Health and Pre-Professional Health care is currently Canada's second-largest service industry. In addition to traditional health-related roles (e.g., physician, nurse, dentist, pharmacist), a wealth of new health care careers are opening as a result of recent scientific, medical and technological advances
One of the fundamental rights of every human being is to enjoy "the highest attainable standard of health". Achieving better health requires no only adequate medical knowledge and technologies, laws and social measures in the field of health care, but also sufficient funding for fulfilling people's right to health. However, economic crisis has left every community with limited possibility of investing in health care and forced them to use the available resources more efficiently. This is the reason why health financing policy represents an important and integral part of the health system concerned with how financial resources are generated, allocated and used. Development of new drugs and medical technologies, population aging, increased incidence of chronic diseases as well as the peoples' rising demands from health care providers lead to a constant increase of health system costs worldwide. In these circumstances, countries in transition, like Serbia, face difficult challenges in financing their health systems. Current economic crisis and budget constraints do not allow the Government to simply allocate more public revenues for health and solve the people's expectations by increasing the spending. Instead, Serbia is forced to start reforms to provide a more efficient health system. The reform processes are positioned within the wider context of European integration and public administration reforms. This paper provides a short description of the health care system in Serbia focusing on the healthcare economics and reforms and their influence on financial sustainability. PMID:25536810
Stosi?, Sanja; Karanovi?, Nevena
The National Council on Disabilities (NCD) undertook this study in 2007 to focus the nation's attention on the health care disparities experienced by people with disabilities, and to provide information and recommendations that can help to eliminate health care inequities for people with disabilities. Among the key findings were that: (1) People…
Breslin, Mary Lou; Yee, Silvia
The health care industry is currently experiencing a fundamental change. Health care organizations are reorganizing their processes to reduce costs, be more competitive, and provide better and more personalized customer care. This new business strategy requires health care organizations to implement new technologies, such as Internet applications, enterprise systems, and mobile technologies in order to achieve their desired business changes.
After more than a decade of war, the US military continues to place significant emphasis on psychological health and resilience. While research and programs that focus on the broader military community's resilience continue to emerge, less is known about and until recently little focus has been placed on military medical provider resilience. In this article, we review the literature on military medical provider resilience, provide an overview of the programmatic and technological advances designed to sustain and develop military medical provider resilience, and finally offer recommendations for future research. PMID:25617036
Lester, Paul B; Taylor, Lauren C; Hawkins, Stacy Ann; Landry, Lisa
Mobile Communications for Medical Care a study of current and future healthcare and health Communications for Medical Care Â Final Report 2 21 April 2011 #12;Mobile Communications for Medical Care a study of current and future healthcare and health promotion applications, and their use in China and elsewhere
Talbot, James P.
Health care occupies a distinct niche in an economy struggling to recover from recession. Professions related to the care of patients are thought to be relatively resistant to downturns, and thus become attractive to students typically drawn to more lucrative pursuits. Currently, a higher profile for clinical laboratory technology among college students and those considering career change results in larger and better prepared applicant pools. However, after decades of contraction marked by closing of programs, prospective students encounter an educational system without the capacity or vigor to meet their needs. Here discussed are some principles and proposals to allow universities, partnering with health-care providers, government agencies, and other stake-holders to develop new programs, or reenergize existing ones to serve our students and patients. Principles include academic rigor in biomedical and clinical science, multiple points of entry for students, flexibility in format, cost effectiveness, career ladders and robust partnerships. PMID:23653802
The demographic factors of the United Arab Emirates (UAE) have changed drastically within one generation. This is evident in how quickly it has moved from a developing nation, where fishing was once the main source of income, to a country that is quite developed, competing on a global level. From one perspective, socio-economic progress has brought many benefits to the population. These include improved education, better access to health care, and safe drinking water. However, on the other hand, economic development has been the cause for changes in lifestyles, eating habits, and traditional societal and family structures. Over time, these changes have added up, creating an unprecedented impact on the population's health. This impact has crept up onto the society until suddenly a notable epidemic has become recognized in the country. According to the UAE Ministry of Health, 19.5 percent of the UAE population has diabetes, making it the second highest rate in the world. The structure and responsibilities of the current UAE health care systems along with other cultural factors were investigated in order to determine their impact on the growing epidemic. PMID:25223161
Mosaad, Aliye T; Younis, Mustafa Z
For more information, contact Barbara Otto, HDA, 312-265-9090 or go to www.hdadvocates.org 1 Impact of Current Health Care Reform Proposals on People with Chronic Illnesses November 7, 2009 State high-risk insurance pools serve people... who have been denied coverage because of pre- existing conditions or who don’t have access to employer based coverage. There are 35 state high-risk insurance pools across the country serving approximately 200,000 people. The U.S. Congress...
Hall, Jean P.; Moore, Janice M.; Otto, B.; Salley, S.
This document is comprised of the six 2002 issues of a bimonthly newsletter on children's health for California's child care professionals. The newsletter provides information on current and emerging health and safety issues relevant to child care providers and links the health, safety, and child care communities. Regular features include columns…
Guralnick, Eva, Ed.; Zamani, Rahman, Ed.; Evinger, Sara, Ed.; Dailey, Lyn, Ed.; Sherman, Marsha, Ed.; Oku, Cheryl, Ed.; Kunitz, Judith, Ed.
Objective To provide an overview of why health care organizations (HCOs) should collect race, ethnicity, and language data, review current practices, discuss the rationale for collecting this information directly from patients, and describe barriers and solutions. Principal Findings Hospitals and HCOs with data from their own institutions may be more likely to look at disparities in care, design targeted programs to improve quality of care, and provide patient-centered care. Yet data collection is fragmented and incomplete within and across organizations. A major factor affecting the quality of data is the lack of understanding about how best to collect this information from patients. Conclusions If HCOs make a commitment to systematically collect race/ethnicity and language data from patients, it would be a major step in enhancing the ability of HCOs to monitor health care processes and outcomes for different population groups, target quality initiatives more efficiently and effectively, and provide patient-centered care. PMID:16899021
Hasnain-Wynia, Romana; Baker, David W
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.
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. PMID:24591853
Iuga, Aurel O; McGuire, Maura J
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. PMID:25436438
Powell, Suzanne K
Outlines access to health care for children in out-of-home care under current law, reviews how health care access for these children would be affected by President Clinton's health care reform initiative, and proposes additional measures that could be considered to improve access and service coordination for children in the child welfare system.…
Halfon, Neal; And Others
The quality of health care is measured today using performance measures that calculate the percentage of people whose health conditions are managed according to specified processes or who meet specified treatment goals. This approach has several limitations. For instance, each measure looks at a particular process, risk factor, or biomarker one by one, and each uses sharp thresholds for defining "success" versus "failure." We describe a new measure of quality called the Global Outcomes Score (GO Score), which represents the proportion of adverse outcomes expected to be prevented in a population under current levels of care compared to a target level of care, such as 100 percent performance on certain clinical guidelines. We illustrate the use of the GO Score to measure blood pressure and cholesterol care in a longitudinal study of people at risk of atherosclerotic diseases, or hardening of the arteries. In that population the baseline GO Score was 40 percent, which indicates that the care being delivered was 40 percent as effective in preventing myocardial infarctions and strokes as our target level of care. The GO Score can be used to assess the potential effectiveness of different interventions such as prevention activities, tests, and treatments. PMID:23129674
Eddy, David M; Adler, Joshua; Morris, Macdonald
In this study, we examine the management and operational problems faced by different categories of health care delivery platforms such as corporate hospitals, medium level private hospitals and public hospitals in Mumbai. Some suggestions are made and we believe many of the short falls or limitations that exist in the current set up can be removed and a way forward can be made in alleviating the suffering of vast majority of humankind living in our mega cities. Three major issues emerged as far as a public health system is concerned--that is shifting of trained health manpower from the public system to private or corporate hospitals, severe strain on the public health system's infrastructure and support services compounded by lack of accountability as far as management and governance are concerned. PMID:23342758
Surendra, Kumar; Amit, Sengupta; Kumar, Agarwal Vishnu
This paper discusses the issues involved with establishing an integrated satellite health network in West Africa based on currently available technology. The system proposed makes use of a central national facility capable of transmitting and receiving voice/data and video signals from the entire country. Regional, field and local facilities provides timely epidemiologic information, sharing of medical expertise through telemedical consultations, enhances optimized resource distribution and builds a framework for telecommunications for the entire country.
Jemison, Mae C.; Thomas, J. S.
This paper discusses the issues involved with establishing an integrated satellite health network in West Africa based on currently available technology. The system proposed makes use of a central national facility capable of transmitting and receiving voice/data and video signals from the entire country. Regional, field and local facilities provide timely epidemiologic information, sharing of medical expertise through telemedical consultations, enhance optimized resource distribution and build a framework for telecommunications for the entire country.
Jemison, Mae C.; Thomas, J. Segun
... Home Find Health Care Share This Page: 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 ...
The period of youth and adolescence has been shown to have continuous demographic growth in the developing world. Young nations thus have to contend with the specific health needs of teenagers and young adults. This is illustrated by an analysis of the health-care needs of Brazilian adolescents. The issues highlighted here are adolescent morbidity and mortality, current delivery of adolescent health care, and future directions of adolescent programs in Brazil. PMID:6464825
Silber, T J
A discussion of the implications of health care reform for academic health centers (a complex of institutions which educate health professionals) looks at problems in the current system, the role of academic health centers in the current system, financial pressures, revenue sources other than patient care, impact on health research, and human…
Kimmey, James R.
This article critically reviews the current status of primary health care services in India. It was observed that medical services have primarily relied on Western medicine, and are incompatible with prevailing health beliefs and practices. The failure of Western medicine and, as a consequence, that of primary health care, calls for developing some culturally compatible health care models for India.
Ajit K. Dalal
Brazil has great geopolitical importance because of its size, environmental resources, and potential economic power. The organisation of its health care system reflects the schisms within Brazilian society. High technology private care is available to the rich and inadequate public care to the poor. Limited financial resources have been overconcentrated on health care in the hospital sector and health professionals are generally inappropriately trained to meet the needs of the community. However, recent changes in the organisation of health care are taking power away from federal government to state and local authorities. This should help the process of reform, but many vested interests remain to be overcome. A link programme between Britain and Brazil focusing on primary care has resulted in exchange of ideas and staff between the two countries. If primary care in Brazil can be improved it could help to narrow the health divide between rich and poor. Images p503-a p504-a p505-a PMID:8448465
Health Care and Dependent Care Flexible Spending Accounts Discovery Benefits, Inc. (866) 451 for certain health care and child care expenses with pre-tax dollars. FSA's may allow you to save money of money that is withheld from your pay on a pre-tax basis. Note: Health Care Reform extends medical FSA
It has long been known that a segment of the population enjoys distinctly better health status and higher quality of health care than others. To solve this problem, prioritization is unavoidable, and the question is how priorities should be set. Rational priority setting would seek equity amongst the whole population, the extent to which people receive equal care for equal needs. Equity in health care is an ethical imperative not only because of the intrinsic worth of good health, or the value that society places on good health, but because, without good health, people would be unable to enjoy life's other sources of happiness. This paper also argues the importance of the health care's efficiency, but at the same time, it highlights how any innovation and rationalization undertaken in the provision of the health system should be achieved from the consideration of human dignity, making the person prevail over economic criteria. Therefore, the underlying principles on which this health care equity paper is based are fundamental human rights. The main aim is to ensure the implementation of these essential rights by those carrying out public duties. Viewed from this angle, equity in health care means equality: equality in access to services and treatment, and equality in the quality of care provided. As a result, this paper attempts to address both human dignity and efficiency through the context of equity to reconcile them in the middle ground. PMID:18611079
La Rosa-Salas, Virginia; Tricas-Sauras, Sandra
Aim. To raise questions about how the United States of America - which spends 1.3 trillion dollars on health care, con- ducts cutting-edge biomedical research, has the most advanced medical technology, and trains a cadre of highly com- petent health professionals - cares for the most vulnerable members of its population. Methods. Relevant statistical data were extrapolated from the most
Edward J. Eckenfels
Principles of Lean management are being adopted more widely in health care as a way of improving quality and safety while controlling costs. The authors, who are chief executive officers of rural North Carolina hospitals, explain how their organizations are using Lean principles to improve quality and safety of health care delivery. PMID:23802475
Hawthorne, Henry C; Masterson, David J
Court decisions taking away someone's freedom by requiring them to serve a jail sentence should not deny them access to the same health care available to free citizens in full compliance with patient confidentiality. Health institutions, responsible for administering somatic care, offer a comprehensive response to the medical needs of those under justice control, both in jails and conventional care units. For a physician, working in the correctional setting implies accepting its constraints, and violence, and protecting and enforcing fundamental rights, as well as rights to dignity, confidential care and freedom to accept or refuse a treatment. PMID:23457834
Aims: The aim of the current study was to explore the extent of knowledge health care providers working in primary health care units in Aydin, Turkey, had about emergency contraception (EC), to determine whether they provide EC counseling, and to understand the barriers and misconceptions in this context. Methods: A total of 120 health care professionals working in primary health
Hilmiye Aksu; Mert Kucuk; Banu Karaoz
This article examines issues on health care costs and describes measures taken by public districts to reduce spending. As in most companies in America, health plan designs in public districts are being changed to reflect higher out-of-pocket costs, such as higher deductibles on visits to providers, hospital stays, and prescription drugs. District…
There has been growing interest in discrete choice experiments (DCEs) in health economics over the last few years. This paper identifies and describes applications conducted during 1990-2000. From this basis some important areas for future research are reflected upon. These include: having a better understanding of how respondents interpret price, risk and time attributes; strengthening designs and analysis; investigating decision making heuristics employed when completing DCEs, and the extent these are related to the complexity of the task; external validity, reliability and generalisability. Collaborative work with statistical design experts, psychologists, sociologists and qualitative researchers will prove useful when investigating these issues. It is also critical to link, more generally, the research agenda to work being carried out in marketing, transport and environmental economics and health economics benefit assessment. PMID:14619274
Ryan, Mandy; Gerard, Karen
As the federal government shifted from its traditional roles in health to the payment for personal health care, the relationship between public and private sectors has deteriorated. Today federal and state revenue funds and trusts are the largest purchasers of services from a predominantly private health system. This financing or “gap-filling” role is essential; so too is the purchaser's concern for the costs and prices it must meet. The cost per person for personal health care in 1980 is expected to average $950, triple for the aged. Hospital costs vary considerably and inexplicably among states; California residents, for example, spend 50 percent more per year for hospital care than do state of Washington residents. The failure of each sector to understand the other is potentially damaging to the parties and to patients. First, and most important, differences can and must be moderated through definite changes in the attitudes of the protagonists. PMID:6770551
Derzon, Robert A.
The completion of the sequencing of the human genome in 2003 signaled the onset of the genomic era in health care. The knowledge gleaned from the Human Genome Project has led to the understanding that every health problem has a genetic component and that clinicians should include the application of genetic information in all aspects of health care. This article describes the genetic competencies essential for all health care professionals in primary care. Health care professionals should augment their current practice by obtaining a multigenerational genetic family history for each patient, assessing all patients for potentially heritable conditions, providing referrals to genetic health professionals as needed, offering genetic testing when indicated, and considering an individual's genetic makeup in the selection of medications and treatments for that person. Finally, all health care professionals ought to be prepared to address the complex personal, cultural, theological, ethical, legal, and social issues associated with genetic testing and other genetic issues commonly encountered in clinical practice. PMID:15894994
Engstrom, Janet L; Sefton, Marlene G S; Matheson, Jolie Kim; Healy, Kristine M
This study explores the relationship between burnout and health care utilization of 238 employed adults. Burnout was measured by the Maslach Burnout Inventory and health care utilization by insurance company records regarding these employees' health care costs and number of times they accessed health care services over a one year period. ANOVAs were conducted using Golembiewski and Munzenrider's approach to define the burnout phase. Significant differences in health care costs were found. PMID:10152340
Jackson, C N; Manning, M R
... Bar Home Current Issue Past Issues Orthopedic Health Joint Health and Care: Prevention, Symptoms, Diagnosis & Treatment Past ... Exercise helps bone density, improves muscle strength and joint flexibility, and enhances your balance. Take part in ...
The theory of inclusion is the foundation for the study reported here; inclusion is a focus not only of formal education, but also of nonformal educational settings such as 4-H. Ideally, 4-H camps are designed to serve youth of all backgrounds and abilities. By accommodating youth with special health care needs, 4-H camps are effectively meeting…
Mouton, Lauren; Bruce, Jacklyn
An unintended consequence of tobacco control's success in marginalizing smoking is that smokers may conceal their smoking from those who are best positioned to help them quit: health care providers (HCPs). The purpose of this study was to identify the prevalence of, and factors related to, nondisclosure of smoking to HCPs. Data were obtained from…
Curry, Laurel Erin; Richardson, Amanda; Xiao, Haijun; Niaura, Raymond S.
