programs and developed process models describing the creation and transmission of identity information among various organizations for activities subsequent to a birth event. We searched for existing relevant ontologies. We validated the content of our ontology with simulated identity information conforming to scenarios identified in our process models. We chose the Simple Event Model (SEM) to describe events in early childhood and integrated the Clinical Element Model (CEM) for demographic information. We demonstrated the ability of the combined SEM-CEM ontology to model identity events over time. The use of an ontology can overcome issues of semantic and syntactic heterogeneity to facilitate record linkage.

  8. Toward More Compassionate Healthcare Systems; Comment on “Enabling Compassionate Healthcare: Perils, Prospects and Perspectives”

    Directory of Open Access Journals (Sweden)

    Beth A. Lown

    2014-05-01

    Full Text Available Compassion is central to the purpose of medicine and the care of patients and their families. Compassionate healthcare begins with compassionate people, but cannot be consistently provided without systemic changes that enable clinicians and staff to collaborate and to care. We propose seven essential commitments to foster more compassionate healthcare organizations and systems: a commitment to compassionate leadership, to teach compassion, to value and reward compassionate care, to support clinical caregivers, to involve and partner with patients and families, to build compassion into the organization of healthcare delivery, and a commitment to deepen our understanding of compassion and its impact through research. Acting on these commitments will help us attend with care to the ill, injured, and vulnerable in every interaction.

  9. Private investment in hospitals: a comparison of three healthcare systems and possible implications for real estate strategies.

    Science.gov (United States)

    van der Zwart, Johan; van der Voordt, Theo; Jonge, Hans de

    2010-01-01

    This article explores lessons to be learned from three different healthcare systems and the possible implications for the management of healthcare real estate, in particular in connection to the Dutch system. It discusses similarities and differences among the different systems, in search of possible consequences on cost, financing, and design innovation. To keep healthcare affordable in the future, the Dutch government is currently in the process of changing legislation to move from a centrally directed system to a so-called regulated market system. The deregulation of real estate investment that accompanies the new healthcare delivery system offers healthcare organizations new opportunities, but also more responsibility and greater risk in return on investment. Consequently, healthcare organizations must find new methods of financing. Private investment is one of the options. Three healthcare systems were analyzed on the basis of a literature review and document analysis, then schematized to show similarities and dissimilarities with regard to private investment in hospitals. Observations are based on a selection of recently published articles on private-sector financing and its implications for healthcare real estate decision making in the Netherlands, the United Kingdom, and Germany. The strengths and weaknesses of three healthcare systems with differing proportions of private and public investment in hospitals were explored. Research revealed a gap between intended effects and actual effects with regard to quality and cost. Costly private finance does not necessarily lead to "value for money." Transferring real estate decisions to private investors decreases the influence of the healthcare organization on future costs and quality. The three healthcare systems show substantial differences between public and private responsibilities. Less governmental involvement affords both opportunities and risks for hospitals. Private investment may lead to innovation

  10. FORMATION OF THE STATE POLICY IN PUBLIC HEALTHCARE IN THE RUSSIAN FEDERATION: PROBLEMS AND SOLUTIONS

    Directory of Open Access Journals (Sweden)

    A.A. Baranov

    2006-01-01

    Full Text Available The article analyzes the legal grounds for the state policy development in public healthcare in the Russian federation. The urgency of this program is well substantiated. The authors introduce the working definition of the governmental policy in public healthcare, which is viewed as a component of the internal policy of the state and which interacts with other trends of the state policy within the framework of its tasks. The adequate state regulation of the legal, social and economic and other relations within the society is necessary to achieve maximum full observance of the citizens' rights for the disease prevention, affordable highly qualified medical care and medical rehabilitation.Key words: public healthcare, medical care.

  11. Healthcare waste generation and its management system: the case ...

    African Journals Online (AJOL)

    Healthcare waste generation and its management system: the case of health ... in the course of activities, the generation of hazardous and non hazardous waste is a ... Segregation of wastes and pre treatment of infectious wastes were not ...

  12. [Production chain supply management for public hospitals: a logistical approach to healthcare].

    Science.gov (United States)

    Infante, Maria; dos Santos, Maria Angélica Borges

    2007-01-01

    Despite their importance for hospital operations, discussions of healthcare organization logistics and supply and materials management are notably lacking in Brazilian literature. This paper describes a methodology for organizing the supply of medical materials in public hospitals, based on an action-research approach. Interventions were based on the assumption that a significant portion of problems in Brazil's National Health System (SUS) facilities derive from the fact that their clinical and administrative departments do not see themselves as belonging to the same production chain - neither the hospital nor the supply department is aware of what the other produces. The development of the methodology and its main steps are presented and discussed, against a background of recent literature and total quality and supply chain management concepts.

  13. Integrating hospital information systems in healthcare institutions: a mediation architecture.

    Science.gov (United States)

    El Azami, Ikram; Cherkaoui Malki, Mohammed Ouçamah; Tahon, Christian

    2012-10-01

    Many studies have examined the integration of information systems into healthcare institutions, leading to several standards in the healthcare domain (CORBAmed: Common Object Request Broker Architecture in Medicine; HL7: Health Level Seven International; DICOM: Digital Imaging and Communications in Medicine; and IHE: Integrating the Healthcare Enterprise). Due to the existence of a wide diversity of heterogeneous systems, three essential factors are necessary to fully integrate a system: data, functions and workflow. However, most of the previous studies have dealt with only one or two of these factors and this makes the system integration unsatisfactory. In this paper, we propose a flexible, scalable architecture for Hospital Information Systems (HIS). Our main purpose is to provide a practical solution to insure HIS interoperability so that healthcare institutions can communicate without being obliged to change their local information systems and without altering the tasks of the healthcare professionals. Our architecture is a mediation architecture with 3 levels: 1) a database level, 2) a middleware level and 3) a user interface level. The mediation is based on two central components: the Mediator and the Adapter. Using the XML format allows us to establish a structured, secured exchange of healthcare data. The notion of medical ontology is introduced to solve semantic conflicts and to unify the language used for the exchange. Our mediation architecture provides an effective, promising model that promotes the integration of hospital information systems that are autonomous, heterogeneous, semantically interoperable and platform-independent.

  14. Some perspectives on affordable healthcare systems in China.

    Science.gov (United States)

    Zhang, Y T; Yan, Y S; Poon, C C Y

    2007-01-01

    Consistent with the global population trend, China is becoming an aging society. Over one-fifth of the world's elderly population (aged 65 and over) lives in China. Statistics show that the elderly populace in China constitutes 8% of the total population in 2006 and the percentage will be tripled to become 24% in 2050. As a result, there is inevitably an increase in the prevalence of chronic disease that accounted for almost 80% of all deaths in China in 2005. On the other hand, from 1978 to 2003, the total expenditure on healthcare in China increased from 11.02 billion RMB up to 658.41 billion RMB, and in terms of GDP, it is an increase from 3.04% to 5.62%. The annual average increase (12.1%) in healthcare investment is therefore even higher than the annual rate of GDP increase (9.38%) during the last two decades. Meeting the long-term healthcare needs of this growing elderly population and escalating healthcare expenditure pose a grim challenge to the current Chinese healthcare system and the solvency of state budgets. In fact, the healthcare services in China have become less accessible since the early 1980s when its costs soared up. The rising costs have prevented many Chinese people from seeking early medical care. The phenomenon has created a wide disparity in seeking healthcare between urban and rural areas. These trends are of particular concern to the elderly, who have higher healthcare needs yet lesser means to afford the services. Furthermore, according to the 3rd National Health Service Survey, 79.1% of rural residents and 44.8% of urban citizens did not have any form of medical insurance. Such a low percentage of coverage of medical insurance indicates that many people may not be able to afford medical services when they suffer from severe diseases. Therefore, there is a great need of a more effective and low-cost healthcare system. A new system that can allow multi-level, multi-dimensional and standardized healthcare services for urban and rural

  15. Design principles for achieving integrated healthcare information systems.

    Science.gov (United States)

    Jensen, Tina Blegind

    2013-03-01

    Achieving integrated healthcare information systems has become a common goal for many countries in their pursuit of obtaining coordinated and comprehensive healthcare services. This article focuses on how a small local project termed 'Standardized pull of patient data' expanded and is now used on a large scale providing a majority of hospitals, general practitioners and citizens across Denmark with the possibility of accessing healthcare data from different electronic patient record systems and other systems. I build on design theory for information infrastructures, as presented by Hanseth and Lyytinen, to examine the design principles that facilitated this smallscale project to expand and become widespread. As a result of my findings, I outline three lessons learned that emphasize: (i) principles of flexibility, (ii) expansion from the installed base through modular strategies and (iii) identification of key healthcare actors to provide them with immediate benefits.

  16. Engineering Value-Effective Healthcare Solutions: A Systems Design Perspective

    DEFF Research Database (Denmark)

    Patou, François; Maier, Anja

    2017-01-01

    Our modern healthcare systems commonly face an important dilemma. While they depend on innovation to provide continuously greater healthcare value, they also struggle financially with the burden of adopting a continuous flow of new products and services. Although several disruptive healthcare...... models, i.e. decentralised, personalised, pervasive, connected, and stratified, promise to relieve some of this tension, they do not per se guarantee optimal value generation. We argue that systems thinking and engineering design can remedy this limitation. We support this claim by making the case...... of Design for Evolvability and by elaborating on two examples: MRI systems and Point-of-Care in-vitro diagnostics solutions. We specifically argue that Design for Evolvability can realign the agendas of various healthcare stakeholders, serving both individual and national interests. We finally acknowledge...

  17. Measuring fragmentation of ambulatory care in a tripartite healthcare system.

    Science.gov (United States)

    Liu, Su; Yeung, Philip C

    2013-05-15

    Hong Kong has a tripartite healthcare system, where western medicine provided in both public and private sectors coexist with Chinese medicine practice. The purpose of this study is to measure fragmentation of ambulatory care experienced by the non-institutionalized population aged 15 and over in such a tripartite system, thus shed light on the ongoing primary care reform. This is a cross-sectional secondary data analysis using the Thematic Household Survey, which was conducted by the Hong Kong Census and Statistics Department during November 2009 to February 2010 to collect territory-wide health-related information. Among 18,226 individuals with two or more ambulatory visits during the past 12 months before interview, we grouped each visit into one of the three care segments-public western, private western and Chinese medicine. Two individual-level measures were used to quantify longitudinal fragmentation of care across segments over the one-year period: Most Frequent Provider Continuity Index (MFPC) and Fragmentation of Care Index (FCI). Both are analyzed for distribution and subgroup comparison. A Tobit model was used to further examine the determinants of fragmentation. More than a quarter of individuals sought care in two or all three segments, with an average MFPC of 65% and FCI of 0.528. Being older, female, married, unemployed, uninsured, or born in mainland China, with lower education, lower income, higher number of chronic conditions or poorer health were found to have experienced higher fragmentation of care. We also found that, fragmentation of care increased with the total number of ambulatory care visits and it varied significantly depending on what segment the individual chose to visit most frequently-those chose private western clinics had lower FCI, compared with those chose public western or Chinese medicine as the most frequently visited segment. Even measured at healthcare segment level, people in Hong Kong experienced modest fragmentation of

  18. Strategies for transforming reproductive healthcare delivery in an integrated healthcare system: a national model with system-wide implications.

    Science.gov (United States)

    Zephyrin, Laurie C; Katon, Jodie G; Yano, Elizabeth M

    2014-12-01

    As the number of women serving in the US military has grown, so too has the number of women using the US Department of Veterans Affairs Healthcare System (VA). This poses tremendous opportunity to integrate reproductive health services across a national healthcare system. This review summarizes the approaches used to assess, rapidly design, and integrate VA's first National Reproductive Health Program. Compared with the civilian population, women Veterans have poorer health status including increased likelihood of medical comorbidities and mental health conditions. Given these complex health needs, a health systems approach that integrates reproductive health with other needs is essential in this vulnerable population. Delivery of high-quality reproductive healthcare must incorporate a systems perspective. Promoting major organizational and cultural change in a national system has required use of an evidence-based strategic framework, which has relied on several key tenets including the following: understanding the population of women Veterans served, developing research-clinical partnerships, building interdisciplinary initiatives for system-wide integration of reproductive healthcare, and developing innovative tools for enhancing care delivery. This approach can serve as a model for other healthcare systems committed to developing an integrated system of reproductive healthcare and addressing reproductive health conditions in women with complex needs.

  19. Mobile healthcare applications: system design review, critical issues and challenges.

    Science.gov (United States)

    Baig, Mirza Mansoor; GholamHosseini, Hamid; Connolly, Martin J

    2015-03-01

    Mobile phones are becoming increasingly important in monitoring and delivery of healthcare interventions. They are often considered as pocket computers, due to their advanced computing features, enhanced preferences and diverse capabilities. Their sophisticated sensors and complex software applications make the mobile healthcare (m-health) based applications more feasible and innovative. In a number of scenarios user-friendliness, convenience and effectiveness of these systems have been acknowledged by both patients as well as healthcare providers. M-health technology employs advanced concepts and techniques from multidisciplinary fields of electrical engineering, computer science, biomedical engineering and medicine which benefit the innovations of these fields towards healthcare systems. This paper deals with two important aspects of current mobile phone based sensor applications in healthcare. Firstly, critical review of advanced applications such as; vital sign monitoring, blood glucose monitoring and in-built camera based smartphone sensor applications. Secondly, investigating challenges and critical issues related to the use of smartphones in healthcare including; reliability, efficiency, mobile phone platform variability, cost effectiveness, energy usage, user interface, quality of medical data, and security and privacy. It was found that the mobile based applications have been widely developed in recent years with fast growing deployment by healthcare professionals and patients. However, despite the advantages of smartphones in patient monitoring, education, and management there are some critical issues and challenges related to security and privacy of data, acceptability, reliability and cost that need to be addressed.

  20. Using Business Intelligence Tools for Predictive Analytics in Healthcare System

    Directory of Open Access Journals (Sweden)

    Mihaela-Laura IVAN

    2016-05-01

    Full Text Available The scope of this article is to highlight how healthcare analytics can be improved using Business Intelligence tools. Healthcare system has learned from the previous lessons the necessity of using healthcare analytics for improving patient care, hospital administration, population growth and many others aspects. Business Intelligence solutions applied for the current analysis demonstrate the benefits brought by the new tools, such as SAP HANA, SAP Lumira, and SAP Predictive Analytics. In detailed is analyzed the birth rate with the contribution of different factors to the world.

  1. The Healthcare Future for the iGeneration: Integrating the Patient and the Healthcare System

    OpenAIRE

    Cathy H. Ficzere, PharmD, BCPS; Traci M. Poole, PharmD, BCACP; Rachel B. Franks, PharmD, BCACP; Elisa M. Greene, PharmD, BCACP; Kristina D. Wood, PharmD, BCACP; Philip E. Johnston, PharmD

    2013-01-01

    Objective: To propose a vision to integrate patients, their health-related data, and their wellness plans into the healthcare system using smartphone and tablet computer technology.Setting: Ambulatory care and community practicePractice Innovation: Utilization of smartphone and tablet computer technology to assess health care conditions, educate and involve patients, and facilitate seamless communication between the patient, electronic health record, pharmacy system, third-party payers, point...

  2. Approaches to the international standards application in healthcare and public health in different countries

    Directory of Open Access Journals (Sweden)

    Vitaliy Sarancha

    2017-06-01

    Full Text Available As a result of consequent development, and guided by an increasing demand of different types of the organizations regarding structured management, the system of standardization has been established. The idea behind standardization is adjusting the characteristics of a product, process or a production cycle to make them consistent and in line with the rules regarding what is proper and acceptable. The “standard” is a document that specifies such established set of criteria covering a broad range of topics and applicable to commissioners of health, specialists in primary care, public health staff, and social care providers, as well as the local authorities and service users. Health products, ranging from medical devices and health informatics to traditional medicines and unconventional healing tools are all in the focus of standards’ application. Different countries have their own quality management traditions based on their history, mentality, socio-economic environment and the local regulations. Taking into consideration that community social system organization and the quality of social infrastructure are the main foundations of social relations and future prosperity, here we review the existing standardization environment in the health sector in different countries, both developed and those on a convergence path. We focused on standardization environment in the United States of America, Great Britain, Germany, Ukraine, Russian Federation, Croatia and Albania. In order to simplify comprehension, we also demonstrate the algorithm of standardization, as well as the opportunities for application of the international standards in healthcare and public health.

  3. Change readiness for SAP in the Canadian healthcare system.

    Science.gov (United States)

    O'Neill, Mary Lou; Downer, Pauline

    2004-01-01

    The study described in this article was designed to assess the change readiness for e-business cost management systems (particularly SAP) within the Canadian healthcare system. Previous studies and experts suggest that change readiness is an important variable in the application of e-business cost management system implementation. One hundred and fifty-four chief executive officers within the Canadian healthcare system were surveyed. The response rate was 25.9 percent. The survey included a demographic sheet, which supported a better understanding of the profile of Canadian healthcare CEOs, their operational budget responsibilities, and their feelings toward e-business cost management systems. A change readiness instrument reviewed CEOs' change readiness scores in relation to four independent variables (implementation of an e-business cost management system, healthcare restructuring, budget size and tenure of the CEO). There was a significant difference between change readiness scores and the implementation of an e-business cost management system. Given the small sample size (n = 40), findings are limited. However the study offers more information on this issue than is found in the Canadian healthcare literature to date.

  4. Mapping healthcare systems: a policy relevant analytic tool.

    Science.gov (United States)

    Sekhri Feachem, Neelam; Afshar, Ariana; Pruett, Cristina; Avanceña, Anton L V

    2017-07-01

    In the past decade, an international consensus on the value of well-functioning systems has driven considerable health systems research. This research falls into two broad categories. The first provides conceptual frameworks that take complex healthcare systems and create simplified constructs of interactions and functions. The second focuses on granular inputs and outputs. This paper presents a novel translational mapping tool - the University of California, San Francisco mapping tool (the Tool) - which bridges the gap between these two areas of research, creating a platform for multi-country comparative analysis. Using the Murray-Frenk framework, we create a macro-level representation of a country's structure, focusing on how it finances and delivers healthcare. The map visually depicts the fundamental policy questions in healthcare system design: funding sources and amount spent through each source, purchasers, populations covered, provider categories; and the relationship between these entities. We use the Tool to provide a macro-level comparative analysis of the structure of India's and Thailand's healthcare systems. As part of the systems strengthening arsenal, the Tool can stimulate debate about the merits and consequences of different healthcare systems structural designs, using a common framework that fosters multi-country comparative analyses.

  5. Investments in information systems and technology in the healthcare: Project management mediation

    Directory of Open Access Journals (Sweden)

    Jorge Gomes

    2017-03-01

    Full Text Available Healthcare organisations must improve their business practices and internal procedures in order to answer the increasing demand of health professionals and the general public for more and better information. Hospitals invest massively in information systems and technology (IS/IT in the hope that these investments will improve healthcare and meet patients’ demands. The main objective of our research is to study how organisational maturity, enhanced by investments in IS/IT, project management and best practices, leads to successful projects in public healthcare organisations. The rational of our model is that organisational maturity has a positive effect on IS/IT project success, and that this success is also positively enhanced by the use of project management practices. We emphasise that this combination of approaches can increase the effectiveness of projects. Furthermore, it can also improve the confidence that the results of investments will meet stakeholders’ expectations.

  6. Information security requirements in patient-centred healthcare support systems.

    Science.gov (United States)

    Alsalamah, Shada; Gray, W Alex; Hilton, Jeremy; Alsalamah, Hessah

    2013-01-01

    Enabling Patient-Centred (PC) care in modern healthcare requires the flow of medical information with the patient between different healthcare providers as they follow the patient's treatment plan. However, PC care threatens the stability of the balance of information security in the support systems since legacy systems fall short of attaining a security balance when sharing their information due to compromises made between its availability, integrity, and confidentiality. Results show that the main reason for this is that information security implementation in discrete legacy systems focused mainly on information confidentiality and integrity leaving availability a challenge in collaboration. Through an empirical study using domain analysis, observations, and interviews, this paper identifies a need for six information security requirements in legacy systems to cope with this situation in order to attain the security balance in systems supporting PC care implementation in modern healthcare.

  7. The Healthcare Future for the iGeneration: Integrating the Patient and the Healthcare System

    Directory of Open Access Journals (Sweden)

    Cathy H. Ficzere, PharmD, BCPS

    2013-01-01

    Full Text Available Objective: To propose a vision to integrate patients, their health-related data, and their wellness plans into the healthcare system using smartphone and tablet computer technology.Setting: Ambulatory care and community practicePractice Innovation: Utilization of smartphone and tablet computer technology to assess health care conditions, educate and involve patients, and facilitate seamless communication between the patient, electronic health record, pharmacy system, third-party payers, point-of-care testing, and all health-care providers.Main Outcome Measures: By providing integrated and customized information at the point of use, medication adherence and access to care will be increased and patients will engage in healthy behaviors more often resulting in an improved level of care for patients.Results: In the future, the authors believe if the vision is achieved, the health care system and patients will see improved health outcomes and more efficient utilization of the healthcare system.Conclusions: Our proposed use of technology provides an opportunity to empower patients to positively improve their own health which could be a vital advancement in health care, especially in the areas of medication adherence, improving access to care, and health behavior support. As pharmacists, we may also embrace technology opportunities to expand our roles as health care professionals as we continue to partner with patients and the health care team to improve outcomes.

  8. Breakdown of continuity in public mental healthcare in the Netherlands: a longitudinal case study

    Directory of Open Access Journals (Sweden)

    André Wierdsma

    2011-09-01

    Full Text Available Introduction: Continuity of care for long-term service-dependent patients in the public mental health system requires intensive collaboration between all agencies involved. Understanding the ways in which various aspects of continuity of care interact may reveal help to find out more about how care de­livered over time improves outcomes. Case study: Based on medical records, an addicted couple was monitored for number and type of contacts with health and social services. Over the years, 81 social workers or nurses, spread over 25 health and social services, have been involved in the rehabilitation process. Breakdown of continuity of care is linked to lack of information, missing procedures and guidelines, fragile relationships with the patient, and a reluctant public health approach. Conclusion: Prominent among relevant factors is the absence of protocols governing the transfer of patients between the various links in the continuum of mental healthcare services. High-quality follow-up after admission is partly a matter of professional principle in ensuring that problems in the chain of services are discussed. Case presen­tation in psychiatric journals should give syste­matic at­ten­tion to sources of error in continuity of mental health­care.

  9. Mobile technology and healthcare: the adoption issues and systemic problems.

    Science.gov (United States)

    Standing, Susan; Standing, Craig

    2008-01-01

    Although the benefits that are associated with mobile technology have been recognised as offering great potential in the healthcare sector, its widespread adoption has been lagging. We propose that fundamental systemic issues are likely to be the main barriers to adoption. We explain that the fragmented nature of the conservative healthcare system, the contradictory incentives and improper outcome measures conspire to make the innovative adoption of mobile technology problematic. Researchers can only gain a limited understanding of a technology's potential success by using technology adoption frameworks and need to supplement this with a 'systems' perspective that takes a more strategic view.

  10. Integration of healthcare and financial information: Evaluation in a public hospital using a comprehensive approach.

    Science.gov (United States)

    Escobar-Pérez, Bernabé; Escobar-Rodríguez, Tomás; Bartual-Sopena, Lourdes

    2016-12-01

    Public healthcare organisations are moving towards the use of new technologies to automate and improve their internal processes in order to increase the effectiveness and efficiency of their use of resources. The aim of this research is to tackle the systematic evaluation of an experience of integrating information in a healthcare organisation, paying attention to the implications that this entails. The results show that the integration of the information in the hospital results in higher levels of quality. This study contributes a vision of interrelated work, in which tasks are shared and aims are jointly established.

  11. The CRACK programme: a scientific alliance for bridging healthcare research and public health policies in Italy

    Directory of Open Access Journals (Sweden)

    Giovanni Corrao

    2013-09-01

    Full Text Available Healthcare utilisation databases, and other secondary data sources, have been used with growing frequency to assess health outcomes and healthcare interventions worldwide. Their increased popularity as a research tool is due to their timely availability, the large patient populations covered, low cost, and applicability for studying real-world clinical practice. Despite the need to measure Italian National Health Service performance both at regional and national levels, the wealth of good quality electronic data and the high standards of scientific research in this field, healthcare research and public health policies seem to progress along orthogonal dimensions in Italy. The main barriers to the development of evidence-based public health include the lack of understanding of evidence-based methodologies by policy makers, and of involvement of researchers in the policy process. The CRACK programme was launched by some academics from the Lombardy Region. By extensively using electronically stored data, epidemiologists, biostatisticians, pharmacologists and clinicians applied methods and evidence to several issues of healthcare research. The CRACK programme was based on their intention to remove barriers that thwart the process of bridging methods and findings from scientific journals to public health practice. This paper briefly describes aim, articulation and management of the CRACK programme, and discusses why it might find articulated application in Italy.

  12. Enhancing Health-Care Services with Mixed Reality Systems

    Science.gov (United States)

    Stantchev, Vladimir

    This work presents a development approach for mixed reality systems in health care. Although health-care service costs account for 5-15% of GDP in developed countries the sector has been remarkably resistant to the introduction of technology-supported optimizations. Digitalization of data storing and processing in the form of electronic patient records (EPR) and hospital information systems (HIS) is a first necessary step. Contrary to typical business functions (e.g., accounting or CRM) a health-care service is characterized by a knowledge intensive decision process and usage of specialized devices ranging from stethoscopes to complex surgical systems. Mixed reality systems can help fill the gap between highly patient-specific health-care services that need a variety of technical resources on the one side and the streamlined process flow that typical process supporting information systems expect on the other side. To achieve this task, we present a development approach that includes an evaluation of existing tasks and processes within the health-care service and the information systems that currently support the service, as well as identification of decision paths and actions that can benefit from mixed reality systems. The result is a mixed reality system that allows a clinician to monitor the elements of the physical world and to blend them with virtual information provided by the systems. He or she can also plan and schedule treatments and operations in the digital world depending on status information from this mixed reality.

  13. An Action Research Study of a Healthcare Enterprise information System at the Faroe Islands

    DEFF Research Database (Denmark)

    Schlichter, Bjarne Rerup; Svejvig, Per; Andersen, Povl Erik Rostgaard

    2015-01-01

    that it is not possible to distinguish between working processes and HIS, that benefit realization in healthcare (a public organization) has a much broader perspective than just financial value and that the reaping of benefits is quite difficult. This paper reports on the first two action cycles. Framed by the theory......Obtaining business value from IT is a recurring theme that has diffused into healthcare information systems (HIS) where stakeholders often question the value of IT investments. Having completed the implementation of an integrated HIS, the Faroese Health Service (FHS) has commenced discussions...

  14. Public healthcare--welfare, market share or laissez-faire?--a Sentosa Carlsberg skytower view.

    Science.gov (United States)

    Toh, Han-Chong

    2006-02-01

    How much the Government should provide for its people in sickness and in health, till death do us part, is open to different interpretation in different societies. One of the great paradoxes is that welfare states with high taxation can be globally competitive, innovative, successful market economies, and still provide quality universal healthcare. The Nordic countries, classical welfare states, have achieved top global ranking in economic competitiveness. Denmark's people are the most satisfied with their healthcare in the world, and the world's fourth most responsive healthcare system. This paper examines some of the factors that have made Denmark a successful, open and civil society that provides free-access healthcare to all of its people.

  15. Using Publicly Available Data to Characterize Consumers Use of Email to Communicate with Healthcare Providers.

    Science.gov (United States)

    Sandefer, Ryan H; Khairat, Saif S; Pieczkiewicz, David S; Speedie, Stuart M

    2015-01-01

    The use of patient focused technology has been proclaimed as a means to improve patient satisfaction and improve care outcomes. The Center for Medicaid/Medicare Services, through its EHR Incentive Program, has required eligible hospitals and professionals to send and receive secure messages from patients in order to receive financial incentives and avoid reimbursement penalties. Secure messaging between providers and patients has the potential to improve communication and care outcomes. The purpose of this study was to use National Health Interview Series (NHIS) data to identify the patient characteristics associated with communicating with healthcare providers via email. Individual patient characteristics were analyzed to determine the likelihood of emailing healthcare providers. The use of email for this purpose is associated with educational attainment, having a usual place of receiving healthcare, income, and geography. Publicly available data such as the NHIS may be used to better understand trends in adoption and use of consumer health information technologies.

  16. Future of the US healthcare system and the effects on the practice of hand surgery.

    Science.gov (United States)

    Pushman, Allison G; Chung, Kevin C

    2009-06-01

    The multitier healthcare system of the USA has several major flaws. High costs and uncertain quality of care indicate that this system is no longer practical. Several improvement initiatives, such as the Oregon Health Plan, Leapfrog, Lean Manufacturing, and Pay-for-Performance have been implemented into the current system. All of these quality improvement models are being experimented in a limited fashion and do not address the biggest problem in the US healthcare, inequality of care. There is now increasing support for a universal health coverage model as an ethically sound and just way to decrease health disparities in the USA. The current quality initiatives as well as an adoption of universal coverage appear to be the best way to improve quality of care, reduce cost, and increase equality in healthcare. These initiatives may have considerable effects on the practice of hand surgery in the near future, and thus, it is important for the field of hand surgery to become more engaged in advocacy and public policy arena. The purpose of this paper is to examine the current problems in the US healthcare system and to evaluate potential solutions that will enhance quality while simultaneously curbing the unchecked increase in healthcare expenditure.

  17. Polypathology, an emerging phenomenon and a challenge for healthcare systems.

    Science.gov (United States)

    Román, P; Ruiz-Cantero, A

    2017-05-01

    Improvements in living conditions and scientific advances have led to an unprecedented demographic change. The curing of numerous acute diseases and the growing adoption of unhealthy lifestyles have caused a pandemic of cumulative chronic diseases that constitute the leading cause of death worldwide. Currently, the most common situation is the coexistence of multiple chronic diseases (or polypathology). This situation undermines socio-economic development and increases inequality. This results in an overriding need to change the way in which health and disease are addressed. Healthcare systems are not prepared to meet the needs of complex polypathological patients. In this article, we summarise the challenges facing healthcare systems and states, as well as the main recommendations from the organisations responsible for healthcare. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI). All rights reserved.

  18. Implications of climate change (global warming) for the healthcare system.

    Science.gov (United States)

    Raffa, R B; Eltoukhy, N S; Raffa, K F

    2012-10-01

    Temperature-sensitive pathogenic species and their vectors and hosts are emerging in previously colder regions as a consequence of several factors, including global warming. As a result, an increasing number of people will be exposed to pathogens against which they have not previously needed defences. We illustrate this with a specific example of recent emergence of Cryptococcus gattii infections in more temperate climates. The outbreaks in more temperate climates of the highly virulent--but usually tropically restricted--C. gattii is illustrative of an anticipated growing challenge for the healthcare system. There is a need for preparedness by healthcare professionals in anticipation and for management of such outbreaks, including other infections whose recent increased prevalence in temperate climates can be at least partly associated with global warming. (Re)emergence of temperature-sensitive pathogenic species in more temperate climates will present new challenges for healthcare systems. Preparation for outbreaks should precede their occurrence. © 2012 Blackwell Publishing Ltd.

  19. Provision of healthcare in the context of financial crisis: approaches to the Greek health system and international implications.

    Science.gov (United States)

    Milionis, Charalampos

    2013-01-01

    Both healthcare professionals and the healthcare system must defend each patient's health individually while simultaneously seeking to protect the population's health in general. Nowadays, there is an important increase in the cost of healthcare supply, mainly due to the developments of medical science, the public's expectations and the demographic ageing. Since healthcare resources are not unlimited, it is obvious that immoderate consumption of them by certain patients limits the use of the same funds by others. Therefore, we have to seek an optimal distribution of the existing resources in order to manage a constriction of expenses, especially under the circumstances of the modern economic crisis. The criteria of effectiveness and efficiency should be used. Health policies focus on both the public's behaviour and the rules of medical practice. Under the modern challenges the physician's role is particularly important for the protection of the patient's health and the promotion of public health. © 2012 Blackwell Publishing Ltd.

  20. Sustainable public health systems for rare diseases.

    Science.gov (United States)

    Ferrelli, Rita Maria; Gentile, Amalia Egle; De Santis, Marta; Taruscio, Domenica

    2017-01-01

    In the framework of the Joint Action for Rare Diseases (RD-ACTION), a specific task was defined to identify mechanisms influencing sustainability, equity and resilience of health systems for rare diseases (RDs). Literature narrative review on health systems sustainability and resilience for RDs. Years: 2000-2015. Databases: PubMed, Scopus, EBSCOHost, EMBAL, PASCAL, EMBASE, STN International and GoogleScholar. interpretive synthesis concept and thematic analysis (Dixon-Wood, et al.). 97 papers and 4 grey literature publications were identified. Two main topics stand out: economic evaluation and networks. The first topic did not identify widely accepted criterion to assign more weight to individuals with greater health needs. Healthcare network are identified as increasingly important for sustainability and resilience, in all of their aspects: professional "expertise", "experience" networks of users and carers; policy, learning, and interest networks. Possible mechanisms for ensuring sustainability can be identified in networking, patients' empowerment and reorienting healthcare towards integrated community and home care.

  1. Wireless Body Area Network in a Ubiquitous Healthcare System for Physiological Signal Monitoring and Health Consulting

    Directory of Open Access Journals (Sweden)

    Joonyoung Jung

    2008-12-01

    Full Text Available We developed a ubiquitous healthcare system consisted of aphysiological signal devices, a mobile system, a device provider system, a healthcare service provider system, a physician system, and a healthcare personal system. In this system, wireless body area network (WBAN such as ZigBee is used to communicate between physiological signal devices and the mobile system. WBAN device needs a specific function for ubiquitous healthcare application. We propose a scanning algorithm, dynamic discovery and installation, reliable data transmission, device access control, and a healthcare profile for ubiquitous healthcare system.

  2. Web-based healthcare hand drawing management system.

    Science.gov (United States)

    Hsieh, Sheau-Ling; Weng, Yung-Ching; Chen, Chi-Huang; Hsu, Kai-Ping; Lin, Jeng-Wei; Lai, Feipei

    2010-01-01

    The paper addresses Medical Hand Drawing Management System architecture and implementation. In the system, we developed four modules: hand drawing management module; patient medical records query module; hand drawing editing and upload module; hand drawing query module. The system adapts windows-based applications and encompasses web pages by ASP.NET hosting mechanism under web services platforms. The hand drawings implemented as files are stored in a FTP server. The file names with associated data, e.g. patient identification, drawing physician, access rights, etc. are reposited in a database. The modules can be conveniently embedded, integrated into any system. Therefore, the system possesses the hand drawing features to support daily medical operations, effectively improve healthcare qualities as well. Moreover, the system includes the printing capability to achieve a complete, computerized medical document process. In summary, the system allows web-based applications to facilitate the graphic processes for healthcare operations.

  3. Healthcare decision support system for administration of chronic diseases.

    Science.gov (United States)

    Woo, Ji-In; Yang, Jung-Gi; Lee, Young-Ho; Kang, Un-Gu

    2014-07-01

    A healthcare decision-making support model and rule management system is proposed based on a personalized rule-based intelligent concept, to effectively manage chronic diseases. A Web service was built using a standard message transfer protocol for interoperability of personal health records among healthcare institutions. An intelligent decision service is provided that analyzes data using a service-oriented healthcare rule inference function and machine-learning platform; the rules are extensively compiled by physicians through a developmental user interface that enables knowledge base construction, modification, and integration. Further, screening results are visualized for the self-intuitive understanding of personal health status by patients. A recommendation message is output through the Web service by receiving patient information from the hospital information recording system and object attribute values as input factors. The proposed system can verify patient behavior by acting as an intellectualized backbone of chronic diseases management; further, it supports self-management and scheduling of screening. Chronic patients can continuously receive active recommendations related to their healthcare through the rule management system, and they can model the system by acting as decision makers in diseases management; secondary diseases can be prevented and health management can be performed by reference to patient-specific lifestyle guidelines.

  4. Epistemological challenges in contemporary Western healthcare systems exemplified by people's widespread use of complementary and alternative medicine.

    Science.gov (United States)

    Salamonsen, Anita; Ahlzén, Rolf

    2017-01-01

    Modern Western public healthcare systems offer predominantly publicly subsidized healthcare traditionally based on biomedicine as the most important basis to cure persons who suffer from disorders of somatic or psychiatric nature. To which extent this epistemological position is suitable for this purpose is under scientific debate and challenged by some people's personal understandings of health and illness, their individual illness experiences and their decision-making. Current studies show decreasing levels of patient trust in Western public healthcare and a widespread patient-initiated use of complementary and alternative medicine which is often linked to unmet patient-defined healthcare needs. Patients'/complementary and alternative medicine users' understandings of their afflictions are often based on elements of biomedical knowledge as well as embodied and experience-based knowledge. We believe this points to the need for a phenomenologically and socially based understanding of health and illness. In this article, we analyze challenges in contemporary healthcare systems, exemplified by people's widespread use of complementary and alternative medicine and based on three ways of understanding and relating to unhealth: disease (the biomedical perspective), illness (the phenomenological perspective), and sickness (the social perspective). In public healthcare systems aiming at involving patients in treatment processes, acknowledging the coexistence of differing epistemologies may be of great importance to define and reach goals of treatment and compliance.

  5. The Learning Healthcare System: Where are we now? A systematic review.

    Science.gov (United States)

    Budrionis, Andrius; Bellika, Johan Gustav

    2016-12-01

    The Learning Healthcare System paradigm has attracted the attention of researchers worldwide. The great potential originating from high-scale health data reuse and the inclusion of patient perspectives into care models promises personalized care, lower costs of health services and minimized consumption of resources. The aim of this review is to summarize the attempts to adopt the novel paradigm, putting emphasis on implementations and evaluating the impact on current medical practices. PRISMA methodology was followed for structuring the review process. Three major research databases (PubMed, IEEE Xplore and ACM DL) were queried with the predefined search terms "learning healthcare" and "learning health". Publications containing specific theoretical or empirical results were considered. Three hundred and fifty-eight publications were identified; however, only 32 met the inclusion criteria. Nineteen papers were characterized as theoretical contributions, while the rest presented empirical achievements. Only one paper described the initial estimates of impact and economy. Individualistic communication of studies ignoring popular frameworks for assessing and reporting research achievements prevents the systematic generation of knowledge. Evaluating the impact of the Learning Healthcare System instances where it is implemented could work as a catalyst in reaching higher acceptance and adoption of the proposed ideas by healthcare worldwide; however, it mostly remains described in theory. The review demonstrated the interest of researchers in exploring the Learning Healthcare System ideas. However, it also revealed minimal focus on evaluating the impact of the novel paradigm on both healthcare service delivery and patient outcome. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Healthcare Utilization and Costs of Systemic Lupus Erythematosus in Medicaid

    Directory of Open Access Journals (Sweden)

    Hong J. Kan

    2013-01-01

    Full Text Available Objective. Healthcare utilization and costs associated with systemic lupus erythematosus (SLE in a US Medicaid population were examined. Methods. Patients ≥ 18 years old with SLE diagnosis (ICD-9-CM 710.0x were extracted from a large Medicaid database 2002–2009. Index date was date of the first SLE diagnosis. Patients with and without SLE were matched. All patients had a variable length of followup with a minimum of 12 months. Annualized healthcare utilization and costs associated with SLE and costs of SLE flares were assessed during the followup period. Multivariate regressions were conducted to estimate incremental healthcare utilization and costs associated with SLE. Results. A total of 14,777 SLE patients met the study criteria, and 14,262 were matched to non-SLE patients. SLE patients had significantly higher healthcare utilization per year than their matched controls. The estimated incremental annual cost associated with SLE was $10,984, with the highest increase in inpatient costs (P<0.001. Cost per flare was $11,716 for severe flares, $562 for moderate flares, and $129 for mild flares. Annual total costs for patients with severe flares were $49,754. Conclusions. SLE patients had significantly higher healthcare resource utilization and costs than non-SLE patients. Patients with severe flares had the highest costs.

  7. CAREER MANAGEMENT IN THE HEALTHCARE SYSTEM

    OpenAIRE

    Puşa Tania Ţăpligă; Roxana Nicoleta Matei; Simona Daniela Grigore

    2013-01-01

    Career management is a specialized activity that provides the relation between HRM and the individual and organizational career planning. The health system is changing, more than any other field. Career Management in the health care system involves a complex process of analysis and human resource planning at both the organizational and the individual level.

  8. Career management in the healthcare system

    OpenAIRE

    Pusa Tania Tapliga; Roxana Nicoleta Matei

    2014-01-01

    Career management is a specialized activity that provides the relation between HRM and the individual and organizational career planning. The health system is changing, more than any other field. Career Management in the health care system involves a complex process of analysis and human resource planning at both the organizational and the individual level.

  9. Critical Study Regarding the Evolution of Incomes and Expenses of the Romanian Healthcare System in the Context of Budgetary Decentralization

    Directory of Open Access Journals (Sweden)

    Violeta ISAI

    2016-04-01

    Full Text Available The healthcare system in Romania is continuously under a reform process, in order to make more efficient the medical care and to allow a wide access for the population to the healthcare services. The incomes of the healthcare system mainly come from the contribution to the social healthcare insurance, but also from other taxes, the system also benefits from subsidies from the state budget. The public healthcare expenses have a relatively low percentage from the total public expenses, being mainly oriented towards hospitals, subsidized drugs and primary medical assistance. The integration of Romania into the EU brought for the healthcare system opportunities as well as threats: the increase of the competence and quality of the medical act, the favourable context of decentralization but also the increase of the costs for medical services, the mobility of the patients and the pronounced migration of the qualified medical staff to other countries of the EU. The paper wants to analyse the incomes and expenses from the healthcare, taking into account all these aspects.

  10. Wearable Smart Systems for Personal Healthcare and Lifestyle

    NARCIS (Netherlands)

    Vullers, Rudolf; Penders, Julien; Brongersma, Sywert; Wijsman, Jacqueline; Altini, Marco; Van Hoof, Chris

    2013-01-01

    We discussed the rising cost of healthcare, and argued that Personalized, Predictive, Preventive, and Participatory health care or P4 medicine can help in reducing these costs considerably. Smart Systems Technology is an important enabler in enforcing the individual to monitor vital body parameters.

  11. Wearable Smart Systems for Personal Healthcare and Lifestyle

    NARCIS (Netherlands)

    Vullers, Rudolf; Penders, Julien; Brongersma, Sywert; Wijsman, J.L.P; Altini, Marco; Van Hoof, Chris

    2013-01-01

    We discussed the rising cost of healthcare, and argued that Personalized, Predictive, Preventive, and Participatory health care or P4 medicine can help in reducing these costs considerably. Smart Systems Technology is an important enabler in enforcing the individual to monitor vital body parameters.

  12. [Restructuring the healthcare system: redesigning based on needs].

    Science.gov (United States)

    Szentes, Tamás; Vályi-Nagy, István

    2015-01-18

    The main task of a healthcare system is the provision of the healthcare services demanded by the population. These needs are mostly defined by the epidemiological status, which has been significantly changed during the last century. Due to development of medical science and technology, the main health problems in modern industrial societies are related to chronic diseases rather than infectious diseases occurring at the beginning of the 20th century. However, healthcare services provided by health institutions are still reactive, formed as reactions to current conditions, and they are hardly suited to requirements related to chronic diseases. This paper outlines international and national healthcare models and their shortcomings, and it traces novel paths of a future solution. The structure of the optimal model is suited to systematically produce the services which are needed by the population, decisively in the case of chronic, non communicable diseases. This can significantly relieve the expensive, technology-based reactive care system, nevertheless, it can provide efficient services in case of tertiary prevention. The configuration of this system is cheap, there is no need of significant infrastructure, but needs massive human resource, so that it can be rationally designed in parallel with the constriction of the reactive care system.

  13. General Public Expectation from the Communication Process with their Healthcare Providers

    OpenAIRE

    Hassali, MA; Shafie, AA; Khan, TM

    2012-01-01

    The current study aimed to explore the public views and expectation about a successful communication process between the healthcare providers/physicians and patients in Penang Island, Malaysia. A cross-sectional study was conducted in Penang Island using a 14-item questionnaire. Statistical Package for Social Sciences (SPSS) software version 15.0® were used to analyze the collected data. A nonparametric statistics was applied; the Chi-square test was applied to measure the association among t...

