WorldWideScience

Sample records for underlying health care

  1. Health care under the Taliban.

    Science.gov (United States)

    Faiz, A

    1997-04-26

    When the Taliban swept into Kabul, Afghanistan in September 1996, they began a reign of terror over the people of that city, especially the women. Adhering to a fundamentalist interpretation of Islamic law, the group has severely restricted women's freedom of movement and access to health care, education, and employment. Some female physicians and nurses have been able to continue working because the Taliban has decreed that male doctors can not treat women patients unless they are their relatives. Female physicians and nurses have been subjected to beatings by armed Taliban guards who enforce "morals." Male and female doctors are viewed with suspicion by the Taliban and are routinely ridiculed in public. Women are attacked when they venture into the streets to seek medical care for themselves or their children, and a pregnant woman recently delivered her baby in the street while her husband was being beaten for trying to take her to the hospital. This interference with the delivery of health care has occurred at a time when many people require treatment for injuries inflicted in connection with the war and when the public utility system has collapsed. Few physicians are willing to discuss the patients they treat for injuries inflicted by the torturous Taliban, especially since some physicians have collaborated with the Taliban in order to avoid reprisals.

  2. Health care under transformation in Poland.

    Science.gov (United States)

    Tymowska, K

    2001-05-01

    The general health insurance introduced in Poland in 1999 is essentially a social insurance. In this article, the main features of the present health care system are discussed, i.e. the sources and principles of financing, ownership relations, structures, entitlements to obtain medical services and the rules of access to services. Emphasis has been put on the operations of various entities operating within the health care sector, including opportunistic conduct of the providers of services financed from public sources, cost dumping, establishing provider alliances, methods of cost control, and the fact that some patients leave the publicly financed system. In Poland, a parallel private system has been developing for many years. Systemic transformations have not changed that direction, but increased considerably the significance of household income and education as the factors that differentiate patient in equality. This article is concluded with the note on the opportunities for the development of supplementary private insurance.

  3. Equity in Access to Health Care Provision under the Medicare ...

    African Journals Online (AJOL)

    The main objective of this study was to assess equity in access to health care provision under the Medicare Security for Small Scale Entrepreneurs (SSE). Methodological triangulation was used to an exploratory and randomized cross- sectional study in order to supplement information on the topic under investigation.

  4. 42 CFR 1001.601 - Exclusion or suspension under a Federal or State health care program.

    Science.gov (United States)

    2010-10-01

    ... health care program. 1001.601 Section 1001.601 Public Health OFFICE OF INSPECTOR GENERAL-HEALTH CARE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OIG AUTHORITIES PROGRAM INTEGRITY-MEDICARE AND STATE HEALTH CARE PROGRAMS Permissive Exclusions § 1001.601 Exclusion or suspension under a Federal or State health care...

  5. The outcome of Mental Health Care Users admitted under Section ...

    African Journals Online (AJOL)

    Objective: To determine the outcomes of mental health care users (MHCU's) admitted in terms of Section 40 of the South African Mental Health Care Act (No 17 of 2002) (MHCA) and the factors, if any, that are associated with these outcomes. Method: The study was a retrospective record review of MHCU's, 18 years and ...

  6. New systems of care for substance use disorders: treatment, finance, and technology under health care reform.

    Science.gov (United States)

    Pating, David R; Miller, Michael M; Goplerud, Eric; Martin, Judith; Ziedonis, Douglas M

    2012-06-01

    This article outlined ways in which persons with addiction are currently underserved by our current health care system. However, with the coming broad scale reforms to our health care system, the access to and availability of high-quality care for substance use disorders will increase. Addiction treatments will continue to be offered through traditional substance abuse care systems, but these will be more integrated with primary care, and less separated as treatment facilities leverage opportunities to blend services, financing mechanisms, and health information systems under federally driven incentive programs. To further these reforms, vigilance will be needed by consumers, clinicians, and policy makers to assure that the unmet treatment needs of individuals with addiction are addressed. Embedded in this article are essential recommendations to facilitate the improvement of care for substance use disorders under health care reform. Ultimately, as addiction care acquires more of the “look and feel” of mainstream medicine, it is important to be mindful of preexisting trends in health care delivery overall that are reflected in recent health reform legislation. Within the world of addiction care, clinicians must move beyond their self-imposed “stigmatization” and sequestration of specialty addiction treatment. The problem for addiction care, as it becomes more “mainstream,” is to not comfortably feel that general slogans like “Treatment Works,” as promoted by Substance Abuse and Mental Health Services Administration’s Center for Substance Abuse Treatment during its annual Recovery Month celebrations, will meet the expectations of stakeholders outside the specialty addiction treatment community. Rather, the problem is to show exactly how addiction treatment works, and to what extent it works-there have to be metrics showing changes in symptom level or functional outcome, changes in health care utilization, improvements in workplace attendance and

  7. The new frontier of strategic alliances in health care: New partnerships under accountable care organizations.

    Science.gov (United States)

    Lewis, Valerie A; Tierney, Katherine I; Colla, Carrie H; Shortell, Stephen M

    2017-10-01

    Accountable care organizations (ACOs) and similar reforms aim to improve coordination between health care providers; however, due to the fragmented nature of the US health care system, successful coordination will hinge in large part on the ability of health care organizations to successfully partner across organizational boundaries. Little is known about new partnerships formed under the ACO model. We use mixed methods data from the National Survey of ACOs, Medicare ACO performance data and interviews with executive leaders across 31 ACOs to examine the prevalence, characteristics, and capabilities of partnership ACOs and why and how ACO partnerships form. We find that a striking percentage of ACOs - 81% - involve new partnerships between independent health care organizations. These "partnership ACOs" generally report lower capabilities on care management, care coordination, and health information technology. Additionally, under Medicare ACO programs partnership ACO achieved somewhat lower quality performance. Qualitative interviews revealed that providers are motivated to partner for resource complementarity, risk reduction, and legislative requirements, and are using a variety of formal and informal accountability mechanisms. Most partnership ACOs were formed out of existing, positive relationships, but a minority of ACOs formed out of previously competitive or conflictual relationships. Our findings suggests that the success of the ACO model will hinge in large part upon the success of new partnerships, with important implications for understanding ACO readiness and capabilities, the relatively small savings achieved to date by ACO programs, and the path to providers bearing more risk for population health management. In addition, ACO partnerships may provide an important window to monitor a potential wave of health care consolidation or, in contrast, a new model of independent providers successfully coordinating patient care. Copyright © 2017 Elsevier Ltd

  8. Comprehensive primary health care under neo-liberalism in Australia.

    Science.gov (United States)

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

    2016-11-01

    This paper applies a critical analysis of the impact of neo-liberal driven management reform to examine changes in Australian primary health care (PHC) services over five years. The implementation of comprehensive approaches to primary health care (PHC) in seven services: five state-managed and two non-government organisations (NGOs) was tracked from 2009 to 2014. Two questions are addressed: 1) How did the ability of Australian PHC services to implement comprehensive PHC change over the period 2009-2014? 2) To what extent is the ability of the PHC services to implement comprehensive PHC shaped by neo-liberal health sector reform processes? The study reports on detailed tracking and observations of the changes and in-depth interviews with 63 health service managers and practitioners, and regional and central health executives. The documented changes were: in the state-managed services (although not the NGOs) less comprehensive service coverage and more focus on clinical services and integration with hospitals and much less development activity including community development, advocacy, intersectoral collaboration and attention to the social determinants. These changes were found to be associated with practices typical of neo-liberal health sector reform: considerable uncertainty, more directive managerial control, budget reductions and competitive tendering and an emphasis on outputs rather than health outcomes. We conclude that a focus on clinical service provision, while highly compatible with neo-liberal reforms, will not on its own produce the shifts in population disease patterns that would be required to reduce demand for health services and promote health. Comprehensive PHC is much better suited to that task. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  9. Oral health in children in Denmark under different public dental health care schemes.

    Science.gov (United States)

    Christensen, L B; Petersen, P E; Hede, B

    2010-06-01

    To describe and analyse oral health of children and adolescents under two types of dental health care schemes under the Public Dental Health Service in Denmark, and to analyse possible influence of socio-economic and socio-cultural factors. Data on children's oral health status was obtained from public oral health registers and were pooled with data from questionnaires sent to parents of the children and adolescents. The study comprised individuals aged 5, 12 and 15, in total 2168 persons, randomly drawn from four municipalities with dental care provided by salaried dentists in public dental clinics and three municipalities with dental care provided by dentists in private practice. 70% of the parents completed a questionnaire including questions on socio-economic and socio-cultural background, lifestyle-related factors, self assessment of parents' oral- and general health. After the data were merged, the final study population represented 60% of the original target population. The mean caries experience (DMFS+dmfs) was 2.2 and further analysis of caries experience in each age group showed no variations in relation to type of provider of dental care. However, multiple dummy regression analyses demonstrated that low education, poor general health, foreign citizenship and smoking habits of the parents were important determinants for high level of caries in their children. Occurrence of dental caries as well as changes over time in levels of dental caries of Danish children did not vary by scheme of Public Dental Health Service, i.e. whether dental health care was provided by public employed dentists or by private practitioners. However, social inequalities still relate to caries experience in children and adolescents. Adjustment of preventive oral health activities strategy seems to be needed.

  10. Which moral hazard? Health care reform under the Affordable Care Act of 2010.

    Science.gov (United States)

    Mendoza, Roger Lee

    2016-06-20

    Purpose - Moral hazard is a concept that is central to risk and insurance management. It refers to change in economic behavior when individuals are protected or insured against certain risks and losses whose costs are borne by another party. It asserts that the presence of an insurance contract increases the probability of a claim and the size of a claim. Through the US Affordable Care Act (ACA) of 2010, this study seeks to examine the validity and relevance of moral hazard in health care reform and determine how welfare losses or inefficiencies could be mitigated. Design/methodology/approach - This study is divided into three sections. The first contrasts conventional moral hazard from an emerging or alternative theory. The second analyzes moral hazard in terms of the evolution, organization, management, and marketing of health insurance in the USA. The third explains why and how salient reform measures under the ACA might induce health care consumption and production in ways that could either promote or restrict personal health and safety as well as social welfare maximization. Findings - Insurance generally induces health care (over) consumption. However, not every additional consumption, with or without adverse selection, can be considered wasteful or risky, even if it might cost insurers more in the short run. Moral hazard can generate welfare and equity gains. These gains might vary depending on which ACA provisions, insured population, covered illnesses, treatments, and services, as well as health outcomes are taken into account, and because of the relative ambiguities surrounding definitions of "health." Actuarial risk models can nonetheless benefit from incorporating welfare and equity gains into their basic assumptions and estimations. Originality/value - This is the first study which examines the ACA in the context of the new or alternative theory of moral hazard. It suggests that containing inefficient moral hazard, and encouraging its desirable

  11. Health care transition from pediatric care to adult care: opportunities and challenges under the Affordable Care Act.

    Science.gov (United States)

    Webb, Lauren; Shah, Parag K; Harisiades, James P; Boudos, Rebecca; Agrawal, Rishi

    2015-01-01

    Enrollment of young adults is foundational to the success of the Affordable Care Act (ACA). This article analyzes the implications for young adults transitioning from pediatric to adult care with the implementation of the ACA. We review the key characteristics of this population relevant to health care utilization and access as well as the impact of private insurance market reforms, health insurance marketplaces, Medicaid expansion, and workforce development provisions on this population. We then analyze how reform is impacting and will continue to impact specific populations of young adults, including individuals with disabilities, college students, immigrants, young adults who age out of the foster care system and individuals involved with the criminal justice system. Finally, we look at the socio-economic and political factors influencing outreach efforts, and make recommendations to maximize the benefits of the law for young adults to empower them to have access to care and financial security.

  12. Parity for Mental Health and Substance Abuse Care Under Managed Care

    OpenAIRE

    Richard G. Frank; Thomas G. McGuire

    1998-01-01

    Background: Parity in insurance coverage for mental health and substance abuse has been a key goal of mental health and substance abuse care advocates in the United States during most of the past 20 years. The push for parity began during the era of indemnity insurance and fee for service payment when benefit design was the main rationing device in health care. The central economic argument for enacting legislation aimed at regulating the insurance benefit was to address market failure stemmi...

  13. Burnout of Physicians Working in Primary Health Care Centers under Ministry of Health Jeddah, Saudi Arabia.

    Science.gov (United States)

    Bawakid, Khalid; Abdulrashid, Ola; Mandoura, Najlaa; Shah, Hassan Bin Usman; Ibrahim, Adel; Akkad, Noura Mohammad; Mufti, Fauad

    2017-11-25

    Introduction The levels of physicians' job satisfaction and burnout directly affect their professionalism, punctuality, absenteeism, and ultimately, patients' care. Despite its crucial importance, little is known about professional burnout of the physicians in Saudi Arabia. The objectives of this research are two-fold: (1) To assess the prevalence of burnout in physicians working in primary health care centers under Ministry of Health; and (2) to find the modifiable factors which can decrease the burnout ratio. Methodology Through a cross-sectional study design, a representative sample of the physicians working in primary health care centers (PHCCs) Jeddah (n=246) was randomly selected. The overall burnout level was assessed using the validated abbreviated Maslach burnout inventory (aMBI) questionnaire. It measures the overall burnout prevalence based on three main domains i.e., emotional exhaustion, depersonalization, and personal accomplishment. Independent sample T-test, analysis of variance (ANOVA), and multivariate regression analysis were performed using Statistical Package for the Social Sciences (SPSS Version 22, IBM, Armonk, NY). Results Overall, moderate to high burnout was prevalent in 25.2% of the physicians. Emotional exhaustion was noted in 69.5%. Multivariate regression analysis showed that patient pressure/violence (p burnout. The patient's pressure/violence was the only significant independent predictor of overall burnout. Conclusion Emotional exhaustion is the most prominent feature of overall burnout in the physicians of primary health care centers. The main reasons include patient's pressure/violence, unorganized patient flow, less cooperative colleague doctors, fewer support services at the PHCCs, more paperwork, and less cooperative colleagues. Addressing these issues could lead to a decrease in physician's burnout.

  14. Viewpoint: Re-instating a 'public health' system under universal health care in India.

    Science.gov (United States)

    George, Mathew

    2015-02-01

    I examine possibilities for strengthening essential public health functions in the context of India's drive to implement universal health care. In a country where population health outcomes are rooted in social, political, economic, cultural, and ecological conditions, it is important to have a state mediated public health system that can modify the causes of the major public health problems. This calls for strengthening the social epidemiological approach in public health by demarcating public health functions distinct from medical care. This will be a prerequisite for the growth of the public health profession in the country, because it can offer avenues for newly trained professionals within the country to work in 'core' public health.

  15. "Recognizing rapport": health professionals' lived experience of caring for patients under transmission-based precautions in an Australian health care setting.

    Science.gov (United States)

    Godsell, Mary-Rose; Shaban, Ramon Z; Gamble, Jenny

    2013-11-01

    Preventing health care-associated infections is essential to the safety and quality of health care. Although patients' experience of care under isolation is well established, little is known of health care workers' experiences when providing such care. This study explored the health professionals; lived experience of caring for patients under transmission-based precautions. Interpretive phenomenology was used to examine 12 health care professionals' lived experience of providing care under transmission-based precautions in 3 health care facilities in Australia. Data were obtained from in-depth interviews and observations of health professionals. The essential phenomena of "recognizing rapport" represented the health professionals' lived experience. Three themes emerged starting with (1) relationships with others, their rapport and communication with patients, patients' families and visitors, and colleagues. These relationships are influenced by (2) barriers to practice, such as personal level of comfort when wearing personal protective equipment, physical limitations of the environment, and management of workload and resources. Such barriers influence (3) patient outcomes, namely the quality of the care provided and adverse events. In the context of caring for patients under transmission-based precautions, the relationships between health professionals and their patients are critical to the quality and safety of health care with respect to infection prevention and control. Copyright © 2013 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

  16. Burnout of Physicians Working in Primary Health Care Centers under Ministry of Health Jeddah, Saudi Arabia

    Science.gov (United States)

    Bawakid, Khalid; Mandoura, Najlaa; Shah, Hassan Bin Usman; Ibrahim, Adel; Akkad, Noura Mohammad; Mufti, Fauad

    2017-01-01

    Introduction The levels of physicians' job satisfaction and burnout directly affect their professionalism, punctuality, absenteeism, and ultimately, patients' care. Despite its crucial importance, little is known about professional burnout of the physicians in Saudi Arabia. The objectives of this research are two-fold: (1) To assess the prevalence of burnout in physicians working in primary health care centers under Ministry of Health; and (2) to find the modifiable factors which can decrease the burnout ratio. Methodology Through a cross-sectional study design, a representative sample of the physicians working in primary health care centers (PHCCs) Jeddah (n=246) was randomly selected. The overall burnout level was assessed using the validated abbreviated Maslach burnout inventory (aMBI) questionnaire. It measures the overall burnout prevalence based on three main domains i.e., emotional exhaustion, depersonalization, and personal accomplishment. Independent sample T-test, analysis of variance (ANOVA), and multivariate regression analysis were performed using Statistical Package for the Social Sciences (SPSS Version 22, IBM, Armonk, NY). Results Overall, moderate to high burnout was prevalent in 25.2% of the physicians. Emotional exhaustion was noted in 69.5%. Multivariate regression analysis showed that patient pressure/violence (p <0.001), unorganized patients flow to clinics (p=0.021), more paperwork (p<0.001), and less co-operative colleague doctors (p=0.045) were the significant predictors for high emotional exhaustion. A positive correlation was noted between the number of patients per day and burnout. The patient’s pressure/violence was the only significant independent predictor of overall burnout. Conclusion Emotional exhaustion is the most prominent feature of overall burnout in the physicians of primary health care centers. The main reasons include patient’s pressure/violence, unorganized patient flow, less cooperative colleague doctors, fewer

  17. 75 FR 8927 - Autism Services Demonstration Project for TRICARE Beneficiaries Under the Extended Care Health...

    Science.gov (United States)

    2010-02-26

    ... DEPARTMENT OF DEFENSE Office of the Secretary Autism Services Demonstration Project for TRICARE... Access to Autism Services Demonstration Project under the Extended Care Health Option for beneficiaries diagnosed with an Autism Spectrum Disorder (ASD). Under the demonstration, the Department implemented a...

  18. Mental health care in China: providing services for under-treated patients.

    Science.gov (United States)

    Qian, Jiwei

    2012-12-01

    Mental health in China is a great concern given the large number of patients and huge social and economic costs. The one-month prevalence rate of adult mental disorder in China is about 17.5%. Over 170 million adults have one or more types of mental disorder. Of this, 16 million people are estimated to have serious mental diseases. Over 90% of patients with serious mental diseases in China have not been given proper medical treatment. Over 60% of suicide cases in China are associated with mental disorders and suicide is the most significant reason for death between 19 and 34 years old in China. This paper reviews the mental health care condition in China and discusses policy implications, given current import issues for mental health care. We review research literature for mental health care in China and collect reports from various published sources. Under-supply of the mental health services is the most pivotal issue for policymakers. The utilization of mental health care services in China has increased by double digits in recent years. In 2011, outpatient visits for mental health care were over 27 million. The situation is aggravated by the lack of qualified doctors and the shortage of physical infrastructures such as wards and equipment, leading to many patients with mental disorders being under-treated and under-reported. There are only 1.46 psychiatrists per 100,000 people and 15 beds per 100,000 people. Current government input for mental health in China accounts for less than 1% of total health expenditure. According to the 12th Five-Year Program (2011-2015), the Chinese government will increase its spending on the prevention and treatment of mental health care. The mental health law has been passed by the National People's Congress in October, 2012 and will come into effect on May 1st, 2013. The financial coverage of patients with mental diseases and relevant regulations for involuntary admission are still being debated. Three more issues are discussed

  19. Children's environmental health: an under-recognised area in paediatric health care.

    Science.gov (United States)

    Gavidia, Tania G; Pronczuk de Garbino, Jenny; Sly, Peter D

    2009-02-06

    The knowledge that the environment in which we live, grow and play, can have negative or positive impacts on our health and development is not new. However the recognition that adverse environments can significantly and specifically affect the growth and development of a child from early intrauterine life through to adolescence, as well as impact their health later in adulthood, is relatively recent and has not fully reached health care providers involved in paediatric care.Over the past 15 years, world declarations and statements on children's rights, sustainable development, chemical safety and most recently climate change, have succeeded in cultivating a global focus on children's health and their right to a healthy environment. Many international calls for research in the area, have also been able to identify patterns of environmental diseases in children, assess children's exposures to many environmental toxicants, identify developmental periods of vulnerability, and quantify the cost benefits to public health systems and beyond, of addressing environmentally related diseases in children. Transferring this information to front-line health care providers and increasing their awareness about the global burden of disease attributed to the environment and children's special vulnerability to environmental threats is the salient aim of this commentary.

  20. Consumer-directed health care for persons under 65 years of age with private health insurance: United States, 2007.

    Science.gov (United States)

    Cohen, Robin A; Martinez, Michael E

    2009-03-01

    Data from the National Health Interview Survey. In 2007, 17.3% of persons under 65 years of age with private health insurance were enrolled in a high deductible health plan (HDHP), 4.5% were enrolled in a consumer-directed health plan (CDHP), and 14.8% were in a family with a flexible spending account for medical expenses (FSA); Persons with directly purchased private health insurance were more likely to be enrolled in a high deductible plan than those who obtained their private health insurance through an employer or union; Higher incomes and higher educational attainment were associated with greater uptake and enrollment in HDHPs, CDHPs, and FSAs. National attention to consumer-directed health care has increased following the enactment of the Medicare Prescription Drug Improvement and Modernization Act of 2003 (P.L. 108-173), which established tax-advantaged health savings accounts (1). Consumer-directed health care enables individuals to have more control over when and how they access care, what types of care they use, and how much they spend on health care services. This report includes estimates of three measures of consumer-directed private health care. Estimates for 2007 are provided for enrollment in high deductible health plans (HDHPs), plans with high deductibles coupled with health savings accounts also known as consumer-directed health plans (CDHPs), and the percentage of individuals with private coverage whose family has a flexible spending account (FSA) for medical expenses, by selected sociodemographic characteristics. All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.

  1. Social capital and preventive care use among the elderly under Taiwan's National Health Insurance.

    Science.gov (United States)

    Peng, Yu-I; Lin, Tsui-Fang

    The National Health Insurance (NHI) system in Taiwan provides free annual preventive care services and other disease-specific preventive care services under low copayments to people aged 65 and older, yet their utilization rates remain low ever since implementation. This study investigates whether social capital is associated with preventive care use among people aged 65 and older. Using the 2009 National Health Interview Study, this study measures social capital by the elderly's social network and social participation, and employs the logistic regressions to estimate the association between social capital and the odds of using a variety of preventive care services. The results show that social capital in terms of social network and social participation is significantly associated with the use of NHI general preventive care services. For disease-specific preventive care, it is social participation, rather than social network, that is related to the utilization rate. The associations between social capital and different types of preventive care use found in our study could be considered as an important factor when making policies to promote the utilization of preventive care. Copyright © 2017 Elsevier B.V. All rights reserved.

  2. Californians newly eligible for Medi-Cal under health care reform.

    Science.gov (United States)

    Pourat, Nadereh; Martinez, Ana E; Kominski, Gerald F

    2011-05-01

    About 2.13 million nonelderly Californians who were uninsured for all or part of 2009 are newly-eligible for Medi-Cal under the Patient Protection and Affordable Care Act (ACA) of 2010. Analysis of the 2009 California Health Interview Survey indicates that this newly-eligible population is often single, working-age and employed. Their rates of most chronic conditions are similar to those currently enrolled in Medi-Cal, but they have less access to care. The characteristics of the population of the newly-eligible for Medi-Cal under ACA are likely to change by 2014 when the major provisions of the law are fully implemented. However, coverage of this newly-eligible low-income population is likely to improve their access to health services.

  3. Toward a Unified Integration Approach: Uniting Diverse Primary Care Strategies Under the Primary Care Behavioral Health (PCBH) Model.

    Science.gov (United States)

    Sandoval, Brian E; Bell, Jennifer; Khatri, Parinda; Robinson, Patricia J

    2017-12-12

    Primary care continues to be at the center of health care transformation. The Primary Care Behavioral Health (PCBH) model of service delivery includes patient-centered care delivery strategies that can improve clinical outcomes, cost, and patient and primary care provider satisfaction with services. This article reviews the link between the PCBH model of service delivery and health care services quality improvement, and provides guidance for initiating PCBH model clinical pathways for patients facing depression, chronic pain, alcohol misuse, obesity, insomnia, and social barriers to health.

  4. Health status of children aged under two years cared for in day-care ...

    African Journals Online (AJOL)

    Background: As a result of the increasing numbers of Nigerian women in the labour force and also the gradual disintegration of the extended family system, a demand for alternative means of caring for children is being created. Day-care as an alternative source of childcare has now become a necessity rather than an option ...

  5. Models of psychological service provision under Australia's Better Outcomes in Mental Health Care program.

    Science.gov (United States)

    Pirkis, Jane; Burgess, Philip; Kohn, Fay; Morley, Belinda; Blashki, Grant; Naccarella, Lucio

    2006-08-01

    The Access to Allied Psychological Services component of Australia's Better Outcomes in Mental Health Care program enables eligible general practitioners to refer consumers to allied health professionals for affordable, evidence-based mental health care, via 108 projects conducted by Divisions of General Practice. The current study profiled the models of service delivery across these projects, and examined whether particular models were associated with differential levels of access to services. We found: 76% of projects were retaining their allied health professionals under contract, 28% via direct employment, and 7% some other way; Allied health professionals were providing services from GPs' rooms in 63% of projects, from their own rooms in 63%, from a third location in 42%; and The referral mechanism of choice was direct referral in 51% of projects, a voucher system in 27%, a brokerage system in 24%, and a register system in 25%. Many of these models were being used in combination. No model was predictive of differential levels of access, suggesting that the approach of adapting models to the local context is proving successful.

  6. 75 FR 36099 - Legislative Changes to Primary Care Loan Program Authorized Under Title VII of the Public Health...

    Science.gov (United States)

    2010-06-24

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration Legislative Changes to Primary Care Loan Program Authorized Under Title VII of the Public Health Service Act AGENCY... changes Section 723 of the Public Health Service Act (PHSA) regarding administration of the PCL program...

  7. Health Care Utilization Patterns of Homeless Individuals in Boston: Preparing for Medicaid Expansion Under the Affordable Care Act

    Science.gov (United States)

    Zhang, Jianying; O’Connell, Elizabeth; Taube, Robert; Clark, Robin E.

    2013-01-01

    Objectives. We studied 6494 Boston Health Care for the Homeless Program (BHCHP) patients to understand the disease burden and health care utilization patterns for a group of insured homeless individuals. Methods. We studied merged BHCHP data and MassHealth eligibility, claims, and encounter data from 2010. MassHealth claims and encounter data provided a comprehensive history of health care utilization and expenditures, as well as associated diagnoses, in both general medical and behavioral health services sectors and across a broad range of health care settings. Results. The burden of disease was high, with the majority of patients experiencing mental illness, substance use disorders, and a number of medical diseases. Hospitalization and emergency room use were frequent and total expenditures were 3.8 times the rate of an average Medicaid recipient. Conclusions. The Affordable Care Act provides a framework for reforming the health care system to improve the coordination of care and outcomes for vulnerable populations. However, improved health care coverage alone may not be enough. Health care must be integrated with other resources to address the complex challenges presented by inadequate housing, hunger, and unsafe environments. PMID:24148046

  8. Laying foundations for health: food provision for under 5s in day care.

    Science.gov (United States)

    Moore, Helen; Nelson, Pauline; Marshall, Joyce; Cooper, Mary; Zambas, Helen; Brewster, Kevin; Atkin, Karl

    2005-04-01

    This study investigated the food offered to children under 5 years of age in UK day care, the influence of the childcare providers on a child's diet and their attitudes towards this role. A postal survey of a randomised quota sample of childcare providers enquired after the range of food on offer and explored attitudes towards the role of food in health and the role of promoting health. Themes emerging from these data were explored by in-depth interviews with a sample of 18 childcare providers and 7 Local Authority Early Years Service staff. We received 194 (56%) responses to 345 copies of the questionnaire. Half (46%) of nurseries and 23% of childminders provided a fruit or vegetable with the main meal 5 days a week. Only 14% of nurseries and 21% of childminders provided a dairy food (i.e. calcium-rich) at the main meal every day. Almost all the childcare providers saw themselves as responsible for promoting healthy diet, but it was rare for them to have had any formal training in nutrition, while current dietary guidance was perceived as too vague to be useful. The study also highlighted tensions on the issue of food provision between those delivering childcare and parents; further research should explore the parents' perspectives. Nursery staff and childminders should have access to carefully designed advice on nutritionally appropriate food and drink services for under-fives.

  9. Health care utilization of patients with multiple chronic diseases in the Netherlands: differences and underlying factors.

    NARCIS (Netherlands)

    Hopman, P.; Heins, M.J.; Korevaar, J.C.; Rijken, M.; Schellevis, F.G.

    2016-01-01

    Purpose: To examine health care utilization of people with multiple chronic diseases in The Netherlands compared to people with a single chronic disease, and to identify subgroups of multimorbid patients according to health care utilization. Methods: All patients diagnosed with one or more chronic

  10. Health care utilization of patients with multiple chronic diseases in The Netherlands: Differences and underlying factors

    NARCIS (Netherlands)

    Hopman, P.; Heins, M.J.; Rijken, M.; Schellevis, F.G.

    2015-01-01

    Purpose To examine health care utilization of people with multiple chronic diseases in The Netherlands compared to people with one chronic disease, and to identify different subgroups of multimorbid patients based on differences in health care utilization. Methods All patients diagnosed with one or

  11. A Comprehensive Assessment of Health Care Utilization Among Homeless Adults Under a System of Universal Health Insurance

    Science.gov (United States)

    Chambers, Catharine; Chiu, Shirley; Katic, Marko; Kiss, Alex; Redelmeier, Donald A.; Levinson, Wendy

    2013-01-01

    Objectives. We comprehensively assessed health care utilization in a population-based sample of homeless adults and matched controls under a universal health insurance system. Methods. We assessed health care utilization by 1165 homeless single men and women and adults in families and their age- and gender-matched low-income controls in Toronto, Ontario, from 2005 to 2009, using repeated-measures general linear models to calculate risk ratios and 95% confidence intervals (CIs). Results. Homeless participants had mean rates of 9.1 ambulatory care encounters (maximum = 141.1), 2.0 emergency department (ED) encounters (maximum = 104.9), 0.2 medical–surgical hospitalizations (maximum = 14.9), and 0.1 psychiatric hospitalizations per person-year (maximum = 4.8). Rate ratios for homeless participants compared with matched controls were 1.76 (95% CI = 1.58, 1.96) for ambulatory care encounters, 8.48 (95% CI = 6.72, 10.70) for ED encounters, 4.22 (95% CI = 2.99, 5.94) for medical–surgical hospitalizations, and 9.27 (95% CI = 4.42, 19.43) for psychiatric hospitalizations. Conclusions. In a universal health insurance system, homeless people had substantially higher rates of ED and hospital use than general population controls; these rates were largely driven by a subset of homeless persons with extremely high-intensity usage of health services. PMID:24148051

  12. Spatial Accessibility to Health Care Services: Identifying under-Serviced Neighbourhoods in Canadian Urban Areas

    OpenAIRE

    Shah, Tayyab Ikram; Bell, Scott; Wilson, Kathi

    2016-01-01

    Background Urban environments can influence many aspects of health and well-being and access to health care is one of them. Access to primary health care (PHC) in urban settings is a pressing research and policy issue in Canada. Most research on access to healthcare is focused on national and provincial levels in Canada; there is a need to advance current understanding to local scales such as neighbourhoods. Methods This study examines spatial accessibility to family physicians using the Thre...

  13. Equity in access to health care provision under the medicare security for small scale entrepreneurs in Dar es Salaam.

    Science.gov (United States)

    Urassa, J A E

    2012-03-01

    The main objective of this study was to assess equity in access to health care provision under the Medicare Security for Small Scale Entrepreneurs (SSE). Methodological triangulation was used to an exploratory and randomized cross- sectional study in order to supplement information on the topic under investigation. Questionnaires were administered to 281 respondents and 6 Focus Group Discussions (FGDs) were held with males and females. Documentary review was also used. For quantitative aspect of the study, significant associations were measured using confidence intervals (95% CI) testing. Qualitative data were analyzed with assistance of Open code software. The results show that inequalities in access to health care services were found in respect to affordability of medical care costs, distance from home to health facilities, availability of drugs as well as medical equipments and supplies. As the result of existing inequalities some of clients were not satisfied with the provided health services. The study concludes by drawing policy and research implications of the findings.

  14. Under the influence: informing oral health care providers about substance abuse.

    Science.gov (United States)

    Riemer, Lynn; Holmes, Ronald

    2014-06-01

    Treating the drug addicted dental patient is different than treating the non-addicted patient due to differences related to the emotional/behavioral/personality issues of the addict, the addict's often poor general health and poor nutrition, ongoing problems of oral hygiene and the effects of drugs on the oral mucosa, gingiva and dentition Oral health care providers need to be aware of the emerging trends in substance abuse, able to recognize patient's addicted to drugs and to be knowledgeable about the effects of substance abuse to provide the most efficacious treatment to avoid the consequences of contraindicated dental procedures and therapy. This article defines the scope of the problem of drug abuse and provides an overview of commonly abused substances and their effects on health and oral health. A review of the literature combined with the authors' extensive experience in the substance abuse field explains parameters of oral health care treatment of the drug addicted individual for patient and provider safety. The drug culture has evolved and the drug user is different. Oral health care providers need to realize that any patient may be an addict in order to identify them, provide appropriate oral care and direct them, if they desire, toward appropriate treatment. Copyright © 2014 Elsevier Inc. All rights reserved.

  15. Spatial Accessibility to Health Care Services: Identifying under-Serviced Neighbourhoods in Canadian Urban Areas.

    Science.gov (United States)

    Shah, Tayyab Ikram; Bell, Scott; Wilson, Kathi

    2016-01-01

    Urban environments can influence many aspects of health and well-being and access to health care is one of them. Access to primary health care (PHC) in urban settings is a pressing research and policy issue in Canada. Most research on access to healthcare is focused on national and provincial levels in Canada; there is a need to advance current understanding to local scales such as neighbourhoods. This study examines spatial accessibility to family physicians using the Three-Step Floating Catchment Area (3SFCA) method to identify neighbourhoods with poor geographical access to PHC services and their spatial patterning across 14 Canadian urban settings. An index of spatial access to PHC services, representing an accessibility score (physicians-per-1000 population), was calculated for neighborhoods using a 3km road network distance. Information about primary health care providers (this definition does not include mobile services such as health buses or nurse practitioners or less distributed services such as emergency rooms) used in this research was gathered from publicly available and routinely updated sources (i.e. provincial colleges of physicians and surgeons). An integrated geocoding approach was used to establish PHC locations. The results found that the three methods, Simple Ratio, Neighbourhood Simple Ratio, and 3SFCA that produce City level access scores are positively correlated with each other. Comparative analyses were performed both within and across urban settings to examine disparities in distributions of PHC services. It is found that neighbourhoods with poor accessibility scores in the main urban settings across Canada have further disadvantages in relation to population high health care needs. The results of this study show substantial variations in geographical accessibility to PHC services both within and among urban areas. This research enhances our understanding of spatial accessibility to health care services at the neighbourhood level. In

  16. Automated dose dispensing in Danish primary health care - a technology under construction

    OpenAIRE

    Herborg, Hanne; Haugbølle, Lotte S.; Lee, Anne

    2008-01-01

    Objectives: The purpose of this study was to conduct a health technology assessment (HTA) of automated dose dispensing in the Danish primary health care sector. The present article answers the sub question of how various groups of actors spoke about and understood the shaping of automated dose dispensing (positioning in discourses).Methods: The project utilized two methods: 11 qualitative research interviews with selected key actors and a net-based qualitative questionnaire of 97 selected pra...

  17. Health care seeking behavior for diarrhea in children under 5 in rural Niger: results of a cross-sectional survey

    Directory of Open Access Journals (Sweden)

    Djibo Ali

    2011-05-01

    Full Text Available Abstract Background Diarrhea remains the second leading cause of death in children under 5 years of age in sub-Saharan Africa. Health care seeking behavior for diarrhea varies by context and has important implications for developing appropriate care strategies and estimating burden of disease. The objective of this study was to determine the proportion of children under five with diarrhea who consulted at a health structure in order to identify the appropriate health care levels to set up surveillance of severe diarrheal diseases. Methods A cluster survey was done on 35 clusters of 21 children under 5 years of age in each of four districts of the Maradi Region, Niger. Caretakers were asked about diarrhea of the child during the recall period and their health seeking behavior in case of diarrhea. A weighted cluster analysis was conducted to determine the prevalence of diarrhea, as well as the proportion of consultations and types of health structures consulted. Results In total, the period prevalence of diarrhea and severe diarrhea between April 24th and May 21st 2009 were 36.8% (95% CI: 33.7 - 40.0 and 3.4% (95% CI: 2.2-4.6, respectively. Of those reporting an episode of diarrhea during the recall period, 70.4% (95% CI: 66.6-74.1 reported seeking care at a health structure. The main health structures visited were health centers, followed by health posts both for simple or severe diarrhea. Less than 10% of the children were brought to the hospital. The proportion of consultations was not associated with the level of education of the caretaker, but increased with the number of children in the household. Conclusions The proportion of consultations for diarrhea cases in children under 5 years old was higher than those reported in previous surveys in Niger and elsewhere. Free health care for under 5 years old might have participated in this improvement. In this type of decentralized health systems, the WHO recommended hospital-based surveillance of

  18. Patient satisfaction with primary health care - a comparison between the insured and non-insured under the National Health Insurance Policy in Ghana.

    Science.gov (United States)

    Fenny, Ama Pokuaa; Enemark, Ulrika; Asante, Felix A; Hansen, Kristian S

    2014-04-01

    Ghana has initiated various health sector reforms over the past decades aimed at strengthening institutions, improving the overall health system and increasing access to healthcare services by all groups of people. The National Health Insurance Scheme (NHIS) instituted in 2005, is an innovative system aimed at making health care more accessible to people who need it. Currently, there is a growing amount of concern about the capacity of the NHIS to make quality health care accessible to its clients. A number of studies have concentrated on the effect of health insurance status on demand for health services, but have been quiet on supply side issues. The main aim of this study is to examine the overall satisfaction with health care among the insured and uninsured under the NHIS. The second aim is to explore the relations between overall satisfaction and socio-demographic characteristics, health insurance and the various dimensions of quality of care. This study employs logistic regression using household survey data in three districts in Ghana covering the 3 ecological zones (coastal, forest and savannah). It identifies the service quality factors that are important to patients' satisfaction and examines their links to their health insurance status. The results indicate that a higher proportion of insured patients are satisfied with the overall quality of care compared to the uninsured. The key predictors of overall satisfaction are waiting time, friendliness of staff and satisfaction of the consultation process. These results highlight the importance of interpersonal care in health care facilities. Feedback from patients' perception of health services and satisfaction surveys improve the quality of care provided and therefore effort must be made to include these findings in future health policies.

  19. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    sexual intercourse under the influence of alcohol or adolescents and younger adults. psychoactive substances. Respondents were. Risky sexual behaviour among young people has categorized as engaging in risky sexual behaviour if. JOURNAL OF COMMUNITY MEDICINE AND PRIMARY HEALTH CARE VOL. 26, NO 2 ...

  20. If it quacks like a duck: reviewing health care providers' speech restrictions under the first prong of Central Hudson.

    Science.gov (United States)

    Fultz, Shawn L

    2013-01-01

    The First Amendment protects the speech of health care providers. This protection can limit states' abilities to protect patients from harmful therapies involving speech, such as sexual orientation change efforts. Because providers' speech is more similar to commercial speech than traditional political discourse, it is possible to create a First Amendment review analysis that better balances states' police powers with providers' First Amendment rights. Under a "single-prong" approach, the first prong of Central Hudson can be used to identify quackery, which is analogous to false or misleading commercial speech and would therefore be outside the protection of the First Amendment. Because health care must be tailored to individual patients, restrictions on speech that survive the first prong of Central Hudson would be subject to strict scrutiny in order to leave the therapeutic decision to the provider and her patient, and maintain consistency with current jurisprudence. This Comment examines litigation from California's attempted ban on sexual orientation change therapy to illustrate the conflicts created by the current approach to First Amendment review of health care provider speech. This Comment then demonstrates the benefit of the proposed single-prong approach, including how it simultaneously protects patients from harm while protecting health care providers' speech.