Health-care system reforms can change the structure of the current U.S. health-care system, from centralized large hospitals to a distributed, networked healthcare system. In our model, medical care is delivered locally in neighborhoods and individual homes, using computer technologies like telemedicine, to link patients and primary care providers to tertiary medical providers. This decentralization could reduce costs enough to provide
C. EVERETT KOOP; ROBYN MOSHER; LUIS KUN; JIM GEILING; ELIOT GRIGG; SARAH LONG; RONALD C. MERRELL; RICHARD SATAVA; JOSEPH M. ROSEN
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 differ- ences, legal barriers and a health workforce with generally low awareness of issues specific to refugees. Importantly, current Australian govern- ment migration and settlement policy also impacts on access to health and health
Sally B Murray; Sue A Skull
An unintended consequence of tobacco control's success in marginalizing smoking is that smokers may conceal their smoking from those who are best positioned to help them quit: health care providers (HCPs). The purpose of this study was to identify the prevalence of, and factors related to, nondisclosure of smoking to HCPs. Data were obtained from a cross-sectional survey of adults from a nationally representative Knowledge Networks online panel in March to April 2011. Current and former smokers (n = 2,803) were asked questions about nondisclosure, tobacco use, cessation behavior, and perceived social unacceptability of smoking. All variables significantly related (p < .05) to nondisclosure in bivariate logistic regression were included in the multivariate logistic regression model, which also adjusted for gender, age, race, marital status, and education. Approximately 1 in 10 smokers (12.9%) and 5.8% of former smokers has withheld their smoking status from HCPs. Ever smokers who were 18 to 34 years, those who had used a prescription medication or behavioral therapy in their last quit attempt, and those who were uncomfortable discussing smoking with their HCP were more likely to report nondisclosure than those in their respective comparison groups. Respondents who perceived either medium or high smoker-related stigma (odds ratio [OR] = 1.70, 95% confidence interval [CI] = 1.05, 2.77 and OR = 2.60, 95% CI = 1.51, 4.48, respectively) and those who reported concealing smoking to gain benefits from health insurance were also significantly more likely to have kept smoking a secret from an HCP (OR = 5.66, 95% CI = 1.88, 17.02). Smokers should be encouraged to be forthright about their smoking in order for practitioners to offer treatment and services that increase their chances of quitting. PMID:22984217
Curry, Laurel Erin; Richardson, Amanda; Xiao, Haijun; Niaura, Raymond S
Soaring health care expenditures and the large number of uninsured Americans-now estimated at 35 million-have received much public attention in recent years. The widespread concerns have led to demands for substantial reform of the U.S. health care system. ; Beverly Fox, Lori Taylor, and Mine Yucel identify several distortions in the current health care system that may be contributing to
Beverly J. Fox; Lori L. Taylor; Mine K. Yücel
This research uses data from a longitudinal study to examine how two provisions in the Patient Protection and Affordable Care Act could affect health insurance coverage among young women who have aged out of foster care. It also explores how allowing young people to remain in foster care until age twenty-one affects their health insurance coverage, use of family planning services, and information about birth control. We find that young women are more likely to have health insurance if they remain in foster care until their twenty-first birthday and that having health insurance is associated with an increase in the likelihood of receiving family planning services. Our results also suggest that many young women who would otherwise lack health insurance after aging out of foster care will be eligible for Medicaid under the health care reform law. Because having health insurance is associated with use of family planning services, this increase in Medicaid eligibility may result in fewer unintended pregnancies among this high-risk population. PMID:23262773
Dworsky, Amy; Ahrens, Kym; Courtney, Mark
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. PMID:23494290
Morrisette, Shelley; Oberman, William D; Watts, Allison D; Beck, Joseph B
Individual health savings accounts are an important part of the current basic medical insurance system for urban workers in China. Since 1998 when the system of personal medical insurance accounts was first implemented, there has been considerable controversy over its function and significance within different social communities. This paper analyzes the main problems in the practical implementation of individual medical insurance accounts and discusses the social and cultural foundations for the establishment of family health savings accounts from the perspective of Chinese Confucian familism. Accordingly, it addresses the direction of the reform and the development of the current system of individual health insurance accounts in China. PMID:23192456
Kong, Xiangjin; Yang, Yang; Gong, Fuqing; Zhao, Mingjie
... serve as a primary care provider in family medicine (FNP), pediatrics (PNP), adult care (ANP), or geriatrics (GNP). Others are trained to address women's health care (common concerns and ... of Medicine (MD) or a Doctor of Osteopathic Medicine (DO). ...
Grasping both the extent and the actual situation of psychosomatic disorders, neurotic habits and developmental disorders of infancy and childhood is vital for their prevention and for taking appropriate measures to deal with the current situation. The purpose of this study is to explore the current situation of infant mental health in Japanese…
Takizawa, Tohru; Kondo, Tsuyoshi; Tanaka, Osamu; Wake, Norie; Naka, Kuoichi; Todoriki, Hidemi; Ishizu, Hiroshi
A series of articles that examine environmental health and discuss health care reform; connections between chlorine, chlorinated pesticides, and dioxins and reproductive disorders and cancers; the rise in asthma; connections between poverty and environmental health problems; and organizations for health care professionals who want to address…
Fadope, Cece Modupe; And Others
Target Audience: Health care professionals Workshop Facilitator: Valerie Spironello, MSW, RSW Valerie has been a social worker for over 20 years working in a variety of settings including health care provided workshops and presentations to health care providers on a variety of topics such as compassion
Hitchcock, Adam P.
Within the current exercise of reforming the health care system, underlying all issues, is the reassessment of the role of government. It is a government's responsibility and concern that the health sector be accessible and equitable to the population, and more important that the health sector be more efficient and affordable. Many governments in the world attempt to provide universal health care services to their population through public health care provisions. This paper reviews and analyses the experience of the Malaysian health system, focusing on the performance of the system in relation to access and equity. The performance of the Malaysian health system has been impressive. At minimum cost it has achieved virtually accessible and equitable health care to the entire population. This is evident by analysing almost all the commonly used indicators. These clearly show that when matched to comparable countries, health outcome is even better than predicted value. PMID:8870140
Bin Juni, M H
Leadership in Health Care Systems: Health Care Organization Management and Leadership Track Â Program Evaluation in 2007: Our grads told us they needed more leadership, informatics and management, employer interviews, needs assessment The Program #12;Leadership in Heath Care Systems Â· Three tracks
Goldman, Steven A.
The family physician/pediatrician who sees a child from birth as part of the well-baby visit program is in the best position to identify early dental problems and to educate the family about early oral preventive health care. Since children under three years of age are not seen routinely by dentists, they are at risk of developing dental disease. This paper briefly covers the areas of infant oral pathology, early preventive care, teething, suckling habits, and dental trauma in the toddler. The physician will then be in a better position to recommend to parents when they should seek dental advice and treatment for their young children. ImagesFigure 1Figure 2Figure 3Figure 4Figure 5Figure 6 PMID:21253204
Sigal, Michael J.; Levine, Norman
Health care firms of all types helped fuel the biggest short-selling frenzy in the New York Stock Exchange's history, recently hitting a record 2.2 billion shares. While some analysts say this means nothing, the fact is that many investors are "shorting" the stock; in other words, they're betting against it. What appears as a lack of confidence may be nothing more than a simple quirk of Wall Street. Good, bad or indifferent, selling short is no tall tale. PMID:8640268
An urgent need in American health care is improving quality and efficiency while controlling costs. One promising management approach implemented by some leading health care institutions is Lean, a quality improvement philosophy and set of principles originated by the Toyota Motor Company. Health care cases reveal that Lean is as applicable in complex knowledge work as it is in assembly-line manufacturing. When well executed, Lean transforms how an organization works and creates an insatiable quest for improvement. In this article, we define Lean and present 6 principles that constitute the essential dynamic of Lean management: attitude of continuous improvement, value creation, unity of purpose, respect for front-line workers, visual tracking, and flexible regimentation. Health care case studies illustrate each principle. The goal of this article is to provide a template for health care leaders to use in considering the implementation of the Lean management system or in assessing the current state of implementation in their organizations. PMID:23274021
Toussaint, John S; Berry, Leonard L
The need for palliative care education remains vital to contribute to the quality of life of patients, both adults and children, with cancer in Africa. The number of patients with cancer continues to rise, and with them the burden of palliative care needs. Palliative care has been present in Africa for nearly four decades, and a number of services are developing in response to the HIV/AIDS epidemic. However, the needs of cancer patients remain a challenge. Education and training initiatives have developed throughout this time, using a combination of educational methods, including, more recently, e-learning initiatives. The role of international and national organisations in supporting education has been pivotal in developing models of education and training that are robust, sustainable, and affordable. Developing a material for education and professional development needs to continue in close collaboration with that already in production in order to optimise available resources. Seeking ways to evaluate programmes in terms of their impact on patient care remains an important part of programme delivery. This article reviews the current situation.
Rawlinson, FM; Gwyther, L; Kiyange, F; Luyirika, E; Meiring, M; Downing, J
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.…
Tracy, Jane; McDonald, Rachael
Advance health care decisions animate an intense debate in several European countries, which started more than 20 years ago in the USA and led to the adoption of different rules, based on the diverse legal, sociocultural and philosophical traditions of each society. In Italy, the controversial issue of advance directives and end of life's rights, in the absence of a clear and comprehensive legislation, has been over time a subject of interest of the Supreme Court. Since 2004 a law introduced the “Public Guardian,” aiming to provide an instrument of assistance to the person lacking in autonomy because of an illness or incapacity. Recently, this critical issue has once again been brought to the interest of the Supreme Court, which passed a judgment trying to clarify the legislative application of the appointment of the Guardian in the field of advance directives. PMID:24729977
Busardò, Francesco Paolo; Bello, Stefania; Gulino, Matteo; Zaami, Simona; Frati, Paola
Advance health care decisions animate an intense debate in several European countries, which started more than 20 years ago in the USA and led to the adoption of different rules, based on the diverse legal, sociocultural and philosophical traditions of each society. In Italy, the controversial issue of advance directives and end of life's rights, in the absence of a clear and comprehensive legislation, has been over time a subject of interest of the Supreme Court. Since 2004 a law introduced the "Public Guardian," aiming to provide an instrument of assistance to the person lacking in autonomy because of an illness or incapacity. Recently, this critical issue has once again been brought to the interest of the Supreme Court, which passed a judgment trying to clarify the legislative application of the appointment of the Guardian in the field of advance directives. PMID:24729977
Busardò, Francesco Paolo; Bello, Stefania; Gulino, Matteo; Zaami, Simona; Frati, Paola
OBJECTIVE: To explore lesbian and bisexual women's experiences with their family physicians to learn about barriers to care and about how physicians can provide supportive care. DESIGN: Qualitative study that was part of a larger study of lesbian and bisexual women's health care. SETTING: The province of Nova Scotia, both urban and rural counties. PARTICIPANTS: Ninety-eight self-identified lesbian or bisexual women who volunteered through snowball sampling. Women were interviewed by lesbian, bisexual, or heterosexual female interviewers. METHOD: Semistructured, audiotaped, face-to-face interviews, exploring questions about demographic information, sexual orientation, general health care patterns, preferences for health care providers, disclosure issues, health care information, access issues, and important health care services. Transcription of audiotapes of interviews was followed by content, thematic, and discourse analyses. Thematic analysis is reported in this paper. MAIN OUTCOME FINDINGS: Three themes important for family physicians emerged: the importance of being gay positive, barriers to care, and strategies for providing appropriate care. CONCLUSIONS: Family physicians are in a pivotal position to ensure supportive care for lesbian and bisexual women. Physicians need to recognize barriers to care and to use gay-positive strategies, paying attention to self-education, health history, and clinic environment. PMID:9721419
Mathieson, C. M.
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.
Jones, W. L.
By 2020, the population of Ulaanbaatar will reach 1,522,400 inhabitants. In addition, estimates show that relative to 2010, there will be 13.1% more outpatient registrations and 11.6% more inpatients by 2020. This study, conducted by descriptive design based on demographic and morbidity data, analyzes whether current health care facilities meet the demands and needs of the Ulaanbaatar population. It also assesses health care needs and accessibilty in Ulaanbaatar by 2020. Both data analysis and qualitative interviews with different sub-groups of the population reveal the neccesity to both reorganize primary level health care facilities and adjust resources in accordance with changing morbidity patterns. PMID:24938031
Nanjid, Khuderchuluun; Ochir, Chimedsuren; Nyamjav, Sumberzul; Mendsaikhan, Purevjav
Financial problems plague both higher education and health care, two sectors that struggle to meet public expectations for quality services at affordable rates. Both higher education and health care also have a complex bottom line, heavy reliance on relatively autonomous professionals, and clients who share personal responsibility for achieving…
This editorial reviews areas of health care reform including managed health care, diagnosis-related groups, and the Resource-Based Relative Value Scale for physician services. Relevance of such reforms to people with developmental disabilities is considered. Much needed insurance reform is not thought to be likely, however. (DB)
There are continual "crises" in health care systems worldwide as producer and patient groups unify and decry the "underfunding" of health care. Sometimes this cacophony is the self interest of profit seeking producers and often it is advocacy of unproven therapies. Such pressure is to be expected and needs careful management by explicit rationing criteria which determine who gets access to what health care. Science and rationality, however, are unfortunately, rarely the rules of conduct in the medical market-place. Key Words: Underfunding • rationing • efficiency • equity • accountability PMID:11479351
Background The clinical profile and outcome of nosocomial and non-nosocomial health care–associated native valve endocarditis are not well defined. Objective To describe the prevalence, clinical characteristics, and outcomes of nosocomial and non-nosocomial health care–associated native valve endocarditis. Design Prospective observational study. Setting 61 hospitals in 28 countries. Patients Patients with definite native valve endocarditis and no history of injection drug use who were enrolled in the International Collaboration on Endocarditis–Prospective Cohort Study from June 2000 to August 2005. Measurements Characteristics of nosocomial and non-nosocomial health care–associated native valve endocarditis cases were described and compared with those cases acquired in the community. Results Health care–associated native valve endocarditis was present in 557 (34%) of 1622 patients with native valve endocarditis and no history of injection drug use (nosocomial native valve endocarditis 303 patients [54%]; non-nosocomial health care–associated native valve endocarditis 254 patients [46%]). Staphylococcus aureus was the most common cause of health care-associated native valve endocarditis (nosocomial native valve endocarditis, 47%; non-nosocomial health care–associated native valve endocarditis, 42%; p=0.3), with a notable proportion of methicillin-resistant S. aureus (nosocomial native valve endocarditis, 57%; non-nosocomial health care–associated native valve endocarditis, 41%; p=0.014). Patients with health care–associated native valve endocarditis had lower rates of cardiac surgery (41% health care–associated native valve endocarditis vs 51% community-acquired native valve endocarditis, p<0.001) and higher in-hospital mortality rates than patients with community-acquired native valve endocarditis (25% health care–associated native valve endocarditis vs. 13% community-acquired native valve endocarditis vs., p<0.001). Multivariable analysis confirmed a higher mortality associated with health care–associated native valve endocarditis (incidence risk ratio=1.20 (CI 95%, 1.03–1.61). Limitations This study involves tertiary hospitals with cardiac surgery programs. The results may not be generalized to patient populations receiving care in other types of facility. Conclusions More than one-third of all cases of native valve endocarditis in non-drug users involve contact with health care. S. aureus is the leading cause of health care–associated native valve endocarditis. Non-nosocomial health care–associated native valve endocarditis is common, especially in the US. Patients with health care-associated and community-acquired native valve endocarditis differ in their presentation, microbiology, and outcome. By contrast, patients with nosocomial and non-nosocomial healthcare-associated endocarditis are similar. PMID:19414837
Benito, Natividad; Miró, José M.; de Lazzari, Elisa; Cabell, Christopher H; del Río, Ana; Altclas, Javier; Commerford, Patrick; Delahaye, Francois; Dragulescu, Stefan; Giamarellou, Helen; Habib, Gilbert; Kamarulzaman, Adeeba; Kumar, A. Sampath; Nacinovich, Francisco M.; Suter, Fredy; Tribouilloy, Christophe; Venugopal, K; Moreno, Asuncion; Fowler, Vance G.
Survey responses from 71 health professionals, benchmarking data from 8 hospitals, continuing education program evaluations, and focus groups with nursing, allied health, and primary care providers indicated a need for professional continuing education on women's health issues. Primary topic needs were identified. The data formed the basis for…
Beatty, Rebecca M.
A discussion of the role of academic health centers in health care reform efforts looks at the following issues: balancing academic objectivity and social advocacy; managing sometimes divergent interests of centers, faculty, and society; and the challenge to develop infrastructure support for reform. Academic health centers' participation in…
Miles, Stephen H.; And Others
In India a draft Health Policy has been formulated with the following objectives: to improve and expand the health care delivery system to make primary health care services available to each individual; to make people conscious of their health needs and to encourage their involvement and participation in the planning and implementation of the health programs; to improve the standards of environmental sanitation and personal hygiene leading to reduction in the incidence of diseases and a healthier life; to improve maternal and child health services and to create such services; to control and eradicate common communicable and infectious desease; and to lower by about 50% maternal and infant mortality rates and other mortality rates. To achieve the general objectives, it is proposed to use certain specific indicators to plan and monitor the health programs. The indicators proposed, which are outlined, fall into the categories of health status indicators and indicators for provision of health services. The main objective of primary health care will be to provide better health care services to the rural areas and urban slums. The population will be encouraged both individually and collectively to participate in the development of health. The government and the medical profession will help the people to realize their responsibility by providing a large band of health volunteers from among the community itself to take care of the basic health needs of the community. There will be a more equitable distribution of health resources, and, to correct past imbalances, preferential allocations will be made for developing health facilities in rural areas. The primary emphasis will be on preventive, promotive, and rehabilitative aspects of health which will be integrated with functions and responsibilities of all these institutions which currently are providing only curative services. In providing primary health care, full advantage will be taken of the traditional methods and techniques which are scientifically sound, familiar and acceptable to the community, and easy to adopt. Primary health care will form an integral part of the health system. At this time 5739 primary health centers are operating in India, each covering a population of between 80,000-125,000. Primary health care to the rural population will be backed up by proper referral services. PMID:7183715
Saigal, M D
This review offers American radiologists the information required to understand the Canadian health care system. It includes a brief history of the Canadian system and describes the relationship between health care and the Canadian constitution. A comprehensive appraisal of current conditions addresses the performance of the Canadian system and provides an overview of policy and planning responsibilities for health care
Harald O. Stolberg
Children with special health care needs should have access to proper resources for safe transportation. This statement reviews important considerations for transporting children with special health care needs and provides current guidelines for the protection of children with specific health care needs, including those with a tracheostomy, a spica cast, challenging behaviors, or muscle tone abnormalities as well as those
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. PMID:23898737
Merlino, James I; Raman, Ananth
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. PMID:24846726
Stempsey, William E
This reference manual and resource guide describes high standards for health policies and day care procedures that reflect current research and recommendations of experts. Chapters 1 and 2, which concern day care's role in health, cover health education in day care and the basics relating to policies, providers, and records. Chapters 3-5 concern…
Kendrick, Abby Shapiro, Ed.; Messenger, Katherine P., Ed.
Background The impact of unmet eye care needs in sub-Saharan Africa is compounded by barriers to accessing eye care, limited engagement with communities, a shortage of appropriately skilled health personnel, and inadequate support from health systems. The renewed focus on primary health care has led to support for greater integration of eye health into national health systems. The aim of this paper is to demonstrate available evidence of integration of eye health into primary health care in sub-Saharan Africa from a health systems strengthening perspective. Methods A scoping review method was used to gather and assess information from published literature, reviews, WHO policy documents and examples of eye and health care interventions in sub-Saharan Africa. Findings were compiled using a health systems strengthening framework. Results Limited information is available about eye health from a health systems strengthening approach. Particular components of the health systems framework lacking evidence are service delivery, equipment and supplies, financing, leadership and governance. There is some information to support interventions to strengthen human resources at all levels, partnerships and community participation; but little evidence showing their successful application to improve quality of care and access to comprehensive eye health services at the primary health level, and referral to other levels for specialist eye care. Conclusion Evidence of integration of eye health into primary health care is currently weak, particularly when applying a health systems framework. A realignment of eye health in the primary health care agenda will require context specific planning and a holistic approach, with careful attention to each of the health system components and to the public health system as a whole. Documentation and evaluation of existing projects are required, as are pilot projects of systematic approaches to interventions and application of best practices. Multi-national research may provide guidance about how to scale up eye health interventions that are integrated into primary health systems. PMID:23506686
...the Accreditation Commission for Health Care for Continued CMS-Approval of...the Accreditation Commission for Health Care (ACHC) for continued recognition...The Accreditation Commission for Health Care's (ACHC's) current term...