  14. Evaluating Complex Healthcare Systems: A Critique of Four Approaches

    Directory of Open Access Journals (Sweden)

    Heather Boon

    2007-01-01

    Full Text Available The purpose of this paper is to bring clarity to the emerging conceptual and methodological literature that focuses on understanding and evaluating complex or ‘whole’ systems of healthcare. An international working group reviewed literature from interdisciplinary or interprofessional groups describing approaches to the evaluation of complex systems of healthcare. The following four key approaches were identified: a framework from the MRC (UK, whole systems research, whole medical systems research described by NCCAM (USA and a model from NAFKAM (Norway. Main areas of congruence include acknowledgment of the inherent complexity of many healthcare interventions and the need to find new ways to evaluate these; the need to describe and understand the components of complex interventions in context (as they are actually practiced; the necessity of using mixed methods including randomized clinical trials (RCTs (explanatory and pragmatic and qualitative approaches; the perceived benefits of a multidisciplinary team approach to research; and the understanding that methodological developments in this field can be applied to both complementary and alternative medicine (CAM as well as conventional therapies. In contrast, the approaches differ in the following ways: terminology used, the extent to which the approach attempts to be applicable to both CAM and conventional medical interventions; the prioritization of research questions (in order of what should be done first especially with respect to how the ‘definitive’ RCT fits into the process of assessing complex healthcare systems; and the need for a staged approach. There appears to be a growing international understanding of the need for a new perspective on assessing complex healthcare systems.

  15. National healthcare information system in Croatian primary care: the foundation for improvement of quality and efficiency in patient care

    Directory of Open Access Journals (Sweden)

    Darko Gvozdanovi_

    2007-09-01

    Full Text Available In order to improve the quality of patient care, while at the same time keeping up with the pace of increased needs of the population for healthcare services that directly impacts on the cost of care delivery processes, the Republic of Croatia, under the leadership of the Ministry of Health and Social Welfare, has formed a strategy and campaign for national public healthcare system reform. The strategy is very comprehensive and addresses all niches of care delivery processes; it is founded on the enterprise information systems that will aim to support end-to-end business processes in the healthcare domain. Two major requirements are in focus: (1 to provide efficient healthcare-related data management in support of decision-making processes; (2 to support a continuous process of healthcare resource spending optimisation. The first project is the Integrated Healthcare Information System (IHCIS on the primary care level; this encompasses the integration of all primary point-of-care facilities and subjects with the Croatian Institute for Health Insurance and Croatian National Institute of Public Health. In years to come, IHCIS will serve as the main integration platform for connecting all other stakeholders and levels of health care (that is, hospitals, pharmacies, laboratories into a single enterprise healthcare network. This article gives an overview of Croatian public healthcare system strategy aims and goals, and focuses on properties and characteristics of the primary care project implementation that started in 2003; it achieved a major milestone in early 2007 - the official grand opening of the project with 350 GPs already fully connected to the integrated healthcare information infrastructure based on the IHCIS solution.

  16. The impacts of motivation, personal traits of managers and management education on the performances of public healthcare facilities

    OpenAIRE

    Karanović Nevena; Stošić Sanja

    2016-01-01

    Background/Aim. Exposed to increasing needs of users for better and faster services, more medications and innovative health technologies, managers of healthcare services in the public sector need motivation, permanent updating of information and constant personal development. The aim of this paper was to evaluate, on the basis of experienced healthcare managers, the impact of their motivation, selected character traits, managerial skills and formal education in management on healthcare facili...

  17. Healthcare systems, the State, and innovation in the pharmaceutical industry

    Directory of Open Access Journals (Sweden)

    Ignacio José Godinho Delgado

    Full Text Available Abstract: This article discusses the relations between healthcare systems and the pharmaceutical industry, focusing on state support for pharmaceutical innovation. The study highlights the experiences of the United States, United Kingdom, and Germany, developed countries and paradigms of modern health systems (liberal, universal, and corporatist, in addition to Japan, a case of successful catching up. The study also emphasizes the experiences of China, India, and Brazil, large developing countries that have tried different catching up strategies, with diverse histories and profiles in their healthcare systems and pharmaceutical industries. Finally, with a focus on state forms of support for health research, the article addresses the mechanisms for linkage between health systems and the pharmaceutical industry, evaluating the possibilities of Brazil strengthening a virtuous interaction, favoring the expansion and consolidation of the Brazilian health system - universal but segmented ‒ and the affirmation of the innovative national pharmaceutical industry.

  18. Lifestyle Solidarity in the Healthcare System

    NARCIS (Netherlands)

    Trappenburg, M.J.

    2000-01-01

    Encompassing health care systems in modern welfare states embody several forms of solidarity: between the sick and the healthy, the old and the young and between those who take good care of their health on the one hand and fellow citizens who choose to risk their lives by smoking or unsafe sex on th

  19. A modified no-fault malpractice system can resolve multiple healthcare system deficiencies.

    Science.gov (United States)

    Segal, Jeffrey J; Sacopulos, Michael

    2009-02-01

    Medical professional liability in the United States, as measured by total premiums paid by physicians and healthcare facilities, costs approximately $30 billion a year in direct expenses, less than 2% of the entire annual healthcare expenditures. Only a fraction of those dollars reach patients who are negligently injured. Nonetheless, the tort system has far-reaching effects that create substantial indirect costs. Medical malpractice litigation is pervasive and physicians practice defensively to avoid being named in a suit. Those extra expenditures provide little value to patients. Despite an elaborate existing tort system, patient safety remains a vexing problem. Many injured patients are denied access to timely, reasonable remedies. We propose a no-fault system supplemented by a variation of the traditional tort system whereby physicians are incentivized to follow evidence-based guidelines. The proposed system would guarantee a substantial decrease in, but not elimination of, litigation. The system would lower professional liability premiums. Injured patients would ordinarily be compensated with no-fault disability and life insurance proceeds. To the extent individual physicians pose a recurrent danger, their care would be reviewed on an administrative level. Savings would be invested in health information technology and purchase of insurance coverage for the uninsured. We propose a financial model based on publicly accessible sources.

  20. Integrating and rationalizing public healthcare services as a source of cost containment in times of economic crises.

    Science.gov (United States)

    Pettoello-Mantovani, Massimo; Namazova-Baranova, Leyla; Ehrich, Jochen

    2016-02-24

    Serious concern has been raised about the sustainability of public health care systems of European Nations and ultimately about the health of European citizens, as a result of the economic crisis that has distressed Europe since 2008. The severe economic crisis of the Euro zone, which is still afflicting Europe in 2016, has in fact threatened to equally impact public health services of nations presenting either a weak or a strong domestic growth. On behalf of the European Paediatric Association, the Union of National European Societies and Associations, the authors of the Commentary debates the relationship between the effects of economic instability and health, through the report on an article recently published in the Italian Journal of Pediatrics, which emphasized the importance of integrating existing public health care services, otherwise independently provided by public hospitals, and Primary Care Paediatric networks. The interconnections between the effects of economic instability and health are briefly commented, following the observation that these two factors are not yet fully understood, and that the definition of proper solutions to be applied in circumstances, where health is negatively impacted by periods of economic distress, is still open for discussion. Furthermore it is noted that the pressure to "deliver more for less" often seems to be the driving force forging the political strategic decisions in the area of pediatric healthcare, rather than social, cultural, and economic sensitivity and competences. Thus, the delivery of appropriate pediatric healthcare seems not to be related exclusively to motivations aimed to the benefit of children, but more often to other intervening factors, including economic, and political rationales. The conclusions emphasize that local European experiences suggest that positive and cost effective healthcare programs are possible, and they could serve as a model in the development of effective cross-border regional

  1. General Public Expectation from the Communication Process with their Healthcare Providers.

    Science.gov (United States)

    Hassali, Ma; Shafie, Aa; Khan, Tm

    2012-07-01

    The current study aimed to explore the public views and expectation about a successful communication process between the healthcare providers/physicians and patients in Penang Island, Malaysia. A cross-sectional study was conducted in Penang Island using a 14-item questionnaire. Statistical Package for Social Sciences (SPSS) software version 15.0(®) were used to analyze the collected data. A nonparametric statistics was applied; the Chi-square test was applied to measure the association among the variables. P-values less than 0.05 were considered statistically significant. A total of N (500) respondents have shown willingness to participate in the study with a response rate of 83.3%. The majority 319 (63.9%) have disclosed to communicate with their healthcare providers in the Malay language and about 401 (80.4%) of the respondents were found satisfied with the information provided by the physician. It was a common expectation by the most of the sample to focus more on the patient history before prescribing any medicine. Moreover, about 60.0% of the respondents expected that the healthcare providers must show patience to the patient's queries. The level of satisfaction with the information shared by the healthcare providers was higher among the respondents with a higher education level. Furthermore, patients with higher level of education expect that physician shouldwell understand their views and medical history to prescribe a better therapeutic regimen.

  2. Academic productivity and its relationship to physician salaries in the University of California Healthcare System.

    Science.gov (United States)

    Fijalkowski, Natalia; Zheng, Luo Luo; Henderson, Michael T; Moshfeghi, Andrew A; Maltenfort, Mitchell; Moshfeghi, Darius M

    2013-07-01

    To evaluate whether physicians with higher academic productivity, as measured by the number of publications in Scopus and the Scopus Hirsch index (h-index), earn higher salaries. This was a cross-sectional study. Participants were ophthalmologists, otolaryngologists, neurosurgeons, and neurologists classified as "top earners" (>$100,000 annually) within the University of California (UC) healthcare system in 2008. Bibliometric searches on Scopus were conducted to retrieve the total number of publications and Hirsch indices (h-index), a measure of academic productivity. The association between the number of publications and h-index on physicians' total compensation was determined with multivariate regression models after controlling for the four specialties (ophthalmology, otolaryngology, neurosurgery, and neurology), the five institutions (UC San Francisco, UC Los Angeles, UC San Diego, UC Irvine, and UC Davis), and academic rank (assistant professor, associate professor, and professor). The UC healthcare system departments reported 433 faculty physicians among the four specialties, with 71.6% (n = 310) earning more than $100,000 in 2008 and classifying as top earners. After controlling for the specialty, institution, and ranking, there was a significant association between the number of publications on salary (P Scopus number of publications and h-index were correlated (P Scopus h-index was of borderline significance in predicting physician salary (P = 0.12). Physicians with higher Scopus publications had higher total salaries across all four specialties. Every 10 publications were associated with a 2.40% increase in total salary after controlling for specialty, institution, rank, and chair. Ophthalmologists, otolaryngologists, neurosurgeons, and neurologists in the UC healthcare system who are more academically productive receive greater remuneration.

  3. Diagnosis of a public policy: an introduction to user fee exemptions for healthcare in the Sahel

    Science.gov (United States)

    2015-01-01

    During the last ten years, Burkina Faso, Mali and Niger have opted for selective user fee exemption policies, while remaining within the general framework of cost recovery. But they have each developed their own particular institutional mechanisms, different from those of their neighbour. This was the topic of a comparative research program combining both quantitative and qualitative surveys over a four-year period. This special issue presents papers setting exemption policies in the wider context of public policy and the day-to-day functioning of health systems (part 1); presenting overarching case studies (part 2); and reflecting on our methodological approach (part 3). User fee exemption policies were introduced in Burkina Faso, Mali and Niger during the first decade of this century. They cover several sector-based measures ('free healthcare' in everyday language), and sometimes come on top of high levels of subsidies which enabled significant reductions in the cost of certain drugs and treatments. From the late 1980s, these three countries were - and still are - subject to a comprehensive system of cost recovery at the point of delivery (a policy introduced following the Bamako Initiative), or, to be more precise, a system of partial payment of drugs and services by the user. Only a small proportion of the costs are actually recovered as the amounts charged to the users do not take salaries, investments or recurrent costs, which are all paid by the state, into account, and represent only a small percentage of the overall health budget (an order of magnitude of five percent is often cited at state level [1,2]. Nevertheless, the sums recovered by health centres enabled them to buy drugs and cover certain local expenses. However, for public health reasons, cost recovery has always been subject to a variety of sector-based exceptions, determined by the nature of the disease or intervention involved. For example, mass immunization (National Immunization Days) and

  4. A secure steganography for privacy protection in healthcare system.

    Science.gov (United States)

    Liu, Jing; Tang, Guangming; Sun, Yifeng

    2013-04-01

    Private data in healthcare system require confidentiality protection while transmitting. Steganography is the art of concealing data into a cover media for conveying messages confidentially. In this paper, we propose a steganographic method which can provide private data in medical system with very secure protection. In our method, a cover image is first mapped into a 1D pixels sequence by Hilbert filling curve and then divided into non-overlapping embedding units with three consecutive pixels. We use adaptive pixel pair match (APPM) method to embed digits in the pixel value differences (PVD) of the three pixels and the base of embedded digits is dependent on the differences among the three pixels. By solving an optimization problem, minimal distortion of the pixel ternaries caused by data embedding can be obtained. The experimental results show our method is more suitable to privacy protection of healthcare system than prior steganographic works.

  5. A post-Bertalanffy Systemics Healthcare Competitive Framework Proposal.

    Science.gov (United States)

    Fiorini, Rodolfo A; Santacroce, Giulia F

    2014-01-01

    Health Information community can take advantage of a new evolutive categorization cybernetic framework. A systemic concept of principles organizing nature is proposed. It can be used as a multiscaling reference framework to develop successful and competitive antifragile system and new HRO information management strategies in advanced healthcare organization (HO) and high reliability organization (HRO) conveniently. Expected impacts are multifarious and quite articulated at different system scale level: major one is that, for the first time, Biomedical Engineering ideal system categorization levels can be matched exactly to practical system modeling interaction styles, with no paradigmatic operational ambiguity and information loss.

  6. Improving Healthcare through Lean Management: Experiences from the Danish healthcare system

    DEFF Research Database (Denmark)

    Edwards, Kasper; Nielsen, Anders Paarup

    The ideas and principles from lean management are now widely being adopted within the healthcare sector. The analysis in this paper shows that organizations within healthcare most often only implement a limited set of tools and methods from the lean tool-box. Departing from a theoretical analysis...... of the well-known and universal lean management principles in the context of the healthcare this paper will attempt to formulate and test four hypotheses about possible barriers to the successful implementation of lean management in healthcare. The first hypothesis states that lean management in healthcare...... still is in its infancy and it is just a matter of letting sufficient time pass in order have a successful implementation of lean in all areas of healthcare. The second hypothesis states that a major barrier to lean management in healthcare simply is lacking understanding of the lean concepts leading...

  7. An integrated healthcare enterprise information portal and healthcare information system framework.

    Science.gov (United States)

    Hsieh, S L; Lai, Feipei; Cheng, P H; Chen, J L; Lee, H H; Tsai, W N; Weng, Y C; Hsieh, S H; Hsu, K P; Ko, L F; Yang, T H; Chen, C H

    2006-01-01

    The paper presents an integrated, distributed Healthcare Enterprise Information Portal (HEIP) and Hospital Information Systems (HIS) framework over wireless/wired infrastructure at National Taiwan University Hospital (NTUH). A single sign-on solution for the hospital customer relationship management (CRM) in HEIP has been established. The outcomes of the newly developed Outpatient Information Systems (OIS) in HIS are discussed. The future HEIP blueprints with CRM oriented features: e-Learning, Remote Consultation and Diagnosis (RCD), as well as on-Line Vaccination Services are addressed. Finally, the integrated HEIP and HIS architectures based on the middleware technologies are proposed along with the feasible approaches. The preliminary performance of multi-media, time-based data exchanges over the wireless HEIP side is collected to evaluate the efficiency of the architecture.

  8. Public healthcare in Mozambique: strategic issues in the ICT development during managerial changes and public reforms.

    Science.gov (United States)

    Piotti, B; Macome, E

    2007-06-01

    It has been predicted that major introduction of information communication technology (ICT) for health care organisations (HCO) over the next 10 years will be used to achieve the universal coverage and improve the quality of health care delivered to people. Which is the best strategy on ICT transfer, adoption and adaptation for the local Mozambican HCO? This paper argues that a sociotechnical approach of ICT development can help policy makers and health managers to address the technology transfer in a better and more appropriate way to their social context and to the public health reforms in progress. The urgency of health care demands (e.g. AIDS epidemic) and the institutional changes implemented by the Government and the local Ministry of Health (MOH), open a dynamic process of re-organisation inside the health institutions in the next years. This process needs to be monitored and initiatives planned, which places pressure on the evolution of health information system (HIS). The increase in the use of ICT can be an ally for health managers. The emergence of the open source software (OSS) and the recent ICT market trends towards networking may also enable local HCO to better face and solve the long process of health care standardisation, which usually prepares and accompanies any introduction of ICT. On the other side, the "big bang" introduction of electronic packages, devices and software applications may be an obstacle framing and anchoring local HCO to external settings, "modern" and universal models. Thus, a uniform step-by-step implementation of hospital-based health information system is desirable.

  9. Designing an architectural style for Pervasive Healthcare systems.

    Science.gov (United States)

    Rafe, Vahid; Hajvali, Masoumeh

    2013-04-01

    Nowadays, the Pervasive Healthcare (PH) systems are considered as an important research area. These systems have a dynamic structure and configuration. Therefore, an appropriate method for designing such systems is necessary. The Publish/Subscribe Architecture (pub/sub) is one of the convenient architectures to support such systems. PH systems are safety critical; hence, errors can bring disastrous results. To prevent such problems, a powerful analytical tool is required. So using a proper formal language like graph transformation systems for developing of these systems seems necessary. But even if software engineers use such high level methodologies, errors may occur in the system under design. Hence, it should be investigated automatically and formally that whether this model of system satisfies all their requirements or not. In this paper, a dynamic architectural style for developing PH systems is presented. Then, the behavior of these systems is modeled and evaluated using GROOVE toolset. The results of the analysis show its high reliability.

  10. Medical data transmission system for remote healthcare centres

    Energy Technology Data Exchange (ETDEWEB)

    Gonzalez, E A; Cagnolo, F J; Olmos, C E; Centeno, C A; Riva, G G; Zerbini, C A [Clinical Engineering Group, National Technological University, Cordoba Regional Faculty, Maestro M Lopez St and Cruz Roja Argentina St, Cordoba (Argentina)

    2007-11-15

    The main motivation of this project is to improve the healthcare centres equipment and human resources efficiency, enabling those centres for transmission of parameters of medical interest. This system facilitates remote consultation, in particular between specialists and remote healthcare centres. Likewise it contributes to the qualification of professionals. The electrocardiographic (ECG) and electroencephalographic (EEG) signals are acquired, processed and then sent, fulfilling the effective norms, for application in the hospital network of Cordoba Province, which has nodes interconnected by phone line. As innovative aspects we emphasized the low cost of development and maintenance, great versatility and handling simplicity with a modular design for interconnection with diverse data transmission media (Wi-Fi, GPRS, etc.). Successfully experiences were obtained during the acquisition of the signals and transmissions on wired LAN networks. As improvements, we can mention: energy consumption optimization and mobile communication systems usage, in order to offer more autonomy.

  11. Public Water Supply Systems (PWS)

    Data.gov (United States)

    Kansas Data Access and Support Center — This dataset includes boundaries for most public water supply systems (PWS) in Kansas (525 municipalities, 289 rural water districts and 13 public wholesale water...

  12. [A system of indicators for identifying the specific healthcare needs of communities by large health departments].

    Science.gov (United States)

    Ciaralli, Fabrizio; D'Ascanio, Italo; Saffioti, Concetto; Spunticchia, Giorgio; Perria, Carla; Vicario, Gianni; Zega, Maurizio; Panà, Augusto

    2012-01-01

    Clinical governance of healthcare and community services by healthcare organizations requires the use of validated tools for identifying the specific healthcare needs of the local population. The population served by a local health organization may be large and although data regarding this population as a whole is useful for a preliminary evaluation, it may be too generic for an accurate estimation of the healthcare needs at the district level since different districts may face different challenges and have profoundly different realities. In this context, it can be strategically useful to use a system of indicators targeted at districts, the latter regarded as the basic unit of the health care system and characterized by a relatively constant structure and size.A set of district indicators has been developed and adopted by a local health authority in Rome (Italy) "ASL Roma B", as part of a collaborative project with the Public Health Agency of the Lazio region. In this paper, we present the main results of the first four years of implementation of the system (from 2007 to 2010).The data shows that even within a metropolitan health organization serving an apparently homogeneous population, health needs, provision of services and outcomes may vary greatly between different districts suggesting the adoption of diverse operational strategies.

  13. Planning of public healthcare facility using a location allocation modelling: A case study

    Science.gov (United States)

    Shariff, S. Sarifah Radiah; Moin, Noor Hasnah; Omar, Mohd

    2014-09-01

    Finding the correct location of any facility and determining the demands which are to be assigned to it is very crucial in public health service. This is to ensure that the public gain maximum benefits. This article analyzes the previous location decisions of public primary healthcare (PHC) facilities in the district of Kuala Langat, Malaysia. With total population of 220214 (in 2010), the PHC in the district is currently served by 28 facilities. The percentages of total population covered (in 2007) within the maximum allowable distance of 3km and 5km are 69.7 percent and 77.8 percent respectively. This is very low compared to the Malaysian National Health Policy of Health for All or 100 percent coverage. The determination of health facility location should be planned carefully to further increase effective primary health service to the nation that is required for economic sustainability.

  14. On the supply of China's healthcare resources in a decentralized healthcare system

    OpenAIRE

    Zheng, Xinye; Wang, Jing; Li, Xilu; Yu, Yihua

    2013-01-01

    The structure of China’s current governance bears prominent features of fiscal decentralization. The supply of healthcare resources in China has clearly witnessed slower growth in the last two decades during which the fiscal decentralization process has taken place. Using China’s provincial panel data, we examine the determinants of healthcare resource supply while paying particular attention to the role of fiscal decentralization. We find that the supply of healthcare resources is inversely ...

  15. Executable Design Models for a Pervasive Healthcare Middleware System

    DEFF Research Database (Denmark)

    Jørgensen, Jens Bæk; Christensen, Søren

    2002-01-01

     UML is applied in the design of a pervasive healthcare middleware system for the hospitals in Aarhus County, Denmark. It works well for the modelling of static aspects of the system, but with respect to describing the behaviour, UML is not sufficient. This paper explains why and, as a remedy......, suggests to supplement the UML models with behaviour descriptions in the modelling language Coloured Petri Nets, CPN. CPN models are executable and fine-grained, and a combined use of UML and CPN thus supports design-time investigation of the detailed behaviour of system components. In this way...

  16. Public healthcare expenditure in Spain: measuring the impact of driving factors.

    Science.gov (United States)

    Blanco-Moreno, Ángela; Urbanos-Garrido, Rosa M; Thuissard-Vasallo, Israel John

    2013-06-01

    To assess the impact of demography, health status, death related costs and some macroeconomic variables on the evolution of health expenditure. We follow the methodology used by the Ageing Working Group (AWG) of the European Union to simulate expenditure projections on the basis of healthcare expenditure profiles for age-sex population groups. We estimate the profiles using data from Hospital Discharges Statistics and the Spanish National Health Survey. The differences between the compression of morbidity scenario and the expansion of morbidity scenario range from 1.35 to 1.57 points of GDP in 2060. The overestimation of healthcare expenditure when death related costs are ignored ranges from 0.04 to 0.11 percentage points, depending on the health status hypothesis. Moreover, the effect of death related cost diminishes as health status improves. Our results support the fact that intensity of healthcare use, instead of ageing, is the main driver of health expenditure. Thus, the concern of keeping expenditure under control should be focused on factors such as the population's health status, economic growth and development, new technologies and medical progress, and the organization and management of the healthcare system. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  17. PolicyNet Publication System

    Data.gov (United States)

    Social Security Administration — The PolicyNet Publication System project will merge the Oracle-based Policy Repository (POMS) and the SQL-Server CAMP system (MSOM) into a new system with an Oracle...

  18. Research information systems are path to high-quality healthcare.

    Science.gov (United States)

    Ziegenfuss, J T

    1987-10-01

    Research is the key to dealing with the major issues facing the healthcare industry. And an information system for organization and management research is a necessary component in healthcare organizations. Research information systems should support action, not theory. Their purpose is to educate information users about their system of services; provide data for planning, developing, directing, and evaluating both technical and management work; and provide a basis for "steering" the program. Four key subjects for a research information system are service activities, patient characteristics, costs and budget, and outcomes. The goal in developing a research information system is to integrate the various types of information into a format that provides the information for management use at a given time. Development of a research information system requires concentrating on the design and the process of developing and using the data for action research. Each design step requires an analysis of existing and future research requirements, of what clinical and managerial leaders would like to know. Identifying users is important, since they will ultimately judge the adequacy of the system. Each user has to make decisions based on the data. Such decisions include setting goals, forming policy, organizing activities, and budgeting.

  19. The fourth mission of hospitals and the role of researchers as innovation drivers in the public healthcare sector

    Directory of Open Access Journals (Sweden)

    Rey-Rocha, Jesús

    2014-03-01

    Full Text Available This article explores the role of researchers as innovation drivers in the public healthcare sector. The Triple Helix model is proposed for the analysis of the role of public hospitals in innovation processes. We discuss the role of public hospitals in innovation and in economic and social development, and identify this role as a ‘fourth mission’ of hospitals in addition to their widely recognized threefold function of healthcare provision, education and research. We discuss the evolution of hospital administration from healthcare towards the ‘entrepreneurial hospital’ model. More specifically, we investigate the extent to which the incorporation of full-time researchers can help to foster innovation at research and healthcare centres affiliated with the Spanish National Health System. Data were obtained through a survey of researchers, research group leaders and heads of departments and centres where these researchers worked, as well as through content analysis of researchers’ annual reports.Se estudia el papel de los investigadores como promotores de la innovación en el sector sanitario público. Se propone el modelo de la Triple Hélice para el estudio del papel de los hospitales en los procesos de innovación. Se identifica la innovación y la contribución al desarrollo económico y social como la ‘cuarta misión’ de los hospitales públicos, adicional a su triple misión asistencial, docente e investigadora. Este enfoque aboga por una evolución desde el modelo asistencial tradicional hacia el modelo del ‘hospital emprendedor’. A través del Programa FIS/Miguel Servet, se investiga en qué medida la incorporación de investigadores contribuye a fomentar la innovación en los centros del Sistema Nacional de Salud español. Los datos proceden de sendas encuestas a los investigadores y a los responsables de los grupos y de los distintos departamentos y centros a los que éstos se incorporaron, así como del análisis de

  20. Improving Transgender Healthcare in the New York City Correctional System.

    Science.gov (United States)

    Jaffer, Mohamed; Ayad, John; Tungol, Jose Gabriel; MacDonald, Ross; Dickey, Nathaniel; Venters, Homer

    2016-04-01

    Correctional settings create unique challenges for patients with special needs, including transgender patients, who have an increased rate of overall discrimination, sexual abuse, healthcare disparities, and improper housing. As part of our correctional health quality improvement process, we sought to review and evaluate the adequacy of care for transgender patients in the New York City jail system. Using correctional pharmacy records, transgender patients receiving hormonal treatment were identified. A brief in-person survey was conducted to evaluate their care in the community before incarceration, medical care in jail, and experience in the jail environment. Survey findings and analysis of transgender patient healthcare-related complaints revealed opportunities for improvements in the provision of care and staff understanding of this population. Utilizing these findings, we conducted lesbian, gay, bisexual, and transgender (LGBT) trainings in all 12 jail clinics for medical, nursing, and mental health staff. Three months after LGBT training, patient complaints dropped by over 50%. After the development and implementation of a newly revised transgender healthcare policy, complaints dropped to zero within 6 months. Our efforts to assess the quality of care provided to transgender patients revealed significant areas for improvement. Although we have made important gains in providing quality care through the implementation of policies and procedures rooted in community standards and the express wishes of our patients, we continue to engage this patient population to identify other issues that impact their health and well-being in the jail environment.

  1. Geographic information system-based healthcare waste management planning for treatment site location and optimal transportation routeing.

    Science.gov (United States)

    Shanmugasundaram, Jothiganesh; Soulalay, Vongdeuane; Chettiyappan, Visvanathan

    2012-06-01

    In Lao People's Democratic Republic (Lao PDR), a growth of healthcare centres, and the environmental hazards and public health risks typically accompanying them, increased the need for healthcare waste (HCW) management planning. An effective planning of an HCW management system including components such as the treatment plant siting and an optimized routeing system for collection and transportation of waste is deemed important. National government offices at developing countries often lack the proper tools and methodologies because of the high costs usually associated with them. However, this study attempts to demonstrate the use of an inexpensive GIS modelling tool for healthcare waste management in the country. Two areas were designed for this study on HCW management, including: (a) locating centralized treatment plants and designing optimum travel routes for waste collection from nearby healthcare facilities; and (b) utilizing existing hospital incinerators and designing optimum routes for collecting waste from nearby healthcare facilities. Spatial analysis paved the way to understand the spatial distribution of healthcare wastes and to identify hotspots of higher waste generating locations. Optimal route models were designed for collecting and transporting HCW to treatment plants, which also highlights constraints in collecting and transporting waste for treatment and disposal. The proposed model can be used as a decision support tool for the efficient management of hospital wastes by government healthcare waste management authorities and hospitals.

  2. Protecting Public Health: Plug-In Electric Vehicle Charging and the Healthcare Industry

    Energy Technology Data Exchange (ETDEWEB)

    Ryder, Carrie; Lommele, Stephen

    2016-10-01

    In 2014, the U.S. transportation sector consumed more than 13 million barrels of petroleum a day, approximately 70% of all domestic petroleum consumption. Internal combustion engine vehicles are major sources of greenhouse gases (GHGs), smog-forming compounds, particulate matter, and other air pollutants. Widespread use of alternative fuels and advanced vehicles, including plug-in electric vehicles (PEVs), can reduce our national dependence on petroleum and decrease the emissions that impact our air quality and public health. Healthcare organizations are major employers and community leaders that are committed to public well-being and are often early adopters of employer best practices. A growing number of hospitals are offering PEV charging stations for employees to help promote driving electric vehicles, reduce their carbon footprint, and improve local air quality.

  3. The holistic architectural approach to integrating the healthcare record in the overall information system.

    Science.gov (United States)

    Ferrara, F M; Sottile, P A; Grimson, W

    1999-01-01

    The integration and evolution of existing systems represents one of the most urgent problems facing those responsible for healthcare information systems so that the needs of the whole organisation are addressed. The management of the healthcare record represents one of the major requirements in the overall process, however it is also necessary to ensure that the healthcare record and other healthcare information is integrated within the context of an overall healthcare information system. The CEN ENV 12967-1 'Healthcare Information Systems Architecture' standard defines a holistic architectural approach where the various, organisational, clinical, administrative and managerial requirements co-exist and cooperate, relying on a common heritage of information and services. This paper reviews the middleware-based approach adopted by CEN ENV 12967-1 and the specialisation necessary for the healthcare record based on CEN ENV 12265 'Electronic Healthcare Record Architecture'.

  4. Towards Fractal Approach in Healthcare Information Systems: A Review

    Directory of Open Access Journals (Sweden)

    Nawzat S. Ahmed

    2011-01-01

    Full Text Available Recently, traditional information systems need adaption capabilities in order to overcome modifications and maintains of external environment. For that, researchers proposed many solutions from the Fractal method to improve the flexibility and quick adaptive of the system. Computer Information System, as widely used systems, needs modifications and adaptations to real changes. The most important action is to circulate and updating new data and information among the hosts in agent-based information systems. This paper presents the review of using features of fractal method to solve many problems in different fields. The  paper is also suggesting employing fractal features for improving the flexibility and adaption of Healthcare Information System (HIS.

  5. IT management and governance systems and their emergence in healthcare.

    Science.gov (United States)

    Mohrmann, Gregg; Kropf, Roger

    2007-01-01

    Today's healthcare IT departments are challenged with understanding the total service demand imposed by their user communities and how much of their limited resources are available to meet that demand. This challenge is being addressed through the use of new IT management and governance (IT-MG) systems. This software supports IT governance and project and portfolio management. IT-MG is a relatively new term to healthcare; it entails reviewing and managing demand for IT services from inception to completion through the application of IT resources. These systems help save time through automated reporting and quicker delivery of services; they save money by more effectively addressing resource needs on time and on budget. The systems also reduce the number of administrative tasks through process automation; increase customer satisfaction by communicating services and deliverables more quickly and accurately; and help executives make better and more informed decisions about priorities and expectations through reporting that was previously nonexistent. This article will explore IT-MG systems and present a case study of a hospital that rapidly implemented this type of system.

  6. Teaching total quality management: developing and deploying education throughout a healthcare system.

    Science.gov (United States)

    Kleeb, T E

    1997-01-01

    Healthcare organizations are faced with the responsibility of teaching their entire staff the founding principles, concepts, and practices of total quality management (TQM), to improve organizational effectiveness. Purchasing training products from outside consultants can be costly, but healthcare leaders can design and develop their own TQM training products, integrating each product with their organization's mission and values. This article describes how a Catholic healthcare system successfully developed and deployed a compendium of TQM educational products throughout the health-care system.

  7. Human resource capacity for information management in selected public healthcare facilities in Meru County, Kenya.

    Science.gov (United States)

    Kiilu, Elizabeth Mueke; Okero, Dominic Charles; Muiruri, Lillian; Owuondo, Pacific Akinyi

    2015-01-01

    Reliable health information is essential for decision making in the healthcare system. Information management in Kenya was considered the weakest area under the Health Information System pillar mainly due to inadequate health workers capacity. The study therefore aimed at assessing health workers skills and current training needs for information management in the selected healthcare facilities. Cross-section research design was adopted and both purposive sampling technique and censuses were used to establish the study participants. Analysis was done using SPSS version 20 and results were presented in tables, charts and graphs. It was established that capacity building was usually undertaken through on-job trainings i.e. 85.1% (103) health workers had on-job training on filling of data collection tools and only 10% (13) had received formal classroom training on the same. Further, only 9.1% (11) health workers had received information management training while 90.9% (110) had not received such training. Health workers demonstrated below average skills on information management i.e. only 17.4% (21) could check for data accuracy, only 16.5% (20) could compute trends from bar charts and only 16.5% (20) could transform the data they collected into meaningful information for use. The researcher recommended that healthcare facilities management teams develop a competency based framework for defining the desired skill mix for information management and have a yearly Training Needs Assessment for assessing training needs for information management among the health workers.

  8. Graduate public health training in healthcare of refugee asylum seekers and clinical human rights: evaluation of an innovative curriculum.

    Science.gov (United States)

    Asgary, Ramin

    2016-04-01

    An innovative curriculum was developed to equip public health students with appropriate attitude and skills to address healthcare of asylum seekers. Implemented in 2005 the curriculum included: (1) didactic sessions covering epidemiology and health sequelae of torture, asylum laws, and approaches to identify survivors' healthcare needs; (2) panel discussions with survivors and advocates; and (3) participating in medico-legal process of asylum seeking. Complementary mixed methods evaluations included pre- and post-curriculum questionnaires, formal curriculum evaluations, final papers and oral presentations. 125 students participated. Students showed improved knowledge regrading sequelae of abuse and survivors' healthcare needs (P rights careers. As an advocacy and cultural competency training in public health practice addressing healthcare of refugees domestically, this curriculum was well received and effective, and will also help students better serve other similar populations. Population case-based domestic opportunities to teach global health and health and human rights should be effectively utilized to develop a well-equipped global health corps.

  9. Wireless Network of Collaborative Physiological Signal Devices in a U-Healthcare System

    Science.gov (United States)

    Jung, Joonyoung; Kim, Daeyoung

    We designed and implemented collaborative physiological signal devices in a u-healthcare(ubiquitous healthcare) system. In this system, wireless body area network (WBAN) such as ZigBee is used to communicate between physiological signal devices and the mobile system. WBAN device needs a specific function for ubiquitous healthcare application. We show several collaborative physiological devices and propose WBAN mechanism such as a fast scanning algorithm, a dynamic discovery and installation mechanism, a reliable data transmission, a device access control for security, and a healthcare profile for u-healthcare system.

  10. Security of healthcare information systems based on the CORBA middleware.

    Science.gov (United States)

    Blobel, B; Holena, M

    1997-01-01

    The development of healthcare systems in accordance to the "Shared Care" paradigm results in co-operative health information systems across the boundaries of organisational, technological, and policy domains. Increasingly, these distributed and heterogeneous systems are based on middleware approaches, such as CORBA. Regarding the sensitivity of personal and medical data, such open, distributed, and heterogeneous health information systems demand a high level of data protection and data security, both with respect to patient information and with respect to users. The security concepts and measures available and additionally needed in health information systems based on CORBA architecture are described in this paper. The proposed security solution is also open to other middleware approaches, such as DHE or HL7.

  11. Systems Design Perspective of Healthcare Provision in Humanitarian Aid

    Directory of Open Access Journals (Sweden)

    Ana Laura Santos

    2014-12-01

    Full Text Available This study focuses on the role of Systems Design in addressing the challenges of healthcare provision by international emergency relief organizations in developing countries. More specifically the challenges related to the safety and performance of medical equipment that is transferred in the aftermath of a humanitarian crisis. The aim of this paper is to describe the transfer of medical equipment and its associated challenges from a systems perspective and to reflect on the value of Systems Design as an approach to humanitarian innovation, addressing the identified systemic challenges. The concepts of Human Factors and Ergonomics, and Product-Service Systems will be presented as valuable contributions to support designers in handling a larger degree of complexity throughout the design process and to support them to make informed choices regarding this particular context.

  12. Review of Cyber-Physical System in Healthcare

    OpenAIRE

    Shah Ahsanul Haque; Syed Mahfuzul Aziz; Mustafizur Rahman

    2014-01-01

    Cyber-physical system (CPS) is an integration of physical processes with computation and communication. It has the ability to add more intelligence to social life. Wireless sensor networks (WSN) can be a vital part of CPS as strong sensing capability is one of the major driving factors for CPS applications. CPS is still considered to be a nascent technology, and there are many challenges yet to be addressed. A few CPS applications in healthcare have been proposed to date, and they lack the fl...

  13. [Barriers to the normalization of telemedicine in a healthcare system model based on purchasing of healthcare services using providers' contracts].

    Science.gov (United States)

    Roig, Francesc; Saigí, Francesc

    2011-01-01

    Despite the clear political will to promote telemedicine and the large number of initiatives, the incorporation of this modality in clinical practice remains limited. The objective of this study was to identify the barriers perceived by key professionals who actively participate in the design and implementation of telemedicine in a healthcare system model based on purchasing of healthcare services using providers' contracts. We performed a qualitative study based on data from semi-structured interviews with 17 key informants belonging to distinct Catalan health organizations. The barriers identified were grouped in four areas: technological, organizational, human and economic. The main barriers identified were changes in the healthcare model caused by telemedicine, problems with strategic alignment, resistance to change in the (re)definition of roles, responsibilities and new skills, and lack of a business model that incorporates telemedicine in the services portfolio to ensure its sustainability. In addition to suitable management of change and of the necessary strategic alignment, the definitive normalization of telemedicine in a mixed healthcare model based on purchasing of healthcare services using providers' contracts requires a clear and stable business model that incorporates this modality in the services portfolio and allows healthcare organizations to obtain reimbursement from the payer. 2010 SESPAS. Published by Elsevier Espana. All rights reserved.

  14. Health care and ideology: a reconsideration of political determinants of public healthcare funding in the OECD.

    Science.gov (United States)

    Herwartz, Helmut; Theilen, Bernd

    2014-02-01

    In this article, we examined if partisan ideology and electoral motives influence public healthcare expenditure (HCE) in countries of the Organization for Economic Cooperation and Development. We distinguished between the effects on the growth of the expenditures and its adjustment to violations of a long-run equilibrium linking HCE with macroeconomic and demographic trends. Regarding the influence of partisan ideology, we found that if governments are sufficiently long in power, right-wing governments spend less on public health than their left-wing counterparts. Furthermore, if a right-wing party governs without coalition partners, it responds more strongly to deviations from the long-run HCE equilibrium than left-wing governments. With regard to electoral motives, we found that health expenditure increases in years of elections. Independent of their partisan ideology, single-party (minority) governments induce higher (lower) growth of public HCE. Each of these political factors by its own may increase (decrease) HCE growth by approximately one percentage point. Given an average annual growth of HCE of approximately 4.1%, political factors turn out to be important determinants of trends in public HCE. Copyright © 2013 John Wiley & Sons, Ltd.

  15. Policy Capacity in the Learning Healthcare System; Comment on “Health Reform Requires Policy Capacity”

    Directory of Open Access Journals (Sweden)

    William Gardner

    2015-12-01

    Full Text Available Pierre-Gerlier Forest and his colleagues make a strong argument for the need to expand policy capacity among healthcare actors. In this commentary, I develop an additional argument in support of Forest et al view. Forest et al rightly point to the need to have embedded policy experts to successfully translate healthcare reform policy into healthcare change. Translation of externally generated innovation policy into local solutions is only one source of healthcare system change. We also need to build learning healthcare systems that can discover new health solutions at the frontline of care. Enhanced policy capacity staffing in those organizations will be key to building continuously learning health systems.

  16. The Indiana University Center for Healthcare Innovation and Implementation Science: Bridging healthcare research and delivery to build a learning healthcare system.

    Science.gov (United States)

    Azar, Jose; Adams, Nadia; Boustani, Malaz

    2015-01-01

    In the United States, it is estimated that 75,000 deaths every year could be averted if the healthcare system implemented high quality care more effectively and efficiently. Patient harm in the hospital occurs as a consequence of inadequate procedures, medications and other therapies, nosocomial infections, diagnostic evaluations and patient falls. Implementation science, a new emerging field in healthcare, is the development and study of methods and tools aimed at enhancing the implementation of new discoveries and evidence into daily healthcare delivery. The Indiana University Center for Healthcare Innovation and Implementation Science (IU-CHIIS) was launched in September 2013 with the mission to use implementation science and innovation to produce great-quality, patient-centered and cost-efficient healthcare delivery solutions for the United States of America. Within the first 24 months of its initiation, the IU-CHIIS successfully scaled up an evidence-based collaborative care model for people with dementia and/or depression, successfully expanded the Accountable Care Unit model positively impacting the efficiency and quality of care, created the first Certificate in Innovation and Implementation Science in the US and secured funding from National Institutes of Health to investigate innovations in dementia care. This article summarizes the establishment of the IU-CHIIS, its impact and outcomes and the lessons learned during the journey. Copyright © 2015. Published by Elsevier GmbH.

  17. Wireless Health Data Exchange for Home Healthcare Monitoring Systems

    Directory of Open Access Journals (Sweden)

    Malrey Lee

    2010-04-01

    Full Text Available Ubiquitous home healthcare systems have been playing an increasingly significant role in the treatment and management of chronic diseases, such as diabetes and hypertension, but progress has been hampered by the lack of standardization in the exchange of medical health care information. In an effort to establish standardization, this paper proposes a home healthcare monitoring system data exchange scheme between the HL7 standard and the IEEE1451 standard. IEEE1451 is a standard for special sensor networks, such as industrial control and smart homes, and defines a suite of interfaces that communicate among heterogeneous networks. HL7 is the standard for medical information exchange among medical organizations and medical personnel. While it provides a flexible data exchange in health care domains, it does not provide for data exchange with sensors. Thus, it is necessary to develop a data exchange schema to convert data between the HL7 and the IEEE1451 standard. This paper proposes a schema that can exchange data between HL7 devices and the monitoring device, and conforms to the IEEE 1451 standard. The experimental results and conclusions of this approach are presented and show the feasibility of the proposed exchange schema.

  18. Attitude toward the Patient Safety Culture in healthcare systems

    Directory of Open Access Journals (Sweden)

    Fereydoon Laal

    2016-04-01

    Full Text Available Introduction: Patient Safety Culture (PSC involves a harmonious pattern of individual and organization behaviors based on common beliefs and values. This study aimed to evaluate the attitude of healthcare providers toward PSC in the hospitals and clinics of Zabol city, Iran. Materials and Methods: This descriptive cross-sectional study was conducted in 2015. Sample population consisted of the physicians, nurses, and paraclinical staff (radiologists and laboratory experts engaged in different healthcare centers of Zabol city, Iran. Data were collected using the Hospital Survey on Patient Safety Culture (HSOPSC questionnaire. Data analysis was performed in SPSS V.22 at the significance level of 0.05. Results: In total, 231 healthcare practitioners were enrolled in this study. Participants were divided into three groups of physicians, nurses, and paraclinical staff (n=77, 33.33%. Mean of age and clinical experience was 29.94 and 6.23 years, respectively. Among the main aspects of PSC, “general understanding of patient safety” had the highest mean score (13.53, and the lowest mean score was achieved in “non-punitive response to error” (8.89. In the aspect of “manager expectations and actions promoting safety”, a significant difference was observed in the mean scores of the study groups (P=0.030. Moreover, our results showed a significant difference between the mean scores of physicians and nurses in the aspect of “openness and honesty in communication” (P=0.023. Conclusion: According to the results of this study, improvement of PSC is necessary for the efficient management of hospitals and clinics. This is attainable through collaborative and instructive workshops, developing educational programs, and designing incident reporting systems.

  19. [Involving patients, the insured and the general public in healthcare decision making].