  1. Social Effects of Health Care Reform: Medicaid Expansion under the Affordable Care Act and changes in Volunteering

    Science.gov (United States)

    Sohn, Heeju; Timmermans, Stefan

    2017-01-01

    Do public health policy interventions result in pro-social behaviors? The Affordable Care Act (ACA)’s Medicaid expansions were responsible for the largest gains in public insurance coverage since its inception in 1965. These gains were concentrated in states that opted to expand Medicaid eligibility and provide a unique opportunity to study not just medical but also social consequences of increased public health coverage. This article examines the association between Medicaid and volunteer work. Volunteerism is implicated in individuals’ health and well-being yet it is highly correlated with a person’s existing socioeconomic resources. Medicaid expansions improved financial security and a sense of health—two factors that predict volunteer work—for a socioeconomic group that has had low levels of volunteerism. Difference-in-difference analyses of the Volunteer Supplement of the Current Population Survey (2010–2015) find increased reports of formal volunteering for organizations as well as informal helping behaviors between neighbors for low-income non-elderly adults who would have likely benefited from expansions. Furthermore, increased volunteer work associated with Medicaid was greater among minority groups and narrowed existing ethnic differences in volunteerism in states that expanded Medicaid eligibility. PMID:29142907

  2. Health care expenditure disparities in the European Union and underlying factors: a distribution dynamics approach.

    Science.gov (United States)

    Villaverde, José; Maza, Adolfo; Hierro, María

    2014-09-01

    This paper examines health care expenditure (HCE) disparities between the European Union countries over the period 1995-2010. By means of using a continuous version of the distribution dynamics approach, the key conclusions are that the reduction in disparities is very weak and, therefore, persistence is the main characteristic of the HCE distribution. In view of these findings, a preliminary attempt is made to add some insights into potentially main factors behind the HCE distribution. The results indicate that whereas per capita income is by far the main determinant, the dependency ratio and female labour participation do not play any role in explaining the HCE distribution; as for the rest of the factors studied (life expectancy, infant mortality, R&D expenditure and public HCE expenditure share), we find that their role falls somewhat in between.

  3. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    com. +234 803 5837179. KEYWORDS. Disease surveillance, notification, resident doctors,. Edo State journal of. COMMUNITY HEALTH. & PRIMARY HEALTH CARE. Journal of Community Medicine and Primary Health Care. 26(2) 107-115 ...

  4. Automated dose dispensing in Danish primary health care - a technology under construction

    Directory of Open Access Journals (Sweden)

    Herborg H

    2008-06-01

    Full Text Available Objectives: The purpose of this study was to conduct a health technology assessment (HTA of automated dose dispensing in the Danish primary health care sector. The present article answers the sub question of how various groups of actors spoke about and understood the shaping of automated dose dispensing (positioning in discourses.Methods: The project utilized two methods: 11 qualitative research interviews with selected key actors and a net-based qualitative questionnaire of 97 selected practitioners.Results: Three main types of discourse were identified with respect to the development of automated dose dispensing, namely ‘optimistic’, ‘sceptical’ and ‘pragmatic’. A wide diversity of opinion about automated dose dispensing was identified among the three discourses and their attendant scenarios. A number of factors are found in all three types of discourse, and are therefore considered to express common recommendations for decision makers and practitioners. These factors are described in the article.Conclusions: The article argues in favour of HTA, which to a great extent clarifies and initiates the perspectives of various groups of actors about the same technology. Our analyses show that conscious strategies must be employed to make the technology work successfully with the actors involved. The preferences, ideas and proposals for future actions and initiatives identified in the project could be the basis for defining future development strategies.

  5. Automated dose dispensing in Danish primary health care - a technology under construction.

    Science.gov (United States)

    Herborg, Hanne; Haugbølle, Lotte S; Lee, Anne

    2008-04-01

    The purpose of this study was to conduct a health technology assessment (HTA) of automated dose dispensing in the Danish primary health care sector. The present article answers the sub question of how various groups of actors spoke about and understood the shaping of automated dose dispensing (positioning in discourses). THE PROJECT UTILIZED TWO METHODS: 11 qualitative research interviews with selected key actors and a net-based qualitative questionnaire of 97 selected practitioners. Three main types of discourse were identified with respect to the development of automated dose dispensing, namely 'optimistic', 'sceptical' and 'pragmatic'. A wide diversity of opinion about automated dose dispensing was identified among the three discourses and their attendant scenarios. A number of factors are found in all three types of discourse, and are therefore considered to express common recommendations for decision makers and practitioners. These factors are described in the article. The article argues in favour of HTA, which to a great extent clarifies and initiates the perspectives of various groups of actors about the same technology. Our analyses show that conscious strategies must be employed to make the technology work successfully with the actors involved. The preferences, ideas and proposals for future actions and initiatives identified in the project could be the basis for defining future development strategies.

  6. Perception of quality health care delivery under capitation payment: a cross-sectional survey of health insurance subscribers and providers in Ghana.

    Science.gov (United States)

    Andoh-Adjei, Francis-Xavier; Nsiah-Boateng, Eric; Asante, Felix Ankomah; Spaan, Ernst; van der Velden, Koos

    2018-03-07

    Ghana introduced capitation payment method in 2012 but was faced with resistance for its perceived poor quality of care. This paper assesses National Health Insurance Scheme subscribers and care providers' perception of quality of care under the capitation payment method. This is a cross-sectional survey of subscribers and care providers perception of quality of care in three administrative regions of Ghana using a 5-point Likert scale for the assessment based on a set of quality of care measures. We performed descriptive analysis to determine average perception of quality of care scores for each of the measures used. Bivariate and multivariate analyses were also performed to examine relationships between respondent's characteristics and their perception of quality of care. In general, subscribers expressed positive perception about the quality of care though subscribers in Ashanti were less positive compared to those in the Central region. A chi-square analysis, however, showed significant differences in subscribers' perception of quality of care by occupation (p = 0.002), region (p = 0.007) length of NHIS membership (p = 0.006), and age (p = 0.014). Multivariate logistic regression analysis also showed that different factors, other than region of residence, were significantly associated with perceived good quality of care. Analysis of health care providers' responses also showed significant differences in their perception of quality of care by region (p = 0.001). Multivariate logistic model showed that health care providers in the Volta region (OR = 0.14, 95% CI: 0.03-0.58) were significantly less likely to perceive quality of care as good compared to those in the Ashanti region. Subscribers and care providers across the three regions have relatively good perception of the quality of health care in general though subscribers in Ashanti were less positive than those in the Central region. It is, therefore, plausible that capitation payment

  7. A difficult balancing act: policy actors' perspectives on using economic evaluation to inform health-care coverage decisions under the Universal Health Insurance Coverage scheme in Thailand.

    Science.gov (United States)

    Teerawattananon, Yot; Russell, Steve

    2008-03-01

    In Thailand, policymakers have come under increasing pressure to use economic evaluation to inform health-care resource allocation decisions, especially after the introduction of the Universal Health Insurance Coverage (UC) scheme. This article presents qualitative findings from research that assessed a range of policymakers' perspectives on the acceptability of using economic evaluation for the development of health-care benefit packages in Thailand. The policy analysis examined their opinions about existing decision-making processes for including health interventions in the UC benefit package, their understanding of health economic evaluation, and their attitudes, acceptance, and values relating to the use of the method. Semistructured interviews were conducted with 36 policy actors who play a major role or have some input into health resource allocation decisions within the Thai health-care system. These included 14 senior policymakers at the national level, 5 hospital directors, 10 health professionals, and 7 academics. Policy actors thought that economic evaluation information was relevant for decision-making because of the increasing need for rationing and more transparent criteria for making UC coverage decisions. Nevertheless, they raised several difficulties with using economic evaluation that would pose barriers to its introduction, including distrust in the method, conflicting philosophical positions and priorities compared to that of "health maximization," organizational allegiances, existing decision-making procedures that would be hard to change, and concerns about political pressure and acceptability.

  8. Health care technology assessment

    Science.gov (United States)

    Goodman, Clifford

    1994-12-01

    The role of technology in the cost of health care is a primary issue in current debates concerning national health care reform. The broad scope of studies for understanding technological impacts is known as technology assessment. Technology policy makers can improve their decision making by becoming more aware, and taking greater advantage, of key trends in health care technology assessment (HCTA). HCTA is the systematic evaluation of the properties, impacts, and other attributes of health care technologies, including: technical performance; clinical safety and efficacy/effectiveness; cost-effectiveness and other economic attributes; appropriate circumstances/indications for use; and social, legal, ethical, and political impacts. The main purpose of HCTA is to inform technology-related policy making in health care. Among the important trends in HCTA are: (1) proliferation of HCTA groups in the public and private sectors; (2) higher standards for scientific evidence concerning technologies; (3) methodological development in cost analyses, health-related quality of life measurement, and consolidation of available scientific evidence (e.g., meta-analysis); (4) emphasis on improved data on how well technologies work in routine practice and for traditionally under-represented patient groups; (5) development of priority-setting methods; (6) greater reliance on medical informatics to support and disseminate HCTA findings.

  9. Health Care Team

    Science.gov (United States)

    ... Events Advocacy Donate A to Z Health Guide Health Care Team Print Email Good health care is always a team effort - especially for people ... chronic kidney failure. Since each member of the health care staff contributes to your care, it is important ...

  10. Respiratory Home Health Care

    Science.gov (United States)

    ... Healthy Living > Living With Lung Disease > Respiratory Home Health Care Font: Aerosol Delivery Oxygen Resources Immunizations Pollution Nutrition ... Disease Articles written by Respiratory Experts Respiratory Home Health Care Respiratory care at home can contribute to improved ...

  11. Health care operations management

    NARCIS (Netherlands)

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

    2012-01-01

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

  12. Amendment to the interim final rules for group health plans and health insurance coverage relating to status as a grandfathered health plan under the Patient Protection and Affordable Care Act. Amendment to interim final rules with request for comments.

    Science.gov (United States)

    2010-11-17

    This document contains an amendment to interim final regulations implementing the rules for group health plans and health insurance coverage in the group and individual markets under provisions of the Patient Protection and Affordable Care Act regarding status as a grandfathered health plan; the amendment permits certain changes in policies, certificates, or contracts of insurance without loss of grandfathered status.

  13. Prevalence and determinants of depression among patients under the care of traditional health practitioners in a Kenyan setting: Policy implications.

    Science.gov (United States)

    Musyimi, Christine W; Mutiso, Victoria N; Musau, Abednego M; Matoke, Lydia K; Ndetei, David M

    2017-06-01

    In Kenya, there is paucity of information on depression among traditional health practitioner (THP) patients, particularly in rural areas. The aim of this study was to estimate prevalence and identify determinants of major depressive disorder (MDD) among patients of THP in rural Kenya using the World Health Organization (WHO) Mental Health Gap Action Programme Intervention Guideline (mhGAP-IG). All adult patients seeking care from trained THPs (either traditional healers such as diviners and herbalists or faith healers, who use treatments such as prayers, laying hands on patients, or providing holy water and ash to their patients) over a period of 3 months (September 2014 to November 2014) were screened for depression using mhGAP-IG and their sociodemographic characteristics recorded. Overall, the prevalence of depression among THP patients was 22.9%. Being older, female, single, divorced or separated, as well as unemployment and lack of education were found to be significant determinants of depression. Patients with MDD frequently presented with suicidal behavior (32.9%, OR = 5.94, p < .0001) compared to those that had at least one psychotic symptom (26.3%, OR = 3.65, p < .0001). A measure of the accuracy of THPs' assessment of MDD showed 86% specificity and 46% sensitivity and the area under receiver operating characteristics (ROC) curve was 0.686. Our findings shed light on the prevalence of depression among THP patients and thus highlight the need for further research on diagnostic tools for use among THPs in order to avoid substandard care and promote reliance on more evidence-based methods of care.

  14. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    the_monk

    2012-05-01

    May 1, 2012 ... Journal of Community Medicine and Primary Health Care. 27 (1) 27-36. KEYWORDS out-of-pocket payment, user fees, quality, tertiary health services;. Nigeria. .... and research committee of the Delta State .... Methods of funding and perceived satisfaction patient's waiting time, attitude of health care.

  15. Unplanned health care tourism.

    Science.gov (United States)

    Powell, Suzanne K

    2015-01-01

    Health care tourism is often a preplanned event carefully laying out all the details. Sometimes, when one least expects it, medical care is needed outside of the mainland. This Editorial speaks to an unplanned experience.

  16. [Does the nutritional care plan and report upon discharge under the health care system substitute the nutrition support team summary at patient discharge?].

    Science.gov (United States)

    Hidaka, Kumi; Matsuoka, Mio; Kajiwara, Kanako; Hinokiyama, Hiromi; Mito, Saori; Doi, Seiko; Konishi, Eriko; Ibata, Takeshi; Komuro, Ryutaro; lijima, Shohei

    2013-12-01

    Our nutrition support team (NST) designed the NST summary for cooperation among personnel providing medical care for nutritional management of high-need patients in our area. After the introduction of the NST fee under the health care system, the number of summary publications decreased. The requested NST fee is necessary for publication of a nutritional care plan and report upon patient discharge. We hypothesized that the nutritional care plan and discharge report were being substituted for the NST summary at the time of patient discharge. We retrospectively investigated 192 cases with NST fee. There were only 13 cases of overlapping publication, and the NST summary was necessary for 107 of 179 cases in which no NST summary had been prepared. Since the space on the report form is limited, it can provide only limited information. However, the NST summary can convey detailed supplementary information. Therefore, there is a high need for the NST summary, and publication of NST summaries for the appropriate cases must continue.

  17. Vacation health care

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/001937.htm Vacation health care To use the sharing features on this page, ... and help you avoid problems. Talk to your health care provider or visit a travel clinic 4 to ...

  18. National Health Care Survey

    Science.gov (United States)

    This survey encompasses a family of health care provider surveys, including information about the facilities that supply health care, the services rendered, and the characteristics of the patients served.

  19. Health care agents

    Science.gov (United States)

    ... do not want these treatments. Order sterilization or abortion. Choosing Your Health Care Agent Choose a person ... working well. A health care proxy is a legal paper that you fill out. You can get ...

  20. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    adedamla

    enrol in an insurance scheme feeling that they need more information on health insurance and the willingness to enrol in a ... health policy makers. Irrespective of the option, the choice of health care financing should mobilize resources for health and provide financial protection. 1 ..... Opportunities for Sub-Saharan African.

  1. 2 CFR 376.147 - Does an exclusion from participation in Federal health care programs under Title XI of the Social...

    Science.gov (United States)

    2010-01-01

    ... 2 Grants and Agreements 1 2010-01-01 2010-01-01 false Does an exclusion from participation in Federal health care programs under Title XI of the Social Security Act affect a person's eligibility to... NONPROCUREMENT DEBARMENT AND SUSPENSION General § 376.147 Does an exclusion from participation in Federal health...

  2. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    adedamla

    ABSTRACT. Background: The well-being of women and children is one of the major determinants of the health of any nation and can ... preconception care, the result showed that majority (65.9%, n=247) of the respondents have not sought the care before pregnancy ... women have optimal health in order to give birth to.

  3. Health Care in China.

    Science.gov (United States)

    Younger, David S

    2016-11-01

    China has recently emerged as an important global partner. However, like other developing nations, China has experienced dramatic demographic and epidemiologic changes in the past few decades. Population discontent with the health care system has led to major reforms. China's distinctive health care system, including its unique history, vast infrastructure, the speed of health reform, and economic capacity to make important advances in health care, nonetheless, has incomplete insurance coverage for urban and rural dwellers, uneven access, mixed quality of health care, increasing costs, and risk of catastrophic health expenditures. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Day care health risks

    Science.gov (United States)

    ... as head lice and scabies are other common health problems that occur in day care centers. You can do a number of ... for the child How to contact your child's health care provider ... sure your child's day care staff knows how to follow that plan.

  5. Indian Health Service: Find Health Care

    Science.gov (United States)

    ... IHS Home for Patients Find Health Care Find Health Care IMPORTANT If you are having a health emergency ... services, continuous nursing services and that provides comprehensive health care including diagnosis and treatment. Health Locations An ambulatory ...

  6. Provision of Oral Health Care to Children under Seven Covered by Bolsa Família Program. Is This a Reality?

    Science.gov (United States)

    Petrola, Krishna Andréia Feitosa; Bezerra, Ítalo Barroso; de Menezes, Érico Alexandro Vasconcelos; Calvasina, Paola; Saintrain, Maria Vieira de Lima; Pimentel G F Vieira-Meyer, Anya

    2016-01-01

    to dentists than children covered by the Bolsa Familia Program (p≤0.001). Parents/caregivers (99.2%; n = 381) agreed that oral health care is important and 99.5% (n = 382) would like their children to be seen regularly. No collaboration was observed between the Bolsa Família Program and the Family Health Program with regard to the provision of oral health care. Making oral health care a Bolsa Família Program conditionality may reduce oral health care inequalities for extreme poor children under seven in Brazil.

  7. Resilient health care

    DEFF Research Database (Denmark)

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

    . Whereas current safety approaches primarily aim to reduce or eliminate the number of things that go wrong, Resilient Health Care aims to increase and improve the number of things that go right. Just as the WHO argues that health is more than the absence of illness, so does Resilient Health Care argue...... rights reserved....

  8. Health care delivery systems.

    NARCIS (Netherlands)

    Stevens, F.; Zee, J. van der

    2007-01-01

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

  9. US health care crisis.

    Science.gov (United States)

    Cirić, Ivan

    2013-01-01

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

  10. Care profession under change

    DEFF Research Database (Denmark)

    Rask Eriksen, Tine; Engel, Lisbeth Vinberg; Vedsegaard, Helle

    Backgound and aims: Sygeplejerskemanglen i Danmark er stor. Udfordringerne består i disse år i at rekruttere og fastholde sygeplejestuderende i studiet. Hensigten med projektet er dels at undersøge hvilke livshistoriske omsorgsforudsætninger, de studerende møder med i uddannelsen og dels at beskr...

  11. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    user

    Early detection and treatment of these morbidities could prevent deterioration. The aim of the survey was to determine and compare the prevalence of ..... interventions. Increasing the detection rate of mental morbidity in the community is fundamental. The inclusion of mental health care as a component of primary health ...

  12. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    adedamla

    Background. The availability of drugs on a continuous basis is paramount to the success of any health care system. The Bamako Initiative (BI) had provision of essential drugs as one of its key thrusts in order to improve the utilization of health facilities. This study compared the perceived availability of essential drugs and ...

  13. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    adedamla

    catastrophic health expenditures (CHE) and risk of being impoverished as a result of cost of care were assessed. Statistical ... Study found a high prevalence of catastrophic health expenditure and near absence of financial risk protection for patients with long term ... services especially for the target group in Nigeria.

  14. Patient satisfaction with primary health care - a comparison between the insured and non-insured under the National Health Insurance Policy in Ghana

    DEFF Research Database (Denmark)

    Fenny, Ama Pokuaa; Enemark, Ulrika; Asante, Felix A

    2014-01-01

    system aimed at making health care more accessible to people who need it. Currently, there is a growing amount of concern about the capacity of the NHIS to make quality health care accessible to its clients. A number of studies have concentrated on the effect of health insurance status on demand......, health insurance and the various dimensions of quality of care. This study employs logistic regression using household survey data in three districts in Ghana covering the 3 ecological zones (coastal, forest and savannah). It identifies the service quality factors that are important to patients......Ghana has initiated various health sector reforms over the past decades aimed at strengthening institutions, improving the overall health system and increasing access to healthcare services by all groups of people. The National Health Insurance Scheme (NHIS) instituted in 2005, is an innovative...

  15. [Health care networks].

    Science.gov (United States)

    Mendes, Eugênio Vilaça

    2010-08-01

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

  16. Case management of the elderly in a health maintenance organization: the implications for program administration under managed care.

    Science.gov (United States)

    Marshall, B S; Long, M J; Voss, J; Demma, K; Skerl, K P

    1999-01-01

    Kaiser Permanente initiated a two-year demonstration ambulatory case management program in its Ohio region to evaluate five outcomes: perceived health status, functional status, and satisfaction with care, service use, and service costs. Expected results were not consistently obtained for the five outcome measures. Treatment group members did not, however, experience the functional status impairments or decline in health status perceptions reported by the control group during the study period. The unexpected finding that costs were not affected may be attributed to the type of case management intervention used in the demonstration program. This study is broadly applicable to managed care settings facing the challenge of developing programs to minimize the risk for bearing the costs of the Medicare beneficiaries' overall health when all services are not covered. Managed care administrators should be favorably disposed to implementing a case management model with the potential for affecting functional status, the most significant predictor of expensive continuing care for this cohort of Medicare beneficiaries, while working to develop more effective protocols and resource control strategies.

  17. Management of severe acute malnutrition in children under 5 years through the lens of health care workers in two rural South African hospitals

    OpenAIRE

    Muzigaba, Moise; van Wyk, Brian; Puoane, Thandi

    2018-01-01

    Background Despite the widespread implementation of the World Health Organization (WHO) guidelines for the management of severe malnutrition in South Africa, poor treatment outcomes for children under 5 years are still observed in some hospitals, particularly in rural areas. Objective To explore health care workers’ perceptions about upstream and proximal factors contributing to poor treatment outcomes for severe acute malnutrition in two district hospitals in South Africa. Methods An explora...

  18. Management of severe acute malnutrition in children under 5 years through the lens of health care workers in two rural South African hospitals

    OpenAIRE

    Moise Muzigaba; Brian van Wyk; Thandi Puoane

    2018-01-01

    Background: Despite the widespread implementation of the World Health Organization (WHO) guidelines for the management of severe malnutrition in South Africa, poor treatment outcomes for children under 5 years are still observed in some hospitals, particularly in rural areas.Objective: To explore health care workers’ perceptions about upstream and proximal factors contributing to poor treatment outcomes for severe acute malnutrition in two district hospitals in South Africa.Methods: An explor...

  19. Evaluating a complex model designed to increase access to high quality primary mental health care for under-served groups: a multi-method study.

    Science.gov (United States)

    Dowrick, Christopher; Bower, Peter; Chew-Graham, Carolyn; Lovell, Karina; Edwards, Suzanne; Lamb, Jonathan; Bristow, Katie; Gabbay, Mark; Burroughs, Heather; Beatty, Susan; Waheed, Waquas; Hann, Mark; Gask, Linda

    2016-02-17

    Many people with mental distress are disadvantaged because care is not available or does not address their needs. In order to increase access to high quality primary mental health care for under-served groups, we created a model of care with three discrete elements: community engagement, primary care training and tailored wellbeing interventions. We have previously demonstrated the individual impact of each element of the model. Here we assess the effectiveness of the combined model in increasing access to and improving the quality of primary mental health care. We test the assumptions that access to the wellbeing interventions is increased by the presence of community engagement and primary care training; and that quality of primary mental health care is increased by the presence of community engagement and the wellbeing interventions. We implemented the model in four under-served localities in North-West England, focusing on older people and minority ethnic populations. Using a quasi-experimental design with no-intervention comparators, we gathered a combination of quantitative and qualitative information. Quantitative information, including referral and recruitment rates for the wellbeing interventions, and practice referrals to mental health services, was analysed descriptively. Qualitative information derived from interview and focus group responses to topic guides from more than 110 participants. Framework analysis was used to generate findings from the qualitative data. Access to the wellbeing interventions was associated with the presence of the community engagement and the primary care training elements. Referrals to the wellbeing interventions were associated with community engagement, while recruitment was associated with primary care training. Qualitative data suggested that the mechanisms underlying these associations were increased awareness and sense of agency. The quality of primary mental health care was enhanced by information gained from our

  20. Benchmarking HIV health care

    DEFF Research Database (Denmark)

    Podlekareva, Daria; Reekie, Joanne; Mocroft, Amanda

    2012-01-01

    ABSTRACT: BACKGROUND: State-of-the-art care involving the utilisation of multiple health care interventions is the basis for an optimal long-term clinical prognosis for HIV-patients. We evaluated health care for HIV-patients based on four key indicators. METHODS: Four indicators of health care were...... assessed: Compliance with current guidelines on initiation of 1) combination antiretroviral therapy (cART), 2) chemoprophylaxis, 3) frequency of laboratory monitoring, and 4) virological response to cART (proportion of patients with HIV-RNA 90% of time on cART). RESULTS: 7097 Euro...... to North, patients from other regions had significantly lower odds of virological response; the difference was most pronounced for East and Argentina (adjusted OR 0.16[95%CI 0.11-0.23, p HIV health care utilization...

  1. Ninety-day waiting period limitation and technical amendments to certain health coverage requirements under the Affordable Care Act. Final rule.

    Science.gov (United States)

    2014-02-24

    These final regulations implement the 90-day waiting period limitation under section 2708 of the Public Health Service Act, as added by the Patient Protection and Affordable Care Act (Affordable Care Act), as amended, and incorporated into the Employee Retirement Income Security Act of 1974 and the Internal Revenue Code. These regulations also finalize amendments to existing regulations to conform to Affordable Care Act provisions. Specifically, these rules amend regulations implementing existing provisions such as some of the portability provisions added by the Health Insurance Portability and Accountability Act of 1996 (HIPAA) because those provisions of the HIPAA regulations have become superseded or require amendment as a result of the market reform protections added by the Affordable Care Act.

  2. Attending Unintended Transformations of Health Care Infrastructure

    DEFF Research Database (Denmark)

    Wentzer, Helle; Bygholm, Ann

    2007-01-01

    Introduction: Western health care is under pressure from growing demands on quality and efficiency. The development and implementation of information technology, IT is a key mean of health care authorities to improve on health care infrastructure. Theory and methods: Against a background of theor......Introduction: Western health care is under pressure from growing demands on quality and efficiency. The development and implementation of information technology, IT is a key mean of health care authorities to improve on health care infrastructure. Theory and methods: Against a background...... of theories on human-computer interaction and IT-mediated communication, different empirical studies of IT implementation in health care are analyzed. The outcome is an analytical discernment between different relations of communication and levels of interaction with IT in health care infrastructure...

  3. Organizing Rural Health Care

    DEFF Research Database (Denmark)

    Bunkenborg, Mikkel

    2012-01-01

    The liberalization of health care in the course of three decades of ‘reform and opening up’ has given people in rural China access to a diverse range of treatment options, but the health care system has also been marred by accusations of price hikes, fake pharmaceuticals, and medical malpractice....... This chapter offers an ethnographic description of health as an issue in a Hebei township and it focuses on a popular and a statist response to the perceived inadequacy of the rural health care system. The revival of religious practices in rural China is obviously motivated by many factors, but in the township...... roads to healing. The recent introduction of new rural cooperative medicine in the township represents an attempt to bring the state back in and address popular concern with the cost and quality of health care. While superficially reminiscent of the traditional socialist system, this new state attempt...

  4. Federalism and Health Care

    Directory of Open Access Journals (Sweden)

    G. Alan Tarr

    2011-10-01

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

  5. Organizing Rural Health Care

    DEFF Research Database (Denmark)

    Bunkenborg, Mikkel

    2012-01-01

    The liberalization of health care in the course of three decades of ‘reform and opening up’ has given people in rural China access to a diverse range of treatment options, but the health care system has also been marred by accusations of price hikes, fake pharmaceuticals, and medical malpractice...... roads to healing. The recent introduction of new rural cooperative medicine in the township represents an attempt to bring the state back in and address popular concern with the cost and quality of health care. While superficially reminiscent of the traditional socialist system, this new state attempt...

  6. Adherence and health care costs

    Directory of Open Access Journals (Sweden)

    Iuga AO

    2014-02-01

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

  7. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    replaced in January 2000, with free health service, which involves supplying free drugs from the state medical store to local government areas. This study aimed to ... The drug revolving fund initiative as a strategic opportunity to support local ... Iwajowa Local Government in symbols of quality care to consumers; in Nigeria,.

  8. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    the_monk

    campaigns; use of cigarette (nicotine). Information was collected on socio- substitutes and alternative approaches like demographic characteristics of respondents, acupuncture, aromatherapy, hypnosis and knowledge and attitude of the health care. 9-12 herbs. Often times, combinations of workers about smoking cessation ...

  9. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    adedamla

    order words, it refers to any abusive treatment to women, thus violating the law of basic human ... JOURNAL OF COMMUNITY MEDICINE AND PRIMARY HEALTH CARE VOL. 27, NO 2, SEPTEMBER 2015. 20 journal of ... Some women victims, for the fear of repeated attacks by perpetrators, refused to even to report to. 3.

  10. Health care utilization

    DEFF Research Database (Denmark)

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

    An important task in governing health services is to control costs. The literatures on both costcontainment and supplier induced demand focus on the effects of economic incentives on health care costs, but insights from these literatures have never been integrated. This paper asks how economic cost...... containment measures affect the utilization of health services, and how these measures interact with the number of patients per provider. Based on very valid register data, this is investigated for 9.556 Danish physiotherapists between 2001 and 2008. We find that higher (relative) fees for a given service...... are important, but that economics cannot alone explain the differences in health care utilization....

  11. Mental Health Care

    OpenAIRE

    Švab, Vesna; Zaletel-Kragelj, Lijana

    2008-01-01

    Mental health conceptualize a state of well-being, perceived self efficacy, competence, autonomy, intergenerational dependence and recognition of the ability to realize one's intellectual and emotional potential. Mental health care are services provided to individuals or communities by agents of the health services or professions to promote, maintain, monitor, or restore mental health. Students will become familiar with extensiveness of the problem, and levels of preventing it. It is illustra...

  12. Types of health care providers

    Science.gov (United States)

    ... article describes health care providers involved in primary care, nursing care, and specialty care. ... MD) or a Doctor of Osteopathic Medicine (DO). NURSING CARE Licensed practical nurses (LPNs) are state-licensed caregivers ...

  13. Influence of municipality-level mean income on access to aortic valve surgery: a cross-sectional observational study under Japan's universal health-care coverage.

    Science.gov (United States)

    Lee, Seitetsu L; Hashimoto, Hideki; Kohro, Takahide; Horiguchi, Hiromasa; Koide, Daisuke; Komuro, Issei; Fushimi, Kiyohide; Yamazaki, Tsutomu; Yasunaga, Hideo

    2014-01-01

    Universal health-care coverage has attracted the interest of policy makers as a way of achieving health equity. However, previous reports have shown that despite universal coverage, socioeconomic disparity persists in access to high-tech invasive care, such as cardiac treatment. In this study, we aimed to investigate the association between socioeconomic status and care of aortic stenosis in the context of Japan's health-care system, which is mainly publicly funded. We chose aortic stenosis in older people as a target because such patients are likely to be affected by socioeconomic disparity. Using a large Japanese claim-based inpatient database, we identified 12,893 isolated aortic stenosis patients aged over 65 years who were hospitalized between July 2010 and March 2012. Municipality socioeconomic status was represented by the mean household income of the patients' residential municipality, categorized into quartiles. The likelihood of undergoing aortic valve surgery and in-hospital mortality was regressed against socioeconomic status level with adjustments for hospital volume, regional number of cardiac surgeons per 1 million population, and patients' clinical status. We found no significant differences between the highest and lowest quartile groups in surgical indication (odds ratio, 0.84; 95% confidence interval, 0.69-1.03) or in-hospital mortality (1.00; 0.68-1.48). Hospital volume was significantly associated with lower postoperative mortality (odds ratio of the highest volume tertile to the lowest, 0.49; 0.34-0.71). Under Japan's current universal health-care coverage, municipality socioeconomic status did not appear to have a systematic relationship with either treatment decision for surgical intervention or postoperative survival following aortic valve surgery among older patients. Our results imply that universal health-care coverage with high publicly funded coverage offers equal access to high-tech cardiovascular care.

  14. American Health Care Association

    Science.gov (United States)

    ... for more information reguarding Please take a moment today to speak out, stay informed and spread. Looking for more information reguarding Prefered Provider Program Quality ... Nursing Home Administrator | Benedictine Health System US - MO - St. Louis, Qualifications Required: Bachelor’s degree in business, marketing, health care administration or a related field ...

  15. Health care reforms.

    Science.gov (United States)

    Marušič, Dorjan; Prevolnik Rupel, Valentina

    2016-09-01

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

  16. Challenges in management of tuberculosis under programmatic conditions: Perceptions of health care providers from four states of India

    Directory of Open Access Journals (Sweden)

    Ranjith Babu

    2017-12-01

    Full Text Available Background: Among the global estimation of 10.4 million new cases of Tuberculosis (TB in 2015, 27% of cases are contributed by India. Revised national TB control program (RNTCP started in 1993, and now heading towards for universal access. Despite its achievements, the program faces number of implementation challenges. This qualitative study explored ‘what is healthcare providers take on it?’. Material & Methods: A total of 28 in-depth interviews were conducted in Uttarakhand, Chhattisgarh, Delhi and Maharashtra from October 2014 to January 2015, under the thematic areas of finance, human resource, and communications. Participants included senior level policy makers like principal secretaries of health, National Health Mission Directors, Director Health Services, state TB officers and district TB officers, medical officers, community volunteers and TB consultants from international agencies. Analytic induction method was used for data analysis. Results: Participants identified many barriers in the overall management and implementation of RNTCP. Convergence of RNTCP needs to be more effective. Inadequate Human resources, issues in public private partnership, insufficient budget allocation and interrupted fund flow, inefficient Information Education and Communication strategy are a few. Conclusion: This study could gather the perspectives of senior health officials, implementers and other stakeholders on challenges in implementation of TB control programme in four states. Challenges perceived by them are vital in strategic revisions of RNTCP.

  17. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    could afford to pay for the cost of the vaccine at the prevailing market price. Most health .... At present there are two types of Pneumococcus Nigeria still has a high under-five mortality of. 14 vaccine which .... parent's characteristics and willingness to accept PCV. parents with higher income significantly reported. Parents who ...

  18. Health care need

    DEFF Research Database (Denmark)

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

    2006-01-01

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

  19. Health care seeking patterns and out of pocket payments for children under five years of age living in Katchi Abadis (slums), in Islamabad, Pakistan.

    Science.gov (United States)

    Rehman, Aneeqa; Shaikh, Babar Tasneem; Ronis, Katrina A

    2014-04-16

    Since 1990, Pakistan has faced an unprecedented rate of urbanization, thereby resulting in the uncontrolled proliferation of slums (Katchi Abadis) in all large cities. These areas lack the basic municipal services such as safe water supply, sanitation and waste collection. There is limited access to quality health care services, both curative and preventive. Therefore, communities living in katchi abadis are faced with health seeking challenges and catastrophic expenditure to pay for health care services (formal or informal). This cross-sectional quantitative study was conducted in Islamabad, using a semi-structured questionnaire with mothers of children 5 years of age. There are 34 katchi abadis, 11 are recognized by the Capital Development Authority, out of which seven were included in the study. The calculated sample size was 207. Average household income was found to be Pak Rupee 10,000 (approx.US$100) per month. Diarrhea, fever, common cold and cough were common illnesses among under 5 children. Approximately 43% of the mothers were illiterate and they preferred consulting a private doctor or a private dispenser in the katchi abadi. Mother's level of education was significantly associated with the type of health provider consulted. Majority had to spend out of pocket, while many either borrowed money from relatives or friends or sold a household item. Delay in seeking health care added to the out of pocket expense. The mean cost on child's treatment was approximately PkRs400 (approximately US$ 4) for a single consultation. There are several factors associated with health seeking behavior of mothers of children under the age of 5 years, living in the katchi abadis of Islamabad. The latter population group is one of the most vulnerable given their poor standard of living conditions. A multi-sectoral approach is needed to address the provision of basic amenities, the availability of safety nets to pay for health care is crucial to avoid catastrophic expenditure

  20. Nursing care community health

    Directory of Open Access Journals (Sweden)

    Diana Acosta-Salazar

    2016-07-01

    Full Text Available Process Nursing Care (PAE is a systematic tool that facilitates the scientificity of care in community practice nurse, the application of scientific method in community practice, allows nursing to provide care in logical, systematic and comprehensive reassessing interventions to achieve the proposed results. It began with the valuation of Marjory Gordon Functional Patterns and then at the stage of diagnosis and planning North American Nursing Diagnosis Association (NANDA, Nursing Interventions Classification (NIC and Nursing Outcomes Classification (NOC is interrelate. It is a descriptive and prospective study. Diagnosis was made by applying the instruments measuring scale of the socio-demographic characteristics, symptom questionnaire for early detection of mental disorders in the community and appreciation for functional patterns. The PAE includes more frequent diagnoses, criteria outcomes, indicators, interventions and activities to manage community issues. alteration was evidenced in patterns: Adaptation and Stress Tolerance, Self-perception-Self-concept-, Role-Relationships, sleep and rest and Perception and Health Management. A standardized NANDA-NIC-NOC can provide inter care holistic care from the perspective of community mental health with a degree of scientific nature that frames the professional work projecting the individual, family and community care.

  1. Accountability in Health Care

    DEFF Research Database (Denmark)

    Vrangbæk, Karsten; Byrkjeflot, Haldor

    2016-01-01

    adjustment of such frameworks. In this article we present a framework for analyzing accountability within health care. The paper makes use of the concept of "accountability regime" to signify the combination of different accountability forms, directions and functions at any given point in time. We show...

  2. Health Care Industry

    Science.gov (United States)

    2007-01-01

    technology. Advanced medical technologies are abundant in the U.S., especially computed tomography (CT) scanners and magnetic resonance imaging (MRI...Science) degree and practice general or specialized dentistry or dental surgery (IBISWorld, 2007, March 26). Health care practitioners include a wide

  3. Compliance monitoring of prohibition of smoking (under section-4 of COTPA) at a tertiary health-care institution in a smoke-free city of India.

    Science.gov (United States)

    Tripathy, Jaya Prasad; Goel, Sonu; Patro, Binod Kumar

    2013-10-01

    India enacted a comprehensive tobacco control law known as cigarettes and other tobacco products act (COTPA) in 2003. However, enforcement of the provisions under the law is still a matter of concern. Compliance survey is an effective tool to measure the status of implementation of the law at various public places. Smoke-free hospital campus demonstrates commitment to good health and sends a pro-healthy signal to the community. The objective of this study was to assess the compliance to the prohibition of smoking at public places (under section-4 of COTPA) in a tertiary health-care institution in a smoke-free city of India. An observational cross-sectional study was conducted at 40 different venues within a tertiary health-care institution in a smoke-free city of India. These places were observed for certain parameters of assessment by a structured checklist, which included evidence of active smoking, evidence of recent smoking, display of signages, presence of smoking aids, cigarette butts and bidi ends. Overall compliance rate for section-4 of COTPA was found to be mere 23%. Evidence of active smoking was observed in 21 (52.5%) venues. Signages were seen at only 8 places (20%). Butt ends and other smoking aids were seen in 37 (92.5%) and 26 (65%) places respectively. These dismal findings suggest non-compliance to the provisions under COTPA, which calls for a sensitization workshop and advocacy for all the stakeholders.

  4. Health care clinics in Cambodia.

    Science.gov (United States)

    Wollschlaeger, K

    1995-04-01

    Under the Pol Pot Khmer Rouge regime, most physicians with clinical experience were either killed or fled the country. The few practitioners who managed to survive were forced to hide their knowledge; much of that knowledge and experience is now lost. As part of a general process of national rehabilitation, Cambodia has trained since the 1980s hundreds of physicians and physician assistants. There were 700 physicians, 1300 physician assistants, and 4000 nurses in the country by 1992. Problems do, however, remain with medical education in Cambodia. In particular, the medical texts and lectures are in French, a language which very few of the younger generation speak; instructional texts are designed to meet the needs of developing nations, not a rehabilitating one like Cambodia; emphasis is upon curative health care, hospitals, and vertical programs instead of primary and preventive health care; Cambodian physicians are used to a system based upon the division of patients by ability to pay instead of by age, disease, or need; corruption has grown as the cost of living has outstripped the level of official salaries; and there is neither professional contact, feedback, nor program evaluation within health care programs. The authors is a resident in obstetrics and gynecology at the University of Chicago who worked at two clinics during a stay in Phnom Penh. She recommends that instead of simply training more doctors, these training-related problems should be addressed, including a revision of the curriculum to include both primary health care medicine and psychiatry. Moreover, people in Cambodia need to be taught the importance of preventive health care, which should then reduce the number of visits to physicians. This process will be accomplished more effectively with the cooperation of physicians, the government, nongovernmental organizations, and international organizations associated with health care.

  5. Covering young adults under the Affordable Care Act: the importance of outreach and Medicaid expansion: findings from the Commonwealth Fund Health Insurance Tracking Survey of Young Adults, 2013.

    Science.gov (United States)

    Collins, Sara R; Rasmussen, Petra W; Garber, Tracy; Doty, Michelle M

    2013-08-01

    There is concern that many young adults (ages 19--29) will remain without health insurance in 2014 despite the Affordable Care Act's reforms, including subsidized private coverage offered in new state marketplaces and expanded Medicaid eligibility. How things turn out will likely depend on outreach efforts and states' decisions on expanding Medicaid. Commonwealth Fund Health Insurance Tracking Survey data from 2011 and 2013 show increasing awareness among young adults of the 2010 requirement that health plans cover children under age 26. Of the estimated 15 million young adults enrolled in a parent's plan in the prior 12 months, 7.8 million would not likely have been eligible to enroll prior to the law. Still, only 27 percent of 19-to-29-year-olds are aware of the marketplaces. Meanwhile, most uninsured young adults living below poverty will not have access to subsidized public or private insurance in states opting out of the Medicaid expansion.

  6. Rural-urban differences in receiving guideline-recommended diabetes care and experiencing avoidable hospitalizations under a universal coverage health system: evidence from the past decade.