Delivery of health care in any country is complicated by a variety of circumstances owing to characteristic organisation of health care. Information is central to health care delivery, meaning information and communications technology (ICT) offer considerable promise. Yet there are several barriers to successful health care ICT deployment. This article outlines the promises and challenges facing both governments and health
It is widely recognized throughout the health care industry that the United States leads the world in health care spending per capita. However, the chilling dose of reality for American health care consumers is that for all of their spending, the World Health Organization ranks the country's health care system 37th in overall performance--right…
Buchanan, Larry M.
Describes the essential features of a health care system that can meet the special needs of children in out-of-home care. Discusses some of the major recent changes brought about by welfare and health care reform. Notes that it remains to be seen whether the quality of services will improve as a result of these reforms. (Author)
Simms, Mark D.; Freundlich, Madelyn; Battistelli, Ellen S.; Kaufman, Neal D.
Advertising by health care institutions has increased steadily in recent years. While direct-to-consumer prescription drug advertising is subject to unique oversight by the Federal Drug Administration, advertisements for health care services are regulated by the Federal Trade Commission and treated no differently from advertisements for consumer goods. In this article, we argue that decisions about pursuing health care services are distinguished by informational asymmetries, high stakes, and patient vulnerabilities, grounding fiduciary responsibilities on the part of health care providers and health care institutions. Using examples, we illustrate how common advertising techniques may mislead patients and compromise fiduciary relationships, thereby posing ethical risks to patients, providers, health care institutions, and society. We conclude by proposing that these risks justify new standards for advertising when considered as part of the moral obligation of health care institutions and suggest that mechanisms currently in place to regulate advertising for prescription pharmaceuticals should be applied to advertising for health care services more broadly. PMID:24592839
Schenker, Yael; Arnold, Robert M; London, Alex John
...Implementation specifications: Health care clearinghouses. 162.414 ...Standard Unique Health Identifier for Health Care Providers § 162.414 Implementation specifications: Health care clearinghouses. A health...
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…
National Environmental Education & Training Foundation, 2012
Changes in patterns of delivery of mental health care over several decades are putting pressure on primary health and social care services to increase their involvement. Mental health policy in countries like the UK, Australia and New Zealand recognises the need for these services to make a greater contribution and calls for increased intersectoral collaboration. In Australia, most investment to date has focused on the development and integration of specialist mental health services and primary medical care, and evaluation research suggests some progress. Substantial inadequacies remain, however, in the comprehensiveness and continuity of care received by people affected by mental health problems, particularly in relation to social and psychosocial interventions. Very little research has examined the nature of the roles that non-medical primary health and social care services actually or potentially play in mental health care. Lack of information about these roles could have inhibited development of service improvement initiatives targeting these services. The present paper reports the results of an exploratory study that examined the mental health care roles of 41 diverse non-medical primary health and social care services in the state of Victoria, Australia. Data were collected in 2004 using a purposive sampling strategy. A novel method of surveying providers was employed whereby respondents within each agency worked as a group to complete a structured survey that collected quantitative and qualitative data simultaneously. This paper reports results of quantitative analyses including a tentative principal components analysis that examined the structure of roles. Non-medical primary health and social care services are currently performing a wide variety of mental health care roles and they aspire to increase their involvement in this work. However, these providers do not favour approaches involving selective targeting of clients with mental disorders. PMID:18700871
UK HealthCare University of Kentucky 800 Rose St. Lexington KY 40536 RENEWALYour resource for the latest UK HealthCare construction and facilities news WINTER 2011 RENEWALYour resource for the latest UK HealthCare construction and facilities news In thIs Issue: UK HealthCare and Norton Healthcare officials
The authors provide a brief overview of counseling and mental health care in Palestine, including their history and a summary of their current status. Finally, a discussion is presented of future trends in the development of the profession with regard to recent changes in the region.
Shawahin, Lamise; Ciftci, Ayse
There are few data on the interactions of health care professionals with bereaved relatives. The objective of this study was to explore the current practice of health care professionals in oncology and palliative care in contacting bereaved relatives, and to elicit their views regarding the purpose, the optimal means, the format, timing, and content of these contacts. We conducted 28
Silke Collins-Tracey; Josephine M. Clayton; Laura Kirsten; Phyllis N. Butow; Martin H. N. Tattersall; Richard Chye
Currently 59 bills are awaiting Congressional action. Meanwhile, a national coalition of economists and medical specialists (the National Leadership Coalition for Health Care Reform) are circulating a sensible consensus health reform plan proposing national practice guidelines; universal health care access; and efficient cost control, delivery,…
In this document, the Federal Communications Commission reforms its universal service support program for health care, transitioning its existing Internet Access and Rural Health Care Pilot programs into a new, efficient Healthcare Connect Fund. This Fund will expand health care provider access to broadband, especially in rural areas, and encourage the creation of state and regional broadband health care networks. Access to broadband for medical providers saves lives while lowering health care costs and improving patient experiences. PMID:23476995
Health Care has traditionally been dominated by a strong professional culture, to which information and communications technology has not maybe fitted in the optimal way. Currently, however, strong currents are changing the intellectual climate in the field. Modern information and communications technology is being taken into usage in the Health Care sector at an increasing pace. This article provides and
Addresses the crisis in health care, considering costs, lack of access, and system ineffectiveness. Reviews "Setting Relationships Right," the Catholic Health Association's proposal for health care reform. Advocates educators' awareness of children's health needs and health care reform issues and support for the Every Fifth Child Act of 1992. (DMM)
An article on American health care which focuses on health care costs and benefits is combined with a lesson plan on health care issues to enable students to consider both issues of cost effectiveness and morality in decisions about the allocation of health care. The article covers the history of interest in health care, the reasons for the…
Lewis, John; Dempsey, Joanne R.
PHAR 3207 Leadership in Health Care PHAR 5207 Applied Leadership in Health Care Course Syllabus exploring leadership theories as they relate to health care; professional health care students; and graduate students with interest in the subject of leadership within health care organizations. [Moodle: Course
Thomas, David D.
This review of the allied health occupations training programs offered by Brevard Community College (Cocoa, Florida) covers organization of the division, objectives, selection and admission process, instructional delivery system, clinical facilities, advisory committees, high school relations, continuing education programs, and program success.…
Linton, Corinne B.
Summary Objectives Address current topics in consumer health informatics. Methods Literature review. Results Current health care delivery systems need to be more effective in the management of chronic conditions as the population turns older and experiences escalating chronic illness that threatens to consume more health care resources than countries can afford. Most health care systems are positioned poorly to accommodate this. Meanwhile, the availability of ever more powerful and cheaper information and communication technology, both for professionals and consumers, has raised the capacity to gather and process information, communicate more effectively, and monitor the quality of care processes. Conclusions Adapting health care systems to serve current and future needs requires new streams of data to enable better self-management, improve shared decision making, and provide more virtual care. Changes in reimbursement for health care services, increased adoption of relevant technologies, patient engagement, and calls for data transparency raise the importance of patient-generated health information, remote monitoring, non-visit based care, and other innovative care approaches that foster more frequent contact with patients and better management of chronic conditions. PMID:25123739
Wald, J. S.
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. PMID:7787486
The provision of medical facilities to rural areas is a major objective of development in Pakistan and the government has undertaken several programs to train and deploy auxiliary health workers on a large scale. Programs to train lady health visitors, dispensers and sanitary inspectors, have been in operation for decades and their graduates have a place in the workforce. Currently the Government is developing a Basic Health Program to train auxiliary health workers and to establish a network of rural health facilities throughout the country. The research here reported was meant to help plan this program. The 4 week study was conducted in four districts of the Punjab and North West Frontier Provinces. We first interviewed women patients of rural dispensaries in the four districts to determine their views of their needs and of the constraints of the purdah system when seeking health care. We then interviewed principals of medical colleges and training institutes, who were in a position to assess the availability of women to enter the medical workforce and female mid-level health workers who were currently serving in their posts. Finally, since allopathic medical institutions compete with indigenous medical specialists, we interviewed two hakims and a homeopathic physician to obtain their view of rural health needs, as well as their potential for contributing to a broad based rural health care system. PMID:6867786
Schmidt, R L
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
Antonio, Gisele Damian; Tesser, Charles Dalcanale; Moretti-Pires, Rodrigo Otavio
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…
Heller, Kathryn Wolff; Avant, Mary Jane Thompson
The current emphasis on preventive health care and wellness services suggests that measures of skills and competencies needed to effectively navigate the health care system need to be better defined. We take an expanded perspective of health literacy and define it as a set of skills used to organize and apply health knowledge, attitudes and…
Massey, Philip M.; Prelip, Michael; Calimlim, Brian M.; Quiter, Elaine S.; Glik, Deborah C.
This paper examines the current notion of universal health care (UHC) in key legal and policy documents and argues that the recommendations for UHC in these entail further abdication of the State's responsibility in health care with the emphasis shifting from public provisioning of services to merely ensuring universal access to services. Acts of commission (recommendations for public private partnership [PPPs], definition and provision of an essential health package to vulnerable populations to ensure universal access to care) and omission (silence maintained on tertiary care) will eventually strengthen the private and corporate sector at the cost of the public health care services and access to care for the marginalized. Thus, the current UHC strategy uses equity as a tool for promoting the private sector in medical care rather than health for all. PMID:24351383
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. PMID:24152056
Bender, Bruce G
Internet and Your Health 1 UC Irvine Health Care Facilitator Internet and Your Health Health 2 UC Irvine Health Care Facilitator 10. www.tricare.mil/tfl/ - Web site for Tri-Care for Life insurance that is a Medicare supplement available to retired military and their spouse. 11. www.bluecrossca.com/uc
Medical care futures contracts offer new hedging opportunities to increase protection against unexpected price changes. Commodity futures contracts can be designed explicitly to hedge volatile group health insurance premiums and capitated hospital and physician prices. This article describes one way to design and use these hedging instruments. PMID:10103960
Hayes, J A
... News Spotlights Media Resources Selected Profiles & Interviews Multimedia Health Care Visits to Check More Than Just Health? Skip ... media links Share this: Page Content Study Shows Health Care Providers Can Help with School Readiness During Primary ...
Improving care transitions, or "handoffs" as patients migrate from one care setting to another, is a priority across stakeholder groups and health-care settings and additionally is included in national health-care goals set forth in the National Quality Strategy. Although many demonstrations of improved care transitions have succeeded, particularly for hospital discharges, ensuring consistent, high-quality, and safe transitions of care remains challenging. This paper highlights the potential for health information technology to become an increasing part of effective transitional care interventions, with the potential to reduce the resource burden currently associated with effective care transitions, the ability to spread improved practices to larger numbers of patients and providers efficiently and at scale, and, as health technology interoperability increases, the potential to facilitate critical information flow and feedback loops to clinicians, patients, and caregivers across disparate information systems and care settings. PMID:24522208
Marcotte, Leah; Kirtane, Janhavi; Lynn, Joanne; McKethan, Aaron
Agent-based health care management 1 An Agent-based Approach to Health Care Management Jun Huang1, London WC2A 3PX, UK. Abbreviated title: Agent-based health care management Complete Mailing Address. London E1 4NS UK #12;Agent-based health care management 2 Abstract The provision of medical care
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…
The population of adolescents and young adults (AYA) with perinatally-acquired HIV (PHIV) present challenges to HIV healthcare providers (HHCPs). Originally not expected to survive childhood, they are now living well into young adulthood. Little is known about the type of sexual and reproductive (SRH) information/services offered to AYA with PHIV by HHCPs. HHCPs (n=67) were recruited using snowball sampling, and completed an online survey. Providers' most frequently endorsed SRH topics discussed with both male and female patients included condom use (77.3%), STD prevention (73.1%), and screening (62.1%). Providers' reports indicated that females received significantly more education about SRH topics overall. The most frequently noted barriers to SRH communication included more pressing health concerns (53.0%), parent/guardian not receptive (43.9%), and lack of time during appointment (43.9%). Provider-reported SRH conversations with HHCPs were highly focused on horizontal transmission and pregnancy prevention. Salient social aspects of SRH promotion for AYAs with PHIV (e.g., managing disclosure and romantic relationships) were less commonly discussed, though such conversations may serve to reduce secondary transmission and enhance the overall well-being of AYA with PHIV. Findings indicated that further work must be done to identify strategies to address unmet SRH needs of the aging population of AYA with PHIV. PMID:25290765
Albright, Jamie N; Fair, Cynthia D
The Institute of Medicine has recommended doubling the number of nurses with doctorates by 2020. The National Research Council has recommended a clearer distinction between doctoral preparation for a practice profession and that for the preparation of scientists. To support the central premise that both the research-oriented doctorate (PhD) and the practice-oriented doctorate, the doctor of nursing practice (DNP), are critical to achieve and expand doctoral education, we present current information regarding the impact of DNP programs, including enrollments, scholarly productivity of DNP graduates, and the employment setting of DNP scholars. Scholarly productivity was estimated by searching publication databases between 2005 and 2012 using three strategies to estimate the publication record of nurses who had earned a DNP degree. The large numbers of nurses receiving the DNP are helping to fulfill the Institute of Medicine's recommendation and are increasingly contributing to the scholarly output in the field, especially related to clinical practice. PMID:25241137
Redman, Richard W; Pressler, Susan J; Furspan, Philip; Potempa, Kathleen
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
Don E Detmer
Private medicine has been growing rapidly in Great Britian, a trend the author says indicates dissatisfaction with the National Health Service (NHS). Spivak notes that even when free medical treatment is available, citizens will pay for a private room, quicker treatment, and the chance to choose their own physicians and hospitals. Membership in private health plans has increased 15 fold since the inception of NHS 30 years ago. These plans are adding over 100,000 members a year so that the private sector now accounts for about $550 million, or 2-3% of Britian's annual outlay on medical care. The author attributes this trend to three factors: (1) private medicine is now generating enough capital to finance a substantial expansion of its own facilities; (2) deterioration in NHS; and (3) the low price of private health plans. Critics of private health care have described it as an alternative restricted to the affluent; the author counters that private plans are beginning to enroll blue-collar workers for the first time. He cites the opinions of experts who foresee the private sector covering for NHS shortcomings in non-emergency care until a full-fledged partnership develops. Spivak concludes by pointing to a conservative plan, now in its early stages, to promote a move in this direction. Whether or not this scheme comes to fruition, he adds, private medicine is beginning to flourish in a socialized system. PMID:10247824
This study aims to measure the causal effect of informal caregiving on the health and health care use of women who are caregivers, using instrumental variables. We use data from South Korea, where daughters and daughters-in-law are the prevalent source of caregivers for frail elderly parents and parents-in-law. A key insight of our instrumental variable approach is that having a parent-in-law with functional limitations increases the probability of providing informal care to that parent-in-law, but a parent-in-law's functional limitation does not directly affect the daughter-in-law's health. We compare results for the daughter-in-law and daughter samples to check the assumption of the excludability of the instruments for the daughter sample. Our results show that providing informal care has significant adverse effects along multiple dimensions of health for daughter-in-law and daughter caregivers in South Korea. Copyright © 2013 John Wiley & Sons, Ltd. PMID:24753386
Do, Young Kyung; Norton, Edward C; Stearns, Sally C; Van Houtven, Courtney Harold
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. PMID:23766585
Bhatnagar, Kavita; Srivastava, Kalpana
... About CDC.gov . Vital Signs Share Compartir Making Health Care Safer Stop Infections from Lethal CRE Germs Now ... CRE infections on your state's Notifiable Diseases list. Health Care CEOs/Medical Officers can Require and strictly enforce ...
... Trials Resources and Publications En Español How do health care providers diagnose vulvodynia? Skip sharing on social media ... been ruled out. To diagnose vulvodynia, 1 a health care provider may recommend that a woman have blood ...
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... Businesses & Schools > Transitions Transitions From Pediatric to Adult Health Care Transitioning from teenage years to adulthood can be ... management and make more independent judgments about their health care needs. NDEP has assembled the materials below to ...
... Trials Resources and Publications En Español How do health care providers diagnose pheochromocytoma? Skip sharing on social media links Share this: Page Content A health care provider uses blood and urine tests that measure ...
... Information Clinical Trials Resources and Publications How do health care providers diagnose hypoparathyroidism? Skip sharing on social media links Share this: Page Content A health care provider will order a blood test to determine ...
Women in the United States make approximately 80% of the health care decisions for their families, yet often go without health care coverage themselves. The implementation of the Affordable Care Act provides an historical opportunity for women to gain health care coverage for themselves and their families. The focus of this commentary is on women's leadership roles in the context of health care decision- making and Affordable Care Act education and outreach, and implications for reaching broader health and social goals. PMID:25418222
Matoff-Stepp, Sabrina; Applebaum, Bethany; Pooler, Jennifer; Kavanagh, Erin
Patient centered healthcare delivery is an inherently collaborative process. This involves a wide range of individuals and organizations with diverse perspectives: primary care physicians, hospital administrators, labs, clinics, and insurance. The key to cost reduction and quality improvement in health care is effective management of this collaborative process. The use of multi-media collaboration technology can facilitate timely delivery of patient care and reduce cost at the same time. During the last five years, the Concurrent Engineering Research Center (CERC), under the sponsorship of DARPA (Defense Advanced Research Projects Agency, recently renamed ARPA) developed a number of generic key subsystems of a comprehensive collaboration environment. These subsystems are intended to overcome the barriers that inhibit the collaborative process. Three subsystems developed under this program include: MONET (Meeting On the Net)--to provide consultation over a computer network, ISS (Information Sharing Server)--to provide access to multi-media information, and PCB (Project Coordination Board)--to better coordinate focussed activities. These systems have been integrated into an open environment to enable collaborative processes. This environment is being used to create a wide-area (geographically distributed) research testbed under DARPA sponsorship, ARTEMIS (Advance Research Testbed for Medical Informatics) to explore the collaborative health care processes. We believe this technology will play a key role in the current national thrust to reengineer the present health-care delivery system. PMID:8130536
Reddy, R; Jagannathan, V; Srinivas, K; Karinthi, R; Reddy, S M; Gollapudy, C; Friedman, S
This article is a condensed and edited version of a speech delivered to The Business of Medicine: A Course for Physician Leaders symposium presented by Yale-New Haven Hospital and the Medical Directors Leadership Council at Yale University in November 2012 and drawn from Politics, Health, and Health Care: Selected Essays by Theodore R. Marmor and Rudolf Klein . It faithfully reflects the major argument delivered, but it does not include the typical range of citations in a journal article. The material presented here reflects more than 40 years of teaching a course variously described as Political Analysis and Management, Policy and Political Analysis, and The Politics of Policy. The aim of all of these efforts is to inform audiences about the necessity of understanding political conflict in any arena, not least of which is the complex and costly world of medical care. PMID:24058315
Marmor, Theodore Richard
... health care provider or service is accredited The location of a service Hours that the service is available Whether you like a health care provider's personality On this page you'll find information to help you choose a health care provider or service.