    Science.gov (United States)

    Mühlbacher, Axel C; Juhnke, Christin

    2016-01-01

    No doubt, the public should be involved in healthcare decision making, especially when decision makers from politics and self-government agencies are faced with the difficult task of setting priorities. There is a general consensus on the need for a stronger patient centeredness, even in HTA processes, and internationally different ways of public participation are discussed and tested in decision making processes. This paper describes how the public can be involved in different decision situations, and it shows how preference measurement methods are currently being used in an international context to support decision making. It distinguishes between different levels of decision making on health technologies: approval, assessment, pricing, and finally utilization. The range of participation efforts extends from qualitative surveys of patients' needs (Citizen Councils of NICE in the UK) to science-based documentation of quantitative patient preferences, such as in the current pilot projects of the FDA in the US and the EMA at the European level. Possible approaches for the elicitation and documentation of preference structures and trade-offs in relation to alternate health technologies are decision aids, such as multi-criteria decision analysis (MCDA), that provide the necessary information for weighting and prioritizing decision criteria.

  20. The healthcare system and the provision of oral healthcare in EU Member States: France.

    Science.gov (United States)

    Pegon-Machat, E; Faulks, D; Eaton, K A; Widström, E; Hugues, P; Tubert-Jeannin, S

    2016-02-26

    The French oral health system is based on the provision of dental treatment and is organised around a fee-per-item model. The system is funded by a complex mix of public and complementary health insurance schemes. The system is successful in that it provides access to affordable dental treatment to the majority of the French population. However, France had the highest health expenditure as a share of gross domestic product (GDP) of all European Union countries in 2008 and rising oral health inequalities may be exacerbated by the manner in which oral health care is provided and funded. In addition, there is no organised national strategy for the prevention of oral diseases or for oral health promotion.

  1. OPTIMED Platform: Curriculum Harmonisation System for Medical and Healthcare Education.

    Science.gov (United States)

    Komenda, Martin; Schwarz, Daniel; Vaitsis, Christos; Zary, Nabil; Štěrba, Jaroslav; Dušek, Ladislav

    2015-01-01

    This contribution introduces a new web-based OPTIMED platform for an effective harmonisation of medical and healthcare curriculum. Behind the engineering background stays an original methodology covering planning model based on formal parameterisation of curriculum, which fully support the outcome-based approach to education. With the use of developed system curriculum, designers and senior guarantors can provide a clear and transparent composition of compulsory and optional courses, and easily identify potential duplicities and overlaps across a domain of medical and healthcare education. For students, it means an absolutely new way of how to understand what is really taught during a learning period, including all necessary meta information. All members across the academic community are able to search and consequently display in detail the most important domains related to the particular year, term, course, medical discipline or topic. The presented solution significantly enhances the transparency and continuity of the environment in which the authors of the teaching materials as well as their consumers work daily. Suggestions for future improvements of the OPTIMED platform are discussed.

  2. Wearable nanosensor systems and their applications in healthcare

    Science.gov (United States)

    Ramasamy, Mouli; Kumar, Prashanth S.; Varadan, Vijay K.

    2017-04-01

    The development of intelligent miniaturized nano-bio-and info-tech based sensors capable of wireless communication will fundamentally change the way we monitor and treat patients with chronic disease and after surgery. These new sensors will allow the monitoring of the patients as they maintain their normal daily activities, and provide warning to healthcare workers when critical events arise. This will facilitate early discharge of patients from hospitals as well as providing reassurance to patients and family that potential problems will be detected at an early stage. The use of continuous monitoring allows both transient and progressive abnormalities to be reliably detected thus avoiding the problems of conventional diagnosis and monitoring methods where by data is captured only for a brief period during hospital/clinic visits. We have been working with a printable organic semiconductor and thin film transistor, and have fabricated and tested various biosensors that can measure important physiological signs before and after surgery. Integrated into "smart" fabrics - garments with wireless technology - and independent e-bandaid sensors, nanosensors in tattoos and socks, minimally invasive implantable devices, the sensor systems will be able to monitor a patient's condition in real time and thus provide point-of-care diagnostics to health-care professionals and greater freedom for patients.

  3. Unemployment, public-sector healthcare spending and stomach cancer mortality in the European Union, 1981-2009.

    Science.gov (United States)

    Maruthappu, Mahiben; Painter, Annabelle; Watkins, Johnathan; Williams, Callum; Ali, Raghib; Zeltner, Thomas; Faiz, Omar; Sheth, Hemant

    2014-11-01

    We sought to determine the association between changes in unemployment, healthcare spending and stomach cancer mortality. Multivariate regression analysis was used to assess how changes in unemployment and public-sector expenditure on healthcare (PSEH) varied with stomach cancer mortality in 25 member states of the European Union from 1981 to 2009. Country-specific differences in healthcare infrastructure and demographics were controlled for 1- to 5-year time-lag analyses and robustness checks were carried out. A 1% increase in unemployment was associated with a significant increase in stomach cancer mortality in both men and women [men: coefficient (R)=0.1080, 95% confidence interval (CI)=0.0470-0.1690, P=0.0006; women: R=0.0488, 95% CI=0.0168-0.0809, P=0.0029]. A 1% increase in PSEH was associated with a significant decrease in stomach cancer mortality (men: R=-0.0009, 95% CI=-0.0013 to -0.005, Punemployment or PSEH. Increases in unemployment are associated with a significant increase in stomach cancer mortality. Stomach cancer mortality is also affected by public-sector healthcare spending. Initiatives that bolster employment and maintain public-sector healthcare expenditure may help to minimize increases in stomach cancer mortality during economic downturns.

  4. Public views of mobile medical devices and services: a US national survey of consumer sentiments towards RFID healthcare technology.

    Science.gov (United States)

    Katz, James E; Rice, Ronald E

    2009-02-01

    A 2007 national public opinion survey of 1404 Americans revealed variations in sentiments concerning the desirability of several mobile healthcare technologies based on RFID. The survey appears to be the first reasonably national public opinion survey of US adults concerning their attitudes towards mobile healthcare technology. The survey revealed high levels of interest in emergency intervention services, but much less so in health information and monitoring services. Interest in RFID personal medical technology was positively associated with high levels of trust in others and social support. At the same time, a small minority were negatively disposed towards such applications. In those cases, the negative sentiment appears heightened when the mobile healthcare application is offered in a modality attached to the body as opposed to a somewhat more physically remote option, i.e., attached to one's cell phone.

  5. The Learning Healthcare System and Cardiovascular Care: A Scientific Statement From the American Heart Association.

    Science.gov (United States)

    Maddox, Thomas M; Albert, Nancy M; Borden, William B; Curtis, Lesley H; Ferguson, T Bruce; Kao, David P; Marcus, Gregory M; Peterson, Eric D; Redberg, Rita; Rumsfeld, John S; Shah, Nilay D; Tcheng, James E

    2017-04-04

    The learning healthcare system uses health information technology and the health data infrastructure to apply scientific evidence at the point of clinical care while simultaneously collecting insights from that care to promote innovation in optimal healthcare delivery and to fuel new scientific discovery. To achieve these goals, the learning healthcare system requires systematic redesign of the current healthcare system, focusing on 4 major domains: science and informatics, patient-clinician partnerships, incentives, and development of a continuous learning culture. This scientific statement provides an overview of how these learning healthcare system domains can be realized in cardiovascular disease care. Current cardiovascular disease care innovations in informatics, data uses, patient engagement, continuous learning culture, and incentives are profiled. In addition, recommendations for next steps for the development of a learning healthcare system in cardiovascular care are presented. © 2017 American Heart Association, Inc.

  6. Patient Experienced Continuity of Care in the Psychiatric Healthcare System

    DEFF Research Database (Denmark)

    Jensen, Natasja Koitzsch; Johansen, Katrine Schepelern; Kastrup, Marianne

    2014-01-01

    are complex and diverse and the patient perspective of continuity of care provides important insight into the delivery of care. The study highlights the importance of person-centred care irrespective of migration background though it may be beneficial to have an awareness of areas that may be of more specific......Aim: The purpose of this study was to investigate continuity of care in the psychiatric healthcare system from the perspective of patients, including vulnerable groups such as immigrants and refugees. Method: The study is based on 19 narrative interviews conducted with 15 patients with diverse...... migration backgrounds (immigrants, descendents, refugees, and ethnic Danes). Patients were recruited from a community psychiatric centre situated in an area with a high proportion of immigrants and refugees. Data were analysed through the lens of a theoretical framework of continuity of care in psychiatry...

  7. The Guatemala-Penn Partners: An Innovative Inter-Institutional Model for Scientific Capacity-Building, Healthcare Education, and Public Health.

    Science.gov (United States)

    Paniagua-Avila, Maria Alejandra; Messenger, Elizabeth; Nelson, Caroline A; Calgua, Erwin; Barg, Frances K; Bream, Kent W; Compher, Charlene; Dean, Anthony J; Martinez-Siekavizza, Sergio; Puac-Polanco, Victor; Richmond, Therese S; Roth, Rudolf R; Branas, Charles C

    2017-01-01

    Population health outcomes are directly related to robust public health programs, access to basic health services, and a well-trained health-care workforce. Effective health services need to systematically identify solutions, scientifically test these solutions, and share generated knowledge. The World Health Organization (WHO)'s Global Healthcare Workforce Alliance states that the capacity to perform research is an essential factor for well-functioning public health systems. Low- and middle-income countries have greater health-care worker shortages and lower research capacity than higher-income countries. International global health partnerships between higher-income countries and low-middle-income countries aim to directly address such inequalities through capacity building, a process by which human and institutional resources are strengthened and developed, allowing them to perform high-level functions, solve complex problems, and achieve important objectives. The Guatemala-Penn Partners (GPP) is a collaboration among academic centers in Guatemala and the University of Pennsylvania (Penn), in Philadelphia, Pennsylvania that echoes the vision of the WHO's Global Healthcare Workforce Alliance. This article describes the historical development and present organization of the GPP according to its three guiding principles: university-to-university connections, dual autonomies with locally led capacity building, and mutually beneficial exchanges. It describes the GPP activities within the domains of science, health-care education, and public health, emphasizing implementation factors, such as sustainability and scalability, in relation to the guiding principles. Successes and limitations of this innovative model are also analyzed in the hope that the lessons learned may be applied to similar partnerships across the globe.

  8. Growth surveillance in the context of the Primary Public Healthcare Service Network in Brazil: literature review

    Directory of Open Access Journals (Sweden)

    Dixis Figueroa Pedraza

    2016-03-01

    Full Text Available Abstract Objectives: to identify and analyze the scientific literature on child growth monitoring in the context of the primary public healthcare service network in Brazil, focusing on the main problems detected in studies. Methods: the review was based on searches ofSciELO, Lilacs and PubMed databases to identify articles published between 2006 and 2014. The articles were categorized according to the analytical categories of structure (items needed to carry out primary activities or work processes (set of activities and procedures used in the management of resources. Results: of the 16 articles included in this review, only six dealt with structure and, in these, thetraining of professionals and availability of protocols were the most frequently identified problems. Processes, addressed in 15 articles, highlighted the underutilization of Child Health Handbook to record growth measurements and the adoption of guidelines on the basis of notes taken. Conclusions: the difficulties found demonstrate the everyday circumstances of the public health service which have a detrimental effect on growth surveillance.

  9. The Pharma Summit 2010: competing in the future healthcare system.

    Science.gov (United States)

    Kibble, Alexandra

    2010-04-01

    The Pharma Summit 2010, held in London, included topics covering the future changes and developments that are expected in the pharmaceutical industry. This conference report highlights selected presentations on various visions for the future of the pharma industry, the expected revolution in healthcare, changes with patients driving healthcare innovation, the future of healthcare technology, and the outlook for the global economy and emerging markets in the pharma industry.

  10. Medical simulation topic interests in a pediatric healthcare system.

    Science.gov (United States)

    Deutsch, Ellen S; Olivieri, Jason J; Hossain, Jobayer; Sobolewski, Heather L

    2010-10-01

    Encouraged by evidence suggesting that simulation-based educational programs can translate to improved patient care, interest and investment in medical simulation have grown considerably in the past decade. Despite such growth, simulation is still a developing field, and little is known of the perceived needs for simulation training among practicing clinicians. This study describes medical simulation interests among clinicians in a pediatric health care system. A web-based survey addressing previous medical simulation experience, medical simulation interests, and demographics was distributed to physicians, nurses, and respiratory therapists within a pediatric healthcare system in the Delaware Valley. All three groups expressed the highest level of interest in simulated resuscitation events ("mock codes") and the least interest in simulations involving communication and electronic medical records. "Airway problems" was identified as the most popular medical simulation topic of interest. Although the rank order of interest in medical simulation categories was similar across groups, physicians reported the lowest levels of interest in all simulation categories. Characteristics such as previous simulation experience and group (eg, nurses and respiratory therapists) were associated with medical simulation interests. Years in practice did not impact interest. For adult learners, educational experiences should be targeted to the learners' perceived needs but should also address unrecognized deficits. Collectively, physicians, nurses, and respiratory therapists were most interested in participating in simulations addressing "codes" (emergency resuscitations) and airway management; these perceptions may provide a focus for designing simulation events that appeal to diverse learning styles. Prior experience with medical simulation seems to increase interest in subsequent simulation activities and offers the optimistic possibility that first-hand experience with simulation

  11. How do public child healthcare professionals and primary school teachers identify and handle child abuse cases? A quilitative study

    NARCIS (Netherlands)

    Schols, M.W.A.; Ruiter, C. de; Ory, F.G.

    2013-01-01

    Background Public child healthcare doctors and nurses, and primary school teachers play a pivotal role in the detection and reporting of child abuse, because they encounter almost all children in the population during their daily work. However, they report relatively few cases of suspected child

  12. How Multi-Levels of Individual and Team Learning Interact in a Public Healthcare Organisation: A Conceptual Framework

    Science.gov (United States)

    Doyle, Louise; Kelliher, Felicity; Harrington, Denis

    2016-01-01

    The aim of this paper is to review the relevant literature on organisational learning and offer a preliminary conceptual framework as a basis to explore how the multi-levels of individual learning and team learning interact in a public healthcare organisation. The organisational learning literature highlights a need for further understanding of…

  13. How do public child healthcare professionals and primary school teachers identify and handle child abuse cases? A quilitative study

    NARCIS (Netherlands)

    Schols, M.W.A.; Ruiter, C. de; Ory, F.G.

    2013-01-01

    Background Public child healthcare doctors and nurses, and primary school teachers play a pivotal role in the detection and reporting of child abuse, because they encounter almost all children in the population during their daily work. However, they report relatively few cases of suspected child abu

  14. Unit cost of healthcare services at 200-bed public hospitals in Myanmar: what plays an important role of hospital budgeting?

    Science.gov (United States)

    Than, Thet Mon; Saw, Yu Mon; Khaing, Moe; Win, Ei Mon; Cho, Su Myat; Kariya, Tetsuyoshi; Yamamoto, Eiko; Hamajima, Nobuyuki

    2017-09-19

    Cost information is important for efficient allocation of healthcare expenditure, estimating future budget allocation, and setting user fees to start new financing systems. Myanmar is in political transition, and trying to achieve universal health coverage by 2030. This study assessed the unit cost of healthcare services at two public hospitals in the country from the provider perspective. The study also analyzed the cost structure of the hospitals to allocate and manage the budgets appropriately. A hospital-based cross-sectional study was conducted at 200-bed Magway Teaching Hospital (MTH) and Pyinmanar General Hospital (PMN GH), in Myanmar, for the financial year 2015-2016. The step-down costing method was applied to calculate unit cost per inpatient day and per outpatient visit. The costs were calculated by using Microsoft Excel 2010. The unit costs per inpatient day varied largely from unit to unit in both hospitals. At PMN GH, unit cost per inpatient day was 28,374 Kyats (27.60 USD) for pediatric unit and 1,961,806 Kyats (1908.37 USD) for ear, nose, and throat unit. At MTH, the unit costs per inpatient day were 19,704 Kyats (19.17 USD) for medicine unit and 168,835 Kyats (164.24 USD) for eye unit. The unit cost of outpatient visit was 14,882 Kyats (14.48 USD) at PMN GH, while 23,059 Kyats (22.43 USD) at MTH. Regarding cost structure, medicines and medical supplies was the largest component at MTH, and the equipment was the largest component at PMN GH. The surgery unit of MTH and the eye unit of PMN GH consumed most of the total cost of the hospitals. The unit costs were influenced by the utilization of hospital services by the patients, the efficiency of available resources, type of medical services provided, and medical practice of the physicians. The cost structures variation was also found between MTH and PMN GH. The findings provided the basic information regarding the healthcare cost of public hospitals which can apply the efficient utilization of the

  15. Biosecurity through Public Health System Design.

    Energy Technology Data Exchange (ETDEWEB)

    Beyeler, Walter E. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Finley, Patrick D. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Arndt, William [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Walser, Alex Christian [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Mitchell, Michael David [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2016-11-01

    We applied modeling and simulation to examine the real-world tradeoffs between developingcountry public-health improvement and the need to improve the identification, tracking, and security of agents with bio-weapons potential. Traditionally, the international community has applied facility-focused strategies for improving biosecurity and biosafety. This work examines how system-level assessments and improvements can foster biosecurity and biosafety. We modeled medical laboratory resources and capabilities to identify scenarios where biosurveillance goals are transparently aligned with public health needs, and resource are distributed in a way that maximizes their ability to serve patients while minimizing security a nd safety risks. Our modeling platform simulates key processes involved in healthcare system operation, such as sample collection, transport, and analysis at medical laboratories. The research reported here extends the prior art by provided two key compone nts for comparative performance assessment: a model of patient interaction dynamics, and the capability to perform uncertainty quantification. In addition, we have outlined a process for incorporating quantitative biosecurity and biosafety risk measures. Two test problems were used to exercise these research products examine (a) Systemic effects of technological innovation and (b) Right -sizing of laboratory networks.

  16. National Healthcare Delivery Systems Influence Lung Transplant Outcomes for Cystic Fibrosis.

    Science.gov (United States)

    Merlo, C A; Clark, S C; Arnaoutakis, G J; Yonan, N; Thomas, D; Simon, A; Thompson, R; Thomas, H; Orens, J; Shah, A S

    2015-07-01

    Successful lung transplantation (LTx) depends on multiple components of healthcare delivery and performance. Therefore, we conducted an international registry analysis to compare post-LTx outcomes for cystic fibrosis (CF) patients using the UNOS registry in the United States and the National Health Service (NHS) Transplant Registry in the United Kingdom. Patients with CF who underwent lung or heart-lung transplantation in the United States or United Kingdom between January 1, 2000 and December 31, 2011 were included. The primary outcome was all-cause mortality. Kaplan-Meier analysis and Cox proportional hazards regression evaluated the effect of healthcare system and insurance on mortality after LTx. 2,307 US LTx recipients and 451 individuals in the United Kingdom were included. 894 (38.8%) US LTx recipients had publically funded Medicare/Medicaid insurance. US private insurance and UK patients had improved median predicted survival compared with US Medicare/Medicaid recipients (p insurance was associated with worse survival after LTx (US private: HR0.78,0.68-0.90,p = 0.001 and UK: HR0.63,0.41-0.97, p = 0.03). This study in CF patients is the largest comparison of LTx in two unique health systems. Both the United States and United Kingdom have similar early survival outcomes, suggesting important dissemination of best practices internationally. However, the performance of US public insurance is significantly worse and may put patients at risk.

  17. Modeling Virtual Healthcare Systems: Methods for Qualitative Case Analysis and Sociometry of Institutional Infrastructures

    OpenAIRE

    Séror, Ann

    2003-01-01

    The objective of this paper is to present a strategy for the qualitative analysis of virtual institutional infrastructures serving complex healthcare systems. Methodologies considered include case analysis, grounded theory, and sociometry. The discussion is illustrated with references to case analyses of diverse healthcare systems. Particular attention is focused on ideological values expressed in market dynamics and system control structures.

  18. Modeling virtual healthcare systems: methods for qualitative case analysis and sociometry of institutional infrastructures.

    Science.gov (United States)

    Séror, Ann

    2003-01-01

    The objective of this paper is to present a strategy for the qualitative analysis of virtual institutional infrastructures serving complex healthcare systems. Methodologies considered include case analysis, grounded theory, and sociometry. The discussion is illustrated with references to case analyses of diverse healthcare systems. Particular attention is focused on ideological values expressed in market dynamics and system control structures.

  19. Healthcare systems, the State, and innovation in the pharmaceutical industry.

    Science.gov (United States)

    Delgado, Ignacio José Godinho

    2016-11-03

    This article discusses the relations between healthcare systems and the pharmaceutical industry, focusing on state support for pharmaceutical innovation. The study highlights the experiences of the United States, United Kingdom, and Germany, developed countries and paradigms of modern health systems (liberal, universal, and corporatist), in addition to Japan, a case of successful catching up. The study also emphasizes the experiences of China, India, and Brazil, large developing countries that have tried different catching up strategies, with diverse histories and profiles in their healthcare systems and pharmaceutical industries. Finally, with a focus on state forms of support for health research, the article addresses the mechanisms for linkage between health systems and the pharmaceutical industry, evaluating the possibilities of Brazil strengthening a virtuous interaction, favoring the expansion and consolidation of the Brazilian health system - universal but segmented ‒ and the affirmation of the innovative national pharmaceutical industry. Resumo: O artigo discute as relações entre os sistemas de saúde e a indústria farmacêutica, concentrando-se no apoio do Estado à inovação farmacêutica. Salienta as trajetórias dos Estados Unidos, Reino Unido e Alemanha, países desenvolvidos, paradigmáticos dos modernos sistemas de saúde (liberais, universais e corporativos), além do Japão, um caso de emparelhamento bem-sucedido. Também enfatiza as trajetórias de China, Índia e Brasil, países em desenvolvimento, extensos, que experimentaram diferentes estratégias de emparelhamento, dispondo de sistemas de saúde e indústrias farmacêuticas com trajetórias e perfis diversos. Finalmente, com foco nas formas estatais de apoio à pesquisa em saúde, considera os mecanismos de conexão entre os sistemas de saúde e a indústria farmacêutica, avaliando as possibilidades, no Brasil, de fortalecer uma interação virtuosa que favoreça a expansão e

  20. Patient Education as an Information System, Healthcare Tool and Interaction

    Science.gov (United States)

    Pirhonen, Antti; Silvennoinen, Minna; Sillence, Elizabeth

    2014-01-01

    Patient education (PE) has a crucial role in the function of a healthcare organisation. For the care process of a patient, it is essential to get the right information at the right moment and in the right form. This paper analyses PE as the primary mode of interaction between a patient and a healthcare organisation. The approach is illustrated…

  1. Patient Education as an Information System, Healthcare Tool and Interaction

    Science.gov (United States)

    Pirhonen, Antti; Silvennoinen, Minna; Sillence, Elizabeth

    2014-01-01

    Patient education (PE) has a crucial role in the function of a healthcare organisation. For the care process of a patient, it is essential to get the right information at the right moment and in the right form. This paper analyses PE as the primary mode of interaction between a patient and a healthcare organisation. The approach is illustrated…

  2. Patient Relationship Management: What the U.S. Healthcare System Can Learn from Other Industries.

    Science.gov (United States)

    Poku, Michael K; Behkami, Nima A; Bates, David W

    2017-01-01

    As the U.S. healthcare system moves to value-based care, the importance of engaging patients and families continues to intensify. However, simply engaging patients and families to improve their subjective satisfaction will not be enough for providers who want to maximize value. True optimization entails developing deep and long-term relationships with patients. We suggest that healthcare organizations must build such a discipline of "patient relationship management" (PRM) just as companies in non-healthcare industries have done with the concept of customer relationship management (CRM). Some providers have already made strides in this area, but overall it has been underemphasized or ignored by most healthcare systems to date. As healthcare providers work to develop their dedicated PRM systems, tools, and processes, we suggest they may benefit from emulating companies in other industries who have been able to engage their customers in innovative ways while acknowledging the differences between healthcare and other industries.

  3. Using Ontologies for the E-learning System in Healthcare Human Resources Management

    Directory of Open Access Journals (Sweden)

    Lidia BAJENARU

    2015-01-01

    Full Text Available This paper provides a model for the use of ontology in e-learning systems for structuring educational content in the domain of healthcare human resources management (HHRM in Romania. In this respect we propose an effective method to improve the learning system by providing personalized learning paths created using ontology and advanced educational strategies to provide a personalized learning content for the medical staff. Personalization of e-learning process for the chosen target group will be achieved by setting up learning path for each user according to his profile. This will become possible using: domain ontology, learning objects, modeling student knowledge. Developing an ontology-based system for competence management allows complex interactions, providing intelligent interfacing. This is a new approach for the healthcare system managers in permanent training based on e-learning technologies and specific ontologies in a complex area that needs urgent modernization and efficiency to meet the public health economic, social and political context of Romania.

  4. Do Capitation-based Reimbursement Systems Underfund Tertiary Healthcare Providers? Evidence from New Zealand.

    Science.gov (United States)

    Shin, Somi; Schumacher, Christoph; Feess, Eberhard

    2017-02-01

    One of the main concerns about capitation-based reimbursement systems is that tertiary institutions may be underfunded due to insufficient reimbursements of more complicated cases. We test this hypothesis with a data set from New Zealand that, in 2003, introduced a capitation system where public healthcare provider funding is primarily based on the characteristics of the regional population. Investigating the funding for all cases from 2003 to 2011, we find evidence that tertiary providers are at a disadvantage compared with secondary providers. The reasons are that tertiary providers not only attract the most complicated, but also the highest number of cases. Our findings suggest that accurate risk adjustment is crucial to the success of a capitation-based reimbursement system. Copyright © 2017 John Wiley & Sons, Ltd.

  5. Embedding 'speaking up' into systems for safe healthcare product development and marketing surveillance.

    Science.gov (United States)

    Edwards, Brian; Hugman, Bruce; Tobin, Mary; Whalen, Matthew

    2012-04-01

    Robust, active cooperation, and effective, open communication between all stakeholders is essential for ensuring regulatory compliance and healthcare product safety; avoiding the necessity for whistle-blowing; and, most essentially, meeting the transparency requirements of public trust.The focus here is on what can be done within a healthcare product organization (HPO) to achieve actionable, sustainable policies and practices such as leadership, management, and supervision role-modelling of best practice; ongoing process review and improvements in every department; protection of those who report concerns through robust policies endorsed at Board level throughout an organization to eliminate the fear of retaliation; training in open, non-defensive team-working principles; and mediation structure and process for resolution of differences of opinion or interpretation of contradictory and volatile data.Based on analyses of other safety systems, workplace silence and interpersonal breakdowns are warning signs of defective systems underlying poor compliance and compromising safety. Remedying the situation requires attention to the root causes underlying such symptoms of dysfunction, especially the human factor, i.e. those factors that influence human performance. It is essential that leadership and management listen to employees' concerns about systems and processes, assess them impartially and reward contributions that improve safety.Fundamentally, the safety, transparency, and trustworthiness of HPOs, both commercial and regulatory, can be judged by the extent of the freedom of their staff to 'speak up' when the time is right. This, in turn, consolidates the trust of external stakeholders in the safety of a system and its products. The promotion of 'speaking up' in an organization provides an important safeguard against the risk of poor compliance and the undermining of societal confidence in the safety of healthcare products.

  6. Intelligent diagnosis and prescription for a customized physical fitness and healthcare system.

    Science.gov (United States)

    Huang, Chung-Chi; Liu, Hsiao-Man; Huang, Chung-Lin

    2015-01-01

    With the advent of the era of global high-tech industry and commerce and its associated sedentary lifestyle, opportunities for physical activity are reduced. People's physical fitness and health is deteriorating. Therefore, it is necessary to develop a system that can enhance people's physical fitness and health. However, it is difficult for general physical fitness and healthcare systems to meet individualized needs. The main purpose of this research is to develop a method of intelligent diagnosis and prescription for a customized physical fitness and healthcare system. The proposed system records all processes of the physical fitness and healthcare system via a wireless sensor network and the results of the diagnosis and prescription will be generated by fuzzy logic inference. It will improve individualized physical fitness and healthcare. Finally, we demonstrate the advantages of intelligent diagnosis and prescription for a customized physical fitness and healthcare system.

  7. Source characterization of nervous system active pharmaceutical ingredients in healthcare wastewaters

    Science.gov (United States)

    Nervous system active pharmaceutical ingredients (APIs), including anti-depressants and opioids, are important clinically administered pharmaceuticals within healthcare facilities. Concentrations and mass loadings of ten nervous system APIs and three nervous system API metaboli...

  8. [Art, mental health, and public healthcare: profile of a care culture in the history of São Paulo city].

    Science.gov (United States)

    Galvanese, Ana Tereza Costa; D'Oliveira, Ana Flávia Pires Lucas; Lima, Elizabeth Maria Freire de Araújo; Pereira, Lygia Maria de França; Nascimento, Ana Paula; Nascimento, Andréia de Fátima

    2016-01-01

    By studying the inclusion of artistic and cultural activities in the care provided throughout the history of public mental healthcare in greater São Paulo, Brazil, we can better understand and characterize the practices adopted in the Psychosocial Care Centers in the city today. Experiments carried out between the 1920s and 1990s are investigated, based on bibliographic research. The contemporary data were obtained from research undertaken at 126 workshops at 21 Psychosocial Care Centers in the same city between April 2007 and April 2008. The findings indicate that the current trend in mental healthcare, whose clinical perspective spans the realms of art and mental health and has territorial ramifications, has maintained some of the features encountered in earlier mental healthcare experiments.

  9. IoT-based Asset Management System for Healthcare-related Industries

    OpenAIRE

    2015-01-01

    The healthcare industry has been focusing efforts on optimizing inventory management procedures through the incorporation of Information and Communication Technology, in the form of tracking devices and data mining, to establish ideal inventory models. In this paper, a roadmap is developed towards a technological assessment of the Internet of Things (IoT) in the healthcare industry, 2010–2020. According to the roadmap, an IoT-based healthcare asset management system (IoT-HAMS) is proposed and...

  10. Do reviews of healthcare interventions teach us how to improve healthcare systems?

    Science.gov (United States)

    Pawson, Ray; Greenhalgh, Joanne; Brennan, Cathy; Glidewell, Elizabeth

    2014-08-01

    Planners, managers and policy makers in modern health services are not without ingenuity - they will always try, try and try again. They face deep-seated or 'wicked' problems, which have complex roots in the labyrinthine structures though which healthcare is delivered. Accordingly, the interventions devised to deal with such stubborn problems usually come in the plural. Many different reforms are devised to deal with a particular stumbling block, which may be implemented sequentially, simultaneously or whenever policy fashion or funding dictates. This paper examines this predicament from the perspective of evidence based policy. How might researchers go about reviewing the evidence when they are faced with multiple or indeed competing interventions addressing the same problem? In the face of this plight a rather unheralded form of research synthesis has emerged, namely the 'typological review'. We critically review the fortunes of this strategy. Separating the putative reforms into series of subtypes and producing a scorecard of their outcomes has the unintended effect of divorcing them all from an understanding of how organisations change. A more fruitful approach may lie in a 'theory-driven review' underpinned by an understanding of dynamics of social change in complex organisations. We test this thesis by examining the primary and secondary research on the many interventions designed to tackle a particularly wicked problem, namely the inexorable rise in demand for healthcare.

  11. Implementation of Wireless Group Support System in Mobile Healthcare

    Directory of Open Access Journals (Sweden)

    Karupothula Madhavi Latha

    2011-11-01

    Full Text Available In Mobile healthcare service, Wireless Group Support System can assist physicians or nurses in improving the quality of care and saving valuable time for emergency patients. Medical practitioners (often nurses collect various physiological signals, as well as subjective parameters. Physiological signals may include ECG, EEG, SpO2, temperature, continuous blood pressure etc. On the contrary, subjective parameters may include level of pain, level of alertness, awareness, behavioral responses etc. After successful accumulation of these data, a scoring system is utilized for early detection of critical illnesses. In many cases, the existing mechanism of scoring is performed manually, where the medical practitioner ticks on to a scoring board. In some cases the information from scoring board is relocated to a PC, where the software performs the scoring calculation. This paper demonstrates a new approach of using mobile phones to calculate the scoring. In the proposed system, the medical practitioner inputs the parameters directly on to their mobile phone while collecting the parameters from the patient. The score is automatically calculated by miniature java based software running inside the mobile phone. Based on the score, level of urgency is ascertained by the intelligent program. At the end, specialists are contacted automatically by messaging services. Moreover, the results of the scoring are transmitted to the hospital server. The proposed mobile phone based intelligent scoring system is integrated with SMS, MMS and HTTP capabilities. With the proposed mobile phone based scoring mechanism in place, volunteers without medical knowledge will be capable of patient monitoring. During any catastrophic event, required number of medical professionals is often absent. Therefore, assistance from civilians with mobile phone based medical intelligence can save precious life.

  12. The future and perspectives of financing the healthcare system

    OpenAIRE

    Gheorghe MATEI; Bianca MIHART

    2009-01-01

    This paper aims at analyzing characteristics of private health insurance (PHI) in low- and middle income countries and evaluating its significance for national health systems. In many countries the importance of PHI to finance health care is on a rise. Various factors contribute to this development: growing dissatisfaction with public health care, liberalization of markets and increased international trade in the insurance industry, and overall economic growth allowing higher and more diversi...

  13. Improving the effectiveness of service delivery in the public healthcare sector: the case of ophthalmology services in Malaysia.

    Science.gov (United States)

    Foo, Chee Yoong; Lim, Ka Keat; Sivasampu, Sheamini; Dahian, Kamilah Binti; Goh, Pik Pin

    2015-08-28

    Rising demand of ophthalmology care is increasingly straining Malaysia's public healthcare sector due to its limited human and financial resources. Improving the effectiveness of ophthalmology service delivery can promote national policy goals of population health improvement and system sustainability. This study examined the performance variation of public ophthalmology service in Malaysia, estimated the potential output gain and investigated several factors that might explain the differential performance. Data for 2011 and 2012 on 36 ophthalmology centres operating in the Ministry of Health hospitals were used in this analysis. We first consulted a panel of ophthalmology service managers to understand the production of ophthalmology services and to verify the production model. We then assessed the relative performance of these centres using Data Envelopment Analysis (DEA). Efficiency scores (ES) were decomposed into technical, scale, and congestion component. Potential increase in service output was estimated. Sensitivity analysis of model changes was performed and stability of the result was assessed using bootstrap approach. Second stage Tobit regression was conducted to determine if hospital type, availability of day services and population characteristics were related to the DEA scores. In 2011, 33% of the ophthalmology centres were found to have ES > 1 (mean ES = 1.10). Potential output gains were 10% (SE ± 2.92), 7.4% (SE ± 2.06), 6.9% (SE ± 1.97) if the centres could overcome their technical, scale and congestion inefficiencies. More centres moved to the performance frontier in 2012 (mean ES = 1.07), with lower potential output gain. The model used has good stability. Robustness checks show that the DEA correctly identified low performing centres. Being in state hospital was significantly associated with better performance. Using DEA to benchmarking service performance of ophthalmology care could provide insights for policy

  14. Hadoop-Based Healthcare Information System Design and Wireless Security Communication Implementation

    Directory of Open Access Journals (Sweden)

    Hongsong Chen

    2015-01-01

    Full Text Available Human health information from healthcare system can provide important diagnosis data and reference to doctors. However, continuous monitoring and security storage of human health data are challenging personal privacy and big data storage. To build secure and efficient healthcare application, Hadoop-based healthcare security communication system is proposed. In wireless biosensor network, authentication and key transfer should be lightweight. An ECC (Elliptic Curve Cryptography based lightweight digital signature and key transmission method are proposed to provide wireless secure communication in healthcare information system. Sunspot wireless sensor nodes are used to build healthcare secure communication network; wireless nodes and base station are assigned different tasks to achieve secure communication goal in healthcare information system. Mysql database is used to store Sunspot security entity table and measure entity table. Hadoop is used to backup and audit the Sunspot security entity table. Sqoop tool is used to import/export data between Mysql database and HDFS (Hadoop distributed file system. Ganglia is used to monitor and measure the performance of Hadoop cluster. Simulation results show that the Hadoop-based healthcare architecture and wireless security communication method are highly effective to build a wireless healthcare information system.

  15. Construction and application of an intelligent air quality monitoring system for healthcare environment.

    Science.gov (United States)

    Yang, Chao-Tung; Liao, Chi-Jui; Liu, Jung-Chun; Den, Walter; Chou, Ying-Chyi; Tsai, Jaw-Ji

    2014-02-01

    Indoor air quality monitoring in healthcare environment has become a critical part of hospital management and policy. Manual air sampling and analysis are cost-inhibitive and do not provide real-time air quality data and response measures. In this month-long study over 14 sampling locations in a public hospital in Taiwan, we observed a positive correlation between CO(2) concentration and population, total bacteria, and particulate matter concentrations, thus monitoring CO(2) concentration as a general indicator for air quality could be a viable option. Consequently, an intelligent environmental monitoring system consisting of a CO(2)/temperature/humidity sensor, a digital plug, and a ZigBee Router and Coordinator was developed and tested. The system also included a backend server that received and analyzed data, as well as activating ventilation and air purifiers when CO(2) concentration exceeded a pre-set value. Alert messages can also be delivered to offsite users through mobile devices.

  16. Predictive Analytics in Healthcare System Using Data Mining Techniques

    Directory of Open Access Journals (Sweden)

    Basma Boukenze

    2016-04-01

    Full Text Available The health sector has witnessed a great evolution f ollowing the development of new computer technologies, and that pushed this area to produce more medical data, which gave birth to multiple fields of research. Many efforts are done to cope with the explosion of medical data on one hand, and to obtain useful knowledge from it on the other hand. This prompted researchers to apply all the technical innovations like big dat a analytics, predictive analytics, machine learning and learning algorithms in order to extrac t useful knowledge and help in making decisions. With the promises of predictive analytic s in big data, and the use of machine learning algorithms, predicting future is no longer a diffic ult task, especially for medicine because predicting diseases and anticipating the cure becam e possible. In this paper we will present an overview on the evolution of big data in healthcare system, and we will apply a learning algorithm on a set of medical data. The objective i s to predict chronic kidney diseases by using Decision Tree (C4.5 algorithm.

  17. Computerised decision support systems for healthcare professionals: an interpretative review

    Directory of Open Access Journals (Sweden)

    Kathrin Cresswell

    2013-03-01

    Full Text Available Purpose Computerised decision support systems are designed to support clinicians in making decisions and thereby enhance the quality and safety of care. We aimed to undertake an interpretative review of the empirical evidence on computerised decision support systems, their contexts of use, and summarise evidence on the effectiveness of these tools and insights into how these can be successfully implemented and adopted.Methods We systematically searched the empirical literature to identify systematic literature reviews on computerised decision support applications and their impact on the quality and safety of healthcare delivery over a 13-year period (1997–2010. The databases searched included: MEDLINE, EMBASE, The Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, The Cochrane Central Register of Controlled Trials, The Cochrane Methodology Register, The Health Technology Assessment Database, and The National Health Service (NHS Economic Evaluation Database. To be eligible for inclusion, systematic reviews needed to address computerised decision support systems, and at least one of the following: impact on safety; quality; or organisational, implementation or adoption considerations.Results Our searches yielded 121 systematic reviews relating to eHealth, of which we identified 41 as investigating computerised decision support systems. These indicated that, whilst there was a lack of investigating potential risks, such tools can result in improvements in practitioner performance in the promotion of preventive care and guideline adherence, particularly if specific information is available in real time and systems are effectively integrated into clinical workflows. However, the evidence regarding impact on patient outcomes was less clear-cut with reviews finding either no, inconsistent or modest benefits.Conclusions Whilst the potential of clinical decision support systems in improving, in particular

  18. Public health law research: exploring law in public health systems.

    Science.gov (United States)

    Ibrahim, Jennifer K; Burris, Scott; Hays, Scott

    2012-11-01

    The importance of law in the organization and operation of public health systems has long been a matter of interest to public health lawyers and practitioners, but empirical research on law as a factor in health system performance has been limited in quantity and sophistication. The emergence of Public Health Law Research and Public Health Systems and Services Research within a coordinated effort to strengthen public health research and practice has dramatically changed matters. This article introduces Public Health Law Research as an integral part of Public Health Systems and Services Research, discusses the challenges of integrating the 2 fields, and highlights 2 examples of current research that demonstrate the benefits of an integrated approach to improve the use of law in public health practice.

  19. Doing their part for reform. Many of the Top 25 Women in Healthcare are on the front lines of reform as policymakers work to restructure our healthcare system.

    Science.gov (United States)

    Vesely, Rebecca

    2009-04-20

    The Top 25 Women in Healthcare followed a variety of paths to prominence, but many share this: They're among those working hard to reform our fractured system and covering the uninsured. "It's not just about coverage," says Mary Grealy of the Healthcare Leadership Council, left. "It's as much about reforming the system. There's a lot of bipartisanship around these ideas".

  20. The convergence of systemic threads shaping a future South African healthcare dispensation: A technology management perspective

    Directory of Open Access Journals (Sweden)

    Richard Weeks

    2013-02-01

    Full Text Available Orientation: Underpinning healthcare service delivery are a number of support systems. This paper focuses on the development of a healthcare services framework that reflects the systems that need to be integrated, from a technology healthcare support perspective.Research purpose: The purpose of this paper is gain an understanding of some of the intricacies associated with the management of the transition to a future South African healthcare dispensation, with reference to the convergence of technology, financial healthcare and socio-political systems.Motivation for the study: South Africa is in the process of implementing the National Health Insurance initiative and the approach adopted will have a significant impact on the business model design.Research design, approach and method: A multidisciplinary literature study was undertaken. In addition, a limited narrative enquiry was also conducted. Practitioners interviewed were from the healthcare, informatics and management and technology sectors respectively. The research study constituted an insight study – analytically descriptive and not statistical in nature.Main findings: The literature reflects two very contrasting and different business models of healthcare service provision, namely a primarily curative and preventative stance. Each assumes a very different convergence of technology, healthcare, financial and social systems and consequently gives rise to contrasting business models. The dominant model appears to be based on primary healthcare, with a different technology support infrastructure to the previously-adopted curative approach. It is a model that would also appear to necessitate a complex adaptive management approach, necessitating a bottom-up as opposed to a top-down hierarchal management orientation.Contribution/Value-add: The National Healthcare Insurance initiative entails a very fundamental restructuring of the healthcare infrastructure. The insights gained from this

  1. Extrinsic and intrinsic factors impacting on the retention of older rural healthcare workers in the north Victorian public sector: a qualitative study.

    Science.gov (United States)

    Warburton, Jeni; Moore, Melissa L; Clune, Samantha J; Hodgkin, Suzanne P

    2014-01-01

    Workforce shortages in Australia's healthcare system, particularly across rural areas, are well documented. Future projections suggest that as the healthcare workforce ages and retires, there is an urgent need for strategies to retain older skilled employees. Very few qualitative studies, with theoretical underpinning, have focused on the retention of older rural nurses and allied healthcare workers. This study aimed to address these gaps in research knowledge. This qualitative study is phase 2 of a large mixed-methods study to determine the factors that impact on the retention of older rural healthcare workers across northern Victoria, Australia. The initial phase, drawing on the effort-reward imbalance model found high levels of imbalance across a large sample of this population. The present study builds on these findings to explore in more depth the organisational (extrinsic) and individual/social (intrinsic) factors associated with retention. A purposeful stratified sample was drawn from participants at the survey phase (phase 1) and invited to take part in a semistructured telephone interview. A diverse group of 17 rural healthcare workers (nurses and allied health) aged 55 years or more, employed in the north Victorian public sector, were interviewed. The data were transcribed and later analysed thematically and inductively. Data were categorised into extrinsic and intrinsic factors that influenced their decisions to remain in their roles or leave employment. The main extrinsic factors included feeling valued by the organisation, workload pressures, feeling valued by clients, collegial support, work flexibility, and a lack of options. The main intrinsic factors included intention to retire, family influences, work enjoyment, financial influences, health, sense of self, and social input. Given the noted imbalance between (high) effort and (low) reward among participants overall, strategies were identified for improving this balance, and in turn, the retention

  2. Pension System Related Public Politics

    Directory of Open Access Journals (Sweden)

    LIVIU RADU

    2015-05-01

    Full Text Available This paper aims to find some answers regarding the long term sustainability of the pension system. Romania’s pension system originates from the invalidity insurances and pension system designed by the German cancellor Otto Eduard Leopold von Bismark in 1889. From a European perspective, Romania has to fill an obvious gap regarding the reformation of the national public pension system. International experience, particularly of the last 130 years, indicates that, in actuality, multiple pension systems have been put into function in most of the world’s countries and which are diferenciated by some elements (organizing and managing the system, defyning pension rights, method of forming the resources, the pension’s level rapported to the average income etc. and after the eficacity degree dependent on internal influences, social, economic and demographic environment, and last but not least by the political factor.