    Science.gov (United States)

    Chen, C-C; Chen, L-W; Cheng, S-H

    2017-10-01

    Rural-urban differences in health remain a concern worldwide. Few studies have investigated the dynamic changes in health between rural and urban areas. This study aims to examine whether the rural-urban gap in patients' receipt of guideline-recommended care and avoidable hospitalizations has decreased in 10 years under a universal coverage health system. A retrospective cohort study design. This study utilized nationwide health insurance claims data of 3 representative cohorts of patients with newly diagnosed type 2 diabetes in 2000, 2005, and 2010 in Taiwan. The two outcome variables were receipt of guideline-recommended care and avoidable hospitalizations for diabetes. Generalized estimating equations models were used to estimate the rural-urban differences while controlling for physician-clustering effects. Rural diabetic patients were less likely to receive guideline-recommended examinations/tests in 2000 (e β  = 0.97; 95% confidence interval [CI]: 0.96-0.99); however, the average number of examinations/tests increased and the rural-urban difference had diminished in 2010. The likelihood of avoidable hospitalizations for diabetes among rural diabetic patients was higher than that for their urban counterparts in 2000 (odds ratio [OR]: 1.13; 95% CI: 1.01-1.25). Although the likelihood of avoidable hospitalizations for diabetes decreased from 2000 to 2010, the rural-urban gap remained during this period. The rural-urban disparity in receiving recommended diabetes care diminished over the past decade. However, significant gaps between rural and urban areas in avoidable hospitalizations for diabetes persisted despite the universal health system. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  7. Integrated primary health care in Australia

    Directory of Open Access Journals (Sweden)

    Gawaine Powell Davies

    2009-10-01

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

  8. Health care need

    DEFF Research Database (Denmark)

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

    2006-01-01

    The argument that scarce health care resources should be distributed so that patients in 'need' are given priority for treatment is rarely contested. In this paper, we argue that if need is to play a significant role in distributive decisions it is crucial that what is meant by need can...... be precisely articulated. Following a discussion of the general features of health care need, we propose three principal interpretations of need, each of which focuses on separate intuitions. Although this account may not be a completely exhaustive reflection of what people mean when they refer to need......, the three interpretations provide a starting-point for further debate of what the concept means in its specific application. We discuss combined interpretations, the meaning of grading needs, and compare needs-based priority setting to social welfare maximisation...

  9. Medicaid Expansion Under the Affordable Care Act: Potential Changes in Receipt of Mental Health Treatment Among Low-Income Nonelderly Adults With Serious Mental Illness

    Science.gov (United States)

    Gfroerer, Joe; Kuramoto, S. Janet; Ali, Mir; Woodward, Albert M.; Teich, Judith

    2015-01-01

    Objectives. We designed this study to examine differences in receipt of mental health treatment between low-income uninsured nonelderly adults with serious mental illness (SMI) who were eligible for Medicaid under the Affordable Care Act (ACA) and their existing Medicaid counterparts. Assessing these differences might estimate the impact of the Medicaid expansion efforts under the ACA on receipt of mental health treatment among uninsured nonelderly adults with SMI. Methods. We examined data from 2000 persons aged 18 to 64 years who participated in the 2008 to 2013 National Survey on Drug Use and Health, had income below 138% of the federal poverty level, met SMI criteria, and either were uninsured (n = 1000) or had Medicaid-only coverage (n = 1000). We defined SMI according to the Alcohol, Drug Abuse, and Mental Health Administration Reorganization Act. We used descriptive analyses and logistic regression modeling. Results. In the 28 states currently expanding Medicaid, the model-adjusted prevalence (MAP) of receiving mental health treatment among Medicaid-only enrollees with SMI (MAP = 71.3%; 95% confidence interval [CI] = 65.74%, 76.29%) was 30.1% greater than their uninsured counterparts (MAP = 54.8%; 95% CI = 48.16%, 61.33%). In the United States, the MAP of receiving mental health treatment among Medicaid-only enrollees with SMI (MAP = 70.4%; 95% CI = 65.67%, 74.70%) was 35.9% higher than their uninsured counterparts (MAP = 51.8%; 95% CI = 46.98%, 56.65%). Conclusions. Estimated increases in receipt of mental health treatment because of enrolling in Medicaid among low-income uninsured adults with SMI might help inform planning and implementation efforts for the Medicaid expansion under the ACA. PMID:25790424

  10. Does capitation payment under national health insurance affect subscribers' trust in their primary care provider? a cross-sectional survey of insurance subscribers in Ghana.

    Science.gov (United States)

    Andoh-Adjei, Francis-Xavier; Cornelissen, Dennis; Asante, Felix Ankomah; Spaan, Ernst; van der Velden, Koos

    2016-08-24

    Ghana introduced capitation payment for primary care in 2012 with the view to containing escalating claims expenditure. This shift in provider payment method raised issues about its potential impact on patient-provider trust relationship and insured-patients' trust in the Ghana National Health Insurance Scheme. This paper presents findings of a study that explored insured-patients' perception about, and attitude towards capitation payment in Ghana; and determined whether capitation payment affect insured-patients' trust in their preferred primary care provider and the National Health Insurance Scheme in general. We adopted a survey design for the study. We administered closed-ended questionnaires to collect data from insurance card-bearing members aged 18 years and above. We performed both descriptive statistics to determine proportions of observations relating to the variables of interest and chi-square test statistics to determine differences within gender and setting. Sixty-nine per cent (69 %) out of 344 of respondents selected hospital level of care as their primary care provider. The two most important motivations for the choice of a provider were proximity in terms of geographical access (40 %) and perceived quality of care (38 %). Eighty-eight per cent (88 %) rated their trust in their provider as (very) high. Eighty-two per cent (82 %) actively selected their providers. Eighty-eight per cent (88 %) had no intention to switch provider. A majority (91 %) would renew their membership when it expires. Female respondents (91 %; n = 281) were more likely to renew their membership than males (87 %; n = 63). Notwithstanding capitation payment experience, 81 % of respondents would recommend to their peers to enrol with the NHIS with rural dwellers (87 %; n = 156) being more likely to do so than urban dwellers (76 %; n = 188). Almost all respondents (92 %) rated the NHIS as (very) good. Health Insurance subscribers in Ghana have high

  11. COMMUNITY MEDICINE & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    systems deteriorated in parallel with the deepening the gross inequalities in health care system, many economic crisis, while the subsequent introduction countries adopted the National Health Insurance of user fees further impeded access to care and. Scheme (NHIS) as a way of health care financing. 1 aggravated inequity ...

  12. Compliance monitoring of prohibition of smoking (under section-4 of COTPA at a tertiary health-care institution in a smoke-free city of India

    Directory of Open Access Journals (Sweden)

    Jaya Prasad Tripathy

    2013-01-01

    Full Text Available Background: India enacted a comprehensive tobacco control law known as cigarettes and other tobacco products act (COTPA in 2003. However, enforcement of the provisions under the law is still a matter of concern. Compliance survey is an effective tool to measure the status of implementation of the law at various public places. Smoke-free hospital campus demonstrates commitment to good health and sends a pro-healthy signal to the community. Objective: The objective of this study was to assess the compliance to the prohibition of smoking at public places (under section-4 of COTPA in a tertiary health-care institution in a smoke-free city of India. Materials and Methods: An observational cross-sectional study was conducted at 40 different venues within a tertiary health-care institution in a smoke-free city of India. These places were observed for certain parameters of assessment by a structured checklist, which included evidence of active smoking, evidence of recent smoking, display of signages, presence of smoking aids, cigarette butts and bidi ends. Results: Overall compliance rate for section-4 of COTPA was found to be mere 23%. Evidence of active smoking was observed in 21 (52.5% venues. Signages were seen at only 8 places (20%. Butt ends and other smoking aids were seen in 37 (92.5% and 26 (65% places respectively. Conclusion: These dismal findings suggest non-compliance to the provisions under COTPA, which calls for a sensitization workshop and advocacy for all the stakeholders.

  13. Redirecting health care spending: consumer-directed health care.

    Science.gov (United States)

    Nolin, JoAnn; Killackey, Janet

    2004-01-01

    In an environment of rising health care costs, defined contribution plans and closely related consumer-directed health plans are emerging as a possible next phase in health plan development and offer new opportunities for the nursing profession.

  14. Health care law versus constitutional law.

    Science.gov (United States)

    Hall, Mark A

    2013-04-01

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

  15. Health care engineering

    CERN Document Server

    Frize, Monique

    2013-01-01

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

  16. Management of severe acute malnutrition in children under 5 years through the lens of health care workers in two rural South African hospitals

    Directory of Open Access Journals (Sweden)

    Moise Muzigaba

    2018-01-01

    Full Text Available Background: Despite the widespread implementation of the World Health Organization (WHO guidelines for the management of severe malnutrition in South Africa, poor treatment outcomes for children under 5 years are still observed in some hospitals, particularly in rural areas.Objective: To explore health care workers’ perceptions about upstream and proximal factors contributing to poor treatment outcomes for severe acute malnutrition in two district hospitals in South Africa.Methods: An explorative descriptive qualitative study was conducted. Four focus group discussions were held with 33 hospital staff (senior clinical and management staff, and junior clinical staff using interview guide questions developed based on the findings from an epidemiological study that was conducted in the same hospitals. Qualitative data were analysed using the framework analysis.Findings: Most respondents believed that critical illness, which was related to early and high case fatality rates on admission, was linked to a web of factors including preference for traditional medicine over conventional care, gross negligence of the child at household level, misdiagnosis of severe malnutrition at the first point of care, lack of specialised skills to deal with complex presentations, shortage of patient beds in the hospital and policies to discharge patients before optimal recovery. The majority believed that the WHO guidelines were effective and relatively simple to implement, but that they do not make much difference among severe acute malnutrition cases that are admitted in a critical condition. Poor management of cases was linked to the lack of continuity in training of rotating clinicians, sporadic shortages of therapeutic resources, inadequate staffing levels after normal working hours and some organisational and system-wide challenges beyond the immediate control of clinicians.Conclusion: Findings from this study suggest that effective management of paediatric

  17. Management of severe acute malnutrition in children under 5 years through the lens of health care workers in two rural South African hospitals.

    Science.gov (United States)

    Muzigaba, Moise; Van Wyk, Brian; Puoane, Thandi

    2018-01-30

    Despite the widespread implementation of the World Health Organization (WHO) guidelines for the management of severe malnutrition in South Africa, poor treatment outcomes for children under 5 years are still observed in some hospitals, particularly in rural areas. To explore health care workers' perceptions about upstream and proximal factors contributing to poor treatment outcomes for severe acute malnutrition in two district hospitals in South Africa. An explorative descriptive qualitative study was conducted. Four focus group discussions were held with 33 hospital staff (senior clinical and management staff, and junior clinical staff) using interview guide questions developed based on the findings from an epidemiological study that was conducted in the same hospitals. Qualitative data were analysed using the framework analysis. Most respondents believed that critical illness, which was related to early and high case fatality rates on admission, was linked to a web of factors including preference for traditional medicine over conventional care, gross negligence of the child at household level, misdiagnosis of severe malnutrition at the first point of care, lack of specialised skills to deal with complex presentations, shortage of patient beds in the hospital and policies to discharge patients before optimal recovery. The majority believed that the WHO guidelines were effective and relatively simple to implement, but that they do not make much difference among severe acute malnutrition cases that are admitted in a critical condition. Poor management of cases was linked to the lack of continuity in training of rotating clinicians, sporadic shortages of therapeutic resources, inadequate staffing levels after normal working hours and some organisational and system-wide challenges beyond the immediate control of clinicians. Findings from this study suggest that effective management of paediatric severe acute malnutrition in the study setting is affected by a

  18. Primary mental health care: Indications and obstacles

    Directory of Open Access Journals (Sweden)

    Y.G. Pillay

    1992-09-01

    Full Text Available This paper considers indications and obstacles for the development of primary mental health care practice in both developed and under-developed countries. Both are considered as this represents the South African reality. While a significant body of literature has documented the need for primary mental health care, the obstacles (especially in terms of the commodification of health to its fruition are seldom addressed.

  19. Attending unintended transformations of health care infrastructure

    Directory of Open Access Journals (Sweden)

    Helle Wentzer

    2007-11-01

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

  20. Attending unintended transformations of health care infrastructure

    Science.gov (United States)

    Wentzer, Helle; Bygholm, Ann

    2007-01-01

    Introduction Western health care is under pressure from growing demands on quality and efficiency. The development and implementation of information technology, IT is a key mean of health care authorities to improve on health care infrastructure. Theory and methods Against a background of theories on human-computer interaction and IT-mediated communication, different empirical studies of IT implementation in health care are analyzed. The outcome is an analytical discernment between different relations of communication and levels of interaction with IT in health care infrastructure. These relations and levels are synthesized into a framework for identifying tensions and potential problems in the mediation of health care with the IT system. These problems are also known as unexpected adverse consequences, UACs, from IT implementation into clinical health care practices. Results This paper develops a conceptual framework for addressing transformations of communication and workflow in health care as a result of implementing IT. Conclusion and discussion The purpose of the conceptual framework is to support the attention to and continuous screening for errors and unintended consequences of IT implementation into health care practices and outcomes. PMID:18043725

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

    Science.gov (United States)

    Petrochuk, M A; Javalgi, R G

    1996-01-01

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

  2. Health care process and workflow in continuity of care.

    Science.gov (United States)

    Mennerat, François; Lundell, Karl-Henrik; Fogelberg, Magnus; Hofdijk, Jacob; Braga, Silviu

    2009-01-01

    Basically, the workshop aims to raise and collect input to Part 2 ("Health care process and workflow"), currently under development, of the European standard EN 13940 "Health informatics - System of concepts to support continuity of care", the general objective of which is to enable communication at the semantic level between information systems in health care in the perspective of continuity of care. Its scope encompasses identifying the various processes and process objects involved, taking into consideration resource management aspects, responsibilities of health care providers, and means for patients' participation. While the process description and concept system model is meant as a tool for the development of information systems, it may also be used for enterprise analysis and form the basis for organizational decisions and more widely organizational developments that are not inherently tied to the use of ICT.

  3. Primary health care practitioners' tools for mental health care.

    Science.gov (United States)

    Hyvonen, S; Nikkonen, M

    2004-10-01

    The purpose of this study was to describe and analyse the content of mental health care from the practitioner's point of view. The specific aim of this paper was to outline the types of mental health care tools and the ways in which they are used by primary health care practitioners. The data were derived from interviews with doctors and nurses (n = 29) working in primary health care in six different health care centres of the Pirkanmaa region in Finland. The data were analysed by using qualitative content analysis. The tools of mental health care used in primary health care were categorized as communicative, ideological, technical and collaborative tools. The interactive tools are either informative, supportive or contextual. The ideological tools consist of patient initiative, acceptance and permissiveness, honesty and genuineness, sense of security and client orientation. The technical tools are actions related to the monitoring of the patient's physical health and medical treatment. The collaborative tools are consultation and family orientation. The primary health care practitioner him/herself is an important tool in mental health care. On the one hand, the practitioner can be categorized as a meta-tool who has control over the other tools. On the other hand, the practitioner him/herself is a tool in the sense that s/he uses his/her personality in the professional context. The professional skills and attitudes of the practitioner have a significant influence on the type of caring the client receives. Compared with previous studies, the present informants from primary health care seemed to use notably versatile tools in mental health work. This observation is important for the implementation and development of mental health practices and education.

  4. Occupational Health for Health Care Providers

    Science.gov (United States)

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

  5. Primary health care models

    Science.gov (United States)

    Brown, Judith Belle; French, Reta; McCulloch, Amy; Clendinning, Eric

    2012-01-01

    Abstract Objective To explore the knowledge and perceptions of fourth-year medical students regarding the new models of primary health care (PHC) and to ascertain whether that knowledge influenced their decisions to pursue careers in family medicine. Design Qualitative study using semistructured interviews. Setting The Schulich School of Medicine and Dentistry at The University of Western Ontario in London. Participants Fourth-year medical students graduating in 2009 who indicated family medicine as a possible career choice on their Canadian Residency Matching Service applications. Methods Eleven semistructured interviews were conducted between January and April of 2009. Data were analyzed using an iterative and interpretive approach. The analysis strategy of immersion and crystallization assisted in synthesizing the data to provide a comprehensive view of key themes and overarching concepts. Main findings Four key themes were identified: the level of students’ knowledge regarding PHC models varied; the knowledge was generally obtained from practical experiences rather than classroom learning; students could identify both advantages and disadvantages of working within the new PHC models; and although students regarded the new PHC models positively, these models did not influence their decisions to pursue careers in family medicine. Conclusion Knowledge of the new PHC models varies among fourth-year students, indicating a need for improved education strategies in the years before clinical training. Being able to identify advantages and disadvantages of the PHC models was not enough to influence participants’ choice of specialty. Educators and health care policy makers need to determine the best methods to promote and facilitate knowledge transfer about these PHC models. PMID:22518904

  6. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    the_monk

    Health may be seen as “a state of complete as stated in the United Nations Charter on physical, mental, and social well-being and not. 6. Human Rights. Although, health may seem merely the absence of disease or infirmity” idealistic, healthy living can best be achieved according to the World Health Organization. 1.

  7. Spiritual Care Education of Health Care Professionals

    Directory of Open Access Journals (Sweden)

    Donia Baldacchino

    2015-05-01

    Full Text Available Nurses and health care professionals should have an active role in meeting the spiritual needs of patients in collaboration with the family and the chaplain. Literature criticizes the impaired holistic care because the spiritual dimension is often overlooked by health care professionals. This could be due to feelings of incompetence due to lack of education on spiritual care; lack of inter-professional education (IPE; work overload; lack of time; different cultures; lack of attention to personal spirituality; ethical issues and unwillingness to deliver spiritual care. Literature defines spiritual care as recognizing, respecting, and meeting patients’ spiritual needs; facilitating participation in religious rituals; communicating through listening and talking with clients; being with the patient by caring, supporting, and showing empathy; promoting a sense of well-being by helping them to find meaning and purpose in their illness and overall life; and referring them to other professionals, including the chaplain/pastor. This paper outlines the systematic mode of intra-professional theoretical education on spiritual care and its integration into their clinical practice; supported by role modeling. Examples will be given from the author’s creative and innovative ways of teaching spiritual care to undergraduate and post-graduate students. The essence of spiritual care is being in doing whereby personal spirituality and therapeutic use of self contribute towards effective holistic care. While taking into consideration the factors that may inhibit and enhance the delivery of spiritual care, recommendations are proposed to the education, clinical, and management sectors for further research and personal spirituality to ameliorate patient holistic care.

  8. Medical imaging and alternative health care organizations

    International Nuclear Information System (INIS)

    Levy, E.

    1987-01-01

    Imaging is not easy to measure in economic terms for France to day. The impact of innovation process is no more clear and especially the substitutions expected between different techniques. Nevertheless, these new techniques could provoque big changes in medical practices and health care organizations. They should probably increase the proportion of ambulatory patients in total examinations and encourage the development of extra-hospital health care. But, in France, alternative health care organizations (day hospital, home care, etc...) are under developed because of many non technical factors (behavioural managerial and institutional). Perhaps major potential change shall come from imaging networks. But can imaging development contribute to moderate health expanses growth rate. Economic evaluations of each new technique are difficult and ambiguous but necessary to maximize health care system efficiency [fr

  9. Health care enters the real world.

    Science.gov (United States)

    Schroeder, N J

    1987-01-01

    The U.S. health care system is undergoing restructuring as a result of a complex interplay of social, political, and economic forces. Where once the medical profession had a monopoly position in the health care system, its position has been challenged by the Federal Trade Commission under the Sherman Antitrust Act. More and more, the health care field is characterized by entrepreneurialism, a concept that is at odds with the traditional tenets of the medical profession. The restructuring of health care in the U.S. has the potential to allow the entrepreneur to function to the benefit of patients, despite the fact that this is a change resisted by those providing health care services.

  10. The health care learning organization.

    Science.gov (United States)

    Hult, G T; Lukas, B A; Hult, A M

    1996-01-01

    To many health care executives, emphasis on marketing strategy has become a means of survival in the threatening new environment of cost attainment, intense competition, and prospective payment. This paper develops a positive model of the health care organization based on organizational learning theory and the concept of the health care offering. It is proposed that the typical health care organization represents the prototype of the learning organization. Thus, commitment to a shared vision is proposed to be an integral part of the health care organization and its diagnosis, treatment, and delivery of the health care offering, which is based on the exchange relationship, including its communicative environment. Based on the model, strategic marketing implications are discussed.

  11. COMMUNITY MEDICINE & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    ajiboro

    1,2. Organization, the community health worker was health system when the country adopted the PHC introduced into the health system for various strategy to achieve the goal of health for all. 76. JOURNAL OF COMMUNITY MEDICINE AND PRIMARY HEALTH CARE VOL. 25, NO 2, SEPTEMBER 2013. Correspondence to.

  12. Health and Disability: Partnerships in Health Care

    Science.gov (United States)

    Tracy, Jane; McDonald, Rachael

    2015-01-01

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

  13. The use of psychotropic medication in patients with emotionally unstable personality disorder under the care of UK mental health services.

    Science.gov (United States)

    Paton, Carol; Crawford, Michael J; Bhatti, Sumera F; Patel, Maxine X; Barnes, Thomas R E

    2015-04-01

    Guideline recommendations for the pharmacologic treatment of personality disorder lack consensus, particularly for emotionally unstable personality disorder (EUPD), and there is limited information on current prescribing practice in the United Kingdom. To characterize the nature and quality of current prescribing practice for personality disorder across the United Kingdom, as part of a quality improvement program. A cross-sectional survey of self-selected psychiatric services providing care for adults with personality disorder (ICD-10 criteria) was conducted. Data were collected during May 2012. Of 2,600 patients with a diagnosis of personality disorder, more than two-thirds (68%) had a diagnosis of EUPD. Almost all (92%) patients in the EUPD subgroup were prescribed psychotropic medication, most commonly an antidepressant or antipsychotic, principally for symptoms and behaviors that characterize EUPD, particularly affective dysregulation. Prescribing patterns were similar between those who had a diagnosed comorbid mental illness and those who had EUPD alone, but the latter group was less likely to have had their medication reviewed over the previous year, particularly with respect to tolerability (53% vs 43%). The use of psychotropic medication in EUPD in the United Kingdom is largely outside the licensed indications. Whether the treatment target is identified as intrinsic symptoms of EUPD or comorbid mental illness may depend on the diagnostic threshold of individual clinicians. Compared with prescribing for EUPD where there is judged to be a comorbid mental illness, the use of off-label medication for EUPD alone is less systematically reviewed and monitored, so opportunities for learning may be lost. Treatment may be continued long term by default. © Copyright 2015 Physicians Postgraduate Press, Inc.

  14. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    and occupational infections among staff of in ward rounds, in operation theatres and. 1. 3,4 ... 2Department of Medical Microbiology and Parasitology, Faculty of Basic Medical Sciences, College of Health Sciences, Obafemi Awolowo University, ... the mobile phones of health workers and subjected to microbiology analysis.

  15. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    1Department of Paediatrics and Child Health, Faculty of Clinical Sciences, College of Health Sciences,. Obafemi Awolowo ... Younger parents less than 35years, parents with lower educational attainments and low .... staffing, availability of immunization consumables was estimated using the Computer Programme for.

  16. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    Background/Objective: There is some evidence that weak leadership in health institutions contributes to underutilization of health services, resulting in high levels of morbidities and mortalities. Employee-rated leadership gaps in a hospital, as done in this study, can promote employee engagement in leadership capacity ...

  17. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    user

    share of the total burden due to mental illness is 70-75% compared with 5% in developed countries, primarily due to the disproportionate burden of communicable, maternal, prenatal and nutritional. 9 conditions. Globally, the findings from the first of a series of World Health Organization. (WHO) World Mental Health Surveys.

  18. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    Methodology. A cross-sectional survey of patients at the antiretroviral clinic of the Federal Medical Centre,. Makurdi, Nigeria, was conducted between June and August 2008. An adapted version of the RAND. Patient Satisfaction Questionnaire Long Form was used to assess seven dimensions of care: general satisfaction ...

  19. Multipurpose Health Care Telemedicine System

    National Research Council Canada - National Science Library

    Kyriacou, E

    2001-01-01

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

  20. Space age health care delivery

    Science.gov (United States)

    Jones, W. L.

    1977-01-01

    Space age health care delivery is being delivered to both NASA astronauts and employees with primary emphasis on preventive medicine. The program relies heavily on comprehensive health physical exams, health education, screening programs and physical fitness programs. Medical data from the program is stored in a computer bank so epidemiological significance can be established and better procedures can be obtained. Besides health care delivery to the NASA population, NASA is working with HEW on a telemedicine project STARPAHC, applying space technology to provide health care delivery to remotely located populations.

  1. Health care's service fanatics.

    Science.gov (United States)

    Merlino, James I; Raman, Ananth

    2013-05-01

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

  2. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    the_monk

    Background and Objectives: Vaccine preventable diseases cause significant morbidity and mortality among children in developing countries despite the availability of vaccines. This study determined childhood immunization uptake and associated factors among mothers of under- fives in Kosofe, Lagos State. Methodology:.

  3. Diaspora, disease, and health care.

    Science.gov (United States)

    Wick, Jeannette Y; Zanni, Guido R

    2007-03-01

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

  4. Foster Care and Child Health.

    Science.gov (United States)

    McDavid, Lolita M

    2015-10-01

    Children in foster care need more from health providers than routine well-child care. The changes in legislation that were designed to prevent children from languishing in foster care also necessitate a plan that works with the child, the biological family, and the foster family in ensuring the best outcome for the child. This approach acknowledges that most foster children will return to the biological family. Recent research on the effect of adverse childhood experiences across all socioeconomic categories points to the need for specifically designed, focused, and coordinated health and mental health services for children in foster care. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. The Politics of Health Care.

    Science.gov (United States)

    Anderson, John B.

    Before the mid-1960's the Federal role in health care was extremely limited, but technological breakthroughs, the new importance of hospitals, and the recognition that the poor and elderly have been underserved prompted Congress to pass the Medicare and Medicaid package in 1966. Since then the Federal share of the health care dollar has risen by…

  6. COMMUNITY MEDICINE & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    the_monk

    Department of Community Medicine,. Ahmadu Bello University,Zaria. +234 803 705 3845. Email: firstmsibrahim@yahoo.com. Department of Community Medicine, Ahmadu Bello University, Zaria journal of. COMMUNITY MEDICINE. & PRIMARY HEALTH CARE. Journal of Community Medicine and Primary Health Care.

  7. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    the_monk

    Patients attending the sexually transmitted disease clinic of the Lagos State University Teaching Hospital,. Ikeja, Lagos were ... psychological disturbances and also work with mental health experts to provide psychological services for identified .... Another study from also facilitate change in risk behaviour.24 This. Pakistan ...

  8. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    user

    2011-10-07

    Oct 7, 2011 ... which are quite common in human populations. These infections are of major public health concern in sub-Saharan Africa because of existing predisposing factors in the region. These factors include poor environmental and personal hygiene, poverty, malnutrition, unsafe water supply and. 1, 2 ignorance.

  9. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    adedamla

    of Dust Mask among Crushers of Selected Quarry (Crushed. Stone) Industry in Ebonyi State: Effect of Health Education. 1. 2. 2. 2. 3. 1. Uwakwe K.A , Agu A.P , Ogbonnaya L.U , Nwonwu E.U , Aguwa E.N , Duru C.B. INTRODUCTION. Occupational exposure to respirable crystalline silica in dust from stone quarrying has. 1,2.

  10. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    the_monk

    Intestinal parasites are among the most common infection of school age-children worldwide and remain a major cause of morbidity and ... There is need to improve sanitation and peoples' living conditions, provide clean water, health education, chemotherapy ... other domestic activities and also as refuse children in Ilesha ...

  11. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    user

    mania) and anxiety disorders (General anxiety, agoraphobia, social phobia, obsessive-compulsive disorder and post traumatic stress disorder). ... understaffed, and underutilized in both developed and developing settings despite the growing burden of mental health. 16,17,18 illness. Compared to developed settings,.

  12. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    user

    effects. Others are illiteracy; power imbalance among couples; socio-cultural, religion and. 13 gender related issues. The use of contraceptives reduces maternal mortality and improves the woman's health by preventing unwanted and high risk pregnancies and therefore the need for unsafe abortion. Some of these.

  13. Health Care in South Africa.

    Science.gov (United States)

    Younger, David S

    2016-11-01

    The South African health care system is embedded in a background of racial subordination and sexual violence against girls and women and of hierarchical male authority from youth to adulthood. Low wages, unemployment, urban overcrowding, inadequate sanitation, malnutrition, crime, and violence have contributed to economic and health inequality. With more health-insured whites than blacks and the proportion of gross national product spent on health care slowly increasing, two-thirds of health expenditures have been consumed by the private sector at a time when the cost of health insurance has risen to more than 3 times the rate of the consumer price index. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Integrating sustainability and health care.

    Science.gov (United States)

    Podein, Rian J; Hernke, Michael T

    2010-03-01

    Unsustainable development around the world has contributed to ecological degradation and human suffering while compromising the ability of ecosystems and social institutions to support human life. The United States health care system and its institutions are significant contributors to unsustainable development, but leaders of change are emerging from the health care arena. Health professionals, including primary care providers, are poised to serve as models for sustainability and to facilitate the necessary transformation toward more sustainable practices. Health professionals must, within a practical framework, embrace an objective definition of sustainability and then act to achieve it. Copyright 2010 Elsevier Inc. All rights reserved.

  15. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    Results: Of the 686 respondents, most were farmers (69.7%). In terms of malaria prevention, most of the households (81.8%) own a mosquito net, but in 40.8% of the households, no member slept under a mosquito net the night before the survey. A significant proportion of the households (32.9%) use. “otapiapia”, a cheap ...

  16. Health care of hunting dogs

    OpenAIRE

    Spasojević-Kosić, Ljubica; Savić, Sara

    2013-01-01

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

  17. Promoting coordination in Norwegian health care

    Directory of Open Access Journals (Sweden)

    Tor I. Romøren

    2011-10-01

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

  18. Promoting coordination in Norwegian health care

    Directory of Open Access Journals (Sweden)

    Tor I. Romøren

    2011-10-01

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

  19. Finding Health Care Services

    Science.gov (United States)

    If you have been diagnosed with cancer, finding a doctor and treatment hospital for your cancer care is an important step to getting the best treatment possible. Learn tips for choosing a doctor and treatment facility to manage your cancer care.

  20. Hope for health and health care.

    Science.gov (United States)

    Stempsey, William E

    2015-02-01

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

  1. 29 CFR 825.125 - Definition of health care provider.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 3 2010-07-01 2010-07-01 false Definition of health care provider. 825.125 Section 825.125... Definition of health care provider. (a) The Act defines “health care provider” as: (1) A doctor of medicine... under State law; (3) Christian Science Practitioners listed with the First Church of Christ, Scientist...

  2. Child Health Care Services in Austria.

    Science.gov (United States)

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

    2016-10-01

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

  3. COMMUNITY MEDICINE & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    Objective: The study aimed at involving adolescents in school-based health promotion activities as a strategy to improve ... Adolescents, perception of risk, sexual behaviour, active participation, health promotion. journal of. COMMUNITY MEDICINE. & PRIMARY HEALTH CARE .... behaviour, importance of self esteem and.

  4. Health Care for the Homeless.

    Science.gov (United States)

    Altman, Drew; And Others

    1989-01-01

    This supplementary statement, prepared by 10 members of the Institute of Medicine's Committee on Health Care for the Homeless, expands upon the Committee's report, "Homelessness, Health and Human Needs." Argues that the only broad, long-term solution to the health problems of the homeless is immediate action to provide decent, affordable…

  5. COMMUNITY MEDICINE & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    CHILDREN,. SCHOOL HEALTH. Correspondence to. Dr Kofoworola A Odeyemi. Department of Community Health, University of Lagos . Lagos. Nigeria. Email kofoodeyemi@yahoo.com. Journal of Community Medicine and Primary Health Care. 25 (1) 51-57. Background: Visual impairment is usually due to conditions that ...

  6. DOD Health Care: Domestic Health Care for Female Servicemembers

    Science.gov (United States)

    2013-01-01

    established in order to provide for medical recovery from childbirth and to allow additional time to prepare family care plans and child care. However...affect both men and women, and with the exception of postpartum depression , are not easily distinguished by gender. Consequently, behavioral health...disorder (PTSD), postpartum depression , parenting, and general female servicemember issues. With respect to privacy when providing behavioral health

  7. Improving access to health care.

    Science.gov (United States)

    Peters, B; Haynes, K

    2001-01-01

    It is a problem that has plagued the American health care system for years, and it is not getting any better. While the majority of our population enjoys ready access to the finest health care in the world, a steadily growing number are joining the ranks of the uninsured. Despite a strong economy throughout the last decade, the uninsured rate in Michigan is at a higher level today than it was in 1990, and more than one million residents currently have no health care insurance.

  8. Conscientious objection in health care

    Directory of Open Access Journals (Sweden)

    Kuře Josef

    2016-12-01

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

  9. Home Health Care Agencies

    Data.gov (United States)

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

  10. Strategies for targeting health care disparities among Hispanics.

    Science.gov (United States)

    Daniel, Manju

    2010-01-01

    Hispanics are the largest minority group in United States and at a great risk for poor health outcomes linked to poor access to health care. Their large geographic distribution makes it critical that the underlying factors resulting in health care disparities among documented and undocumented Hispanics be addressed at local, state, and national levels. Health care systems should establish community partnership for effective strategies to address these disparities. This article presents factors identified in the literature that contribute to health care disparities among Hispanics and provides strategies for improving access to health care for health promotion.

  11. Quality of prescribing of antipsychotic medication for people with intellectual disability under the care of UK mental health services: a cross-sectional audit of clinical practice.

    Science.gov (United States)

    Paton, Carol; Bhatti, Sumera; Purandare, Kiran; Roy, Ashok; Barnes, Tre

    2016-12-05

    To determine the prevalence and quality of antipsychotic prescribing for people with intellectual disability (ID). A clinical audit of prescribing practice in the context of a quality improvement programme. Practice standards for audit were derived from relevant, evidence-based guidelines, including NICE. Data were mainly collected from the clinical records, but to determine the clinical rationale for using antipsychotic medication in individual cases, prescribers could also be directly questioned. 54 mental health services in the UK, which were predominantly NHS Trusts. Information on prescribing was collected for 5654 people with ID. Almost two-thirds (64%) of the total sample was prescribed antipsychotic medication, of whom almost half (49%) had a schizophrenia spectrum or affective disorder diagnosis, while a further third (36%) exhibited behaviours recognised by NICE as potentially legitimate targets for such treatment such as violence, aggression or self-injury. With respect to screening for potential side effects within the past year, 41% had a documented measure of body weight (range across participating services 18-100%), 32% blood pressure (0-100%) and 37% blood glucose and blood lipids (0-100%). These data from mental health services across the UK suggest that antipsychotic medications are not widely used outside of licensed and/or evidence-based indications in people with ID. However, screening for side effects in those patients on continuing antipsychotic medication was inconsistent across the participating services and the possibility that a small number of these services failed to meet basic standards of care cannot be excluded. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  12. Towards Sustainable Health Care Organizations

    Directory of Open Access Journals (Sweden)

    Mauro ROMANELLI

    2017-09-01

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

  13. Concept of Health Care Counseling for Pediatricians.

    Science.gov (United States)

    Nair, M Kc; Leena, M L; Ajithkumar, K

    2016-11-15

    Health care counseling (HCC) is a relatively new concept that amalgamates human biology, human psychology and medical sociology principles, and applies the same in real-time clinical situations. In India, there is a real paucity of trained mental health personnel, and hence counseling services are restricted to few departments. HCC is especially important for the child population, as the pediatricians need to partner the parenting responsibilities in different illness care settings covering the period from newborn to adolescence. This paper proposes steps for further development of the concept, expertise and systematic training program for health personnel, as an activity of Centre for Health Care Counseling Studies under Kerala University of Health Sciences. Once the process is documented, we hope that the same would be made available to other states in India.

  14. Health care seeking patterns and determinants of out-of-pocket expenditure for malaria for the children under-five in Uganda.

    Science.gov (United States)

    Nabyonga Orem, Juliet; Mugisha, Frederick; Okui, Albert Peter; Musango, Laurent; Kirigia, Joses Muthuri

    2013-05-31

    The objectives of this study were to assess the patterns of treatment seeking behaviour for children under five with malaria; and to examine the statistical relationship between out-of-pocket expenditure (OOP) on malaria treatment for under-fives and source of treatment, place of residence, education and wealth characteristics of Uganda households. OOP expenditure on health care is now a development concern due to its negative effect on households' ability to finance consumption of other basic needs. The 2009 Uganda Malaria Indicator Survey was the source of data on treatment seeking behaviour for under-five children with malaria, and patterns and levels of OOP expenditure for malaria treatment. Binomial logit and Log-lin regression models were estimated. In logit model the dependent variable was a dummy (1=incurred some OOP, 0=none incurred) and independent variables were wealth quintiles, rural versus urban, place of treatment, education level, sub-region, and normal duty disruption. The dependent variable in Log-lin model was natural logarithm of OOP and the independent variables were the same as mentioned above. Five key descriptive analysis findings emerge. First, malaria is quite prevalent at 44.7% among children below the age of five. Second, a significant proportion seeks treatment (81.8%). Third, private providers are the preferred option for the under-fives for the treatment of malaria. Fourth, the majority pay about 70.9% for either consultation, medicines, transport or hospitalization but the biggest percent of those who pay, do so for medicines (54.0%). Fifth, hospitalization is the most expensive at an average expenditure of US$7.6 per child, even though only 2.9% of those that seek treatment are hospitalized.The binomial logit model slope coefficients for the variables richest wealth quintile, Private facility as first source of treatment, and sub-regions Central 2, East central, Mid-eastern, Mid-western, and Normal duties disrupted were positive and

  15. Health care seeking patterns and determinants of out-of-pocket expenditure for Malaria for the children under-five in Uganda

    Science.gov (United States)

    2013-01-01

    Background The objectives of this study were to assess the patterns of treatment seeking behaviour for children under five with malaria; and to examine the statistical relationship between out-of-pocket expenditure (OOP) on malaria treatment for under-fives and source of treatment, place of residence, education and wealth characteristics of Uganda households. OOP expenditure on health care is now a development concern due to its negative effect on households’ ability to finance consumption of other basic needs. Methods The 2009 Uganda Malaria Indicator Survey was the source of data on treatment seeking behaviour for under-five children with malaria, and patterns and levels of OOP expenditure for malaria treatment. Binomial logit and Log-lin regression models were estimated. In logit model the dependent variable was a dummy (1=incurred some OOP, 0=none incurred) and independent variables were wealth quintiles, rural versus urban, place of treatment, education level, sub-region, and normal duty disruption. The dependent variable in Log-lin model was natural logarithm of OOP and the independent variables were the same as mentioned above. Results Five key descriptive analysis findings emerge. First, malaria is quite prevalent at 44.7% among children below the age of five. Second, a significant proportion seeks treatment (81.8%). Third, private providers are the preferred option for the under-fives for the treatment of malaria. Fourth, the majority pay about 70.9% for either consultation, medicines, transport or hospitalization but the biggest percent of those who pay, do so for medicines (54.0%). Fifth, hospitalization is the most expensive at an average expenditure of US$7.6 per child, even though only 2.9% of those that seek treatment are hospitalized. The binomial logit model slope coefficients for the variables richest wealth quintile, Private facility as first source of treatment, and sub-regions Central 2, East central, Mid-eastern, Mid-western, and Normal

  16. Will Boeing Change Health Care?

    Science.gov (United States)

    Stempniak, Marty

    2015-12-01

    Big employers like Boeing and Intel are directly contracting with hospitals in an effort to control health care prices. Some hospital CEOs see direct contracting as the future, while others wonder how they can participate.

  17. Understanding your health care costs

    Science.gov (United States)

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

  18. [Corruption and health care system].

    Science.gov (United States)

    Marasović Šušnjara, Ivana

    2014-06-01

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

  19. The carbon footprint of Australian health care.

    Science.gov (United States)

    Malik, Arunima; Lenzen, Manfred; McAlister, Scott; McGain, Forbes

    2018-01-01

    Carbon footprints stemming from health care have been found to be variable, from 3% of the total national CO 2 equivalent (CO 2 e) emissions in England to 10% of the national CO 2 e emissions in the USA. We aimed to measure the carbon footprint of Australia's health-care system. We did an observational economic input-output lifecycle assessment of Australia's health-care system. All expenditure data were obtained from the 15 sectors of the Australian Institute of Health and Welfare for the financial year 2014-15. The Australian Industrial Ecology Virtual Laboratory (IELab) data were used to obtain CO 2 e emissions per AUS$ spent on health care. In 2014-15 Australia spent $161·6 billion on health care that led to CO 2 e emissions of about 35 772 (68% CI 25 398-46 146) kilotonnes. Australia's total CO 2 e emissions in 2014-15 were 494 930 kilotonnes, thus health care represented 35 772 (7%) of 494 930 kilotonnes total CO 2 e emissions in Australia. The five most important sectors within health care in decreasing order of total CO 2 e emissions were: public hospitals (12 295 [34%] of 35 772 kilotonnes CO 2 e), private hospitals (3635 kilotonnes [10%]), other medications (3347 kilotonnes [9%]), benefit-paid drugs (3257 kilotonnes [9%]), and capital expenditure for buildings (2776 kilotonnes [8%]). The carbon footprint attributed to health care was 7% of Australia's total; with hospitals and pharmaceuticals the major contributors. We quantified Australian carbon footprint attributed to health care and identified health-care sectors that could be ameliorated. Our results suggest the need for carbon-efficient procedures, including greater public health measures, to lower the impact of health-care services on the environment. None. Copyright © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.