As immediate past permanent secretary of the Lagos State Ministry of Health in Nigeria and former chief medical director of one of the country?s top medical centers, Lagos State University Teaching Hospital (LASUTH), Femi Olugbile has had a close view of his country?s health care progress over the years. Despite decades of economic booms and busts and sociopolitical turmoil, Nigeria?s health systems have grown, Olugbile says?but not enough. The average life expectancy is around 52 years. Ongoing problems with extremist groups like Boko Haram have hamstrung vaccination programs, and this year, the country experienced the first Ebola threat in its history. PMID:25415881
The five leading issues identified, in order of importance, were 1. The need for treatment outcome and efficacy data. 2. The need for changes in clinical and academic preparation of entry-level practitioners. 3. The lack of inclusion or use of services for communication and related disorders in public and private health care programs. 4. The need for greater professional autonomy within the health care system. 5. The need to improve services to underserved populations with communication and related disorders. This report was forwarded to key National Office staff and appropriate ASHA boards, councils, and committees for the purposes of determining its feasibility and developing a national plan for action. The feasibility and action plan will detail completed, ongoing and future activities of the Association related to each issue, recommendation, and strategy. Periodic review of the actions taken and progress achieved will be monitored by the Executive Board, other appropriate boards and councils, and designated National Office staff. The plan represents a progressive view of needed change for the professions of speech-language pathology and audiology within the context of the broader health care delivery system. PMID:8216494
Health and Social Care Is Health and Social Care right for me? Are you are interested in caring for a specialised degree in medicine, nursing or social work? If yes, then Health and Social Care could be the subject for you. You will need good time management skills as well as a passion for care in order to get
The Alma-Ata declaration and global strategy of Health for All by the year 2000 have given political and practical momentum to the delivery of primary health care in developing countries. WHO has provided leadership for this process, with support from other UN agencies and international donor organizations. Primary health care is based on the concept of a District Health System which provides comprehensive services. Community participation and intersectoral collaboration are the cornerstones of primary health care. Using Malawi, Uganda, India and Indonesia as examples, the article explores experiences of health problems and of health care delivery to underprivileged populations in African and Asian countries. PMID:1866729
BACKGROUND: Lithuanian primary health care (PHC) is undergoing changes from the systems prevalent under the Soviet Union, which ensured free access to specialised health care. Currently four different PHC models work in parallel, which offers the opportunity to study their respective effect on referral rates. Our aim was to investigate whether there were differences in referrals rates from different Lithuanian
Andrzej Zielinski; Anders Håkansson; Arnoldas Jurgutis; Ingvar Ovhed; Anders Halling
Despite of an insignificant track record of quasi-market models in Sweden, new models of this kind have recently been introduced in health care; commonly referred to as "choice of care". This time citizens act as purchasers; choosing the primary care centre or family physician they want to be treated by, which, in turn, generates a capitation payment to the chosen unit. Policy makers believe that such systems will be self-remedial, that is, as a result of competition the strong providers survive while unprofitable ones will be eliminated. Because of negative consequences of the fragmented health care delivery, policy makers at the same time also promote different forms of integrated health care arrangements. One example is "local health care", which could be described as an upgraded community-oriented primary care, supported by adaptable hospital services, fitting the needs of a local population. This article reviews if it is possible to combine this kind of integrated care system with a competition driven model of governance, or if they are incompatible. The findings indicate that some choice of care schemes could hamper the development of integration in local health care. However, geographical monopolies like local health care, enclosed in a non-competitive context, lack the stimulus of competition that possibly improves performance. Thus, it could be argued that if choice of care and local health care should be combined, patients ought to choose between integrated health care arrangements and not among individual health professionals. PMID:20153910
Health Care ReimbursementAccount (HCRA) OVERVIEW The CSU Health Care Reimbursement Account is reduced. Expenses eligible to be reimbursed from the Health Care Reimbursement Account are expenses You are eligible to enroll in the Health Care Reimbursement Account if you are in an Executive
de Lijser, Peter
Ethics have long been recognized as underpinning primary health care. While dis- crete understandings of ethics have developed to support many areas of health care and research, there has been little attempt to formulate an ethics framework which is focused on primary health care. Developments both within and external to primary health care practice make it timely to address primary
Amid the swirl of change in today's US health care system, there are opportunities for new care delivery models to slow rising costs and improve outcomes in family medicine. This review summarizes the possibilities. PMID:25061618
Wexler, Randy; Hefner, Jennifer; Welker, Mary Jo; McAlearney, Ann Scheck
In 2008, a government hospital in southwest Tanzania added a "first-class ward," which, unlike existing inpatient wards defined by sex, age, and ailment, would treat patients according to their wealth. A generation ago, Tanzanians viewed health care as a right of citizenship. In the 1980s and 1990s, structural adjustment programs and user fees reduced people's access to biomedical attention. Tanzania currently promotes "amenity" wards and health insurance to increase health care availability, generate revenue from patients and potential patients, and better integrate for-profit care. In this article, I examine people's discussions of these changes, drawing on ethnographic fieldwork in the 2000s and 1990s. I argue that Tanzanians criticize unequal access to care and health insurance, although the systemic structuring of inequalities is becoming normalized. People transform the language of socialism to frame individualized market-based care as mutual interdependence and moral necessity, articulating a new biomedical citizenship. PMID:24753314
The evolving Chinese cooperative medical system is examined in an effort to gain some valuable knowledge for both the 3rd world and developed countries. The changes occurring in the Chinese health system are the unintended consequences of economic reforms that have exerted direct and indirect effects on the organization, financing, and delivery of health care. As China does not publish complete or current information on its health care system, the discussion draws on limited published information. China, an agrarian nation, has a population of 1 billion with 80% of the people living in rural areas. A gross national product of US$300/person in 1981 places China in the bottom 1/3 of the developing countries. In 1981 China had 2 hospital beds/1000 people. There are 516,000 senior doctors trained in Western medicine and 290,000 senior doctors trained in traditional Chinese medicine, yielding a ratio of 0.8 senior doctors/1000 people. China also has 436,000 assistant doctors in Western medicine, but most of the primary health care is provided by "barefoot doctors." Hospital beds and health personnel are unevenly distributed between the urban and rural areas. Health personnel, health stations, and hospitals are organized on a 3-tier system. In 1980 China inaugurated major economic reforms in agricultural production and public financing. Alterations in the rural economic structure brought about major changes in the Chinese cooperative medical system. The most influential reform provided financial incentives to peasants, who now receive direct rewards for individual output. Because of economic reform, collective financing and public support for the cooperative medical system diminished. The proportion of the rural population protected by the system has been reduced by 50%. The rapid, continuing decline in the cooperative medical system has affected several important elements of health care: the number of barefoot doctors per capita has diminished; most barefoot doctors forego continuing education; there has been an increase in the financial burden borne by peasants; and hospitals are experiencing financial problems. With the collapse of cooperative health care financing, many barefoot doctors have created private practices, charging patients on a fee for service basis and selling drugs to them. In some brigades, the peasants have organized voluntary health insurance programs, but the peasants face problems in organizing voluntary insurance programs. 1 consequence of the rising income of peasants is their demand for higher quality medical care. The Chinese experience illustrates the effects of economic structure on the supply of health personnel, the demand for services, and the organization and financing of health care. Economic incentives affected the supply of health personnel. Another lesson to be learned is the need to establish a universal, compulsory financial system for health care. The Chinese experience also demonstrates that the pricing structure influences the demand and need for insurance. PMID:6700690
Hsiao, W C
BACKGROUND: In 2001, the New Zealand government introduced its Primary Health Care Strategy (PHCS), aimed at strengthening the role of primary health care, in order to improve health and to reduce inequalities in health. As part of the Strategy, new funding was provided to reduce the fees that patients pay when they use primary health care services in New Zealand,
Jacqueline Cumming; Nicholas Mays; Barry Gribben
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. PMID:9130961
Health Information Systems for Primary Health Care: Thinking About Participation Elaine Byrne in supporting primary health care functioning, the design, development and implementation of these systems care, especially in the context of developing countries, a very challenging task. An important step
Health care reform represents a major step toward achieving the goal of improved preventive and primary care services for all Americans, including children and adolescents. Adolescence is a unique developmental age district from both childhood and adulthood with special vulnerabilities, health concerns, and barriers to accessing health care. It is…
Irwin, Charles E., Jr., Ed.; And Others
OBJECTIVES: This study explores the pattern of weight loss counseling by health care providers in Connecticut and the associated weight loss efforts by patients. METHODS: Data from the 1994 Connecticut Behavioral Risk Factor Surveillance System survey were analyzed to determine (1) the frequency of weight management counseling by health care providers of overweight adults with and without additional cardiovascular risk factors and (2) the current weight loss practices of overweight subjects. RESULTS: Only 29% of all overweight respondents and fewer than half with additional cardiovascular risk factors, reported that they had been counseled to lose weight. CONCLUSIONS: The findings suggest a need for more counseling of overweight persons, especially those with cardiovascular disease risk factors. PMID:10224993
Nawaz, H; Adams, M L; Katz, D L
Well-child care is the main source of preventive health care for children in the United States. Repeated examinations of healthy children during health supervision visits are used to assess biomedical health, development, behavior, and family functioning. In addition, well-child care serves to provide parent education through age appropriate counseling referred to as anticipatory guidance. Recommendations for well-child care are found in the Health Supervision Guidelines III, published by American Academy of Pediatrics, last revised in 1993, and a publication from the National Center for Education in Maternal and Child Health, The Bright Futures, Guidelines for Health Supervision of Infants, Children and Adolescents, revised in 2000. This article reviews the evidence for the effectiveness of the current recommendation for well-child care including the recommendations for the number of visits, history and physical examination as a screening technique, observation of parent-child interaction, and the recommendation for provision of anticipatory guidance. This article also summarizes the recent advances in well-child care and identifies an agenda for future research. PMID:12041716
Dinkevich, Eugene; Ozuah, Philip O
An overview of the current oral health status of Americans looks at the epidemiology of oral/dental diseases, rates of use of dental services, and expenditures for dental health care. Substantial progress in improving oral health is seen as are particular challenges resulting from the aging and ethnic diversification of the population. (MSE)
White, B. Alex
Health Sciences Center Department of Internal Medicine Employee Health Promotion Program Health Care Provider Report Dear Health Care Provider: Your patient, ______________________________, has applied for enrollment in a fitness program sponsored by the University of New Mexico, Employee Health
New Mexico, University of
Amid tremendous changes in contemporary health care stimulated by shifts in social, economic and political environments, health care managers are challenged to provide new structures and processes to continually improve health service delivery. The general public and the media are becoming less tolerant of poor levels of health care, and health care professionals need to be involved and supported to bring about positive change in health care. Appreciative inquiry (AI) is a philosophy and method for promoting transformational change, shifting from a traditional problem-based orientation to a more strength-based approach to change, that focuses on affirmation, appreciation and positive dialog. This paper discusses how an innovative participatory approach such as AI may be used to promote workforce engagement and organizational learning, and facilitate positive organizational change in a health care context. PMID:24099230
Trajkovski, Suza; Schmied, Virginia; Vickers, Margaret; Jackson, Debra
The 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 series of workshops during which physicians, health policy experts, health insurance executives, business leaders, hospital administrators, economists, and others who represent diverse perspectives came together. This group agreed that the following 8 recommendations are fundamental to successful reform: 1. Replace the current fee-for-service payment system with a payment system that encourages and rewards innovation in the efficient delivery of quality care. The new payment system should invest in the development of outcome measures to guide payment. 2. Establish a securely funded, independent agency to sponsor and evaluate research on the comparative effectiveness of drugs, devices, and other medical interventions. 3. Simplify and rationalize federal and state laws and regulations to facilitate organizational innovation, support care coordination, and streamline financial and administrative functions. 4. Develop a health information technology infrastructure with national standards of interoperability to promote data exchange. 5. Create a national health database with the participation of all payers, delivery systems, and others who own health care data. Agree on methods to make de-identified information from this database on clinical interventions, patient outcomes, and costs available to researchers. 6. Identify revenue sources, including a cap on the tax exclusion of employer-based health insurance, to subsidize health care coverage with the goal of insuring all Americans. 7. Create state or regional insurance exchanges to pool risk, so that Americans without access to employer-based or other group insurance could obtain a standard benefits package through these exchanges. Employers should also be allowed to participate in these exchanges for their employees' coverage. 8. Create a health coverage board with broad stakeholder representation to determine and periodically update the affordable standard benefit package available through state or regional insurance exchanges. PMID:19258550
Arrow, Kenneth; Auerbach, Alan; Bertko, John; Brownlee, Shannon; Casalino, Lawrence P; Cooper, Jim; Crosson, Francis J; Enthoven, Alain; Falcone, Elizabeth; Feldman, Robert C; Fuchs, Victor R; Garber, Alan M; Gold, Marthe R; Goldman, Dana; Hadfield, Gillian K; Hall, Mark A; Horwitz, Ralph I; Hooven, Michael; Jacobson, Peter D; Jost, Timothy Stoltzfus; Kotlikoff, Lawrence J; Levin, Jonathan; Levine, Sharon; Levy, Richard; Linscott, Karen; Luft, Harold S; Mashal, Robert; McFadden, Daniel; Mechanic, David; Meltzer, David; Newhouse, Joseph P; Noll, Roger G; Pietzsch, Jan B; Pizzo, Philip; Reischauer, Robert D; Rosenbaum, Sara; Sage, William; Schaeffer, Leonard D; Sheen, Edward; Silber, B Michael; Skinner, Jonathan; Shortell, Stephen M; Thier, Samuel O; Tunis, Sean; Wulsin, Lucien; Yock, Paul; Nun, Gabi Bin; Bryan, Stirling; Luxenburg, Osnat; van de Ven, Wynand P M M
This collection offers a wide-ranging introduction to contemporary issues surrounding the health care needs of members of minority ethnic communities within the framework of community care in Britain. The following chapters consider state welfare, minority communities, family structures, and social change: (1) "'Race' and Community Care: An…
Ahmad, Waqar I. U., Ed.; Atkin, Karl, Ed.
Discusses research and interventions related to family health care. Topics include health promotion; risk behaviors; vulnerability and illness onset; choosing health care systems; stress; caregiving and coping; family counseling; and family responses to Alzheimer's Disease, pediatric cancer, cystic fibrosis, diabetes, and obesity. (JAC)
Doherty, William J., Ed.; McCubbin, Hamilton I., Ed.
Mental Health Consultation in Child Care and Early Childhood Settings Opportunities to Expand Department of Children & Families Children's Mental Health Program June 30, 2006 Florida State University-922-1300 Â· www.cpeip.fsu.edu #12;Mental Health Consultation in Child Care and Early Childhood Settings
McQuade, D. Tyler
Managed-care organizations have a unique opportunity, still largely unrealized, to collaborate with health-care providers and epidemiologists to prevent health care-associated infections. Several attributes make these organizations logical collaborators for infection control programs: they have responsibility for defined populations of enrollees and for their overall health, including preventive care; they possess unique data resources about their members and their care; and they are able to make systemwide changes in care. Health care-associated infections merit the attention and effort of managed-care organizations because these infections are common, incur substantial illness and costs, and can be effectively prevented by using methods that are unevenly applied in different health-care settings. Both national and local discussions will be required to enable the most effective and efficient collaborations between managed care organizations and health-care epidemiologists. It will be important to articulate clear goals and standards that can be readily understood and widely adopted. PMID:11294740
Platt, R.; Caldwell, B.
We present the findings of a descriptive case study of a primary care unit (PCU) in rural Thailand five years after the introduction of Universal Health Coverage (UHC) in 2001. The aim was to access the quality of primary health care (PHC) in rural Thailand and to make recommendations to Thai stakeholders for its improvement within current resource constraints. The
Mary J Ditton; Leigh Lehane
There is near consensus that the US health care system requires reform. Only a quarter of the American public has faith in the current system. Health care was one of the major issues considered in the 1992 US presidential election and the search for innovative solutions has transcended administrations. PMID:8505751
Kaplan, R M
Psychology as both a science and a profession has been closely identified with other disciplines in the broad field of health since the turn of the present century. Recent advances in health care have reinforced the growing belief that the promotion of health and the prevention and treatment of illness can be greatly enhanced by incorporating the scientific findings and modern techniques of psychology into everyday practices. This review outlines the contributions of psychology to health care throughout the world; only some of the most timely and relevant issues are mentioned, together with examples of current work in the field. After an introductory overview, special attention is given to each of the major areas within the broad field of health care where psychological applications have been particularly useful. PMID:3325189
Holtzman, W. H.; Evans, R. I.; Kennedy, S.; Iscoe, I.
The public health care services in Bulgaria were deteriorating, especially during the decade of transitional process. The method of health care finance was a major reason for the poor performance of the Bulgarian public health care sector. Bulgarian policy-makers decided that an insurance-based financial mechanism could help to rescue the failing public health care services. This paper explores the social benefits and the feasibility of the insurance-based finance in the Bulgarian public health care sector. The discussion in the paper implies that, in the current conditions of economic recession, the insurance-based health care finance can not be socially beneficial for Bulgaria. Moreover, the insurance implementation seams to be unfeasible due to a lack of sufficient financial resources. PMID:10996066
Pavlova, M; Groot, W; van Merode, F
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
Wentzer, Helle; Bygholm, Ann
Health care–associated viral respiratory infections, common among hospitalized children, also occur among adults and institutionalized persons and result in increased patient morbidity, mortality, and health care costs. Approximately 20% of patients with health care–associated pneumonia have viral respiratory infections, with 70% of these infections caused by adenovirus, influenza virus, parainfluenza virus, and respiratory syncytial virus (RSV).1 These infections typically reflect the level of viral activity within the community.1,2 This article focuses on the epidemiology, transmission, and control of health care–associated RSV and influenza virus. PMID:21316002
Goins, William P.; Talbot, H. Keipp; Talbot, Thomas R.