  3. Public stewardship of private for-profit healthcare providers in low- and middle-income countries

    Science.gov (United States)

    Wiysonge, Charles S; Abdullahi, Leila H; Ndze, Valantine N; Hussey, Gregory D

    2016-01-01

    Background Governments use different approaches to ensure that private for-profit healthcare services meet certain quality standards. Such government guidance, referred to as public stewardship, encompasses government policies, regulatory mechanisms, and implementation strategies for ensuring accountability in the delivery of services. However, the effectiveness of these strategies in low- and middle-income countries (LMICs) have not been the subject of a systematic review. Objectives To assess the effects of public sector regulation, training, or co-ordination of the private for-profit health sector in low- and middle-income countries. Search methods For related systematic reviews, we searched the Cochrane Database of Systematic Reviews (CDSR) 2015, Issue 4; Database of Abstracts of Reviews of Effectiveness (DARE) 2015, Issue 1; Health Technology Assessment Database (HTA) 2015, Issue 1; all part of The Cochrane Library, and searched 28 April 2015. For primary studies, we searched MEDLINE, Epub Ahead of Print, In-Process & Other Non-Indexed Citations, MEDLINE Daily and MEDLINE 1946 to Present, OvidSP (searched 16 June 2016); Science Citation Index and Social Sciences Citation Index 1987 to present, and Emerging Sources Citation Index 2015 to present, ISI Web of Science (searched 3 May 2016 for papers citing included studies); Cochrane Central Register of Controlled Trials (CENTRAL), 2015, Issue 3, part of The Cochrane Library (including the Cochrane Effective Practice and Organisation of Care (EPOC) Group Specialised Register) (searched 28 April 2015); Embase 1980 to 2015 Week 17, OvidSP (searched 28 April 2015); Global Health 1973 to 2015 Week 16, OvidSP (searched 30 April 2015); WHOLIS, WHO (searched 30 April 2015); Science Citation Index and Social Sciences Citation Index 1975 to present, ISI Web of Science (searched 30 April 2015); Health Management, ProQuest (searched 22 November 2013). In addition, in April 2016, we searched the reference lists of relevant

  4. INVESTMENTS AS A FACTOR OF STABILITY OF THE RUSSIAN HEALTHCARE SYSTEM

    Directory of Open Access Journals (Sweden)

    Lyudmila Valentinovna Tokun

    2016-01-01

    Full Text Available In this article the author examines the structure of public expenditure on health in Russia and analyzes the adequacy of the investments in the health system. Goal / Objectives. The aim of this article is to analyze the expenses of the project “Development strategy of the Russian healthcare system for the long-term period 2015–2030”. The main objectives of this article are the definition of the technical condition of the buildings and improvement of health facilities, evaluation of the value of fixed assets in the healthcare and medical equipment depreciation, evaluation of tariff s in the compulsory health insurance system. Methodology. the method of comparative analysis of 10 past years indicators is used in this article Results. From 2005 to 2014 healthcare expenditures have increased 3 times, which is comparable to GDP growth. In the same period, investments in health have increased by 2 times. The main increase in expenditures occurred in the wages. These trends may indicate a lack of attention in relation to fixed assets. In relation to the renovation and the depreciation factor, rate of growth and the level of investment cast doubt on the adequacy and sustainability of the healthcare’s material basis for the provision of necessary medical assistance. It is required to calculate the standard, which includes continuous updating of fixed assets based on the each region of RF, depending on the regional characteristics and the structure of fixed assets. Conclusions / Significance. The study concluded that at the moment the size of the annual investment in health by the federal and regional budgets do not meet the needs of even simple reproduction, not to mention the modernization and development. Planning budget investment requirements can be carried out based on a special standard ratio, which takes into account the volume, composition and structure of fixed assets. Financial stability of the Russian healthcare depends not only on

  5. Healthcare professional perspectives on quality and safety in New Zealand public hospitals: findings from a national survey.

    Science.gov (United States)

    Gauld, Robin; Horsburgh, Simon

    2014-02-01

    Few studies have sought to measure health professional perceptions of quality and safety across an entire system of public hospitals. Therefore, three questions that gauge different aspects of quality and safety were included in a national New Zealand survey of clinical governance. Three previously used questions were adapted. A total of 41040 registered health professionals employed in District Health Boards were invited to participate in an online survey. Analyses were performed using the R statistical environment. Proportional odds mixed models were used to quantify associations between demographic variables and responses on five-point scales. Relationships between other questions in the survey and the three quality and safety questions were quantified with the Pearson correlation coefficient. A 25% response rate delivered 10303 surveys. Fifty-seven percent of respondents (95% CI: 56-58%) agreed that health professionals in their District Health Board worked together as a team; 70% respondents (95% CI: 69-70%) agreed that health professionals involved patients and families in efforts to improve patient care; and 69% (95% CI: 68-70%) agreed that it was easy to speak up in their clinical area if they perceived a problem with patient care. Correlations showed links between perceptions of stronger clinical leadership and performances on the three questions, as well as with other survey items. The proportional mixed model also revealed response differences by respondent characteristics. The findings suggest positive commitment to quality and safety among New Zealand health professionals and their employers, albeit with variations by district, profession, gender and age, but also scope for improvement. The study also contributes to the literature indicating that clinical leadership is an important contributor to quality improvement. WHAT IS KNOWN ABOUT THE TOPIC? Various studies have explored aspects of healthcare quality and safety, generally within a hospital or

  6. Coordinating Healthcare Under a Pluralistic Health Insurance System: The Case of Slovakia

    NARCIS (Netherlands)

    Nemec, J.; Spacek, D.; Vries, M.S. de

    2015-01-01

    The Slovak approach to decreasing healthcare costs is based on a changed interpretation of the concept of ‘a minimum network of providers’. This study describes the changes made in the healthcare system in Slovakia in order to keep it affordable. It shows how the initial interpretation of a minimum

  7. The Erasure of Sex and Gender Minorities in the Healthcare System

    Directory of Open Access Journals (Sweden)

    Marianne LeBreton

    2013-09-01

    Full Text Available Socio-cultural notions of gender and sex influence the structuring of healthcare systems. This case study exemplifies how the Western gender binary, and cisnormativity in particular, can create barriers to accessing healthcare services for transgender populations and lead to erasure.

  8. It is time to talk about people: a human-centered healthcare system

    Directory of Open Access Journals (Sweden)

    Borgi Lea

    2010-11-01

    Full Text Available Abstract Examining vulnerabilities within our current healthcare system we propose borrowing two tools from the fields of engineering and design: a Reason's system approach 1 and b User-centered design 23. Both approaches are human-centered in that they consider common patterns of human behavior when analyzing systems to identify problems and generate solutions. This paper examines these two human-centered approaches in the context of healthcare. We argue that maintaining a human-centered orientation in clinical care, research, training, and governance is critical to the evolution of an effective and sustainable healthcare system.

  9. It is time to talk about people: a human-centered healthcare system.

    Science.gov (United States)

    Searl, Meghan M; Borgi, Lea; Chemali, Zeina

    2010-11-26

    Examining vulnerabilities within our current healthcare system we propose borrowing two tools from the fields of engineering and design: a) Reason's system approach 1 and b) User-centered design 23. Both approaches are human-centered in that they consider common patterns of human behavior when analyzing systems to identify problems and generate solutions. This paper examines these two human-centered approaches in the context of healthcare. We argue that maintaining a human-centered orientation in clinical care, research, training, and governance is critical to the evolution of an effective and sustainable healthcare system.

  10. Characterizing public health emergency perceptions and influential modifiers of willingness to respond among pediatric healthcare staff.

    Science.gov (United States)

    Watson, Christopher M; Barnett, Daniel J; Thompson, Carol B; Hsu, Edbert B; Catlett, Christina L; Gwon, Howard S; Semon, Natalie L; Balicer, Ran D; Links, Jonathan M

    2011-01-01

    The aim of this study was to characterize the public health emergency perceptions and willingness to respond (WTR) of hospital-based pediatric staff and to use these findings to propose a methodology for developing an institution-specific training package to improve response willingness. A prospective anonymous web-based survey was conducted at the Johns Hopkins Hospital, including the 180-bed Johns Hopkins Children's Center, between January and March 2009. In this survey, participants' attitudes/beliefs regarding emergency response to a pandemic influenza and a radiological dispersal device (RDD or "dirty bomb") event were assessed. Of the 1,620 eligible pediatric staff 246 replies (15.2 percent response rate) were received, compared with an overall staff response rate of 18.4 percent. Characteristics of respondent demographics and professions were similar to those of overall hospital staff. Self-reported WTR was greater for a pandemic influenza than for an RDD event if required (84.6 percent vs 75.1 percent), and if asked, but not required (74.4 percent vs 64.5 percent). The majority of pediatric staff were not confident in their safety at work (pandemic influenza: 51.8 percent and RDD: 76.6 percent), were far less likely to respond if personal protective equipment was unavailable (pandemic influenza: 33.5 percent and RDD: 21.6percent), and wanted furtherpre-event preparation and training (pandemic influenza: 89.6 percent and RDD: 82.6 percent). The following six distinct perceived attitudes / beliefs were identified as having institution-specific high impact on response willingness: colleague response, skill mastery, safety getting to work, safety at work, ability to perform duties, and individual response efficacy. Children represent a uniquely vulnerable population in public health emergencies, and pediatric hospital staff accordingly represent a vital subset of responders distinguished by specialized education, training, clinical skills, and disaster

  11. Understanding safety in healthcare: the system evolution, erosion and enhancement model

    Directory of Open Access Journals (Sweden)

    Jane Carthey

    2013-12-01

    Full Text Available The paper summarises previous theories of accident causation, human error, foresight, resilience and system migration. Five lessons from these theories are used as the foundation for a new model which describes how patient safety emerges in complex systems like healthcare: the System Evolution Erosion and Enhancement model. It is concluded that to improve patient safety, healthcare organisations need to understand how system evolution both enhances and erodes patient safety.

  12. Depiction of Trends in Administrative Healthcare Data from Hospital Information System.

    Science.gov (United States)

    Kalankesh, Leila R; Pourasghar, Faramarz; Jafarabadi, Mohammad Asghari; Khanehdan, Negar

    2015-06-01

    class of final diagnosis and age. this study presents trends in administrative health care data residing in hospital information system of a general public hospital. Patterns in morbidity, mortality and length of stay can inform decision making in health care management. Mining trends in administrative healthcare data can add value to the health care management.

  13. An analysis of the healthcare informatics and systems in Southeast Asia: a current perspective from seven countries.

    Science.gov (United States)

    Nguyen, Q T; Naguib, R N G; Abd Ghani, M K; Bali, R K; Lee, I M

    2008-01-01

    This paper presents an overview of the healthcare systems in Southeast Asia, with a focus on the healthcare informatics development and deployment in seven countries, namely, Singapore, Cambodia, Malaysia, Thailand, Laos, the Philippines and Vietnam. Brief geographic and demographic information is provided for each country, followed by a historical review of the national strategies for healthcare informatics development. An analysis of the state-of-the-art healthcare infrastructure is also given, along with a critical appraisal of national healthcare provisions.

  14. A qualitative study of health system barriers to accessibility and utilization of maternal and newborn healthcare services in Ghana after user-fee abolition.

    Science.gov (United States)

    Ganle, John Kuumuori; Parker, Michael; Fitzpatrick, Raymond; Otupiri, Easmon

    2014-12-21

    To reduce financial barriers to access, and improve access to and use of skilled maternal and newborn healthcare services, the government of Ghana, in 2003, implemented a new maternal healthcare policy that provided free maternity care services in all public and mission healthcare facilities. Although supervised delivery in Ghana has increased from 47% in 2003 to 55% in 2010, strikingly high maternal mortality ratio and low percentage of skilled attendance are still recorded in many parts of the country. To explore health system factors that inhibit women's access to and use of skilled maternal and newborn healthcare services in Ghana despite these services being provided free. We conducted qualitative research with 185 expectant and lactating mothers and 20 healthcare providers in six communities in Ghana between November 2011 and May 2012. We used Attride-Stirling's thematic network analysis framework to analyze and present our data. We found that in addition to limited and unequal distribution of skilled maternity care services, women's experiences of intimidation in healthcare facilities, unfriendly healthcare providers, cultural insensitivity, long waiting time before care is received, limited birthing choices, poor care quality, lack of privacy at healthcare facilities, and difficulties relating to arranging suitable transportation were important health system barriers to increased and equitable access and use of services in Ghana. Our findings highlight how a focus on patient-side factors can conceal the fact that many health systems and maternity healthcare facilities in low-income settings such as Ghana are still chronically under-resourced and incapable of effectively providing an acceptable minimum quality of care in the event of serious obstetric complications. Efforts to encourage continued use of maternity care services, especially skilled assistance at delivery, should focus on addressing those negative attributes of the healthcare system that

  15. Systems of evidence-based healthcare and personalised health information: some international and national trends.

    Science.gov (United States)

    Gordon, C; Gray, J A; Toth, B; Veloso, M

    2000-01-01

    In Europe, North America and elsewhere, growing interest has focussed on evidence-based healthcare systems, incorporating the deployment of practice guidelines, as a field of application for health telematics. The clinical benefit and technical feasibility of common European approaches to this task has recently been demonstrated. In Europe it is likely that, building on recent progress in electronic health record architecture (EHRA) standards, a sufficient state of maturity can be reached to justify initiation within CEN TC251 of a prestandards process on guideline content formats during the current 5th Framework of EC RT&D activity. There is now a similar impetus to agree standards for this field in North America. Thanks to fruitful EC-USA contacts during the 4th Framework programme, there is now a chance, given well-planned coordination, to establish a global consensus optimally suited to serve the world-wide delivery and application of evidence-based medicine. This review notes three factors which may accelerate progress to convergence: (1) revolutionary changes in the knowledge basis of professional/patient/public healthcare partnerships, involving the key role of the Web as a health knowledge resource for citizens, and a rapidly growing market for personalised health information and advice; (2) the emergence at national levels of digital warehouses of clinical guidelines and EBM knowledge resources, agencies which are capable of brokering common mark-up and interchange media definitions between knowledge providers, industry and healthcare organizations; (3) the closing gap in knowledge management technology, with the advent of XML and RDF, between approaches and services based respectively on text mark-up and knowledge-base paradigms. A current project in the UK National Health Service (the National electronic Library of Health) is cited as an example of a national initiative designed to harness these trends.

  16. An Action Research Study of a Healthcare Enterprise information System at the Faroe Islands

    DEFF Research Database (Denmark)

    Schlichter, Bjarne Rerup; Svejvig, Per; Andersen, Povl Erik Rostgaard

    2015-01-01

    Obtaining business value from IT is a recurring theme that has diffused into healthcare information systems (HIS) where stakeholders often question the value of IT investments. Having completed the implementation of an integrated HIS, the Faroese Health Service (FHS) has commenced discussions...... concerning getting value from their IT investment. In order to fulfill this objective an action research project was started in the fall of 2010 consisting of two cycles: (1) setting the stage for benefit realization and; (2) benefit realization in a pilot area. The first cycle has revealed...... of Style Composition in action research we suggest a method to identify and realize emergent IT public value in an HIS action research project. The method is presented and discussed, and issues and concerns for further research are presented....

  17. A healthcare management system for Turkey based on a service-oriented architecture.

    Science.gov (United States)

    Herand, Deniz; Gürder, Filiz; Taşkin, Harun; Yuksel, Emre Nuri

    2013-09-01

    The current Turkish healthcare management system has a structure that is extremely inordinate, cumbersome and inflexible. Furthermore, this structure has no common point of view and thus has no interoperability and responds slowly to innovations. The purpose of this study is to show that using which methods can the Turkish healthcare management system provide a structure that could be more modern, more flexible and more quick to respond to innovations and changes taking advantage of the benefits given by a service-oriented architecture (SOA). In this paper, the Turkish healthcare management system is chosen to be examined since Turkey is considered as one of the Third World countries and the information architecture of the existing healthcare management system of Turkey has not yet been configured with SOA, which is a contemporary innovative approach and should provide the base architecture of the new solution. The innovation of this study is the symbiosis of two main integration approaches, SOA and Health Level 7 (HL7), for integrating divergent healthcare information systems. A model is developed which is based on SOA and enables obtaining a healthcare management system having the SSF standards (HSSP Service Specification Framework) developed by the framework of the HSSP (Healthcare Services Specification Project) under the leadership of HL7 and the Object Management Group.

  18. Is healthcare a 'Necessity' or 'Luxury'? an empirical evidence from public and private sector analyses of South-East Asian countries?

    Science.gov (United States)

    Khan, Jahangir Am; Mahumud, Rashidul Alam

    2015-01-01

    South-East Asian Regional (SEAR) countries range from low- to middle-income countries and have considerable differences in mix of public and private sector expenditure on health. This study intends to estimate the income-elasticities of healthcare expenditure in public and private sectors separately for investigating whether healthcare is a 'necessity' or 'luxury' for citizens of these countries. Panel data from 9 SEAR countries over 16 years (1995-2010) were employed. Fixed- and random-effect models were fitted to estimate income-elasticity of public, private and total healthcare expenditure. Results showed that one percent point increase in GDP per capita increased private expenditure on healthcare by 1.128%, while public expenditure increased by only 0.412%. Inclusion of three-year lagged variables of GDP per capita in the models did not have remarkable influence on the findings. The citizens of SEAR countries consider healthcare as a necessity while provided through public sector and a luxury when delivered by private sector. By increasing the public provisions of healthcare, more redistribution of healthcare resources can be ensured, which can accelerate the journey of SEAR countries towards universal health coverage.

  19. Bringing Big Data to the Forefront of Healthcare Delivery: The Experience of Carolinas HealthCare System.

    Science.gov (United States)

    Dulin, Michael F; Lovin, Carol A; Wright, Jean A

    2017-01-01

    The use of big data to transform care delivery is rapidly becoming a reality. To deliver on the promise of value-based care, providers must know the key drivers of wellness at the patient and community levels, as well as understand resource constraints and opportunities to improve efficiency in the health-care system itself. Data are the linchpin. By gathering the right data and finding innovative ways to glean knowledge, we can improve clinical care, advance the health of our communities, improve the lives of our patients, and operate more efficiently. At Carolinas HealthCare System-one of the nation's largest health-care systems, with nearly 12 million patient encounters annually at more than 900 care locations-we have made substantial investments to establish a centralized data and analytics infrastructure that is transforming the way we deliver care across the continuum. Although the impetus and vision for our program have evolved over the past decade, our efforts coalesced into a strategic, centralized initiative with the launch of the Dickson Advanced Analytics (DA) group in 2012. DA has yielded significant gains in our ability to use data, not only for reporting purposes and understanding our business but also for predicting outcomes and informing action.While these efforts have been successful, the path has not been easy. Effectively harnessing big data requires navigating myriad technological, cultural, operational, and other hurdles. Building a program that is feasible, effective, and sustainable takes concerted effort and a rigorous process of continuous self-evaluation and strategic adaptation.

  20. Data Privacy in Cloud-assisted Healthcare Systems: State of the Art and Future Challenges.

    Science.gov (United States)

    Sajid, Anam; Abbas, Haider

    2016-06-01

    The widespread deployment and utility of Wireless Body Area Networks (WBAN's) in healthcare systems required new technologies like Internet of Things (IoT) and cloud computing, that are able to deal with the storage and processing limitations of WBAN's. This amalgamation of WBAN-based healthcare systems to cloud-based healthcare systems gave rise to serious privacy concerns to the sensitive healthcare data. Hence, there is a need for the proactive identification and effective mitigation mechanisms for these patient's data privacy concerns that pose continuous threats to the integrity and stability of the healthcare environment. For this purpose, a systematic literature review has been conducted that presents a clear picture of the privacy concerns of patient's data in cloud-assisted healthcare systems and analyzed the mechanisms that are recently proposed by the research community. The methodology used for conducting the review was based on Kitchenham guidelines. Results from the review show that most of the patient's data privacy techniques do not fully address the privacy concerns and therefore require more efforts. The summary presented in this paper would help in setting research directions for the techniques and mechanisms that are needed to address the patient's data privacy concerns in a balanced and light-weight manner by considering all the aspects and limitations of the cloud-assisted healthcare systems.

  1. Mobile healthcare.

    Science.gov (United States)

    Morgan, Stephen A; Agee, Nancy Howell

    2012-01-01

    Mobile technology's presence in healthcare has exploded over the past five years. The increased use of mobile devices by all segments of the US population has driven healthcare systems, providers, and payers to accept this new form of communication and to develop strategies to implement and leverage the use of mobile healthcare (mHealth) within their organizations and practices. As healthcare systems move toward a more value-driven model of care, patient centeredness and engagement are the keys to success. Mobile healthcare will provide the medium to allow patients to participate more in their care. Financially, mHealth brings to providers the ability to improve efficiency and deliver savings to both them and the healthcare consumer. However, mHealth is not without challenges. Healthcare IT departments have been reluctant to embrace this shift in technology without fully addressing security and privacy concerns. Providers have been hesitant to adopt mHealth as a form of communication with patients because it breaks with traditional models. Our healthcare system has just started the journey toward the development of mHealth. We offer an overview of the mobile healthcare environment and our approach to solving the challenges it brings to healthcare organizations.

  2. Determinants of job satisfaction of healthcare professionals in public hospitals in Belgrade, Serbia - cross-sectional analysis

    Directory of Open Access Journals (Sweden)

    Kuburović Nina B.

    2016-01-01

    Full Text Available Introduction. The quality of health care significantly depends on the satisfaction of the employees. Objective. The objective of this study was to establish the level of professional satisfaction of healthcare professionals in state hospitals in Belgrade, Serbia, and to determine and to rank the factors which impact on their satisfaction or dissatisfaction. Method. Professional satisfaction survey was designed and conducted as a cross-sectional study in 2008. Completed questionnaires were returned by 6,595 healthcare professionals from Belgrade’s hospitals. Statistical analysis was performed using the Student’s t-test, χ2 test and ANOVA. Factor analysis was applied in order to define determinants of professional satisfaction, i.e. dissatisfaction. Results. This study showed that the degree of professional satisfaction of Serbian healthcare professionals was low. The main causes of professionals’ dissatisfaction were wages, equipment, the possibility of continuous medical education/training and the opportunities for professional development. Healthcare professionals with university education were more satisfied with all the individual aspects of job satisfaction than those with secondary school and college education. Conclusion. There were significantly more healthcare professionals satisfied with their job among males, older than 60 years, in the age group 50-59 years, with managerial function, and with 30 or more years of service. Development strategy of human resources in the Serbian health care system would significantly improve the professional satisfaction and quality of the provided health care.

  3. Relation of people-centered public health and person-centered healthcare management: a case study to reduce burn-out.

    Science.gov (United States)

    Stoyanov, Drozdstoj S; Cloninger, C Robert

    2012-01-01

    Healthcare management is one practical tool for mediation and implementation of public health into clinical healthcare outcomes and is taken in our case study as an exemplar arena to demonstrate the vital importance of the person-centered approach. Healthcare personnel are frequently at risk for the 'burn-out' syndrome. However, modern measures of burn-out recognize burn-out only at a late stage when it is fully developed. There are no available methods to assess the risk for vulnerability to burnout in healthcare systems. Our aim was therefore to design a complex person-centered model for detection of high risk for burn-out at an early stage, that has been termed 'flame-out'. We accept the observation that decreased personal performance is one crucial expression of burn-out. Low personal performance and negative emotions are strongly related to low self-directedness as measured by the Temperament and Character Inventory (TCI). At the same time, burn-out is characterized by decreased interest and positive emotions from work. Decreased positive emotion is directly related to low self-transcendence as measured by the TCI. Burn-out is also frequently associated with feelings of social alienation or inadequacy of support, which is in turn related to low TCI Cooperativeness. However, high Persistence and Harm Avoidance are predisposing traits for burn-out in healthcare professionals who are often overly perfectionistic and compulsive, predisposing them to anxiety, depression, suicide and burn-out. Hence, people at risk for future burn-out are often highly conscientious over-achievers with intense mixtures of positive and negative emotions. The high demand for perfection comes from both intrinsic characteristics and from features of the social milieu in their psychological climate. Letting go of the unfulfillable desire to be perfect by increasing self-transcendence allows acceptance of the imperfection of the human condition, thereby preventing burn-out and other

  4. Using grey literature to prepare pharmacy students for an evolving healthcare delivery system.

    Science.gov (United States)

    Happe, Laura E; Walker, Desiree'

    2013-05-13

    To assess the impact of using "grey literature" (information internally produced in print or electronic format by agencies such as hospitals, government, businesses, etc) rather than a textbook in a course on healthcare delivery systems on students' perception of the relevance of healthcare delivery system topics and their ability to identify credible sources of this information. A reading from the grey literature was identified and assigned to the students for each topic in the course. Pre- and post-course survey instruments were used for the assessment. Students reported healthcare delivery systems topics to be moderately relevant to the profession of pharmacy on both the pre- and post-course survey instruments. Students' knowledge of current and credible sources of information on healthcare delivery system topics significantly improved based on self-reports and scores on objective assessments (phealthcare delivery systems can be used to ensure that information in the pharmacy school curriculum is the most current and credible information available.

  5. The enhancement of security in healthcare information systems.

    Science.gov (United States)

    Liu, Chia-Hui; Chung, Yu-Fang; Chen, Tzer-Shyong; Wang, Sheng-De

    2012-06-01

    With the progress and the development of information technology, the internal data in medical organizations have become computerized and are further established the medical information system. Moreover, the use of the Internet enhances the information communication as well as affects the development of the medical information system that a lot of medical information is transmitted with the Internet. Since there is a network within another network, when all networks are connected together, they will form the "Internet". For this reason, the Internet is considered as a high-risk and public environment which is easily destroyed and invaded so that a relevant protection is acquired. Besides, the data in the medical network system are confidential that it is necessary to protect the personal privacy, such as electronic patient records, medical confidential information, and authorization-controlled data in the hospital. As a consequence, a medical network system is considered as a network requiring high security that excellent protections and managerial strategies are inevitable to prevent illegal events and external attacks from happening. This study proposes secure medical managerial strategies being applied to the network environment of the medical organization information system so as to avoid the external or internal information security events, allow the medical system to work smoothly and safely that not only benefits the patients, but also allows the doctors to use it more conveniently, and further promote the overall medical quality. The objectives could be achieved by preventing from illegal invasion or medical information being stolen, protecting the completeness and security of medical information, avoiding the managerial mistakes of the internal information system in medical organizations, and providing the highly-reliable medical information system.

  6. Applying analytic hierarchy process to assess healthcare-oriented cloud computing service systems.

    Science.gov (United States)

    Liao, Wen-Hwa; Qiu, Wan-Li

    2016-01-01

    Numerous differences exist between the healthcare industry and other industries. Difficulties in the business operation of the healthcare industry have continually increased because of the volatility and importance of health care, changes to and requirements of health insurance policies, and the statuses of healthcare providers, which are typically considered not-for-profit organizations. Moreover, because of the financial risks associated with constant changes in healthcare payment methods and constantly evolving information technology, healthcare organizations must continually adjust their business operation objectives; therefore, cloud computing presents both a challenge and an opportunity. As a response to aging populations and the prevalence of the Internet in fast-paced contemporary societies, cloud computing can be used to facilitate the task of balancing the quality and costs of health care. To evaluate cloud computing service systems for use in health care, providing decision makers with a comprehensive assessment method for prioritizing decision-making factors is highly beneficial. Hence, this study applied the analytic hierarchy process, compared items related to cloud computing and health care, executed a questionnaire survey, and then classified the critical factors influencing healthcare cloud computing service systems on the basis of statistical analyses of the questionnaire results. The results indicate that the primary factor affecting the design or implementation of optimal cloud computing healthcare service systems is cost effectiveness, with the secondary factors being practical considerations such as software design and system architecture.

  7. Operationalization of the Ghanaian Patients' Charter in a Peri-urban Public Hospital: Voices of Healthcare Workers and Patients.

    Science.gov (United States)

    Yarney, Lily; Buabeng, Thomas; Baidoo, Diana; Bawole, Justice Nyigmah

    2016-04-23

    Health is a basic human right necessary for the exercise of other human rights. Every human being is, therefore, entitled to the highest possible standard of health necessary to living a life of dignity. Establishment of patients' Charter is a step towards protecting the rights and responsibilities of patients, but violation of patients' rights is common in healthcare institutions, especially in the developing world. This study which was conducted between May 2013 and May 2014, assessed the operationalization of Ghana's Patients Charter in a peri-urban public hospital. Qualitative data collection methods were used to collect data from 25 healthcare workers and patients who were purposively selected. The interview data were analyzed manually, using the principles of systematic text condensation. The findings indicate that the healthcare staff of the Polyclinic are aware of the existence of the patients' Charter and also know some of its contents. Patients have no knowledge of the existence or the contents of the Charter. Availability of the Charter, community sensitization, monitoring and orientation of staff are factors that promote the operationalization of the Charter, while institutional implementation procedures such as lack of complaint procedures and low knowledge among patients militate against operationalization of the Charter. Public health facilities should ensure that their patients are well-informed about their rights and responsibilities to facilitate effective implementation of the Charter. Also, patients' rights and responsibilities can be dramatized and broadcasted on television and radio in major Ghanaian languages to enhance awareness of Ghanaians on the Charter.

  8. Quality use of medicine in a developing economy: Measures to overcome challenges in the Malaysian healthcare system

    Directory of Open Access Journals (Sweden)

    Nurul-Ain Mohd-Tahir

    2015-07-01

    Full Text Available Malaysia inherits a highly subsidized tax-based public healthcare system complemented by a fee-for-service private sector. Population health in Malaysia has considerably improved since independence using a relatively small amount of gross domestic product (~4%. Brain drain of highly specialized personnel, growth in healthcare spending, demographic and disease pattern changes and increase in patients’ demands and expectations towards better medical care are exerting pressure on the sustainability of the system to continuously provide efficient and effective services at relatively low cost. Malaysia has adopted and implemented some of the quality use of medicine concepts such as National Essential Medicine List, health technology assessment and promotion of generic medicines in their health policy, but so far the results may not be optimal. Activities to further promote these strategies are needed for successful implementation to achieve more positive and sustained beneficial outcomes. Better strategic planning, management and collaboration between various stakeholders, considering the needs and barriers of the strategies, are important to ensure effective implementation of the strategies. More emphasis should be placed upon more equitable and rational distribution of healthcare resources to cater for rapid urbanization. Additionally, a sustainable health financing structure that is more progressive and does not encourage moral hazard should be established. In conclusion, Malaysia has achieved good outcomes in population health with relatively low financial inputs since independence. However, changes in the overall environment have created issues which would threaten the long-term viability of the healthcare system if not tackled properly. The numbers of internationally trialled strategies could be used to deal with these challenges. In addition, coordinated implementation of these strategies and effective engagement and communication between

  9. Quality use of medicine in a developing economy: Measures to overcome challenges in the Malaysian healthcare system.

    Science.gov (United States)

    Mohd-Tahir, Nurul-Ain; Paraidathathu, Thomas; Li, Shu-Chuen

    2015-01-01

    Malaysia inherits a highly subsidized tax-based public healthcare system complemented by a fee-for-service private sector. Population health in Malaysia has considerably improved since independence using a relatively small amount of gross domestic product (~4%). Brain drain of highly specialized personnel, growth in healthcare spending, demographic and disease pattern changes and increase in patients' demands and expectations towards better medical care are exerting pressure on the sustainability of the system to continuously provide efficient and effective services at relatively low cost. Malaysia has adopted and implemented some of the quality use of medicine concepts such as National Essential Medicine List, health technology assessment and promotion of generic medicines in their health policy, but so far the results may not be optimal. Activities to further promote these strategies are needed for successful implementation to achieve more positive and sustained beneficial outcomes. Better strategic planning, management and collaboration between various stakeholders, considering the needs and barriers of the strategies, are important to ensure effective implementation of the strategies. More emphasis should be placed upon more equitable and rational distribution of healthcare resources to cater for rapid urbanization. Additionally, a sustainable health financing structure that is more progressive and does not encourage moral hazard should be established. In conclusion, Malaysia has achieved good outcomes in population health with relatively low financial inputs since independence. However, changes in the overall environment have created issues which would threaten the long-term viability of the healthcare system if not tackled properly. The numbers of internationally trialled strategies could be used to deal with these challenges. In addition, coordinated implementation of these strategies and effective engagement and communication between various stakeholders

  10. Development of a Mobile System Decision-support for Medical Diagnosis of Asthma in Primary Healthcare--InteliMED.

    Science.gov (United States)

    Menezes, Júlio; Gusmão, Cristine

    2015-01-01

    The structure of public and primary healthcare in Brazil is organized in a way to provide decentralized services. In theory, this scenario could enable the usage of mobile devices integrated with information systems of several purposes. In addition, there is a need of decision-support tools that are based on collected evidences, once the professional of primary healthcare, which essentially has general knowledge (non-specialist). Therefore there is a need of information that support the decision-making process on more specific contexts. This paper presents the proposal, experience of development and application of the InteliMED, a decision-support system to asthma diagnosis of children and adolescents through decision-trees and mobile devices (smartphones and tablets).

  11. Improvement and modification of the routing system for the health-care waste collection and transportation in Istanbul.

    Science.gov (United States)

    Alagöz, Aylin Zeren; Kocasoy, Günay

    2008-01-01

    Handling of health-care wastes is among the most important environmental problems in Turkey as it is in the whole world. Approximately 25-30tons of health-care wastes, in addition to the domestic and recyclable wastes, are generated from hospitals, clinics and other small health-care institutions daily on the European and the Asian sides of Istanbul [Kocasoy, G., Topkaya, B., Zeren, B.A., Kiliç, M., et al., 2004. Integrated Health-care Waste Management in Istanbul, Final Report of the LIFE00 TCY/TR/054 Project, Turkish National Committee on Solid Wastes, Istanbul, Turkey; Zeren, B.A., 2004. The Health-care Waste Management of the Hospitals in the European Side of Istanbul, M.S. Thesis, Boğaziçi University, Istanbul, Turkey; Kiliç, M., 2004. Determination of the Health-care Waste Handling and Final Disposal of the Infected Waste of Hospital-Medical Centers in the Anatolian Side of Istanbul. M.S. Thesis, Boğaziçi University, Istanbul, Turkey]. Unfortunately, these wastes are not handled, collected or temporarily stored at the institutions properly according to the published Turkish Medical Waste Control Regulation [Ministry of Environment and Forestry, 2005. Medical Waste Control Regulation. Official Gazette No. 25883, Ankara, Turkey]. Besides the inappropriate handling at the institutions, there is no systematic program for the transportation of the health-care wastes to the final disposal sites. The transportation of these wastes is realized by the vehicles of the municipalities in an uncontrolled, very primitive way. As a consequence, these improperly managed health-care wastes cause many risks to the public health and people who handle them. This study has been conducted to develop a health-care waste collection and transportation system for the city of Istanbul, Turkey. Within the scope of the study, the collection of health-care wastes from the temporary storage rooms of the health-care institutions, transportation of these wastes to the final disposal

  12. A Qualitative Study Investigating Experiences, Perceptions, and Healthcare System Performance in Relation to the Surveillance of Typhoid Fever in Madagascar.

    Science.gov (United States)

    Pach, Alfred; Warren, Michelle; Chang, Irene; Im, Justin; Nichols, Chelsea; Meyer, Christian G; Pak, Gi Deok; Panzner, Ursula; Park, Se Eun; von Kalckreuth, Vera; Baker, Stephen; Rabezanahary, Henintsoa; Rakotondrainiarivelo, Jean Philibert; Raminosoa, Tiana Mirana; Rakotozandrindrainy, Raphaël; Marks, Florian

    2016-03-15

    The burden of typhoid fever (TF) in sub-Saharan Africa is largely unknown but is increasingly thought to be high, given that water and sanitary conditions remain unimproved in many countries. To address this gap in information, the Typhoid Fever Surveillance in Africa Program (TSAP) founded a surveillance system for TF in 10 African countries. This study was a component of the TSAP surveillance project in Madagascar. The study entailed a qualitative assessment of patients' experiences and perceptions of services for febrile symptoms at the studies' rural and urban sentinel public health clinics. The study examined influences on the use of these facilities, alternative sources of care, and providers' descriptions of medical consultations and challenges in providing services. Data were collected through semistructured and open-ended individual interviews and a focus group with patients, caregivers, and medical personnel. Thirty-three patients and 12 healthcare providers participated in the data collection across the 2 healthcare facilities. The quality of services, cost, and travel distance were key factors that enabled access to and use of these clinics. Divergent healthcare-seeking patterns were related to variability in the care utilized, socioeconomic status, and potential distance from the facilities : These factors influenced delivery of care, patient access, and the health facilities' capacity to identify cases of febrile illness such as TF. This approach provided an in-depth investigation and understanding of healthcare-seeking behavior at the study facilities, and factors that facilitated or acted as barriers to their use. Our findings demonstrate the relevance of these public health clinics as sites for the surveillance of TF in their role as central healthcare sources for families and communities within these rural and urban areas of Madagascar. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All

  13. Potentiality of big data in the medical sector: focus on how to reshape the healthcare system.

    Science.gov (United States)

    Jee, Kyoungyoung; Kim, Gang-Hoon

    2013-06-01

    The main purpose of this study was to explore whether the use of big data can effectively reduce healthcare concerns, such as the selection of appropriate treatment paths, improvement of healthcare systems, and so on. By providing an overview of the current state of big data applications in the healthcare environment, this study has explored the current challenges that governments and healthcare stakeholders are facing as well as the opportunities presented by big data. Insightful consideration of the current state of big data applications could help follower countries or healthcare stakeholders in their plans for deploying big data to resolve healthcare issues. The advantage for such follower countries and healthcare stakeholders is that they can possibly leapfrog the leaders' big data applications by conducting a careful analysis of the leaders' successes and failures and exploiting the expected future opportunities in mobile services. First, all big data projects undertaken by leading countries' governments and healthcare industries have similar general common goals. Second, for medical data that cuts across departmental boundaries, a top-down approach is needed to effectively manage and integrate big data. Third, real-time analysis of in-motion big data should be carried out, while protecting privacy and security.

  14. Using grey literature to prepare pharmacy students for an evolving healthcare delivery system

    National Research Council Canada - National Science Library

    Happe, Laura E; Walker, Desiree'

    2013-01-01

    .... Pre- and post-course survey instruments were used for the assessment. Students reported healthcare delivery systems topics to be moderately relevant to the profession of pharmacy on both the pre- and post-course survey instruments...

  15. Development and User Research of a Smart Bedside Station System toward Patient-Centered Healthcare System.

    Science.gov (United States)

    Yoo, Sooyoung; Lee, Kee-Hyuck; Baek, Hyunyoung; Ryu, Borim; Chung, Eunja; Kim, Kidong; Yi, Jay Chaeyong; Park, Soo Beom; Hwang, Hee

    2015-09-01

    User experience design that reflects real-world application and aims to support suitable service solutions has arisen as one of the current issues in the medical informatics research domain. The Smart Bedside Station (SBS) is a screen that is installed on the bedside for the personal use and provides a variety of convenient services for the patients. Recently, bedside terminal systems have been increasingly adopted in hospitals due to the rapid growth of advanced technology in healthcare at the point of care. We designed user experience (UX) research to derive users' unmet needs and major functions that are frequently used in the field. To develop the SBS service, a service design methodology, the Double Diamond Design Process Model, was undertaken. The problems or directions of the complex clinical workflow of the hospital, the requirements of stakeholders, and environmental factors were identified through the study. The SBS system services provided to patients were linked to the hospital's main services or to related electronic medical record (EMR) data. Seven key services were derived from the results of the study. The primary services were as follows: Bedside Check In and Out, Bedside Room Service, Bedside Scheduler, Ready for Rounds, My Medical Chart, Featured Healthcare Content, and Bedside Community. This research developed a patient-centered SBS system with improved UX using service design methodology applied to complex and technical medical services, providing insights to improve the current healthcare system.

  16. “Take in two parks and call me in the morning” – Perception of parks as an essential component of our healthcare system

    Directory of Open Access Journals (Sweden)

    A.J. Mowen

    2017-06-01

    Full Text Available As a feature of the built neighborhood environment, parks have been associated with a range of positive health outcomes. Recognition of these contributions has prompted advocates to suggest parks are a part of our healthcare system. Despite these developments, park investments have declined over the past decade nationally, lagging behind expenditures on other community services such as health. Perhaps the idea of parks as a solution to the nation's health concerns has not diffused across the population. To date, however, public perception of parks' role in healthcare has not been documented. This study responds to this gap by assessing whether parks are perceived as an essential part of the healthcare system. Self-administered surveys were completed by a statewide sample of Pennsylvania adults (2014 and by a sample of primary care clinic visitors in Hershey, Pennsylvania (2015. Participants from both studies were asked the extent they agreed with the following statement: Parks, trails, and open space are an essential component of our healthcare system. Response was also compared across demographic characteristics to assess whether this belief was universally held. Findings indicate 73% of the statewide sample and 68% of the clinical sample agreed parks, trails, and open space are an essential element of the healthcare system. Males, those with lower levels of educational attainment, and rural residents were statistically less likely to agree with this statement. Results indicate widespread belief in parks as an essential part of the healthcare system, suggesting consideration of health-sector investments in these settings.

  17. Development of Intelligent Auxiliary System for Customized Physical Fitness and Healthcare

    Directory of Open Access Journals (Sweden)

    Huang Chung-Chi

    2016-01-01

    Full Text Available With the advent of global high-tech industry and commerce era, the sedentary reduces opportunities of physical activity. And physical fitness and health of people is getting worse and worse. At present, the shortage of physical fitness instructors greatly affected the effectiveness of health promotion. Therefore, it is necessary to develop an auxiliary system which can reduce the workload of instructors and enhance physical fitness and health for people. But current general physical fitness and healthcare system is hard to meet individualized needs. The main purpose of this research is to develop an intelligent auxiliary system for customized physical fitness and healthcare. It records all processes of physical fitness and healthcare system by wireless sensors network. The results of intelligent auxiliary systems for customized physical fitness and healthcare will be generated by fuzzy logic Inference. It will improve individualized physical fitness and healthcare. Finally, we will demonstrate the advantages of the intelligent auxiliary system for customized physical fitness and healthcare.

  18. Complaint handling in healthcare : Expectation gaps between physicians and the public. Results of a survey study

    NARCIS (Netherlands)

    Friele, R.D.; Reitsma, P.M.; de Jong, J.D.

    2015-01-01

    Background Patients who submit complaints about the healthcare they have received are often dissatisfied with the response to their complaints. This is usually attributed to the failure of physicians to respond adequately to what complainants want, e.g. an apology or an explanation. However, expecta

  19. Complaint handling in healthcare: expectation gaps between physicians and the public. Results of a survey study.

    NARCIS (Netherlands)

    Friele, R.D.; Reitsma, P.M.; Jong, J.D. de

    2015-01-01

    Background: Patients who submit complaints about the healthcare they have received are often dissatisfied with the response to their complaints. This is usually attributed to the failure of physicians to respond adequately to what complainants want, e.g. an apology or an explanation. However, expect

  20. Complaint handling in healthcare: expectation gaps between physicians and the public. Results of a survey study.

    NARCIS (Netherlands)

    Friele, R.D.; Reitsma, P.M.; Jong, J.D. de

    2015-01-01

    Background: Patients who submit complaints about the healthcare they have received are often dissatisfied with the response to their complaints. This is usually attributed to the failure of physicians to respond adequately to what complainants want, e.g. an apology or an explanation. However, expect

  1. A comparison of social accounting between local public healthcare services:An empirical research

    Directory of Open Access Journals (Sweden)

    Paolo Ursillo

    2010-03-01

    Full Text Available

    Introduction: Social accounting in healthcare is a quantitative–qualitative accounting tool which marks the bond between the business and its social background. It displays healthcare business results and information to the stakeholder. Actually, its use is not widespread in Italy, but often published in United States and other Countries.

    Methods: This work is based upon an empirical research, studying social accounting from Local Health Units (LHU, Italian ASL of Adria, Brindisi, Firenze and Umbria region published between 2006 and 2008. These documents have been analyzed, studying the business’ structure, healthcare services, social and economical conditions, financial status, performance indexes and much more data about most company activities.

    Results: Accountability in Italy has been studied carefully through longitudinal and cross sectional analysis, observing models and contents, elaborating a concrete proposal for social accounting.

    Discussion: Social accounting in healthcare can guarantee important information for non-expert users and expert technicians, allowing the former to take more conscious decisions, and the latter to study its business aspects more deeply. This is made possible by the consideration of extended economical data available in other accountability forms (like annual financial statement, and other performance indexes which give valuable data about social impact, efficiency and effectiveness to the end user.

  2. Specific factors influencing information system/information and communication technology sourcing strategies in healthcare facilities.

    Science.gov (United States)

    Potančok, Martin; Voříšek, Jiří

    2016-09-01

    Healthcare facilities use a number of information system/information and communication technologies. Each healthcare facility faces a need to choose sourcing strategies most suitable to ensure provision of information system/information and communication technology services, processes and resources. Currently, it is possible to observe an expansion of sourcing possibilities in healthcare informatics, which creates new requirements for sourcing strategies. Thus, the aim of this article is to identify factors influencing information system/information and communication technology sourcing strategies in healthcare facilities. The identification was based on qualitative research, namely, a case study. This study provides a set of internal and external factors with their impact levels. The findings also show that not enough attention is paid to these factors during decision-making. © The Author(s) 2015.