  20. Health care entrepreneurship: financing innovation.

    Science.gov (United States)

    Grazier, Kyle L; Metzler, Bridget

    2006-01-01

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

  1. Helping You Choose Quality Behavioral Health Care

    Science.gov (United States)

    Helping You Choose Quality Behavioral Health Care Selecting quality behavioral health care services for yourself, a relative or friend requires special thought and attention. The Joint Commission on ...

  2. Home Health Care

    Science.gov (United States)

    ... content Skip Navigation Department of Health and Human Services Your Browser does not support javascript, so the search function on this page is disabled 1-800-677-1116 Home > Resources > Factsheets > Home ...

  3. The changing roles of health care personnel in health and health care management.

    Science.gov (United States)

    Hunter, D J

    1996-09-01

    Health care reform has become a global phenomenon. Countries are experiencing similar problems with their health care systems and are reaching for similar solutions. Management is seen as crucial in many countries as the principal means of securing supply-side reforms. Many of these centre on establishing a new relationship between professionals, notably the medical profession, and the state. The aim has been to exercise greater influence over how professionals practice and use resources. The application of new public management principles based on industrial sector practices and concepts of management has created tensions within professional groups who feel themselves, and their craft, to be under attack. But the new managerialism has to be seen within a context of rapid social and economic change. It is not possible to predict what the impact of such change is likely to be on health services in the future or on those who provide them. The paper offers an overview of health care reforms and assesses how it is shaping, or re-shaping, the roles and tasks of health care personnel. One conclusion is the mismatch between the management style favoured by policy-makers and reformers and the necessary flexibility required in skill mix and organization of work. High-trust relations lie at the heart of professional forms of organisation whereas the new managerialism appears to be based on the expectation of low-trust relations. The paper concludes with a brief look at the implications of all these developments for training and education and finds that there is still a long way to go before there is any real prospect of providing and equipping health care personnel with the requisite skills to enable them to meet the complex challenges that are a common characteristic of health care systems.

  4. Babesiosis for Health Care Providers

    Centers for Disease Control (CDC) Podcasts

    2012-04-25

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

  5. Rural migration and health care

    DEFF Research Database (Denmark)

    Svendsen, Gunnar Lind Haase; Jensen, Marit Vatn

    This literature study focuses on possible links between access to health services and migration in rural areas. Why do people move to or from rural areas or why do they stay? What determines where people settle? And, in this context, do local health care services play an important or minor role...

  6. primary health care in nigeria

    African Journals Online (AJOL)

    user1

    2014-07-31

    Jul 31, 2014 ... The Alma Ata declaration on Primary Health Care (PHC) which was made in 1978 is meant to address the main health problems in communities by providing promotive, preventive, curative and rehabilitative services. Nigeria was among the 134 signatories to this invaluable idea. Subsequently, several ...

  7. Health care's 100 most wired.

    Science.gov (United States)

    Solovy, A; Serb, C

    1999-02-01

    They're wired all right, and America's 100 most techno-savvy hospitals and health systems share one more thing: a commitment to using technology to link with employees, patients, suppliers, and insurers. "We want to be a health care travel agency for our community," says one chief information officer. "And we see Internet technology as a key."

  8. COMMUNITY MEDICINE & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    ajiboro

    population of the big cities live urban slums. our environment are diarrhea diseases, pneumonia,. Urban slums pose special health problems due to. JOURNAL OF COMMUNITY MEDICINE AND PRIMARY HEALTH CARE VOL. 26, NO 1, MARCH 2014. 1. 1Department of Paediatrics, University of Nigeria Teaching Hospital, ...

  9. COMMUNITY MEDICINE & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    ajiboro

    Nigeria has one of the largest stocks of. In all situations, volunteers add to the quality and human resources for ... profit making enterprise by the partners the health care objectives, including the involved.Rather, it is a health ..... Investing in volunteerism: The impact of service initiatives in selected state agencies. Austin, TX: ...

  10. Health care transition for youth with special health care needs.

    Science.gov (United States)

    Bloom, Sheila R; Kuhlthau, Karen; Van Cleave, Jeanne; Knapp, Alixandra A; Newacheck, Paul; Perrin, James M

    2012-09-01

    Youth with special health care needs (YSHCN) increasingly live into adulthood, and approximately 500,000 U.S. youth transition from pediatric to adult health care systems annually. Through a systematic literature review, we sought to (1) determine adult outcomes for YSHCN who have no special transition interventions and (2) identify evidence for strategies that lead to better outcomes, in particular, access to adult health care. We searched the medical, nursing, psychology, and social science literature and reviewed selected articles' reference lists. Transition experts also recommended relevant articles. Search criteria included health conditions, transition-related activities, and health care and related outcomes. We selected English-language articles published from 1986 to 2010, with an abstract, description of transition-related interventions (objective 2), and posttransition outcomes. Investigators abstracted study design, population, sample size, description of intervention, data collection methods, and findings. The search yielded 3,370 articles, of which 15 met study criteria. Although many YSHCN appear to make the transition to adult health providers successfully, some experience serious gaps in outcomes; those with more complex conditions or with conditions affecting the nervous system appear to have less good transitions. Some evidence supports introducing YSHCN to adult providers before leaving the pediatric system; one study supports using care coordinators to improve outcomes. Evidence regarding programs to facilitate transition for YSHCN is inconclusive. Weak evidence suggests that meeting adult providers before transfer may facilitate posttransition access to care. We recommend additional studies with strong research designs to guide best practice in preparing YSHCN for adulthood. Copyright © 2012 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  11. Febrile illness management in children under five years of age: a qualitative pilot study on primary health care workers' practices in Zanzibar.

    Science.gov (United States)

    Baltzell, Kimberly; Elfving, Kristina; Shakely, Deler; Ali, Abdullah S; Msellem, Mwinyi; Gulati, Shilpa; Mårtensson, Andreas

    2013-01-28

    In Zanzibar, malaria prevalence dropped substantially in the last decade and presently most febrile patients seen in primary health care facilities (PHCF) test negative for malaria. The availability of rapid diagnostic tests (RDTs) allows rural health workers to reliably rule out malaria in fever patients. However, additional diagnostic tools to identify alternative fever causes are scarce, often leaving RDT-negative patients without a clear diagnosis and management plan. This pilot study aimed to explore health workers' practices with febrile children and identify factors influencing their diagnostic and management decisions in non-malarial fever patients. Semi-structured key informant interviews were conducted with 12 health workers in six PHCFs in North A district, Zanzibar, April to June 2011. Interviews were coded using Atlas.ti to identify emerging themes that play a role in the diagnosis and management of febrile children. The following themes were identified: 1) health workers use caregivers' history of illness and RDT results for initial diagnostic and management decisions, but suggest caregivers need more education to prevent late presentation and poor health outcomes; 2) there is uncertainty regarding viral versus bacterial illness and health workers feel additional point-of-care diagnostic tests would help with differential diagnoses; 3) stock-outs of medications and limited caregivers' resources are barriers to delivering good care; 4) training, short courses and participation in research as well as; 5) weather also influences diagnostic decision-making. This pilot study found that health workers in Zanzibar use caregiver history of fever and results of malaria RDTs to guide management of febrile children. However, since most febrile children test negative for malaria, health workers believe additional training and point-of-care tests would improve their ability to diagnose and manage non-malarial fevers. Educating caregivers on signs and symptoms of

  12. Benchmarking and performance management in health care

    OpenAIRE

    Buttigieg, Sandra; ; EHMA Annual Conference : Public Health Care : Who Pays, Who Provides?

    2012-01-01

    Current economic conditions challenge health care providers globally. Healthcare organizations need to deliver optimal financial, operational, and clinical performance to sustain quality of service delivery. Benchmarking is one of the most potent and under-utilized management tools available and an analytic tool to understand organizational performance. Additionally, it is required for financial survival and organizational excellence.

  13. Chiropractic care and public health

    DEFF Research Database (Denmark)

    Johnson, Claire; Rubinstein, Sidney M; Côté, Pierre

    2012-01-01

    to public health? What public health roles can chiropractic interns perform for underserved communities in a collaborative environment? Can the chiropractic profession contribute to community health? What opportunities do doctors of chiropractic have to be involved in health care reform in the areas...... of prevention and public health? What role do citizen-doctors of chiropractic have in organizing community action on health-related matters? How can our future chiropractic graduates become socially responsible agents of change?......The purpose of this collaborative summary is to document current chiropractic involvement in the public health movement, reflect on social ecological levels of influence as a profession, and summarize the relationship of chiropractic to the current public health topics of: safety, health issues...

  14. Health Care in India

    Directory of Open Access Journals (Sweden)

    BM Hegde

    2010-05-01

    Full Text Available The modern medical facilities in India are of such good quality that the National Health Service of the UK is negotiating with many corporate hospitals in India to get their patients on the long waiting lists to be flown to India for elective surgery. Be that as it may, health is not contigent on the availability of medical technology but contigent on basic provisions; clean water, three square meals a day, freedom from the effects of pollution and the skills to earn a living.

  15. Health Care Wide Hazards

    Science.gov (United States)

    ... Other Hazards (Lack of) PPE Slips/Trips/Falls Stress Tuberculosis Universal Precautions Workplace Violence Use of Medical Lasers Health Effects Use ... Needlesticks Noise Mercury Inappropriate PPE Slips/Trips/Falls ... of Universal Precautions Workplace Violence For more information, see Other Healthcare Wide ...

  16. The health care home model: primary health care meeting public health goals.

    Science.gov (United States)

    Grant, Roy; Greene, Danielle

    2012-06-01

    In November 2010, the American Public Health Association endorsed the health care home model as an important way that primary care may contribute to meeting the public health goals of increasing access to care, reducing health disparities, and better integrating health care with public health systems. Here we summarize the elements of the health care home (also called the medical home) model, evidence for its clinical and public health efficacy, and its place within the context of health care reform legislation. The model also has limitations, especially with regard to its degree of involvement with the communities in which care is delivered. Several actions could be undertaken to further develop, implement, and sustain the health care home.

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

    Science.gov (United States)

    Dwinnells, Ronald; Misik, Lauren

    2017-10-01

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

  18. Health Care Provider Initiative Strategic Plan

    Science.gov (United States)

    National Environmental Education & Training Foundation, 2012

    2012-01-01

    This document lays out the strategy for achieving the goals and objectives of NEETF's "Health Care Provider Initiative." The goal of NEETF's "Health Care Provider Initiative" is to incorporate environmental health into health professionals' education and practice in order to improve health care and public health, with a special emphasis on…

  19. Privatizing health care: caveat emptor.

    Science.gov (United States)

    Young, D W

    1990-01-01

    Many Western European countries are moving toward privatization of their health care systems. The United States' health care system, since it is almost entirely privatized, is therefore worthy of study. Doing so raises several questions. How is privatization being managed in the US? How could its management be improved? What management lessons must be kept in mind if it is to be used effectively? What potential pitfalls should European countries consider as they move toward greater privatization? With operating costs, European countries must avoid the mistakes that have led to dramatic increases in annual health care costs in the US, simultaneous with reductions in access and quality. Doing so requires designing systems that promote hospital behavior consistent with a country's health objectives. With capital costs, an approach must be designed that allows policy-makers to work closely with both managers and physicians in order to make strategically sound choices about access and quality. Such an approach will require physicians to incorporate their clinical judgments into community standards of care, and to adopt a regional (rather than an institutional or personal) perspective in the determination of any incremental capital expenditures. By making regulation proactive and strategic, rather than punitive, health policymakers in Western Europe can achieve the best privatization has to offer without feeling the sting of its unintended consequences. In so doing they can help to move their health systems toward achieving the multiple and illusive goals of access, quality and reasonable cost.

  20. Attitude and practice of health care providers towards autopsies in ...

    African Journals Online (AJOL)

    Background: Attitude and practice of health care professionals toward autopsy are important as they will give information regarding factors that contribute to the low rate of autopsies in children under five years. Objective: To evaluate the attitude and practice of health care providers towards autopsies in children under five ...

  1. Health Care in Brazil: Implications for Public Health and Epidemiology.

    Science.gov (United States)

    Younger, David S

    2016-11-01

    A network of family-based community-oriented primary health programs, or Programa Agentes Communita˙rios de Saúde, and family health programs, or Programa Saúde da Família, introduced almost 2 decades ago were the Brazilian government's health care models to restructure primary care under the Unified Health System, or Sistema Único de Saúde. The latter offers comprehensive coverage to all, although it is used by those of lower income, and despite achievement in the last quarter century, access to health services and gradients of health status continue to persist along income, educational background, racial, and religious lines. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Nanotechnology in health care

    CERN Document Server

    Sahoo, Sanjeeb K

    2012-01-01

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

  3. Access to Health Care

    Centers for Disease Control (CDC) Podcasts

    2010-11-09

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

  4. Is health care financing in Uganda equitable?

    Science.gov (United States)

    Zikusooka, C M; Kyomuhang, R; Orem, J N; Tumwine, M

    2009-10-01

    Health care financing provides the resources and economic incentives for operating health systems and is a key determinant of health system performance. Equitable financing is based on: financial protection, progressive financing and cross-subsidies. This paper describes Uganda's health care financing landscape and documents the key equity issues associated with the current financing mechanisms. We extensively reviewed government documents and relevant literature and conducted key informant interviews, with the aim of assessing whether Uganda's health care financing mechanisms exhibited the key principles of fair financing. Uganda's health sector remains significantly under-funded, mainly relying on private sources of financing, especially out-of-pocket spending. At 9.6 % of total government expenditure, public spending on health is far below the Abuja target of 15% that GoU committed to. Prepayments form a small proportion of funding for Uganda's health sector. There is limited cross-subsidisation and high fragmentation within and between health financing mechanisms, mainly due to high reliance on out-of-pocket payments and limited prepayment mechanisms. Without compulsory health insurance and low coverage of private health insurance, Uganda has limited pooling of resources, and hence minimal cross-subsidisation. Although tax revenue is equitable, the remaining financing mechanisms for Uganda are inequitable due to their regressive nature, their lack of financial protection and limited cross-subsidisation. Overall, Uganda's current health financing is inequitable and fragmented. The government should take explicit action to promote equitable health care financing by establishing pre-payment schemes, enhancing cross-subsidisation mechanisms and through appropriate integration of financing mechanisms.

  5. Good Health Before Pregnancy: Preconception Care

    Science.gov (United States)

    ... Management Education & Events Advocacy For Patients About ACOG Good Health Before Pregnancy: Preconception Care Home For Patients ... Pregnancy: Preconception Care FAQ056, April 2017 PDF Format Good Health Before Pregnancy: Preconception Care Pregnancy What is ...

  6. Phytotherapy in primary health care

    Science.gov (United States)

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

    2014-01-01

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

  7. Phytotherapy in primary health care

    Directory of Open Access Journals (Sweden)

    Gisele Damian Antonio

    2014-06-01

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

  8. Phytotherapy in primary health care.

    Science.gov (United States)

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

    2014-06-01

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

  9. Primary health care services for effective health care development in ...

    African Journals Online (AJOL)

    This is an empirical study of 7 communities among the O-kun Yoruba of Ijumu, Kogi State, Nigeria. The general objective of the study was to investigate the prioritizing pattern of the various Primary Health Care services (PHC) in the study area. Data for the study were generated mainly through multi-stage sampling ...

  10. Health Care Procedure Considerations and Individualized Health Care Plans

    Science.gov (United States)

    Heller, Kathryn Wolff; Avant, Mary Jane Thompson

    2011-01-01

    Teachers need to maintain a safe, healthy environment for all their students in order to promote learning. However, there are additional considerations when students require health care procedures, such as tube feeding or clean intermittent catheterization. Teachers must effectively monitor their students and understand their roles and…

  11. Choosing a Primary Health Care Provider (PCP): A Guide for Young Men

    Science.gov (United States)

    ... Medical Conditions Nutrition & Fitness Emotional Health Choosing a Primary Health Care Provider (PCP): General Information Posted under Health Guides . ... Content Facebook Twitter email Print Going to a primary health care provider (PCP) is a very important part of ...

  12. Thermography for health care

    International Nuclear Information System (INIS)

    Bagavathiappan, S.; Saravanan, T.; Philip, John; Jayakumar, T.; Raj, Baldev; Karunanithi, R.; Panicker, T.M.R.; Paul Korath, M.; Jagadeesan, K.

    2009-01-01

    Body temperature is a very useful parameter for diagnosing diseases. Often there is a definite correlation between body temperature and diseases. We have used infrared thermography to carry out non-invasive diagnosis of peripheral vascular diseases. Temperature gradients are observed in the affected regions of patients with vascular disorders, which indicate abnormal blood flow in the affected region. Thermal imaging results are well correlated with the clinical findings. Certain areas on the affected limbs showed increased temperature profiles, due to inflammation and underlying venues flow changes. In general, the temperature contrast in the affected regions is about 0.7 to 1 deg C above the normal regions, due to sluggish blood circulation. The results suggest that the thermal imaging technique is an effective technique for detecting small temperature changes in human body due to vascular disorders. (author)

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

    Science.gov (United States)

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

    2017-08-01

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

  14. Health care of hunting dogs

    Directory of Open Access Journals (Sweden)

    Spasojević-Kosić Ljubica

    2013-01-01

    Full Text Available There are two basic aspects of hunting dog’s health care: infectious diseases of hunting dogs and dog’s hunting performance. Concerning infectious diseases of hunting dogs, special attention is paid to public health, preventing possible dangers that could possibly arise. On the other hand, hunting performance of dogs depends on their nutrition. A complete analysis of hunting dogs’ health care in our country requires an assessment of awareness level in hunters about dangers which both humans and hunting dogs are exposed to, evaluation of preventive measures implementation in dogs by hunters, the prevalence of certain infections in dogs and determination of health risk for dogs and people related to hunting. This paper shows the results of a survey conducted among hunters with the objective to perceive their awareness of medical risks that hunters and hunting dogs could possibly be exposed to during hunting. [Projekat Ministarstva nauke Republike Srbije, br. TR 31084

  15. National Health-Care Reform

    Science.gov (United States)

    2009-03-24

    Federal Hospital Insurance (HI) Trust Fund, or Medicare Part A, called for decisive policy action to achieve long-term solvency of the trust fund. For the... insurance companies . To prevent a loss of income, these groups have used tactics such as stoking fears of socialism and communism to thwart reform.33...the next most expensive country in the world, Switzerland.9 Health-care insurance costs exceed the national average inflation. From 2000 to 2007, health

  16. Phytotherapy in primary health care

    OpenAIRE

    Gisele Damian Antonio; Charles Dalcanele Tesser; Rodrigo Otavio Moretti-Pires

    2014-01-01

    OBJECTIVE To characterize the integration of phytotherapy in primary health care in Brazil. METHODS Journal articles and theses and dissertations were searched for in the following databases: SciELO, Lilacs, PubMed, Scopus, Web of Science and Theses Portal Capes, between January 1988 and March 2013. We analyzed 53 original studies on actions, programs, acceptance and use of phytotherapy and medicinal plants in the Brazilian Unified Health System. Bibliometric data, characteristics of the ...

  17. Quality of Big Data in health care.

    Science.gov (United States)

    Sukumar, Sreenivas R; Natarajan, Ramachandran; Ferrell, Regina K

    2015-01-01

    The current trend in Big Data analytics and in particular health information technology is toward building sophisticated models, methods and tools for business, operational and clinical intelligence. However, the critical issue of data quality required for these models is not getting the attention it deserves. The purpose of this paper is to highlight the issues of data quality in the context of Big Data health care analytics. The insights presented in this paper are the results of analytics work that was done in different organizations on a variety of health data sets. The data sets include Medicare and Medicaid claims, provider enrollment data sets from both public and private sources, electronic health records from regional health centers accessed through partnerships with health care claims processing entities under health privacy protected guidelines. Assessment of data quality in health care has to consider: first, the entire lifecycle of health data; second, problems arising from errors and inaccuracies in the data itself; third, the source(s) and the pedigree of the data; and fourth, how the underlying purpose of data collection impact the analytic processing and knowledge expected to be derived. Automation in the form of data handling, storage, entry and processing technologies is to be viewed as a double-edged sword. At one level, automation can be a good solution, while at another level it can create a different set of data quality issues. Implementation of health care analytics with Big Data is enabled by a road map that addresses the organizational and technological aspects of data quality assurance. The value derived from the use of analytics should be the primary determinant of data quality. Based on this premise, health care enterprises embracing Big Data should have a road map for a systematic approach to data quality. Health care data quality problems can be so very specific that organizations might have to build their own custom software or data

  18. Intercultural Health Care and Welfare

    DEFF Research Database (Denmark)

    Nielsen, Ben

    2014-01-01

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

  19. COMMUNITY MEDICINE & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    ajiboro

    attitudes towards Basic Cardiopulmonary Resuscitation (CPR) among Community Nurses in Remo Area of. Ogun State, Nigeria with ... Knowledge of basic CPR amongst nurses at primary health care level is generally poor with the young ones having better performance. ..... Fetuga, B. Okeniyi, A. Neonatal. Knowledge and ...

  20. Mental health care in Cambodia.

    Science.gov (United States)

    Somasundaram, D J; van de Put, W A

    1999-01-01

    An effort is being made in Cambodia to involve grass-roots personnel in the integration of the care of the mentally ill into a broad framework of health services. This undertaking is examined with particular reference to the work of the Transcultural Psychosocial Organization.

  1. COMMUNITY MEDICINE & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    ajiboro

    determine the awareness, willingness and use of. Voluntary HIV testing and counseling services by. One of the priorities of national HTC students of Niger Delta University. programmes is to ensure that at least 80% of. JOURNAL OF COMMUNITY MEDICINE AND PRIMARY HEALTH CARE VOL. 25, NO 2, SEPTEMBER ...

  2. & PRIMARY HEALTH CARE COMMUNITY MEDICINE

    African Journals Online (AJOL)

    the stigmatization of people living with HIV/AIDS among traders in model markets in Lagos State. Methodology: ... traders, Pre- intervention and post- intervention. JOURNAL OF COMMUNITY MEDICINE AND PRIMARY HEALTH CARE VOL. 24, NO 1&2, MARCH 2013. 34 ..... Oladele J, Adeiga ZA, Ricketts F, Goodluck H.

  3. COMMUNITY MEDICINE & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    the_monk

    microeconomic costs data are useful in assessing. 12 for treatment. the ability of individuals and households to afford health care services. Nigeria receives donor support for malaria control. Global Fund is currently its largest funding partner. This study was conducted to assess the direct cost. Through the Global Fund, SFH ...

  4. COMMUNITY MEDICINE & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    ajiboro

    2013-09-02

    Sep 2, 2013 ... Incidence and reasons for Discharge Against Medical Advice in a tertiary health care facility in Port Harcourt, south-south Nigeria. Ordinioha B. Community Medicine Department. University of Port Harcourt Teaching Hospital,Port Harcourt. Email: ruralhealthforum@yahoo.com. +2348037075300.

  5. The impact of physician entrepreneurship on escalating health care costs.

    Science.gov (United States)

    Fletcher, Thomas

    2005-05-01

    Health care costs in this country are escalating at an alarming rate. Many economists predict this rate is unsustainable due to the long-term financial burden on our citizenry. Moreover, our health care delivery is fragmented and wasteful. United States health care is ranked last among the industrialized nations. Proponents of the U.S. system of health care extoll the virtues of our "free market." This article explores the role of physician entrepreneurship in the perversion of the marketplace of health care delivery. Medicine has become overcommercialized at the expense of patients and taxpayers. The time has come to implement legislative measures to redirect our dysfunctional health care system. This article explores the role of physician entrepreneurship in rising health care costs. Under the wrong circumstances, the invisible hand of the free market can become dysfunctional.

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

    Data.gov (United States)

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

  7. Can health care organizations improve health behavior and treatment adherence?

    Science.gov (United States)

    Bender, Bruce G

    2014-04-01

    Many Americans are failing to engage in both the behaviors that prevent and those that effectively manage chronic health conditions, including pulmonary disorders, cardiovascular conditions, diabetes, and cancer. Expectations that health care providers are responsible for changing patients' health behaviors often do not stand up against the realities of clinical care that include large patient loads, limited time, increasing co-pays, and restricted access. Organizations and systems that might share a stake in changing health behavior include employers, insurance payers, health care delivery systems, and public sector programs. However, although the costs of unhealthy behaviors are evident, financial resources to address the problem are not readily available. For most health care organizations, the return on investment for developing behavior change programs appears highest when addressing treatment adherence and disease self-management, and lowest when promoting healthy lifestyles. Organizational strategies to improve adherence are identified in 4 categories: patient access, provider training and support, incentives, and information technology. Strategies in all 4 categories are currently under investigation in ongoing studies and have the potential to improve self-management of many chronic health conditions.

  8. Managed consumerism in health care.

    Science.gov (United States)

    Robinson, James C

    2005-01-01

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

  9. Health care technology as a policy issue

    NARCIS (Netherlands)

    Banta, H.D.

    1994-01-01

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

  10. Compliance monitoring of prohibition of smoking (under section-4 of COTPA) at a tertiary health-care institution in a smoke-free city of India

    OpenAIRE

    Tripathy, Jaya Prasad; Goel, Sonu; Patro, Binod Kumar

    2013-01-01

    Background: India enacted a comprehensive tobacco control law known as cigarettes and other tobacco products act (COTPA) in 2003. However, enforcement of the provisions under the law is still a matter of concern. Compliance survey is an effective tool to measure the status of implementation of the law at various public places. Smoke-free hospital campus demonstrates commitment to good health and sends a pro-healthy signal to the community. Objective: The objective of this study was to assess ...

  11. Improving eye care in the primary health care setting

    Directory of Open Access Journals (Sweden)

    M de Wet

    2000-09-01

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

  12. Health care for Micronesians and constitutional rights.

    Science.gov (United States)

    Shek, Dina; Yamada, Seiji

    2011-11-01

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

  13. Health Care Efficiencies: Consolidation and Alternative Models vs. Health Care and Antitrust Regulation - Irreconcilable Differences?

    Science.gov (United States)

    King, Michael W

    2017-11-01

    health care, rather than specifics for the delivery of health care. 4 With the U.S. expenditures on health care producing inferior results, experts see consolidation and alternatives to fee-for-service as fundamental to reducing costs. 5 Integrating care coordination and delivery and increasing scale to drive efficiencies allows organizations to benefit from shared savings and relationships with payors and vendors. 6 Deloitte forecasts that, by 2024, the current health system landscape-which includes roughly 80 national health systems, 275 regional systems, 130 academic medical centers, and 1,300 small community systems-will morph into just over 900 multi-hospital systems. 7 Even though health care market and payment reforms encourage organizations to consolidate and integrate, innovators must proceed with extreme caution. Health care organizations attempting to drive efficiencies and bring down costs through mergers may run afoul of numerous federal and state laws and regulations. 8 Calls for updates or leniency in these laws are growing, including the possible recognition of an "Obamacare defense" to antitrust restrictions 9 and speculation that laws restricting physicians from having financial relationships will be repealed, ostensibly to allow sharing of the rewards reaped from coordinated care. 10 In the meantime, however, absent specific waivers or exemptions, all the usual rules and regulations apply, including antitrust constraints, 11 physician self-referral 12 and anti-kickback laws and regulations, 13 state fraud and abuse restrictions, 14 and more. In short, a maelstrom of conflicting political prescriptions, health care regulations, and antitrust restrictions undermine the ability of innovators to achieve efficiencies through joint ventures, transactions, innovative models, and other structures. This article first considers the conflicting positions taken by the United States government with respect to achieving efficiencies in health care under the ACA and

  14. Ageing world: Health care challenges

    Directory of Open Access Journals (Sweden)

    Vinay Mahishale

    2015-01-01

    Full Text Available The world population reached 7 billion in 2012, which is 6 billion more than in 1800. This remarkable population growth is the result of several factors like advances in the medical, technological and public health systems resulting in the control and treatment of communicable diseases, the control of pandemics, the end of large-scale wars, improvements in living conditions and the revolutions in the field of agriculture. Because of all these factors, there has been a considerable improvement in the life expectancy of human beings. There is also an alarming reduction in fertility rates. The combination of declining fertility rate and augmented life expectancies has led to a change in the demographics of the population with the strata of older individuals growing faster than the younger individuals. The aging of populations is poised to become the next global public health challenge. Advances in medicine and socioeconomic development have substantially reduced mortality and morbidity rates due to infectious conditions and, to some extent, non-communicable diseases. These demographic and epidemiological changes, coupled with rapid urbanization, modernization, globalization, and accompanying changes in risk factors and lifestyles, have increased the prominence of chronic non-infective conditions. Health systems need to find effective strategies to extend health care and to respond to the needs of older adults. This review highlights the pathophysiology of aging, biological and physiological changes, impact of aging on health, epidemiological transitions, multi-morbidity in elderly and challenges for health care system.

  15. Health Care as Commons: An Indigenous Approach to Universal Health Coverage

    Directory of Open Access Journals (Sweden)

    Young Soon Wong

    2014-06-01

    Full Text Available Modern health care systems of today are predominantly derived from Western models and are either state owned or under private ownership. Government, through their health policies, generally aim to facilitate access for the majority of the population through the design of their health systems. However, there are communities, such as Indigenous peoples, who do not necessarily fall under the formal protection of state systems. Throughout history, these societies have developed different ways to provide health care to its population. These health care systems are held and managed under different property regimes with their attendant advantages and disadvantages. This article investigates the gaps in health coverage among Indigenous peoples using the Malaysian Indigenous peoples as a case study. It conceptually examines a commons approach to health care systems through a study of the traditional health care system of indigenous peoples and suggests how such an approach can help close this gap in the remaining gaps of universal health coverage.

  16. [Managing diversity in Swiss Health care].

    Science.gov (United States)

    Bodenmann, P; Bossart, R; Di Bernardo, N; Dominice Dao, M; Durieux, S; Faucherre, F; Hudelson, P; Keller, M; Schuster, S; Zellweger, E; Houmard, S

    2014-11-19

    The development of Migrant Friendly Hospitals is an important first step towards eliminating health care disparities in Switzerland and an important reminder to health policy makers and practitioners across the health care system of their responsibility to provide non-discriminatory quality health care to all patients.

  17. What is the health care product?

    Science.gov (United States)

    France, K R; Grover, R

    1992-06-01

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

  18. Improving oral health and oral health care delivery for children.

    Science.gov (United States)

    Crall, James J

    2011-02-01

    National and state-level evidence has documented ongoing disparities in children's health and utilization of oral health care services, prompting a re-examination of factors associated with poor oral health and low use of oral health services. These efforts have yielded a wide array of proposals for improving children's oral health and oral health care delivery. This paper offers a perspective on the current context of efforts to improve children's oral health and oral health care delivery.

  19. Health Care Access among Latinos: Implications for Social and Health Care Reforms

    Science.gov (United States)

    Perez-Escamilla, Rafael

    2010-01-01

    According to the Institute of Medicine, health care access is defined as "the degree to which people are able to obtain appropriate care from the health care system in a timely manner." Two key components of health care access are medical insurance and having access to a usual source of health care. Recent national data show that 34% of Latino…

  20. Integrating Primary Oral Health Care into Primary Care.

    Science.gov (United States)

    Isman, Robert E.

    1993-01-01

    Primary oral health care, and the scope of services it includes, are defined. The proposed scope of services is a set of basic dental services used by the Indian Health Service. Policy recommendations for improving the integration of primary oral health services with primary health care and delivery are offered. (Author/MSE)

  1. Teaching tomorrow's health care leaders.

    Science.gov (United States)

    Mitchell, W

    1993-01-01

    Business school curricula have traditionally emphasized functional skills for people who will work in functional departments and general management skills for people who will organize interdepartmental work. Recently, some business schools have begun to develop programs that teach cross-functional work and team skills to functional specialists. Students educated in such programs will be well prepared to meet the new challenges that health care organizations will face.

  2. The Chinese Health Care System

    DEFF Research Database (Denmark)

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

    In the present paper we describe the structure of the Chinese health care system and sketch its future development. We analyse issues of provider incentives and the actual burden sharing between government, enterprises and people. We further aim to identify a number of current problems and link...... these to a discussion of future challenges in the form of an aging population, increased privatization and increased inequity...

  3. Choosing a health care provider.

    Science.gov (United States)

    Harris, Katherine M; Beeuwkes Buntin, Melinda

    2008-05-01

    In a consumer-driven health care model, consumers, armed with information, would select providers based on quality and cost, thus increasing competition. This synthesis examines the availability of quality information and the evidence of how consumers use such information to choose a provider. Key findings include: information is publicly available from multiple sources regarding hospitals, but not individual doctors. Hospital information is predominantly made available online; but this limits awareness and access. Awareness is low overall, but highest among well-educated, healthy people. Even when consumers are aware of the data available, they rarely use it because they do not find it relevant: they do not foresee needing a hospital soon; are happy with their current provider; or did not find information pertinent to their specific health condition or hospital. While there is some evidence that hospitals that do poorly on public quality scorecards lose market share, there is better evidence that the providers themselves react to the quality scores by addressing care problems. Studies consistently show that consumers value health care quality and want information, but instead they rely on input from friends, family and their personal physicians about the quality of providers.

  4. Oncology in primary health care

    International Nuclear Information System (INIS)

    Mendoza del Pino, Mario Valentín

    2009-01-01

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

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

    African Journals Online (AJOL)

    Part one describes conceptual issues underlying the development of South African standards for people with severe psychiatric disorders. Mental health care standards seek to describe what is an acceptable and adequate quality of mental health care for service users. A focus on service quality is especially crucial in ...

  6. How Do Health Care Providers Diagnose Endometriosis?

    Science.gov (United States)

    ... Share Facebook Twitter Pinterest Email Print How do health care providers diagnose endometriosis? Surgery is currently the only ... larger incision—is used to make a diagnosis. Health care providers may also use imaging methods to produce ...

  7. Accreditation Association for Ambulatory Health Care

    Science.gov (United States)

    ... Press Release Archives learn more » For Patients Your health care choices matter. Whether you're anticipating a surgical ... certificate of accreditation is a sign that a health care organization meets or exceeds nationally-recognized Standards. Learn ...

  8. Job satisfaction in health-care organizations

    Directory of Open Access Journals (Sweden)

    Kavita Bhatnagar

    2012-01-01

    Full Text Available Job satisfaction among health-care professionals acquires significance for the purpose of maximization of human resource potential. This article is aimed at emphasizing importance of studying various aspects of job satisfaction in health-care organizations.

  9. Job satisfaction in health-care organizations

    OpenAIRE

    Bhatnagar, Kavita; Srivastava, Kalpana

    2012-01-01

    Job satisfaction among health-care professionals acquires significance for the purpose of maximization of human resource potential. This article is aimed at emphasizing importance of studying various aspects of job satisfaction in health-care organizations.

  10. Medicaid Adult Health Care Quality Measures

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Affordable Care Act (Section 1139B) requires the Secretary of HHS to identify and publish a core set of health care quality measures for adult Medicaid...

  11. The Cultural Geography of Health Care Delivery.

    Science.gov (United States)

    Gesler, Wilbert M.

    1987-01-01

    This article shows how health care delivery is related to cultural or human geography. This is accomplished by describing health care delivery in terms of 12 popular themes of cultural geography. (JDH)

  12. Passion in today's health care leaders.

    Science.gov (United States)

    Piper, Llewellyn E

    2005-01-01

    Passion in today's health care leaders is essential as health care organizations face increasing demands for survival. Leaders in health care have been educated, selected, promoted, and retained based on their analytical and creativity skills. Today's health care leaders must also have emotional intelligence. Emotional intelligence is primal for passion. Emotional intelligence, which leads to passion, is crucial to the survivability of today's health care organizations. In order for health care organizations to go from good to great, the leader must inspire followers through passion. This article encourages health care leaders to gain awareness of emotional intelligence and to use emotional intelligence as part of their leadership to inspire passion. Through passion, leaders and followers become more motivated to accomplish the health care mission of serving others.

  13. Effective Nutrition Intervention to Treat Children Under 5 Years Old Suffering MAM in Public Primary Health Care Services in El Salvador

    International Nuclear Information System (INIS)

    Sanchez, Ana

    2014-01-01

    Full text: Background: In El Salvador Moderate Acute Malnutrition (MAM) affects less than 1% of children under 5 years old. The importance of MAM has been neglected as a public health issue. Although moderate wasting is not a condition of medical urgency, it can easily deteriorate. If some of these undernourished children with moderate wasting do not receive adequate support, they may progress towards severe acute malnutrition (SAM), defined by the presence of severe wasting and/or bilateral pitting oedema, which is a life-threatening condition. Since 2010, a complementary feeding program for children from 6 to 59 months old was implemented at the primary health clinics for the management of moderate malnutrition. Program was implemented in 100 municipalities identified with the greatest levels of poverty at national level and it consists of a corn-soy fortified flour to be prepared at home as a poudrige given to children during the routine health controls. During the first months of program implementation, an acceptability test was conducted and it was determined that more than 85% of children had good acceptance of the product. The treatment consists of 45 grams per day of complementary food. Mothers were instructed on how to prepare the product and every month they would have to bring their children to the clinic to receive complementary food and control weight gain. If mothers did not attend the control, a health promotion worker would go visit the mother at their home and bring the complementary food to the child. Objective: Assess the results on nutritional status of children under 5 years old with MAM treated with complementary food during health controls at primary health facilities in El Salvador during January to October 2013. Methods: Transversal study. Inclusion criteria was children 6 to 59 months old attending health controls coming from prioritize municipalities, diagnose with MAM by a health professional without other disease or infections that

  14. Pegasus Health Pastoral Care Programme.

    Science.gov (United States)

    Christie, Caroline; Wynn-Thomas, Simon; McKinnon, Bianca

    2017-09-01

    INTRODUCTION In New Zealand, 41% of general practitioners (GPs) intend to retire by 2025. Increasing workforce shortages and other stressors are putting doctors at risk of burnout, which in turn can put patients at risk of harm. Offering a range of resources can signal an organisation's commitment to physician wellness while improving patient safety and organisational stability. AIM To replace the current reactive approach to impaired doctors with a proactive system of monitoring performance with the goal of identifying problems early. METHODS This paper reports on an initiative of Pegasus Health Charitable to provide pastoral care to GPs in Canterbury experiencing increased stress, burnout or problems leading to impaired performance. RESULTS The pastoral care programme has been running successfully for 9 years and has helped 32 GPs. Because of the low numbers, the programme needs to be individualised and confidential. CONCLUSION Recent developments have seen Pegasus Health adopt a systematic approach to monitoring and supporting health practitioners. This includes the monitoring of available data on GPs at risk. Data collection is being used to manage the "psychological health" of doctors, including complaints, prescribing, referral data and attendance at education sessions.

  15. Blockchain distributed ledger technologies for biomedical and health care applications.

    Science.gov (United States)

    Kuo, Tsung-Ting; Kim, Hyeon-Eui; Ohno-Machado, Lucila

    2017-11-01

    To introduce blockchain technologies, including their benefits, pitfalls, and the latest applications, to the biomedical and health care domains. Biomedical and health care informatics researchers who would like to learn about blockchain technologies and their applications in the biomedical/health care domains. The covered topics include: (1) introduction to the famous Bitcoin crypto-currency and the underlying blockchain technology; (2) features of blockchain; (3) review of alternative blockchain technologies; (4) emerging nonfinancial distributed ledger technologies and applications; (5) benefits of blockchain for biomedical/health care applications when compared to traditional distributed databases; (6) overview of the latest biomedical/health care applications of blockchain technologies; and (7) discussion of the potential challenges and proposed solutions of adopting blockchain technologies in biomedical/health care domains. © The Author 2017. Published by Oxford University Press on behalf of the American Medical Informatics Association.

  16. Reforms of health care system in Romania

    NARCIS (Netherlands)

    Bara, AC; van den Heuvel, WJA; Maarse, JAM; Bara, Ana Claudia; Maarse, Johannes A.M.

    Aim. To describe health care reforms and analyze the transition of the health care system in Romania in the 1989-2001 period. Method. We analyzed policy documents, political intentions and objectives of health care reform, described new legislation, and presented changes in financial resources of

  17. Teaching Health Care in Introductory Economics

    Science.gov (United States)

    Cutler, David M.

    2017-01-01

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

  18. Corruption in the health care system: the circumstantial evidence.

    Science.gov (United States)

    Ibrahim, Joseph; Majoor, Jennifer

    2002-01-01

    Health care systems are under intense scrutiny, and there is an increasing emphasis on patient safety and quality of care in general. Evidence continues to emerge demonstrating that health systems are performing at sub-optimal levels. The evidence includes the under-use, over-use and mis-use of health care services; new standards asking for respect, dignity, honesty and transparency; the corporatization of health; and the existing inequalities in power and health outcomes. Recommendations for improving health care often refer to increasing the level of collaboration and consultation. These strategies are unlikely to remedy the root causes of our ailing health systems if we accept the circumstantial evidence that suggests the system is rotten.