Health care in the United States has entered a period of economic upheaval. Episodic, fee-for-service care financed by indemnity insurance is being replaced by managed care financed by fixed-price, capitated health plans. The resulting focus on reducing costs, especially in areas where there is competition fueled by oversupply of health services providers and facilities, poses new threats to the livelihood of medical libraries and medical librarians but also offers new opportunities. Internet services, consumer health education, and health services research will grow in importance, and organizational mergers will provide librarians with opportunities to assume new roles within their organizations. PMID:8938325
Masys, D R
Health Services and Economics Branch staff have collaborated with colleagues at the Agency for Healthcare Research and Quality (AHRQ), the Department of Veterans Affairs (VA), and Emory University to develop a supplement to the journal Medical Care. The supplement, published in July 2009, examines a broad array of methodologic issues related to health care cost estimation. The supplement's papers are led by experts in health economics, epidemiology, health services research, and biostatistics.
In this article, we provide an overview of social network research in health care, with a focus on social interactions between professionals in organizations. We begin by introducing key concepts defining the social network approach, including network density, centrality, and brokerage. We then review past and current research on the antecedents of health care professionals' social networks-including demographic attributes, professional groups, and organizational arrangements-and their consequences-including satisfaction at work, leadership, behaviors, knowledge transfer, diffusion of innovation, and performance. Finally, we examine future directions for social network research in health care, focusing on micro-macro linkages and network dynamics. PMID:25380607
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Investing in Primary Health Care Achieving better health care in the community #12;Images by Nasir of primary care and this investment has been more than matched by considerable national research funding to Oxford of some of the UK's top primary care senior scientists by attracting a large number of junior
Oxford, University of
Purpose: 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. Discussion: 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. Conclusion: 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. PMID:25552938
Bandy, Margaret Moylan
Until relatively recently, the concept of information literacy, and teaching the skills to enable it, was mainly a concern of academic libraries. Now, it is also seen to be of high importance within the context of health care libraries. Health care libraries and librarians can provide crucial support towards the implementation of evidence-based practice in patient care through both information literacy skills training and by conducting mediated searches on behalf of health care practitioners. This article reports the findings from an investigation conducted by Charlotte Kelham as part of her MA in Librarianship from the University of Sheffield. Her dissertation investigated how health care librarians understand the concept of information literacy, the implications of this for their role and their perceptions around how their role is valued. Charlotte graduated from Sheffield in 2013 and is currently job hunting. AM. PMID:25155981
A work group consisting of representatives of public agencies, education, the health care industry, and unions and professional associations was formed to examine education and training issues related to the shortage of health care workers in Washington state. The group concluded that the shortage of available workers in many health care…
Washington State Workforce Training and Education Coordinating Board, Olympia.
Lack of sufficient accessible community-based health care services for individuals with developmental disabilities has led to disparities in health outcomes and an overreliance on expensive models of care delivered in hospitals and other safety net or state-subsidized providers. A functioning community-based primary health care model, with an…
Kastner, Theodore A.; Walsh, Kevin K.
German Statutory Health Insurance (national health insurance) has remained relatively intact over the past century, even in the face of governmental change and recent reforms. The overall story of German national health insurance is one of political compromise and successful implementation of communitarian values. Several key lessons from the German experience can be applied to the American health care system. PMID:12511381
Wayne Myers, director of the Office of Rural Health Policy, discusses Appalachian rural health and access to health care. The health manpower shortage in Central Appalachia still exists but is less severe than 10 years ago. The needs of underserved areas could be address by training local people in the community and through telemedicine and…
Myers, Wayne; Russell, Jack; Baldwin, Fred D.
Excellence in Mental HealthCare: PuttingEvidence intoPractice Health Service and Population and improving the quality of life of people with mental health problems and their families throughout the world. We passionately believe that people with mental health problems should be treated with dignity
The U.S. Patient Protection and Affordable Care Act (hence, Affordable Care Act, or ACA) was signed into law on March 23, 2010. Goals of the ACA include decreasing the number of uninsured people, controlling cost and spending on health care, increasing the quality of care provided, and increasing insurance coverage benefits. This manuscript focuses on how the ACA affects pharmacy benefit managers and consumers when they have prescriptions dispensed. PBMs use formularies and utilization control tools to steer drug usage toward cost-effective and efficacious agents. A logic model was developed to explain the effects of the new legislation. The model draws from peer-reviewed and gray literature commentary about current and future U.S. healthcare reform. Outcomes were identified as desired and undesired effects, and expected unintended consequences. The ACA extends health insurance benefits to almost 32 million people and provides financial assistance to those up to 400% of the poverty level. Increased access to care leads to a similar increase in overall health care demand and usage. This short-term increase is projected to decrease downstream spending on disease treatment and stunt the continued growth of health care costs, but may unintentionally exacerbate the current primary care physician shortage. The ACA eliminates limitations on insurance and increases the scope of benefits. Online health care insurance exchanges give patients a central location with multiple insurance options. Problems with prescription drug affordability and control utilization tools used by PBMs were not addressed by the ACA. Improving communication within the U.S. healthcare system either by innovative health care delivery models or increased usage of health information technology will help alleviate problems of health care spending and affordability. PMID:25217142
Ung, Brian L; Mullins, C Daniel
The management of biohazard in health care settings entails multidisciplinarity, valuing the interactions among stakeholders (General Manager, Medical Director, health care workers, prevention and protection units, infection control panels, occupational physicians), with the aim of protecting health and safety of workers, third parties and the health care service. The management issue was tackled within SIMLII guidelines on biohazards, as well as by the SIMLII Section on Preventive Medicine for Health Care Workers, followed by editorial initiatives. This contribution focuses on afield example on the management of data stemming from accidents involving biohazards, highlighting the need of information technology enabling management of enormous amount of health data. This work underlines the primacy of individual risk assessment and management, while combining information on working techniques and procedures with modern health surveillance, on the basis of accredited literature and good medical, organizational and technical practices. PMID:23405633
Porru, S; Agresta, A; Cimaglia, C; De Carli, G; Piselli, P; Puro, V; Micheloni, G P
Appropriate application of information technology in primary health care will extend traditional diagnosis and patient management beyond the doctor’s clinic into the everyday living environment. We describe a model of information management in primary health care, and place special emphasis on the emerging areas of clinical decision support, computerised clinical measurements, patient education and network connectivity. Briefly discussed is the
Nigel H. Lovell; Branko G. Celler
Nursing and radiology students (n=15) at the University of Malta who completed an interdisciplinary module on primary health care reported they found the theoretical material applicable to practice; the module enabled them to learn about their potential role in primary health care. (SK)
Bezzina, Paul; Keogh, Johann J.; Keogh, Mariana
Purpose: To examine the feasibility and impact of a health care provider’s (HCP) physical activity (PA) prescription on the PA of patients on preventive care visits. Methods: Consenting adult patients completed health and PA questionnaires and were sequentially assigned to intervention groups. HCPs prescribed PA using a written prescription only…
Josyula, Lakshmi; Lyle, Roseann
Accountable care organizations, scheduled to become part of the Medicare program under the Affordable Care Act, have been promoted as a way to improve health care quality, reduce growth in costs, and increase patients' satisfaction. It is unclear how these organizations will develop. Yet in principle they will have to meet quality metrics, adopt improved care processes, assume risk, and provide incentives for population health and wellness. These capabilities represent a radical departure from today's health delivery system. In May 2010 the Premier healthcare alliance formed the Accountable Care Implementation Collaborative, which consists of health systems that seek to pursue accountability by forming partnerships with private payers to evolve from fee-for-service payment models to new, value-driven models. This article describes how participants in the collaborative are building models and developing best practices that can inform the implementation of accountable care organizations as well as public policies. PMID:21209436
Devore, Susan; Champion, R Wesley
A survey of 522 colleges and universities investigated the impact of health care reform proposals. Results provide an overview of typical current medical plan design, including coverage for part- and full-time employees, and give insight into attitudes toward the idea of regional health alliances, a potentially useful reform approach. (MSE)
This article focuses on the redistributive effects of different measures to finance public health insurance. We analyse the implications of different financing options for public health insurance on the redistribution of income from good to bad health risks and from high-income to low-income individuals. The financing options considered are either income-related (namely income taxes, payroll taxes, and indirect taxes), health-related (co-insurance, deductibles, and no-claim), or neither (flat fee). We show that governments who treat access to health care as a basic right for everyone should consider redistributive effects when reforming health care financing. PMID:18347823
Honekamp, Ivonne; Possenriede, Daniel
Examining data on the recent health care legislation, we demonstrate that public opinion polls on health care should be treated with caution because of item nonresponse--or "don't know" answers--on survey questions. Far from being the great equalizer, opinion polls can actually misrepresent the attitudes of the population. First, we show that respondents with lower levels of socioeconomic resources are systematically more likely to give a "don't know" response when asked their opinion about health care legislation. Second, these same individuals are more likely to back health care reform. The result is an incomplete portrait of public opinion on the issue of health care in the United States. PMID:22232421
Berinsky, Adam J; Margolis, Michele
... You are here: Plan of care Share Home health care: what it is and what to expect What is home health care? Home health care is a wide range of ... agency listed. What should you expect from home health care? Doctor’s orders are needed to start care. Once ...
Today, family medicine deals with a spectrum of physical, social, psychological, and developmental issues in day-to-day practice. It is unrealistic to expect family physicians to intervene with all issues. Multidisciplinary health care teams can provide comprehensive and effective care, but teamwork does not occur automatically. This article reviews the process required to develop an effective team and the role of family physicians on health care teams. Images p2166-a PMID:8219864
Huffman, M. C.
With obstacles to the Affordable Care Act (ACA) growing, nurses need to continue to educate themselves about the ACA and the issues it is designed to address. While it has many shortcomings, the ACA invests in creating a new infrastructure that holds the potential to improve care quality and contain costs. Health economist Victor Fuchs suggests three areas must change if we are to have a health care system that is quality focused: information, infrastructure, and incentives. The current health care legislation is noble and lays a basis for future structural cost containment. The health care system continues to unravel as our politicians remain polarized over reform efforts. We must engage or we will never find solutions, never see reform. PMID:22479963
Gardner, Deborah B
Abstract Background: Online technologies offer the promise of an efficient, improved healthcare system. Patients benefit from increased access to care, physicians are afforded greater flexibility in care delivery, and the health system itself benefits from lower costs to provide such care. One method of incorporating online care into clinical practice, called electronic office visits or "eVisits," allows physicians to provide a consultation with patients online. We performed an analysis of the current published literature on eVisits as well as present emerging research describing the use of mobile platforms as the delivery model. We focused on the role of eVisits in acute primary care practice. Materials and Methods: A literature review was conducted using electronic databases with a variety of search terms related to the use of eVisits in primary care. Results: Several advantages to eVisit utilization in the primary care setting were identified, namely, improvements in efficiency, continuity of care, quality of care, and access to care. Barriers to eVisit implementation were also identified, including challenges with incorporation into workflow, reimbursement, physician technological literacy, patient health literacy, overuse, security, confidentiality, and integration with existing medical technologies. Conclusions: Only one study of patient satisfaction with eVisit acute primary care services was identified, and this suggests that previous analyses of eVisit utilization are lacking this key component of healthcare service delivery evaluations. The delivery of primary care via eVisits on mobile platforms is still in adolescence, with few methodologically rigorous analyses of outcomes of efficiency, patient health, and satisfaction. PMID:25474083
Hickson, Ryan; Talbert, Jeffery; Thornbury, William C; Perin, Nathan R; Goodin, Amie J
Technology continues to evolve and improve making our everyday tasks appear sometimes routine and mundane. The health care industry has embraced technological advances to improve on its daily operations in an effort to run more efficiently. Health care providers must be aware that these technologies collect data, lots of data, which is discoverable and may be used to defend or refute your actions as a nurse. This article will take a closer look at health care technology, cell phones, medical equipment, social media, telematics, and Health Insurance Portability and Accountability Act requirements, so that you will become familiar with the information and electronic fingerprint left behind. PMID:25463007
Quail, M Thomas
Given the importance of health care employees in the delivery of patient-centered care, understanding their unique perspectives is essential for quality improvement. The purpose of this study was to use photovoice to evaluate perceptions and experiences around patient-centered care among U.S. Veterans Affairs (VA) health care employees. We asked participants to take photographs of salient features in their environment related to patient-centered care. We used the photographs to facilitate dialogue during follow-up interviews. Twelve VA health care employees across two VA sites participated in the project. Although most participants felt satisfied with their work environment and experiences at the VA, they identified several areas for improvement. These included a need for more employee health and wellness initiatives and a need for enhanced opportunities for training and professional growth. Application of photovoice enabled us to learn about employees' unique perspectives around patient-centered care while engaging them in an evaluation of care delivery. PMID:25274626
Balbale, Salva Najib; Turcios, Stephanie; LaVela, Sherri L
This paper describes the methodology and presents preliminary results of an economic appraisal of a community based health care project in Kenya. Community health workers, trained for 12 weeks and deployed in two locations in Kenya's Western Province, act as first contact providers of basic health care and promoters of selected health, sanitation and nutrition practices. A Cost Benefit Analysis
Joseph K. Wangombe
Appropriate application of information technology in primary health care will extend traditional diagnosis and patient management beyond the doctor's clinic into the everyday living environment. We describe a model of information management in primary health care, and place special emphasis on the emerging areas of clinical decision support, computerised clinical measurements, patient education and network connectivity. Briefly discussed is the design of innovative home monitoring techniques and a telemedicine based communications infrastructure that should improve access to high quality primary health care for all citizens, irrespective of their distance from major urban centres. A preliminary design for a telemedicine-assisted primary health care network is presented, based on this model of information management. The premise is that improvements in health care services and reductions in health care costs can be effected by establishing a continuum of patient care from the patient's home, to the doctor's surgery, to speciality services in hospitals and to other service providers in the health care sector. While, the proposal focuses on new opportunities arising from the imminent introduction of broad band interactive fibre optic networks throughout Australia, the technology and projected data transfers could easily be handled in the short-term using modem access to the standard telephone network. A simple connectivity scheme for system integration is also presented. PMID:10471237
Lovell, N H; Celler, B G
This study investigated the transition experiences of youth with special health care needs (YSHCN). Fifty-five YSHCN completed a phone survey, which asked about their educational and vocational goals, current health care (e.g., access to adult care providers, health insurance, medications), life experiences (exercise, doing chores, cooking, types…
Bryan, Tanis; Stiles, Nora; Burstein, Karen; Ergul, Cevriye; Chao, Pen-Chiang
Patient Data Confidentiality Issues of the Dutch Electronic Health Care Record Perry Groot Ferry.O.Box 9010, 6500GL Nijmegen Abstract Health care is currently in a phase of transition. One of the recent developments that seems to be in- escapable is the introduction of an Electronic Health care Record
The literature is replete with evidence that the stress inherent in health care negatively impacts health care professionals, leading to increased depression, decreased job satisfaction, and psychological distress. In an attempt to address this, the current study examined the effects of a short-term stress management program, mindfulness-based stress reduction (MBSR), on health care professionals. Results from this prospective randomized controlled
Shauna L. Shapiro; John A. Astin; Scott R. Bishop; Matthew Cordova
The increasing costs and complexity of technologic advances in diagnosis and treatment have been accompanied by other important issues. They are often moral or ethical in nature; they include the public's desire and determination to have access to these "high-tech" advances; and the quality and equity with which those advances are apportioned and applied must be addressed. Seven criteria that can be applied to technology assessment are identified as is a process for that assessment. Together, these procedures can provide valuable information and assistance to those who make decisions about health benefits coverage--both in the public and the private sectors. PMID:2980910
Schaffarzick, R W
Maternal and neonatal health is the current focus of central and state governments as well as various funding organizations. There is a lot happening in terms of expansion of secondary healthcare facilities and training of the healthcare personnel. This offers an exciting opportunity like never before, for those interested in the welfare of the newborns. Although infant and neonatal mortality rates in our country have been falling progressively, the pace has been much slower than expected, especially for neonatal mortality and we are likely to miss the Millennium Development Goals. In this article, the authors critically review the current status of neonatal health, infrastructure for neonatal care, the current national programs, the peculiar challenges we face and offer suggestions for alternative approaches to the way forward. The authors propose that neonatal care should be delivered as a continuum through an integrated district based model run by empowered District Coordination Committees with a smooth flow of referral and back-referrals between different levels of care. The prioritization and planning should be based on local data, needs and geopolitical scenario rather than a single national plan, which can provide a broad guideline. The need of the hour is to revive and make the primary care system functional and accountable while expanding and ensuring quality of special care services. PMID:23263977
Bhakoo, O N; Kumar, Praveen
The increasing number of acute and severe digestive diseases presenting to hospital emergency departments, mainly related with an ageing population, demands an appropriate answer from health systems organization, taking into account the escalating pressure on cost reduction. However, patients expect and deserve a response that is appropriate, effective, efficient and safe. The huge variety of variables which can influence the evolution of such cases warranting intensive monitoring, and the coordination and optimization of a range of human and technical resources involved in the care of these high-risk patients, requires their admission in hospital units with conveniently equipped facilities, as is done for heart attack and stroke patients. Little information of gastroenterology emergencies as a function of structure, processes and outcome is available at the organizational level. Surveys that have been conducted in different countries just assess local treatment outcome and question the organizational structure and existing resources but its impact on the outcome is not clear. Most studies address the problem of upper gastrointestinal bleeding and the out-of-hours endoscopy services in the hospital setting. The demands placed on emergency (part of the overall continuum of care) are obvious, as are the needs for the efficient use of resources and processes to improve the quality of care, meaning data must cover the full care cycle. Gastrointestinal emergencies, namely gastrointestinal bleeding, must be incorporated into the overall emergency response as is done for heart attack and stroke. This chapter aims to provide a review of current literature/evidence on organizational health system models towards a better management of gastroenterology emergencies and proposes a research agenda. PMID:24160936
Pedroto, Isabel; Amaro, Pedro; Romãozinho, José Manuel
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
Bednarz, Daniel; Bae, Jaeyong; Pierce, Jessica
\\u000a Health care costs and ageing population are two factors which are of major concern to western governments in the 21st century.\\u000a Existing work in affective health care is primary focused on developing avatars in the tele-health space. This paper reports\\u000a on the modeling of emotions (anxiety level) of patients in pre-operative stage using communication robots to assist nurses\\u000a in providing
Rajiv Khosla; Mei-Tai Chu; Kerstin Denecke; K. G. Yamada; T. Yamaguchi
Reviews research pertinent to mental health services under health care reform proposals. Examines redistributional impact of inclusion of outpatient mental health benefits, optimal benefit packages, and findings that mental health services lower medical utilization costs. Argues that extending minimalist model of time-limited benefits to national…
Hudson, Christopher G.; DeVito, Jo Anne
Osteoporosis care after a fracture is often suboptimal. Suboptimal treatment seems to be most common in fragmented health\\u000a care systems. We examined the literature to assess possible causes for suboptimal postfracture osteoporosis care within fragmented\\u000a health care systems. The review of the literature did not attempt to meta-analyze prior studies. We found several possible\\u000a methods for improving postfracture osteoporosis care
D. H. Solomon
Despite strong evidence linking patients' social circumstances to their health, little guidance exists for health care practitioners and institutions on addressing social needs in clinical settings. Current approaches to social determinants generally focus on population-level and policy interventions; these overlook individual and clinical innovations within health care that can address patients' social circumstances. This article proposes a framework for how social determinants interventions in the health care system can be construed across 3 tiers-patient, institution, and broader population-and describes ways to collect data and target interventions at these levels. PMID:23699778
Gottlieb, Laura; Sandel, Megan; Adler, Nancy E
BackgroundResearch consistently shows that gaps in health and health care persist, and are even widening. While the strength of a country¿s primary health care system and its primary care attributes significantly improves populations¿ health and reduces inequity (differences in health and health care that are unfair and unjust), many areas, such as inequity reduction through the provision of health promotion and preventive services, are not explicitly addressed by general practice. Substantiating the role of primary care in reducing inequity as well as establishing educational training programs geared towards health inequity reduction and improvement of the health and health care of underserved populations are needed.MethodsThis paper summarizes the work performed at the World WONCA (World Organization of National Colleges and Academies of Family Medicine) 2013 Meetings¿ Health Equity Workshop which aimed to explore how a better understanding of health inequities could enable primary care providers (PCPs) / general practitioners (GPs) to adopt strategies that could improve health outcomes through the delivery of primary health care. It explored the development of a health equity curriculum and opened a discussion on the future and potential impact of health equity training among GPs.ResultsA survey completed by workshop participants on the current and expected levels of primary care participation in various inequity reduction activities showed that promoting access (availability and coverage) to primary care services was the most important priority. Assessment of the gaps between current and preferred priorities showed that to bridge expectations and actual performance, the following should be the focus of governments and health care systems: forming cross-national collaborations; incorporating health equity and cultural competency training in medical education; and, engaging in initiation of advocacy programs that involve major stakeholders in equity promotion policy making as well as promoting research on health equity.ConclusionsThis workshop formed the basis for the establishment of WONCA¿s Health Equity Special Interest Group, set up in early 2014, aiming to bring the essential experience, skills and perspective of interested GPs around the world to address differences in health that are unfair, unjust, unnecessary but avoidable. PMID:25376383
Shadmi, Efrat; Wong, William; Kinder, Karen; Heath, Iona; Kidd, Michael
The Professional Health Card Public interest group (Groupement d'Intérêt Public-Carte de professionnel de Santé (GIP-CPS)) was founded in 1993 as a joint initiative by the different parties involved in health care in France: the state, the representatives of the health care professions and the compulsory and complementary health insurance organizations. The CPS system enables safe exchange and electronic sharing of medical data. Via Intranet connections and Extranet hosting of medical files, databases, the CPS system enables health care professionals who access servers to be identified with certainty. For email exhanges, the CPS systems guarantees the sender's identity and capacity. The electronic signature gives legal value to the email. The system also enables confidential email. The health card system (CPS) contributes to making the health service efficient. Shared medical files, health care networks, health warning systems or electronic requests for reimbursement of health insurance expenses all use the CPS system. More than 300,000 health care professionals use it regularly. The freedom of movement of patients throughout Europe has led to the growth of exchanges and information sharing between health professionals in the States of the Union. More and more health professionals will be leaving their own countries to work in foreign countries in the future. It is essential that their freedom of movement is accompanied by the ability to prove their rights to practice. PMID:16385785
This guide furnishes health care providers serving migrant and seasonal farmworkers with information to cope with the complexities of health care delivery in a multiethnic, multicultural environment. Section I provides an introduction to basic cultural concepts that influence the outcome of interactions between providers and their migrant…
Trotter, Robert T., II
Baylor Health Care System* has a long history of addressing health disparities at its hospitals and clinics and in the communities it serves. The organization's definition of health equity has evolved from simply providing care that looks the same for all patients to providing care that is tailored to and effective at producing equitable outcomes for the highly diverse populations of North Texas. Baylor's overarching framework for achieving health equity requires work in three dimensions: improving access to care, improving care delivery, and ultimately producing equitable outcomes for patients. The strategies and tactics used by Baylor have also evolved over time and range from initiatives supporting volunteerism and community service to the operation of a network of clinics tailored to meet the needs of uninsured and underinsured patients. The factors contributing to disparities among different populations include a broad range of health system, medical, and societal issues, many of which are outside the direct scope of influence of hospitals and other healthcare organizations. We share how Baylor has proactively addressed disparities within the organization and its community in the hope of encouraging other hospitals and providers to engage in similar efforts to improve care for all patients. PMID:25291890
Allison, Joel T; Fullerton, Cliff; Chabira, Adam
and Sano also are supported by the Department of Veterans Affairs, Veterans Health Administration of the Department of Veterans Affairs. Address correspondence to: Carolyn W. Zhu, PhD, Health Economist, GeriatricHome Health and Informal Care Utilization and Costs Over Time in Alzheimer's Disease Carolyn W. Zhu
A program for an earth-based remote health service system is discussed as a necessary step for the development and verification of a remote health services spacecraft capability. This demonstration program is described to provide data for developing health care for future manned space missions.