  3. The application of the unified modeling language in object-oriented analysis of healthcare information systems.

    Science.gov (United States)

    Aggarwal, Vinod

    2002-10-01

    This paper concerns itself with the beneficial effects of the Unified Modeling Language (UML), a nonproprietary object modeling standard, in specifying, visualizing, constructing, documenting, and communicating the model of a healthcare information system from the user's perspective. The author outlines the process of object-oriented analysis (OOA) using the UML and illustrates this with healthcare examples to demonstrate the practicality of application of the UML by healthcare personnel to real-world information system problems. The UML will accelerate advanced uses of object-orientation such as reuse technology, resulting in significantly higher software productivity. The UML is also applicable in the context of a component paradigm that promises to enhance the capabilities of healthcare information systems and simplify their management and maintenance.

  4. Redesigning healthcare systems to meet the health challenges associated with climate change in the twenty-first century.

    Science.gov (United States)

    Phua, Kai-Lit

    2015-01-01

    In the twenty-first century, climate change is emerging as a significant threat to the health and well-being of the public through links to the following: extreme weather events, sea level rise, temperature-related illnesses, air pollution patterns, water security, food security, vector-borne infectious diseases, and mental health effects (as a result of extreme weather events and climate change-induced population displacement). This article discusses how national healthcare systems can be redesigned through changes in its components such as human resources, facilities and technology, health information system, and health policy to meet these challenges.

  5. [Robot technology in the Italian Health-CARE system: cost-efficacy economic analysis].

    Science.gov (United States)

    Gulino, Gaetano; Antonucci, Michele; Palermo, Giuseppe; D'Agostino, Daniele; D'Addessi, Alessandro; Racioppi, Marco; Pinto, Francesco; Sacco, Emilio; Bassi, Pierfrancesco

    2012-01-01

    Robotic technology is used in multiple fields of surgery, especially radical prostatectomy in patients with prostate cancer. The purpose of this study was to evaluate the introduction of robotic technology in the Italian Public Heath-care context, from the perspective of the Health Technology Assessment (HTA). An economic analysis that compares the costs and effectiveness of the method was developed. Data were compared with those of the most important international literature, analyzing structural and organizational problems related to the method. A systematic review of literature on tertiary literature (Health Technology Assessment reports) and secondary (systematic reviews) published since 2002 was conducted. The review was also conducted on more recent primary literature regarding the clinical effectiveness and the economic analysis in the fields of surgery where Da Vinci robot is most promising. 18 studies were selected out of a total of 65 evaluated. The "Break-Even Point" (BEP) is the minimum number of cases needed to be treated in order to achieve a balance between costs and revenues, below which the system is losing money. It was calculated that the total fixed costs are € 378,000 and variable costs are € 3,810 per surgery. Considering that the current value of DRG (Diagnosis-Related Group) refunded by the public Health-care system is actually € 4,553, the BEP would be achieved performing 508 surgeries, so that the robotic technology does not generate neither profit nor loss. It is not possible to demonstrate the superiority of robotic surgery in terms of efficacy. The robotic surgery is safe and effective only if performed by surgical teams with relevant experience. Considering the reported case of an Italian University Hospital with public Health-care system refund, the BEP target of 508 radical prostatectomies could be achieved after a few years. The use of the robot in multiple fields on one hand shortens recovery time costs, but on the other hand

  6. Embedding economic relationships through social learning? The limits of patient and public involvement in healthcare governance in England.

    Science.gov (United States)

    Vincent-Jones, Peter

    2011-01-01

    The strategy for NHS modernization in England is privileging individual choice over collective voice in the governance of healthcare. This paper explores the tension between economic and democratic strands in the current reform agenda, drawing on sociological conceptions of embeddedness and on theories of reflexive governance. Building on a Polanyian account of the disembedding effects of the increasing commercialization of health services, we consider the prospects for re-embedding economic relationships in this field. An analysis is provided of the limits of the present legal and regulatory framework of Patient and Public Involvement (PPI) in establishing the democratic and pragmatist conditions of social learning necessary for effective embedding. We show how the attainment of reflexive governance in the public interest is dependent on such conditions, and on the capacities of patients and the public to contribute to debate and deliberation in decision making, including on fundamental policy questions such as how services are provided and by whom.

  7. Impact of strategic orientation adopted by an organisation on its performance, as shown on the example of public healthcare entities

    Directory of Open Access Journals (Sweden)

    Szymaniec-Mlicka Karolina

    2016-12-01

    Full Text Available The resource-based view has an established position in the strategic management of a public organisation. However, it is not given much attention in the area of public governance, focusing instead on analysing the impact of a single resource on an organisation’s performance. This article attempts to fill this gap by analysing the impact of strategic orientation adopted by an organisation on its performance. In addition, the analysis also covers the impact of the approach to stakeholder relations management adopted by an organisation on its performance. Studies were conducted on public healthcare entities, using a survey questionnaire and quantitative methods. The obtained results indicate that a resource-based view to strategic thinking has an impact on an organisation’s performance (negative correlation. A positive correlation, on the other hand, exists between the approach to stakeholder relations management adopted by an organisation and its performance.

  8. ICT use for information management in healthcare system for chronic disease patient

    Science.gov (United States)

    Wawrzyniak, Zbigniew M.; Lisiecka-Biełanowicz, Mira

    2013-10-01

    Modern healthcare systems are designed to fulfill needs of the patient, his system environment and other determinants of the treatment with proper support of technical aids. A whole system of care is compatible to the technical solutions and organizational framework based on legal rules. The purpose of this study is to present how can we use Information and Communication Technology (ICT) systemic tools in a new model of patient-oriented care, improving the effectiveness of healthcare for patients with chronic diseases. The study material is the long-term process of healthcare for patients with chronic illness. Basing on the knowledge of the whole circumstances of patient's ecosystem and his needs allow us to build a new ICT model of long term care. The method used is construction, modeling and constant improvement the efficient ICT layer for the patient-centered healthcare model. We present a new constructive approach to systemic process how to use ICT for information management in healthcare system for chronic disease patient. The use of ICT tools in the model for chronic disease can improve all aspects of data management and communication, and the effectiveness of long-term complex healthcare. In conclusion: ICT based model of healthcare can be constructed basing on the interactions of ecosystem's functional parts through information feedback and the provision of services and models as well as the knowledge of the patient itself. Systematic approach to the model of long term healthcare assisted functionally by ICT tools and data management methods will increase the effectiveness of patient care and organizational efficiency.

  9. Improved Glycemic Control Without Hypoglycemia in Elderly Diabetic Patients Using the Ubiquitous Healthcare Service, a New Medical Information System

    Science.gov (United States)

    Lim, Soo; Kang, Seon Mee; Shin, Hayley; Lee, Hak Jong; Won Yoon, Ji; Yu, Sung Hoon; Kim, So-Youn; Yoo, Soo Young; Jung, Hye Seung; Park, Kyong Soo; Ryu, Jun Oh; Jang, Hak C.

    2011-01-01

    OBJECTIVE To improve quality and efficiency of care for elderly patients with type 2 diabetes, we introduced elderly-friendly strategies to the clinical decision support system (CDSS)-based ubiquitous healthcare (u-healthcare) service, which is an individualized health management system using advanced medical information technology. RESEARCH DESIGN AND METHODS We conducted a 6-month randomized, controlled clinical trial involving 144 patients aged >60 years. Participants were randomly assigned to receive routine care (control, n = 48), to the self-monitored blood glucose (SMBG, n = 47) group, or to the u-healthcare group (n = 49). The primary end point was the proportion of patients achieving A1C <7% without hypoglycemia at 6 months. U-healthcare system refers to an individualized medical service in which medical instructions are given through the patient’s mobile phone. Patients receive a glucometer with a public switched telephone network-connected cradle that automatically transfers test results to a hospital-based server. Once the data are transferred to the server, an automated system, the CDSS rule engine, generates and sends patient-specific messages by mobile phone. RESULTS After 6 months of follow-up, the mean A1C level was significantly decreased from 7.8 ± 1.3% to 7.4 ± 1.0% (P < 0.001) in the u-healthcare group and from 7.9 ± 1.0% to 7.7 ± 1.0% (P = 0.020) in the SMBG group, compared with 7.9 ± 0.8% to 7.8 ± 1.0% (P = 0.274) in the control group. The proportion of patients with A1C <7% without hypoglycemia was 30.6% in the u-healthcare group, 23.4% in the SMBG group (23.4%), and 14.0% in the control group (P < 0.05). CONCLUSIONS The CDSS-based u-healthcare service achieved better glycemic control with less hypoglycemia than SMBG and routine care and may provide effective and safe diabetes management in the elderly diabetic patients. PMID:21270188

  10. THE DESIGN OF PERFORMANCE MONITORING SYSTEMS IN HEALTHCARE ORGANIZATIONS: A STAKEHOLDER PERSPECTIVE.

    Science.gov (United States)

    Rouhana, Rima E; Van Caillie, Didier

    2016-01-01

    Monitoring hospitals performance is evolving over time in search of more efficiency by integrating additional levels of care, reducing costs and keeping staff up-to-date. To fulfill these three potentially divergent aspects and to monitor performance, healthcare administrators are using dissimilar management control tools. To explain why, we suggest to go beyond traditional contingent factors to assess the role of the different stakeholders that are at the heart of any healthcare organization. We rely first on seminal studies to appraise the role of the main healthcare players and their influence on some organizational attributes. We then consider the managerial awareness and the perception of a suitable management system to promote a strategy-focused organization. Our methodology is based on a qualitative approach of twenty-two case studies, led in two heterogeneous environments (Belgium and Lebanon), comparing the managerial choice of a management system within three different healthcare organizational structures. Our findings allow us to illustrate, for each healthcare player, his positioning within the healthcare systems. Thus, we define how his role, perception and responsiveness manipulate the organization's internal climate and shape the design of the performance monitoring systems. In particular, we highlight the managerial role and influence on the choice of an adequate management system.

  11. In science communication, why does the idea of a public deficit always return? How do the shifting information flows in healthcare affect the deficit model of science communication?

    Science.gov (United States)

    Ko, Henry

    2016-05-01

    The healthcare field contains a multitude of opportunities for science communication. Given the many stakeholders dancing together in a multidirectional tango of communication, we need to ask how much does the deficit model apply to the health field? History dictates that healthcare professionals are the holders of all knowledge, and the patients and other stakeholders are the ones that need the scientific information communicated to them. This essay argues otherwise, in part due to the rise of shared decision-making and patients and other stakeholders acting as partners in healthcare. The traditional deficit model in health held that: (1) doctors were experts and patients were consumers, (2) it is impossible for the public to grasp the many disciplines of knowledge in medicine, (3) if experts have trouble keeping up with medical research then the public surely can't keep up, and (4) it is safer for healthcare professionals to communicate to the public using a deficit model. However, with the rise of partnerships with patients in healthcare decision-making, the deficit model might be weakening. Examples of public participation in healthcare decision-making include: (1) crowd-sourcing public participation in systematic reviews, (2) public participation in health policy, (3) public collaboration in health research, and (4) health consumer groups acting as producers of health information. With the challenges to the deficit model in science communication in health, caution is needed with the increasing role of technology and social media, and how these may affect the legitimacy of healthcare information flows away from the healthcare professional.

  12. IoT-based Asset Management System for Healthcare-related Industries

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    Lee Carman Ka Man

    2015-11-01

    Full Text Available The healthcare industry has been focusing efforts on optimizing inventory management procedures through the incorporation of Information and Communication Technology, in the form of tracking devices and data mining, to establish ideal inventory models. In this paper, a roadmap is developed towards a technological assessment of the Internet of Things (IoT in the healthcare industry, 2010–2020. According to the roadmap, an IoT-based healthcare asset management system (IoT-HAMS is proposed and developed based on Artificial Neural Network (ANN and Fuzzy Logic (FL, incorporating IoT technologies for asset management to optimize the supply of resources.

  13. Awareness and implementation of tobacco dependence treatment guidelines in Arizona: Healthcare Systems Survey 2000

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    Menke J Michael

    2008-12-01

    Full Text Available Abstract Background This paper presents findings from the Tobacco Control in Arizona Healthcare Systems Survey, conducted in 2000. The purpose of the survey was to assess the status of Arizona healthcare systems' awareness and implementation of tobacco cessation and prevention measures. Methods The 20-item survey was developed by The University of Arizona HealthCare Partnership in collaboration with the Arizona Department of Health Services Bureau of Tobacco Education and Prevention. It was mailed to representatives of Arizona's 40 healthcare systems, including commercial and Medicare managed care organizations, "managed Medicaid" organizations, Veterans Affairs Health Care Systems, and Indian Health Service Medical Centers. Thirty-three healthcare systems (83% completed the survey. Results The majority of healthcare systems reported awareness of at least one tobacco cessation and prevention clinical practice guideline, but only one third reported full guideline implementation. While a majority covered some form of behavioral therapy, less than half reported covering tobacco treatment medications. "Managed Medicaid" organizations administered through the Arizona Health Care Cost Containment System were significantly less likely to offer coverage for behavioral therapy and less likely to cover pharmacotherapy than were their non-Medicaid counterparts in managed care, Veterans Affairs Health Care Systems and Indian Health Service Medical Centers. Conclusion Arizona healthcare system coverage for tobacco cessation in the year 2000 was comparable to national survey findings of the same year. The findings that only 10% of "Managed Medicaid" organizations covered tobacco treatment medication and were significantly less likely to cover behavioral therapy were important given the nearly double smoking prevalence among Medicaid patients. Throughout the years of the program, the strategic plan of the Arizona Department of Health Services Bureau of Tobacco

  14. Healthcare is primary.

    Science.gov (United States)

    Kumar, Raman

    2015-01-01

    India is undergoing a rapid transformation in terms of governance, administrative reforms, newer policy develoment, and social movements. India is also considered one of the most vibrant economies in the world. The current discourse in public space is dominated by issues such as economic development, security, corruption free governance, gender equity, and women safety. Healthcare though remains a pressing need of population; seems to have taken a backseat. In the era of decreasing subsidies and cautious investment in social sectors, the 2(nd) National Conference on Family Medicine and Primary Care 2015 (FMPC) brought a focus on "healthcare" in India. The theme of this conference was "Healthcare is Primary." The conference participants discussed on the theme of why healthcare should be a national priority and why strong primary care should remain at the center of healthcare delivery system. The experts recommended that India needs to strengthen the "general health system" instead of focusing on disease based vertical programs. Public health system should have capacity and skill pool to be able to deliver person centered comprehensive health services to the community. Proactive implementation of policies towards human resource in health is the need of the hour. As the draft National Health Policy 2015 is being debated, "family medicine" (academic primary care), the unfinished agenda of National Health Policy 2002, remains a priority area of implementation.

  15. Orthopedic surgeons’ and neurologists’ attitudes towards second opinions in the Israeli healthcare system: a qualitative study

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    Greenfield Geva

    2012-07-01

    Full Text Available Abstract Background Second opinion is a treatment ratification tool that may critically influence diagnosis, treatment, and prognosis. Second opinions constitute one of the largest expenditures of the supplementary health insurance programs provided by the Israeli health funds. The scarcity of data on physicians’ attitudes toward second opinion motivated this study to explore those attitudes within the Israeli healthcare system. Methods We interviewed 35 orthopedic surgeons and neurologists in Israel and qualitatively analyzed the data using the Grounded Theory approach. Results As a common tool, second opinion reflects the broader context of the Israeli healthcare system, specifically tensions associated with health inequalities. We identified four issues: (1 inequalities between central and peripheral regions of Israel; (2 inequalities between private and public settings; (3 implementation gap between the right to a second opinion and whether it is covered by the National Health Insurance Law; and (4 tension between the authorities of physicians and religious leaders. The physicians mentioned that better mechanisms should be implemented for guiding patients to an appropriate consultant for a second opinion and for making an informed choice between the two opinions. Conclusions While all the physicians agreed on the importance of the second opinion as a tool, they raised concerns about the way it is provided and utilized. To be optimally implemented, second opinion should be institutionalized and regulated. The National Health Insurance Law should strive to provide the mechanisms to access second opinion as stipulated in the Patient’s Rights Law. Further studies are needed to assess the patients' perspectives.

  16. Population aging and its impacts: strategies of the health-care system in Taipei.

    Science.gov (United States)

    Lin, Ming-Hsien; Chou, Ming-Yueh; Liang, Chih-Kuang; Peng, Li-Ning; Chen, Liang-Kung

    2010-11-01

    Taiwan is one of the fastest aging countries in the world. As such, the government has developed various strategies to promote an age-friendly health-care system. Health services are supported by National Health Insurance (NHI), which insures over 97% of citizens and over 99% of health-care institutes. The current health-care system has difficulties in caring for older patients with multiple comorbidities, complex care needs, functional impairments, and post-acute care needs. Taipei, an international metropolis with a well-preserved tradition of filial piety in Chinese societies, has developed various strategies to overcome the aforementioned barriers to an age-friendly health-care system. These include an emphasis on general medical care and a holistic approach in all specialties, development of a geriatrics specialty training program, development of post-acute services, and strengthening of linkages between health and social care services. Despite achievements thus far, challenges still include creating a more extensive integration between medical specialties, promotion of an interdisciplinary care model across specialties and health-care settings, and integration of health and social care services. The experiences of Taipei in developing an age-friendly health-care service system may be a culturally appropriate model for other Chinese and Asian communities.

  17. Seven Guiding Commitments: Making the U.S. Healthcare System More Compassionate

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    Beth A. Lown MD

    2014-11-01

    Full Text Available Despite the current focus on patient centeredness, healthcare professionals face numerous challenges that impede their ability to provide compassionate care that ameliorates concerns, distress, or suffering. These include fragmentation and discontinuity of care, technologies that both help and hinder communication and relationship-building, burgeoning operational and administrative requirements, inadequate communication skills training, alarming rates of burnout, and increased cost and market pressures. A compassionate healthcare system begins with compassionate people, but the organizations in which they train and work must reliably enable them to express and act on their compassion rather than impede it. We present a set of guiding commitments and recommendations to foster a more compassionate healthcare system. We urge healthcare organizations to adopt these commitments and take action to embed compassionate care in all aspects of training, research, patient care and organizational life.

  18. Healthcare Team Performance in Time Critical Environments: Coordinating Events, Foraging, and System Processes

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    Barrett S. Caldwell

    2010-01-01

    Full Text Available This review paper addresses issues in how healthcare providers search, obtain, and share resources in provider teams. Based in part on a System of Systems (SoS analysis of provider coordination and resource flows, this paper expands the concepts of resource foraging theory and event dynamics to develop systematic methods for studying healthcare provider coordination. Process flow and human factors emphases from industrial engineering are used to address critical concerns of single-scale and multi-scale performance in healthcare delivery settings. Provider strategies for acquiring the information and resources needed for successful healthcare delivery are dependent on interactions between task requirements, time constraints, and provider coordination processes, as well as limitations of information and resource flow capabilities. These improved definitions and measures will enhance engineers' ability to contribute to improved patient care timeliness, effectiveness, quality, and safety.

  19. System-Level Reform in Healthcare Delivery for Patients and Populations Living with Chronic Disease.

    Science.gov (United States)

    Wedge, Richard; Currie, Douglas W

    2016-01-01

    Healthcare in Canada has generally not kept pace with the evolving needs of patients since the creation of medicare in the 1960s. Budgets for hospitals, physicians and prescription drugs make up the bulk of spending in health, despite the need for better prevention and management of chronic disease, the needed expansion of home-based care services and the call for reform of front-line primary care. Over the past decade, a number of Canadian health authorities have adopted the US-based Institute for Healthcare Improvement Triple Aim philosophy (better population health, better patient experience and better per capita cost of care) in order to build system-level change. The Atlantic Healthcare Collaboration was one attempt to initiate system-level reform in healthcare delivery for patients living with chronic disease.

  20. An IoT-cloud Based Wearable ECG Monitoring System for Smart Healthcare.

    Science.gov (United States)

    Yang, Zhe; Zhou, Qihao; Lei, Lei; Zheng, Kan; Xiang, Wei

    2016-12-01

    Public healthcare has been paid an increasing attention given the exponential growth human population and medical expenses. It is well known that an effective health monitoring system can detect abnormalities of health conditions in time and make diagnoses according to the gleaned data. As a vital approach to diagnose heart diseases, ECG monitoring is widely studied and applied. However, nearly all existing portable ECG monitoring systems cannot work without a mobile application, which is responsible for data collection and display. In this paper, we propose a new method for ECG monitoring based on Internet-of-Things (IoT) techniques. ECG data are gathered using a wearable monitoring node and are transmitted directly to the IoT cloud using Wi-Fi. Both the HTTP and MQTT protocols are employed in the IoT cloud in order to provide visual and timely ECG data to users. Nearly all smart terminals with a web browser can acquire ECG data conveniently, which has greatly alleviated the cross-platform issue. Experiments are carried out on healthy volunteers in order to verify the reliability of the entire system. Experimental results reveal that the proposed system is reliable in collecting and displaying real-time ECG data, which can aid in the primary diagnosis of certain heart diseases.

  1. LEAN thinking in Finnish healthcare.

    Science.gov (United States)

    Jorma, Tapani; Tiirinki, Hanna; Bloigu, Risto; Turkki, Leena

    2016-01-01

    Purpose - The purpose of this study is to evaluate how LEAN thinking is used as a management and development tool in the Finnish public healthcare system and what kind of outcomes have been achieved or expected by using it. The main focus is in managing and developing patient and treatment processes. Design/methodology/approach - A mixed-method approach incorporating the Webropol survey was used. Findings - LEAN is quite a new concept in Finnish public healthcare. It is mainly used as a development tool to seek financial savings and to improve the efficiency of patient processes, but has not yet been deeply implemented. However, the experiences from LEAN initiatives have been positive, and the methodology is already quite well-known. It can be concluded that, because of positive experiences from LEAN, the environment in Finnish healthcare is ready for the deeper implementation of LEAN. Originality/value - This paper evaluates the usage of LEAN thinking for the first time in the public healthcare system of Finland as a development tool and a management system. It highlights the implementation and achieved results of LEAN thinking when used in the healthcare environment. It also highlights the expectations for LEAN thinking in Finnish public healthcare.

  2. 75 FR 38819 - National Advisory Council for Healthcare Research and Quality: Request for Nominations for Public...

    Science.gov (United States)

    2010-07-06

    ... public members. SUMMARY: Section 921 (now Section 941 of the Public Health Service Act (PHS Act)), 42 U.S... medicine; (4) in other health professions; (5) in the fields of health care economics, information...

  3. X-PAT: a multiplatform patient referral data management system for small healthcare institution requirements.

    Science.gov (United States)

    Masseroli, Marco; Marchente, Mario

    2008-07-01

    We present X-PAT, a platform-independent software prototype that is able to manage patient referral multimedia data in an intranet network scenario according to the specific control procedures of a healthcare institution. It is a self-developed storage framework based on a file system, implemented in eXtensible Markup Language (XML) and PHP Hypertext Preprocessor Language, and addressed to the requirements of limited-dimension healthcare entities (small hospitals, private medical centers, outpatient clinics, and laboratories). In X-PAT, healthcare data descriptions, stored in a novel Referral Base Management System (RBMS) according to Health Level 7 Clinical Document Architecture Release 2 (CDA R2) standard, can be easily applied to the specific data and organizational procedures of a particular healthcare working environment thanks also to the use of standard clinical terminology. Managed data, centralized on a server, are structured in the RBMS schema using a flexible patient record and CDA healthcare referral document structures based on XML technology. A novel search engine allows defining and performing queries on stored data, whose rapid execution is ensured by expandable RBMS indexing structures. Healthcare personnel can interface the X-PAT system, according to applied state-of-the-art privacy and security measures, through friendly and intuitive Web pages that facilitate user acceptance.

  4. THE IMPACT OF MEDICAL TOURISM ON THE QUALITY OF ORGANIZATIONAL AND FUNCTIONAL CHANGES IN THE POLISH HEALTHCARE SYSTEM

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    Marcin Olkiewicz

    2016-06-01

    Full Text Available The role of Medical Tourism in the process of a complex satisfaction of the prosumers and the impact played in the organizational and functional changes in the Polish healthcare system. The analysis of the literature on the subject as well as an analysis of the documentation were the inspiration to write this work. The main emphasis was put on stating the conditions stimulating the development of this sector of the economy as well as the risk factors determining the quality of process changes in the healthcare system (functioning of public hospitals. To approximate the characteristics of the involved risk within the framework of health tourism functioning in the conditions of a market economy. Selected research methods allowed to present the motives behind undertaken actions of both the regulators as well as participants of the health tourism. Polish accession to the EU was an important impulse changing the way of thinking about health tourism in healthcare as well as, what is important, changes in the institutional and financial policy in Poland. In order to meet health-oriented demands of a prosumer, there should be a coordinated and effective informational system, aimed at improving the quality, reliability, availability of information concerning health tourism.

  5. Perceptions of quality and safety and experience of adverse events in 27 European Union healthcare systems, 2009-2013.

    Science.gov (United States)

    Filippidis, Filippos T; Mian, Saba S; Millett, Christopher

    2016-12-01

    To assess trends in the perception of quality and safety between 2009 and 2013 in the European Union (EU). We analysed data from waves 72.2 and 80.2 of the Eurobarometer survey. Multilevel logistic regression models adjusted for sociodemographic factors and country-level health expenditure were fitted to assess changes between 2009 and 2013 in each of the assessed outcomes. Twenty-seven EU member states. A total of n = 26 663 (2009) and n = 26 917 (2013) individuals aged ≥15 years. Outcomes included the perception of being harmed in hospital and non-hospital care; rating of the overall quality of the healthcare system; and personal or family experience of adverse events. Respondents in 2013 were more likely to think that it was likely to be harmed in hospital (Odds Ratio [OR] = 1.09; 95% Confidence Interval [CI]: 1.05-1.13; P quality of their country's healthcare system as good (OR = 1.26; 95% CI: 1.21-1.32; P quality and perceptions of harm. There was significant variation between and within countries in all indicators. The public's perception of safety in European healthcare systems declined in recent years, which highlights that there are safety issues that could be addressed.

  6. Big Data, Big Problems: A Healthcare Perspective.

    Science.gov (United States)

    Househ, Mowafa S; Aldosari, Bakheet; Alanazi, Abdullah; Kushniruk, Andre W; Borycki, Elizabeth M

    2017-01-01

    Much has been written on the benefits of big data for healthcare such as improving patient outcomes, public health surveillance, and healthcare policy decisions. Over the past five years, Big Data, and the data sciences field in general, has been hyped as the "Holy Grail" for the healthcare industry promising a more efficient healthcare system with the promise of improved healthcare outcomes. However, more recently, healthcare researchers are exposing the potential and harmful effects Big Data can have on patient care associating it with increased medical costs, patient mortality, and misguided decision making by clinicians and healthcare policy makers. In this paper, we review the current Big Data trends with a specific focus on the inadvertent negative impacts that Big Data could have on healthcare, in general, and specifically, as it relates to patient and clinical care. Our study results show that although Big Data is built up to be as a the "Holy Grail" for healthcare, small data techniques using traditional statistical methods are, in many cases, more accurate and can lead to more improved healthcare outcomes than Big Data methods. In sum, Big Data for healthcare may cause more problems for the healthcare industry than solutions, and in short, when it comes to the use of data in healthcare, "size isn't everything."

  7. Confiabilidade dos dados relativos ao cumprimento da Emenda Constitucional nº. 29 declarados ao Sistema de Informações sobre Orçamentos Públicos em Saúde pelos municípios de Pernambuco, Brasil Reliability of data on compliance with Constitutional Amendment 29 reported to the Public Healthcare Budget Information System by municipalities in Pernambuco State, Brazil

    Directory of Open Access Journals (Sweden)

    Rogério Fabiano Gonçalves

    2009-12-01

    Full Text Available O estudo analisa a confiabilidade dos dados relativos ao cumprimento da Emenda Constitucional nº. 29 (EC29 declarados ao Sistema de Informações sobre Orçamentos Públicos em Saúde (SIOPS pelos municípios de Pernambuco, Brasil. Configura-se como um estudo quantitativo, do tipo transversal e de caráter analítico, tendo como referência o período de 2000 a 2005. Os demonstrativos contábeis auditados pelo Tribunal de Contas do Estado (TCE foram tomados como parâmetro para verificar a confiabilidade dos percentuais de aplicação da EC29 declarados ao SIOPS, sendo utilizado o coeficiente de correlação intraclasses (CCI como prova estatística na medição da concordância dos dados. Os resultados demonstram a dissonância existente entre as bases consultadas, sugerindo um nível de concordância discreto a moderado entre os dados do SIOPS e do TCE. A baixa concordância identificada pode ser decorrente da falta de consenso pelos municípios acerca da composição das receitas e despesas vinculadas à saúde ou da existência de critérios diferentes no cálculo da EC29 entre o SIOPS e a auditoria do TCE.The present study analyzes the reliability of data on compliance with Constitutional Amendment 29 (CA29 reported to the Public Healthcare Budget Information System (known as SIOPS by municipalities in the State of Pernambuco, Brazil. A quantitative, analytical cross-sectional study was conducted using the years 2000 to 2005 as the reference. Invoices audited by the State Accounts Court were used as the parameter for determining reliability of the percentage of compliance with CA29 as reported to SIOPS, using the intraclass correlation coefficient (ICC to measure data agreement. The results show a mismatch between the databases, suggesting slight to moderate agreement between the SIOPS data and those from the State Accounts Court. The low degree of agreement may result from lack of consensus among municipalities regarding definition of

  8. Integrating child health information systems in public health agencies.

    Science.gov (United States)

    Bara, Debra; McPhillips-Tangum, Carol; Wild, Ellen L; Mann, Marie Y

    2009-01-01

    Public health agencies at state and local levels are integrating information systems to improve health outcomes for children. An assessment was conducted to describe the extent to which public health agencies are currently integrating child health information systems (CHIS). Using online technology information was collected, to assess completed and planned activities related to integration of CHIS, maturity of these systems, and factors that influence decisions by public health agencies to pursue integration activities. Of the 39 public health agencies that participated, 18 (46%) reported already integrating some or all of their CHIS, and 13 (33%) reported to be planning to integrate during the next 3 years. Information systems most commonly integrated include Early Hearing Detection and Intervention (EHDI), immunization, vital records, and Newborn Dried Bloodspot Screening (NDBS). Given the high priority that has been placed on using technology to improve health status in the United States, the emphasis on expanding the capability for the electronic exchange of health information, and federal support for electronic health records by 2014, public health agencies should be encouraged and supported in their efforts to develop, implement, and maintain integrated CHIS to facilitate the electronic exchange of health information with the clinical healthcare sector.

  9. [Data coding in the Israeli healthcare system - do choices provide the answers to our system's needs?].

    Science.gov (United States)

    Zelingher, Julian; Ash, Nachman

    2013-05-01

    The IsraeLi healthcare system has undergone major processes for the adoption of health information technologies (HIT), and enjoys high Levels of utilization in hospital and ambulatory care. Coding is an essential infrastructure component of HIT, and ts purpose is to represent data in a simplified and common format, enhancing its manipulation by digital systems. Proper coding of data enables efficient identification, storage, retrieval and communication of data. UtiLization of uniform coding systems by different organizations enables data interoperability between them, facilitating communication and integrating data elements originating in different information systems from various organizations. Current needs in Israel for heaLth data coding include recording and reporting of diagnoses for hospitalized patients, outpatients and visitors of the Emergency Department, coding of procedures and operations, coding of pathology findings, reporting of discharge diagnoses and causes of death, billing codes, organizational data warehouses and national registries. New national projects for cLinicaL data integration, obligatory reporting of quality indicators and new Ministry of Health (MOH) requirements for HIT necessitate a high Level of interoperability that can be achieved only through the adoption of uniform coding. Additional pressures were introduced by the USA decision to stop the maintenance of the ICD-9-CM codes that are also used by Israeli healthcare, and the adoption of ICD-10-C and ICD-10-PCS as the main coding system for billing purpose. The USA has also mandated utilization of SNOMED-CT as the coding terminology for the ELectronic Health Record problem list, and for reporting quality indicators to the CMS. Hence, the Israeli MOH has recently decided that discharge diagnoses will be reported using ICD-10-CM codes, and SNOMED-CT will be used to code the cLinical information in the EHR. We reviewed the characteristics, strengths and weaknesses of these two coding

  10. Trials without tribulations: Minimizing the burden of pragmatic research on healthcare systems.

    Science.gov (United States)

    Larson, Eric B; Tachibana, Chris; Thompson, Ella; Coronado, Gloria D; DeBar, Lynn; Dember, Laura M; Honda, Stacey; Huang, Susan S; Jarvik, Jeffrey G; Nelson, Christine; Septimus, Edward; Simon, Greg; Johnson, Karin E

    2016-09-01

    Pragmatic clinical trials are increasingly common because they have the potential to yield findings that are directly translatable to real-world healthcare settings. Pragmatic clinical trials need to integrate research into clinical workflow without placing an undue burden on the delivery system. This requires a research partnership between investigators and healthcare system representatives. This paper, organized as a series of case studies drawn from our experience in the NIH Health Care Systems Research Collaboratory, presents guidance from informational interviews of physician-scientists, health services researchers, and delivery system leaders who recently launched pragmatic clinical trials.

  11. A Security Analysis of Cyber-Physical Systems Architecture for Healthcare

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    Darren Seifert

    2016-10-01

    Full Text Available This paper surveys the available system architectures for cyber-physical systems. Several candidate architectures are examined using a series of essential qualities for cyber-physical systems for healthcare. Next, diagrams detailing the expected functionality of infusion pumps in two of the architectures are analyzed. The STRIDE Threat Model is then used to decompose each to determine possible security issues and how they can be addressed. Finally, a comparison of the major security issues in each architecture is presented to help determine which is most adaptable to meet the security needs of cyber-physical systems in healthcare.

  12. Operationalization of the Ghanaian Patients’ Charter in a Peri-urban Public Hospital: Voices of Healthcare Workers and Patients

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    Lily Yarney

    2016-09-01

    Full Text Available Background Health is a basic human right necessary for the exercise of other human rights. Every human being is, therefore, entitled to the highest possible standard of health necessary to living a life of dignity. Establishment of patients’ Charter is a step towards protecting the rights and responsibilities of patients, but violation of patients’ rights is common in healthcare institutions, especially in the developing world. This study which was conducted between May 2013 and May 2014, assessed the operationalization of Ghana’s Patients Charter in a peri-urban public hospital. Methods Qualitative data collection methods were used to collect data from 25 healthcare workers and patients who were purposively selected. The interview data were analyzed manually, using the principles of systematic text condensation. Results The findings indicate that the healthcare staff of the Polyclinic are aware of the existence of the patients’ Charter and also know some of its contents. Patients have no knowledge of the existence or the contents of the Charter. Availability of the Charter, community sensitization, monitoring and orientation of staff are factors that promote the operationalization of the Charter, while institutional implementation procedures such as lack of complaint procedures and low knowledge among patients militate against operationalization of the Charter. Conclusion Public health facilities should ensure that their patients are well-informed about their rights and responsibilities to facilitate effective implementation of the Charter. Also, patients’ rights and responsibilities can be dramatized and broadcasted on television and radio in major Ghanaian languages to enhance awareness of Ghanaians on the Charter.

  13. Operationalization of the Ghanaian Patients’ Charter in a Peri-urban Public Hospital: Voices of Healthcare Workers and Patients

    Science.gov (United States)

    Yarney, Lily; Buabeng, Thomas; Baidoo, Diana; Bawole, Justice Nyigmah

    2016-01-01

    Background: Health is a basic human right necessary for the exercise of other human rights. Every human being is, therefore, entitled to the highest possible standard of health necessary to living a life of dignity. Establishment of patients’ Charter is a step towards protecting the rights and responsibilities of patients, but violation of patients’ rights is common in healthcare institutions, especially in the developing world. This study which was conducted between May 2013 and May 2014, assessed the operationalization of Ghana’s Patients Charter in a peri-urban public hospital. Methods: Qualitative data collection methods were used to collect data from 25 healthcare workers and patients who were purposively selected. The interview data were analyzed manually, using the principles of systematic text condensation. Results: The findings indicate that the healthcare staff of the Polyclinic are aware of the existence of the patients’ Charter and also know some of its contents. Patients have no knowledge of the existence or the contents of the Charter. Availability of the Charter, community sensitization, monitoring and orientation of staff are factors that promote the operationalization of the Charter, while institutional implementation procedures such as lack of complaint procedures and low knowledge among patients militate against operationalization of the Charter. Conclusion: Public health facilities should ensure that their patients are well-informed about their rights and responsibilities to facilitate effective implementation of the Charter. Also, patients’ rights and responsibilities can be dramatized and broadcasted on television and radio in major Ghanaian languages to enhance awareness of Ghanaians on the Charter. PMID:27694679

  14. Coordinating Healthcare Under a Pluralistic Health Insurance System: The Case of Slovakia

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    Juraj NEMEC

    2015-06-01

    Full Text Available The Slovak approach to decreasing health-care costs is based on a changed interpretation of the concept of ‘a minimum network of provid-ers’. This study describes the changes made in the healthcare system in Slovakia in order to keep it affordable. It shows how the initial inter-pretation of a minimum network as an assurance for general access to healthcare services slow-ly changed into a cutback making the minimum network an upper limit for healthcare. The study argues that the complexity of the network made for non-transparent policies, in which consulta-tion was nearly absent and vertical power be-came dominant, despite the semi-independence of actors in the network. This observation runs counter to the network theory suggestion that in complex networks, with semi-independent actors, vertical power becomes useless.

  15. Healthcare information systems: data mining methods in the creation of a clinical recommender system

    Science.gov (United States)

    Duan, L.; Street, W. N.; Xu, E.

    2011-05-01

    Recommender systems have been extensively studied to present items, such as movies, music and books that are likely of interest to the user. Researchers have indicated that integrated medical information systems are becoming an essential part of the modern healthcare systems. Such systems have evolved to an integrated enterprise-wide system. In particular, such systems are considered as a type of enterprise information systems or ERP system addressing healthcare industry sector needs. As part of efforts, nursing care plan recommender systems can provide clinical decision support, nursing education, clinical quality control, and serve as a complement to existing practice guidelines. We propose to use correlations among nursing diagnoses, outcomes and interventions to create a recommender system for constructing nursing care plans. In the current study, we used nursing diagnosis data to develop the methodology. Our system utilises a prefix-tree structure common in itemset mining to construct a ranked list of suggested care plan items based on previously-entered items. Unlike common commercial systems, our system makes sequential recommendations based on user interaction, modifying a ranked list of suggested items at each step in care plan construction. We rank items based on traditional association-rule measures such as support and confidence, as well as a novel measure that anticipates which selections might improve the quality of future rankings. Since the multi-step nature of our recommendations presents problems for traditional evaluation measures, we also present a new evaluation method based on average ranking position and use it to test the effectiveness of different recommendation strategies.

  16. Using ESB and BPEL for Evolving Healthcare Systems Towards Pervasive, Grid-Enabled SOA

    Science.gov (United States)

    Koufi, V.; Malamateniou, F.; Papakonstantinou, D.; Vassilacopoulos, G.

    Healthcare organizations often face the challenge of integrating diverse and geographically disparate information technology systems to respond to changing requirements and to exploit the capabilities of modern technologies. Hence, systems evolution, through modification and extension of the existing information technology infrastructure, becomes a necessity. Moreover, the availability of these systems at the point of care when needed is a vital issue for the quality of healthcare provided to patients. This chapter takes a process perspective of healthcare delivery within and across organizational boundaries and presents a disciplined approach for evolving healthcare systems towards a pervasive, grid-enabled service-oriented architecture using the enterprise system bus middleware technology for resolving integration issues, the business process execution language for supporting collaboration requirements and grid middleware technology for both addressing common SOA scalability requirements and complementing existing system functionality. In such an environment, appropriate security mechanisms must ensure authorized access to integrated healthcare services and data. To this end, a security framework addressing security aspects such as authorization and access control is also presented.

  17. Design and implementation of a wearable healthcare monitoring system.

    Science.gov (United States)

    Sagahyroon, Assim; Raddy, Hazem; Ghazy, Ali; Suleman, Umair

    2009-01-01

    A wearable healthcare monitoring unit that integrates various technologies was developed to provide patients with the option of leading a healthy and independent life without risks or confinement to medical facilities. The unit consists of various sensors integrated to a microcontroller and attached to the patient's body, reading vital signs and transmitting these readings via a Bluetooth link to the patient's mobile phone. Short-Messaging-Service (SMS) is incorporated in the design to alert a physician in emergency cases. Additionally, an application program running on the mobile phone uses the internet to update (at regular intervals) the patient records in a hospital database with the most recent readings. To reduce development costs, the components used were both off-the-shelf and affordable.

  18. Firms’ reshaping of commercialization practices to overcome the ‘not invented here’ phenomenon in public healthcare organizations

    DEFF Research Database (Denmark)

    Nissen, Helle Aarøe; Evald, Majbritt Rostgaard; Clarke, Ann Højbjerg

    2015-01-01

    processes. Consequently, PPI is rarely examined from a private sector perspective, including how private firms seek to commercialize new innovations after co-creating these innovations in collaboration with public organizations. However, commercialization is a critical aspect of innovation because...... by elucidating how private firms commercialize co-created welfare solutions. The empirical setting is a multiple case study consisting of four PPI projects conducted in public Danish healthcare. The findings reveal that PPI firms experience the ‘not invented here’ (NIH) phenomenon across Danish hospitals....... This phenomenon appears in the short run to hamper the firms’ commercialization of new welfare innovations. However, in the longer run, firms respond to NIH by reshaping their commercialization practices as they redirect their focus towards the potential benefits of exporting their new welfare solutions...

  19. The public health implications of United Kingdom offender healthcare policy: a holistic approach to achieve individual and societal gains.

    Science.gov (United States)

    Senior, Jane; Shaw, Jenny

    2011-01-01

    In 2009, two seminal documents were published by the United Kingdom (UK) government concerning healthcare services for offenders. The Bradley review into diversion for people with mental health problems and learning disabilities emphasised a need to improve offender health, not least because of the high economic costs to society as a whole resulting from unresolved mental illness, physical ill-health and substance abuse problems commonly experienced by offenders. The Bradley review made wide-reaching recommendations for change, requiring strong partnership between health and justice agencies at both central government and local levels. A framework for the delivery of Bradley's recommendations has been set out in Improving health, supporting justice, the Department of Health's offender health strategy which sets out the direction of travel for the next 10 years. This paper discusses the reality of working toward improving health services for this marginalised group in the context of the influence of the current straitened financial climate on the allocation of resources to publically funded healthcare in the UK; it examines the historically based, and widely held, belief in the principle of "less eligibility" within our society, whereby there is much public and media resistance to allocating resources to improving care for offenders when other, more "deserving", groups are perceived to be in continuing need.

  20. Management accounting use and financial performance in public health-care organisations: evidence from the Italian National Health Service.

    Science.gov (United States)

    Macinati, Manuela S; Anessi-Pessina, E

    2014-07-01

    Reforms of the public health-care sector have emphasised the role of management accounting (MA). However, there is little systematic evidence on its use and benefits. To fill this gap, we propose a contingency-based model which addresses three related issues, that is, whether: (i) MA use is influenced by contextual variables and MA design; (ii) top-management satisfaction with MA mediates the relationship between MA design and MA use; and (iii) financial performance is influenced by MA use. A questionnaire was mailed out to all Italian public health-care organisations. Structural equation modelling was performed to validate the research hypotheses. The response rate was 49%. Our findings suggest that: (i) cost-containment strategies encourage more sophisticated MA designs; (ii) MA use is directly and indirectly influenced by contingency, organisational, and behavioural variables; (iii) a weakly significant positive relationship exists between MA use and financial performance. These findings are relevant from the viewpoint of both top managers and policymakers. The former must make sure that MA is not only technically advanced, but also properly understood and appreciated by users. The latter need to be aware that MA may improve performance in ways and along dimensions that may not fully translate into better financial results.