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

    Science.gov (United States)

    Wesolowski, C E

    1990-01-01

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

  20. Stigma experienced by persons under psychiatric care.

    Science.gov (United States)

    Struch, Naomi; Levav, Itzhak; Shereshevsky, Yechiel; Baidani-Auerbach, Alona; Lachman, Max; Daniel, Noga; Zehavi, Tali

    2008-01-01

    Mental health-related stigma causes suffering and interferes with care and social inclusion. This study explored stigma as experienced by mental health service users. Particular attention is given to their use of coping mechanisms. Interviews were held with 167 adults undergoing outpatient psychiatric treatment; two-thirds of them had previously been hospitalized. Examples of frequency of stigma-related situations included the following: Over half of service users expect people to refuse to have a person with a mental disorder as a co-worker or neighbor, or to engage in other types of social contact. A sizeable group acknowledged that they feared or had experienced rejection. A third of respondents reported they feared or had experienced inappropriate treatment by their doctor. Service users utilize several coping mechanisms to deal with stigma, among them: education, withdrawal, secrecy, and positive distinctiveness. Although we studied a convenience sample of service users, our findings provide sufficient basis to suggest different types of intervention, i.e., to address stigma in the course of treatment in the specialist settings, to promote the establishment of mutual support groups, and to raise family physicians' awareness with regard to the stigma that may be present when caring for persons with mental disorders.

  1. Building health care system capacity: training health care professionals in disaster preparedness health care coalitions.

    Science.gov (United States)

    Walsh, Lauren; Craddock, Hillary; Gulley, Kelly; Strauss-Riggs, Kandra; Schor, Kenneth W

    2015-04-01

    This study aimed to learn from the experiences of well-established, disaster preparedness-focused health care coalition (HCC) leaders for the purpose of identifying opportunities for improved delivery of disaster-health principles to health professionals involved in HCCs. This report describes current HCC education and training needs, challenges, and promising practices. A semi-structured interview was conducted with a sample of leaders of nine preparedness-focused HCCs identified through a 3-stage purposive strategy. Transcripts were analyzed qualitatively. Training needs included: stakeholder engagement; economic sustainability; communication; coroner and mortuary services; chemical, biological, radiological, nuclear, and explosives (CBRNE); mass-casualty incidents; and exercise design. Of these identified training needs, stakeholder engagement, economic sustainability, and exercise design were relevant to leaders within HCCs, as opposed to general HCC membership. Challenges to education and training included a lack of time, little-to-no staff devoted to training, and difficulty getting coalition members to prioritize training. Promising practices to these challenges are also presented. The success of mature coalitions in improving situational awareness, promoting planning, and enabling staff- and resource-sharing suggest the strengths and opportunities that are inherent within these organizations. However, offering effective education and training opportunities is a challenge in the absence of ubiquitous support, incentives, or requirements among health care professions. Notably, an online resource repository would help reduce the burden on individual coalitions by eliminating the need to continually develop learning opportunities.

  2. Hurdles to health: immigrant and refugee health care in Australia.

    Science.gov (United States)

    Murray, Sally B; Skull, Sue A

    2005-02-01

    Refugees and asylum seekers face a number of barriers to accessing health care and improved health status. These include language difficulties, financial need and unemployment, cultural differences, legal barriers and a health workforce with generally low awareness of issues specific to refugees. Importantly, current Australian government migration and settlement policy also impacts on access to health and health status. An adequate understanding of these 'hurdles to health' is a prerequisite for health providers and health service managers if they are to tailor health care and services appropriately. We include tables of available resources and entitlements to health care according to visa category to assist providers and managers.

  3. Health savings accounts and health care spending.

    Science.gov (United States)

    Lo Sasso, Anthony T; Shah, Mona; Frogner, Bianca K

    2010-08-01

    The impact of consumer-driven health plans (CDHPs) has primarily been studied in a small number of large, self-insured employers, but this work may not generalize to the wide array of firms that make up the overall economy. The goal of our research is to examine effects of health savings accounts (HSAs) on total, medical, and pharmacy spending for a large number of small and midsized firms. Health plan administrative data from a national insurer were used to measure spending for 76,310 enrollees over 3 years in 709 employers. All employers began offering a HSA-eligible plan either on a full-replacement basis or alongside traditional plans in 2006 and 2007 after previously offering only traditional plans in 2005. We employ difference-in-differences generalized linear regression models to examine the impact of switching to HSAs. DATA EXTRACTION METHODS; Claims data were aggregated to enrollee-years. For total spending, HSA enrollees spent roughly 5-7 percent less than non-HSA enrollees. For pharmacy spending, HSA enrollees spent 6-9 percent less than traditional plan enrollees. More of the spending decrease was observed in the first year of enrollment. Our findings are consistent with the notion that CDHP benefit designs affect decisions that are at the discretion of the consumer, such as whether to fill or refill a prescription, but have less effect on care decisions that are more at the discretion of the provider.

  4. Children with Special Health Care Needs

    Science.gov (United States)

    ... I Waiting So Long? Admission to the Hospital Heroes on Medicine's Front Line Observation Emergency Care Fact Sheet Health & Safety Tips Campaigns SUBSCRIBE Health Tips Share this! Home » Health Tips » Child Emergencies Children With Special Health Care Needs Parents ...

  5. [Motivational interviewing in health care].

    Science.gov (United States)

    Lev-Ran, Shaul; Nitzan, Uri

    2011-09-01

    Harmful behaviors and low adherence to medical treatment significantly contribute to an increased rate of hospitalizations, mortality and morbidity. Leading health organizations worldwide are making great efforts to find and develop efficient strategies in order to recruit patients to adhere to medical treatment and adopt a healthier lifestyle. Motivational interviewing is an evidence-based approach that the physician can apply in numerous health care situations in order to increase patients' adherence to treatment. It is a patient-centered approach, based on principles of collaboration, autonomy and evocation. Research indicates that the patient's verbal commitment towards change is directly correlated to future behavioral change. Therefore, the approach includes learnable techniques which assist in allowing the patient to speak about the advantages of behavioral change and treatment. Thus, motivational interviewing helps patients adopt a healthier lifestyle while contributing to the professionalism of physicians and their sense of satisfaction from work.

  6. Physical Health Problems and Barriers to Optimal Health Care Among Children in Foster Care.

    Science.gov (United States)

    Deutsch, Stephanie Anne; Fortin, Kristine

    2015-10-01

    Children and adolescents in foster care placement represent a unique population with special health care needs, often resulting from pre-placement early adversity and neglected, unaddressed health care needs. High rates of all health problems, including acute and/or chronic physical, mental, and developmental issues prevail. Disparities in health status and access to health care are observed. This article summarizes the physical health problems of children in foster care, who are predisposed to poor health outcomes when complex care needs are unaddressed. Despite recognition of the significant burden of health care need among this unique population, barriers to effective and optimal health care delivery remain. Legislative solutions to overcome obstacles to health care delivery for children in foster care are discussed. Copyright © 2015 Mosby, Inc. All rights reserved.

  7. Prenatal Care for Adolescents and attributes of Primary Health Care

    Directory of Open Access Journals (Sweden)

    Maria Cristina Barbaro

    2014-01-01

    Full Text Available OBJECTIVE: evaluate prenatal care for adolescents in health units, in accordance with the attributes of Primary Health Care (PHC guidelines. METHOD: quantitative study conducted with health professionals, using the Primary Care Assessment Tool-Brazil to assess the presence and extent of PHC attributes. RESULTS: for all the participating units, the attribute Access scored =6.6; the attributes Longitudinality, Coordination (integration of care, Coordination (information systems and Integrality scored =6.6, and the Essential Score =6.6. Comparing basic units with family health units, the attribute scores were equally distributed; Accessibility scored =6.6, the others attributes scored =6.6; however, in the basic units, the Essential Score was =6.6 and, in the family health units, =6.6. CONCLUSION: expanding the coverage of family health units and the training of professionals can be considered strategies to qualify health care.

  8. Health care: a brave new world.

    Science.gov (United States)

    Morrisette, Shelley; Oberman, William D; Watts, Allison D; Beck, Joseph B

    2015-03-01

    The current U.S. health care system, with both rising costs and demands, is unsustainable. The combination of a sense of individual entitlement to health care and limited acceptance of individual responsibility with respect to personal health has contributed to a system which overspends and underperforms. This sense of entitlement has its roots in a perceived right to health care. Beginning with the so-called moral right to health care (all life is sacred), the issue of who provides health care has evolved as individual rights have trumped societal rights. The concept of government providing some level of health care ranges from limited government intervention, a 'negative right to health care' (e.g., prevention of a socially-caused, preventable health hazard), to various forms of a 'positive right to health care'. The latter ranges from a decent minimum level of care to the best possible health care with access for all. We clarify the concept of legal rights as an entitlement to health care and present distributive and social justice counter arguments to present health care as a privilege that can be provided/earned/altered/revoked by governments. We propose that unlike a 'right', which is unconditional, a 'privilege' has limitations. Going forward, expectations about what will be made available should be lowered while taking personal responsibility for one's health must for elevated. To have access to health care in the future will mean some loss of personal rights (e.g., unhealthy behaviors) and an increase in personal responsibility for gaining or maintaining one's health.

  9. Normative grounds of health care practice in Brazilian nursing.

    Science.gov (United States)

    Andrade, Selma Regina de; Piccoli, Talita; Ruoff, Andriela Backes; Ribeiro, Janara Caroline; Sousa, Fernando Miguel de

    2016-01-01

    to understand the normative grounds of health care practice in Brazilian nursing. qualitative study with the use of document research, carried out based on resolutions of the Federal Nursing Council. From a total of 263 resolutions, in the period from 1975 to 2015, 38 which were in accordance with the objective of the study were selected. three analytical categories were systematized: Normative grounds of health care practice by the nursing team, under coordination/supervision of the nurse; Normative grounds of the care performed privately by the nurse; and Management and administrative aspects which affect and permeate the practice of health care in nursing. the set of normative grounds of health care practice by the nursing team leads to the reflection on the possible overlapping of attributions between professional levels and requires expansion to the other fields of nursing which are coherent with the health care network model.

  10. Health Seeking Behaviour and Access to Health Care Facilities at ...

    African Journals Online (AJOL)

    Context: Health care at the primary level is accepted as the model for delivering basic health care to low income populations especially in developing countries such as Nigeria. Despite all the efforts and strategiesadapted in Nigeria, there is still high level of morbidity and mortality from the diseases primary health care ...

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

    African Journals Online (AJOL)

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

  12. Integrated occupational health care at sea

    DEFF Research Database (Denmark)

    Jensen, Olaf Chresten

    2011-01-01

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

  13. Controversies in faith and health care.

    Science.gov (United States)

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

    2015-10-31

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

  14. Fostering health in the foster care maze.

    Science.gov (United States)

    Sobel, A; Healy, C

    2001-01-01

    The fastest growing population of children in foster care today is quite young, and many of these children have significant health care needs. The General Accounting Office (GAO) reported that children in foster care "are among the most vulnerable individuals in the welfare population" (GAO, 1995, p. 1). Poverty, increased homelessness, substance abuse, and a rise in the incidence of persons with HIV all contribute to the problems faced by these children. The Caring Communities for Children in Foster Care Project, funded by the Maternal Child Health Bureau Integrated Services Medical Home Initiative with the American Academy of Pediatrics (AAP), investigated the availability of comprehensive health care services for children in foster care. The AAP recommends that pediatricians serve as the primary health care provider for children in foster care and also as consultants to child welfare agencies. Pediatric nurses play a crucial role in providing health care services to children in foster care. With an increased understanding of the potential physical and mental health care needs of children in foster care and the important role of foster parents, pediatric nurses can increase the likelihood of positive health outcomes for children in foster care.

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

    Science.gov (United States)

    Sorrell, Jeanne M

    2009-01-01

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

  16. Delegation within municipal health care.

    Science.gov (United States)

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

    2011-05-01

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

  17. The oral health care experiences of NSW Aboriginal Community Controlled Health Services.

    Science.gov (United States)

    Campbell, Megan A; Hunt, Jennifer; Walker, David; Williams, Rodger

    2015-02-01

    Aboriginal people continue to experience a disproportionately heavy burden of oral disease. A range of oral health services may be available to Aboriginal communities, including those provided by Aboriginal Community Controlled Health Services (ACCHSs). This study explored the oral health care experiences and activities of ACCHSs to inform policy and program decision making. Mixed methods, including an online survey and semi-structured interviews with senior ACCHS staff, were used. Areas of inquiry included perceived community need for oral health care, oral health care models, accessibility of other oral health services and barriers to providing oral health care. Twenty-nine NSW ACCHSs participated in the study. The activities of NSW ACCHSs in oral health care are diverse and reflect the localised approaches they take to delivering primary health care. ACCHSs commonly face barriers in delivering oral health care, as do Aboriginal communities in accessing other oral health services. NSW ACCHSs are important but under-acknowledged providers of a range of oral health services to Aboriginal communities and are well placed to provide this care as part of their comprehensive primary health care model. ACCHS roles in improving Aboriginal oral health would be strengthened by greater acknowledgement of their contributions and expertise and the development of transparent, long-term funding policies that respond to community need. © 2014 Public Health Association of Australia.

  18. Health Care Information System (HCIS) Data File

    Data.gov (United States)

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

  19. Latex allergy in health care

    Directory of Open Access Journals (Sweden)

    Tina Virtič

    2012-11-01

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

  20. Reforming health care in Hungary.

    Science.gov (United States)

    Császi, L; Kullberg, P

    1985-01-01

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

  1. Not your father's health care.

    Science.gov (United States)

    Flower, J

    1999-01-01

    We in health care are living and working in a world that, for all its technical changes, differs little in its basic assumptions, structures, payment systems, beliefs, expectations, and job titles from the world of health care a generation back. How much change can we expect over the coming years? A lot more than we are prepared for. Look at the array of new technologies headed our way, from genomic sciences to customized vaccinations. Many of the breakthroughs promise incredible abilities to prevent disease, to profile our proclivities, and to manage our genetic predispositions over long periods of time, rather than merely wait until the disease manifests in an acute phase, then treat the symptoms. Digital technologies bring physicians executives enormous opportunities for new ways of gathering, storing, and mining information, for new types of communication between medical professionals, for new communications with customers, and new ways of steering large, complex enterprises. Unprecedented opportunities for change keep piling in through the door. Vast pressures for change keep building from every side. And the rewards for anyone who can lead the change keep compounding.

  2. The Engineering 4 Health Challenge - an interdisciplinary and intercultural initiative to foster student engagement in B.C. and improve health care for children in under-serviced communities.

    Science.gov (United States)

    Price, Morgan; Weber-Jahnke, Jens H

    2009-01-01

    This paper describes the Engineering 4 Health (E4H) Challenge, an interdisciplinary and intercultural initiative that, on the one hand, seeks to improve health education of children in under-serviced communities and, on the other, seeks to attract students in British Columbia to professions in engineering and health. The E4H Challenge engages high school and university students in BC to cooperatively design and develop health information and communication technology (ICT) to educate children living in under-serviced communities. The E4H Challenge works with the One Laptop Per Child (OLPC) program to integrate applications for health awareness into the school programs of communities in developing countries. Although applications developed by the E4H Challenge use the low-cost, innovative XO laptop (the "$100 laptop" developed by the OLPC foundation) the software can also be used with other inexpensive hardware.

  3. Abstract: Promotion of Primary Health Care Philosophy in a ...

    African Journals Online (AJOL)

    Learning experiences in community-based settings provide the students with opportunities to learn by means of being actively engaged in primary health care associated activities to under-resourced communities (Mtshali, 2009, 2005; World Health Organization ,2011a; World Health Organization, 2011b). International ...

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

    Science.gov (United States)

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

    2017-12-01

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

  5. Health care in the 2004 presidential election.

    Science.gov (United States)

    Blendon, Robert J; Altman, Drew E; Benson, John M; Brodie, Mollyann

    2004-09-23

    We examined the importance for voters of health care as an issue in the presidential election of 2004, how this ranking compares with the importance of health care in past elections, and which issues voters regard as the most important health care issues in the months before the election. We studied data from 22 national opinion surveys, 9 of them conducted as telephone surveys during the 2004 presidential campaign, 10 conducted as telephone surveys during the previous three presidential elections, and 3 conducted as national exit polls of voters. Voters ranked health care as the fourth most important issue in deciding their vote for president in 2004. The top health care issues for voters were the costs of health care and prescription drugs, prescription-drug benefits for the elderly, the uninsured, and Medicare. Bioterrorism and abortion were also important issues for voters. The voters most concerned about health care were older persons and those who identified themselves as Democrats. Four issues less salient to voters were racial disparities in health care, aid to developing countries to prevent and treat human immunodeficiency virus infection and the acquired immunodeficiency syndrome, medical malpractice, and the quality of care. Although health care ranks higher in importance among voters than most other domestic issues, it is only fourth in importance in deciding their vote for president. The health care issues of greatest concern are the affordability of health care and health care insurance. Health care issues do not appear likely to play a decisive role in the presidential election in 2004, but they might make a difference in some swing states if the race is close. Copyright 2004 Massachusetts Medical Society

  6. Caring for Children with Special Health Care Needs: Profiling Pediatricians and Their Health Care Resources.

    Science.gov (United States)

    Okumura, Megumi J; Knauer, Heather A; Calvin, Kris E; Takayama, John I

    2018-03-01

    Background and Objectives Pediatricians face numerous challenges in providing care for children with special health care needs (CSHCN). Few studies have described health care resources available to support pediatricians to care for CSHCN. This study investigated available resources to care for CSHCN and factors associated with having a greater proportion of CSHCN in practice. Methods We conducted a statewide survey of active members of the American Academy of Pediatrics in California to study pediatric subspecialty care access, community and office resources and practice barriers. We performed a logistic regression model on having an "above average proportion" of CSHCN in practice, adjusting for demographics, practice type (rural vs. suburban/urban) and medical resources, care satisfaction, and ease of subspecialty access. Results Our response rate was 50.2% (n = 1290); 75% of respondents reported providing some primary care services, with many primary care pediatricians caring for a high proportion of CSHCN. Pediatricians reported an average of 28% CSHCN in their practices. Rural pediatricians lacked subspecialty access (10-59% reporting no access to the various subspecialties). Factors relating to higher CSHCN in practice included being in academic medical centers and satisfaction in caring for CSHCN. Conclusions Pediatricians report lack of access to mental health services, care coordination and case management. Academic medical centers and higher physician satisfaction in care delivery for CSHCN are associated with more CSHCN in practice. Promoting ways to support pediatricians, such as practice collaboration with behavioral specialists, may be necessary to encourage primary care pediatricians to provide medical homes for CSHCN.

  7. Health Care, capabilities and AI assistive technologies.

    NARCIS (Netherlands)

    Coeckelbergh, Mark

    2009-01-01

    Scenarios involving the introduction of artificially intelligent (AI) assistive technologies in health care practices raise several ethical issues. In this paper, I discuss four objections to introducing AI assistive technologies in health care practices as replacements of human care. I analyse them

  8. [Frequent nursing diagnoses and interventions for women under critical care].

    Science.gov (United States)

    Oliveira, Mirna Fontenele de; Freitas, Maria Célia de

    2009-01-01

    This study aimed at identifying the most frequent Nursing Diagnoses and propose interventions for women under critical care into a maternal intensive care unit in a public hospital in Fortaleza, CE, Brazil. Retrospective study conducted with women's hospital health records. Ten Nursing Diagnoses were elaborated, being four risk: risk of infection, risk of unbalance of liquids volume, risk of aspiration, risk of damaged skin integrity and six real: altered maternity, impaired physical mobility, anxiety and impaired verbal communication. For the referred Nursing Diagnoses, nursing interventions are proposed according to the link between NANDA, NIC and NOC. It was concluded that the use of ND is a necessary technology for the Nursing reality, as it makes possible the integral care.

  9. Telementoring Primary Care Clinicians to Improve Geriatric Mental Health Care.

    Science.gov (United States)

    Fisher, Elisa; Hasselberg, Michael; Conwell, Yeates; Weiss, Linda; Padrón, Norma A; Tiernan, Erin; Karuza, Jurgis; Donath, Jeremy; Pagán, José A

    2017-10-01

    Health care delivery and payment systems are moving rapidly toward value-based care. To be successful in this new environment, providers must consistently deliver high-quality, evidence-based, and coordinated care to patients. This study assesses whether Project ECHO ® (Extension for Community Healthcare Outcomes) GEMH (geriatric mental health)-a remote learning and mentoring program-is an effective strategy to address geriatric mental health challenges in rural and underserved communities. Thirty-three teleECHO clinic sessions connecting a team of specialists to 54 primary care and case management spoke sites (approximately 154 participants) were conducted in 10 New York counties from late 2014 to early 2016. The curriculum consisted of case presentations and didactic lessons on best practices related to geriatric mental health care. Twenty-six interviews with program participants were conducted to explore changes in geriatric mental health care knowledge and treatment practices. Health insurance claims data were analyzed to assess changes in health care utilization and costs before and after program implementation. Findings from interviews suggest that the program led to improvements in clinician geriatric mental health care knowledge and treatment practices. Claims data analysis suggests that emergency room costs decreased for patients with mental health diagnoses. Patients without a mental health diagnosis had more outpatient visits and higher prescription and outpatient costs. Telementoring programs such as Project ECHO GEMH may effectively build the capacity of frontline clinicians to deliver high-quality, evidence-based care to older adults with mental health conditions and may contribute to the transformation of health care delivery systems from volume to value.

  10. The Ongoing Syrian Arab Republic Health Care Crisis.

    Science.gov (United States)

    Phillips, Steven J

    2017-07-31

    Prior to the Syrian civil war, access and delivery of health care and health care information over the past 4 decades had steadily improved. The life expectancy of the average Syrian in 2012 was 75.7 years, compared to 56 years in 1970. As a result of the civil war, this trend has reversed, with the life expectancy reduced by 20 years from the 2012 level. The Syrian government and its allies have specifically targeted the health care infrastructure not under government control. (Disaster Med Public Health Preparedness. 2015;page 1 of 3).

  11. Health care market deviations from the ideal market.

    Science.gov (United States)

    Mwachofi, Ari; Al-Assaf, Assaf F

    2011-08-01

    A common argument in the health policy debate is that market forces allocate resources efficiently in health care, and that government intervention distorts such allocation. Rarely do those making such claims state explicitly that the market they refer to is an ideal in economic theory which can only exist under very strict conditions. This paper explores the strict conditions necessary for that ideal market in the context of health care as a means of examining the claim that market forces do allocate resources efficiently in health care.

  12. Incentives of Health Care Expenditure

    Directory of Open Access Journals (Sweden)

    Eero Siljander

    2012-12-01

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

  13. Primary Health Care and Narrative Medicine.

    Science.gov (United States)

    Murphy, John W

    2015-01-01

    Primary health care has received a lot of attention since the Alma Ata Conference, convened by the World Health Organization in 1978. Key to the strategy to improve health care outlined at the Alma Ata conference is citizen participation in every phase of service delivery. Although the goals of primary health care have not been achieved, the addition of narrative medicine may facilitate these ends. But a new epistemology is necessary, one that is compatible with narrative medicine, so that local knowledge is elevated in importance and incorporated into the planning, implementation, and evaluation of health programs. In this way, relevant, sustainable, and affordable care can be provided. The aim of this article is to discuss how primary health care might be improved through the introduction of narrative medicine into planning primary health care delivery.

  14. Knowledge of Health Insurance Among Primary Health-Care ...

    African Journals Online (AJOL)

    Background: The National Health Insurance Scheme (NHIS) was formally launched in Nigeria in 2005 as an option to help bridge the evident gaps in health care financing, with the expectation of it leading to significant improvement in the country's dismal health status indices. Primary Health Care (PHC) is the nation's ...

  15. [Trends in health care expenditures in Lithuania].

    Science.gov (United States)

    Jankauskiene, Danguole; Zemguliene, Jolanta; Gaizauskiene, Aldona

    2002-01-01

    The aim of the study was to analyze the tendencies of public and private health care expenditure in Lithuania during 1994-1999. Crude examination of statistical data show, that the growth rate of health care spending per capital is largely determined by growth of national gross domestic product (GDP). We have estimated that health care spending in Lithuania have risen twice faster than GDP during 1994-1999. (Percentage of rise in health care spending, divided by percentage rise of GDP, is +2.26). The introduction of compulsory health insurance in 1997, and the development of private health care sector in Lithuania, led to increase health care expenditure in total, and has influenced changes in public-private spending proportions. A source of private spending in national health account has increased from 15 per cent in 1994-1995 to 24 percent in 1996-1999. The tendency of increasing private spending shows, the evidence, that households are facing more financial risk of purchasing health care. This should be an implication for health care policy makers. Further decisions to increase private payments have to be based on evidence after detailed analysis of impact of consequences on health care access for various social economic groups of population.

  16. Health care and the illegal immigrant.

    Science.gov (United States)

    Glen, Patrick

    2013-01-01

    The question of whether illegal immigrants should be entitled to some form of health coverage in the United States sits at the intersection of two contentious debates: health reform and immigration reform. Proponents of extending coverage argue that the United States has a moral obligation to provide health care to all those within its borders. Conversely, those against doing so argue that immigrants illegally present in the country should not be entitled to public benefits. This Article seeks to chart a middle course between these extremes while answering two questions. First, does constitutional law mandate extending health coverage to illegal immigrants? Second, even if not legally mandated, are there compelling policy reasons for extending such coverage? This Article concludes that while health coverage for illegal immigrants is not required under prevailing constitutional norms, extending coverage as a matter of policy would serve the broader interests of the United States. Extending coverage would be beneficial as a matter of economics and public health, generating spillover benefits for all US citizens and those in the US healthcare and health insurance systems.

  17. Ethics, Politics, and Religion in Public Health Care: A Manifesto for Health Care Chaplains in Canada.

    Science.gov (United States)

    Lasair, Simon

    2016-03-01

    Health care chaplaincy positions in Canada are significantly threatened due to widespread health care cutbacks. Yet the current time also presents a significant opportunity for spiritual care providers. This article argues that religion and spirituality in Canada are undergoing significant changes. The question for Canadian health care chaplains is, then: how well equipped are they to understand these changes in health care settings and to engage them? This article attempts to go part way toward an answer. © The Author(s) 2016.

  18. Distributed leadership in health care

    DEFF Research Database (Denmark)

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

    2018-01-01

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

  19. Spirulina in health care management.

    Science.gov (United States)

    Kulshreshtha, Archana; Zacharia, Anish J; Jarouliya, Urmila; Bhadauriya, Pratiksha; Prasad, G B K S; Bisen, P S

    2008-10-01

    Spirulina is a photosynthetic, filamentous, spiral-shaped and multicellular edible microbe. It is the nature's richest and most complete source of nutrition. Spirulina has a unique blend of nutrients that no single source can offer. The alga contains a wide spectrum of prophylactic and therapeutic nutrients that include B-complex vitamins, minerals, proteins, gamma-linolenic acid and the super anti-oxidants such as beta-carotene, vitamin E, trace elements and a number of unexplored bioactive compounds. Because of its apparent ability to stimulate whole human physiology, Spirulina exhibits therapeutic functions such as antioxidant, anti-bacterial, antiviral, anticancer, anti-inflammatory, anti-allergic and anti-diabetic and plethora of beneficial functions. Spirulina consumption appears to promote the growth of intestinal micro flora as well. The review discusses the potential of Spirulina in health care management.

  20. 8 ways to cut health care costs

    Science.gov (United States)

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

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

    African Journals Online (AJOL)

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

  2. Competition in the Dutch Health Care Sector

    NARCIS (Netherlands)

    F.T. Schut (Erik)

    1995-01-01

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

  3. Health Care Access among Deaf People

    Science.gov (United States)

    Kuenburg, Alexa; Fellinger, Paul; Fellinger, Johannes

    2016-01-01

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

  4. Understanding a Value Chain in Health Care.

    Science.gov (United States)

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

    2015-10-01

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

  5. Suicide Prevention: An Emerging Priority For Health Care.

    Science.gov (United States)

    Hogan, Michael F; Grumet, Julie Goldstein

    2016-06-01

    Suicide is a significant public health problem. It is the tenth leading cause of death in the United States, and the rate has risen in recent years. Many suicide deaths are among people recently seen or currently under care in clinical settings, but suicide prevention has not been a core priority in health care. In recent years, new treatment and management strategies have been developed, tested, and implemented in some organizations, but they are not yet widely used. This article examines the feasibility of improving suicide prevention in health care settings. In particular, we consider Zero Suicide, a model for better identification and treatment of patients at risk for suicide. The approach incorporates new tools for screening, treatment, and support; it has been deployed with promising results in behavioral health programs and primary care settings. Broader adoption of improved suicide prevention care may be an effective strategy for reducing deaths by suicide. Project HOPE—The People-to-People Health Foundation, Inc.

  6. The future of health insurance for children with special health care needs.

    Science.gov (United States)

    Newacheck, Paul W; Houtrow, Amy J; Romm, Diane L; Kuhlthau, Karen A; Bloom, Sheila R; Van Cleave, Jeanne M; Perrin, James M

    2009-05-01

    Because of their elevated need for services, health insurance is particularly important for children with special health care needs. In this article we assess how well the current system is meeting the insurance needs of children with special health care needs and how emerging trends in health insurance may affect their well-being. We begin with a review of the evidence on the impact of health insurance on the health care experiences of children with special health care needs based on the peer-reviewed literature. We then assess how well the current system meets the needs of these children by using data from 2 editions of the National Survey of Children With Special Health Care Needs. Finally, we present an analysis of recent developments and emerging trends in the health insurance marketplace that may affect this population. Although a high proportion of children with special health care needs have insurance at any point in time, nearly 40% are either uninsured at least part of the year or have coverage that is inadequate. Recent expansions in public coverage, although offset in part by a contraction in employer-based coverage, have led to modest but significant reductions in the number of uninsured children with special health care needs. Emerging insurance products, including consumer-directed health plans, may expose children with special health care needs and their families to greater financial risks. Health insurance coverage has the potential to secure access to needed care and improve the quality of life for these children while protecting their families from financially burdensome health care expenses. Continued vigilance and advocacy for children and youth with special health care needs are needed to ensure that these children have access to adequate coverage and that they fare well under health care reform.

  7. Health care and equity in India.

    Science.gov (United States)

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

    2011-02-05

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

  8. Mobile Health Care over 3G Networks: the MobiHealth Pilot System and Service

    NARCIS (Netherlands)

    Wac, K.E.; Bults, Richard G.A.; Konstantas, D.; van Halteren, Aart; Jones, Valerie M.; Widya, I.A.; Herzog, Rainer

    2004-01-01

    Health care is one of the most prominent areas for the application of wireless technologies. New services and applications are today under research and development targeting different areas of health care, from high risk and chronic patients’ remote monitoring to mobility tools for the medical

  9. Health care for under-fives in Ile-Ife, South-West Nigeria: Effect of the Integrated Management of Childhood Illnesses (IMCI strategy on growth and development of under-fives

    Directory of Open Access Journals (Sweden)

    Olufunke M. Ebuehi

    2009-04-01

    Full Text Available Background: The study obtained information on key growth promotion and developmental household and community health practices in Community-Integrated Management of Childhood Illnesses (C-IMCI and non-C-IMCI in local government areas (LGAs in Osun State, Nigeria, to determine the differences that existed, between these LGAs.Method: A cross-sectional comparative study to compare Integrated Management of Childhood Illnesses (IMCI key growth promotion and development health practices in two LGAs in Osun State was conducted using quantitative and qualitative techniques. Data analysis was done using Epi Info version 6.0 for the quantitative survey and a content analysis method for the qualitative survey. The subjects were mothers or caregivers of children 0–59 months of age, and their index children.Results: Findings revealed that the IMCI key growth and development health practices were generally better rated in the CIMCI-compliant LGA than in the non-CIMCI compliant LGA. Breastfeeding practice was widespread in both LGAs. However, the exclusive breastfeeding (EBF rate among children under six months was higher in the compliant LGA (66.7% than in the non-compliant LGA (25%. More caregivers (59.7% from the non-compliant LGA introduced complementary feeds earlier than six months. Growth monitoring activities revealed that there were more underweight children (19.1% in the non-compliant LGA. Community Resource Persons (CORPs and health workers were the most popular sources of information on IMCI key practices in the compliant LGA, while in the non-compliant LGA the traditional healers, elders and, to a lesser extent, health workers provided information on these key practices.Conclusion: The IMCI strategy, if well implemented, is an effective and low-cost intervention that is useful in achieving optimal growth, development and survival of Nigerian children.

  10. Health care needs and use of health care services among newly arrived Syrian refugees: a cross-sectional study.

    Science.gov (United States)

    Oda, Anna; Tuck, Andrew; Agic, Branka; Hynie, Michaela; Roche, Brenda; McKenzie, Kwame

    2017-05-03

    Canada welcomed 33 723 Syrian refugees between November 2015 and November 2016. This paper reports the results of a rapid assessment of health care needs and use of health care services among newly arrived Syrian refugees in Toronto. A cross-sectional study was conducted in Toronto among Syrian refugees aged 18 years or more who had been in Canada for 12 months or less. Participants were recruited initially through distribution of flyers in hotels and through direct referrals and communication with community and settlement agency partners, and then through snowball sampling. We collected sociodemographic information and data on self-perceived physical health and mental health, unmet health care needs and use of health care services. A total of 400 Syrian refugees (221 women [55.2%] and 179 men [44.8%]) were enrolled. Of the 400, 209 (52.2%) were privately sponsored refugees, 177 (44.2%) were government-assisted refugees, and 12 (3.0%) were refugees under the Blended Visa Office-Referred Program. They reported high levels of self-perceived physical and mental health. Over 90% of the sample saw a doctor in their first year in Canada, and 79.8% had a family doctor they saw regularly. However, almost half (49.0%) of the respondents reported unmet health care needs, with the 3 most common reasons reported being long wait times, costs associated with services and lack of time to seek health care services. Many factors may explain our respondents' high levels of self-perceived physical and mental health during the first year of resettlement, including initial resettlement support and eligibility for health care under the Interim Federal Health Program. However, newly arrived Syrian refugees report unmet health care needs, which necessitates more comprehensive care and management beyond the initial resettlement support. Copyright 2017, Joule Inc. or its licensors.

  11. The long term importance of English primary care groups for integration in primary health care and deinstitutionalisation of hospital care

    Directory of Open Access Journals (Sweden)

    Nick Goodwin

    2001-03-01

    Full Text Available Purpose: This article reviews the impact of successive experiments in the development of primary care organisations in England and assesses the long-term importance of English primary care groups for the integration of health and community and health and social care and the deinstitutionalisation of hospital care. Theory: Governments in a number of Western countries are attempting to improve the efficiency, appropriateness and equity of their health systems. One of the main ways of doing this is to devolve provision and commissioning responsibility from national and regional organisations to more local agencies based in primary care. Such primary care organisations are allocated budgets that span both primary and secondary (hospital services and also, potentially, social care. Method: This article is based on a systematic review of the literature forthcoming from the UK Government's Department of Health-funded evaluations of successive primary care organisational developments. These include total purchasing pilots, GP commissioning group pilots, personal medical services pilots and primary care groups and trusts. Results: Primary care organisations in England have proved to be a catalyst in facilitating the development of integrated care working between primary and community health services. Conversely, primary care organisations have proved less effective in promoting integration between health and social care agencies where most progress has been made at the strategic commissioning level. The development of primary care trusts in England is heralding an end to traditional community hospitals. Conclusions: The development of primary care groups in England are but an intermediate step of a policy progression towards future primary care-based organisations that will functionally integrate primary and community health services with local authority services under a single management umbrella.

  12. The long term importance of English primary care groups for integration in primary health care and deinstitutionalisation of hospital care.

    Science.gov (United States)

    Goodwin, N

    2001-01-01

    This article reviews the impact of successive experiments in the development of primary care organisations in England and assesses the long-term importance of English primary care groups for the integration of health and community and health and social care and the deinstitutionalisation of hospital care. Governments in a number of Western countries are attempting to improve the efficiency, appropriateness and equity of their health systems. One of the main ways of doing this is to devolve provision and commissioning responsibility from national and regional organisations to more local agencies based in primary care. Such primary care organisations are allocated budgets that span both primary and secondary (hospital) services and also, potentially, social care. This article is based on a systematic review of the literature forthcoming from the UK Government's Department of Health-funded evaluations of successive primary care organisational developments. These include total purchasing pilots, GP commissioning group pilots, personal medical services pilots and primary care groups and trusts. Primary care organisations in England have proved to be a catalyst in facilitating the development of integrated care working between primary and community health services. Conversely, primary care organisations have proved less effective in promoting integration between health and social care agencies where most progress has been made at the strategic commissioning level. The development of primary care trusts in England is heralding an end to traditional community hospitals. The development of primary care groups in England are but an intermediate step of a policy progression towards future primary care-based organisations that will functionally integrate primary and community health services with local authority services under a single management umbrella.

  13. Care Coordination with Schools: The Role of Family-Centered Care for Children with Special Health Care Needs.

    Science.gov (United States)

    Barnard-Brak, Lucy; Stevens, Tara; Carpenter, Julianna

    2017-05-01

    Objectives Family-centered care has been associated with positive outcomes for children with special health care needs. The purpose of the current study was to examine the relationship of family-centered care as associated with care coordination with schools and school absences (e.g., missed days) as reported by parents of children with special health care needs. Methods The current study utilized data from the National Survey of Children with Special Health Care Needs 2009-201 (N = 40,242) to achieve this purpose. The National Survey of Children with Special Health Care Needs may be considered a nationally-representative and community-based sample of parent responses for children with special health care needs across the United States. Results Results from the current study indicate that family-centered care is associated with fewer absences and improved care coordination with schools when applicable. The variables of functional difficulties, poverty level, and the number of conditions were statistically controlled. Conclusions We suggest that the positive influence of family-centered care when practiced extends beyond the family and interacts with educational outcomes. We also suggest that the role of schools appears to be under-studied given the role that schools can play in family-centered care.

  14. Patient involvement in Danish health care

    DEFF Research Database (Denmark)

    Vrangbaek, Karsten

    2015-01-01

    for analysis of patient involvement in health care. This framework is used to analyze key governance features of patient involvement in Denmark based on previous research papers and reports describing patient involvement in Danish health care. FINDINGS: Patient involvement is important in Denmark...... implications for the development of patient involvement in health care. ORIGINALITY/VALUE: This paper fulfills a need to study different types of patient involvement and to develop a theoretical framework for characterizing and analyzing such involvement strategies....

  15. Robotics Technology in Mental Health Care

    OpenAIRE

    Riek, Laurel D.

    2015-01-01

    This chapter discusses the existing and future use of robotics and intelligent sensing technology in mental health care. While the use of this technology is nascent in mental health care, it represents a potentially useful tool in the practitioner's toolbox. The goal of this chapter is to provide a brief overview of the field, discuss the recent use of robotics technology in mental health care practice, explore some of the design issues and ethical issues of using robots in this space, and fi...

  16. Blogging and the health care manager.

    Science.gov (United States)

    Malvey, Donna; Alderman, Barbara; Todd, Andrew D

    2009-01-01

    The use of blogs in the workplace has emerged as a communication tool that can rapidly and simultaneously connect managers with their employees, customers, their peers, and other key stakeholders. Nowhere is this connection more critical than in health care, especially because of the uncertainty surrounding health care reform and the need for managers to have access to timely and authentic information. However, most health care managers have been slow to join the blogging bandwagon. This article examines the phenomenon of blogging and offers a list of blogs that every health care manager should read and why. This article also presents a simplified step-by-step process to set up a blog.

  17. Celiac Disease Testing (for Health Care Professionals)

    Science.gov (United States)

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

  18. Immigrants and health care: sources of vulnerability.

    Science.gov (United States)

    Derose, Kathryn Pitkin; Escarce, José J; Lurie, Nicole

    2007-01-01

    Immigrants have been identified as a vulnerable population, but there is heterogeneity in the degree to which they are vulnerable to inadequate health care. Here we examine the factors that affect immigrants' vulnerability, including socioeconomic background; immigration status; limited English proficiency; federal, state, and local policies on access to publicly funded health care; residential location; and stigma and marginalization. We find that, overall, immigrants have lower rates of health insurance, use less health care, and receive lower quality of care than U.S.-born populations; however, there are differences among subgroups. We conclude with policy options for addressing immigrants' vulnerabilities.

  19. [Qualitative research methodology in health care].

    Science.gov (United States)

    Bedregal, Paula; Besoain, Carolina; Reinoso, Alejandro; Zubarew, Tamara

    2017-03-01

    Health care research requires different methodological approaches such as qualitative and quantitative analyzes to understand the phenomena under study. Qualitative research is usually the least considered. Central elements of the qualitative method are that the object of study is constituted by perceptions, emotions and beliefs, non-random sampling by purpose, circular process of knowledge construction, and methodological rigor throughout the research process, from quality design to the consistency of results. The objective of this work is to contribute to the methodological knowledge about qualitative research in health services, based on the implementation of the study, “The transition process from pediatric to adult services: perspectives from adolescents with chronic diseases, caregivers and health professionals”. The information gathered through the qualitative methodology facilitated the understanding of critical points, barriers and facilitators of the transition process of adolescents with chronic diseases, considering the perspective of users and the health team. This study allowed the design of a transition services model from pediatric to adult health services based on the needs of adolescents with chronic diseases, their caregivers and the health team.

  20. What Health Care Reform Means for Immigrants: Comparing the Affordable Care Act and Massachusetts Health Reforms.

    Science.gov (United States)

    Joseph, Tiffany D

    2016-02-01

    The 2010 Patient Protection and Affordable Care Act (ACA) was passed to provide more affordable health coverage to Americans beginning in 2014. Modeled after the 2006 Massachusetts health care reform, the ACA includes an individual mandate, Medicaid expansion, and health exchanges through which middle-income individuals can purchase coverage from private insurance companies. However, while the ACA provisions exclude all undocumented and some documented immigrants, Massachusetts uses state and hospital funds to extend coverage to these groups. This article examines the ACA reform using the Massachusetts reform as a comparative case study to outline how citizenship status influences individuals' coverage options under both policies. The article then briefly discusses other states that provide coverage to ACA-ineligible immigrants and the implications of uneven ACA implementation for immigrants and citizens nationwide. Copyright © 2016 by Duke University Press.