Fifteen in-depth interviews were conducted to explore young people's experiences of mental health care in Australia with the aim of informing the headspace National Youth Mental Health Foundation. The interviews revealed that significant numbers of respondents had been aware of their mental health problems for several years before seeking help and…
Cohen, Anjalee; Medlow, Sharon; Kelk, Norm; Hickie, Ian; Whitwell, Bradley
Health care reform needs to assure coverage to all children regardless of income level or illnesses; address benefits, financing, administration, and delivery systems; provide substantial subsidies to low-income families; be equitable for all people; provide better monitoring of child health; protect and strengthen health providers who assist…
Lewit, Eugene M.; And Others
Improved health care in Nicaragua is a major priority of the Sandinista revolution; it has been pursued by major reforms of the national health care system, something few developing countries have attempted. In addition to its internationally recognized advances in public health, considerable progress has been made in health care delivery by expanding curative medical services through training more personnel and building more facilities to fulfill a commitment to free universal health coverage. The very uneven quality of medical care is the leading problem facing curative medicine now. Underlying factors include the difficulty of adequately training the greatly increased number of new physicians. Misdiagnosis and mismanagement continue to be major problems. The curative medical system is not well coordinated with the preventive sector. Recent innovations include initiation of a "medicina integral" residency, similar to family practice. Despite its inadequacies and the handicaps of war and poverty, the Nicaraguan curative medical system has made important progress. PMID:2705603
Slater, R G
In order to provide more patient-centered care for patients suffering from systemic lupus erythematosus (SLE), we studied their current satisfaction and preferences regarding future health care delivery. We sent questionnaires to all SLE patients visiting the rheumatology outpatient clinic in Leiden, the Netherlands. The questionnaire comprised three topics: (a) health care needs using a modified version of SLE Needs Questionnaire (range 0-38), (b) satisfaction with care per provider (visual analogue scale, range 0 (not at all)-100 (very satisfied)), and (c) preferences for future healthcare (four items). One hundred and two patients (63 % response) reported an average of 16 (±6) health care needs, with all patients reporting a need in the physical domain. More needs were significantly associated with worse physical functioning and a higher educational level. The average satisfaction score was 73 (±19) with a lower overall satisfaction score being associated with younger age and an educational level higher or lower than average. Regarding preferences for future health care delivery, 75 % of patients showed interest in a yearly standardized medical assessment, 57 % in regular, specialized nurse contacts using internet, 50 % in a yearly inventory on the need for self-management support, and 36 % in an education course. The association of age, education level and physical functioning with health care needs, and/or satisfaction suggest that the delivery of care should be better tailored to the needs of subgroups of patients. PMID:24744153
Zirkzee, E J M; Steup-Beekman, G M; Schouffoer, A A; Henquet, S M; Caljouw, M A A; Huizinga, T W J; Vliet Vlieland, T P M
...47 CFR Part 54 Rural Health Care Support Mechanism; Final Rule Federal...02-60; FCC 12-150] Rural Health Care Support Mechanism AGENCY: Federal Communications...universal service support program for health care, transitioning its existing Internet...
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... 2011-07-01 false Provision of health care. 17.901 Section 17.901...DEPARTMENT OF VETERANS AFFAIRS MEDICAL Health Care Benefits for Certain Children...Birth Defects § 17.901 Provision of health care. (a) Spina bifida....
...2014-10-01 2014-10-01 false Health care provider contribution. 54.633...SERVICE Universal Service Support for Health Care Providers Healthcare Connect Fund § 54.633 Health care provider contribution. (a)...
... 2014-07-01 false Provision of health care. 17.901 Section 17.901...DEPARTMENT OF VETERANS AFFAIRS MEDICAL Health Care Benefits for Certain Children...Birth Defects § 17.901 Provision of health care. (a) Spina bifida....
... 2013-07-01 false Provision of health care. 17.901 Section 17.901...DEPARTMENT OF VETERANS AFFAIRS MEDICAL Health Care Benefits for Certain Children...Birth Defects § 17.901 Provision of health care. (a) Spina bifida....
... 2014-10-01 2014-10-01 false Health care claim status transaction. 162.1401 ...REQUIREMENTS ADMINISTRATIVE REQUIREMENTS Health Care Claim Status § 162.1401 Health care claim status transaction. The...
...02-60; FCC 12-74] Rural Health Care Support Mechanism AGENCY: Federal...responsible basis for specific Rural Health Care Pilot Program participants that...connectivity and the resulting health care benefits that patients...
...0720-AB30 TRICARE; Continued Health Care Benefit Program Expansion AGENCY...eligible to purchase Continued Health Care Benefit Program (CHCBP) coverage...program that provides continued health care coverage for eligible...
...02-60; FCC 11-101] Rural Health Care Support Mechanism AGENCY: Federal...discounted services under the rural health care program. Grandfathered providers...but play a key role in delivering health care services to surrounding...
Disparities in Health Care Quality Among Minority Women Selected Findings From the 2011 National Healthcare Quality and Dispar Findings From the 2011 ... race and ethnicity are combined. Return to Contents Health Care Delivery and Systems Information about health care delivery ...
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. PMID:24255600
Crema, Maria; Verbano, Chiara
This paper describes the approach followed in the design of a service robot for health care applications. Under the auspices of the NASA Technology Transfer program, a partnership was established between JPL and RWI, a manufacturer of mobile robots, to design and evaluate a mobile robot for health care assistance to the elderly and the handicapped. The main emphasis of the first phase of the project is on the development on a multi-modal operator interface and its evaluation by health care professionals and users. This paper describes the architecture of the system, the evaluation method used, and some preliminary results of the user evaluation.
Fiorini, Paolo; Ali, Khaled; Seraji, Homayoun
This manual on health and safety considerations in caring for young children with exceptional health care needs is a product of Project EXCEPTIONAL (EXceptional Children: Education in Preschool Techniques for Inclusion, Opportunity-building, Nurturing And Learning), which has the goal of increasing the quality and quantity of inclusive child care…
Examines how health care reform might be structured to provide support for a package of primary care services for children of all socioeconomic strata. An insurance-like financing system, such as the special Medicaid payment system adopted by New York State for public and nonprofit primary health care programs, may be useful as a model for a…
The foreign-born population in the United States, according to the “Current Populations Report” published in 2010, is estimated to exceed 39.9 million, or “12.9 percent of the U.S. population.” The increase in foreign-born peoples and their need for health care is a complicated issue facing many cities, health systems and hospitals. Over the course of the past few years Mercy Hospital of Philadelphia has treated increasing numbers of foreign-born African patients. The majority have been presenting in the late stages of disease. The increase of foreign-born documented and undocumented African patients seen by Mercy Hospitals seems to reflect a foreign-born population “boom” in Philadelphia over the past decade. To meet the needs of this growing population, the Mercy Hospital Task Force on African Immigration and the Institute of Catholic Bioethics at Saint Joseph’s University designed a program that centers on the third world concept of “Health Promoters.” This program is intended to serve as one possible solution for hospitals to cost-effectively manage the care of this growing percentage of foreign-born individuals in the population. This notion of a “Health Promoter” program in Philadelphia is unique as one of those rare occasions when a third world concept is being utilized in a first world environment. It is also unique in that it can serve as a paradigm for other hospitals in the United States to meet the growing need of health care for the undocumented population. As of November 2012 the Mercy Hospital of Philadelphia clinic became operative for patients who were referred from the Health Promoter clinics. To date, a total of forty-two patients have actively participated in the screenings, sixteen of which have been referred to Mercy Hospital of Philadelphia clinic for further evaluation. More than 75% of patient referrals were a result of high blood pressure. According to the American Medical Association, readings of 140–159 mmHg and above are indicative of stage 1 hypertension. Among those who presented at the Health Promoter screenings the mean systolic pressure for males was 140 mmHg and for females was 140.48 mmHg. PMID:24084364
Clark, Peter A.; Schadt, Sam
Integration in health care is a key goal of health reform in United States and England. Yet past efforts in the 1990s to better integrate the delivery system were of limited success. Building on work by Bevan and Janus on delivery integration, this article explores integration through the lens of economic theories of integration. Firms generally integrate to increase efficiency through economies of scale, to improve their market power, and resolve the transaction costs involved with multiple external suppliers. Using the United States and England as laboratories, we apply concepts of economic integration to understand why integration does or does not occur in health care, and whether expectations of integrating different kinds of providers (hospital, primary care) and health and social services are realistic. Current enthusiasm for a more integrated health care system expands the scope of integration to include social services in England, but retains the focus on health care in the United States. We find mixed applicability of economic theories of integration. Economies of scale have not played a significant role in stimulating integration in both countries. Managerial incentives for monopoly or oligopoly may be more compelling in the United States, since hospitals seek higher prices and more leverage over payers. In both countries the concept of transaction costs could explain the success of new payment and budgeting methods, since health care integration ultimately requires resolving transaction costs across different delivery organizations. PMID:24759287
Laugesen, Miriam J; France, George
This study examined the health services received and needed among homeless persons in Hillsborough County, FL (N = 823). Lifetime and current need and receipt of health services were assessed with a cross-sectional survey. Participants reported extensive lifetime and current needs for physical and behavioral health care services. Nearly a third of participants reported current unaddressed health problem(s); an inability
Blake Barrett; Sondra J. Fogel; Jack Garrett; M. Scott Young
Recent reform in the National Health Service has moved general practice towards a more intense market and competition structure. Meanwhile in the United States of America there has been an attempt to modify the free enterprise approach to medical care towards a more socially responsive system. This discussion paper provides a family doctor's perspective of primary care and the maelstrom of health care reform in the USA. The cultural, economic and organizational issues underlying the need for reform are considered in turn, and the current situation with regard to health care provision, medical research, medical education and primary care are outlined. General practitioners in the United Kingdom would do well to pay attention to the effects of market reform occurring in general practice among their American counterparts. PMID:7576850
I present a historical study of the role played by the World Health Organization and UNICEF in the emergence and diffusion of the concept of primary health care during the late 1970s and early 1980s. I have analyzed these organizations’ political context, their leaders, the methodologies and technologies associated with the primary health care perspective, and the debates on the meaning of primary health care. These debates led to the development of an alternative, more restricted approach, known as selective primary health care. My study examined library and archival sources; I cite examples from Latin America. PMID:15514221
Electronic health records (EHRs) must support primary care clinicians and patients, yet many clinicians remain dissatisfied with their system. This article presents a consensus statement about gaps in current EHR functionality and needed enhancements to support primary care. The Institute of Medicine primary care attributes were used to define needs and meaningful use (MU) objectives to define EHR functionality. Current objectives remain focused on disease rather than the whole person, ignoring factors such as personal risks, behaviors, family structure, and occupational and environmental influences. Primary care needs EHRs to move beyond documentation to interpreting and tracking information over time, as well as patient-partnering activities, support for team-based care, population-management tools that deliver care, and reduced documentation burden. While stage 3 MU's focus on outcomes is laudable, enhanced functionality is still needed, including EHR modifications, expanded use of patient portals, seamless integration with external applications, and advancement of national infrastructure and policies. PMID:24431335
Krist, Alex H; Beasley, John W; Crosson, Jesse C; Kibbe, David C; Klinkman, Michael S; Lehmann, Christoph U; Fox, Chester H; Mitchell, Jason M; Mold, James W; Pace, Wilson D; Peterson, Kevin A; Phillips, Robert L; Post, Robert; Puro, Jon; Raddock, Michael; Simkus, Ray; Waldren, Steven E
How does one learn about primary health care? Some might attend public health schools while others will find different ways to explore this fascinating field on their own. One particularly nice resource on the subject is this course from the Johns Hopkins School of Public Health. Offered as part of the Open Course Ware initiative, the course was first developed in the fall of 2011 and was co-taught by Henry Taylor and Henry Perry. It was designed to introduce students to "the origins, concepts, and development of community-based primary health care through case studies from both developing and developed countries." The materials here include the syllabus, lecture materials, readings, and assignments. Within the Lecture Materials section visitors can watch or listen to conversions on the roots of community-based primary health care and women's empowerment via public health. Additionally, visitors can look over the course assignments or check out some of the discussion questions.