  1. Unemployment, public-sector health-care spending and breast cancer mortality in the European Union: 1990-2009.

    Science.gov (United States)

    Maruthappu, Mahiben; Watkins, Johnathan A; Waqar, Mueez; Williams, Callum; Ali, Raghib; Atun, Rifat; Faiz, Omar; Zeltner, Thomas

    2015-04-01

    The global economic crisis has been associated with increased unemployment, reduced health-care spending and adverse health outcomes. Insights into the impact of economic variations on cancer mortality, however, remain limited. We used multivariate regression analysis to assess how changes in unemployment and public-sector expenditure on health care (PSEH) varied with female breast cancer mortality in the 27 European Union member states from 1990 to 2009. We then determined how the association with unemployment was modified by PSEH. Country-specific differences in infrastructure and demographic structure were controlled for, and 1-, 3-, 5- and 10-year lag analyses were conducted. Several robustness checks were also implemented. Unemployment was associated with an increase in breast cancer mortality [P unemployment rises (P unemployment and breast cancer mortality remained in all robustness checks. Rises in unemployment are associated with significant short- and long-term increases in breast cancer mortality, while increases in PSEH are associated with reductions in breast cancer mortality. Initiatives that bolster employment and maintain total health-care expenditure may help minimize increases in breast cancer mortality during economic crises. © The Author 2014. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

  2. Return Migrants’ Experience of Access to Care in Corrupt Healthcare Systems: The Bosnian Example

    Science.gov (United States)

    Neerup Handlos, Line; Fog Olwig, Karen; Bygbjerg, Ib Christian; Norredam, Marie

    2016-01-01

    Equal and universal access to healthcare services is a core priority for a just health system. A key societal determinant seen to create inequality in access to healthcare is corruption in the healthcare system. How return migrants’ access to healthcare is affected by corruption is largely unstudied, even though return migrants may be particularly vulnerable to problems related to corruption due to their period of absence from their country of origin. This article investigates how corruption in the healthcare sector affects access to healthcare for refugees who repatriated to Bosnia, a country with a high level of corruption, from Denmark, a country with a low level of corruption. The study is based on 18 semi-structured interviews with 33 refugees who returned after long-term residence in Denmark. We found that the returned refugees faced greater problems with corruption than was the case for those who had not left the country, as doctors considered them to be better endowed financially and therefore demanded larger bribes from them than they did from those who had remained in Bosnia. Moreover, during their stay abroad the returnees had lost the connections that could have helped them sidestep the corruption. Returned refugees are thus particularly vulnerable to the effects of corruption. PMID:27657096

  3. Return Migrants’ Experience of Access to Care in Corrupt Healthcare Systems: The Bosnian Example

    Directory of Open Access Journals (Sweden)

    Line Neerup Handlos

    2016-09-01

    Full Text Available Equal and universal access to healthcare services is a core priority for a just health system. A key societal determinant seen to create inequality in access to healthcare is corruption in the healthcare system. How return migrants’ access to healthcare is affected by corruption is largely unstudied, even though return migrants may be particularly vulnerable to problems related to corruption due to their period of absence from their country of origin. This article investigates how corruption in the healthcare sector affects access to healthcare for refugees who repatriated to Bosnia, a country with a high level of corruption, from Denmark, a country with a low level of corruption. The study is based on 18 semi-structured interviews with 33 refugees who returned after long-term residence in Denmark. We found that the returned refugees faced greater problems with corruption than was the case for those who had not left the country, as doctors considered them to be better endowed financially and therefore demanded larger bribes from them than they did from those who had remained in Bosnia. Moreover, during their stay abroad the returnees had lost the connections that could have helped them sidestep the corruption. Returned refugees are thus particularly vulnerable to the effects of corruption.

  4. What Indicates Competency in Systems Based Practice? An Analysis of Perspective Consistency among Healthcare Team Members

    Science.gov (United States)

    Graham, Mark J.; Naqvi, Zoon; Encandela, John A.; Bylund, Carma L.; Dean, Randa; Calero-Breckheimer, Ayxa; Schmidt, Hilary J.

    2009-01-01

    In many parts of the world the practice of medicine and medical education increasingly focus on providing patient care within context of the larger healthcare system. Our purpose is to solicit perceptions of all professional stakeholders (e.g. nurses) of the system regarding the U.S. ACGME competency Systems Based Practice to uncover the extent to…

  5. Attributes of patient-centered primary care associated with the public perception of good healthcare quality in Brazil, Colombia, Mexico and El Salvador.

    Science.gov (United States)

    Doubova, Svetlana V; Guanais, Frederico C; Pérez-Cuevas, Ricardo; Canning, David; Macinko, James; Reich, Michael R

    2016-09-01

    This study evaluated primary care attributes of patient-centered care associated with the public perception of good quality in Brazil, Colombia, Mexico and El Salvador. We conducted a secondary data analysis of a Latin American survey on public perceptions and experiences with healthcare systems. The primary care attributes examined were access, coordination, provider-patient communication, provision of health-related information and emotional support. A double-weighted multiple Poisson regression with robust variance model was performed. The study included between 1500 and 1503 adults in each country. The results identified four significant gaps in the provision of primary care: not all respondents had a regular place of care or a regular primary care doctor (Brazil 35.7%, Colombia 28.4%, Mexico 22% and El Salvador 45.4%). The communication with the primary care clinic was difficult (Brazil 44.2%, Colombia 41.3%, Mexico 45.1% and El Salvador 56.7%). There was a lack of coordination of care (Brazil 78.4%, Colombia 52.3%, Mexico 48% and El Salvador 55.9%). Also, there was a lack of information about healthy diet (Brazil 21.7%, Colombia 32.9%, Mexico 16.9% and El Salvador 20.8%). The public's perception of good quality was variable (Brazil 67%, Colombia 71.1%, Mexico 79.6% and El Salvador 79.5%). The primary care attributes associated with the perception of good quality were a primary care provider 'who knows relevant information about a patient's medical history', 'solves most of the health problems', 'spends enough time with the patient', 'coordinates healthcare' and a 'primary care clinic that is easy to communicate with'. In conclusion, the public has a positive perception of the quality of primary care, although it has unfulfilled expectations; further efforts are necessary to improve the provision of patient-centered primary care services in these four Latin American countries.

  6. E-health and healthcare enterprise information system leveraging service-oriented architecture.

    Science.gov (United States)

    Hsieh, Sung-Huai; Hsieh, Sheau-Ling; Cheng, Po-Hsun; Lai, Feipei

    2012-04-01

    To present the successful experiences of an integrated, collaborative, distributed, large-scale enterprise healthcare information system over a wired and wireless infrastructure in National Taiwan University Hospital (NTUH). In order to smoothly and sequentially transfer from the complex relations among the old (legacy) systems to the new-generation enterprise healthcare information system, we adopted the multitier framework based on service-oriented architecture to integrate the heterogeneous systems as well as to interoperate among many other components and multiple databases. We also present mechanisms of a logical layer reusability approach and data (message) exchange flow via Health Level 7 (HL7) middleware, DICOM standard, and the Integrating the Healthcare Enterprise workflow. The architecture and protocols of the NTUH enterprise healthcare information system, especially in the Inpatient Information System (IIS), are discussed in detail. The NTUH Inpatient Healthcare Information System is designed and deployed on service-oriented architecture middleware frameworks. The mechanisms of integration as well as interoperability among the components and the multiple databases apply the HL7 standards for data exchanges, which are embedded in XML formats, and Microsoft .NET Web services to integrate heterogeneous platforms. The preliminary performance of the current operation IIS is evaluated and analyzed to verify the efficiency and effectiveness of the designed architecture; it shows reliability and robustness in the highly demanding traffic environment of NTUH. The newly developed NTUH IIS provides an open and flexible environment not only to share medical information easily among other branch hospitals, but also to reduce the cost of maintenance. The HL7 message standard is widely adopted to cover all data exchanges in the system. All services are independent modules that enable the system to be deployed and configured to the highest degree of flexibility

  7. Methods to evaluate health information systems in healthcare settings: a literature review.

    Science.gov (United States)

    Rahimi, Bahlol; Vimarlund, Vivian

    2007-10-01

    Although information technology (IT)-based applications in healthcare have existed for more than three decades, methods to evaluate outputs and outcomes of the use of IT-based systems in medical informatics is still a challenge for decision makers, as well as to those who want to measure the effects of ICT in healthcare settings. The aim of this paper is to review published articles in the area evaluations of IT-based systems in order to gain knowledge about methodologies used and findings obtained from the evaluation of IT-based systems applied in healthcare settings. The literature review includes studies of IT-based systems between 2003 and 2005. The findings show that economic and organizational aspects dominate evaluation studies in this area. However, the results focus mostly on positive outputs such as user satisfaction, financial benefits and improved organizational work. This review shows that there is no standard framework for evaluation effects and outputs of implementation and use of IT in the healthcare setting and that until today no studies explore the impact of IT on the healthcare system' productivity and effectiveness.

  8. Impact of data governance on a nation's healthcare system building blocks.

    Science.gov (United States)

    Hovenga, Evelyn J S

    2013-01-01

    This chapter gives an overview of a nation's healthcare system, particularly for those who are familiar with IT but not healthcare or for those working in one area of healthcare who may not be familiar with the system and data requirements across the care continuum. The structure of this chapter uses the World Health Organisation's (WHO) Health systems framework with a focus on the need for data and information governance to achieve a sustainable health system delivering improved health for all, responsively and equitably meeting genuine demands for health services, with social and financial risk protection and overall improved efficiency. It is argued that there is a need to gather the right data and to process these data in a manner that provides good information in order to more fully understand how the health system is working and where and when it isn't working well. This needs to be achieved in the most cost effective manner that doesn't detract from the allocation of resources to healthcare or the clinical workflow required to achieve quality healthcare.

  9. MEDWISE: an innovative public health information system infrastructure.

    Science.gov (United States)

    Sahin, Yasar Guneri; Celikkan, Ufuk

    2012-06-01

    In this paper, we present MedWise, a high level design of a medical information infrastructure, and its architecture. The proposed system offers a comprehensive, modular, robust and extensible infrastructure to be used in public health care systems. The system gathers reliable and evidence based health data, which it then classifies, interprets and stores into a particular database. It creates a healthcare ecosystem that aids the medical community by providing for less error prone diagnoses and treatment of diseases. This system will be standards-compliant; therefore it would be complementary to the existing healthcare and clinical information systems. The key objective of the proposed system is to provide as much medical historical and miscellaneous data as possible about the patients with minimal consultation, thus allowing physicians to easily access Patients' Ancillary Data (PAD) such as hereditary, residential, travel, custom, meteorological, biographical and demographical data before the consultation. In addition, the system can help to diminish problems and misdiagnosis situations caused by language barriers-disorders and misinformation. MedWise can assist physicians to shorten time for diagnosis and consultations, therefore dramatically improving quality and quantity of the physical examinations of patients. Furthermore, since it intends to supply a significant amount of data, it may be used to improve skills of students in medical education.

  10. The implications of e-health system delivery strategies for integrated healthcare: lessons from England.

    Science.gov (United States)

    Eason, Ken; Waterson, Patrick

    2013-05-01

    This paper explores the implications that different technical strategies for sharing patient information have for healthcare workers and, as a consequence, for the extent to which these systems provide support for integrated care. Four technical strategies were identified and the forms of coupling they made with healthcare agencies were classified. A study was conducted in England to examine the human and organizational implications of systems implemented by these four strategies. Results were used from evaluation reports of two systems delivered as part of the NPfIT (National Programme for Information Technology) and from user responses to systems delivered in two local health communities in England. In the latter study 40 clinical respondents reported the use of systems to support integrated care in six healthcare pathways. The implementation of a detailed care record system (DCRS) in the NPfIT was problematic because it could not meet the diverse needs of all healthcare agencies and it required considerable local customization. The programme evolved to allow different systems to be delivered for each local health community. A national Summary Care Record (SCR) was implemented but many concerns were raised about wide access to confidential patient information. The two technical strategies that required looser forms of coupling and were under local control led to wide user adoption. The systems that enabled data to be transferred between local systems were successfully used to support integrated care in specific healthcare pathways. The portal approach gave many users an opportunity to view patient data held on a number of databases and this system evolved over a number of years as a result of requests from the user community. The UK national strategy to deliver single shared database systems requires tight coupling between many users and has led to poor adoption because of the diverse needs of healthcare agencies. Sharing patient information has been more

  11. [China is poised to build a better healthcare delivery system using the integrative health paradigm].

    Science.gov (United States)

    Hui, Ka Kit; Zhang, Wei-jun

    2011-01-01

    China and the United States share similar goals regarding their health care reform: expanding coverage, bending the curve of healthcare expenditure, and ensuring quality improvement and effectiveness of healthcare. Though many differences in the two health care systems exist, there are still many innovative strategies both countries can learn from each other. This paper first discusses two major problems in the America's health care system: an increasing aging population coupled with ineffective chronic disease management; and a failing primary care system. Next it discusses the role of integrative medicine in the United States health care reform. We also review some key strategies in China's health care reform, which we believe if these policies are implemented fully and effectively, China is poised to build a better healthcare delivery system using the integrative health paradigm.

  12. An internet-based simulation system for training and development of regional-healthcare-centers managers.

    Science.gov (United States)

    Bregman, David; Korman, Arik; Shetach, Ana; Shalom, Nira

    2009-01-01

    RHCMS (Regional Healthcare Center Management System) is an Internet-based simulation training system for Regional Healthcare-Centers (RHCs) managers. The system is based on an integrative model, designed and developed by an interdisciplinary team of experts, for the purpose of training and developing RHCs' managers. This model involves the study of the following fields: healthcare management, business administration, organizational behavior, health economics, management science, and information technologies. The simulation system enables the operation of a management decision-making game. In the game, teams of trainees, playing management teams of RHCs, within one specific community, compete among themselves. The simulation focuses on managerial performance, based on periodic team-decisions, within the internal and external environmental context. The simulation game has a major potential contribution in enabling management trainees to transfer theoretical knowledge into managerial practical tools, capabilities and skills.

  13. Choice of health insurer and healthcare provider : An analysis of regulated competition in the Dutch healthcare system

    NARCIS (Netherlands)

    D.M.I.D. Duijmelinck (Daniëlle)

    2015-01-01

    markdownabstractConsumer choice of health insurer is an essential precondition for achieving efficiency and consumer responsiveness in healthcare. In healthcare, consumer preferences are highly heterogeneous. This implies that if groups of consumers with specific preferences feel not free to switch

  14. Injustice to transsexual women in a hetero-normative healthcare system

    Science.gov (United States)

    Duma, Sinegugu

    2014-01-01

    Abstract Background Transsexual women who are on the journey of sexual re-alignment will experience various health problems. These problems are related directly to the treatment regime that they are following in order to attain and maintain their physical embodiment as a woman. They are forced to negotiate a hetero-normative healthcare system in order to receive assistance and care for their health problems related to their sexual re-alignment process. Aim The questions posed were: What are the unique health problems that transsexual women experience whilst on the journey of sexual re-alignment? What is the current context of the South African healthcare system in which transsexual women should negotiate healthcare? These questions were asked in order to explore the health problems with which transsexual women are faced and to describe the hetero-normative healthcare system in South Africa. Method An electronic literature search was executed via the EBSCO host with specific inclusion and exclusion criteria. The search words that were used were: Transsexual/s and Health/Healthcare. All studies had to be peer reviewed and published in the English language, from January 1972 up until February 2013. Literature on transsexual children was excluded. Results Transsexual women have the potential to suffer significant side-effects from their sexual re-alignment treatment, including cardio-vascular problems, endocrine problems and mental ill-health. They are also vulnerable to HIV infection. They have poor access to quality holistic healthcare and this may lead an increase in the mortality and morbidity figures of women. Conclusion A hetero-normative healthcare system has a negative impact on the health of transsexual women and will cause them to be marginalised. This could contribute to both homo- and trans-phobia that will in turn strengthen the belief that transsexual women are un-African. PMID:26245442

  15. Injustice to transsexual women in a hetero-normative healthcare system.

    Science.gov (United States)

    Newman-Valentine, Douglas; Duma, Sinegugu

    2014-11-21

    Transsexual women who are on the journey of sexual re-alignment will experience various health problems. These problems are related directly to the treatment regime that they are following in order to attain and maintain their physical embodiment as a woman. They are forced to negotiate a hetero-normative healthcare system in order to receive assistance and care for their health problems related to their sexual re-alignment process. The questions posed were: What are the unique health problems that transsexual women experience whilst on the journey of sexual re-alignment? What is the current context of the South African healthcare system in which transsexual women should negotiate healthcare? These questions were asked in order to explore the health problems with which transsexual women are faced and to describe the hetero-normative healthcare system in South Africa. An electronic literature search was executed via the EBSCO host with specific inclusion and exclusion criteria. The search words that were used were: Transsexual/s and Health/Healthcare. All studies had to be peer reviewed and published in the English language, from January 1972 up until February 2013. Literature on transsexual children was excluded. Transsexual women have the potential to suffer significant side-effects from their sexual re-alignment treatment, including cardio-vascular problems, endocrine problems and mental ill-health. They are also vulnerable to HIV infection. They have poor access to quality holistic healthcare and this may lead an increase in the mortality and morbidity figures of women. A hetero-normative healthcare system has a negative impact on the health of transsexual women and will cause them to be marginalised. This could contribute to both homo- and trans-phobia that will in turn strengthen the belief that transsexual women are un-African.

  16. A scalable healthcare information system based on a service-oriented architecture.

    Science.gov (United States)

    Yang, Tzu-Hsiang; Sun, Yeali S; Lai, Feipei

    2011-06-01

    Many existing healthcare information systems are composed of a number of heterogeneous systems and face the important issue of system scalability. This paper first describes the comprehensive healthcare information systems used in National Taiwan University Hospital (NTUH) and then presents a service-oriented architecture (SOA)-based healthcare information system (HIS) based on the service standard HL7. The proposed architecture focuses on system scalability, in terms of both hardware and software. Moreover, we describe how scalability is implemented in rightsizing, service groups, databases, and hardware scalability. Although SOA-based systems sometimes display poor performance, through a performance evaluation of our HIS based on SOA, the average response time for outpatient, inpatient, and emergency HL7Central systems are 0.035, 0.04, and 0.036 s, respectively. The outpatient, inpatient, and emergency WebUI average response times are 0.79, 1.25, and 0.82 s. The scalability of the rightsizing project and our evaluation results show that the SOA HIS we propose provides evidence that SOA can provide system scalability and sustainability in a highly demanding healthcare information system.

  17. CASALUD: an innovative health-care system to control and prevent non-communicable diseases in Mexico.

    Science.gov (United States)

    Tapia-Conyer, Roberto; Gallardo-Rincón, Héctor; Saucedo-Martinez, Rodrigo

    2015-07-01

    Mexico and other Latin American countries are currently facing a dramatic increase in the number of adults suffering from non-communicable diseases (NCDs) such as diabetes, cardiovascular disease (CVD) and chronic kidney disease (CKD), which require prolonged, continuous care. This epidemiological shift has created new challenges for health-care systems. Both the World Health Organization (WHO) and the United Nations (UN) have recognised the growing human and economic costs of NCDs and outlined an action plan, recognising that NCDs are preventable, often with common preventable risk factors linked to risky health behaviours. In line with international best practices, Mexico has applied a number of approaches to tackle these diseases. However, challenges remain for the Mexican health-care system, and in planning a strategy for combating and preventing NCDs, it must consider how best to integrate these strategies with existing health-care infrastructure. Shifting the paradigm of care in Mexico from a curative, passive approach to a preventive, proactive model will require an innovative and replicable system that guarantees availability of medicines and services, strengthens human capital through ongoing professional education, expands early and continuous access to care through proactive prevention strategies and incorporates technological innovations in order to do so. Here, we describe CASALUD: an innovative model in health-care that leverages international best practices and uses innovative technology to deliver NCD care, control and prevention. In addition, we describe the lessons learned from the initial implementation of the model for its effective use in Mexico, as well as the plans for wider implementation throughout the country, in partnership with the Mexican Ministry of Health. © Royal Society for Public Health 2013.

  18. Immunization of Health-Care Providers: Necessity and Public Health Policies.

    Science.gov (United States)

    Maltezou, Helena C; Poland, Gregory A

    2016-08-01

    Health-care providers (HCPs) are at increased risk for exposure to vaccine-preventable diseases (VPDs) in the workplace. The rationale for immunization of HCPs relies on the need to protect them and, indirectly, their patients from health-care-associated VPDs. Published evidence indicates significant immunity gaps for VPDs of HCPs globally. Deficits in knowledge and false perceptions about VPDs and vaccines are the most common barriers for vaccine uptake and may also influence communication about vaccines between HCPs and their patients. Most countries have immunization recommendations for HCPs; however, there are no universal policies and significant heterogeneity exists between countries in terms of vaccines, schedules, frame of implementation (recommendation or mandatory), and target categories of HCPs. Mandatory influenza immunization policies for HCPs have been implemented with high vaccine uptake rates. Stronger recommendations for HCP immunization and commitment at the level of the health-care facility are critical in order to achieve high vaccine coverage rates. Given the importance to health, mandatory immunization policies for VPDs that can cause serious morbidity and mortality to vulnerable patients should be considered.

  19. Immunization of Health-Care Providers: Necessity and Public Health Policies

    Science.gov (United States)

    Maltezou, Helena C.; Poland, Gregory A.

    2016-01-01

    Health-care providers (HCPs) are at increased risk for exposure to vaccine-preventable diseases (VPDs) in the workplace. The rationale for immunization of HCPs relies on the need to protect them and, indirectly, their patients from health-care-associated VPDs. Published evidence indicates significant immunity gaps for VPDs of HCPs globally. Deficits in knowledge and false perceptions about VPDs and vaccines are the most common barriers for vaccine uptake and may also influence communication about vaccines between HCPs and their patients. Most countries have immunization recommendations for HCPs; however, there are no universal policies and significant heterogeneity exists between countries in terms of vaccines, schedules, frame of implementation (recommendation or mandatory), and target categories of HCPs. Mandatory influenza immunization policies for HCPs have been implemented with high vaccine uptake rates. Stronger recommendations for HCP immunization and commitment at the level of the health-care facility are critical in order to achieve high vaccine coverage rates. Given the importance to health, mandatory immunization policies for VPDs that can cause serious morbidity and mortality to vulnerable patients should be considered. PMID:27490580

  20. Enabling and controlling parenthood in publicly provided maternity healthcare: becoming a parent in Finland.

    Science.gov (United States)

    Homanen, Riikka

    2016-10-22

    This article discusses practices of parental support in the maternity healthcare provided by the welfare state. Drawing on ethnographic material from clinics in Finland, I discuss maternity healthcare practices and processes as the specific contexts of subjectification to parenthood in the Nordic welfare state. The analysis shows that in both nurses' (work) experience-based knowledge and population-statistical knowledge, parental competence is achieved largely through the 'natural' process of experiencing pregnant life. Care practices can be seen as enabling parenthood through respect for this process. Clinics encourage parents-to-be to self-reflect and be self-reliant. Emphasis on self-reflection and self-reliance has previously been interpreted as the state adoption of therapy culture, and as a response to market demands for the welfare state to offer to and require of its citizens more autonomy and choice. I argue, however, that the parental subject emerging from the practices of this welfare service cannot be reduced to a neoliberal reflexive individual for whom parenthood is an individual project and who is to blame for individual shortcomings. Equally, they are no mere disciplined product of governmentality being pushed to conform to an idealised parent figure derived from collective ideas of good parenthood.

  1. Performance Based Supplementary Payment Systems in Istanbul Public Hospitals

    Directory of Open Access Journals (Sweden)

    Ayşegül YILDIRIM KAPTANOĞLU

    2013-01-01

    Full Text Available Since 2003 new healthcare reforms have been implemented in Turkey. Although, the healthcare system has gone through modifications for the past several years; there is insufficient research to demonstrate the effects of these changes. This paper aims to address the issues in the supplementary payment systems, which are one of the recent changes of the healthcare system in the country. This study is mainly based on a review of the relevant professional literature, a research and interpretation of supplementary payment in the public hospitals. This is a research as well as an assessment work done in secondary and tertiary care hospitals. Performance based supplementary payment system in public hospitals aims to provide bonuses to health care employees like physicians, nurses, etc. The bonus is given to professionals, who produce the qualified health services based on records by the evaluation of the whole institution. Financing of supplementary payment system in Turkey is mainly based on social security premiums. Consequently, balance of income and expenditures at hospitals is needed to be followed sensitively. According to this study, physicians' productivity has increased but number of patients per physician has decreased. Also, the amount of performance paid to the physician for their specialty has decreased. Physicians like cardiologists can benefit more from the pay for performance system as their work contributions are paid more compared to internist work. Also secondary care hospital staffs were better paid compared to tertiary care hospitals because more critical cases are sent to tertiary care and treatment of such cases are of high cost. The reforms resulted satisfactory and very successful improvement in healthcare performance. The main health indicators are now better than at the beginning of the transition period. The sustainability of the reform processes will cause further improvement in the near future. The number of treatments per

  2. [The development of the public health system between an increasing market orientation (commercialisation) and social responsibility].

    Science.gov (United States)

    Trabert, G

    2008-02-01

    The development of the public health system between an increasing market orientation (commercialisation) and social responsibility is critically reflected by examining the medical care of those who are deprived. Poverty in Germany is dramatically increasing. There are confirmed findings on the correlation of being poor and being ill. Poverty leads to an increased number of cases of illness and a higher mortality rate. And vice versa, chronic illnesses very often cause impoverishment. This correlation has largely been ignored not only by the public but also by experts, especially when public health-care issues are on the political agenda. With reference to the current discussion about public health-care and the widespread disregard of the living conditions of the poor, the categories of "reasonable behaviour" (Kant) and "communicative behaviour" (Habermas) are reflected on in a philosophical excursion. Further interest groups affecting the political sphere, such as the pharmaceutical industry, the medical profession, patients and scientists are also examined with regard to public health-care. What are the premises of a health-care discussion that is controlled by economic considerations, particularly when keeping in mind the humanistic and Christian ethics of our society? And what does this mean for our responsibility for those who are handicapped and are in need of our help? Do decision makers and participants of the health-care discussion satisfy these ethical challenges? And what are the effects of the so-called "social peace" on social cooperation and economic power of a country? The increasing market orientation (commercialisation) of the public health sector can only be accepted on the basis of practiced humanity and social responsibility. In the light of a human public health-care, deprived people are in need of our solidarity.

  3. Corruption in health-care systems and its effect on cancer care in Africa.

    Science.gov (United States)

    Mostert, Saskia; Njuguna, Festus; Olbara, Gilbert; Sindano, Solomon; Sitaresmi, Mei Neni; Supriyadi, Eddy; Kaspers, Gertjan

    2015-08-01

    At the government, hospital, and health-care provider level, corruption plays a major role in health-care systems in Africa. The returns on health investments of international financial institutions, health organisations, and donors might be very low when mismanagement and dysfunctional structures of health-care systems are not addressed. More funding might even aggravate corruption. We discuss corruption and its effects on cancer care within the African health-care system in a sociocultural context. The contribution of high-income countries in stimulating corruption is also described. Corrupt African governments cannot be expected to take the initiative to eradicate corruption. Therefore, international financial institutions, health organisations, and financial donors should use their power to demand policy reforms of health-care systems in Africa troubled by the issue of corruption. These modifications will ameliorate the access and quality of cancer care for patients across the continent, and ultimately improve the outcome of health care to all patients. Copyright © 2015 Elsevier Ltd. All rights reserved.

  4. Public Participation in Design of Health Empowering Information Systems

    DEFF Research Database (Denmark)

    Barlach, Anders

    2009-01-01

    Policy makers recognise that effective communication and collaboration between healthcare professionals and patients must be the cornerstone of healthcare, and aims to transform this relationship (Johannsen and Kensing 2005). There is an assumption that empowerment can be organised and is present...... as a result of information being accessible. The British Choose and Book portal (www.healthspace.nhs.uk) and Danish e-health portal (www.sundhed.dk) are examples of making knowledge and services available to the individual citizens: Sundhed.dk is the official Danish eHealth Portal for the public Danish...... Healthcare Services (‘sundhed’ means health in Danish). For the first time, the public Danish Healthcare Services have been brought together on the Internet by Sundhed.dk. This makes it possible for patients, their families and healthcare professionals alike to access information and to communicate with each...

  5. The State Public Health Laboratory System

    OpenAIRE

    Inhorn, Stanley L.; Astles, J. Rex; Gradus, Stephen; Malmberg, Veronica; Snippes, Paula M.; Wilcke, Burton W.; White, Vanessa A.

    2010-01-01

    This article describes the development since 2000 of the State Public Health Laboratory System in the United States. These state systems collectively are related to several other recent public health laboratory (PHL) initiatives. The first is the Core Functions and Capabilities of State Public Health Laboratories, a white paper that defined the basic responsibilities of the state PHL. Another is the Centers for Disease Control and Prevention National Laboratory System (NLS) initiative, the go...

  6. A Systems Approach to Healthcare Innovation Using the MIT Hacking Medicine Model.

    Science.gov (United States)

    Gubin, Tatyana A; Iyer, Hari P; Liew, Shirlene N; Sarma, Aartik; Revelos, Alex; Ribas, João; Movassaghi, Babak; Chu, Zen M; Khalid, Ayesha N; Majmudar, Maulik D; Lee, Christopher Xiang

    2017-07-26

    MIT Hacking Medicine is a student, academic, and community-led organization that uses systems-oriented "healthcare hacking" to address challenges around innovation in healthcare. The group has organized more than 80 events around the world that attract participants with diverse backgrounds. These participants are trained to address clinical needs from the perspective of multiple stakeholders and emphasize utility and implementation viability of proposed solutions. We describe the MIT Hacking Medicine model as a potential method to integrate collaboration and training in rapid innovation techniques into academic medical centers. Built upon a systems approach to healthcare innovation, the time-compressed but expertly guided nature of the events could enable more widely accessible preliminary training in systems-level innovation methodology, as well as creating a structured opportunity for interdisciplinary congregation and collaboration. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. Electronic healthcare information security

    CERN Document Server

    Dube, Kudakwashe; Shoniregun, Charles A

    2010-01-01

    The ever-increasing healthcare expenditure and pressing demand for improved quality and efficiency of patient care services are driving innovation in healthcare information management. The domain of healthcare has become a challenging testing ground for information security due to the complex nature of healthcare information and individual privacy. ""Electronic Healthcare Information Security"" explores the challenges of e-healthcare information and security policy technologies. It evaluates the effectiveness of security and privacy implementation systems for anonymization methods and techniqu

  8. E-prescription as a tool for improving services and the financial viability of healthcare systems: the case of the Greek national e-prescription system.

    Science.gov (United States)

    Pangalos, G; Sfyroeras, V; Pagkalos, I

    2014-01-01

    E-prescription systems can help improve patient service, safety and quality of care. They can also help achieve better compliance for the patients and better alignment with the guidelines for the practitioners. The recently implemented national e-prescription system in Greece already covers approximately 85% of all prescriptions prescribed in Greece today (approximately 5.5 million per month). The system has not only contributed already in significant changes towards improving services and better monitoring and planning of public health, but also substantially helped to contain unnecessary expenditure related to medication use and improve transparency and administrative control. Such issues have gained increasing importance not only for Greece but also for many other national healthcare systems that have to cope with the continuous rise of medication expenditure. Our implementation has, therefore, shown that besides their importance for improving services, national e-prescription systems can also provide a valuable tool for better utilisation of resources and for containing unnecessary healthcare costs, thus contributing to the improvement of the financial stability and viability of the overall healthcare system.

  9. Modelling mobile health systems: an application of augmented MDA for the extended healthcare enterprise

    NARCIS (Netherlands)

    Jones, Valerie M.; Rensink, Arend; Brinksma, Hendrik

    2005-01-01

    Mobile health systems can extend the enterprise computing system of the healthcare provider by bringing services to the patient any time and anywhere. We propose a model-driven design and development methodology for the development of the m-health components in such extended enterprise computing

  10. Modelling mobile health systems: an application of augmented MDA for the extended healthcare enterprise

    NARCIS (Netherlands)

    Jones, Val; Rensink, Arend; Brinksma, Ed

    2005-01-01

    Mobile health systems can extend the enterprise computing system of the healthcare provider by bringing services to the patient any time and anywhere. We propose a model-driven design and development methodology for the development of the m-health components in such extended enterprise computing sys

  11. Task-role-based Access Control Model in Smart Health-care System

    Directory of Open Access Journals (Sweden)

    Wang Peng

    2015-01-01

    Full Text Available As the development of computer science and smart health-care technology, there is a trend for patients to enjoy medical care at home. Taking enormous users in the Smart Health-care System into consideration, access control is an important issue. Traditional access control models, discretionary access control, mandatory access control, and role-based access control, do not properly reflect the characteristics of Smart Health-care System. This paper proposes an advanced access control model for the medical health-care environment, task-role-based access control model, which overcomes the disadvantages of traditional access control models. The task-role-based access control (T-RBAC model introduces a task concept, dividing tasks into four categories. It also supports supervision role hierarchy. T-RBAC is a proper access control model for Smart Health-care System, and it improves the management of access rights. This paper also proposes an implementation of T-RBAC, a binary two-key-lock pair access control scheme using prime factorization.

  12. Peer pressure and public reporting within healthcare setting: improving accountability and health care quality in hospitals.

    Science.gov (United States)

    Specchia, Maria Lucia; Veneziano, Maria Assunta; Cadeddu, Chiara; Ferriero, Anna Maria; Capizzi, Silvio; Ricciardi, Walter

    2012-01-01

    In the last few years, the need of public reporting of health outcomes has acquired a great importance. The public release of performance results could be a tool for improving health care quality and many attempts have been made in order to introduce public reporting programs within the health care context at different levels. It would be necessary to promote the introduction of a standardized set of outcome and performance measures in order to improve quality of health care services and to make health care providers aware of the importance of transparency and accountability.

  13. Public Perspectives on Health Human Resources in Primary Healthcare: Context, Choices and Change

    Science.gov (United States)

    Regan, Sandra; Wong, Sabrina T.; Watson, Diane E.

    2010-01-01

    The purpose of this study was to examine factors identified by patients as relevant to health human resources (HHR) planning for primary healthcare (PHC). Eleven focus groups were conducted in British Columbia and a thematic analysis was undertaken, informed by a needs-based HHR planning framework. Three themes emerged: (a) the importance of geographic context, (b) change management at the practice level and (c) the need for choices and changes in delivery of PHC. Findings suggest that more attention could be focused on overcoming geographic barriers to providing services, change management within office-based practices, and providing support structures that allow primary care providers to work closer to their full scope of practice. That these factors align with many strategic directions set out by government and planners signals the readiness for change in how PHC is delivered and HHR planned. PMID:21286262

  14. Sociodemographic data collection in healthcare settings: an examination of public opinions.

    Science.gov (United States)

    Lofters, Aisha K; Shankardass, Ketan; Kirst, Maritt; Quiñonez, Carlos

    2011-02-01

    Federal, provincial, and municipal organizations in Canada have recently begun to promote an equity agenda for their health systems, but much of the necessary data by which to identify those with social disadvantage are not currently collected. We conducted a national survey of 1005 Canadian adults to assess the perceived importance of, and concern about, the collection of personal sociodemographic information by hospitals. We also examined public preference for practical approaches to the future collection of such information. In this sample of Canadian adults, nearly half did not believe it was important for hospitals to collect individual-level sociodemographic data. The majority had concerns that the collection of these data could negatively affect their or others' care; this was especially true among visible minorities and those who have experienced discrimination. There was substantial variation across participant subgroups in their comfort with the collection of various types of information, but greater discomfort in general for current household income, sexual orientation, and education background. There was consistent discomfort reported from older participants. Participants in general were most comfortable providing this type of information to their family physician. The importance of collecting patient-level equity-relevant data is not widely appreciated in Canada, and our survey has shown that concern about how these data could be misused are high, especially among certain subgroups. Qualitative research to further explore and understand these concerns, patient education about data usage and privacy issues, and using the family doctor's office as a linked electronic data collection point, will likely be important as we move toward high-quality equity measurement.

  15. HEALTH TECHNOLOGY PERFORMANCE ASSESSMENT: REAL-WORLD EVIDENCE FOR PUBLIC HEALTHCARE SUSTAINABILITY.

    Science.gov (United States)

    Guerra-Júnior, Augusto Afonso; Pires de Lemos, Lívia Lovato; Godman, Brian; Bennie, Marion; Osorio-de-Castro, Cláudia Garcia Serpa; Alvares, Juliana; Heaney, Aine; Vassallo, Carlos Alberto; Wettermark, Björn; Benguria-Arrate, Gaizka; Gutierrez-Ibarluzea, Iñaki; Santos, Vania Cristina Canuto; Petramale, Clarice Alegre; Acurcio, Fransciso de Assis

    2017-01-01

    Health technology financing is often based on randomized controlled trials (RCTs), which are often the same ones used for licensing. Because they are designed to show the best possible results, typically Phase III studies are conducted under ideal and highly controlled conditions. Consequently, it is not surprising that technologies do not always perform in real life in the same way as controlled conditions. Because financing (and price paid) decisions can be made with overestimated results, health authorities need to ask whether health systems achieve the results they expect when they choose to pay for a technology. The optimal way to answer this question is to assess the performance of financed technologies in real-world settings. Health technology performance assessment (HTpA) refers to the systematic evaluation of the properties, effects, and/or impact of a health intervention or health technology in the real world to provide information for investment/disinvestment decisions and clinical guideline updates. The objective is to describe the development and principal aspects of the Guideline for HTpA commissioned by the Brazilian Ministry of Health. Our methods used include extensive literature review, refinement with experts across countries, and public consultation. A comprehensive guideline was developed, which has been adopted by the Brazilian government. We believe the guideline, with its particular focus on disinvestment, along with the creation of a specific program for HTpA, will allow the institutionalization and continuous improvement of the scientific methods to use real-world evidence to optimize available resources not only in Brazil but across countries.

  16. Indicators of healthcare system, an important element of SWOT sistemic analysis in this area

    Directory of Open Access Journals (Sweden)

    Claudiu CICEA

    2009-12-01

    Full Text Available The complexity of indicator’s system derives from the very complexity of the health concept as defined by the World Health Organization that "Health is that state of good : physical, mental, social and consists not only in the absence of disease or infirmity". The indicators should cover both aspects of financing health services, technical equipment, human resources in healthcare, quality of healthcare services, issues that affect health, but also short and long term effects of work in this area. The paper analyzes the main indicators characterizing the health system in Romania, aimed at identifying potential strengths and its weaknesses.

  17. [Development method of healthcare information system integration based on business collaboration model].

    Science.gov (United States)

    Li, Shasha; Nie, Hongchao; Lu, Xudong; Duan, Huilong

    2015-02-01

    Integration of heterogeneous systems is the key to hospital information construction due to complexity of the healthcare environment. Currently, during the process of healthcare information system integration, people participating in integration project usually communicate by free-format document, which impairs the efficiency and adaptability of integration. A method utilizing business process model and notation (BPMN) to model integration requirement and automatically transforming it to executable integration configuration was proposed in this paper. Based on the method, a tool was developed to model integration requirement and transform it to integration configuration. In addition, an integration case in radiology scenario was used to verify the method.

  18. Public speaking for the healthcare professional: Part I--Preparing for the program.

    Science.gov (United States)

    Baum, Neil

    2011-01-01

    It is true that most doctors do not enjoy public speaking. Most physicians, although good with one-on-one conversations with patients, are out of their comfort zone when it comes to speaking in front of other physicians, colleagues, and even lay persons. This three-part article will discuss the preparation, the presentation, and what you need to do after the program is over in order to become an effective public speaker.

  19. Public health safety and environment in inadequate hospital and healthcare settings: a review.

    Science.gov (United States)

    Baguma, D

    2017-03-01

    Public health safety and environmental management are concerns that pose challenges worldwide. This paper briefly assesses a selected impact of the environment on public health. The study used an assessment of environmental mechanism to analyse the underlying different pathways in which the health sector is affected in inadequate hospital and health care settings. We reviewed the limited available evidence of the association between the health sector and the environment, and the likely pathways through which the environment influences health. The paper also models the use of private health care as a function of costs and benefits relative to public care and no care. The need to enhancing policies to improve the administration of health services, strengthening interventions on environment using international agreements, like Rio Conventions, including measures to control hospital-related infection, planning for human resources and infrastructure construction development have linkage to improve environment care and public health. The present study findings partly also demonstrate the influence of demand for health on the environment. The list of possible interventions includes enhancing policies to improve the administration of health services, strengthening Rio Conventions implementation on environmental concerns, control of environmental hazards and public health. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  20. Measuring and reporting of the healthcare systems performances

    OpenAIRE

    2014-01-01

    The health care system is one of the most important social systems of each country. That is the reason for considerable interest among the policy makers in obtaining information that indicates the performance of their health care systems. This information is needed to set up a fundament for monitoring the progress of the health care system over time as well as its comparison with other health care systems. Starting hypothesis of this paper is that there is a need of...

  1. Use of herbal medicine during pregnancy among women with access to public healthcare in Nairobi, Kenya: a cross-sectional survey

    OpenAIRE

    Mothupi, Mamothena Carol

    2014-01-01

    Background Maternal health is a public health priority in many African countries, but little is known about herbal medicine use in pregnancy. This study aimed to determine the pattern of use of herbal medicine in an urban setting, where women have relatively high access to public healthcare. Methods This cross-sectional study included 333 women attending a childcare clinic in a district public health hospital in Nairobi, Kenya, during January and February, 2012, and who had delivered a baby w...

  2. Inclusive public participation in health: Policy, practice and theoretical contributions to promote the involvement of marginalised groups in healthcare.

    Science.gov (United States)

    de Freitas, Cláudia; Martin, Graham

    2015-06-01

    Migrants and ethnic minorities are under-represented in spaces created to give citizens voice in healthcare governance. Excluding minority groups from the health participatory sphere may weaken the transformative potential of public participation, (re)producing health inequities. Yet few studies have focused on what enables involvement of marginalised groups in participatory spaces. This paper addresses this issue, using the Participation Chain Model (PCM) as a conceptual framework, and drawing on a case study of user participation in a Dutch mental health advocacy project involving Cape Verdean migrants. Data collection entailed observation, documentary evidence and interviews with Cape Verdeans affected by psychosocial problems (n = 20) and institutional stakeholders (n = 30). We offer practice, policy and theoretical contributions. Practically, we highlight the importance of a proactive approach providing minorities and other marginalised groups with opportunities and incentives that attract, retain and enable them to build and release capacity through involvement. In policy terms, we suggest that both health authorities and civil society organisations have a role in creating 'hybrid' spaces that promote the substantive inclusion of marginalised groups in healthcare decision-making. Theoretically, we highlight shortcomings of PCM and its conceptualisation of users' resources, suggesting adaptations to improve its conceptual and practical utility. Copyright © 2015 Elsevier Ltd. All rights reserved.

  3. Factors influencing HPV vaccine delivery by healthcare professionals at public health posts in São Paulo, Brazil.

    Science.gov (United States)

    Figueroa-Downing, Daniella; Baggio, Maria Luiza; Baker, Misha L; Dias De Oliveira Chiang, Ellen; Villa, Luisa L; Eluf Neto, Jose; Evans, Dabney P; Bednarczyk, Robert A

    2017-01-01

    To assess the association between Brazilian healthcare providers' characteristics and their knowledge, perceptions, and practices regarding the HPV vaccine. An observational cross-sectional study was conducted at five public health posts in São Paulo between July 28 and August 8, 2014. Healthcare professionals directly involved in patient care were asked to complete a written survey. Factors associated with routine verification of HPV vaccination status were evaluated using Poisson regression. Among 200 participants included, 74 (38.5%) reported never and 70 (36.5%) reported always asking about HPV immunization status. Doctors were significantly less likely to report always asking than were community health agents (5/39 [12.8%] vs 32/60 [53.3%]; adjusted prevalence ratio [aPR] 0.25 [95% confidence interval (CI) 0.07-0.91]). Knowledge about the correct dosing schedule was associated with always rather than never verifying vaccination status (aPR 2.46 [95% CI 1.06-5.70]). Knowledge and attitude played secondary roles in influencing HPV vaccine verification. Community health agents were crucial for vaccine promotion; continued education and support of this group is essential for the sustained success of HPV immunization efforts in Brazil. © 2016 International Federation of Gynecology and Obstetrics.

  4. Impact of new water systems on healthcare-associated colonization or infection with Pseudomonas aeruginosa

    Science.gov (United States)

    Lefebvre, Annick; Quantin, Catherine; Vanhems, Philippe; Lucet, Jean-Christophe; Bertrand, Xavier; Astruc, Karine; Chavanet, Pascal; Aho-Glélé, Ludwig S.

    2016-01-01

    Aim: We aimed to study the impact of new water systems, which were less contaminated with P. aeruginosa, on the incidence of healthcare-associated P. aeruginosa cases (colonizations or infections) in care units that moved to a different building between 2005 and 2014. Methods: Generalized Estimated Equations were used to compare the incidence of P. aeruginosa healthcare-associated cases according to the building. Results: Twenty-nine units moved during the study period and 2,759 cases occurred in these units. No difference was observed when the new building was compared with older buildings overall. Conclusion: Our results did not support our hypothesis of a positive association between water system contamination and the incidence of healthcare-associated P. aeruginosa cases. These results must be confirmed by linking results of water samples and patients’ data. PMID:27274443

  5. Productivity changes in OECD healthcare systems: bias-corrected Malmquist productivity approach.

    Science.gov (United States)

    Kim, Younhee; Oh, Dong-Hyun; Kang, Minah

    2016-10-01

    This study evaluates productivity changes in the healthcare systems of 30 Organization for Economic Co-operation and Development (OECD) countries over the 2002-2012 periods. The bootstrapped Malmquist approach is used to estimate bias-corrected indices of healthcare performance in productivity, efficiency and technology by modifying the original distance functions. Two inputs (health expenditure and school life expectancy) and two outputs (life expectancy at birth and infant mortality rate) are used to calculate productivity growth. There are no perceptible trends in productivity changes over the 2002-2012 periods, but positive productivity improvement has been noticed for most OECD countries. The result also informs considerable variations in annual productivity scores across the countries. Average annual productivity growth is evenly yielded by efficiency and technical changes, but both changes run somewhat differently across the years. The results of this study assert that policy reforms in OECD countries have improved productivity growth in healthcare systems over the past decade. Countries that lag behind in productivity growth should benchmark peer countries' practices to increase performance by prioritizing an achievable trajectory based on socioeconomic conditions. For example, relatively inefficient countries in this study indicate higher income inequality, corresponding to inequality and health outcomes studies. Although income inequality and globalization are not direct measures to estimate healthcare productivity in this study, these issues could be latent factors to explain cross-country healthcare productivity for future research. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  6. Five types of OECD healthcare systems: empirical results of a deductive classification.