  1. Public expenditures and health care in Africa.

    Science.gov (United States)

    Ogbu, O; Gallagher, M

    1992-03-01

    Unfavorable economic conditions in most of Africa (in this paper Africa refers to Sub-Saharan Africa only) have meant public austerity and a deceleration in government health spending. Given the dominant role of government in providing health services in Africa there is a need to investigate the links between public spending and the provision of health care. Analyzing information from five Sub-Saharan African countries, namely Botswana, Burkina Faso, Cameroon, Ethiopia and Senegal, we investigate the impacts of shifting expenditure patterns and levels on the process of providing health services as well as on delivery of health care. The country analyses indicate that in addition to the level of public spending, the expenditure mix (i.e. salaries, drugs, supplies etc.), the composition of the health infrastructure (hospitals, clinics, health posts etc.), community efforts, and the availability of private health care all influence health care delivery. Consequently, per capita public expenditure (the most important indicator in a number of related studies) alone as a measure of the availability of health care and especially for cross-country comparisons is inadequate. Reductions in government resources for health care often result in less efficient mixing of resources and hence less health care delivery, in quality and quantity terms. With the recent trends in health care spending in Africa there should be greater effort to increase the efficient use of these increasingly scarce resources, yet the trend in resource mix has been in the opposite direction. Given the input to public health care of local communities, as well as the provision of private health care, it would seem that government spending on health care should be counter-cyclical, i.e. government health spending should accelerate during periods of economic down turns. Such counter-cyclical spending would tend to offset the difficulties facing local communities and the declining ability of individuals to

  2. Social networks in improvement of health care.

    Science.gov (United States)

    Masic, Izet; Sivic, Suad; Toromanovic, Selim; Borojevic, Tea; Pandza, Haris

    2012-01-01

    Social network is a social structure made of individuals or organizations associated with one or more types of interdependence (friendship, common interests, work, knowledge, prestige, etc.) which are the "nodes" of the network. Networks can be organized to exchange information, knowledge or financial assistance under the various interest groups in universities, workplaces and associations of citizens. Today the most popular and widely used networks are based on application of the Internet as the main ICT. Depending on the method of connection, their field of activity and expertise of those who participate in certain networks, the network can be classified into the following groups: a) Social Networks with personal physical connectivity (the citizens' associations, transplant networks, etc.), b) Global social internet network (Facebook, Twitter, Skype), c) specific health internet social network (forums, Health Care Forums, Healthcare Industry Forum), d) The health community internet network of non professionals (DailyStrength, CaringBridge, CarePages, MyFamilyHealth), e) Scientific social internet network (BiomedExperts, ResearchGate, iMedExchange), f) Social internet network which supported professionals (HealthBoards, Spas and Hope Association of Disabled and diabetic Enurgi), g) Scientific medical internet network databases in the system of scientific and technical information (CC, Pubmed/Medline, Excerpta Medica/EMBASE, ISI Web Knowledge, EBSCO, Index Copernicus, Social Science Index, etc.). The information in the network are exchanged in real time and in a way that has until recently been impossible in real life of people in the community. Networks allow tens of thousands of specific groups of people performing a series of social, professional and educational activities in the place of living and housing, place of work or other locations where individuals are. Network provides access to information related to education, health, nutrition, drugs, procedures

  3. Social Networks in Improvement of Health Care

    Science.gov (United States)

    Masic, Izet; Sivic, Suad; Toromanovic, Selim; Borojevic, Tea; Pandza, Haris

    2012-01-01

    Social network is a social structure made of individuals or organizations associated with one or more types of interdependence (friendship, common interests, work, knowledge, prestige, etc.) which are the “nodes” of the network. Networks can be organized to exchange information, knowledge or financial assistance under the various interest groups in universities, workplaces and associations of citizens. Today the most popular and widely used networks are based on application of the Internet as the main ICT. Depending on the method of connection, their field of activity and expertise of those who participate in certain networks, the network can be classified into the following groups: a) Social Networks with personal physical connectivity (the citizens’ associations, transplant networks, etc.), b) Global social internet network (Facebook, Twitter, Skype), c) specific health internet social network (forums, Health Care Forums, Healthcare Industry Forum), d) The health community internet network of non professionals (DailyStrength, CaringBridge, CarePages, MyFamilyHealth), e) Scientific social internet network (BiomedExperts, ResearchGate, iMedExchange), f) Social internet network which supported professionals (HealthBoards, Spas and Hope Association of Disabled and diabetic Enurgi), g) Scientific medical internet network databases in the system of scientific and technical information (CC, Pubmed/Medline, Excerpta Medica/EMBASE, ISI Web Knowledge, EBSCO, Index Copernicus, Social Science Index, etc.). The information in the network are exchanged in real time and in a way that has until recently been impossible in real life of people in the community. Networks allow tens of thousands of specific groups of people performing a series of social, professional and educational activities in the place of living and housing, place of work or other locations where individuals are. Network provides access to information related to education, health, nutrition, drugs

  4. Policy challenges in modern health care

    National Research Council Canada - National Science Library

    Mechanic, David

    2005-01-01

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

  5. Savings account for health care costs

    Science.gov (United States)

    ... patientinstructions/000864.htm Savings account for health care costs To use the sharing features on this page, ... JavaScript. As health insurance changes, out-of-pocket costs continue to grow. With special savings accounts, you ...

  6. The digital transformation of health care.

    Science.gov (United States)

    Coile, R C

    2000-01-01

    The arrival of the Internet offers the opportunity to fundamentally reinvent medicine and health care delivery. The "e-health" era is nothing less than the digital transformation of the practice of medicine, as well as the business side of the health industry. Health care is only now arriving in the "Information Economy." The Internet is the next frontier of health care. Health care consumers are flooding into cyberspace, and an Internet-based industry of health information providers is springing up to serve them. Internet technology may rank with antibiotics, genetics, and computers as among the most important changes for medical care delivery. Utilizing e-health strategies will expand exponentially in the next five years, as America's health care executives shift to applying IS/IT (information systems/information technology) to the fundamental business and clinical processes of the health care enterprise. Internet-savvy physician executives will provide a bridge between medicine and management in the adoption of e-health technology.

  7. eHealth and quality in health care: implementation time

    NARCIS (Netherlands)

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

    2016-01-01

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

  8. The Future of Home Health Care

    Science.gov (United States)

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

    2016-01-01

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

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

    Science.gov (United States)

    Güntert, Bernhard J

    2007-01-01

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

  10. The authoritarian reign in American health care.

    Science.gov (United States)

    Ballou, Kathryn A; Landreneau, Kandace J

    2010-02-01

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

  11. An eHealth Application in Head and Neck Cancer Survivorship Care: Health Care Professionals' Perspectives.

    Science.gov (United States)

    Duman-Lubberding, Sanne; van Uden-Kraan, Cornelia F; Peek, Niels; Cuijpers, Pim; Leemans, C René; Verdonck-de Leeuw, Irma M

    2015-10-21

    Although many cancer survivors could benefit from supportive care, they often do not utilize such services. Previous studies have shown that patient-reported outcomes (PROs) could be a solution to meet cancer survivors' needs, for example through an eHealth application that monitors quality of life and provides personalized advice and supportive care options. In order to develop an effective application that can successfully be implemented in current health care, it is important to include health care professionals in the development process. The aim of this study was to investigate health care professionals' perspectives toward follow-up care and an eHealth application, OncoKompas, in follow-up cancer care that monitors quality of life via PROs, followed by automatically generated tailored feedback and personalized advice on supportive care. Health care professionals involved in head and neck cancer care (N=11) were interviewed on current follow-up care and the anticipated value of the proposed eHealth application (Step 1). A prototype of the eHealth application, OncoKompas, was developed (Step 2). Cognitive walkthroughs were conducted among health care professionals (N=21) to investigate perceived usability (Step 3). Interviews were recorded, transcribed verbatim, and analyzed by 2 coders. Health care professionals indicated several barriers in current follow-up care including difficulties in detecting symptoms, patients' perceived need for supportive care, and a lack of time to encourage survivors to obtain supportive care. Health care professionals expected the eHealth application to be of added value. The cognitive walkthroughs demonstrated that health care professionals emphasized the importance of tailoring care. They considered the navigation structure of OncoKompas to be complex. Health care professionals differed in their opinion toward the best strategy to implement the application in clinical practice but indicated that it should be incorporated in the

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

    NARCIS (Netherlands)

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

    2009-01-01

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

  13. The role of mobile technologies in health care processes: the case of cancer supportive care.

    Science.gov (United States)

    Nasi, Greta; Cucciniello, Maria; Guerrazzi, Claudia

    2015-02-12

    Health care systems are gradually moving toward new models of care based on integrated care processes shared by different care givers and on an empowered role of the patient. Mobile technologies are assuming an emerging role in this scenario. This is particularly true in care processes where the patient has a particularly enhanced role, as is the case of cancer supportive care. This paper aims to review existing studies on the actual role and use of mobile technology during the different stages of care processes, with particular reference to cancer supportive care. We carried out a review of literature with the aim of identifying studies related to the use of mHealth in cancer care and cancer supportive care. The final sample size consists of 106 records. There is scant literature concerning the use of mHealth in cancer supportive care. Looking more generally at cancer care, we found that mHealth is mainly used for self-management activities carried out by patients. The main tools used are mobile devices like mobile phones and tablets, but remote monitoring devices also play an important role. Text messaging technologies (short message service, SMS) have a minor role, with the exception of middle income countries where text messaging plays a major role. Telehealth technologies are still rarely used in cancer care processes. If we look at the different stages of health care processes, we can see that mHealth is mainly used during the treatment of patients, especially for self-management activities. It is also used for prevention and diagnosis, although to a lesser extent, whereas it appears rarely used for decision-making and follow-up activities. Since mHealth seems to be employed only for limited uses and during limited phases of the care process, it is unlikely that it can really contribute to the creation of new care models. This under-utilization may depend on many issues, including the need for it to be embedded into broader information systems. If the purpose

  14. Development of a culture of sustainability in health care organizations.

    Science.gov (United States)

    Ramirez, Bernardo; West, Daniel J; Costell, Michael M

    2013-01-01

    This paper aims to examine the concept of sustainability in health care organizations and the key managerial competencies and change management strategies needed to implant a culture of sustainability. Competencies and management development strategies needed to engrain this corporate culture of sustainability are analyzed in this document. This paper draws on the experience of the authors as health care executives and educators developing managerial competencies with interdisciplinary and international groups of executives in the last 25 years, using direct observation, interviews, discussions and bibliographic evidence. With a holistic framework for sustainability, health care managers can implement strategies for multidisciplinary teams to respond to the constant change, fine-tune operations and successfully manage quality of care. Managers can mentor students and provide in-service learning experiences that integrate knowledge, skills, and abilities. Further empirical research needs to be conducted on these interrelated innovative topics. Health care organizations around the world are under stakeholders' pressure to provide high quality, cost-effective, accessible and sustainable services. Professional organizations and health care providers can collaborate with university graduate health management education programs to prepare competent managers in all the dimensions of sustainability. The newly designated accountable care organizations represent an opportunity for managers to address the need for sustainability. Sustainability of health care organizations with the holistic approach discussed in this paper is an innovative and practical approach to quality improvement that merits further development.

  15. Governance in health care delivery : raising performance

    OpenAIRE

    Lewis, Maureen; Pettersson, Gunilla

    2009-01-01

    The impacts of health care investments in developing and transition countries are typically measured by inputs and general health outcomes. Missing from the health agenda are measures of performance that reflect whether health systems are meeting their objectives; public resources are being used appropriately; and the priorities of governments are being implemented. This paper suggests tha...

  16. Health Training Needs of Child Care Professionals.

    Science.gov (United States)

    Caulfield, Rick; Kataoka-Yahiro, Merle

    2001-01-01

    Child care professionals in Hawaii were surveyed to assess health training needs. Respondents reported a high degree of comfort in managing common health conditions. The most commonly requested health services involved speech/language testing and vision/hearing screening. The most requested health/safety workshop topic was behavioral problems. The…

  17. High and rising health care costs.

    Science.gov (United States)

    Ginsburg, Paul B

    2008-10-01

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

  18. Public reporting in health care: how do consumers use quality-of-care information? A systematic review.

    NARCIS (Netherlands)

    Faber, M.J.; Bosch, M.C.; Wollersheim, H.C.H.; Leatherman, S.; Grol, R.P.T.M.

    2009-01-01

    BACKGROUND: One of the underlying goals of public reporting is to encourage the consumer to select health care providers or health plans that offer comparatively better quality-of-care. OBJECTIVE: To review the weight consumers give to quality-of-care information in the process of choice, to

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

    Science.gov (United States)

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

    2017-10-01

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

  20. Dutch health care performance report 2008.

    NARCIS (Netherlands)

    Westert, G.P.; Berg, M.J. van den; Koolman, X.; Verkleij, H.

    2008-01-01

    This is the second national report on the performance of the Dutch health care system. Its focus is on quality, access and costs in 2006/7. The Dutch Health Care Performance Report presents a broad picture based on 110 indicators. Where possible, comparisons in time and between countries are

  1. Online Health Care Communication in Denmark

    DEFF Research Database (Denmark)

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

    2013-01-01

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

  2. Future health care technology and the hospital

    NARCIS (Netherlands)

    Banta, H.D.

    1990-01-01

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

  3. Performance analysis of online health care system

    African Journals Online (AJOL)

    user

    This paper deals with selection of appropriate indexing techniques applied on MySQL database for a health care system and its related performance issues. The proposed Smart Card based Online Health Care System deals with frequent data storage, exchange and retrieval of data from the database servers. Speed and ...

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

    NARCIS (Netherlands)

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

    1998-01-01

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

  5. Flipping primary health care: A personal story.

    Science.gov (United States)

    Mate, Kedar S; Salinas, Gilbert

    2014-12-01

    There is considerable interest in ideas borrowed from education about "flipping the classroom" and how they might be applied to "flipping" aspects of health care to reach the Triple Aim of improved health outcomes, improved experience of care, and reduced costs. There are few real-life case studies of "flipping health care" in practice at the individual patient level. This article describes the experience of one of the authors as he experienced having to "flip" his primary health care. We describe seven inverted practices in his care, report outcomes of this experiment, describe the enabling factors, and derive lessons for patient-centered primary care redesign. Copyright © 2014 Elsevier Inc. All rights reserved.

  6. Changing trends in health care tourism.

    Science.gov (United States)

    Karuppan, Corinne M; Karuppan, Muthu

    2010-01-01

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

  7. [Female migrants in the health care system. Health care utilisation, access barriers and health promotion strategies].

    Science.gov (United States)

    Wimmer-Puchinger, B; Wolf, H; Engleder, A

    2006-09-01

    Due to the evident interaction between social factors and health, migrants are exposed to specific risk factors and access barriers to health services. Some examples are the lower education level, the low social position and/or the insufficient language skills. This concept is further elaborated in the multi-factorial impacts of health literacy. Female migrants often experience additional discrimination because of their gender. Despite the lack of representative data, consistent studies show that female migrants do not regularly take advantage of health care prevention and present themselves with higher degrees of stress. The current "inadequate health care" manifests itself in a lack of care in the areas of prevention and health education and an abundance in the context of medication and diagnostic procedures. To meet these demands and to further reduce barriers, in particular language barriers, specific strategies for this target group involving both politics and the health care system have to be developed. Besides the employment of interpreters with a native cultural background and the distribution of information booklets, it is an important strategy to reduce structural obstacles such as cultural diversity. To contact these women in their living environment should help to increase their self-determined health promotion. Selected models of good practice in Austria with regard to the themes of FGM (female genital mutilation), violence, heart disease and breast cancer are presented to highlight the specific health situation and risk factors of female migrants as well as successful strategies to confront them.

  8. Future developments in health care performance management

    Directory of Open Access Journals (Sweden)

    Crema M

    2013-11-01

    Full Text Available Maria Crema, Chiara Verbano Department of Management and Engineering, University of Padova, Vicenza, Italy Abstract: This paper highlights the challenges of performance management in health care, wherein multiple different objectives have to be pursued. The literature suggests starting with quality performance, following the sand cone theory, but considering a multidimensional concept of health care quality. Moreover, new managerial approaches coming from an industrial context and adapted to health care, such as lean management and risk management, can contribute to improving quality performance. Therefore, the opportunity to analyze them arises from studying their overlaps and links in order to identify possible synergies and to investigate the opportunity to develop an integrated methodology enabling improved performance. Keywords: health care, lean management, clinical risk management, quality, health care processes

  9. Cognitive systems engineering in health care

    CERN Document Server

    Bisantz, Ann M; Fairbanks, Rollin J

    2014-01-01

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

  10. Management of severe acute malnutrition in children under 5 years through the lens of health care workers in two rural South African hospitals

    Directory of Open Access Journals (Sweden)

    Moise Muzigaba

    2018-01-01

    Conclusion: Findings from this study suggest that effective management of paediatric severe acute malnutrition in the study setting is affected by a multiplicity of factors that manifest at different levels of the health system and the community. A verificatory study is encouraged to collaborate these findings.

  11. Health care without managed care in Hong Kong.

    Science.gov (United States)

    Yuen, P P

    1995-10-01

    Although managed care may be more effective than fee-for-service in containing health care costs in the United States, it is less effective in countries with a national health service. In Hong Kong, costs have been contained despite the fact that 95% of general practitioners still practice on a solo, fee-for-service basis. The author describes in detail how the system of tax-based hospitals guarantees universal access without escalating costs.

  12. Health Education and Health Promotion Skills of Health Care Professionals Working in Family Health Centres

    Directory of Open Access Journals (Sweden)

    Esma Kabasakal

    2017-03-01

    Full Text Available Preventable diseases pose a serious problem worldwide. The role of primary healthcare professionals is especially significant in promoting health. Aim: It is aimed to determine the health care professionals working in family health centres have on health education and health promotion skills. Method: The study sample included 144 health care professionals employed in one of 33 family health centres in Ankara Province. The study data were collected using a survey developed on the health education and health promotion skills included in the family medicine specialty education and curriculum from 2008. Results: It was found that 33.3% of the health care professionals had planned to receive health education, and that approximately half of the health care professionals had actively practiced health education and health promotion skills. Considering that time constraints were reported to be the most significant barriers to health promotion, primary health care professionals, most particularly the nurses, should be provided with comprehensive continuing educative training on health promotion and health education skills to foster their professional development. Health promotion and health education trainings shall serve to help them become more active and take on the responsibility of assuming counselling and training roles in health education.

  13. Community Care for People with Complex Care Needs: Bridging the Gap between Health and Social Care

    Directory of Open Access Journals (Sweden)

    Kerry Kuluski

    2017-07-01

    Full Text Available Introduction: A growing number of people are living with complex care needs characterized by multimorbidity, mental health challenges and social deprivation. Required is the integration of health and social care, beyond traditional health care services to address social determinants. This study investigates key care components to support complex patients and their families in the community. Methods: Expert panel focus groups with 24 care providers, working in health and social care sectors across Toronto, Ontario, Canada were conducted. Patient vignettes illustrating significant health and social care needs were presented to participants. The vignettes prompted discussions on i how best to meet complex care needs in the community and ii the barriers to delivering care to this population.  Results: Categories to support care needs of complex patients and their families included i relationships as the foundation for care, ii desired processes and structures of care, and iii barriers and workarounds for desired care.  Discussion and Conclusions: Meeting the needs of the population who require health and social care requires time to develop authentic relationships, broadening the membership of the care team, communicating across sectors, co-locating health and social care, and addressing the barriers that prevent providers from engaging in these required practices.

  14. Quality Improvement in Athletic Health Care.

    Science.gov (United States)

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

    2017-11-01

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

  15. [Access to health care for migrants].

    Science.gov (United States)

    Nørredam, Marie L; Nielsen, Annette Sonne; Krasnik, Allan

    2006-09-04

    Migrants include a broad category of individuals moving from one place to another, either forced or voluntarily. Ethnicity and migration are interacting concepts which may act as determinants for migrants' health and access to health care. This access to health care may be measured by studying utilisation patterns or clinical outcomes like morbidity and mortality. Migrants' access to health care may be affected by several factors relating to formal and informal barriers. Informal barriers include economic and legal restrictions. Formal barriers include language and psychological and sociocultural factors.

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

    Science.gov (United States)

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

    2014-11-01

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

  17. Keeping parasitology under the One Health umbrella.

    Science.gov (United States)

    Robertson, Lucy J; Utaaker, Kjersti Selstad; Goyal, Kapil; Sehgal, Rakesh

    2014-08-01

    The One Health concept is no longer new, but remains an accepted concept in modern disease control - where the interactions between animal health, human health, and the environment in which we live are recognised as being of importance. However, emerging infectious diseases often garner the greatest attention and resources. Parasitic infections, many of which are zoonotic but cannot truly be considered as emerging, must ensure that they retain their place under the One Health umbrella. Copyright © 2014 Elsevier Ltd. All rights reserved.

  18. Increasing User Involvement in Health Care and Health Research Simultaneously

    DEFF Research Database (Denmark)

    Kaltoft, Mette Kjer; Nielsen, Jesper Bo; Salkeld, Glenn

    2014-01-01

    , Comparators, Outcomes, Timings, and Settings (PICOTS) framework. RESULTS: Our underlying hypothesis concerns the person-as-researcher who is equipped with a prescriptive, transparent, expected value-based opinion-an opinion that combines their criterion importance weights with the Best Estimates Available Now...... and democracy. OBJECTIVE: Our Web-based project aims to increase involvement in health care and health research and is presented in the form of an umbrella protocol for a set of project-specific protocols. We conceptualize the person as a researcher engaged in a continual, living, informal "n-of-1"-type study...... the efforts of the "person-as-researcher" as contributing to the total amount of research undertaken in the community, with research not being confined to that undertaken by professional researchers and institutions. This view is fundamentally compatible with both the emancipatory and conventional approaches...

  19. The resistible growth of health care costs.

    Science.gov (United States)

    Grosjean, O V

    2008-01-01

    Rather than our routinely blamed ageing demography, pharmaceutical promotion and the medical business, not research, are responsible for our ever growing health bill. To keep essential health care affordable, only what has been proved necessary and cost effective should be financed by some kind of risk mutualisation system. Hedonistic care should be left to the free market. From conception to death, a devastating culture of medicalization and therapeutic agressivity has turned naturally inexpensive processes, such as conception, birth, ageing and death, into over-priced medical achievements. The increasing lack of personal and social responsibility triggered by the market, such as junk food, tobacco, drugs, sedentarity or trash media, multiply life-threatening illnesses such as diabetes 2, obesity, cardiovascular diseases and all kinds of cancers. Screenings require millions of participants and intense statistical analysis to prove any efficacy. Screenings, testings and proactive practices make people sick and produce more patients than they save lives , while generating exceptional returns on investments thanks to state and insurance financing; they should be put under public control. New drugs are unaffordable in spite of their dubious efficacy which often relies on biased and underpowered studies. Because they target desperate, debilitating, up to now incurable diseases like metastatic cancers, multiple sclerosis, Alzheimer, polyarthritis, Crohn disease, patients and their families want them by any means and at any price. The answer to the North-South health gap is in a global deal: a declining demographic trend, already well under way and free circulation not only of goods but also of people which would in the long run shape up the age pyramid of a progressively mixed population. That could also save lives at both ends of the human chain: those who die from starvation and those who die from overfeeding.

  20. Strategic service quality management for health care.

    Science.gov (United States)

    Anderson, E A; Zwelling, L A

    1996-01-01

    Quality management has become one of the most important and most debated topics within the service sector. This is especially true for health care, as the controversy rages on how the existing American system should be restructured. Health care reform aimed at reducing costs and ensuring access to all Americans cannot be allowed to jeopardize the quality of care. As such, total quality management (TQM) has become a vital ingredient to strategic planning within the health care domain. At the heart of any such quality improvement effort is the issue of measurement. TQM cannot be effectively utilized as a competitive weapon unless quality can be accurately defined, measured, evaluated, and monitored over time. Through such analysis a hospital can elect how to expend its limited resources toward those quality improvement projects which will impact customer perceptions of service quality the most. Thus, the purpose of this report is to establish a framework by which to approach the issue of quality measurement, delineate the various components of quality that exist in health care, and explore how these elements affect one another. We propose that the issue of quality measurement in health care be approached as an integration of service quality attributes common to other service organizations and technical quality attributes unique to health care. We hope that this research will serve as a first step toward the synthesis of the various quality attributes inherent in the health care domain and encourage other researchers to address the interactions of the various quality attributes.

  1. Escalating Health Care Cost due to Unnecessary Diagnostic Testing

    Directory of Open Access Journals (Sweden)

    MUHAMMAD AZAM ISHAQUE CHAUDHARY

    2017-07-01

    Full Text Available Focusing on health care systems can improve health outcomes now and in the future. Growing economies have serious concerns on the rising cost of health, whereas, in under developed countries like Pakistan, it is not emphasized yet at all. The research is conducted to improve a unique aspect of health care systems to provide effective, patient-centred, high-standard health care while maintaining the cost effectiveness. Research is being qualified in two paradigms qualitative and quantitative. In qualitative research, expert?s interviews have been taken to get the basic knowledge of radiology based testing and their prerequisites, in quantitative research ordered are being analysed to check the frequency and if they are unnecessary or qualified medical necessity guidelines as established in qualitative method. Analysis was made on the basis of the trinity relationship of diagnosis, symptoms and respected order to determine the necessity of the order to get its impact on cost of the overall health of those patients and point out more than 50% unnecessary orders are being performed in two government hospitals. The situation is alarming and policy makers should focus on unnecessary ordering to avoid out of pocket expenses and improve quality of care. The research helps in successful application of health care system modifications and policies pertaining to one aspect of health systems, i.e. cost-effectiveness of health care.

  2. Financing health care for all insurance the first step? is national h-ealth

    African Journals Online (AJOL)

    1990-08-04

    Aug 4, 1990 ... supplemented by a national health insurance scheme, rather than through simply expanding the contribution to health care that comes out of general tax revenue. Given that private ownership of health ..... Commonly excluded under such schemes are specialist dental services, cosmetic surgery, and even ...

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

    Science.gov (United States)

    Caicedo, Carmen

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

  4. Managing complaints in health and social care.

    Science.gov (United States)

    Holmes-Bonney, Kathy

    2010-04-01

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

  5. Health Literacy and Access to Care

    Science.gov (United States)

    Janke, Alex

    2016-01-01

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

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

    African Journals Online (AJOL)

    Health insurance, in addition to being a technique for controlling and managing health risks, helps in placing the insured in a position for accessing health care delivery ahead of an illness. This instrument, which has been well utilized in developed economies, is what the National Health Insurance Scheme (NHIS) in Nigeria ...

  7. Subjective experienced health as a driver of health care behavior

    NARCIS (Netherlands)

    Bloem, S.; Stalpers, J.

    2012-01-01

    This paper describes the key role of the subjective experience of health as the driver of health related behavior. Individuals vary greatly in terms of behaviors related to health. Insights into these interindividual differences are of great importance for all parties involved in health care,

  8. Organizational Learning in Health Care Organizations

    Directory of Open Access Journals (Sweden)

    Savithiri Ratnapalan

    2014-02-01

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

  9. Immigration and health care reform: shared struggles.

    Science.gov (United States)

    Gardner, Deborah B

    2007-01-01

    The connection between health care and immigration share overlaping key areas in policy reform. General concern, anger, and fear about immigration has been spreading nationwide. While illegal immigrants' use of expensive emergency department services does add to the cost for uncompensated care, this expenditure is not a primary cost driver but more a symptom of little or no access to preventative or primary health care. As a result of federal inaction, more state politicians are redefining how America copes with illegal residents including how or whether they have access to health care. The overlap of immigration and health care reform offers an opportunity for us to enter the next round of debate from a more informed vantage point.

  10. Health care and equity in India

    Science.gov (United States)

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

    2011-01-01

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

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

    African Journals Online (AJOL)

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

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

    African Journals Online (AJOL)

    Introduction. Reliable data is necessary to facilitate the effective planning, management and restructuring of mental health care facilities. Access to accurate information on clinical conditions, treatment outcomes and expenditure is essential to ensure accountability, quality and cost-effective mental health care. This article is ...

  13. Evidence-informed person-centred health care (part II): are 'cognitive biases plus' underlying the EBM paradigm responsible for undermining the quality of evidence?

    Science.gov (United States)

    Seshia, Shashi S; Makhinson, Michael; Young, G Bryan

    2014-12-01

    Recently, some leaders of the evidence-based medicine (EBM) movement drew attention to the "unintended" negative consequences associated with EBM. The term 'cognitive biases plus' was introduced in part I to encompass cognitive biases, conflicts of interests, fallacies and certain behaviours. 'Cognitive biases plus' in those closely involved in creating and promoting the EBM paradigm are responsible for their (1) inability to anticipate and then recognize flaws in the tenets of EBM; (2) discounting alternative views; and (3) delaying reform. A narrative review style was used, with methods as in part I. Over the past two decades there has been mounting qualitative and quantitative methodological evidence to suggest that the faith placed in (1) the EBM hierarchy with randomized controlled trials and systematic reviews at the summit; (2) the reliability of biostatistical methods to quantitate data; and (3) the primacy of sources of pre-appraised evidence, is seriously misplaced. Consequently, the evidence that informs person-centred care is compromised. Arguments focusing on 'cognitive biases plus' are offered to support our hypothesis. To the best of our knowledge, EBM proponents have not provided an explanation. Reform is urgently needed to minimize continuing risks to patients. If our hypothesis is correct, then in addition to the suggestions made in part I, deficiencies in the paradigm must be corrected. Meaningful solutions are only possible if the biases of scientific inbreeding and groupthink are minimized by collaboration between EBM leaders and those who have been sounding warning bells. © 2014 John Wiley & Sons, Ltd.

  14. Improving educational preparation for transcultural health care.

    Science.gov (United States)

    Le Var, R M

    1998-10-01

    There is increasing evidence that the health care needs of people from black and ethnic minority groups in England are not being met. A growing number of initiatives are being undertaken to remedy the situation. Many of them are focused on health care delivery at local and national levels. However, unless the preparation of health care professionals in the area of multi-cultural health care is appropriate and effective, a great deal of corrective action will continue to have to be taken. Despite 1997 having been the European Year Against Racism, it is still necessary to consider what educational preparation should be like. The article draws on identified inadequacies in health care provision as well as examples of initiatives taken to improve care provision. The author identifies deficiencies in educational preparation and proposes a range of actions to be taken. The article is focused on nursing, midwifery and health visiting education in England, but is deemed to be relevant to all health care professionals not only in Europe but other continents, as they become increasingly international and multi-ethnic.

  15. Corporate moral responsibility in health care.

    Science.gov (United States)

    Wilmot, S

    2000-01-01

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

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

    Science.gov (United States)

    Hauke, Eugen

    2007-01-01

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

  17. Ethical thinking and discrimination in health care

    Directory of Open Access Journals (Sweden)

    Aleksander Mlinšek

    2012-02-01

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

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

    NARCIS (Netherlands)

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

    2008-01-01

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

  19. Pivoting: leveraging opportunities in a turbulent health care environment.

    Science.gov (United States)

    Bandy, Margaret Moylan

    2015-01-01

    The purpose of this lecture is to challenge librarians in clinical settings to leverage the opportunities presented by the current health care environment and to develop collaborative relationships with health care practitioners to provide relevant services. Health care organizations are under financial and regulatory pressures, and many hospital librarians have been downsized or have had their positions eliminated. The lecture briefly reviews hospital librarians' roles in the past but focuses primarily on our current challenges. This environment requires librarians to be opportunity focused and pivot to a new vision that directs their actions. Many librarians are already doing this, and colleagues are encouraging us to embrace these opportunities. Evidence from publications, websites, discussion lists, personal communications, and the author's experience is explored. Developing interdisciplinary and collaborative relationships in our institutions and providing relevant services will mark our progress as vital, contributing members of our health care organizations.

  20. Primary health care research--essential but disadvantaged.

    Science.gov (United States)

    Yallop, Julie J; McAvoy, Brian R; Croucher, Joanne L; Tonkin, Andrew; Piterman, Leon

    2006-07-17

    Primary health care is the foundation of effective, sustainable population health and is associated with higher patient satisfaction and reduced aggregate health spending. Although improving patient care requires a sound evidence base, rigorously designed studies remain under-represented in primary care research. The pace of research activity in general practice and the rate and quality of publications do not match the pace of structural change or the level of funding provided. Recruitment difficulties are a major impediment, fuelled by general practitioners' time constraints, lack of remuneration, non-recognition, and workforce shortages. Radical reform is required to redress imbalances in funding allocation, including: funding of GP Research Network infrastructure costs; formalising relationships between primary care researchers and academic departments of general practice and rural health; and mandating that research funding bodies consider only proposals that include in the budget nominal payments for GP participation and salaries for dedicated research nurses.

  1. Ideology drives health care reforms in Chile.

    Science.gov (United States)

    Reichard, S

    1996-01-01

    The health care system of Chile evolved from rather unique historical circumstances to become one of the most progressive in Latin America, offering universal access to all citizens. Since the advent of the Pinochet regime in 1973, Chile has implemented Thatcherite/Reaganite reforms resulting in the privatization of much of the health care system. In the process, state support for health care has been sharply curtailed with deleterious effects on health services. As Chile emerges from the shadow of the Pinochet dictatorship, it faces numerous challenges as it struggles to rebuild its health care system. Other developing nations considering free-market reforms may wish to consider the high costs of the Chilean experiment.

  2. A Message to Health Care Professionals

    Centers for Disease Control (CDC) Podcasts

    2011-10-11

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

  3. Towards safe information technology in health care

    NARCIS (Netherlands)

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

    2011-01-01

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

  4. Availability and provision of emergency obstetric care under a public-private partnership in three districts of Gujarat, India: lessons for Universal Health Coverage.

    Science.gov (United States)

    Iyer, V; Sidney, K; Mehta, R; Mavalankar, D

    2016-01-01

    The state of Gujarat in India (population 60 million) has implemented a public-private partnership (PPP) with private obstetricians called the Chiranjeevi Yojana (CY) since 2006. This study investigated the adequacy of basic and comprehensive emergency obstetric care (BEmOC and CEmOC) services through the public and private sectors with reference to the United Nations (UN) guidelines. A cross-sectional facility survey was conducted in three districts. A total of 300 facilities, 151 public and 149 private, had provided obstetric services to a total of 53 896 births in the past 6 months. Nearly half, 135 facilities (104 public and 31 private), individually reported public; 20 private) full CEmOC, 66 (1; 65) 'potential' CEmOC, 12 (3; 9) BEmOC and 57 (40; 17) non-EmOC facilities. All the three districts exceeded the UN recommendation for EmOC availability by 3.3 to 11.3 times. Free provision, through both public and PPP facilities, ranged from 1.42 to 3.43. The actual performance was nearly double the recommendation for CEmOC but inadequate for BEmOC. Public sector EmOC availability and provision is negligible. Private sector availability is well beyond the recommended UN norms. The CY programme has resulted in increased availability and provision of EmOC services. However, the overall provision of EmOC is compromised due to the poor performance of BEmOC functions and clustering of private facilities in towns.

  5. Availability and provision of emergency obstetric care under a public–private partnership in three districts of Gujarat, India: lessons for Universal Health Coverage

    Science.gov (United States)

    Sidney, K; Mehta, R; Mavalankar, D

    2016-01-01

    Objective The state of Gujarat in India (population 60 million) has implemented a public–private partnership (PPP) with private obstetricians called the Chiranjeevi Yojana (CY) since 2006. This study investigated the adequacy of basic and comprehensive emergency obstetric care (BEmOC and CEmOC) services through the public and private sectors with reference to the United Nations (UN) guidelines. Design A cross-sectional facility survey was conducted in three districts. Results A total of 300 facilities, 151 public and 149 private, had provided obstetric services to a total of 53 896 births in the past 6 months. Nearly half, 135 facilities (104 public and 31 private), individually reported public; 20 private) full CEmOC, 66 (1; 65) ‘potential’ CEmOC, 12 (3; 9) BEmOC and 57 (40; 17) non-EmOC facilities. All the three districts exceeded the UN recommendation for EmOC availability by 3.3 to 11.3 times. Free provision, through both public and PPP facilities, ranged from 1.42 to 3.43. The actual performance was nearly double the recommendation for CEmOC but inadequate for BEmOC. Conclusions Public sector EmOC availability and provision is negligible. Private sector availability is well beyond the recommended UN norms. The CY programme has resulted in increased availability and provision of EmOC services. However, the overall provision of EmOC is compromised due to the poor performance of BEmOC functions and clustering of private facilities in towns. PMID:28588914

  6. Simulation modeling for the health care manager.

    Science.gov (United States)

    Kennedy, Michael H

    2009-01-01

    This article addresses the use of simulation software to solve administrative problems faced by health care managers. Spreadsheet add-ins, process simulation software, and discrete event simulation software are available at a range of costs and complexity. All use the Monte Carlo method to realistically integrate probability distributions into models of the health care environment. Problems typically addressed by health care simulation modeling are facility planning, resource allocation, staffing, patient flow and wait time, routing and transportation, supply chain management, and process improvement.

  7. Danish cancer patients’ perspective on health care

    DEFF Research Database (Denmark)

    Sandager, Mette; Sperling, Cecilie; Jensen, Henry

    2015-01-01

    Patient’s experiences and patient surveys are increasingly being used for the evaluation of the quality of health care. Patient information is valuable input when we aim to improve healthcare services. The aim of this study was to assess Danish cancer patients’ experiences and assessment...... and better involvement of patient and relatives. The study indicates that women, younger and higher educated patients tend to be less satisfied with the health care they received. This study shows that even though the majority of patients are satisfied with the quality of health care, there is room...

  8. Robots and service innovation in health care.

    Science.gov (United States)

    Oborn, Eivor; Barrett, Michael; Darzi, Ara

    2011-01-01

    Robots have long captured our imagination and are being used increasingly in health care. In this paper we summarize, organize and criticize the health care robotics literature and highlight how the social and technical elements of robots iteratively influence and redefine each other. We suggest the need for increased emphasis on sociological dimensions of using robots, recognizing how social and work relations are restructured during changes in practice. Further, we propose the usefulness of a 'service logic' in providing insight as to how robots can influence health care innovation. The Royal Society of Medicine Press Ltd 2011.

  9. Mental Health Care: Who's Who

    Science.gov (United States)

    ... 18-21yrs. Healthy Living Healthy Living Healthy Living Nutrition Fitness Sports Oral Health Emotional Wellness Growing Healthy Sleep Safety & ... Word Shop AAP Find a Pediatrician Healthy Living Nutrition Fitness Sports Oral Health Emotional Wellness Building Resilience Sleep Growing ...

  10. Digital health and perioperative care.

    Science.gov (United States)

    Fotis, Theofanis

    2017-06-01

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

  11. Youth with Special Health Care Needs: Transition to Adult Health Care Services

    OpenAIRE

    Oswald, Donald P.; Gilles, Donna L.; Cannady, Mariel S.; Wenzel, Donna B.; Willis, Janet H.; Bodurtha, Joann N.

    2013-01-01

    Transition to adult services for children and youth with special health care needs (CYSHCN) has emerged as an important event in the life course of individuals with disabilities. Issues that interfere with efficient transition to adult health care include the perspectives of stakeholders, age limits on pediatric service, complexity of health conditions, a lack of experienced healthcare professionals in the adult arena, and health care financing for chronic and complex conditions. The purposes...

  12. Change in health status and access to care in young adults with special health care needs: results from the 2007 national survey of adult transition and health.

    Science.gov (United States)

    Okumura, Megumi J; Hersh, Aimee O; Hilton, Joan F; Lotstein, Debra S

    2013-04-01

    Despite over 500,000 adolescents with special health care needs transitioning to adulthood each year, limited information is available on their health status or their access to care after transition. To describe the change in health status and access to care of a nationally sampled, longitudinal cohort of young adults with special health care needs (ASHCN). We analyzed follow-up data collected in the 2007 Survey of Adult Transition and Health on young adults who were 14-17 years of age when their parents participated in the 2001 National Survey of Children with Special Health Care Needs. We describe changes in access to care and health status over time, and used logistic regression to identify characteristics that were associated with declining health status in this cohort. 1,865 participants, aged 19-23 years, completed the Survey of Adult Transition and Health. Between 2001 and 2007, there was a 3.6 fold increase in the proportion experiencing delayed or forgone care; 10% reported a decline in health status. There was a 7.7-fold increase in the proportion reporting no insurance. In regression analysis, factors associated with declining health status between 2001 and 2007 included underlying disease severity and delayed or forgone care in young adulthood. We found significant deterioration in insurance coverage, usual source of care and receiving timely health care as ASHCN aged into adulthood, and that this was associated with decline in health status. Our findings suggest that further population-based analyses of health outcomes are needed to plan for interventions to assist this vulnerable population. Copyright © 2013 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  13. Health promotion in connection to the health care students

    Directory of Open Access Journals (Sweden)

    S. Kyuchukova

    2017-09-01

    Full Text Available The activities of health promotion for the students in health care specialties is organized and managed by the teacher process. During the training communication skills are acquired. It is the time for preparing students for work in counseling and patient education, collecting and providing health information - promotive function in the process of care (1. We assumed that these opportunities could be used in our work with children deprived of parental care. We set a goal to explore experiences, attitudes and ideas about students’ participation in health care in health promotion in the community of children and individuals. The study found that students are aware of the social importance of the knowledge acquired during the training and are convinced of the need to support adolescents to develop a responsible attitude towards their own health.