Native American health care programs face complex and unprecedented challenges resulting from the increased assumption of clinical operations by tribal authorities, shortfalls in Federal funding, modifications in state and Federal health and welfare programs, and intensifying involvement with managed care organizations. These challenges are further complicated by service populations that are increasing at a faster rate than the growth in funding. The authors conducted onsite surveys of 39 Native American health programs in 10 states in order to assess the organizational and management problems they faced. The trend toward transfer of health programs from the Indian Health Service to tribal operation seems likely to continue and accelerate. The survey results indicate that in order for programs to be effective in the long run, they will need to be guided by skilled managers able to adapt to these powerful changes in the health care environment. Images p-a p27-a p28-a p30-a PMID:9885525
Noren, J; Kindig, D; Sprenger, A
Health care is an everlasting challenge that requires effort at all levels, from national and organizational to individual domains, over a long-term period. This article reviews the historical development of health care-related issues worldwide and accentuates the necessity of health care in the current era. Through investigating the historical background in both the occidental and the oriental worlds and the latest achievements from academic and industrial endeavors, many lessons can be learnt, and as a result, an integrative strategy is proposed to meet today’s pressing needs. A government-funded project, “Challenge to 100 years of age”, which involved more than 600 residents in west Aizu village, lasted over 15 years. After reviewing its outcomes, a metrology of health based upon the three-dimensional phase space, which integrates with social well-being, mental status, and physical condition for a lifelong span, is advocated as a measure of the holistic view of health state. PMID:21197368
INTRODUCTION: In September 2005, an overview of current health care system planning efforts was presented to the audience at the Yale University Ethics Symposium on Avian and Pandemic Influenza. The speaker, also the author of this article, provided the audience with a summary of what was being undertaken with the use of federal preparedness funds to improve the overall infrastructure of the health care system. All of Connecticut's 31 acute care hospitals, the Veteran's Administration Hospital in West Haven, Hospital for Special Care, Gaylord Rehabilitation Hospital, Natchaug Psychiatric Hospital, and the state's 13 Community Health Centers are currently recipients of federal preparedness funds. Federal funding for this planning comes from Health Resources and Services Administration, Department of Health and Human Service's National Bioterrorism Hospital Preparedness Program. OBJECTIVES: This article outlines the planning activities around pandemic influenza that the state's health care system partners started in 2004-2005 and also those they are currently participating in or will be participating in the next 12 to 15 months. The article highlights the key objectives and strategies that health care facilities will be using in this planning. There are four major objectives that each health care facility's Emergency Operations Plan must address. They are: increasing bed availability, developing strategies to deal with the potential staffing shortages, developing strategies for dealing with potential critical equipment and pharmaceutical shortages, and, lastly, the implementation of education, training and communication strategies for their health care workers and the public they serve. These plans, and all the activities needed to operationalize the plans, such as education, training, drills, and exercises, will include their key partners, i.e., local health departments, local emergency management, police, fire, and Emergency Medical Services. This article will describe this work plan in detail. METHODS: Descriptive information was obtained through the author's observations and personal experiences, in addition to governmental guidance, reports, and plans. CONCLUSION: The "all-hazards" planning currently being undertaken by the key health care system partners in Connecticut as a result of federal funding for preparedness post 9/11 has fostered great working relationships between these entities and their local, regional, and statewide planning counterparts. Many of the specific grant dollars being provided to these facilities can assist in the planning that must be done for pandemic flu. PMID:17132342
Duley, Mary Grace Keating
Describes and analyzes from a primary health care perspective how sociopolitical and cultural issues are key factors that influence the health of Hispanic women and their ability to access health care. Looks at the implications for nursing practice, theory, and research and advocates social and political changes needed to improve the situation.…
Juarbe, Teresa C.
The first Dutch Dental Hygiene School was opened in 1968. Educating dental hygiene professionals with preventive qualifications was a well-considered decision. From the beginning on, the Dutch Dental Hygienists'Association has aimed at optimizing dental hygienists' role in preventive oral health care. Current developments, such as the introduction of a new national health insurance system and the rearrangement of oral health care, require reflection on the position of dental hygienists. Prevention should remain the core business of the dental hygiene profession. However, preventive oral health care has lost its social priority. Therefore, a new campaign preventing development of both old and new oral health threats should be initiated. In the opinion of the Dutch Dental Hygienists' Association, dental hygienists should be committed both to public and individual oral health prevention. The association pleads for the reinforcement of preventive oral health care for children and young adults, with a special focus on high-risk groups. Likewise, oral health care for elderly people should receive more attention. PMID:16886318
van der Sanden-Stoelinga, M S E; la Rivière-Ilsen, J; Calkoen, P T
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 < 500copies/ml for >90% of time on cART). Results 7097 EuroSIDA patients were included from Northern (n = 923), Southern (n = 1059), West Central (n = 1290) East Central (n = 1366), Eastern (n = 1964) Europe, and Argentina (n = 495). Patients in Eastern Europe with a CD4 < 200cells/mm3 were less likely to initiate cART and Pneumocystis jiroveci-chemoprophylaxis compared to patients from all other regions, and less frequently had a laboratory assessment of their disease status. The proportion of patients with virological response was highest in Northern, 89% vs. 84%, 78%, 78%, 61%, 55% in West Central, Southern, East Central Europe, Argentina and Eastern Europe, respectively (p < 0.0001). Compared to Northern, patients from other regions had significantly lower odds of virological response; the difference was most pronounced for Eastern Europe and Argentina (adjusted OR 0.16 [95%CI 0.11-0.23, p < 0.0001]; 0.20[0.14-0.28, p < 0.0001] respectively). Conclusions This assessment of HIV health care utilization revealed pronounced regional differences in adherence to guidelines and can help to identify gaps and direct target interventions. It may serve as a tool for the assessment and benchmarking of the clinical management of HIV patients in any setting worldwide. PMID:23009317
As health care professionals, we face a grave risk of acquiring HIV infection in the course of our work. But how many of us really know the precautions to be applied in the hospital set up in dealing with HIV infected patients? A knowledge, attitude and practice (KAP) study was conducted in Pune hospitals to assess the current status. Among the results 65% servants had not heard of AIDS, 85% nursing staff did not apply the Universal Safety Precautions (USP) approach, 13.5% resident thought that the HIV was not transmitted by blood, 30% consultants would avoid contact with an HIV positive patient. This study has shown that definite lacunae exist in knowledge specific to the particular population in question. A proposal for an education programme which is target specific and one of constant renewal is sought. PMID:7836241
Menon, V; Bharucha, K
This article has discussed the most common sequelae of victimization with regard to incest, rape, and battering. Although legislators and law-enforcement officials have traditionally been viewed as having primary responsibility for the prevention and control of violence, it is now known that physicians must also act in this regard. Their action is especially required with regard to victim assessment and treatment. Physicians serve as the entry points not only to the health care system, but also to other resources for victims of violence. By identifying their victimized patients and by understanding the antecedents of their patients' symptoms, physicians can go much further in meeting their patients' needs for physical, mental, and social well-being. Given the scope and impact of violence, physicians have a moral and ethical obligation to inquire about the possibility of current violence, past violence, or both in their patients' lives. PMID:8356159
Hendricks-Matthews, M K
GENDER, SOCIAL ROLES AND HEALTH CARE UTILIZATION A Thesis by JENNIFER LOUISE DAVID Submitted to the Office of Graduate Studies of Texas A&M University in partial fulfillment of the requirements for the degree of MASTER OF SCIENCE December... 1992 Major Subject: Sociology GENDER, SOCIAL ROLES AND HEALTH CARE UTILIZATION A Thesis by JENNIFER LOUISE DAVID Approved as to style and content by: Howard B. Kaplan (Chair of Committee) m. Alex Mclntosh (Member) J oehr (Member) 0 0N...
David, Jennifer Louise
Conclusion I examine the role of technological change in health care labor markets. One of the biggest issues in the U.S. economy over\\u000a the recent past has been rapidly rising health care costs. Conventional wisdom holds the main factor driving these costs increases\\u000a has been technological change. These changes in technology have lead to a direct transformation in the delivery of
Edward J. Schumacher
health care services?. Duggan investigates antipsychotic drugs and shows that newer antipsychotic drugs increase prescription drug expenditures by 610 percent, but do not reduce spending on other types of medical care services. These results call...?. Duggan investigates antipsychotic drugs and shows that newer antipsychotic drugs increase prescription drug expenditures by 610 percent, but do not reduce spending on other types of medical care services. The results presented in this paper generalize...
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…
Kane, Robert L.; Mach, John R., Jr.
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,…
McTaggart, Aubrey C.; McTaggart, Lorna, M.
Drawn from a review of policies at over 100 child care programs nationwide, this document compiles model health policies intended for adaptation and selective use by out-of-home child care facilities. Following an introduction, the document presents model policy forms with blanks for adding individualized information for the following areas: (1)…
Aronson, Susan S.
This paper examines issues concerning access to health care for persons with disabilities, specifically the health status of the disabled, utilization and cost of services, and a comparison of health insurance coverage of persons with and without disabilities. Three age groups (children, working-age adults, and the elderly) are considered. Data…
The health status of Australia's Aborigines is far inferior to that of non-Aboriginal Australians. The factors underlying this low standard of health are complex, but relate to the gross social inequality experienced by Aborigines, even today. The social inequality, characterised by extreme socioeconomic deprivation and relative powerlessness, is the end result of the European occupation of Australia, which caused Aboriginal depopulation and dispossession. Since the early 1970s a number of special programs have attempted to overcome the health inequalities of Aborigines, but have really met with only limited success. This limited success is explicable in terms of the gross social inequalities experienced by Aborigines. Alleviation of Aboriginal ill-health requiries integrated comprehensive programs, with continued support, at least in the medium term, of special Aboriginal health programs. PMID:6740341
Simulation is rapidly penetrating the terrain of health care education and has gained growing acceptance as an educational method and patient safety tool. Despite this, the state of simulation in health care education has not yet been evaluated on a global scale. In this project, we studied the global status of simulation in health care education by determining the degree of financial support, infrastructure, manpower, information technology capabilities, engagement of groups of learners, and research and scholarly activities, as well as the barriers, strengths, opportunities for growth, and other aspects of simulation in health care education. We utilized a two-stage process, including an online survey and a site visit that included interviews and debriefings. Forty-two simulation centers worldwide participated in this study, the results of which show that despite enormous interest and enthusiasm in the health care community, use of simulation in health care education is limited to specific areas and is not a budgeted item in many institutions. Absence of a sustainable business model, as well as sufficient financial support in terms of budget, infrastructure, manpower, research, and scholarly activities, slows down the movement of simulation. Specific recommendations are made based on current findings to support simulation in the next developmental stages. PMID:25489254
Qayumi, Karim; Pachev, George; Zheng, Bin; Ziv, Amitai; Koval, Valentyna; Badiei, Sadia; Cheng, Adam
Simulation is rapidly penetrating the terrain of health care education and has gained growing acceptance as an educational method and patient safety tool. Despite this, the state of simulation in health care education has not yet been evaluated on a global scale. In this project, we studied the global status of simulation in health care education by determining the degree of financial support, infrastructure, manpower, information technology capabilities, engagement of groups of learners, and research and scholarly activities, as well as the barriers, strengths, opportunities for growth, and other aspects of simulation in health care education. We utilized a two-stage process, including an online survey and a site visit that included interviews and debriefings. Forty-two simulation centers worldwide participated in this study, the results of which show that despite enormous interest and enthusiasm in the health care community, use of simulation in health care education is limited to specific areas and is not a budgeted item in many institutions. Absence of a sustainable business model, as well as sufficient financial support in terms of budget, infrastructure, manpower, research, and scholarly activities, slows down the movement of simulation. Specific recommendations are made based on current findings to support simulation in the next developmental stages. PMID:25489254
Qayumi, Karim; Pachev, George; Zheng, Bin; Ziv, Amitai; Koval, Valentyna; Badiei, Sadia; Cheng, Adam
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. PMID:24774076
Corrigan, Patrick W; Mittal, Dinesh; Reaves, Christina M; Haynes, Tiffany F; Han, Xiaotong; Morris, Scott; Sullivan, Greer
This regular feature of the journal includes a discussion of recent trends in health care spending, employment, and prices. The statistics presented in this article are valuable in their own right and for understanding the relationship between the health care sector and the overall economy. In addition, they allow us to anticipate the direction and magnitude of health care cost changes prior to the availability of more comprehensive data. PMID:10165035
Sensenig, Arthur L.; Heffler, Stephen K.
In order to address problems related to the health care of children in foster care, policymakers need detailed information about health status, health care utilization, and Medicaid expenditures. This policy brief summarizes a study examining health care utilization and expenditures paid by Medicaid for children in foster care in California,…
The decisions and actions of health care managers are oftentimes heavily scrutinized by the public. Given the current economic climate, managers may feel intense pressure to produce higher results with fewer resources. This could inadvertently test their moral fortitude and their social consciousness. A study was conducted to determine what corporate social responsibility orientation and viewpoint future health care managers may hold. The results of the study indicate that future health care managers may hold patient care in high regard as opposed to profit maximization. However, the results of the study also show that future managers within the industry may continue to need rules, laws, regulations, and legal sanctions to guide their actions and behavior. PMID:21045586
Collins, Sandra K
...designated as a result of the Health Care Safety Net Amendments of 2002...definition of such Tribes in the Indian Health Care Improvement Act of 1976, 25 U...health professional shortages. The Health Care Safety Net Amendments of 2002...
...designated as a result of the Health Care Safety Net Amendments of 2002...definition of such Tribes in the Indian Health Care Improvement Act of 1976, 25 U...health professional shortages. The Health Care Safety Net Amendments of 2002...
...designated as a result of the Health Care Safety Net Amendments of 2002...definition of such Tribes in the Indian Health Care Improvement Act of 1976, 25 U...health professional shortages. The Health Care Safety Net Amendments of 2002...
From the results obtained regarding the financing of health care in Mali, we emphasize two important points. First, there is a lack of criteria for the distribution of finding in the health care sector, resulting in a waste of resources. Secondly, there is an absence of adequate pharmaceutical policies. The field studies led in 1987 provided the following observations. The rate of occupation of the beds is very low. Also, the numerous new investments are not yet put into service because of the lack of necessary equipment of qualified personnel. In addition, this does not consider the excessive investments occurring in certain localities where neither the rate of frequentation nor the economic conditions will ever allow the use of the capacity created. Among the possible solutions for the crisis of health care funding in Mali, the following should be priority: first, to fight against the complete lack of organization of the activities at the health care centers; secondly, to fight against the waste and misappropriation of money resulting from the behavior of the medical and paramedical personnel: and thirdly, to clarify the management of the resources coming from the charges for each service. The pharmaceutical policies adopted and implemented in recent years Largely contributed to, first, the creation of competition between essential generic medications and nongeneric medications that can be replaced, and then, the destruction of the public network of drug distribution. These conditions considerably limited the distribution of essential medications; yet, this is the only manner of reducing the pharmaceutical expenses and accordingly, allowing more funding for other medical services. As the distribution network is disorganized, the only alternative for the population to obtain the medications at the lowest price was to create centers of purchasing and distribution and to multiply the number of retailers of essential medications. Extensive work has been conducted in the health care sector in Mali, accompanied by concrete proposals allowing for improved functioning of the system. However, despite these improvements, these conclusions are rarely considered by the health policy makers. This is because behind the financial aspects of health services, there is an important political stake. Also, the governments of many countries, including Mali, had to resort to adjustment programs that reduce their maneuverability of economic policies in general, and of health care policies in particular. The sponsors "give" large sums of financial aid to the health care sector, but are not interested in the results. The promotion of the health care sector requires a courageous political will. In contrast, microeconomic studies allowed the creation of the first community health centers in Mali. These examples, now followed in many village throughout Mali, constitute the hope of the health care sector. PMID:9053102
Coulibaly, S O; Keita, M
These online course materials were generated from a Johns Hopkins Bloomberg School of Public Health (JHSPH) course on Refugee Health Care. The materials were put online as part of the JHSPH OpenCourseWare program which provides "free, searchable access to JHSPH's course materials for educators, students, and self-learners around the world." The Refugee Health Care course "addresses the provision of basic health requirements for refugees and the coordination of care among agencies concerned with them." Site visitors will find a selection of downloadable lecture notes on such topics as Hemorrhagic Fever Outbreak Investigation, Control of Communicable Diseases, Health and Human Rights Principles for Refugee Health, and more. The site also offers a downloadable Reading List, and case study materials.
ealthcare is entering a new era — one that will be especially important for individuals with autoim- mune and immune deficiency diseases. This new health information technology (HITech) era will make health information interoperable, allowing physicians, labs and insurance companies to exchange data and communicate quickly and efficiently to provide the best possible care for patients — all made possible
A dynamic, proactive health-care environment is beckoning. Fueled by consumer-led awareness, digital television, the Internet and a preoccupation with preventative health maintenance, it will define a new genre of products. In a series of provocative statements, this visionary article explores what the future may hold for diagnostics and medical devices. PMID:10387620
Serious problems beset the military's extensive system of health care: rising budgetary costs, dissatisfaction among its beneficiaries, and inadequate readiness for war. This report was written at the request of the House Committee on Armed Services to examine some of these issues. It looks at a range of possible reforms in the military health…
Reviews changing patterns of health and illness that have led to increased interest in the role of patient and provider behaviors, discussing the advantages of using health care settings as prevention sites. Presents examples of successful behaviorally-based prevention programs, offering evidence supporting their cost-effectiveness. Describes…
Johnson, Suzanne Bennett; Millstein, Susan G.
In this article we present an overview of the publication about the health care in the family context. We developed a bibliographical research taking as source the following databases: SciELO, MEDLINE and Lilacs using the keywords: health care and family caregivers considering the period from 1995 through 2007. We realized that there are few studies on the subject and some of them are quite superficial in their approach. Our focus was directed to the understanding of: types of methodologies applied; theoretical approach; "care" concepts; analysis of culture and social class; references to networking; gender considerations and finally consensus and gaps in the studies. The results show that most of the studies assume a qualitative methodology compatible with the high complexity level of the studied subject and theoretical approaches of comprehensive character exploring meanings and conceptions. The discussion of the role of culture, social class distinctions and gender relations in the production and sourcing of health care arise once in a while but without the proper depth. The importance of the role of woman-mother in producing and providing health care is generally disregarded of criticism. We noticed a trend to use broader health care concepts that synthesize material, affective and social aspects, although without a discussion in a concrete way. PMID:20640312
Gutierrez, Denise Machado Duran; Minayo, Maria Cecília de Souza
HIV offers a lens through which the underlying problems of the US health care system can be examined. New treatments offer the potential of prolonged quality of life for people living with HIV if they have adequate access to health care. However, increasing numbers of new cases of HIV occur among individuals with poor access to health care. Restrictions on eligibility for Medicaid (and state-by-state variability) contribute to uneven access to the most important safety net source of HIV care financing, while relatively modest discretionary programs attempt to fill in the gap with an ever-increasing caseload. Many poor people with HIV are going without care, even though aggregate public spending on HIV-related care will total $7.7 billion in fiscal year 2000, an amount sufficient to cover the care costs of one half of those living with HIV. But inefficiencies and inequities in the system (both structural and geographic) require assessment of the steps that can be taken to create a more rational model of care financing for people living with HIV that could become a model for all chronic diseases. PMID:10897178
Levi, J; Kates, J
Although Congress recently passed health insurance reform legislation, the real catalyst for change in the health care delivery system, the author's argue, will be changes to the reimbursement model. To rein in increasing costs, the Centers for Medicare and Medicaid aims to move Medicare from the current fee-for-service model to a reimbursement approach that shifts the risk to providers and encourages greater accountability both for the cost and the quality of care. This level of increased accountability can only be achieved by clinical integration among health care providers. Central to this reorganized delivery model are primary care providers who coordinate and organize the care of their patients, using best practices and evidence-based medicine while respecting the patient's values, wishes, and dictates. Thus, the authors ask whether primary care physicians will be available in sufficient numbers and if they will be adequately and appropriately trained to take on this role. Most workforce researchers report inadequate numbers of primary care doctors today, a shortage that will only be exacerbated in the future. Even more ominously, the authors argue that primary care physicians being trained today will not have the requisite skills to fulfill their contemplated responsibilities because of a variety of factors that encourage fragmentation of care. If this training issue is not debated vigorously to determine new and appropriate training approaches, the future workforce may eventually have the appropriate number of physicians but inadequately trained individuals, a situation that would doom any effort at system reform. PMID:21270552
Caudill, T Shawn; Lofgren, Richard; Jennings, C Darrell; Karpf, Michael
Despite its widespread adoption, little is known about the effect of Medicaid managed care (MMC) on children using mental health services. To assess the state of current research, we reviewed the literature on MMC and synthesized findings regarding access to care, expenditures, utilization, cost-shifting, and quality of care. A literature search was conducted and updated in November 2001. Studies were
Angela Blair Hutchinson; E. Michael Foster
Those concerned over the excessive commercialization of health care, to the detriment of both professional and patient-centered values, commonly propose remedies that assume that meaningful change can occur largely within the health care sector. I argue instead that a major shift in the public culture and political discourse of the U.S. will be required if the commercialization of health care is to be adequately addressed. The notion that health and health care are commodities to be bought and sold in the market is encouraged by the ideology that is preferably called economism, though also today labeled neoliberalism, market fundamentalism, market triumphalism, and other terms. This ideology has been successful in pushing aside alternative accounts and policies over the past four decades, so that economism-inspired policies seem both commonsensical and inevitable. This dominance of the public political discourse hides two important facts about economism - it is a quasi-religious ideology that pretends to be a reflection of economic science; and it is shot through with internal contradictions that ultimately render it self-defeating as a guide to policy. Advocates for reduced commercialism in health care must directly address economism and attempt to educate the public and policymakers about its flaws. PMID:25565616
How will emergency department utilization and costs be affected by universal coverage provisions? Proponents of health care reform predict that the number of ED visits will decline when currently uninsured Americans become eligible for primary physicians' care. However, economic concepts indicate the contrary: that ED volume and costs will actually escalate upon implementation of health care reform initiatives. These basic
Robert A. Barish; Robert J. Doherty
The current study aims to describe the patient and treatment characteristics of a sample of 505 suicides by mental health care patients, and to determine how clinicians view the care provided and what they learned. The results indicate that the quality of mental health care for suicidal patients could be improved by focusing on communication among…
Huisman, Annemiek; Kerkhof, Ad J. F. M.; Robben, Paul B. M.