    Science.gov (United States)

    Böhm, Katharina; Schmid, Achim; Götze, Ralf; Landwehr, Claudia; Rothgang, Heinz

    2013-12-01

    This article classifies 30 OECD healthcare systems according to a deductively generated typology by Rothgang and Wendt [1]. This typology distinguishes three core dimensions of the healthcare system: regulation, financing, and service provision, and three types of actors: state, societal, and private actors. We argue that there is a hierarchical relationship between the three dimensions, led by regulation, followed by financing and finally service provision, where the superior dimension restricts the nature of the subordinate dimensions. This hierarchy rule limits the number of theoretically plausible types to ten. To test our argument, we classify 30 OECD healthcare systems, mainly using OECD Health Data and WHO country reports. The classification results in five system types: the National Health Service, the National Health Insurance, the Social Health Insurance, the Etatist Social Health Insurance, and the Private Health System. All five types belong to the group of healthcare system types considered theoretically plausible. Merely Slovenia does not comply with our assumption of a hierarchy among dimensions and typical actors due to its singular transformation history. Crown Copyright © 2013. Published by Elsevier Ireland Ltd. All rights reserved.

  7. Homeschooling within the public school system

    OpenAIRE

    Horsburgh, Fergus Bruce Norman

    2005-01-01

    Homeschooling through the public school system is a relatively new trend in education. This qualitative study focuses on the experiences of six families participating in public school homeschooling programs in British Columbia, Canada. (Parents were interviewed and the interviews were recorded with transcripts becoming the primary data for this research.) Parents' motivations for homeschooling through the public system, rather than homeschooling on their own, are centered on financial advanta...

  8. Towards Fractal Approach in Healthcare Information Systems: A Review

    OpenAIRE

    Nawzat S. Ahmed; Norizan Mohd Yasin

    2011-01-01

    Recently, traditional information systems need adaption capabilities in order to overcome modifications and maintains of external environment. For that, researchers proposed many solutions from the Fractal method to improve the flexibility and quick adaptive of the system. Computer Information System, as widely used systems, needs modifications and adaptations to real changes. The most important action is to circulate and updating new data and information among the hosts in agent-based inform...

  9. Public Sector Information Systems (PSIS)

    DEFF Research Database (Denmark)

    Brooks, Laurence; Zinner Henriksen, Helle; Janssen, Marijn

    2014-01-01

    Policies are traditionally developed by experts with limited forms of stakeholder involvement. New technologies can change policy making practice through new methods of citizens’ engagement. As a result, the traditional boundaries between governments and the public are also changing. Policy makers...

  10. [Immigrations to Anatolia, related public health problems and healthcare services in the beginning of the Twentieth Century].

    Science.gov (United States)

    Sarikaya, Ozlem; Civaner, Murat

    Anatolia, one of the most important crossroads between two continents, has witnessed so many immigrations throughout the history. It is a place where different civilizations and cultures met and transformed each other by interaction. History of important immigrations to Anatolia during the reign of the Ottoman Empire goes back to 1683. Also, the period between the end of 19th century and the beginning of 20th century was the time of wars, immigrations, and death and birth of nations. The Ottoman Empire had joined the several wars as well, and the new Republic of Turkey was established after it collapsed. In this study, we investigated the two large scale immigrations to Anatolia between Balkan Wars and the first years of Republic, and tried to compile our knowledge about the public health problems and the healthcare services provided.

  11. Information technology systems in public sector health facilities in developing countries: the case of South Africa

    Directory of Open Access Journals (Sweden)

    Cline Gregory B

    2013-01-01

    Full Text Available Abstract Background The public healthcare sector in developing countries faces many challenges including weak healthcare systems and under-resourced facilities that deliver poor outcomes relative to total healthcare expenditure. Global references demonstrate that information technology has the ability to assist in this regard through the automation of processes, thus reducing the inefficiencies of manually driven processes and lowering transaction costs. This study examines the impact of hospital information systems implementation on service delivery, user adoption and organisational culture within two hospital settings in South Africa. Methods Ninety-four interviews with doctors, nurses and hospital administrators were conducted in two public sector tertiary healthcare facilities (in two provinces to record end-user perceptions. Structured questionnaires were used to conduct the interviews with both qualitative and quantitative information. Results Noteworthy differences were observed among the three sample groups of doctors, nurses and administrators as well as between our two hospital groups. The impact of automation in terms of cost and strategic value in public sector hospitals is shown to have yielded positive outcomes with regard to patient experience, hospital staff workflow enhancements, and overall morale in the workplace. Conclusion The research provides insight into the reasons for investing in system automation, the associated outcomes, and organisational factors that impact the successful adoption of IT systems. In addition, it finds that sustainable success in these initiatives is as much a function of the technology as it is of the change management function that must accompany the system implementation.

  12. Information technology systems in public sector health facilities in developing countries: the case of South Africa

    Science.gov (United States)

    2013-01-01

    Background The public healthcare sector in developing countries faces many challenges including weak healthcare systems and under-resourced facilities that deliver poor outcomes relative to total healthcare expenditure. Global references demonstrate that information technology has the ability to assist in this regard through the automation of processes, thus reducing the inefficiencies of manually driven processes and lowering transaction costs. This study examines the impact of hospital information systems implementation on service delivery, user adoption and organisational culture within two hospital settings in South Africa. Methods Ninety-four interviews with doctors, nurses and hospital administrators were conducted in two public sector tertiary healthcare facilities (in two provinces) to record end-user perceptions. Structured questionnaires were used to conduct the interviews with both qualitative and quantitative information. Results Noteworthy differences were observed among the three sample groups of doctors, nurses and administrators as well as between our two hospital groups. The impact of automation in terms of cost and strategic value in public sector hospitals is shown to have yielded positive outcomes with regard to patient experience, hospital staff workflow enhancements, and overall morale in the workplace. Conclusion The research provides insight into the reasons for investing in system automation, the associated outcomes, and organisational factors that impact the successful adoption of IT systems. In addition, it finds that sustainable success in these initiatives is as much a function of the technology as it is of the change management function that must accompany the system implementation. PMID:23347433

  13. Informatics Metrics and Measures for a Smart Public Health Systems Approach: Information Science Perspective.

    Science.gov (United States)

    Carney, Timothy Jay; Shea, Christopher Michael

    2017-01-01

    Public health informatics is an evolving domain in which practices constantly change to meet the demands of a highly complex public health and healthcare delivery system. Given the emergence of various concepts, such as learning health systems, smart health systems, and adaptive complex health systems, health informatics professionals would benefit from a common set of measures and capabilities to inform our modeling, measuring, and managing of health system "smartness." Here, we introduce the concepts of organizational complexity, problem/issue complexity, and situational awareness as three codependent drivers of smart public health systems characteristics. We also propose seven smart public health systems measures and capabilities that are important in a public health informatics professional's toolkit.

  14. How can insulin initiation delivery in a dual-sector health system be optimised? A qualitative study on healthcare professionals' views.

    Science.gov (United States)

    Lee, Ping Yein; Lee, Yew Kong; Ng, Chirk Jenn

    2012-04-30

    The prevalence of type 2 diabetes is increasing at an alarming rate in developing countries. However, glycaemia control remains suboptimal and insulin use is low. One important barrier is the lack of an efficient and effective insulin initiation delivery approach. This study aimed to document the strategies used and proposed by healthcare professionals to improve insulin initiation in the Malaysian dual-sector (public-private) health system. In depth interviews and focus group discussions were conducted in Klang Valley and Seremban, Malaysia in 2010-11. Healthcare professionals consisting of general practitioners (n = 11), medical officers (n = 8), diabetes educators (n = 3), government policy makers (n = 4), family medicine specialists (n = 10) and endocrinologists (n = 2) were interviewed. We used a topic guide to facilitate the interviews, which were audio recorded, transcribed verbatim and analysed using a thematic approach. Three main themes emerged from the interviews. Firstly, there was a lack of collaboration between the private and public sectors in diabetes care. The general practitioners in the private sector proposed an integrated system for them to refer patients to the public health services for insulin initiation programmes. There could be shared care between the two sectors and this would reduce the disproportionately heavy workload at the public sector. Secondly, besides the support from the government health authority, the healthcare professionals wanted greater involvement of non-government organisations, media and pharmaceutical industry in facilitating insulin initiation in both the public and private sectors. The support included: training of healthcare professionals; developing and disseminating patient education materials; service provision by diabetes education teams; organising programmes for patients' peer group sessions; increasing awareness and demystifying insulin via public campaigns; and subsidising glucose

  15. Drug-induced acute myocardial infarction: identifying 'prime suspects' from electronic healthcare records-based surveillance system.

    Directory of Open Access Journals (Sweden)

    Preciosa M Coloma

    Full Text Available BACKGROUND: Drug-related adverse events remain an important cause of morbidity and mortality and impose huge burden on healthcare costs. Routinely collected electronic healthcare data give a good snapshot of how drugs are being used in 'real-world' settings. OBJECTIVE: To describe a strategy that identifies potentially drug-induced acute myocardial infarction (AMI from a large international healthcare data network. METHODS: Post-marketing safety surveillance was conducted in seven population-based healthcare databases in three countries (Denmark, Italy, and the Netherlands using anonymised demographic, clinical, and prescription/dispensing data representing 21,171,291 individuals with 154,474,063 person-years of follow-up in the period 1996-2010. Primary care physicians' medical records and administrative claims containing reimbursements for filled prescriptions, laboratory tests, and hospitalisations were evaluated using a three-tier triage system of detection, filtering, and substantiation that generated a list of drugs potentially associated with AMI. Outcome of interest was statistically significant increased risk of AMI during drug exposure that has not been previously described in current literature and is biologically plausible. RESULTS: Overall, 163 drugs were identified to be associated with increased risk of AMI during preliminary screening. Of these, 124 drugs were eliminated after adjustment for possible bias and confounding. With subsequent application of criteria for novelty and biological plausibility, association with AMI remained for nine drugs ('prime suspects': azithromycin; erythromycin; roxithromycin; metoclopramide; cisapride; domperidone; betamethasone; fluconazole; and megestrol acetate. LIMITATIONS: Although global health status, co-morbidities, and time-invariant factors were adjusted for, residual confounding cannot be ruled out. CONCLUSION: A strategy to identify potentially drug-induced AMI from electronic healthcare

  16. Factors associated with hospitalisations in chronic conditions deemed avoidable: ecological study in the Spanish healthcare system

    Science.gov (United States)

    Angulo-Pueyo, Ester; Ridao-López, Manuel; Martínez-Lizaga, Natalia; García-Armesto, Sandra; Peiró, Salvador; Bernal-Delgado, Enrique

    2017-01-01

    Objectives Potentially avoidable hospitalisations have been used as a proxy for primary care quality. We aimed to analyse the ecological association between contextual and systemic factors featured in the Spanish healthcare system and the variation in potentially avoidable hospitalisations for a number of chronic conditions. Methods A cross-section ecological study based on the linkage of administrative data sources from virtually all healthcare areas (n=202) and autonomous communities (n=16) composing the Spanish National Health System was performed. Potentially avoidable hospitalisations in chronic conditions were defined using the Spanish validation of the Agency for Health Research and Quality (AHRQ) preventable quality indicators. Using 2012 data, the ecological association between potentially avoidable hospitalisations and factors featuring healthcare areas and autonomous communities was tested using multilevel negative binomial regression. Results In 2012, 151 468 admissions were flagged as potentially avoidable in Spain. After adjusting for differences in age, sex and burden of disease, the only variable associated with the outcome was hospitalisation intensity for any cause in previous years (incidence risk ratio 1.19 (95% CI 1.13 to 1.26)). The autonomous community of residence explained a negligible part of the residual unexplained variation (variance 0.01 (SE 0.008)). Primary care supply and activity did not show any association. Conclusions The findings suggest that the variation in potentially avoidable hospitalisations in chronic conditions at the healthcare area level is a reflection of how intensively hospitals are used in a healthcare area for any cause, rather than of primary care characteristics. Whether other non-studied features at the healthcare area level or primary care level could explain the observed variation remains uncertain. PMID:28237952

  17. Definición de competencia médica según pacientes crónicos del sistema sanitario público de Andalucía Definition of medical competence. The point of view of chronically-ill patients in the Andalusian public healthcare system (Spain

    Directory of Open Access Journals (Sweden)

    M. Ángeles Prieto Rodríguez

    2012-10-01

    Full Text Available Objetivo: Identificar los atributos con los cuales los/las pacientes crónicos/as atendidos/as en el Sistema Sanitario Público de Andalucía (SSPA describen la competencia profesional del personal facultativo que les atiende a lo largo de su proceso asistencial. Métodos: 147 pacientes crónicos de diferentes procesos asistenciales y sus familiares. Investigación cualitativa con grupos focales y entrevistas en profundidad, realizadas en centros de salud y consultas externas de Granada, Málaga, Sevilla, Cádiz y Córdoba, entre 2007 y 2008. Análisis de contenido con Nudist Vivo. Resultados: Las personas participantes definen la competencia médica enlazando elementos de habilidad y conocimientos técnicos (tener conocimientos e interés por la enfermedad, mantener una continuidad en la atención mediante seguimientos correctos o solicitar las pruebas precisas con otros relacionales, tanto sobre comunicación e información (informar, escuchar, confiar, estimular las preguntas como sobre trato (humanidad, amabilidad, respeto, interés, cercanía. En la valoración de la asistencia en atención primaria, las expectativas incluyen relación cercana, trato personalizado, información, gestión de recetas y baja laboral, y derivación al/a la especialista. Sobre las consultas de especialidad destaca acertar diagnóstico y tratamiento, informar y hacer un seguimiento del/de la paciente. En el servicio de urgencias se valoran especialmente el alivio de los síntomas, acertar el diagnóstico, ser derivado al/a la especialista y recibir un trato humano. Conclusiones: Las necesidades y las expectativas de los/as pacientes crónicos/as hacia la competencia médica se organizan en torno a habilidades técnicas y relacionales.Objective: To identify the attributes used by chronically-ill patients to describe physicians´ competence in the public healthcare system in Andalucia. Methods: A total of 147 chronically-ill patients and their relatives were

  18. The Healthcare System and the Hidden Traps of its Logistics

    Directory of Open Access Journals (Sweden)

    Larisa MIHOREANU

    2016-06-01

    into informal possibility to fraud both the public funds and peoples  savings. The paper touches also the public consequences of the undeclared work of employees of public and private sectors emphasising also the need to identifying some specific roles to play in the future by the services business planning, the law application and the policy of autonomy to help the medical market blossom vigorously. In conclusion, we sustain that the fair action is not an alternative conception of developing, in the fashion, neither of human evolution nor of need-based growth. There is a higher need to model individual awareness and motivation in the direction of increasing the self-responsibility for building a better environment based on a proactive personal development, from within and connected to the outer world.

  19. Patients as healthcare consumers in the public and private sectors: a qualitative study of acupuncture in the UK

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    Coghlan Beverly

    2011-05-01

    Full Text Available Abstract Background The aim of this study was to compare patients' experiences of public and private sector healthcare, using acupuncture as an example. In the UK, acupuncture is popular with patients, is recommended in official guidelines for low back pain, and is available in both the private sector and the public sector (NHS. Consumerism was used as a theoretical framework to explore patients' experiences. Methods Semi-structured face-to-face interviews were conducted in 2007-8 with a purposive sample of 27 patients who had recently used acupuncture for painful conditions in the private sector and/or in the NHS. Inductive thematic analysis was used to develop themes that summarised the bulk of the data and provided insights into consumerism in NHS- and private practice-based acupuncture. Results Five main themes were identified: value for money and willingness to pay; free and fair access; individualised holistic care: feeling cared for; consequences of choice: empowerment and vulnerability; and "just added extras": physical environment. Patients who had received acupuncture in the private sector constructed detailed accounts of the benefits of private care. Patients who had not received acupuncture in the private sector expected minimal differences from NHS care, and those differences were seen as not integral to treatment. The private sector facilitated consumerist behaviour to a greater extent than did the NHS, but private consumers appeared to base their decisions on unreliable and incomplete information. Conclusions Patients used and experienced acupuncture differently in the NHS compared to the private sector. Eight different faces of consumerist behaviour were identified, but six were dominant: consumer as chooser, consumer as pragmatist, consumer as patient, consumer as earnest explorer, consumer as victim, and consumer as citizen. The decision to use acupuncture in either the private sector or the NHS was rarely well-informed: NHS

  20. Patients’ perceptions of the triage system in a primary healthcare facility, Cape Town, South Africa

    Directory of Open Access Journals (Sweden)

    Adeloye A. Adeniji

    2016-03-01

    Full Text Available Background: In public healthcare facilities, where the patient numbers and the available resources are often disproportionate, triage is used to prioritise when patients are seen. Patients may not understand the triage process and have strong views on how to improve their experience.Aim: This study explored the views of patients who had undergone triage in the emergency centre of a primary care facility. Setting: Gugulethu Community Health Centre, Cape Town.Methods: A purposive sample consisted of five women (one coded green, three orange, one yellow and four men (one coded green and three yellow. A semi-structured qualitative interview was conducted in either Xhosa or English and the transcripts analysed using the framework method.Results: All of the respondents complained of a lack of information and poor understanding of the triage process. Those coded green experienced the process as biased and unfair and reported that the triage nurse was rude and unprofessional. By contrast, those coded yellow or orange found the triage nurse to be helpful and professional. Most patients turned to support staff (e.g. security staff or cleaners for assistance in dealing with the triage system. Most patients waited longer than the guidelines recommend and the green-coded patients complained about this issue.Conclusion: Patients did not have a good experience of the triage system. Managers of the triage system need to design better strategies to improve patient acceptance and share information. The important role of support staff needs to be recognised and strengthened.Keywords: emergency care; primary care; triage; patient satisfaction

  1. Patients’ perceptions of the triage system in a primary healthcare facility, Cape Town, South Africa

    Directory of Open Access Journals (Sweden)

    Adeloye A. Adeniji

    2016-03-01

    Full Text Available Background: In public healthcare facilities, where the patient numbers and the available resources are often disproportionate, triage is used to prioritise when patients are seen. Patients may not understand the triage process and have strong views on how to improve their experience.Aim: This study explored the views of patients who had undergone triage in the emergency centre of a primary care facility. Setting: Gugulethu Community Health Centre, Cape Town.Methods: A purposive sample consisted of five women (one coded green, three orange, one yellow and four men (one coded green and three yellow. A semi-structured qualitative interview was conducted in either Xhosa or English and the transcripts analysed using the framework method.Results: All of the respondents complained of a lack of information and poor understanding of the triage process. Those coded green experienced the process as biased and unfair and reported that the triage nurse was rude and unprofessional. By contrast, those coded yellow or orange found the triage nurse to be helpful and professional. Most patients turned to support staff (e.g. security staff or cleaners for assistance in dealing with the triage system. Most patients waited longer than the guidelines recommend and the green-coded patients complained about this issue.Conclusion: Patients did not have a good experience of the triage system. Managers of the triage system need to design better strategies to improve patient acceptance and share information. The important role of support staff needs to be recognised and strengthened.Keywords: emergency care; primary care; triage; patient satisfaction

  2. Patient Experienced Continuity of Care in the Psychiatric Healthcare System

    DEFF Research Database (Denmark)

    Jensen, Natasja Koitzsch; Johansen, Katrine Schepelern; Kastrup, Marianne

    2014-01-01

    , developed in 2004 by Joyce et al., which encompasses four domains: accessibility, individualised care, relationship base and service delivery. Results: Investigating continuity of care, we found issues of specific concern to immigrants and refugees, but also commonalities across the groups....... For accessibility, areas pertinent to immigrants and refugees include lack of knowledge concerning mental illness and obligations towards children. In terms of Int. J. Environ. Res. Public Health 2014, 11 9740 individualised care, trauma, additional vulnerability, and taboo concerning mental illness were...... are complex and diverse and the patient perspective of continuity of care provides important insight into the delivery of care. The study highlights the importance of person-centred care irrespective of migration background though it may be beneficial to have an awareness of areas that may be of more specific...

  3. Public Participation: More than a Method?; Comment on “Harnessing the Potential to Quantify Public Preferences for Healthcare Priorities through Citizens’ Juries”

    Directory of Open Access Journals (Sweden)

    Annette Boaz

    2014-10-01

    Full Text Available While it is important to support the development of methods for public participation, we argue that this should not be at the expense of a broader consideration of the role of public participation. We suggest that a rights based approach provides a framework for developing more meaningful approaches that move beyond public participation as synonymous with consultation to value the contribution of lay knowledge to the governance of health systems and health research.

  4. [Nursing and the humanization of the end- of-life care within healthcare systems].

    Science.gov (United States)

    Gómez Arca, Marina

    2014-01-01

    The reflection upon the humanisation of the end-of-life process within healthcare systems and the implication of healthcare professionals is the main objective of this article. The evolution of the model of care and nurses leadership role at the end-of-life process is evaluated. This analysis starts from the first European references regarding advance wills, made in 1997 at the Oviedo Convention, until the introduction of the idea of advance directives incorporated into Spanish law in 2002. It sets the concept of advance planning in health-related decisions, which establishes a process of voluntary dialogue where every person can clarify values, preferences and wishes regarding the final moments of life, with the support of the healthcare professionals.

  5. The Systemic Products as a Source of Competitive Advantage on Healthcare Sector Example. Part II

    Directory of Open Access Journals (Sweden)

    Izabela SZTANGRET

    2015-12-01

    Full Text Available In the healthcare sector, different healthcare providers, such as home care, primary care, pharmacies and hospital clinics but also a financial institution, collaborate in order to increase values for patients, such as better health state, more complex services, high quality of services, and increased feeling of safety. By creating a value, flexible networks health care providers and additional actors create value through collaboration. The purpose of this article is to identify the specific character of systemic healthcare product, created in synergy relations of medical enntities in the area of new way of meeting customers’ needs. Critical analysis of literature in the field of studied category is conducted in the article; furthermore qualitative method of empirical studies (case study and quantitative (online questionnaire is applied for practical illustration of described processes and phenomena. The article is a second part of the stud.

  6. BSNCare+: A Robust IoT-Oriented Healthcare System with Non-Repudiation Transactions

    Directory of Open Access Journals (Sweden)

    Kuo-Hui Yeh

    2016-12-01

    Full Text Available Recently, the rapid advancement in technologies of modern intelligent objects has led to a new network paradigm, called the Internet of Things (IoT, in which every networked and automated object has been connected in a pervasive manner. New types of IoT-based application services are thus presented. In a healthcare oriented environment, the usage of IoT has brought opportunities for assisting physicians (or nurses to provide on-demand and real-time body-care services to patients with higher accuracy and better efficiency. However, while IoT-oriented techniques deliver such advantages, they may encounter system security vulnerabilities and patient privacy threats not seen in the past. In this paper, we propose a robust IoT-based healthcare system, called BSNCare+, in which body sensor networks (BSNs are adopted as the underlying communication architecture. In the proposed healthcare system, we exploit lightweight crypto-primitives to construct a secure communication mechanism that does achieve data confidentiality and entity authentication among intelligent body sensors, the mobile gateway and the backend BSN-Care server. In addition, we evaluate the performance of the proposed healthcare system using the Raspberry PI series platform. The results show the practicability and feasibility of BSNCare+.

  7. [Perceived quality in hospitals of the Andalusia Healthcare System. The case of neurosurgery departments].

    Science.gov (United States)

    Cordero Tous, N; Horcajadas Almansa, Á; Bermúdez González, G J; Tous Zamora, D

    2014-01-01

    To analyse the characteristics of the perceived quality in hospitals of the Andalusia healthcare system and compare this with that in Andalusian Neurosurgery departments. Randomised surveys, adjusted for working age, were performed in Andalusia using a telephone questionnaire based on the SERVQUAL model with the appropriate modification, with the subsequent selection of a subgroup associated with neurosurgery. Perceived quality was classified as; technical, functional and infrastructure quality. The overall satisfaction was 76.3%. Frequency analysis found that variables related to the technical quality (good doctors, successful operations, trained staff, etc.) obtained more favourable outcomes. Those related to time (wait, consulting, organizing schedules) obtained worse outcomes. The care of families variables obtained poor results. There was no difference between the overall Andalusian healthcare system and neurosurgery departments. In the mean analysis, women and older people gave more favourable responses, especially for variables related to infrastructure quality. In the "cluster" analysis, there were more favourable responses by elderly people, with no differences in gender (P<.009). There is no difference in perceived quality between the Andalusian healthcare system overall and neurosurgery departments. The perceived quality of the Andalusian healthcare system is higher in the elderly people. The analysis of perceived quality is useful for promoting projects to improve clinical management. Copyright © 2014 SECA. Published by Elsevier Espana. All rights reserved.

  8. [Scientific evidence and the cost of innovations in the health-care system].

    Science.gov (United States)

    Porzsolt, Franz; Schreyögg, Jonas

    2009-08-01

    When depicting the relationship between evidence and the cost of an innovation in the health-care system, the overall risks of assessment, the redistribution of risks in a regulated market, and the ethical consequences must first be taken into account. There are also evidence-based criteria and economic considerations which are relevant when calculating the cost of an innovation. These topics can indicate, but not exhaustively deal with the complicated relationship between scientific evidence and calculating the cost of an innovation in the health-care system. The following three statements summarize the current considerations in the continuing discussion of this topic: *Scientific evidence undoubtedly exists which should be taken into consideration when calculating the cost of an innovation in the health-care system. *The existing scientific evidence is, however, not sufficient to reach such a decision. Additional information about the benefit perceived by the patient is required. *No standardized method exists to measure this additional information. Therefore, a definition problem also exists in the health-care system when setting a price according to scientific evidence.

  9. An ontology for telemedicine systems resiliency to technological context variations in pervasive healthcare

    NARCIS (Netherlands)

    Larburu Rubio, Nekane; Bults, Richard G.A.; van Sinderen, Marten J.; Widya, I.A.; Hermens, Hermanus J.

    2015-01-01

    Clinical data are crucial for any medical case to study and understand a patient's condition and to give the patient the best possible treatment. Pervasive healthcare systems apply information and communication technology to enable the usage of ubiquitous clinical data by authorized medical persons.

  10. A Data Analytical Framework for Improving Real-Time, Decision Support Systems in Healthcare

    Science.gov (United States)

    Yahav, Inbal

    2010-01-01

    In this dissertation we develop a framework that combines data mining, statistics and operations research methods for improving real-time decision support systems in healthcare. Our approach consists of three main concepts: data gathering and preprocessing, modeling, and deployment. We introduce the notion of offline and semi-offline modeling to…

  11. An Action Research Study of a Healthcare Enterprise information System at the Faroe Islands

    DEFF Research Database (Denmark)

    Schlichter, Bjarne Rerup; Svejvig, Per; Andersen, Povl Erik Rostgaard

    2015-01-01

    Obtaining business value from IT is a recurring theme that has diffused into healthcare information systems (HIS) where stakeholders often question the value of IT investments. Having completed the implementation of an integrated HIS, the Faroese Health Service (FHS) has commenced discussions...

  12. Validation of Autism Spectrum Disorder Diagnoses in Large Healthcare Systems with Electronic Medical Records

    Science.gov (United States)

    Coleman, Karen J.; Lutsky, Marta A.; Yau, Vincent; Qian, Yinge; Pomichowski, Magdalena E.; Crawford, Phillip M.; Lynch, Frances L.; Madden, Jeanne M.; Owen-Smith, Ashli; Pearson, John A.; Pearson, Kathryn A.; Rusinak, Donna; Quinn, Virginia P.; Croen, Lisa A.

    2015-01-01

    To identify factors associated with valid Autism Spectrum Disorder (ASD) diagnoses from electronic sources in large healthcare systems. We examined 1,272 charts from ASD diagnosed youth <18 years old. Expert reviewers classified diagnoses as confirmed, probable, possible, ruled out, or not enough information. A total of 845 were classified with…

  13. Ethics Leadership in Research, Healthcare and Organizational Systems: Commentary and Critical Reflections

    Science.gov (United States)

    Gabriele, Edward F.

    2011-01-01

    In the last decades there has arisen a greater awareness of the ever present need for critical academic reflection on the nature of ethics leadership and committees in research, healthcare, and organizational systems. Yet what is meant by ethics itself? How is ethics understood as a historical phenomenon? What challenges must ethics leaders face…

  14. A Data Analytical Framework for Improving Real-Time, Decision Support Systems in Healthcare

    Science.gov (United States)

    Yahav, Inbal

    2010-01-01

    In this dissertation we develop a framework that combines data mining, statistics and operations research methods for improving real-time decision support systems in healthcare. Our approach consists of three main concepts: data gathering and preprocessing, modeling, and deployment. We introduce the notion of offline and semi-offline modeling to…

  15. Apartheid and healthcare access for paediatric systemic lupus ...

    African Journals Online (AJOL)

    lupus erythematosus (SLE), as a framework for evaluating the structural challenges to ... Paediatric SLE (pSLE) is more severe than the adult disease, and children with SLE .... exploration using a geographical information system. Soc Sci Med ...

  16. National healthcare systems and the need for health information governance.

    Science.gov (United States)

    Hovenga, Evelyn J S

    2013-01-01

    This chapter gives an overview of health data, information and knowledge governance needs and associated generic principles so that information systems are able to automate such data collections from point-of-care operational systems. Also covered are health information systems' dimensions and known barriers to the delivery of quality health services, including environmental, technology and governance influences of any population's health status within the context of national health systems. This is where health information managers and health informaticians need to resolve the many challenges associated with eHealth implementations where data are assets, efficient information flow is essential, the ability to acquire new knowledge desirable, and where the use of data and information needs to be viewed from a governance perspective to ensure reliable and quality information is obtained to enhance decision making.

  17. Using a private-public partnership to supplement healthcare information technology in nursing education.

    Science.gov (United States)

    Cholewka, Patricia A; Harkins, John; Hoelper, Stephen; Schrieber, John; Daniel, Ralph Eddy; Kaur, Jasdip

    2012-01-01

    Various reports by the World Bank and U.S. business technology executives, academics, economists, researchers, and government policymakers have recommended crafting a new educational model for educating America's future workforce including nurses in their professional research pursuits. According to the National League for Nursing, nursing research is an integral part of the scientific enterprise of improving the nation's health. A major aim of this new educational focus is the partnering of private business enterprises and public educational institutions to achieve this outcome, i.e., public-private partnerships. Merck & Co., Inc. will partner/collaborate on a student learning pilot project with New York City College of Technology of the City University of New York Department of Nursing Bachelor of Nursing Program students - all practicing New York State Registered Professional Nurses - who are taking either Nursing Informatics or Leadership in the Management of Client Care courses.

  18. Public speaking for the healthcare professional: Part III--after the program.

    Science.gov (United States)

    Baum, Neil

    2012-01-01

    Public speaking is one of life's greatest fears for many people. However, with practice, repetition, and planning, you can safely leave your comfort zone and make a presentation that will engage the members of the audience, attract their attention, and cause them to take action on your material. This third article in the series will discuss what to do after the last slide is shown.

  19. Quality of life in the workplace for nursing staff at public healthcare institutions

    OpenAIRE

    María Olga Quintana Zavala; Tatiana Paravic Klinj; Katia Lorena Saenz Carrillo

    2016-01-01

    Abstract Objective: to determine the quality of life in the workplace for nursing staff at public institutions in Hermosillo, Sonora, Mexico. Method: quantitative, correlational, cross-sectional, and comparative. We used a probabilistic sample of 345 nurses with data collected in 2013 using an instrument created by the authors to gather bio-socio-demographic data and the CVT-GOHISALO instrument with a Cronbach's alpha of 0.95. SPSS 15 was used to analyze the data. A Kolmogorov-Smirnov tes...

  20. The Regional Healthcare Ecosystem Analyst (RHEA): a simulation modeling tool to assist infectious disease control in a health system.

    Science.gov (United States)

    Lee, Bruce Y; Wong, Kim F; Bartsch, Sarah M; Yilmaz, S Levent; Avery, Taliser R; Brown, Shawn T; Song, Yeohan; Singh, Ashima; Kim, Diane S; Huang, Susan S

    2013-06-01

    As healthcare systems continue to expand and interconnect with each other through patient sharing, administrators, policy makers, infection control specialists, and other decision makers may have to take account of the entire healthcare 'ecosystem' in infection control. We developed a software tool, the Regional Healthcare Ecosystem Analyst (RHEA), that can accept user-inputted data to rapidly create a detailed agent-based simulation model (ABM) of the healthcare ecosystem (ie, all healthcare facilities, their adjoining community, and patient flow among the facilities) of any region to better understand the spread and control of infectious diseases. To demonstrate RHEA's capabilities, we fed extensive data from Orange County, California, USA, into RHEA to create an ABM of a healthcare ecosystem and simulate the spread and control of methicillin-resistant Staphylococcus aureus. Various experiments explored the effects of changing different parameters (eg, degree of transmission, length of stay, and bed capacity). Our model emphasizes how individual healthcare facilities are components of integrated and dynamic networks connected via patient movement and how occurrences in one healthcare facility may affect many other healthcare facilities. A decision maker can utilize RHEA to generate a detailed ABM of any healthcare system of interest, which in turn can serve as a virtual laboratory to test different policies and interventions.

  1. Doctors' experience of coordination across care levels and associated factors. A cross-sectional study in public healthcare networks of six Latin American countries.

    Science.gov (United States)

    Vázquez, María-Luisa; Vargas, Ingrid; Garcia-Subirats, Irene; Unger, Jean-Pierre; De Paepe, Pierre; Mogollón-Pérez, Amparo Susana; Samico, Isabella; Eguiguren, Pamela; Cisneros, Angelica-Ivonne; Huerta, Adriana; Muruaga, María-Cecilia; Bertolotto, Fernando

    2017-06-01

    Improving coordination between primary care (PC) and secondary care (SC) has become a policy priority in recent years for many Latin American public health systems looking to reinforce a healthcare model based on PC. However, despite being a longstanding concern, it has scarcely been analyzed in this region. This paper analyses the level of clinical coordination between PC and SC experienced by doctors and explores influencing factors in public healthcare networks of Argentina, Brazil, Chile, Colombia, Mexico and Uruguay. A cross-sectional study was carried out based on a survey of doctors working in the study networks (348 doctors per country). The COORDENA questionnaire was applied to measure their experiences of clinical management and information coordination, and their related factors. Descriptive analyses were conducted and a multivariate logistic regression model was generated to assess the relationship between general perception of care coordination and associated factors. With some differences between countries, doctors generally reported limited care coordination, mainly in the transfer of information and communication for the follow-up of patients and access to SC for referred patients, especially in the case of PC doctors and, to a lesser degree, inappropriate clinical referrals and disagreement over treatments, in the case of SC doctors. Factors associated with a better general perception of coordination were: being a SC doctor, considering that there is enough time for coordination within consultation hours, job and salary satisfaction, identifying the PC doctor as the coordinator of patient care across levels, knowing the doctors of the other care level and trusting in their clinical skills. These results provide evidence of problems in the implementation of a primary care-based model that require changes in aspects of employment, organization and interaction between doctors, all key factors for coordination. Copyright © 2017 The Authors. Published

  2. Healthcare System Distrust, Physician Trust, and Patient Discordance with Adjuvant Breast Cancer Treatment Recommendations.

    Science.gov (United States)

    Dean, Lorraine T; Moss, Shadiya L; McCarthy, Anne Marie; Armstrong, Katrina

    2017-09-29

    Adjuvant therapy after breast cancer surgery decreases recurrence and increases survival, yet not all women receive and complete it. Previous research has suggested that distrust in medical institutions plays a role in who initiates adjuvant treatment, but has not assessed treatment completion treatment, nor the potential mediating role of physician distrust. Women listed in Pennsylvania and Florida cancer registries, who were under the age of 65 when diagnosed with localized invasive breast cancer between 2005 and 2007, were surveyed by mail in 2007-2009. Survey participants self-reported: demographics; cancer stage and treatments; treatment discordance, as defined by not following their surgeon or oncologist treatment recommendation; healthcare system distrust, and physician trust. Age and cancer stage were verified against cancer registry records. Logistic regression assessed the relationship between highest and lowest tertiles of healthcare system distrust and the dichotomous outcome of treatment discordance, controlling for demographics and clinical treatment factors, and testing for mediation by physician trust. Of the 2,754 participants, 30.2% (n=832) reported not pursing at least one recommended treatment. The mean age was 52. Patients in the highest tertile of healthcare system distrust were 22% more likely to report treatment discordance than the lowest tertile; physician trust did not mediate the association between healthcare system distrust and treatment discordance. Healthcare system distrust is positively associated with treatment discordance, defined as failure to initiate or complete physician recommended adjuvant treatment after breast cancer. Interventions should test whether or not resolving institutional distrust reduces treatment discordance. Copyright ©2017, American Association for Cancer Research.

  3. Rethinking Information Systems in the Public Sector

    DEFF Research Database (Denmark)

    Medaglia, Rony

    2014-01-01

    This section of Information Polity consists of papers presented during the workshop “Rethinking Information Systems in the Public Sector: Bridging Academia and Public Service”. The workshop was held on 8 June 2014 in Tel Aviv, Israel, in conjunction with the European Conference on Information...... Systems (ECIS 2014), and it is part of the activities of the Special Interest Group for eGovernment (SIGeGov) of the Association for Information Systems (AIS)....

  4. Perspectives on the changing healthcare system: teaching systems-based practice to medical residents

    Directory of Open Access Journals (Sweden)

    Johanna Martinez

    2013-09-01

    Full Text Available Purpose: The Accreditation Council for Graduate Medical Education restructured its accreditation system to be based on educational outcomes in six core competencies. Systems-based practice is one of the six core competencies. The purpose of this report is to describe Weill Cornell Medical College's Internal Medicine Residency program curriculum for systems-based practice (SBP and its evaluation process. Methods: To examine potential outcomes of the POCHS curriculum, an evaluation was conducted, examining participants': (1 knowledge gain; (2 course ratings; and (3 qualitative feedback. Results: On average, there was a 19 percentage point increase in knowledge test scores for all three cohorts. The course was rated overall highly, receiving an average of 4.6 on a 1–5 scale. Lastly, the qualitative comments supported that the material is needed and valued. Conclusion: The course, entitled Perspectives on the Changing Healthcare System (POCHS and its evaluation process support that systems-based practice is crucial to residency education. The course is designed not only to educate residents about the current health care system but also to enable them to think critically about the risk and benefits of the changes. POCHS provides a framework for teaching and assessing this competency and can serve as a template for other residency programs looking to create or restructure their SBP curriculum.

  5. Interactions: trade policy and healthcare reform after Chaoulli v. Quebec: is it time for Canada to acknowledge the fragile boundary between health and trade policies and strengthen the separation between private and public health insurance?

    Science.gov (United States)

    Crawford, Mark

    2006-01-01

    The insulation of Canada's healthcare system from trade treaty obligations is crucial to the legitimacy of Canada's trade policy. Legal analysis has suggested, however, that competitive and for-profit delivery of the kind contemplated by the Kirby Report and some provinces may make healthcare more vulnerable to challenges under NAFTA and GATS. The Government of Canada has tried to counter this interpretation by stressing the importance of public financing as the principal criterion for exemption of healthcare from trade treaties, but now the potential for private financing of essential medical services indicated by the Supreme Court's decision in Chaoulli v. Quebec has made that line of argument look risky as well. It is apparent that Canada failed to anticipate the possible interactions of domestic, international and constitutional law when it made commitments in the area of private health insurance at the WTO in 1997. Accordingly, the time has come to acknowledge the fragility of the boundary between health and trade policies, to take the risks and costs associated with trade treaty obligations fully into account when undertaking healthcare reform and to strengthen the separation between private and public health insurance.

  6. Healthcare System Information at Language Schools for Newly Arrived Immigrants: A Pertinent Setting in Times of Austerity

    Science.gov (United States)

    Tynell, Lena Lyngholt; Wimmelmann, Camilla Lawaetz; Jervelund, Signe Smith

    2017-01-01

    Objective: In most European countries, immigrants do not systematically learn about the host countries' healthcare system when arriving. This study investigated how newly arrived immigrants perceived the information they received about the Danish healthcare system. Methods: Immigrants attending a language school in Copenhagen in 2012 received…

  7. Healthcare System Information at Language Schools for Newly Arrived Immigrants: A Pertinent Setting in Times of Austerity

    Science.gov (United States)

    Tynell, Lena Lyngholt; Wimmelmann, Camilla Lawaetz; Jervelund, Signe Smith

    2017-01-01

    Objective: In most European countries, immigrants do not systematically learn about the host countries' healthcare system when arriving. This study investigated how newly arrived immigrants perceived the information they received about the Danish healthcare system. Methods: Immigrants attending a language school in Copenhagen in 2012 received…

  8. How can insulin initiation delivery in a dual-sector health system be optimised? A qualitative study on healthcare professionals’ views

    Directory of Open Access Journals (Sweden)

    Lee Ping Yein

    2012-04-01

    Full Text Available Abstract Background The prevalence of type 2 diabetes is increasing at an alarming rate in developing countries. However, glycaemia control remains suboptimal and insulin use is low. One important barrier is the lack of an efficient and effective insulin initiation delivery approach. This study aimed to document the strategies used and proposed by healthcare professionals to improve insulin initiation in the Malaysian dual-sector (public–private health system. Methods In depth interviews and focus group discussions were conducted in Klang Valley and Seremban, Malaysia in 2010–11. Healthcare professionals consisting of general practitioners (n = 11, medical officers (n = 8, diabetes educators (n = 3, government policy makers (n = 4, family medicine specialists (n = 10 and endocrinologists (n = 2 were interviewed. We used a topic guide to facilitate the interviews, which were audio recorded, transcribed verbatim and analysed using a thematic approach. Results Three main themes emerged from the interviews. Firstly, there was a lack of collaboration between the private and public sectors in diabetes care. The general practitioners in the private sector proposed an integrated system for them to refer patients to the public health services for insulin initiation programmes. There could be shared care between the two sectors and this would reduce the disproportionately heavy workload at the public sector. Secondly, besides the support from the government health authority, the healthcare professionals wanted greater involvement of non-government organisations, media and pharmaceutical industry in facilitating insulin initiation in both the public and private sectors. The support included: training of healthcare professionals; developing and disseminating patient education materials; service provision by diabetes education teams; organising programmes for patients’ peer group sessions; increasing awareness and demystifying

  9. Healthcare decision-tools a growing Web trend: three-pronged public relations campaign heightens presence, recognition for online healthcare information provider.

    Science.gov (United States)

    2006-01-01

    Schwartz Communications, LLC, executes a successful PR campaign to position Subimo, a provider of online healthcare decision tools, as a leader in the industry that touts names such as WebMD.com and HealthGrades.com. Through a three-pronged media relations strategy, Schwartz and Subimo together branded the company as an industry thought-leader.

  10. What to do with healthcare Incident Reporting Systems

    Directory of Open Access Journals (Sweden)

    Julius Cuong Pham

    2013-12-01

    Full Text Available Incident Reporting Systems (IRS are and will continue to be an important influence on improving patient safety. They can provide valuable insights into how and why patients can be harmed at the organizational level. However, they are not the panacea that many believe them to be. They have several limitations that should be considered. Most of these limitations stem from inherent biases of voluntary reporting systems. These limitations include: i IRS can’t be used to measure safety (error rates; ii IRS can’t be used to compare organizations; iii IRS can’t be used to measure changes over time; iv IRS generate too many reports; v IRS often don’t generate in-depth analyses or result in strong interventions to reduce risk; vi IRS are associated with costs. IRS do offer significant value; their value is found in the following: i IRS can be used to identify local system hazards; ii IRS can be used to aggregate experiences for uncommon conditions; iii IRS can be used to share lessons within and across organizations; iv IRS can be used to increase patient safety culture. Moving forward, several strategies are suggested to maximize their value: i make reporting easier; ii make reporting meaningful to the reporter; iii make the measure of success system changes, rather than events reported; iv prioritize which events to report and investigate, report and investigate them well; v convene with diverse stakeholders to enhance the value of IRS.