  14. Leadership research in business and health care.

    Science.gov (United States)

    Vance, Connie; Larson, Elaine

    2002-01-01

    To summarize research on leadership in the health care and business literature and to identify the outcomes of leadership on individuals, groups, and organizations. A computerized search and review of research studies was conducted in the health care and business literature from 1970-1999. Studies were categorized and analyzed according to participants, design, primary topic area, and effects or outcomes of leadership. Most of the health care and business literature on leadership consisted of anecdotal or theoretical discussion. Only 4.4% (n = 290) of 6,628 articles reviewed were data-based. Further, the largest proportion of the research (120/290, 41.4%) was purely descriptive of the demographic characteristics or personality traits of leaders. Other studies showed the influence of leadership on subordinates (27.9%). Only 15 (5.2%) of 290 research articles include correlations of qualities or styles of leadership with measurable outcomes on the recipients of services or positive changes in organizations. Research on leadership in the health care and business literature to date has been primarily descriptive. Although work in the social sciences indicates that leadership styles can have a major influence on performance and outcomes, minimal transfer of this work to the health care system is evident. Limited research on leadership and health care outcomes exists, such as changes in patient care or improvements in organizational outputs. In this era of evidence-based practice, such research, although difficult to conduct, is urgently needed.

  15. Personalized Health Care and Business Success

    Science.gov (United States)

    Ozbolt, Judy G.

    1999-01-01

    Perrow's models of organizational technologies provide a framework for analyzing clinical work processes and identifying the management structures and informatics tools to support each model. From this perspective, health care is a mixed model in which knowledge workers require flexible management and a variety of informatics tools. A Venn diagram representing the content of clinical decisions shows that uncertainties in the components of clinical decisions largely determine which type of clinical work process is in play at a given moment. By reducing uncertainties in clinical decisions, informatics tools can support the appropriate implementation of knowledge and free clinicians to use their creativity where patients require new or unique interventions. Outside health care, information technologies have made possible breakthrough strategies for business success that would otherwise have been impossible. Can health informatics work similar magic and help health care agencies fulfill their social mission while establishing sound business practices? One way to do this would be through personalized health care. Extensive data collected from patients could be aggregated and analyzed to support better decisions for the care of individual patients as well as provide projections of the need for health services for strategic and tactical planning. By making excellent care for each patient possible, reducing the “inventory” of little-needed services, and targeting resources to population needs, informatics can offer a route to the “promised land” of adequate resources and high-quality care. PMID:10495097

  16. Professional values, technology and future health care: The view of health care professionals in The Netherlands

    NARCIS (Netherlands)

    M.E. Nieboer; A.M. van Hout; Joost van Hoof; Sil Aarts; Eveline Wouters

    2014-01-01

    Perceptions and values of care professionals are critical in successfully implementing technology in health care. The aim of this study was threefold: (1) to explore the main values of health care professionals, (2) to investigate the perceived influence of the technologies regarding these values,

  17. HEALTH CARE MODELS AND SOCIAL CONTROL STRATEGIES

    Directory of Open Access Journals (Sweden)

    Aline Vieira Simões

    2011-06-01

    Full Text Available This study aimed to understand the context of health care models and the social control strategies. It is a bibliographic review of critical and reflexive nature based of the references by technical texts, scientific publications and official documents related to public health policies, assisting in the preparation of candidates in the exam for knowledge. It has been selected eleven books and five articles. The material was categorized into three approaches: Historical Context of Public Health Policies, Health Care Models and Social Control Strategies. The results analysis and discussion subsidized the understanding of public health policies, since the implementation of SUS, and regulates health care; however a large country like Brazil, a single model of health care would not be able to meet the demands of health services, which justifies the implementation of various proposals. And, for social control it was possible to understand its influence on public policy changes, where we have identified the health councils and conferences as social control strategies, involving social actors in a critical and constructive role in the process of changing models of care.

  18. Improving oral health for individuals with special health care needs.

    Science.gov (United States)

    Crall, James J

    2007-01-01

    The purpose of this paper was to highlight information and issues raised in a keynote address for the American Academy of Pediatric Dentistry's Symposium on Lifetime Oral Health Care for Patients with Special Needs held in November, 2006. Topics include: (1) relevant statistics and definitions; (2) the prevalence and impact of common oral diseases in individuals with special health care needs (ISHCN); (3) an overview of oral health care delivery for ISHCN; (4) key delivery system and policy issues; and (5) a synopsis of major contextual initiatives related to ISHCN. In light of the Academy's primary interest in infants, children, and adolescents--including children with special health care needs--the major focus is on children. Significant oral health and oral health care issues for adults with special needs, however, generally parallel those for children and are of interest to the Academy, particularly as they relate to the transition from pediatric care to adult care, a critical period for extending the level of oral health and health trajectory established during childhood.

  19. Effects of the Affordable Care Act on Consumer Health Care Spending and Risk of Catastrophic Health Costs.

    Science.gov (United States)

    Nowak, Sarah A; Eibner, Christine; Adamson, David M; Saltzman, Evan

    2014-01-01

    This study examines the likely effects of the Affordable Care Act (ACA) on average annual consumer health care spending and the risk of catastrophic medical costs for the United States overall and in two large states that have decided not to expand their Medicaid programs (Texas and Florida). The ACA will have varied impacts on individuals' and families' spending on health care, depending on income level and on estimated 2016 insurance status without the ACA. The authors find that average out-of-pocket spending is expected to decrease for all groups considered in the analysis, although decreases in out-of-pocket spending will be largest for those who would otherwise be uninsured. People who would otherwise be uninsured who transition to the individual market under the ACA will have higher total health care spending on average after implementation of the ACA because they will now incur the cost of health insurance premiums. The authors also find that risk of catastrophic health care spending will decrease for individuals of all income levels for the insurance transitions considered; decreases will be greatest for those at the lowest income levels. Case studies found that in Texas and Florida, Medicaid expansion would substantially reduce out-of-pocket and total health care spending for those with incomes below 100 percent of the federal poverty level, compared with a scenario in which the ACA is implemented without Medicaid expansion. Expansion would reduce the risk of high medical spending for those covered under Medicaid who would remain uninsured without expansion.

  20. Health Problems and Health Care Seeking Behaviour of Rohingya Refugees

    OpenAIRE

    Masud, Abdullah Al; Ahmed, Md. Shahoriar; Sultana, Mst. Rebeka; Alam, S. M. Iftekhar; Kabir, Russell; Arafat, S. M. Yasir; Papadopoulos, Konstantinos

    2017-01-01

    Abstract Background: Rohingya refugees are one of the most vulnerable group due to lack of health care system, personal hygiene, shelter, sanitation and violence. Aim: The present study aims to find out the health problems and health care seeking behavior of rohingya refugee peoples, to identify the socio-demographic information for such exposure group in relation to age, sex, occupation, living areas, to explore the patient's physical, emotional, perceptions, attitudes and environmen...

  1. THE NEOLIBERAL TURN IN AMERICAN HEALTH CARE.

    Science.gov (United States)

    Gaffney, Adam

    2015-01-01

    Leaving millions both uninsured and underinsured, the Affordable Care Act does not create a system of universal health care in the United States. To understand its shortcomings, we have to understand it as part of a historic shift in the political economy of American health care. This "neoliberal turn" began as a reaction against the welfare state as it expanded during the New Deal and post-World War II period. What began as a movement associated with philosophers like Friedrich Hayek ultimately had a powerful impact via the attraction of powerful corporate sponsors and political supporters, and it was to historically transform American health care thought and organization. In health policy circles, for example, it can be seen in a rising emphasis on "moral hazard," overuse, and cost sharing above a concern with universalism and equity. It was likewise manifested by the corporatization of the health maintenance organization and the rise of the "consumer-driven" health care movement. By the time of the health care reform debate, the influence of corporate "stakeholders" was to prove predominant. These developments, however, must be construed as connected parts of a much larger political transformation, reflected in rising inequality and privatization, occurring both domestically and internationally.

  2. [Supply and demand in home health care].

    Science.gov (United States)

    Braga, Patrícia Pinto; de Sena, Roseni Rosângela; Seixas, Clarissa Terenzi; de Castro, Edna Aparecida Barbosa; Andrade, Angélica Mônica; Silva, Yara Cardoso

    2016-03-01

    The changes in the demographic and epidemiologic profiles of the Brazilian population and the need to rethink the health care model have led many countries like Brazil to consider Home Care (HC) as a care strategy. However, there is a gap between the supply of HC services, the demand for care and the health needs manifested by the population. Thus, this article analyzes scientific output regarding the status of the relation between supply, demand and the needs related to home health care. This work is based on an integrative review of the literature in the following databases: Cumulative Index to Nursing and Allied Health Literature (CINAHL), Latin America and the Caribbean Literature on Health and Science (Lilacs), Medical Literature Analysis and Retrieval System Online (Medline) and Web of Science. Despite the fact that few articles refer to the issue in question, there is evidence indicating that health demands and needs are seldom taken into account either in a quantitative or qualitative approach when developing the organization of HC services. The analysis would indicate that there is a national and international deficit in the supply of HC services considering the demand for health care and needs currently prevailing.

  3. Mental Health Issues in Foster Care.

    Science.gov (United States)

    Lohr, W David; Jones, V Faye

    2016-10-01

    Children in foster care have exceptional needs due to their histories of abuse, neglect, and increased exposure to violence. The rates of psychiatric symptoms and disorders, such as attention-deficit/hyperactivity disorder, posttraumatic stress disorder, and reactive attachment disorder, are much higher in children in foster care; furthermore, the rate of these children receiving psychotropic medications is 3 times that of children who are not in foster care. Pediatricians, in their role of providing a medical home, play a central role in safeguarding the physical and mental health of these children. By taking a trauma-informed approach to understanding the unique needs and gaps in their health care, pediatricians can improve the mental health and maximize outcome for children in foster care. [Pediatr Ann. 2016;45(10):e342-e348.]. Copyright 2016, SLACK Incorporated.

  4. The Shifting Landscape of Health Care: Toward a Model of Health Care Empowerment

    Science.gov (United States)

    2011-01-01

    In a rapidly changing world of health care information access and patients’ rights, there is limited conceptual infrastructure available to understand how people approach and engage in treatment of medical conditions. The construct of health care empowerment is defined as the process and state of being engaged, informed, collaborative, committed, and tolerant of uncertainty regarding health care. I present a model in which health care empowerment is influenced by an interplay of cultural, social, and environmental factors; personal resources; and intrapersonal factors. The model offers a framework to understand patient and provider roles in facilitating health care empowerment and presents opportunities for investigation into the role of health care empowerment in multiple outcomes across populations and settings, including inquiries into the sources and consequences of health disparities. PMID:21164096

  5. Petroleum and Health Care: Evaluating and Managing Health Care's Vulnerability to Petroleum Supply Shifts

    Science.gov (United States)

    Bednarz, Daniel; Bae, Jaeyong; Pierce, Jessica

    2011-01-01

    Petroleum is used widely in health care—primarily as a transport fuel and feedstock for pharmaceuticals, plastics, and medical supplies—and few substitutes for it are available. This dependence theoretically makes health care vulnerable to petroleum supply shifts, but this vulnerability has not been empirically assessed. We quantify key aspects of petroleum use in health care and explore historical associations between petroleum supply shocks and health care prices. These analyses confirm that petroleum products are intrinsic to modern health care and that petroleum supply shifts can affect health care prices. In anticipation of future supply contractions lasting longer than previous shifts and potentially disrupting health care delivery, we propose an adaptive management approach and outline its application to the example of emergency medical services. PMID:21778473

  6. Health Care Issues for Children and Adolescents in Foster Care and Kinship Care.

    Science.gov (United States)

    2015-10-01

    Children and adolescents who enter foster care often do so with complicated and serious medical, mental health, developmental, oral health, and psychosocial problems rooted in their history of childhood trauma. Ideally, health care for this population is provided in a pediatric medical home by physicians who are familiar with the sequelae of childhood trauma and adversity. As youth with special health care needs, children and adolescents in foster care require more frequent monitoring of their health status, and pediatricians have a critical role in ensuring the well-being of children in out-of-home care through the provision of high-quality pediatric health services, health care coordination, and advocacy on their behalves. Copyright © 2015 by the American Academy of Pediatrics.

  7. The construction of a governable health care

    DEFF Research Database (Denmark)

    Peyton, Margit Malmmose

    Many studies have been conducted on the issue of New Public Management (NPM) and health care, not always quoting directly the philosophies of NPM, but using methods deriving from it. This study seeks to explore the development of studies on NPM in health care since the 1970s. The following research...... questions will be addressed: What types of studies are conducted on NPM in health care and how do these studies relate to the construction of the governable person? What are the changes in these relations and is the acceptance of this nationally dependent? Using Miller and O’Leary’s (1987), “The...... construction of the governable person” as a theoretical framework, all academic articles from AA journals on the issues of NPM, health care and/or hospitals are analyzed....

  8. Coverage matters: insurance and health care

    National Research Council Canada - National Science Library

    Board on Health Care Services Staff; Institute of Medicine Staff; Institute of Medicine; National Academy of Sciences

    2001-01-01

    ...: Insurance and Health Care , explores the myths and realities of who is uninsured, identifies social, economic, and policy factors that contribute to the situation, and describes the likelihood faced...

  9. Modeling Health Care Expenditures and Use.

    Science.gov (United States)

    Deb, Partha; Norton, Edward C

    2018-04-01

    Health care expenditures and use are challenging to model because these dependent variables typically have distributions that are skewed with a large mass at zero. In this article, we describe estimation and interpretation of the effects of a natural experiment using two classes of nonlinear statistical models: one for health care expenditures and the other for counts of health care use. We extend prior analyses to test the effect of the ACA's young adult expansion on three different outcomes: total health care expenditures, office-based visits, and emergency department visits. Modeling the outcomes with a two-part or hurdle model, instead of a single-equation model, reveals that the ACA policy increased the number of office-based visits but decreased emergency department visits and overall spending.

  10. Value added telecommunication services for health care.

    Science.gov (United States)

    Danelli-Mylonas, Vassiliki

    2003-01-01

    The successful implementation and operation of health care networks and the efficient and effective provision of health care services is dependent upon a number of different factors: Telecommunications infrastructure and technology, medical applications and services, user acceptance, education and training, product and applications/services development and service provision aspects. The business model and market development regarding policy and legal issues also must be considered in the development and deployment of telemedicine services to become an everyday practice. This chapter presents the initiatives, role and contribution of the Greek Telecommunications Company in the health care services area and also refers to specific case-studies focusing upon the key factors and issues of applications related to the telecommunications, informatics, and health care sectors, which can also be the drivers to create opportunities for Citizens, Society and the Industry.

  11. Increased health care use in cancer survivors.

    OpenAIRE

    Heins, M.J.; Rijken, P.M.; Schellevis, F.G.; Hoek, L. van der; Korevaar, J.C.

    2012-01-01

    Background: As the number of cancer survivors increases and these patients often experience long-lasting consequences of cancer and its treatment, more insight into primary health care use of cancer survivors is needed. We aimed to determine how often and for which reasons do adult cancer patients contact their Primary Care Physician (PCP) 2-5 years after diagnosis. Methods: Using data from the Netherlands Information Network of Primary Care (LINH), we determined the volume and diagnoses made...

  12. Increases health care use in cancer survivors.

    OpenAIRE

    Heins, M.J.; Rijken, P.M.; Schellevis, F.G.; Hoek, L. van der; Korevaar, J.C.

    2012-01-01

    Background: As the number of cancer survivors increases and these patients often experience longlasting consequences of cancer and its treatment, more insight into primary health care use of cancer survivors is needed. Research question: How often and for which reasons do adult cancer patients contact their Primary Care Physician (PCP) 2-5 years after diagnosis. Methods: Using data from the Netherlands Information Network of Primary Care (LINH), we determined the volume and diagnoses made dur...

  13. Improving Health Care for Assisted Living Residents

    Science.gov (United States)

    Kane, Robert L.; Mach, John R., Jr.

    2007-01-01

    Purpose: The purpose of this article is to explore how medical care is delivered to older people in assisted living (AL) settings and to suggest ways for improving it. Design and Methods: We present a review of the limited research available on health care for older AL residents and on building testable models of better ways to organize primary…

  14. The Health Care Dilemma. Second Edition.

    Science.gov (United States)

    McTaggart, Aubrey C.; McTaggart, Lorna, M.

    The purpose of this book is to provide useful information about the components of quality health care and to suggest ways for the consumer to find and avail himself of the best care possible. The following subjects are covered, including brief histories of sociological background and suggestions on how to judge competency: (1) physicians,…

  15. Integrating mental health into primary care: a global perspective

    National Research Council Canada - National Science Library

    Funk, Michelle

    2008-01-01

    ... for mental disorders is enormous 4. Primary care for mental health enhances access 5. Primary care for mental health promotes respect of human rights 6. Primary care for mental health is affordab...

  16. The valuation of health care intangible assets.

    Science.gov (United States)

    Reilly, R F; Rabe, J R

    1997-01-01

    Health care entities (and especially medical practices) are valued for a number of reasons: sale transaction pricing and structuring, merger formation and dissolution, taxation and regulatory compliance, and litigation support and dispute resolution. The identification and quantification of the entity's intangible assets are often the most important aspects of the valuation. This article illustrates the generally accepted methods for valuing health care-related intangible assets.

  17. Evaluating ICT Applications in Health Care

    OpenAIRE

    Stoop, A.P.

    2005-01-01

    textabstractThis thesis is about evaluation of ICT applications in health care. How can information systems for patients and health care professionals best be evaluated? How to take into account that one - in practice - is often confronted with limited resources? The author describes the difficulties in designing information systems that are supposed to replace and add surplus value to existing forms of information exchange. For information systems to become and remain successful, one needs t...

  18. Promoting oral health care among people living in residential aged care facilities: Perceptions of care staff.

    Science.gov (United States)

    Villarosa, Amy R; Clark, Sally; Villarosa, Ariana C; Patterson Norrie, Tiffany; Macdonald, Susan; Anlezark, Jennifer; Srinivas, Ravi; George, Ajesh

    2018-04-23

    This study aimed to look at the practices and perspectives of residential aged care facility (RACF) care staff regarding the provision of oral health care in RACFs. Emphasis has been placed on the provision of adequate oral health care in RACFs through the Better Oral Health in Residential Aged Care programme. Endorsed by the Australian government, this programme provided oral health education and training for aged care staff. However, recent evidence suggests that nearly five years after the implementation of this programme, the provision of oral care in RACFs in NSW remains inadequate. This project utilised an exploratory qualitative design which involved a focus group with 12 RACF care staff. Participants were asked to discuss the current oral health practices in their facility, and their perceived barriers to providing oral health care. The key findings demonstrated current oral health practices and challenges among care staff. Most care staff had received oral health training and demonstrated positive attitudes towards providing dental care. However, some participants identified that ongoing and regular training was necessary to inform practice and raise awareness among residents. Organisational constraints and access to dental services also limited provision of dental care while a lack of standardised guidelines created confusion in defining their role as oral healthcare providers in the RACF. This study highlighted the need for research and strategies that focus on capacity building care staff in oral health care and improving access of aged care residents to dental services. © 2018 John Wiley & Sons A/S and The Gerodontology Association. Published by John Wiley & Sons Ltd.

  19. [Information security in health care].

    Science.gov (United States)

    Ködmön, József; Csajbók, Zoltán Ernő

    2015-07-05

    Doctors, nurses and other medical professionals are spending more and more time in front of the computer, using applications developed for general practitioners, specialized care, or perhaps an integrated hospital system. The data they handle during healing and patient care are mostly sensitive data and, therefore, their management is strictly regulated. Finding our way in the jungle of laws, regulations and policies is not simple. Notwithstanding, our lack of information does not waive our responsibility. This study summarizes the most important points of international recommendations, standards and legal regulations of the field, as well as giving practical advices for managing medical and patient data securely and in compliance with the current legal regulations.

  20. Primary Care Physician Roles in Health Centers with Oral Health Care Units.

    Science.gov (United States)

    Maxey, Hannah L; Norwood, Connor W; Weaver, Donald L

    2017-01-01

    Integrating oral health care and primary care is a priority for improving population health. Primary care physicians (PCP) are filling expanded roles within oral health care to secure strong overall health for their patients. This comparative case study examines the roles of PCPs at 5 federally qualified health centers that have integrated oral health care and primary care. Administrative data were obtained directly from the Health Resources and Services Administration. Key informant interviews were performed with administrators and clinical care team members at each of the health centers. Data were reviewed by 2 experts in oral health to identify emerging roles for physicians. PPCPs' roles in health centers' integration models vary, but 3 distinct roles emerged: (1) the physician as a champion, (2) the physician as a collaborator, and (3) the physician as a member of an interprofessional team. In addition, providing physicians with the necessary training to identify oral health issues was critical to preparing physicians to take on expanded roles in integrated health care delivery models. Regardless of the roles that they play, family physicians can contribute a great deal to the success of integration models. © Copyright 2017 by the American Board of Family Medicine.

  1. Low health literacy: a barrier to effective patient care.

    Science.gov (United States)

    Seurer, Andrea C; Vogt, H Bruce

    2013-02-01

    providing health care than they previously considered. In order to communicate more effectively and better serve our patients, we need to resist stereotyping patients when estimating (e.g., over estimating or under estimating) their health literacy. We also need to identify educational resources and methods of communication that will ease the burden of health illiteracy. With nearly half of patients having low health literacy nationwide, it is essential to understand health literacy and acknowledge this problem in all of our practices.

  2. Health Care Ergonomics: Contributions of Thomas Waters.

    Science.gov (United States)

    Poole Wilson, Tiffany; Davis, Kermit G

    2016-08-01

    The aim of this study was to assess the contributions of Thomas Waters's work in the field of health care ergonomics and beyond. Waters's research of safe patient handling with a focus on reducing musculoskeletal disorders (MSDs) in health care workers contributed to current studies and prevention strategies. He worked with several groups to share his research and assist in developing safe patient handling guidelines and curriculum for nursing students and health care workers. The citations of articles that were published by Waters in health care ergonomics were evaluated for quality and themes of conclusions. Quality was assessed using the Mixed Methods Appraisal Tool and centrality to original research rating. Themes were documented by the type of population the citing articles were investigating. In total, 266 articles that referenced the top seven cited articles were evaluated. More than 95% of them were rated either medium or high quality. The important themes of these citing articles were as follows: (a) Safe patient handling is effective in reducing MSDs in health care workers. (b) Shift work has negative impact on nurses. (c) There is no safe way to manually lift a patient. (d) Nurse curriculums should contain safe patient handling. The research of Waters has contributed significantly to the health care ergonomics and beyond. His work, in combination with other pioneers in the field, has generated multiple initiatives, such as a standard safe patient-handling curriculum and safe patient-handling programs. © 2016, Human Factors and Ergonomics Society.

  3. Applying business management models in health care.

    Science.gov (United States)

    Trisolini, Michael G

    2002-01-01

    Most health care management training programmes and textbooks focus on only one or two models or conceptual frameworks, but the increasing complexity of health care organizations and their environments worldwide means that a broader perspective is needed. This paper reviews five management models developed for business organizations and analyses issues related to their application in health care. Three older, more 'traditional' models are first presented. These include the functional areas model, the tasks model and the roles model. Each is shown to provide a valuable perspective, but to have limitations if used in isolation. Two newer, more 'innovative' models are next discussed. These include total quality management (TQM) and reengineering. They have shown potential for enabling dramatic improvements in quality and cost, but have also been found to be more difficult to implement. A series of 'lessons learned' are presented to illustrate key success factors for applying them in health care organizations. In sum, each of the five models is shown to provide a useful perspective for health care management. Health care managers should gain experience and training with a broader set of business management models.

  4. COMMUNITY MEDICINE & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    ajiboro

    cardiovascular risk factors, such as elevated blood. 18 developing preventable ... with marked weight loss (such as AIDS and in the clinic. advanced ..... Update training pathology in sub-Saharan Africans. programmes for physicians and other health workers and for health researchers are necessary in. This study has ...

  5. COMMUNITY MEDICINE & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    Background:Community Based Health Insurance Scheme is a social service organized at community level. It is a mutual health organization ... As part of her corporate social responsibility. Shell in collaboration ... As a result, communities lost faith in the concept provided before the introduction of the CHIS. For of PHC which ...

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

    African Journals Online (AJOL)

    Acute mental health care according to recent mental health legislation. Part II. Activity-based costing. ABR Janse van Rensburg1, W Jassat2. 1Division of Psychiatry, University of the Witwatersrand, Johannesburg, South Africa. 2School of Public Health, University of the Witwatersrand, Johannesburg, South Africa. Abstract.

  7. Global health strategies versus local primary health care priorities ...

    African Journals Online (AJOL)

    Global health strategies versus local primary health care priorities - a case study of national immunisation days in Southern Africa. ... should, therefore, focus its attention on diminishing the negative side-effects of NIDs and on getting the positive sideeffects incorporated in the integrated health services in a sustainable way.

  8. Health Care Reform, Care Coordination, and Transformational Leadership.

    Science.gov (United States)

    Steaban, Robin Lea

    2016-01-01

    This article is meant to spur debate on the role of the professional nurse in care coordination as well as the role of nursing leaders for defining and leading to a future state. This work highlights the opportunity and benefits associated with transformation of professional nursing practice in response to the mandates of the Affordable Care Act of 2010. An understanding of core concepts and the work of care coordination are used to propose a model of care coordination based on the population health pyramid. This maximizes the roles of nurses across the continuum as transformational leaders in the patient/family and nursing relationship. The author explores the role of the nurse in a transactional versus transformational relationship with patients, leading to actualization of the nurse in care coordination. Focusing on the role of the nurse leader, the challenges and necessary actions for optimization of the professional nurse role are explored, using principles of transformational leadership.

  9. Presenteeism among emergency health care staff.

    Science.gov (United States)

    Sánchez-Zaballos, Marta; Baldonedo-Mosteiro, María; Mosteiro-Díaz, Mª Pilar

    2018-02-01

    To estimate the prevalence of presenteeism among different categories of hospital and pre-hospital emergency health care professionals in the Principality of Asturias, Spain, and to define the sociodemographic characteristics and workplace factors associated with presenteeism in all categories. Cross-sectional descriptive study carried out during the last half of 2014 and first half of 2015. A self-administered questionnaire was used to collecta data on sociodemographic and work-related variables and perception of work as stressful. The respondents, who answered voluntarily and anonymously, assessed themselves on the Stanford Presenteeism Scale-6 adapted for use in Spain. The prevalence of presenteeism was 52.9% among the 323 respondents. Presenteeism was associated with stress (P<.01), place of work (P=.004), and bearing responsibility for dependent persons (P=.034) in the group overall. The association between stress and presenteeism was clearly present in emergency physicians (P=.049) and in nurses with dependents under their care (P=.016). The prevalence of presenteeism is high among emergency staff in the Principality of Asturias. Presenteeism is associated with diverse factors.

  10. Mental health stigma and primary health care decisions.

    Science.gov (United States)

    Corrigan, Patrick W; Mittal, Dinesh; Reaves, Christina M; Haynes, Tiffany F; Han, Xiaotong; Morris, Scott; Sullivan, Greer

    2014-08-15

    People with serious mental illness have higher rates of mortality and morbidity due to physical illness. In part, this occurs because primary care and other health providers sometimes make decisions contrary to typical care standards. This might occur because providers endorse mental illness stigma, which seems inversely related to prior personal experience with mental illness and mental health care. In this study, 166 health care providers (42.2% primary care, 57.8% mental health practice) from the Veteran׳s Affairs (VA) medical system completed measures of stigma characteristics, expected adherence, and subsequent health decisions (referral to a specialist and refill pain prescription) about a male patient with schizophrenia who was seeking help for low back pain due to arthritis. Research participants reported comfort with previous mental health interventions. Path analyses showed participants who endorsed stigmatizing characteristics of the patient were more likely to believe he would not adhere to treatment and hence, less likely to refer to a specialist or refill his prescription. Endorsement of stigmatizing characteristics was inversely related to comfort with one׳s previous mental health care. Implications of these findings will inform a program meant to enhance VA provider attitudes about people with mental illness, as well as their health decisions. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  11. COMMUNITY MEDICINE & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    on the patients and families for self-care and the leading to more effective counselling and better clinical decision-making responsibilities it .... about body image because of their weight. The responsibility of administering .... in the individual a negative effect on self- history of diabetes and were skipping meals as a esteem.

  12. COMMUNITY MEDICINE & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    ajiboro

    2013-09-02

    Sep 2, 2013 ... Background. Disease pattern in Nigeria is changing from communicable diseases to non-communicable diseases. However, the approach to patient care has not changed; neither has the expectations of the general public for quick recovery. These have resulted in poorer treatment outcome and patients'.

  13. Employee motivation in health care

    Directory of Open Access Journals (Sweden)

    Joanna Rosak-Szyrocka

    2015-03-01

    Full Text Available Employees of any organization are the most central part so they need to be influenced and persuaded towards task fulfillment. Examinations connected with medical services were carried out using the Servqual method. It was stated that care of employees and their motivation to work is a very important factor regarding employee engagement but also about the overall success of an organization.

  14. COMMUNITY MEDICINE & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    on the patients and families for self-care and the leading to more effective counselling and better clinical decision-making responsibilities .... T2DM were females aged 14 and 16 years diagnosis of diabetes. With regard to acute respectively and ... about body image because of their weight. The responsibility of administering ...

  15. Addressing Health Care Disparities Among Sexual Minorities.

    Science.gov (United States)

    Baptiste-Roberts, Kesha; Oranuba, Ebele; Werts, Niya; Edwards, Lorece V

    2017-03-01

    There is evidence of health disparities between sexual minority and heterosexual populations. Although the focus of lesbian, gay, bisexual, and transgender health research has been human immunodeficiency virus/acquired immunodeficiency syndrome and sexually transmitted infection among men who have sex with men, there are health disparities among sexual minority women. Using the minority stress framework, these disparities may in part be caused by individual prejudice, social stigma, and discrimination. To ensure equitable health for all, there is urgent need for targeted culturally sensitive health promotion, cultural sensitivity training for health care providers, and intervention-focused research. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. International comparison of health care systems using resource profiles.

    Science.gov (United States)

    Anell, A; Willis, M

    2000-01-01

    The most frequently used bases for comparing international health care resources are health care expenditures, measured either as a fraction of gross domestic product (GDP) or per capita. There are several possible reasons for this, including the widespread availability of historic expenditure figures; the attractiveness of collapsing resource data into a common unit of measurement; and the present focus among OECD member countries and other governments on containing health care costs. Despite important criticisms of this method, relatively few alternatives have been used in practice. A simple framework for comparing data underlying health care systems is presented in this article. It distinguishes measures of real resources, for example human resources, medicines and medical equipment, from measures of financial resources such as expenditures. Measures of real resources are further subdivided according to whether their factor prices are determined primarily in national or global markets. The approach is illustrated using a simple analysis of health care resource profiles for Denmark, France, Germany, Sweden, the United Kingdom, and the USA. Comparisons based on measures of both real resources and expenditures can be more useful than conventional comparisons of expenditures alone and can lead to important insights for the future management of health care systems.

  17. Managing diversity in the health care workplace.

    Science.gov (United States)

    Davidhizar, R; Dowd, S; Newman Giger, J

    1999-03-01

    Cultural diversity is increasing in the United States as increasing numbers of minorities enter the United States from abroad, and cultural diversity is especially prevalent in the health care workplace. In fact, the health care professions are particularly interested in the presence of minorities among caregivers because this often enhances the cultural competence of care delivery. Nevertheless, subtle discrimination can still be found, and managers must be alert that such behavior is not tolerated. Use of the Giger-Davidhizar Cultural Assessment Model can provide managers with information needed to respond to diversity among staff appropriately.

  18. [Collaboration patients-health care providers].

    Science.gov (United States)

    Grezet-Bento de Carvalho, Angela; Griesser, Anne-Claude; Hertz, Silvana; Constantin, Michèle; Forni, Michel; Blagojevic, Stina; Bouchardy, Christine; Vlastos, Georges

    2007-10-24

    Breast cancer is the most common cancer in women. Daily suffering of patients and their relatives is often ignored or underestimated. Scientific advances focus on medical treatments and survival and very little on the psychosocial impact of the disease. The shared expertise between breast cancer patients and health care providers is an innovative and promising approach aiming to provide better quality of life and care. The participation of patients permits to bring together professionals around common goals and to promote multidisciplinary disease management, networking and global care. Focusing on very concrete problems highlighted from patients' expertise also improves research, medical training, and health policy standards.

  19. Understanding Business Models in Health Care.

    Science.gov (United States)

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

    2016-05-01

    The increasing focus on the costs of care is forcing health care organizations to critically look at their basic set of processes and activities, to determine what type of value they can deliver. A business model describes the resources, processes, and cost assumptions that an organization makes that will lead to the delivery of a unique value proposition to a customer. As health care organizations are beginning to transform their structure in preparation for a value-based delivery system, understanding business model theory can help in the redesign process.

  20. Public health capacity in the provision of health care services.

    Science.gov (United States)

    Valdmanis, Vivian; DeNicola, Arianna; Bernet, Patrick

    2015-12-01

    In this paper, we assess the capacity of Florida's public health departments. We achieve this by using bootstrapped data envelopment analysis (DEA) applied to Johansen's definition of capacity utilization. Our purpose in this paper is to measure if there is, theoretically, enough excess capacity available to handle a possible surge in the demand for primary care services especially after the implementation of the Affordable Care Act that includes provisions for expanded public health services. We measure subunit service availability using a comprehensive data source available for all 67 county health departments in the provision of diagnostic care and primary health care. In this research we aim to address two related research questions. First, we structure our analysis so as to fix budgets. This is based on the assumption that State spending on social and health services could be limited, but patient needs are not. Our second research question is that, given the dearth of primary care providers in Florida if budgets are allowed to vary is there enough medical labor to provide care to clients. Using a non-parametric approach, we also apply bootstrapping to the concept of plant capacity which adds to the productivity research. To preview our findings, we report that there exists excess plant capacity for patient treatment and care, but question whether resources may be better suited for more traditional types of public health services.

  1. Infant Care and Infant Health

    Science.gov (United States)

    ... Research Information Find a Study Resources and Publications Osteogenesis Imperfecta (OI) Condition Information NICHD Research Information Find ... How many infants are born each year? What steps can help promote an infant’s health before birth? ...

  2. Dartmouth Atlas of Health Care

    Data.gov (United States)

    U.S. Department of Health & Human Services — For more than 20 years, the Dartmouth Atlas Project has documented glaring variations in how medical resources are distributed and used in the United States. The...

  3. Health Care for College Students

    Science.gov (United States)

    ... Español Text Size Email Print Share Common Health Problems at College Page Content Article Body With students living together in dorms and apartments, eating together in cafeterias, and sitting together in classrooms, illnesses and infections ...

  4. COMMUNITY MEDICINE & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    the_monk

    Centre for Disaster Risk Management and Development Studies,. Ahmadu ... issues in disaster management in Nigeria among others from a public health perspective and the way forward. Methods: ..... the supply chain (medical equipment and.

  5. Addressing inequity in health and health care in Mexico.

    Science.gov (United States)

    Barraza-Lloréns, Mariana; Bertozzi, Stefano; González-Pier, Eduardo; Gutiérrez, Juan Pablo

    2002-01-01

    Despite the fact that life expectancy at birth in Mexico has improved from forty-two years in 1940 to seventy-three in 2000, major inequalities persist in health and access to health care. The Mexican health care system has evolved into a series of disjointed subsystems that are incapable of delivering universal health insurance. Without greatly restructuring the way health care is financed, performance with respect to equity will remain poor. This paper presents the inequities of the system and describes how the current system contributes to the status quo rather than redressing the situation. After tracing the origins of the present system, we discuss policy initiatives for moving toward universal health insurance.

  6. Marketing health care to employees: the structure of employee health care plan satisfaction.

    Science.gov (United States)

    Mascarenhas, O A

    1993-01-01

    Providing cost-contained comprehensive quality health care to maintain healthy and productive employees is a challenging problem for all employers. Using a representative panel of metropolitan employees, the author investigates the internal and external structure of employee satisfaction with company-sponsored health care plans. Employee satisfaction is differentiated into four meaningful groups of health care benefits, whereas its external structure is supported by the traditional satisfaction paradigms of expectation-disconfirmation, attribution, and equity. Despite negative disconfirmation, employees register sufficiently high health care satisfaction levels, which suggests some useful strategies that employers may consider implementing.

  7. Primary health care and child survival in India.

    Science.gov (United States)

    Lahariya, Chandrakant; Khanna, Rajesh; Nandan, Deoki

    2010-03-01

    The Primary Health Care (PHC) has been globally promoted as a comprehensive approach to achieve optimal health status and 'Health for all'. The PHC approach, although, initially received the attention but failed to meet the expectations of the people in India. The child health programs in India had been started for long as verticals programs, which later on integrated and had been planned in a way to deliver the services through the PHC systems. Nevertheless, the last decade has witnessed many new initiatives for improving child health, specially; a number of strategies under National Rural Health Mission have been implemented to improve child survival--Skilled Birth Attendant and Emergency Obstetric Care, Home Based Newborn Care, Sick newborn care units, Integrated Management of Neonatal and Childhood Illnesses, strengthening Immunization services, setting up Nutritional rehabilitation centers etc. However, for a large proportion of rural population, an effective and efficient PHC system is the only way for service delivery, which still needs more attention. The authors note that although there have been improvements in infrastructure, community level health workers, and availability of the funding etc., the areas like community participation, district level health planning, data for action, inter-sectoral coordination, political commitment, public private partnership, accountability, and the improving health work force and need immediate attention, to strengthen the PHC system in the country, making it more child friendly and contributory in child survival, in India.

  8. Cultures for performance in health care

    National Research Council Canada - National Science Library

    Mannion, Russell; Davies, Huw T.O; Marshall, Martin N

    2005-01-01

    ... in performance are intrinsically linked to cultural changes within health care settings. Using theories from a wide range of disciplines including economics, management and organization studies, policy studies and the health sciences, this book sets out definitions of cultures and performance, in particular the specific characteristics that help...

  9. Health Care Workers Contribution to Missed Immunization ...

    African Journals Online (AJOL)

    This study was aimed at identifying the health workers' knowledge and inappropriate practices that potentially contribute to missed immunization opportunities in children. A cross-sectional survey was conducted in August 2007 among Primary Health Care workers in Khana Local Government Area of Rivers State, Nigeria ...

  10. Narratives and communication in health care practice

    DEFF Research Database (Denmark)

    Sørensen, Mariann B.

    2014-01-01

    included in various official visions papers and recommendations. The main question is pedagogical: How do practitioners in the health sector i.e. in nursing deal with these perspectives? The materials are the Danish Health Board´s program of rehabilitation and palliative care, data from a focus group study...

  11. Equity versus humanity in health care

    African Journals Online (AJOL)

    and to the consequences of equity-based health policies. As a result, much policy analysis degenerates into a pre- occupation with the treatment of economic symptoms rather than causes. One manifestation ofthis is the use ofthe notion, the. 'maldistribution' of health care expenditure. For exam- ple: 'The implication of the ...

  12. Health Insurance and Managed Care in Nigeria

    African Journals Online (AJOL)

    ferent models of health insurance have continued to evolve worldwide albeit .... or mental disorders. x. Emergencies in and out of the HMO ... tems for organising doctors, hospitals and other pro- viders into groups to enhance the quality of health care services. These groups also contain healthcare costs by discounting the ...

  13. Primary health care reform, dilemmatic space and risk of burnout among health workers.

    Science.gov (United States)

    Freeman, Toby; Baum, Fran; Labonté, Ronald; Javanparast, Sara; Lawless, Angela

    2018-05-01

    Health system changes may increase primary health care workers' dilemmatic space, created when reforms contravene professional values. Dilemmatic space may be a risk factor for burnout. This study partnered with six Australian primary health care services (in South Australia: four state government-managed services including one Aboriginal health team and one non-government organisation and in Northern Territory: one Aboriginal community-controlled service) during a period of change and examined workers' dilemmatic space and incidence of burnout. Dilemmatic space and burnout were assessed in a survey of 130 staff across the six services (58% response rate). Additionally, 63 interviews were conducted with practitioners, managers, regional executives and health department staff. Dilemmatic space occurred across all services and was associated with higher rates of self-reported burnout. Three conditions associated with dilemmatic space were (1) conditions inherent in comprehensive primary health care, (2) stemming from service provision for Aboriginal and Torres Strait Islander peoples and (3) changes wrought by reorientation to selective primary health care in South Australia. Responses to dilemmatic space included ignoring directives or doing work 'under the radar', undertaking alternative work congruent with primary health care values outside of hours, or leaving the organisation. The findings show that comprehensive primary health care was contested and political. Future health reform processes would benefit from considering alignment of changes with staff values to reduce negative effects of the reform and safeguard worker wellbeing.