  11. A sustainable and affordable support system for rural healthcare delivery

    CSIR Research Space (South Africa)

    Barjis, J

    2013-12-01

    Full Text Available monitoring system facilitates patient information flow from home-based care workers to a local clinic or hospital, where the information is presented on a desktop computer used by clinic nurses and doctors for monitoring the patients' health and ultimately...

  12. Wearable healthcare systems, new frontiers of e-textile.

    Science.gov (United States)

    Paradiso, Rita; Belloc, Carine; Loriga, Giannicola; Taccini, Nicola

    2005-01-01

    There is a growing need of renovation in our health care managing systems; people need to be more interactive and more conscious of their own health condition in a way to adjust incorrect lifestyles, to obtain a personalized therapy tuned to their own physiological reactions and on their own environmental condition. To gain knowledge of a citizen's health status and to monitor without harassing them (until they refuse any medical supervision), a comfortable remote monitoring of important physiological parameters is necessary. The approach is therefore to integrate system solutions into functional clothes with integrated textile sensors. The combination of functional clothes and integrated electronics and on-body processing, is defined as e-textile and gives rise to intelligent biomedical clothes. Systems, designed to be minimally invasive, are based on smart textile technologies, where conductive and piezoresistive materials in the form of fiber and yarn are used to realize clothes, in which knitted fabric sensors and electrodes are distributed and connected to an electronic portable unit. These systems are able to detect, acquire and transmit physiological signals. They are conformable to the human body, and move towards improving the patient's quality of life and their autonomy. These systems are also cost-effective in providing around-the-clock assistance, in helping physicians to monitor for example cardiac patients during periods of rehabilitation, and in addition result in decreased hospitalization time. Finally, by providing direct feedback to the users, they improve their awareness and potentially allow better control of their own condition, while the simultaneous recording of vital signs permits parameter extrapolation and inter-signal elaboration that contributes to produce alert messages and personalized synoptic tables of the patient's health.

  13. Adding justice to the clinical and public health ethics arguments for mandatory seasonal influenza immunisation for healthcare workers.

    Science.gov (United States)

    Lee, Lisa M

    2015-08-01

    Ethical considerations from both the clinical and public health perspectives have been used to examine whether it is ethically permissible to mandate the seasonal influenza vaccine for healthcare workers (HCWs). Both frameworks have resulted in arguments for and against the requirement. Neither perspective resolves the question fully. By adding components of justice to the argument, I seek to provide a more fulsome ethical defence for requiring seasonal influenza immunisation for HCWs. Two critical components of a just society support requiring vaccination: fairness of opportunity and the obligation to follow democratically formulated rules. The fairness of opportunity is informed by Rawls' two principles of justice. The obligation to follow democratically formulated rules allows us to focus simultaneously on freedom, plurality and solidarity. Justice requires equitable participation in and benefit from cooperative schemes to gain or profit socially as individuals and as a community. And to be just, HCW immunisation exemptions should be limited to medical contraindications only. In addition to the HCWs fiduciary duty to do what is best for the patient and the public health duty to protect the community with effective and minimally intrusive interventions, HCWs are members of a just society in which all members have an obligation to participate equitably in order to partake in the benefits of membership. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  14. Quality of life in the workplace for nursing staff at public healthcare institutions 1

    OpenAIRE

    Zavala,María Olga Quintana; Klinj, Tatiana Paravic; Carrillo, Katia Lorena Saenz

    2016-01-01

    Abstract Objective: to determine the quality of life in the workplace for nursing staff at public institutions in Hermosillo, Sonora, Mexico. Method: quantitative, correlational, cross-sectional, and comparative. We used a probabilistic sample of 345 nurses with data collected in 2013 using an instrument created by the authors to gather bio-socio-demographic data and the CVT-GOHISALO instrument with a Cronbach's alpha of 0.95. SPSS 15 was used to analyze the data. A Kolmogorov-Smirnov test wa...

  15. Intercultural and Interlinguistical Mediation in the Healthcare System: The Challenge of Conflict Management

    Directory of Open Access Journals (Sweden)

    Federico Farini

    2008-09-01

    Full Text Available Nowadays, young women and their children are the most important migrant users of health-care services. In particular, these people may encounter different cultural constructions of health, disease, therapy, and motherhood. The observed difficulties in intercultural communication encourage healthcare systems to promote mediation. Mediation consists of the intervention of a third person, who promotes reciprocal understanding and acceptance between participants. The research presented in this article focuses on the intercultural communication that is produced in these services between health-care personnel and migrant patients. To achieve this goal, the research aims at integrating different theoretical and methodological approaches: conversation analysis, in order to observe the interaction between healthcare personnel and patients, pointing out the cues of the participants’ turn-taking sequences; analysis of the cultural presuppositions of the healthcare system as a communication system with a specific function in society, by highlighting contextualization cues, that is, cultural presuppositions that steer the interaction system, which result from the wider social context and are cues of the cultural identities that characterize it. It was observed that the patients in most cases have very few opportunities to answer the physicians’ questions or to pose questions or doubts. Substituting the patients as the main participants in interactions, the mediator never refuses the physicians’ indications, never expresses doubts, and never asks the patients if they have some reason to doubt or refuse. In these cases, interlinguistic and intercultural mediation de-emphasizes the importance of the larger social context, of the durability of relationships between the parties, and of their social and political recognition.

  16. Application of Agent Methodology in Healthcare Information Systems

    Directory of Open Access Journals (Sweden)

    Reem Abdalla

    2017-02-01

    Full Text Available This paper presents a case study to describe the features and the phases of the two agent methodologies. The Gaia methodology for agent oriented analysis and design, Tropos is a detailed agent oriented software engineering methodology to explore each methodology's ability to present solutions for small problems. Also we provide an attempt to discover whether the methodology is in fact understandable and usable. In addition we were collecting and taking notes of the advantages and weaknesses of these methodologies during the study analysis for each methodology and the relationships among their models. The Guardian Angle: Patient-Centered Health Information System (GA: PCHIS is the personal system to help track, manage, and interpret the subject's health history, and give advice to both patient and provider is used as the case study throughout the paper.

  17. Healthcare system and the wealth-health gradient: a comparative study of older populations in six countries.

    Science.gov (United States)

    Maskileyson, Dina

    2014-10-01

    The present study provides a comparative analysis of the association between wealth and health in six healthcare systems (Sweden, the United Kingdom, Germany, the Czech Republic, Israel, the United States). National samples of individuals fifty years and over reveal considerable cross-country variations in health outcomes. In all six countries wealth and health are positively associated. The findings also show that state-based healthcare systems produce better population health outcomes than private-based healthcare systems. The results indicate that in five out of the six countries studied, the wealth-health gradients were remarkably similar, despite significant variations in healthcare system type. Only in the United States was the association between wealth and health substantially different from, and much greater than that in the other five countries. The findings suggest that private-based healthcare system in the U.S. is likely to promote stronger positive associations between wealth and health. Copyright © 2014 Elsevier Ltd. All rights reserved.

  18. Real-Time RFID-Based Intelligent Healthcare Diagnosis System

    Science.gov (United States)

    Khosla, Rajiv; Chowdhury, Belal

    In a health care context, the use of RFID (Radio Frequency Identi- fication) technology can be employed for not only bringing down health care costs but also to facilitate automatic streamlining patient identification processes in health centers and assist medical practitioners in quick and accurate diagnosis and treatments. In this paper, we outline a describe design and application of RFID-based Real-time Intelligent Clinical Diagnosis and Treatment Support System (ICDTS) in health care.

  19. Space Medicine Issues and Healthcare Systems for Space Exploration Medicine

    Science.gov (United States)

    Scheuring, Richard A.; Jones, Jeff

    2007-01-01

    This viewgraph presentation reviews issues of health care in space. Some of the issues reviewed are: (1) Physiological adaptation to microgravity, partial gravity, (2) Medical events during spaceflight, (3) Space Vehicle and Environmental and Surface Health Risks, (4) Medical Concept of Operations (CONOPS), (4a) Current CONOPS & Medical Hardware for Shuttle (STS) and ISS, (4b) Planned Exploration Medical CONOPS & Hardware needs, (5) Exploration Plans for Lunar Return Mission & Mars, and (6) Developing Medical Support Systems.

  20. Public Address Systems. Specifications - Installation - Operation.

    Science.gov (United States)

    Palmer, Fred M.

    Provisions for public address in new construction of campus buildings (specifications, installations, and operation of public address systems), are discussed in non-technical terms. Consideration is given to microphones, amplifiers, loudspeakers and the placement and operation of various different combinations. (FS)

  1. Health insurance coverage, income distribution and healthcare quality in local healthcare markets.

    Science.gov (United States)

    Damianov, Damian S; Pagán, José A

    2013-08-01

    We develop a theoretical model of a local healthcare system in which consumers, health insurance companies, and healthcare providers interact with each other in markets for health insurance and healthcare services. When income and health status are heterogeneous, and healthcare quality is associated with fixed costs, the market equilibrium level of healthcare quality will be underprovided. Thus, healthcare reform provisions and proposals to cover the uninsured can be interpreted as an attempt to correct this market failure. We illustrate with a numerical example that if consumers at the local level clearly understand the linkages between health insurance coverage and the quality of local healthcare services, health insurance coverage proposals are more likely to enjoy public support.

  2. Impact of China's Public Hospital Reform on Healthcare Expenditures and Utilization: A Case Study in ZJ Province.

    Directory of Open Access Journals (Sweden)

    Hao Zhang

    Full Text Available High drug costs due to supplier-induced demand (SID obstruct healthcare accessibility in China. Drug prescriptions can generate markup-related profits, and the low prices of other medical services can lead to labor-force underestimations; therefore, physicians are keen to prescribe drugs rather than services. Thus, in China, a public hospital reform has been instituted to cancel markups and increase service prices.A retrospective pre/post-reform study was conducted in ZJ province to assess the impact of the reform on healthcare expenditures and utilization, ultimately to inform policy development and decision-making. The main indicators are healthcare expenditures and utilization.Post-reform, drug expenditures per visit decreased by 8.2% and 15.36% in outpatient and inpatient care, respectively; service expenditures per visit increased by 23.03% and 27.69% in outpatient and inpatient care, respectively. Drug utilization per visit increased by 5.58% in outpatient care and underwent no significant change in inpatient care. Both were lower than the theoretical drug-utilization level, which may move along the demand curve because of patient-initiated demand (PID; this indicates that SID-promoted drug utilization may decrease. Finally, service utilization per visit increased by 6% in outpatient care and by 13.10% in inpatient care; both were higher than the theoretical level moving along the demand curve, and this indicates that SID-promoted service utilization may increase.The reform reduces drug-prescription profits by eliminating drug markups; additionally, it compensates for service costs by increasing service prices. Post-reform, the SID of drug prescriptions decreased, which may reduce drug-resource waste. The SID of services increased, with potentially positive and negative effects: accessibility to services may be promoted when physicians provide more services, but the risk of resource waste may also increase. This warrants further research

  3. Healthcare Data Gateways: Found Healthcare Intelligence on Blockchain with Novel Privacy Risk Control.

    Science.gov (United States)

    Yue, Xiao; Wang, Huiju; Jin, Dawei; Li, Mingqiang; Jiang, Wei

    2016-10-01

    Healthcare data are a valuable source of healthcare intelligence. Sharing of healthcare data is one essential step to make healthcare system smarter and improve the quality of healthcare service. Healthcare data, one personal asset of patient, should be owned and controlled by patient, instead of being scattered in different healthcare systems, which prevents data sharing and puts patient privacy at risks. Blockchain is demonstrated in the financial field that trusted, auditable computing is possible using a decentralized network of peers accompanied by a public ledger. In this paper, we proposed an App (called Healthcare Data Gateway (HGD)) architecture based on blockchain to enable patient to own, control and share their own data easily and securely without violating privacy, which provides a new potential way to improve the intelligence of healthcare systems while keeping patient data private. Our proposed purpose-centric access model ensures patient own and control their healthcare data; simple unified Indicator-Centric Schema (ICS) makes it possible to organize all kinds of personal healthcare data practically and easily. We also point out that MPC (Secure Multi-Party Computing) is one promising solution to enable untrusted third-party to conduct computation over patient data without violating privacy.

  4. A low-power RFID integrated circuits for intelligent healthcare systems.

    Science.gov (United States)

    Lee, Shuenn-Yuh; Wang, Liang-Hung; Fang, Qiang

    2010-11-01

    This paper presents low-power radio-frequency identification (RFID) technology for intelligent healthcare systems. With attention to power-efficient communication in the body sensor network, RF power transfer was estimated and the required low-power ICs, which are important in the development of a healthcare system with miniaturization and system integration, are discussed based on the RFID platform. To analyze the power transformation, this paper adopts a 915-MHz industrial, scientific, and medical RF with a radiation power of 70 mW to estimate the power loss under the 1-m communication distance between an RFID reader (bioinformation node) and a transponder (biosignal acquisition nodes). The low-power ICs of the transponder will be implemented in the TSMC 0.18-μm CMOS process. The simulation result reveals that the transponder's IC can fit in with the link budget of the UHF RFID system.

  5. Injustice to transsexual women in a hetero-normatie healthcare system

    Directory of Open Access Journals (Sweden)

    Douglas Newman-Valentine

    2014-01-01

    Full Text Available Background: Transsexual women who are on the journey of sexual re-alignment will experience various health problems. These problems are related directly to the treatment regime that they are following in order to attain and maintain their physical embodiment as a woman. They are forced to negotiate a hetero-normative healthcare system in order to receive assistance and care for their health problems related to their sexual re-alignment process.Aim: The questions posed were: What are the unique health problems that transsexual women experience whilst on the journey of sexual re-alignment? What is the current context of the South African healthcare system in which transsexual women should negotiate healthcare? These questions were asked in order to explore the health problems with which transsexual women are faced and to describe the hetero-normative healthcare system in South Africa.Method: An electronic literature search was executed via the EBSCO host with specifi inclusion and exclusion criteria. The search words that were used were: Transsexual/s and Health/Healthcare. All studies had to be peer reviewed and published in the English language, from January 1972 up until February 2013. Literature on transsexual children was excluded.Results: Transsexual women have the potential to suffer signifiant side-effects from their sexual re-alignment treatment, including cardio-vascular problems, endocrine problems and mental ill-health. They are also vulnerable to HIV infection. They have poor access to quality holistic healthcare and this may lead an increase in the mortality and morbidity fiures of women.Conclusion: A hetero-normative healthcare system has a negative impact on the health of transsexual women and will cause them to be marginalised. This could contribute to both homoand trans-phobia that will in turn strengthen the belief that transsexual women are un-African. Normal 0 false false false EN-ZA X-NONE X-NONE

  6. Injustice to transsexual women in a hetero-normatie healthcare system

    Directory of Open Access Journals (Sweden)

    Douglas Newman-Valentine

    2014-01-01

    Full Text Available Background: Transsexual women who are on the journey of sexual re-alignment will experience various health problems. These problems are related directly to the treatment regime that they are following in order to attain and maintain their physical embodiment as a woman. They are forced to negotiate a hetero-normative healthcare system in order to receive assistance and care for their health problems related to their sexual re-alignment process.Aim: The questions posed were: What are the unique health problems that transsexual women experience whilst on the journey of sexual re-alignment? What is the current context of the South African healthcare system in which transsexual women should negotiate healthcare? These questions were asked in order to explore the health problems with which transsexual women are faced and to describe the hetero-normative healthcare system in South Africa.Method: An electronic literature search was executed via the EBSCO host with specifi inclusion and exclusion criteria. The search words that were used were: Transsexual/s and Health/Healthcare. All studies had to be peer reviewed and published in the English language, from January 1972 up until February 2013. Literature on transsexual children was excluded.Results: Transsexual women have the potential to suffer signifiant side-effects from their sexual re-alignment treatment, including cardio-vascular problems, endocrine problems and mental ill-health. They are also vulnerable to HIV infection. They have poor access to quality holistic healthcare and this may lead an increase in the mortality and morbidity fiures of women.Conclusion: A hetero-normative healthcare system has a negative impact on the health of transsexual women and will cause them to be marginalised. This could contribute to both homoand trans-phobia that will in turn strengthen the belief that transsexual women are un-African. Normal 0 false false false EN-ZA X-NONE X-NONE

  7. An Untapped Resource: Patient and Public Involvement in Implementation Comment on "Knowledge Mobilization in Healthcare Organizations: A View From the Resource-Based View of the Firm".

    Science.gov (United States)

    Burton, Christopher; Rycroft-Malone, Jo

    2015-08-07

    This commentary considers the potential role of patient and public involvement in implementation. Developing an analytical thread from the resource-based view of the Firm, we argue that this involvement may create unique resources that have the capacity to enhance the impact of implementation activity for healthcare organisations.

  8. A strategy toward reconstructing the healthcare system of a unified Korea.

    Science.gov (United States)

    Lee, Yo Han; Yoon, Seok-Jun; Kim, Seok Hyang; Shin, Hyun-Woung; Lee, Jin Yong; Kim, Beomsoo; Kim, Young Ae; Yoon, Jangho; Shin, Young Seok

    2013-05-01

    This road map aims to establish a stable and integrated healthcare system for the Korean Peninsula by improving health conditions and building a foundation for healthcare in North Korea through a series of effective healthcare programs. With a basic time frame extending from the present in stages towards unification, the roadmap is composed of four successive phases. The first and second phases, each expected to last five years, respectively, focus on disease treatment and nutritional treatment. These phases would thereby safeguard the health of the most vulnerable populations in North Korea, while fulfilling the basic health needs of other groups by modernizing existing medical facilities. Based on the gains of the first two phases, the third phase, for ten years, would prepare for unification of the Koreas by promoting the health of all the North Korean people and improving basic infrastructural elements such as health workforce capacity and medical institutions. The fourth phase, assuming that unification will take place, provides fundamental principles and directions for establishing an integrated healthcare system across the Korean Peninsula. We are hoping to increase the consistency of the program and overcome several existing concerns of the current program with this roadmap.

  9. Ensuring the security and privacy of information in mobile health-care communication systems

    Directory of Open Access Journals (Sweden)

    Ademola P. Abidoye

    2011-09-01

    Full Text Available The sensitivity of health-care information and its accessibility via the Internet and mobile technology systems is a cause for concern in these modern times. The privacy, integrity and confidentiality of a patient’s data are key factors to be considered in the transmission of medical information for use by authorised health-care personnel. Mobile communication has enabled medical consultancy, treatment, drug administration and the provision of laboratory results to take place outside the hospital. With the implementation of electronic patient records and the Internet and Intranets, medical information sharing amongst relevant health-care providers was made possible. But the vital issue in this method of information sharing is security: the patient’s privacy, as well as the confidentiality and integrity of the health-care information system, should not be compromised. We examine various ways of ensuring the security and privacy of a patient’s electronic medical information in order to ensure the integrity and confidentiality of the information.

  10. Challenges of managing people with multimorbidity in today's healthcare systems.

    Science.gov (United States)

    Moffat, Keith; Mercer, Stewart W

    2015-10-14

    Multimorbidity is a growing issue and poses a major challenge to health care systems around the world. Multimorbidity is related to ageing but many studies have now shown that it is also socially patterned, being more common and occurring at an earlier age in areas of high socioeconomic deprivation. There is lack of research on patients with multimorbidity, and thus guidelines are based on single-conditions. Polypharmacy is common in multimorbidity, increasing drug-disease and drug-drug interactions. Multimorbid patients need holistic care, but secondary care services are highly specialised and thus are often duplicative and fragmented and thus increase treatment burden in multimorbid patients. The cost of care is high in multimorbidity, due to high rates of primary and secondary care consultations and unplanned hospital admissions. The combination of mental and physical conditions increases complexity of care, and costs. Mental-physical multimorbidity is especially common in deprived areas.General practitioners and primary care teams have a key role in managing patients with multimorbidity, using a patient-centred generalist approach. Consultation length and continuity of care may need to be substantially enhanced in order to enable such patients. This will require a radical change in how health care systems are organised and funded in order to effectively meet the challenges of multimorbidity.

  11. Printable low-cost sensor systems for healthcare smart textiles

    Science.gov (United States)

    Rai, Pratyush; Kumar, Prashanth S.; Oh, Sechang; Kwon, Hyeokjun; Mathur, Gyanesh N.; Varadan, Vijay K.

    2011-04-01

    Smart textiles-based wearable health monitoring systems (ST-HMS) have been presented as elegant solutions to the requirements of individuals across a wide range of ages. They can be used to monitor young or elderly recuperating /convalescent patients either in hospital or at home, or they can be used by young athletes to monitor important physiological parameters to better design their training or fitness program. Business and academic interests, all over the world, have fueled a great deal of work in the development of this technology since 1990. However, two important impediments to the development of ST-HMS are:-integration of flexible electrodes, flexible sensors, signal conditioning circuits and data logging or wireless transmission devices into a seamless garment and a means to mass manufacture the same, while keeping the costs low. Roll-to-roll printing and screen printing are two low cost methods for large scale manufacturing on flexible substrates and can be extended to textiles as well. These two methods are, currently, best suited for planar structures. The sensors, integrated with wireless telemetry, facilitate development of a ST-HMS that allows for unobtrusive health monitoring. In this paper, we present our results with planar screen printable sensors based on conductive inks which can be used to monitor EKG, abdominal respiration effort, blood pressure, pulse rate and body temperature. The sensor systems were calibrated, and tested for sensitivity, reliability and robustness to ensure reuse after washing cycles.

  12. Organisational culture: pursuing a theoretical foundation within the Finnish public oral health-care context.

    Science.gov (United States)

    Kasila, Kirsti; Poskiparta, Marita

    2004-01-01

    At the moment, Finnish oral health care is undergoing many changes. Little attention has been paid to issues of organisational culture and communication in Finnish oral health care. Yet the question of culture is of primary importance for changes in an organisation and for planning and reconstructing the rational functioning of an organisation. The purpose of this paper is to examine Finnish public oral health care within a theoretical framework of organisational culture and to identify the various cultural traits that appear to characterise Finnish oral health care. Using a cultural point of view, we develop an orientation for understanding more profoundly and specifically the processes concerning the functioning and change of oral health care.

  13. Healthcare during the pregnancy-puerperium cycle from the perspective of public service users¹

    Directory of Open Access Journals (Sweden)

    Cristina Maria Garcia de Lima Parada

    2008-01-01

    Full Text Available The aim of this paper was to apprehend the social representations of puerperal women about prenatal, childbirth and puerperal period health care, in a public health service regional context in São Paulo state. The qualitative research approach and Collective Subject Speech were used. Data collection was held by semi-structured interviews, led in 20 municipalities of XI Regional Health Administration Office of Botucatu/SP, in 2004. The humanization look under the social representations apprehended and analyzed makes evident the importance of new directions in politics and regional practices for the puerperal-pregnancy cycle, specially in interpersonal relationships; the essentiality of technical quality in service and the perception of woman as the subject of attention and, as so, must effectively take part in it.

  14. Epigenetics: Its Understanding Is Crucial to a Sustainable Healthcare System

    Directory of Open Access Journals (Sweden)

    Michelle Thunders

    2015-04-01

    Full Text Available Understanding the molecular impact of lifestyle factors has never been so important; a period in time where there are so many adults above retirement age has been previously unknown. As a species, our life expectancy is increasing yet the period of our lives where we enjoy good health is not expanding proportionately. Over the next 50 years we will need to almost double the percentage of GDP spent on health care, largely due to the increasing incidence of obesity related chronic diseases. A greater understanding and implementation of an integrated approach to health is required. Research exploring the impact of nutritional and exercise intervention on the epigenetically flexible genome is up front in terms of addressing healthy aging. Alongside this, we need a greater understanding of the interaction with our immune and nervous systems in preserving and maintaining health and cognition.

  15. Impact of Publicly Financed Health Insurance Schemes on Healthcare Utilization and Financial Risk Protection in India: A Systematic Review.

    Science.gov (United States)

    Prinja, Shankar; Chauhan, Akashdeep Singh; Karan, Anup; Kaur, Gunjeet; Kumar, Rajesh

    2017-01-01

    Several publicly financed health insurance schemes have been launched in India with the aim of providing universalizing health coverage (UHC). In this paper, we report the impact of publicly financed health insurance schemes on health service utilization, out-of-pocket (OOP) expenditure, financial risk protection and health status. Empirical research studies focussing on the impact or evaluation of publicly financed health insurance schemes in India were searched on PubMed, Google scholar, Ovid, Scopus, Embase and relevant websites. The studies were selected based on two stage screening PRISMA guidelines in which two researchers independently assessed the suitability and quality of the studies. The studies included in the review were divided into two groups i.e., with and without a comparison group. To assess the impact on utilization, OOP expenditure and health indicators, only the studies with a comparison group were reviewed. Out of 1265 articles screened after initial search, 43 studies were found eligible and reviewed in full text, finally yielding 14 studies which had a comparator group in their evaluation design. All the studies (n-7) focussing on utilization showed a positive effect in terms of increase in the consumption of health services with introduction of health insurance. About 70% studies (n-5) studies with a strong design and assessing financial risk protection showed no impact in reduction of OOP expenditures, while remaining 30% of evaluations (n-2), which particularly evaluated state sponsored health insurance schemes, reported a decline in OOP expenditure among the enrolled households. One study which evaluated impact on health outcome showed reduction in mortality among enrolled as compared to non-enrolled households, from conditions covered by the insurance scheme. While utilization of healthcare did improve among those enrolled in the scheme, there is no clear evidence yet to suggest that these have resulted in reduced OOP expenditures or

  16. Impact of Publicly Financed Health Insurance Schemes on Healthcare Utilization and Financial Risk Protection in India: A Systematic Review

    Science.gov (United States)

    Chauhan, Akashdeep Singh; Karan, Anup; Kaur, Gunjeet; Kumar, Rajesh

    2017-01-01

    Several publicly financed health insurance schemes have been launched in India with the aim of providing universalizing health coverage (UHC). In this paper, we report the impact of publicly financed health insurance schemes on health service utilization, out-of-pocket (OOP) expenditure, financial risk protection and health status. Empirical research studies focussing on the impact or evaluation of publicly financed health insurance schemes in India were searched on PubMed, Google scholar, Ovid, Scopus, Embase and relevant websites. The studies were selected based on two stage screening PRISMA guidelines in which two researchers independently assessed the suitability and quality of the studies. The studies included in the review were divided into two groups i.e., with and without a comparison group. To assess the impact on utilization, OOP expenditure and health indicators, only the studies with a comparison group were reviewed. Out of 1265 articles screened after initial search, 43 studies were found eligible and reviewed in full text, finally yielding 14 studies which had a comparator group in their evaluation design. All the studies (n-7) focussing on utilization showed a positive effect in terms of increase in the consumption of health services with introduction of health insurance. About 70% studies (n-5) studies with a strong design and assessing financial risk protection showed no impact in reduction of OOP expenditures, while remaining 30% of evaluations (n-2), which particularly evaluated state sponsored health insurance schemes, reported a decline in OOP expenditure among the enrolled households. One study which evaluated impact on health outcome showed reduction in mortality among enrolled as compared to non-enrolled households, from conditions covered by the insurance scheme. While utilization of healthcare did improve among those enrolled in the scheme, there is no clear evidence yet to suggest that these have resulted in reduced OOP expenditures or

  17. Retrenchment strategies and tactics for healthcare executives.

    Science.gov (United States)

    Muller, H J; Smith, H L

    1985-01-01

    Retrenchment is a problem confronting many public, private, and voluntary healthcare organizations. With budgetary restrictions in the public sector and the shift toward prospective payment systems and diagnosis-related reimbursement by third-party payors, healthcare executives must address several dilemmas and choices. Yet, retrenchment should not necessarily be viewed as a problem with limited alternatives. It may represent a time for capitalizing on opportunities and for creating innovation within healthcare institutions. Indeed, innovation may represent the only means for survival. This article evaluates the management strategies that transform retrenchment from a problem into an opportunity.

  18. The Imminent Healthcare and Emergency Care Crisis in Japan

    Directory of Open Access Journals (Sweden)

    Suzuki, Tetsuji

    2008-05-01

    Full Text Available Objectives: Japan has a universal healthcare system, and this paper describes the reality of the healthcare services provided, as well as current issues with the system.Methods: Academic, government, and press reports on Japanese healthcare systems and healthcare guidelines were reviewed.Results: The universal healthcare system of Japan is considered internationally to be both low-cost and effective because the Japanese population enjoys good health status with a long life expectancy, while healthcare spending in Japan is below the average given by the Organization for Economic Corporation and Development (OECD. However, in many regions of Japan the existing healthcare resources are seriously inadequate, especially with regard to the number of physicians and other health professionals. Because healthcare is traditionally viewed as “sacred” work in Japan, healthcare professionals are expected to make large personal sacrifices. Also, public attitudes toward medical malpractice have changed in recent decades, and medical professionals are facing legal issues without experienced support of the government or legal professionals. Administrative response to the lack of resources and collaboration among communities are beginning, and more efficient control and management of the healthcare system is under consideration.Conclusion: The Japanese healthcare system needs to adopt an efficient medical control organization to ease the strain on existing healthcare professionals and to increase the number of physicians and other healthcare resources. Rather than continuing to depend on healthcare professionals being able and willing to make personal sacrifices, the government, the public and medical societies must cooperate and support changes in the healthcare system.

  19. The Healthcare Administrator’s Desk Reference: A Managed Care and Health Care Contracting Dictionary for the Military Health System

    Science.gov (United States)

    1998-07-01

    Desk Reference 1 Running head : DICTIONARY The healthcare administrator’s desk reference: A managed care and healthcare contracting dictionary for...Berkowitz, E. N. (1996). Essentials of health care marketing . (4th ed.). Gaithersburg, MD: Aspen Publications. Borsos, D. (1998, October). Bid price...Mediation & Conciliation Service FMG Foreign Medical Graduate FMP 1. Family Member Prefix 2. Fair Market Price 3. Federal Personnel Manual FMS Foreign

  20. Healthcare financing: approaches and trends in India.

    Science.gov (United States)

    Bajpai, Vikas; Saraya, Anoop

    2010-01-01

    Despite the importance of healthcare for the well-being of society, there is little public debate in India on issues relating to it. The 'human capital approach' to finance healthcare largely relies on private investment in health, while the 'human development approach' envisages the State as the guarantorof preventive as well as curative care to achieve universalization of healthcare. The prevailing health indices of India and challenges in the field of public health require a human developmentapproach to healthcare. On the eve of independence, India adopted the human development approach, with the report of the Bhore Committee emphasizing the role of the State in the development and provision of healthcare. However, more recently, successive governments have moved towards the human capital approach. Instead of increasing state spending on health and expanding the public health infrastructure, the government has been relying more and more on the private sector. The public-private partnership has been touted as the new-age panacea for the ills of the Indian healthcare system. This approach has led to a stagnation of public health indices and a decrease in the access of the poor to healthcare.

  1. Media System, Public Knowledge and Democracy

    DEFF Research Database (Denmark)

    Curran, James; Iyengar, Shanto; Lund, Anker Brink;

    2009-01-01

    This article addresses the implications of the movement towards entertainment-centred, market-driven media by comparing what is reported and what the public knows in four countries with different media systems. The different systems are public service (Denmark and Finland), a `dual' model (UK...... consumption and contributes to a smaller within-nation knowledge gap between the advantaged and disadvantaged. But wider processes in society take precedence over the organization of the media in determining how much people know about public life...

  2. Wrestling With a Paradox: Complexity in Interoperability Standards Making for Healthcare Information Systems

    Science.gov (United States)

    Pittaway, Jeff; Archer, Norm

    Medical interventions are often delayed or erroneous when information needed for diagnosing or prescribing is missing or unavailable. In support of increased information flows, the healthcare industry has invested substantially in standards intended to specify, routinize, and make uniform the type and format of medical information in clinical healthcare information systems such as Electronic Medical Record systems (EMRs). However, fewer than one in four Canadian physicians have adopted EMRs. Deeper analysis illustrates that physicians may perceive value in standardized EMRs when they need to exchange information in highly structured situations among like participants and like environments. However, standards present restrictive barriers to practitioners when they face equivocal situations, unforeseen contingencies, or exchange information across different environments. These barriers constitute a compelling explanation for at least part of the observed low EMR adoption rates. Our recommendations to improve the perceived value of standardized clinical information systems espouse re-conceptualizing the role of standards to embrace greater flexibility in some areas.

  3. Ignorance is not bliss: The effect of systematic information on immigrants' knowledge of and satisfaction with the Danish healthcare system.

    Science.gov (United States)

    Jervelund, Signe Smith; Maltesen, Thomas; Wimmelmann, Camilla Lawaetz; Petersen, Jørgen Holm; Krasnik, Allan

    2017-03-01

    Suboptimal healthcare utilisation and lower satisfaction with the patient-doctor encounter among immigrants has been documented. Immigrants' lack of familiarity with the healthcare system has been proposed as an explanation for this. This study investigated whether a systematic delivery of information affected immigrants' knowledge of and satisfaction with the Danish healthcare system. A prospective, randomised intervention study of 1158 adult immigrants attending two language schools in Copenhagen was conducted. Two intervention groups received written information or a 12-hour course on the Danish healthcare system, while a control group received nothing. Survey data included self-assessed knowledge, true/false questions on access and questions relating to satisfaction with the healthcare system. Data were linked to socioeconomic registry data. Logistic regression analyses were performed. The course improved knowledge of who to contact in the event of an accident (odds ratio (OR) = 2.67, 95% confidence interval (CI) = 1.56-4.59) but not in the event of illness. Further, it positively affected correct answers for nine out of 11 questions on the healthcare system (varying from OR = 1.87, 95% CI = 1.08-3.24 to OR = 3.11, 95% CI = 1.58-6.11). Written information positively affected correct answers for three out of 11 questions, but negatively affected one out of 11 compared with the control group. Neither intervention affected immigrants' satisfaction with the healthcare system. Knowledge of the healthcare system is necessary for optimal healthcare-seeking behaviour. The results may form the basis of national and international changes in immigrant reception and optimise immigrants' contact with the healthcare system.

  4. A cloud-based X73 ubiquitous mobile healthcare system: design and implementation.

    Science.gov (United States)

    Ji, Zhanlin; Ganchev, Ivan; O'Droma, Máirtín; Zhang, Xin; Zhang, Xueji

    2014-01-01

    Based on the user-centric paradigm for next generation networks, this paper describes a ubiquitous mobile healthcare (uHealth) system based on the ISO/IEEE 11073 personal health data (PHD) standards (X73) and cloud computing techniques. A number of design issues associated with the system implementation are outlined. The system includes a middleware on the user side, providing a plug-and-play environment for heterogeneous wireless sensors and mobile terminals utilizing different communication protocols and a distributed "big data" processing subsystem in the cloud. The design and implementation of this system are envisaged as an efficient solution for the next generation of uHealth systems.

  5. Evaluation and implementation of QR Code Identity Tag system for Healthcare in Turkey

    OpenAIRE

    UZUN, Vassilya; BILGIN, Sami

    2016-01-01

    For this study, we designed a QR Code Identity Tag system to integrate into the Turkish healthcare system. This system provides QR code-based medical identification alerts and an in-hospital patient identification system. Every member of the medical system is assigned a unique QR Code Tag; to facilitate medical identification alerts, the QR Code Identity Tag can be worn as a bracelet or necklace or carried as an ID card. Patients must always possess the QR Code Identity bracelets within hospi...

  6. Geospatial Information System Analysis of Healthcare Need and Telemedicine Delivery in California.

    Science.gov (United States)

    Kaufman, Taylor; Geraghty, Estella M; Dullet, Navjit; King, Jesse; Kissee, Jamie; Marcin, James P

    2017-05-01

    Geospatial Information Systems (GIS) superimpose data on geographical maps to provide visual representations of data by region. Few studies have used GIS data to investigate if telemedicine services are preferentially provided to communities of greatest need. This study compared the healthcare needs of communities with and without telemedicine services from a university-based telemedicine program. Originating sites for all telemedicine consultations between July 1996 and December 2013 were geocoded using ArcGIS software. ZIP Code Tabulation Areas (ZCTAs) were extracted from the 2010 U.S. Census Bureau's Topologically Integrated Geographic Encoding and Referencing file and assigned a community needs index (CNI) score to reflect the ZCTA community's healthcare needs based on evidence-based barriers to healthcare access. CNI scores were compared across communities with and without active telemedicine services. One hundred ninety-four originating telemedicine clinic sites in California were evaluated. The mean CNI score for ZCTAs with at least one telemedicine clinic was significantly higher (3.32 ± 0.84) than those without a telemedicine site (2.95 ± 0.99) and higher than the mean ZCTAs for all of California (2.99 ± 1.01). Of the 194 telemedicine clinics, 71.4% were located in communities with above average need and 33.2% were located in communities with very high needs. Originating sites receiving telemedicine services from a university-based telemedicine program were located in regions with significantly higher community healthcare needs. Leveraging a geospatial information system to understand community healthcare needs provides an opportunity for payers, hospitals, and patients to be strategic in the allocation of telemedicine services.

  7. An RF-based wearable sensor system for indoor tracking to facilitate efficient healthcare management.

    Science.gov (United States)

    Yuzhe Ouyang; Shan, Kai; Bui, Francis Minhthang

    2016-08-01

    To understand the utilization of clinical resources and improve the efficiency of healthcare, it is often necessary to accurately locate patients and doctors in a healthcare facility. However, existing tracking methods, such as GPS, Wi-Fi and RFID, have technological drawbacks or impose significant costs, thus limiting their applications in many clinical environments, especially those with indoor enclosures. This paper proposes a low-cost and flexible tracking system that is well suited for operating in an indoor environment. Based on readily available RF transceivers and microcontrollers, our wearable sensor system can facilitate locating users (e.g., patients or doctors) or objects (e.g., medical devices) in a building. The strategic construction of the sensor system, along with a suitably designed tracking algorithm, together provide for reliability and dispatch in localization performance. For demonstration purposes, several simplified experiments, with different configurations of the system, are implemented in two testing rooms to assess the baseline performance. From the obtained results, our system exhibits immense promise in acquiring a user location and corresponding time-stamp, with high accuracy and rapid response. This capability is conducive to both short- and long-term data analytics, which are crucial for improving healthcare management.

  8. Levelling vs competition – political trend reversal in the German healthcare system?

    Directory of Open Access Journals (Sweden)

    Sascha Wolf

    2014-12-01

    Full Text Available For almost 20 years, the German federal government has declared that competition is the key to ensuring the financial sustainability of the healthcare system. The aim of this paper is to investigate if German government indeed has followed a direct path to enhancing competition. For this purpose, a qualitative analysis of the most important healthcare reform acts has been conducted. In conclusion, especially since the introduction of the Health Fund in 2009, a clear trend towards more levelling and regulation can be observed. This trend is confirmed by the most recent healthcare reform act in June 2014. The abolishment of flat-rate premiums is the expression of the government’s fear that competitive pressure could endanger the solvency and viability of sickness funds (statutory health insurance funds. In contrast, on the market for selective contracts, an ambivalent picture emerges. On the one hand, several possibilities for establishing new forms of healthcare and strengthening competition have been introduced. On the other hand, sickness funds as well as service providers are often reluctant to enter into selective contracts.

  9. Cancer management: the difficulties of a target-driven healthcare system.

    Science.gov (United States)

    Anderson, Beverley

    This article gives a reflective overview on cancer management from a urological perspective. It is based on anecdotal evidence and observations of local practice, and highlights some of the inherent difficulties of delivering a robust service in a target-driven healthcare system. Cancer is a complex disease. It is crucial that stringent measures are used to ensure those affected by it receive care that is of the highest quality, delivered in a timely manner, and tailored to meet the individual's needs. In 2000, the Government's attempt to increase competition among healthcare providers in the delivery of care, and thereby healthcare quality and efficiency, resulted in a number of healthcare reforms being introduced in the UK. Central to these were the NHS Cancer Waiting Time standards, which were designed to fast-track care delivery in the management of cancer patients. The multidisciplinary teams play a pivotal role in this process and their contribution is imperative to achieving the desired outcomes. It is acknowledged that targets can be beneficial, but there are clear unintended consequences as well. Increases in urgent referrals result in significant screening demands and, consequently, newly diagnosed cancers. This, combined with factors such as patient choice and costs, put added pressure on NHS establishments and health professionals to deliver care within the target specifications.

  10. High rates of adherence and treatment success in a public and public-private HIV clinic in India: potential benefits of standardized national care delivery systems

    Directory of Open Access Journals (Sweden)

    Heylen Elsa

    2011-10-01

    Full Text Available Abstract Background The massive scale-up of antiretroviral treatment (ART access worldwide has brought tremendous benefit to populations affected by HIV/AIDS. Optimising HIV care in countries with diverse medical systems is critical; however data on best practices for HIV healthcare delivery in resource-constrained settings are limited. This study aimed to understand patient characteristics and treatment outcomes from different HIV healthcare settings in Bangalore, India. Methods Participants from public, private and public-private HIV healthcare settings were recruited between 2007 and 2009 and were administered structured interviews by trained staff. Self-reported adherence was measured using the visual analogue scale to capture adherence over the past month, and a history of treatment interruptions (defined as having missed medications for more than 48 hours in the past three months. In addition, CD4 count and viral load (VL were measured; genotyping for drug resistance-associated mutations was performed on those who were in virological failure (VL > 1000 copies/ml. Results A total of 471 individuals were included in the analysis (263 from the public facility, 149 from the public-private facility and 59 from the private center. Private facility patients were more likely to be male, with higher education levels and incomes. More participants reported ≥ 95% adherence among public and public-private groups compared to private participants (public 97%; private 88%; public-private 93%, p Conclusions Adherence and treatment success was significantly higher among patients from public and public-private settings compared with patients from private facilities. These results suggest a possible benefit of the standardized care delivery system established in public and public-private health facilities where counselling by a multi-disciplinary team of workers is integral to provision of ART. Strengthening and increasing public-private partnerships can

  11. Clinical characteristics of healthcare-associated pneumonia in a public hospital in a metropolitan area of Japan.

    Science.gov (United States)

    Sugisaki, Midori; Enomoto, Tatsuji; Shibuya, Yasuhiro; Matsumoto, Aki; Saitoh, Hitoshi; Shingu, Akiko; Narato, Ritsuko; Nomura, Koichiro

    2012-06-01

    Healthcare-associated pneumonia (HCAP) is a new category that is essential in the present aging society. Knowing the different characteristics and outcomes between patients with HCAP and community-acquired pneumonia (CAP) would help physicians manage and treat HCAP patients. Although HCAP is thought to be heterogeneous in regions, there are no reports from a metropolitan area in Japan. We retrospectively reviewed the clinical findings of all consecutive pneumonia patients who required hospitalized care in our hospital between April 2006 and March 2010. There were 184 (35.0%) patients with HCAP and 342 (65.0%) patients with CAP. Previous hospitalization within 90 days of the infection was the most common criterion for HCAP (63.0%). HCAP patients were significantly older than CAP patients (82.5 vs. 70.0 years, P nutritional status and high severity scores on the pneumonia severity scoring system.

  12. 'I think it will eventually be done away with': Attitudes among healthcare professionals towards the current system of animal experimentation.

    Science.gov (United States)

    Dignon, Andrée

    2016-08-01

    This article describes a study of attitudes to the current system of animal experimentation (for the production of health interventions) among 52 UK healthcare professionals. These healthcare professionals participated in three separate focus groups (of 18, 17 and 17 participants) and were invited to respond to the question 'what is your opinion about the current system of animal testing?' The study focused specifically on their views of the current system (rather than their views of animal testing in general). The healthcare professionals were critical of the current system, particularly with regard to regulation, secrecy, validity, unnecessary suffering and welfare. © The Author(s) 2014.

  13. Mining Association Rules in Big Data for E-healthcare Information System

    Directory of Open Access Journals (Sweden)

    N. Rajkumar

    2014-08-01

    Full Text Available Big data related to large volume, multiple ways of growing data sets and autonomous sources. Now the big data is quickly enlarged in many advanced domains, because of rapid growth in networking and data collection. The study is defining the E-Healthcare Information System, which needs to make logical and structural method of approaching the knowledge. And also effectually preparing and controlling the data generated during the diagnosis activities of medical application through sharing information among E-Healthcare Information System devices. The main objective is, A E-Healthcare Information System which is extensive, integrated knowledge system designed to control all the views of a hospital operation, such as medical data’s, administrative, financial, legal information’s and the corresponding service processing. At last the analysis of result will be generated using Association Mining Techniques which processed from big data of hospital information datasets. Finally mining techniques result could be evaluated in terms of accuracy, precision, recall and positive rate.

  14. Traditional healthcare delivery systems in the 21st century Nigeria: moving beyond misconceptions.

    Science.gov (United States)

    Nwokocha, Ezebunwa E

    2008-03-01

    One of the most notable features of medicine in the later part of the preceding century were vigorous criticisms against traditional systems of healthcare delivery, almost to a point of suffocation. Although most of the issues raised to affirm the seemingly inadequate s