  14. The Correlation of a Corporate Culture of Health Assessment Score and Health Care Cost Trend.

    Science.gov (United States)

    Fabius, Raymond; Frazee, Sharon Glave; Thayer, Dixon; Kirshenbaum, David; Reynolds, Jim

    2018-02-19

    Employers that strive to create a corporate environment that fosters a culture of health often face challenges when trying to determine the impact of improvements on health care cost trends. This study aims to test the stability of the correlation between health care cost trend and corporate health assessment scores (CHAS) using a culture of health measurement tool. Correlation analysis of annual health care cost trend and CHAS on a small group of employers using a proprietary CHAS tool. Higher CHAS scores are generally correlated with lower health care cost trend. For employers with several years of CHAS measurements, this correlation remains, although imperfectly. As culture of health scores improve, health care costs trends moderate. These findings provide further evidence of the inverse relationship between organizational CHAS performance and health care cost trend.This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0.

  15. The Colombian health insurance system and its effect on access to health care.

    Science.gov (United States)

    Alvarez, Luz Stella; Salmon, J Warren; Swartzman, Dan

    2011-01-01

    In 1993, the Colombian government sought to reform its health care system under the guidance of international financial institutions (the World Bank and International Monetary Fund). These institutions maintain that individual private health insurance systems are more appropriate than previously established national public health structures for overcoming inequities in health care in developing countries. The reforms carried out following international financial institution guidelines are known as "neoliberal reforms." This qualitative study explores consumer health choices and associated factors, based on interviews with citizens living in Medellin, Colombia, in 2005-2006. The results show that most study participants belonging to low-income and middle-income strata, even with medical expense subsidies, faced significant barriers to accessing health care. Only upper-income participants reported a selection of different options without barriers, such as complementary and alternative medicines, along with private Western biomedicine. This study is unique in that the informal health system is linked to overall neo-liberal policy change.

  16. Equity in health and health care reforms.

    Science.gov (United States)

    Glick, S M

    1999-01-01

    In planning healthcare reforms increasing attention has been focused on the issue of equity. Inequities in the provision of healthcare exist even in relatively egalitarian societies. Poverty is still one of the major contributors to ill health and there are many powerful influences in society that continue to thwart the goal of a maximally equitable system for the provision of healthcare. The principles of equity in a healthcare system have been well articulated in recent years. It is incumbent on healthcare professionals who understand the issues to join the efforts towards a more humane and equitable healthcare system in their societies.

  17. Humanitarian and civic assistance health care training and cultural awareness promoting health care pluralism.

    Science.gov (United States)

    Facchini, Rose E

    2013-05-01

    Integration between traditional and contemporary health care in a host nation can be beneficial to nation- and capacity-building and, subsequently, to the overall health of the society. "Traditional" health care in this sense refers to the indigenous health care system in the host nation, which includes characteristic religious or cultural practices, whereas "contemporary" health care is also known as "conventional" or "Westernized"; integration is a synchronization of these two health care forms. However, the choice of integration depends on the political and cultural situation of the nation in which the Department of Defense health care personnel are intervening. Thus, cultural awareness training is essential to ensure the success of missions related to global health and in promoting a health care system that is most beneficial to the society. The present study attempts to show the benefits of both cultural training and health care integration, and how adequately evaluating their efficacy has been problematic. The author proposes that determinants of this efficacy are better documentation collection, extensive predeployment cultural awareness and sensitivity training, and extensive after-action reports for future development. Reprint & Copyright © 2013 Association of Military Surgeons of the U.S.

  18. Who pays for health care in Ghana?

    Directory of Open Access Journals (Sweden)

    McIntyre Diane

    2011-06-01

    Full Text Available Abstract Background Financial protection against the cost of unforeseen ill health has become a global concern as expressed in the 2005 World Health Assembly resolution (WHA58.33, which urges its member states to "plan the transition to universal coverage of their citizens". An important element of financial risk protection is to distribute health care financing fairly in relation to ability to pay. The distribution of health care financing burden across socio-economic groups has been estimated for European countries, the USA and Asia. Until recently there was no such analysis in Africa and this paper seeks to contribute to filling this gap. It presents the first comprehensive analysis of the distribution of health care financing in relation to ability to pay in Ghana. Methods Secondary data from the Ghana Living Standard Survey (GLSS 2005/2006 were used. This was triangulated with data from the Ministry of Finance and other relevant sources, and further complemented with primary household data collected in six districts. We implored standard methodologies (including Kakwani index and test for dominance for assessing progressivity in health care financing in this paper. Results Ghana's health care financing system is generally progressive. The progressivity of health financing is driven largely by the overall progressivity of taxes, which account for close to 50% of health care funding. The national health insurance (NHI levy (part of VAT is mildly progressive and formal sector NHI payroll deductions are also progressive. However, informal sector NHI contributions were found to be regressive. Out-of-pocket payments, which account for 45% of funding, are regressive form of health payment to households. Conclusion For Ghana to attain adequate financial risk protection and ultimately achieve universal coverage, it needs to extend pre-payment cover to all in the informal sector, possibly through funding their contributions entirely from tax, and

  19. Who pays for health care in Ghana?

    Science.gov (United States)

    2011-01-01

    Background Financial protection against the cost of unforeseen ill health has become a global concern as expressed in the 2005 World Health Assembly resolution (WHA58.33), which urges its member states to "plan the transition to universal coverage of their citizens". An important element of financial risk protection is to distribute health care financing fairly in relation to ability to pay. The distribution of health care financing burden across socio-economic groups has been estimated for European countries, the USA and Asia. Until recently there was no such analysis in Africa and this paper seeks to contribute to filling this gap. It presents the first comprehensive analysis of the distribution of health care financing in relation to ability to pay in Ghana. Methods Secondary data from the Ghana Living Standard Survey (GLSS) 2005/2006 were used. This was triangulated with data from the Ministry of Finance and other relevant sources, and further complemented with primary household data collected in six districts. We implored standard methodologies (including Kakwani index and test for dominance) for assessing progressivity in health care financing in this paper. Results Ghana's health care financing system is generally progressive. The progressivity of health financing is driven largely by the overall progressivity of taxes, which account for close to 50% of health care funding. The national health insurance (NHI) levy (part of VAT) is mildly progressive and formal sector NHI payroll deductions are also progressive. However, informal sector NHI contributions were found to be regressive. Out-of-pocket payments, which account for 45% of funding, are regressive form of health payment to households. Conclusion For Ghana to attain adequate financial risk protection and ultimately achieve universal coverage, it needs to extend pre-payment cover to all in the informal sector, possibly through funding their contributions entirely from tax, and address other issues

  20. Financing health care for all - is national health insurance the first ...

    African Journals Online (AJOL)

    If a substantial proportion of the funds continue to come from private sources, then inequity in access to and the distribution of health care is inevitable. ... It is suggested that it will be more feasible to generate sufficient funds under central control through taxation supplemented by a national health insurance scheme, rather ...

  1. Seeking health care through international medical tourism.

    Science.gov (United States)

    Eissler, Lee Ann; Casken, John

    2013-06-01

    The purpose of this study was the exploration of international travel experiences for the purpose of medical or dental care from the perspective of patients from Alaska and to develop insight and understanding of the essence of the phenomenon of medical tourism. The study is conceptually oriented within a model of health-seeking behavior. Using a qualitative design, 15 Alaska medical tourists were individually interviewed. The data were analyzed using a hermeneutic process of inquiry to uncover the meaning of the experience. Six themes reflecting the experiences of Alaska medical tourists emerged: "my motivation," "I did the research," "the medical care I need," "follow-up care," "the advice I give," and "in the future." Subthemes further categorized data for increased understanding of the phenomenon. The thematic analysis provides insight into the experience and reflects a modern approach to health-seeking behavior through international medical tourism. The results of this study provide increased understanding of the experience of obtaining health care internationally from the patient perspective. Improved understanding of medical tourism provides additional information about a contemporary approach to health-seeking behavior. Results of this study will aid nursing professionals in counseling regarding medical tourism options and providing follow-up health care after medical tourism. Nurses will be able to actively participate in global health policy discussions regarding medical tourism trends. © 2013 Sigma Theta Tau International.

  2. Health care financing: recent experience in Africa.

    Science.gov (United States)

    Dunlop, D W

    1983-01-01

    The economic realities of health sector development in Africa has been analyzed in this paper. Both the global and national macroeconomic context has been defined. Given the available data, it is clear that most African countries face increasingly serious economic realities, such as slow or even declining economic growth (per capita), a depressed food production situation, severe balance of payments crises, and increasing dependence on external financial assistance. Given the limited but increasingly available 1981 and 1982 data, the economic situation in many countries is more constrained than those indicated by the data contained in this paper. In this context, the potential competitive situation facing governmental health care systems was reviewed. In addition, the diversity in the sources of health expenditures between countries in Africa was highlighted. These data provide clear evidence that governments clearly do not finance the entire health care system and that individual payment for service in many countries represent an important source of revenue for many care providers in various health care systems operating in any given country. The potential for governments to finance either an expansion of or improvements to the government component of their health care systems is then reviewed. The highlights of this analysis include the following points. First, the tax structure in many African countries is highly dependent on export and import duties, which in turn creates dependency on sustained foreign demand for exports.(ABSTRACT TRUNCATED AT 250 WORDS)

  3. Developing health and social care planning in collaboration.

    Science.gov (United States)

    Rämgård, Margareta; Blomqvist, Kerstin; Petersson, Pia

    2015-01-01

    Collaboration between different professions in community care for older people is often both difficult and complex. In this project, a participatory action research (PAR) was conducted in order to support the professions involved in the care for older people to develop individualized health and social care plans. Cases from daily work were discussed in different professional groups over a period of one year. A key finding was that lack of knowledge regarding the other professions' field of expertise and their underlying professional culture and values was a barrier in their collaboration. However, as the continuous reflective dialogue process progressed, the participants began to reflect more about the importance of collaboration as a prerequisite to achieve the best possible care for the recipient. This process of reflection led to the often complex needs of the care recipients being given a more central position and thus care plans being better tailored to each person's needs.

  4. Self-care as a health resource of elders

    DEFF Research Database (Denmark)

    Høy, Bente; Wagner, Lis; Hall, Elisabeth O.C.

    2007-01-01

    into self-care as a significant health resource of elders with different health status. It suggests that an elder's self-care ability is determined by the interaction of various sub-resources and conditions and emphasizes the constantly evolving nature of self-care. The framework may be of use in clinical......AIM: To review the literature related to self-care and health promotion for elders and to develop an understanding of self-care as a health resource. BACKGROUND: Self-care may improve health and prevent illness and disabilities in elders. Although studies of self-care are numerous, the significance...... of the concept as a health resource for elders lacks clarity. Before 1989, research focused principally on medical self-care at the expense of health care, and self-care was seen more as supplementary to professional health care rather than as a health-promoting approach in health care. METHOD...

  5. Health care professionals' skills regarding patient safety.

    Science.gov (United States)

    Brasaitė, Indrė; Kaunonen, Marja; Martinkėnas, Arvydas; Mockienė, Vida; Suominen, Tarja

    2016-01-01

    The importance of patient safety is growing worldwide, and every day, health care professionals face various challenges in how to provide safe care for their patients. Patient safety skills are one of the main tools to ensure safe practice. This study looks to describe health care professionals' skills regarding patient safety. Data were collected using the skill scale of the Patient Safety Attitudes, Skills and Knowledge (PS-ASK) instrument from different health care professionals (n=1082: physicians, head nurses, nurses and nurse assistants) working in hospitals for adult patients in three regional multi-profile hospitals in the western part of Lithuania. Overall, the results of this study show that based on their own evaluations, health care professionals were competent regarding their safety skills. In particular, they were competent in the sub-scale areas of error analysis (mean=3.09) and in avoiding threats to patient safety (mean=3.31), but only somewhat competent in using decision support technology (mean=2.00). Demographic and other work related background factors were only slightly associated with these patient safety skills areas. Especially, it was noted that nurse assistants may need more support from managers and colleagues in developing their patient safety skills competence. This study has served to investigate the general skills of health care professionals in regard to patient safety. It provides new knowledge about the topic in the context of the Baltic countries and can thus be used in the future development of health care services. Copyright © 2016 The Lithuanian University of Health Sciences. Production and hosting by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

  6. The Grand Coalition and Pension and Health Care Reform

    NARCIS (Netherlands)

    Haverland, M.; Stiller, S.J.

    2010-01-01

    This article focuses on German pension and health care reform politics under the Grand Coalition. All rich democracies face functional pressures to reform these sectors but are confronted with political and sometimes also institutionalobstacles. This holds in particular for the German party system,

  7. Mental health intervention programs in primary care : their scientific basis

    NARCIS (Netherlands)

    van den Brink, W.; Leenstra, A.; Ormel, J.; van de Willige, G.

    This study examines the scientific basis for mental health intervention programs in primary care. The validity of five underlying assumptions is evaluated, using the results of a naturalistic study covering a representative sample of 25 Dutch family practices and data from the literature. Our

  8. Health care-seeking behaviour for child illnesses among rural ...

    African Journals Online (AJOL)

    The aim of this study was to examine the health care-seeking behaviour of mothers when their children under five years suffer from common childhood illnesses such as diarrhoea, fever, cough and worms. The study was conducted in a rural community in the Limpopo Province of South Africa. The sample consisted of 100 ...

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

    African Journals Online (AJOL)

    Introduction. To assess the use of space requires the review of activities performed and functions executed. The assessment of the use and structuring of space for acute mental health care necessitates the review of all operational areas and related activities incorporated in the care program. At the same time appropriate ...

  10. Health care reform in Belgium.

    Science.gov (United States)

    Schokkaert, Erik; Van de Voorde, Carine

    2005-09-01

    Curbing the growth of public sector health expenditures has been the proclaimed government objective in Belgium since the 1980s. However, the respect for freedom of choice for patients and for therapeutic freedom for providers has blocked the introduction of microeconomic incentives and quality control. Therefore--with some exceptions, particularly in the hospital sector--policy has consisted mainly of tariff and supply restrictions and increases in co-payments. These measures have not been successful in curbing the growth of expenditures. Moreover, there remains a large variation in medical practices. While the structure of health financing is relatively progressive from an international perspective, socioeconomic and regional inequalities in health persist. The most important challenge is the restructuring of the basic decision-making processes; i.e. a simplification of the bureaucratic procedures and a re-examination of the role of regional authorities and sickness funds. Copyright (c) 2002 John Wiley & Sons, Ltd.

  11. Natural Language Generation in Health Care

    Science.gov (United States)

    Cawsey, Alison J.; Webber, Bonnie L.; Jones, Ray B.

    1997-01-01

    Abstract Good communication is vital in health care, both among health care professionals, and between health care professionals and their patients. And well-written documents, describing and/or explaining the information in structured databases may be easier to comprehend, more edifying, and even more convincing than the structured data, even when presented in tabular or graphic form. Documents may be automatically generated from structured data, using techniques from the field of natural language generation. These techniques are concerned with how the content, organization and language used in a document can be dynamically selected, depending on the audience and context. They have been used to generate health education materials, explanations and critiques in decision support systems, and medical reports and progress notes. PMID:9391935

  12. Reliability assessment of home health care services.

    Science.gov (United States)

    Spyrou, Stergiani; Bamidis, Panagiotis; Kilintzis, Vassilis; Lekka, Irini; Maglaveras, Nicos; Pappas, Costas

    2007-01-01

    In this paper, a model of reliability assessment of services in Home Health Care Delivery is presented. Reliability is an important quality dimension for services and is included in non-functional requirements of a system. A stochastic Markov model for reliability assessment is applied to patient communication services, in the field of home health care delivery. The methodology includes the specification of scenarios, the definition of failures in scenarios as well as the application of the analytical model. The results of the methodology reveal the critical states of the Home Health Care System and recommendations for improvement of the services are proposed. The model gives valuable results in predicting service reliability and, independently of the error types, it can be applied to all fields of Regional Health Network (RHN).

  13. [Health care expenditures and the aging population].

    Science.gov (United States)

    Felder, S

    2012-05-01

    The impact of a longer life on future health care expenditures will be quite moderate because of the high costs of dying and the compression of mortality in old age. If not age per se but proximity to death determines the bulk of expenditures, a shift in the mortality risk to higher ages will not significantly affect lifetime health care expenditures, as death occurs only once in every life. A calculation of the demographic effect on health care expenditures in Germany up until 2050 that explicitly accounts for costs in the last years of life leads to a significantly lower demographic impact on per-capita expenditures than a calculation based on crude age-specific health expenditures.

  14. Advancing LGBT Health Care Policies and Clinical Care Within a Large Academic Health Care System: A Case Study.

    Science.gov (United States)

    Ruben, Mollie A; Shipherd, Jillian C; Topor, David; AhnAllen, Christopher G; Sloan, Colleen A; Walton, Heather M; Matza, Alexis R; Trezza, Glenn R

    2017-01-01

    Culturally competent health care is especially important among sexual and gender minority patients because poor cultural competence contributes to health disparities. There is a need to understand how to improve health care quality and delivery for lesbian, gay, bisexual, and transgender (LGBT) veterans in particular, because they have unique physical and mental health needs as both LGBT individuals and veterans. The following article is a case study that focuses on the policy and clinical care practices related to LGBT clinical competency, professional training, and ethical provision of care for veteran patients in the VA Boston Healthcare System. We apply Betancourt et al.'s (2003) cultural competence framework to outline the steps that VA Boston Healthcare System took to increase cultural competency at the organizational, structural, and clinical level. By sharing our experiences, we aim to provide a model and steps for other health care systems and programs, including other VA health care systems, large academic health care systems, community health care systems, and mental health care systems, interested in developing LGBT health initiatives.

  15. Health care consumerism movement takes a step forward.

    Science.gov (United States)

    Thompson, Michael; Cutler, Charles M

    2010-01-01

    One of the contributing factors to both the increase in health care costs and the backlash to managed care was the lack of consumer awareness of the cost of health care service, the effect of health care costs on profits and wages, and the need to engage consumers more actively as consumers in health care decisions. This article reviews the birth of the health care consumerism movement and identifies gaps in health care consumerism today. The authors reveal some of the keys to building a sustainable health care consumerism framework, which involves enlisting consumers as well as other stakeholders.

  16. & PRIMARY HEALTH CARE COMMUNITY MEDICINE

    African Journals Online (AJOL)

    to improving mood and helping to manage stress . physical activity a day at least five times a week . Sedentary lifestyle is associated with obesity, Greater health benefits can be experienced with. KEYWORDS. Practice,. Exercise,. Leisure,. Work- related,. Overweight,. Obesity. Journal of Community Medicine and Primary ...

  17. COMMUNITY MEDICINE & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    ajiboro

    The study is a review of the antenatal and delivery records of PHC Aluu, before and after an educational programme, to improve the ..... but used mainly for logistics, and to a lesser extent,. The efforts of the health center to improve the for the transportation of emergency patients, from utilization of its maternity services did not ...

  18. COMMUNITY MEDICINE & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    ajiboro

    Management Sciences for Health (MSH) defined. Artemisinin Combination Therapy (ACT) has various components of access ... Poor supply chains, weak stock key objective in dealing with the disease has been to ..... logistics of supply and distribution is yet to be http://www.lagosstateministryofhealth.co adequately worked ...

  19. Digital health care: cementing centralisation?

    Science.gov (United States)

    Keen, Justin

    2014-09-01

    This article reviews large-scale digital developments in the National Health Service in England in recent years and argues that there is a mismatch between digital and organisational thinking and practice. The arguments are based on new institutional thinking, where the digital infrastructure is taken to be an institution, which has been shaped over a long period, and which in turn shapes the behaviour of health professionals, managers and others. Many digital services are still being designed in line with a bureaucratic data processing model. Yet health services are increasingly based on a network model, where health professionals and service managers require information systems that allow them to manage risks proactively and to coordinate multiple services on behalf of patients. This article further argues that the data processing model is being reinforced by Open Data policies and by related developments in the acquisition of genomic and telehealth data, suggesting that the mismatch will persist. There is, therefore, an ongoing tension between frontline and central objectives for digital services. It may be that the tension can only be resolved when--or if--there is trust between the interested parties. © The Author(s) 2013.

  20. COMMUNITY MEDICINE & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    Objective: The health status of most people living in developing countries of the world remains poor. Linked to this are some factors, of which low utilization of PHC facilities remain a major issue. This study therefore aimed to determine the utilization of PHC services in a sub-urban community in a developing country in West ...

  1. Seeing Your Health Care Provider

    Science.gov (United States)

    ... Office of Adolescent Health OAR NIH Office of AIDS Research OCR HHS Office for Civil Rights OFBNP HHS ... Personal Stories Photos PLWHA People Living with HIV/AIDS Podcasts PrEP Pre-Exposure Prophylaxis Prevention PWID People Who Inject Drugs Research Research Agenda Ryan White Ryan White HIV/AIDS ...

  2. Achieving Excellence in Palliative Care: Perspectives of Health Care Professionals

    Directory of Open Access Journals (Sweden)

    Margaret I Fitch

    2016-01-01

    Full Text Available Caring for individuals at the end of life in the hospital environment is a challenging proposition. Understanding the challenges to provide quality end of life care is an important first step in order to develop appropriate approaches to support and educate staff members and facilitate their capacity remaining "caring." Four studies were undertaken at our facility to increase our understanding about the challenges health professionals experience in caring for patients at end of life and how staff members could be supported in providing care to patients and families: (1 In-depth interviews were used with cancer nurses (n = 30 to explore the challenges talking about death and dying with patients and families; (2 Surveys were used with nurses (n = 27 and radiation therapists (n = 30 to measure quality of work life; (3 and interprofessional focus groups were used to explore what it means "to care" (five groups held; and (4 interprofessional focus groups were held to understand what "support strategies for staff" ought to look like (six groups held. In all cases, staff members confirmed that interactions concerning death and dying are challenging. Lack of preparation (knowledge and skill in palliative care and lack of support from managers and colleagues are significant barriers. Key strategies staff members thought would be helpful included: (1 Ensuring all team members were communicating and following the same plan of care, (2 providing skill-based education on palliative care, and (3 facilitating "debriefing" opportunities (either one-on-one or in a group. For staff to be able to continue caring for patients at the end of life with compassion and sensitivity, they need to be adequately prepared and supported appropriately.

  3. Health care huddles: managing complexity to achieve high reliability.

    Science.gov (United States)

    Provost, Shannon M; Lanham, Holly J; Leykum, Luci K; McDaniel, Reuben R; Pugh, Jacqueline

    2015-01-01

    Health care huddles are increasingly employed in a range of formats but theoretical mechanisms underlying huddles remain relatively uncharted. A complexity science view implies that essential managerial strategies for high-performing health care organizations include meaningful conversations, enhanced relationships, and a learning culture. These three dimensions informed our approach to studying huddles. We explore new theories for how and why huddles have been useful in health care organizations. We used a study design incorporating literature review, direct observation, and semistructured interviews. A complexity science framework guided data collection in three health care settings; we also incorporated theories on high-reliability organizations to analyze our observations and interpret huddle participants' perspectives. We identify theoretical paths that could link huddles to improvement in patient safety outcomes. Huddles create time and space for conversations, enhance relationships, and strengthen a culture of safety. Huddles can be of particular value to health care organizations seeking or sustaining high reliability. Achieving high reliability, the organizational capacity to deliver what is intended to be delivered every time is difficult in complex systems. Managers have potential to create conditions from which huddle outcomes that support high reliability are more likely to emerge. Huddles support efforts to improve patient safety when they afford opportunities for heedful interactions to take place among individuals caring for patients and embed mindfulness into the organization.

  4. The behavioral economics of health and health care.

    Science.gov (United States)

    Rice, Thomas

    2013-01-01

    People often make decisions in health care that are not in their best interest, ranging from failing to enroll in health insurance to which they are entitled, to engaging in extremely harmful behaviors. Traditional economic theory provides a limited tool kit for improving behavior because it assumes that people make decisions in a rational way, have the mental capacity to deal with huge amounts of information and choice, and have tastes endemic to them and not open to manipulation. Melding economics with psychology, behavioral economics acknowledges that people often do not act rationally in the economic sense. It therefore offers a potentially richer set of tools than provided by traditional economic theory to understand and influence behaviors. Only recently, however, has it been applied to health care. This article provides an overview of behavioral economics, reviews some of its contributions, and shows how it can be used in health care to improve people's decisions and health.

  5. Child Health Booklet: experiences of professionals in primary health care

    Directory of Open Access Journals (Sweden)

    Gisele Nepomuceno de Andrade

    2014-10-01

    Full Text Available Objective: Understanding the experiences of health professionals in primary care with the Child Health Booklet in child health care. Method: A qualitative study with a phenomenological approach, in which participated nurses and doctors from six teams of the Family Health Strategy (FHS in Belo Horizonte, MG. In total, were carried out 12 non-directive interviews, using two guiding questions. Results: A comprehensive analysis of the speeches enabled the construction of three categories that signal the experiences of the professionals with the booklet. The experiments revealed difficulties arising from the limitations of knowledge about the instrument; incomplete filling out of the booklet by many professionals that care for children; the daily confrontations of the process and the organization of work teams; disinterest of families with the instrument. Conclusion: The research points possible and necessary ways to improve the use of booklets as an instrument of full child health surveillance.

  6. Staying alive: strategies for accountable health care.

    Science.gov (United States)

    Marcus, Stuart G; Reid-Lombardo, Kaye M; Halverson, Amy L; Maker, Vijay; Demetriou, Achilles; Fischer, Josef E; Bentrem, David; Rudnicki, Marek; Hiatt, Jonathan R; Jones, Daniel

    2012-05-01

    The Patient Protection and Affordable Care Act signed into law in March 2010, has led to sweeping changes to the US health care system. The ensuing pace of change in health care regulation is unparalleled and difficult for physicians to keep up with. Because of the extraordinary challenges that have arisen, the public policy committee of the Society for Surgery of the Alimentary tract conducted a symposium at their 52nd Annual Meeting in May 2011 to educate participants on the myriad of public policy changes occurring in order to best prepare them for their future. Expert speakers presented their views on policy changes affecting diverse areas including patient safety, patient experience, hospital and provider fiscal challenges, and the life of the practicing surgeon. In all areas, surgical leadership was felt to be critical to successfully navigate the new health care landscape as surgeons have a long history of providing safe, high quality, low cost care. The recognition of shared values among the diverse constituents affected by health care policy changes will best prepare surgeons to control their own destiny and successfully manage new challenges as they emerge.

  7. Prevention of health care-associated infections.

    Science.gov (United States)

    Hsu, Vincent

    2014-09-15

    Health care-associated infections cause approximately 75,000 deaths annually, in addition to increasing morbidity and costs. Over the past decade, a downward trend in health care-associated infections has occurred nationwide. Basic prevention measures include administrative support, educating health care personnel, and hand hygiene and isolation precautions. Prevention of central line- or catheter-associated infections begins with avoidance of unnecessary insertion, adherence to aseptic technique when inserting, and device removal when no longer necessary. Specific recommendations for preventing central line-associated bloodstream infections include use of chlorhexidine for skin preparation, as a component of dressings, and for daily bathing of patients in intensive care units. Catheter-associated urinary tract infections are the most common device-related health care-associated infection. Maintaining a closed drainage system below the patient reduces the risk of infection. To prevent ventilator-associated pneumonia, which is associated with high mortality, mechanically ventilated patients should be placed in the semirecumbent position and receive antiseptic oral care. Prevention of surgical site infections includes hair removal using clippers, glucose control, and preoperative antibiotic prophylaxis. Reducing transmission of Clostridium difficile and multidrug-resistant organisms in the hospital setting begins with hand hygiene and contact precautions. Institutional efforts to reduce unnecessary antibiotic prescribing are also strongly recommended. Reducing rates of methicillin-resistant Staphylococcus aureus infection can be achieved through active surveillance cultures and decolonization therapy with mupirocin.

  8. Health Partners of Western Ohio: Integrated Care Case Study.

    Science.gov (United States)

    Taflinger, Kimberly; West, Elizabeth; Sunderhaus, Janis; Hilton, Irene V

    2016-03-01

    Health centers are unique health care delivery organizations in which multiple disciplines, such as primary care, dental, behavioral health, pharmacy, podiatry, optometry and alternative medicine, are often located at the same site. Because of this characteristic, many health centers have developed systems of integrated care. This paper describes the characteristics of health centers and highlights the integrated health care delivery system of one early adopter health center, Health Partners of Western Ohio.

  9. Health care institutions should not exclude smokers from employment.

    Science.gov (United States)

    Huddle, Thomas S; Kertesz, Stefan G; Nash, Ryan R

    2014-06-01

    Some health care institutions, including academic health centers, have adopted policies excluding smokers from employment. Claims advanced on behalf of these policies include financial savings from reduced health costs and absenteeism as well as advantages consonant with their message of healthy living. The authors suggest that the institutional savings from these policies are speculative and unproven. Also, in settings where large medical schools operate, it is likely to be the poor, including members of minority groups, who, under an employee smoker ban, will lose the opportunity to work for an employer that offers health insurance and other benefits. In response to the incentives created by such bans, some will quit smoking, but most will not. Thus, at the community level, employee smoker bans are more likely to be harmful than beneficial.Although private businesses may rightly choose not to hire smokers in the 19 states where such policies are legal, health care institutions, including academic health centers, should consider hiring choices in light of the values they profess. The traditional values of medicine include service to all persons in need, even when illness results from addiction or unsafe behavior. Secular academic communities require a shared dedication to discovery without requiring strict conformity of private behavior or belief. The authors conclude that for health care institutions, policies of hiring smokers and helping them to quit are both prudent and expressive of the norms of medical care, such as inclusion, compassion, and fellowship, that academic health professionals seek to honor.

  10. Building the national health information infrastructure for personal health, health care services, public health, and research

    Directory of Open Access Journals (Sweden)

    Detmer Don E

    2003-01-01

    Full Text Available Abstract Background Improving health in our nation requires strengthening four major domains of the health care system: personal health management, health care delivery, public health, and health-related research. Many avoidable shortcomings in the health sector that result in poor quality are due to inaccessible data, information, and knowledge. A national health information infrastructure (NHII offers the connectivity and knowledge management essential to correct these shortcomings. Better health and a better health system are within our reach. Discussion A national health information infrastructure for the United States should address the needs of personal health management, health care delivery, public health, and research. It should also address relevant global dimensions (e.g., standards for sharing data and knowledge across national boundaries. The public and private sectors will need to collaborate to build a robust national health information infrastructure, essentially a 'paperless' health care system, for the United States. The federal government should assume leadership for assuring a national health information infrastructure as recommended by the National Committee on Vital and Health Statistics and the President's Information Technology Advisory Committee. Progress is needed in the areas of funding, incentives, standards, and continued refinement of a privacy (i.e., confidentiality and security framework to facilitate personal identification for health purposes. Particular attention should be paid to NHII leadership and change management challenges. Summary A national health information infrastructure is a necessary step for improved health in the U.S. It will require a concerted, collaborative effort by both public and private sectors. If you cannot measure it, you cannot improve it. Lord Kelvin

  11. Unmanaged care: towards moral fairness in health care coverage.

    Science.gov (United States)

    Hoffman, Sharona

    2003-01-01

    Health insurers are generally guided by the principle of "actuarial fairness," according to which they distinguish among various risks on the basis of cost-related factors. Thus, insurers often limit or deny coverage for vision care, hearing aids, mental health care, and even AIDS treatment based on actuarial justifications. Furthermore, approximately forty-two million Americans have no health insurance at all, because most of these individuals cannot afford the cost of insurance. This Article argues that Americans have come to demand more than actuarial fairness from health insurers and are increasingly concerned by what I call "moral fairness." This is evidenced by the hundreds of laws that have been passed to constrain insurers' discretion with respect to particular coverage decisions. Legislative mandates are frequent, but seemingly haphazard, following no systematic methodology. This Article suggests an analytical framework that can be utilized to determine which interventions are appropriate and evaluates a variety of means by which moral fairness could be promoted in the arena of health care coverage.

  12. COMMUNITY MEDICINE & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    ajiboro

    three local government areas namely: Enugu East,. The survey involved interviewing mothers of under-. Enugu South and Enugu North. The area is a five children using interviewer-administered reflection of the demographic picture of South- questionnaire. A pre-tested interviewer-. Eastern Zone of Nigeria. A pilot study had ...

  13. Entrepreneurship Education in Health Care Education

    Directory of Open Access Journals (Sweden)

    L. Salminen

    2014-01-01

    Full Text Available This study describes the content of entrepreneurship education in health care education and the kinds of teaching methods that are used when teaching about entrepreneurship. Health care entrepreneurship has increased in many countries in recent decades and there is evidence that entrepreneurs have also a role in public health care. Therefore the health care professionals need to be educated to have the entrepreneurial skills. Education in the field of health care is still based on traditional forms of teaching and does not give enough attention to the issue of becoming an entrepreneur. The data was collected from teachers (n=111 via e-mail from six Finnish polytechnics. The data were analysed statistically and the open-ended questions were analysed via content analysis. Approximately 23% of the teachers had taught about entrepreneurship. The most popular teaching methods were company visits and cases, lecturing, and project work. The courses dealt with establishing a company, entrepreneurship in general, and marketing. Nearly all of the teachers had cooperated with the entrepreneurs or with the companies in question. Approximately 33% of the teachers took entrepreneurship into consideration often in other courses related to entrepreneurship.

  14. Network solutions for home health care applications.

    Science.gov (United States)

    Herzog, Almut; Lind, Leili

    2003-01-01

    The growing number of the elderly in industrialised countries is increasing the pressure on respective health care systems. This is one reason for recent trends in the development and expansion of home health care organisations. With Internet access available to everyone and the advent of wireless technologies, advanced telehomecare is a possibility for a large proportion of the population. In the near future, one of the authors plans to implement a home health care infrastructure for patients with congestive heart failure and patients with chronic obstructive pulmonary disease. The system is meant to support regular and ad-hoc measurements of medical parameters in patient homes and transmission of measurement data to the home health care provider. In this paper we look at network technologies that connect sensors and input devices in the patient home to a home health care provider. We consider wireless and Internet technologies from functional and security-related perspectives and arrive at a recommendation for our system. Security and usability aspects of the proposed network infrastructures are explored with special focus on their impact on the patient home.

  15. Positive rights, negative rights and health care.

    Science.gov (United States)

    Bradley, Andrew

    2010-12-01

    In the current debate about healthcare reform in the USA, advocates for government-ensured universal coverage assume that health care is a right. Although this position is politically popular, it is sometimes challenged by a restricted view of rights popular with libertarians and individualists. The restricted view of rights only accepts 'negative' rights as legitimate rights. Negative rights, the argument goes, place no obligations on you to provide goods to other people and thus respect your right to keep the fruits of your labour. A classic enumeration of negative rights includes life, liberty, and the pursuit of happiness. Positive rights, by contrast, obligate you either to provide goods to others, or pay taxes that are used for redistributive purposes. Health care falls into the category of positive rights since its provision by the government requires taxation and therefore redistribution. Therefore, the libertarian or individualist might argue that health care cannot be a true right. This paper rejects the distinction between positive and negative rights. In fact, the protection of both positive and negative rights can place obligations on others. Furthermore, because of its role in helping protect equality of opportunity, health care can be tied to the rights to life, liberty, and the pursuit of happiness. There is, therefore, good reason to believe that health care is a human right and that universal access should be guaranteed. The practical application, by governments and non-governmental organisations, of several of the arguments presented in this paper is also discussed.

  16. Health care leadership development and training: progress and pitfalls

    Science.gov (United States)

    Sonnino, Roberta E

    2016-01-01

    Formal training in the multifaceted components of leadership is now accepted as highly desirable for health care leaders. Despite natural leadership instincts, some core leadership competencies (“differentiating competencies”) must be formally taught or refined. Leadership development may begin at an early career stage. Despite the recognized need, the number of comprehensive leadership development opportunities is still limited. Leadership training programs in health care were started primarily as internal institutional curricula, with a limited scope, for the development of faculty or practitioners. More comprehensive national leadership programs were developed in response to the needs of specific cohorts of individuals, such as programs for women, which are designed to increase the ranks of senior women leaders in the health sciences. As some programs reach their 20th year of existence, outcomes research has shown that health care leadership training is most effective when it takes place over time, is comprehensive and interdisciplinary, and incorporates individual/institutional projects allowing participants immediate practical application of their newly acquired skills. The training should envelop all the traditional health care domains of clinical practice, education, and research, so the leader may understand all the activities taking place under his/her leadership. Early career leadership training helps to develop a pipeline of leaders for the future, setting the foundation for further development of those who may chose to pursue significant leadership opportunities later in their career. A combination of early and mid-to-late career development may represent the optimal training for effective leaders. More training programs are needed to make comprehensive leadership development widely accessible to a greater number of potential health care leaders. This paper addresses the skills that health care leaders should develop, the optimal leadership

  17. Health and safety standards under deregulation threat

    NARCIS (Netherlands)

    Cremers, Jan

    2015-01-01

    In the quarterly CLR-News (2-2015), titled ‘The future of the EU health and safety legislation’ (www.clr-news.org under Publications), editor Jan Cremers (Law School UvT and AIAS) questions whether the OHS-policy developed is internal market proof and resistant enough to the reigning dogma of

  18. Impact of Home Health Care on Health Care Resource Utilization Following Hospital Discharge: A Cohort Study.

    Science.gov (United States)

    Xiao, Roy; Miller, Jacob A; Zafirau, William J; Gorodeski, Eiran Z; Young, James B

    2018-04-01

    As healthcare costs rise, home health care represents an opportunity to reduce preventable adverse events and costs following hospital discharge. No studies have investigated the utility of home health care within the context of a large and diverse patient population. A retrospective cohort study was conducted between 1/1/2013 and 6/30/2015 at a single tertiary care institution to assess healthcare utilization after discharge with home health care. Control patients discharged with "self-care" were matched by propensity score to home health care patients. The primary outcome was total healthcare costs in the 365-day post-discharge period. Secondary outcomes included follow-up readmission and death. Multivariable linear and Cox proportional hazards regression were used to adjust for covariates. Among 64,541 total patients, 11,266 controls were matched to 6,363 home health care patients across 11 disease-based Institutes. During the 365-day post-discharge period, home health care was associated with a mean unadjusted savings of $15,233 per patient, or $6,433 after adjusting for covariates (p Home health care independently decreased the hazard of follow-up readmission (HR 0.82, p home health care most benefited patients discharged from the Digestive Disease (death HR 0.72, p home health care was associated with significant reduction in healthcare utilization and decreased hazard of readmission and death. These data inform development of value-based care plans. Copyright © 2018 Elsevier Inc. All rights reserved.

  19. The practice of health care: wisdom as a model.

    Science.gov (United States)

    Edmondson, Ricca; Pearce, Jane

    2007-09-01

    Reasoning and judgement in health care entail complex responses to problems whose demands typically derive from several areas of specialism at once. We argue that current evidence- or value-based models of health care reasoning, despite their virtues, are insufficient to account for responses to such problems exhaustively. At the same time, we offer reasons for contending that health professionals in fact engage in forms of reasoning of a kind described for millennia under the concept of wisdom. Wisdom traditions refer to forms of deliberation which combine knowledge, reflection and life experience with social, emotional and ethical capacities. Wisdom is key in dealing with problems which are vital to human affairs but lack prescribed solutions. Uncertainty and fluidity must be tolerated in seeking to resolve them. We illustrate the application of wisdom using cases in psychiatry, where non-technical aspects of problems are often prominent and require more systematic analysis than conventional approaches offer, but we argue that our thesis applies throughout the health care field. We argue for the relevance of a threefold model of reasoning to modern health care situations in which multifaceted teamwork and complex settings demand wise judgement. A model based on practical wisdom highlights a triadic process with features activating capacities of the self (professional), other (patient and/or carers and/or colleagues) and aspects of the problem itself. Such a framework could be used to develop current approaches to health care based on case review and experiential learning.

  20. Principles of Child Health Care Financing.

    Science.gov (United States)

    Hudak, Mark L; Helm, Mark E; White, Patience H

    2017-09-01

    After passage of the Patient Protection and Affordable Care Act, more children and young adults have become insured and have benefited from health care coverage than at any time since the creation of the Medicaid program in 1965. From 2009 to 2015, the uninsurance rate for children younger than 19 years fell from 9.7% to 5.3%, whereas the uninsurance rate for young adults 19 to 25 years of age declined from 31.7% to 14.5%. Nonetheless, much work remains to be done. The American Academy of Pediatrics (AAP) believes that the United States can and should ensure that all children, adolescents, and young adults from birth through the age of 26 years who reside within its borders have affordable access to high-quality and comprehensive health care, regardless of their or their families' incomes. Public and private health insurance should safeguard existing benefits for children and take further steps to cover the full array of essential health care services recommended by the AAP. Each family should be able to afford the premiums, deductibles, and other cost-sharing provisions of the plan. Health plans providing these benefits should ensure, insofar as possible, that families have a choice of professionals and facilities with expertise in the care of children within a reasonable distance of their residence. Traditional and innovative payment methodologies by public and private payers should be structured to guarantee the economic viability of the pediatric medical home and of other pediatric specialty and subspecialty practices to address developing shortages in the pediatric specialty and subspecialty workforce, to promote the use of health information technology, to improve population health and the experience of care, and to encourage the delivery of evidence-based and quality health care in the medical home, as well as in other outpatient, inpatient, and home settings. All current and future health care insurance plans should incorporate the principles for child