Person-centred care (PCC) is defined as the health-care providers selecting and delivering interventions or treatments that are respectful of and responsive to the characteristics, needs, preferences and values of the individual person. This model of care puts the person at the centre of care delivery. The World Health Organization suggests that PCC is one of the essential dimensions of health care and as such is an important indicator of health-care quality. However, how PCC is implemented differs between countries in response to local cultures, resources and consumer expectations of health care. This article discusses person-centred care in the Indonesian health-care system. PMID:24219813
Dewi, Wan Nishfa; Evans, David; Bradley, Helen; Ullrich, Sandra
This study is a mega evaluation of Korea's health care system as developed thus far. It aims to review the historical context in which this system was developed and the political stage and motivation for such development. It will highlight unique features of the system and some comparative analysis with other developed nations. Then it will introduce selective, specific areas and aspects of the health care system, service delivery, and practices. It will suggest its implications for future direction. PMID:20391257
Kim, Dong Soo
The purpose of this project is to demonstrate, through a case study, how York Community Services (YCS) is a leader in the delivery ofprimary health care through its integration ofhealth, legal and social services. YCS is located in Toronto, Ontario, Canada. YCS's mandate is to serve populations that have traditionally been on the margins ofsociety and therefore have had difficulty
Monica M. Lancaster; David P. Thow
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 PMID:12525262
Detmer, Don E
A case-mix project started in the Netherlands with the primary goal to define a complete set of health care products for hospitals. The definition of the product structure was completed 4 years later. The results are currently being used for billing purposes. This paper focuses on the methodology and techniques that were developed and applied in order to define the casemix product structure. The central research question was how to develop a manageable product structure, i.e., a limited set of hospital products, with acceptable cost homogeneity. For this purpose, a data warehouse with approximately 1.5 million patient records from 27 hospitals was build up over a period of 3 years. The data associated with each patient consist of a large number of a priori independent parameters describing the resource utilization in different stages of the treatment process, e.g., activities in the operating theatre, the lab and the radiology department. Because of the complexity of the database, it was necessary to apply advanced data analysis techniques. The full analyses process that starts from the database and ends up with a product definition consists of four basic analyses steps. Each of these steps has revealed interesting insights. This paper describes each step in some detail and presents the major results of each step. The result consists of 687 product groups for 24 medical specialties used for billing purposes. PMID:21350859
Westerdijk, Machiel; Zuurbier, Joost; Ludwig, Martijn; Prins, Sarah
An analysis of eleven national media polls finds that despite rising health care costs and the growing number of uninsured Americans, health care played a relatively mod- est role as an issue in the 2002 congressional elections. The top health care issue was the cost of prescription drugs. The results suggest that health care's role in the 2004 election is
Robert J. Blendon; Mollyann Brodie; Drew E. Altman; John M. Benson; Stephen R. Pelletier; Marcus D. Rosenbaum
The top two priorities of health care business leaders are to constantly improve the quality of health care while striving to contain and reduce the high cost of health care. The Health Care industry, similar to all businesses, is motivated to deliver innovative solutions that accelerate business transformation and increase business capabilities. …
Shulaiba, Refaat A.
A study aims to examine the existing health care policies in U.S. juvenile detention centres. The results conclude that juvenile detention facilities have many shortfalls in providing care for adolescents, particularly mental health care.
Pajer, Kathleen A.; Kelleher, Kelly; Gupta, Ravindra A.; Rolls, Jennifer; Gardner, William
... Information Clinical Trials Resources and Publications How do health care providers diagnose Klinefelter syndrome (KS)? Skip sharing on ... karyotype (pronounced care-EE-oh-type ) test. A health care provider will take a small blood or skin ...
This study examined the current state of cultural competence in health care using a qualitative descriptive design. Interviews were conducted with 20 multidisciplinary experts in culture and cultural competence from the United States and abroad. Findings identified 3 themes; awareness, engagement, and application that crossed 4 domains of cultural competence; intrapersonal, interpersonal, system/organization, and global. PMID:24469088
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. PMID:25251230
Purpose – This paper aims to compare and contrast quality improvement in the domain of health care disparities with quality improvement in other domains. Design\\/methodology\\/approach – The author provides a descriptive essay and review to put forward the findings of their research. Findings – In the USA, health care quality improvement systems have largely been accepted and institutionalized. Most if
Wally R. Smith
Purpose: The Veterans Affairs or VA health care system is in the process of significantly expanding home health care (HOC) nationwide. We describe VA HHC use in 2003 for all VA HHC users from 2002; we examine whether VA utilization across a broad spectrum of services differed for a sample of VA HHC users and their propensity-score-matched…
Van Houtven, Courtney Harold; Jeffreys, Amy S.; Coffman, Cynthia J.
Because of the development towards community care, care providers not only exchange information in a team, but increasingly also in networks. This is a challenge to confidentiality. The ethical question is how care providers can keep information about the care receiver confidential, whilst at the same time exchanging information about that care receiver in a team or network? Can shared confidentiality be extended from a team to a network? To clarify this question, the article refers to the advice of an expert ethics committee in mental health care. The advice regards exchange of information in a network as a further step in enhancing collaboration among care providers. Therefore, the good and evident practice of shared confidentiality in a team can be extended to a network if the same conditions are met. First, the care providers participate in a clearly defined and identifiable team or network. Secondly, they have a shared care responsibility. Thirdly, they have a duty of confidentiality. Fourth, they dialogue with the care receiver and obtain his or her consent. Finally, they apply the filter of relevance. Hence, conditional shared confidentiality is an ethical justification for the exchange of information in a team or network. PMID:25209901
Liégeois, Axel; Eneman, Marc
Serious deficits in health care education have been identified recently, yet proposed solutions call for faculty skill sets not typically developed in health professional schools or in continuing professional development (CPD) programs. The authors propose that addressing the oft-cited problems in health care education (e.g., it is not learner-centered and does not take advantage of insights gained from the learning sciences) requires faculty to develop "innovator's skills" including the ability to facilitate organizational change. Given increased social responsibilities and decreased financial resources, it is imperative that more health care educators and health care delivery system leaders not only become innovators themselves but also develop systems that support the next generation of innovators. Dyer et al conducted a comprehensive study of successful innovators and found five behavioral and cognitive "discovery" skill sets that constitute the "innovator's DNA": associating, questioning, observing, networking, and experimenting. This article uses the prism of innovator's DNA to examine a CPD program for health care educators, the Harvard Macy Institute (HMI), whose overarching purpose is to develop innovation skills in participants so that they can build their own educational models customized for implementing changes in their home institutions. A retrospective review of HMI alumni from 1995 to 2010 suggests that innovator skills can be taught and applied. The conceptual framework of the innovator's DNA provides a useful model for other CPD program leaders seeking to enable health care educators to develop the capacity for successfully examining problems and then customizing and implementing organizational change to solve them. PMID:23348085
Armstrong, Elizabeth G; Barsion, Sylvia J
Crews and passengers on future long-duration Earth orbital and interplanetary missions must be provided quality health services - to combat illnesses and accidental injuries, and for routine preventive care. People on Earth-orbital missions can be returned relatively easily to Earth, but those on interplanetary missions cannot. Accordingly, crews on long-duration missions will likely include at least one specially trained person, perhaps a physician's assistant, hospital corpsman, nurse, or physician who will be responsible for providing onboard health services. Specifically, we must determine the most effective way to administer health care to a remotely located population. NASA with the cooperation of the Department of Health, Education, and Welfare is pursuing a program for providing health services to remote locations on Earth as a necessary step to developing and verifying this capability on a spacecraft. The STARPAHC program is described.
Pool, Sam L.
Health systems organized in health care networks and coordinated by Primary Health Care can contribute to an improvement in clinical quality with a positive impact on health outcomes and user satisfaction (by improving access and resolubility) and a reduction in the costs of local health systems. Thus, the scope of this paper is to analyze the scientific output about the evidence, potential, challenges and prospects of Primary Health Care in the coordination of Health Care Networks. To achieve this, the integrative review method was selected covering the period between 2000 and 2011. The databases selected were Medline (Medical Literature Analysis and Retrieval System online), Lilacs (Latin American Literature in Health Sciences) and SciELO (Scientific Electronic Library Online). Eighteen articles fulfilled the selection criteria. It was seen that the potential impacts of primary care services supersede the inherent weaknesses. However, the results revealed the need for research with a higher level of classification of the scientific evidence about the role of Primary Healh Care in the coordination of Health Care Networks. PMID:24863811
Rodrigues, Ludmila Barbosa Bandeira; Silva, Patricia Costa Dos Santos; Peruhype, Rarianne Carvalho; Palha, Pedro Fredemir; Popolin, Marcela Paschoal; Crispim, Juliane de Almeida; Pinto, Ione Carvalho; Monroe, Aline Aparecida; Arcêncio, Ricardo Alexandre
The U.S. health care system is currently facing one of its most significant social challenges in decades in terms of its ability to provide access to primary care services to the millions of Americans who have lost their health insurance coverage in the recent economic recession. National statistics compiled by the U.S. Census Bureau for 2009…
Kaplan, Mitchell A.; Inguanzo, Marian M.
The Health Care Reform Tracking Project is a 5-year national project to track and analyze state health care reform initiatives as they affect children and adolescents with emotional/behavioral disorders and their families. The study's first phase was a baseline survey of all 50 states to describe current state reforms as of 1995. Among findings of…
Pires, Sheila A.; Stroul, Beth A.
Context: The Patient Protection and Affordable Care Act (ACA) is changing the landscape of health systems across the United States, as well as the functioning of governmental public health departments. As a result, local health departments are reevaluating their roles, objectives, and the services they provide. Objective: We gathered perspectives on the current and future impact of the ACA on governmental public health departments from leaders of local health departments in the Big Cities Health Coalition, which represents some of the largest local health departments in the country. Design: We conducted interviews with 45 public health officials in 16 participating Big Cities Health Coalition departments. We analyzed data reflecting participants' perspectives on potential changes in programs and services, as well as on challenges and opportunities created by the ACA. Results: Respondents uniformly indicated that they expected ACA to have a positive impact on population health. Most participants expected to conduct more population-oriented activities because of the ACA, but there was no consensus about how the ACA would impact the clinical services that their departments could offer. Local health department leaders suggested that the ACA might create a broad range of opportunities that would support public health as a whole, including expanded insurance coverage for the community, greater opportunity to collaborate with Accountable Care Organizations, increased focus on core public health issues, and increased integration with health care and social services. Conclusions: Leaders of some of the largest health departments in the United States uniformly acknowledged that realignments in funding prompted by the ACA are changing the roles that their offices can play in controlling infectious diseases, providing robust maternal and child health services, and more generally providing a social safety net for health care services in their communities. Health departments will continue to need strong leaders to strengthen and maintain their critical role in protecting and promoting the health of the public they serve. PMID:25423059
Leider, Jonathon P.; Castrucci, Brian C.; Russo, Pamela; Hearne, Shelley
Current and anticipated changes in health care require changes in master's-level nursing education, especially in preparation for health promotion, primary health care, and case management. Questions must be resolved about core knowledge, research preparation, and an appropriate title for advanced practice nurses. (SK)
Long, Kathleen Ann
Training health care professionals to work together in managing the problems of elderly patients is an area where the home health care industry can make a crucialand substantial contribution. Since 1996, Rush Home Care Network, an affiliate agency of Rush-Presbyterian-St. Luke’s Medical Center in Chicago, has served as a clinical training site for an interdisciplinary education program. This program, the
Kathryn Christiansen; Steven K. Rothschild; Lois Halstead
The Military Health Services System is an enormously complex enterprise, consisting of more than 400,000 personnel in the active, reserve, and civilian workforce, operating 148 hospitals and over 800 medical and dental clinics worldwide, and serving nearly 9 million beneficiaries. Expenditures on military health care activities will exceed $15 billion in 1993. Yet many people in leadership positions in government--both inside and outside the Department of Defense--question whether the current organization of the Military Health Services System is appropriate to accomplish the Department's medical missions. Some insiders have observed that having three military medical services is having two too many--that a single "purple" medical service, or at least a single management structure such as a Defense Health Agency, would better meet military mission requirements as the Defense Department undergoes post-Cold War downsizing. One of the most pressing challenges facing military health care managers is how to best organize resources to provide timely access to quality care and achieve economies at a time when civilian health care is itself in turmoil. This article provides a long-awaited update on the spirited debate over the need to reorganize the Military Health Services System--and the prescriptions ordered so far to cure the system's perceived organizational ills. PMID:10127290
Lanier, J O; Boone, C
This article addresses antimicrobial resistance and the threat it poses to an individual’s health and the health care system. Diseases, such as pneumococcus have gained an overabundance of antimicrobial resistance. In addition, previously unknown diseases are surging and sounding alarm bells worldwide. The history and causes of this surge are examined globally. One such cause is the overuse of antibiotics
This book is addressed to anyone involved with or affected by the Acquired Immune Deficiency Syndrome (AIDS) epidemic, including legislators, researchers, health care personnel, insurance providers, educators, health officials, executives in the pharmaceutical industry, blood bank administrators, and other concerned individuals. The following…
Institute of Medicine (NAS), Washington, DC.
....................................................................................................................................................................................... 16 Health Care Is Different -- That's Why Expenditures Matter-sponsored health insurance. We are still on a completely unsustainable path in terms of health expenditure. If youMORE HEALTH CARE REFORM By Victor R. Fuchs #12;2 | MORE HEALTH CARE REFORM The Robert Wood Johnson
Zalta, Edward N.
As major providers and consumers of health care, higher-education institutions have an important role to play in improving health and the nation's health-care system. Health care is a complex issue for colleges and universities. Not only do institutions of higher education provide health insurance to faculty members, staff members, and students,…
Kirch, Darrell G.
Examined health care policies and services for children under 46 state welfare agencies. Found that most states had written policies regarding health care for foster children, but half had no management system to record health care data. Most states did not meet standards set by the Child Welfare League of America for health care of these…
Risley-Curtiss, Christina; Kronenfeld, Jennie Jacobs
... Kidney Disease Additional Kidney Information Talking with Your Health Care Professionals The most important person on your health ... if you already have it. Tips for Your Health Care Visits Be prepared. The more you plan for ...
... Information Clinical Trials Resources and Publications How do health care providers diagnose birth defects? Skip sharing on social ... to begin before health problems occur. Prenatal Screening Health care providers recommend that certain pregnant women, including those ...
This Article examines current tort remedies for personal injury claims and explores the problems that arise when these remedies are applied to physicians' actions that are directed by third-party payers. Part II of this Article explores the organization and historical development of managed health care products. Part III considers the past and present uses of the utilization review process and
Vernellia R. Randall
... degree in social work (M.S.W.); Licensed Clinical Social Workers (L.C.S.W.) have additional supervised training and clinical work experience. Licensed Professional Counselor: Master’s degree in psychology, counseling or a related field. Mental Health Counselor: ...
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. PMID:25183607
, and Director, Health Network, Canadian Policy Research Networks, Toronto, Ontario, Canada. Henry Mintzberg, Ph to the many thoughtful people in the English system, including those of the King's Fund, who participated group in the Netherlands, Richard Higgins, Richard James, Anton Obholzer and members of the TMP Learning
and the California CABG Outcomes Reporting Program (CCORP, a mandatory reporting program with 121 and 120 hospitals contribute during the voluntary program. r Health Research and Educational Trust DOI: 10.1111/j.1475 mandatory CABG surgery reporting program. Key Words. VolumeÂoutcome relationship, coronary artery bypass
Rocke, David M.
Objective: This study examined citation patterns and indexing coverage from 2008 to 2010 to determine (1) the core literature of health care chaplaincy and (2) the resources providing optimum coverage for the literature. Methods: Citations from three source journals (2008–2010 inclusive) were collected and analyzed according to the protocol created for the Mapping the Literature of Allied Health Professions Project. An analysis of indexing coverage by five databases was conducted. A secondary analysis of self-citations by source journals was also conducted. Results: The 3 source journals—Chaplaincy Today, the Journal of Health Care Chaplaincy, and the Journal of Pastoral Care and Counseling—ranked as the top 3 journals in Zone 1 and provided the highest number of most frequently cited articles for health care chaplaincy. Additional journals that appeared in this highly productive zone covered the disciplines of medicine, psychology, nursing, and religion, which were also represented in the Zones 2 and 3 journals. None of the databases provided complete coverage for the core journals; however, MEDLINE provided the most comprehensive coverage for journals in Zones 1 and 2, followed by Academic Search Complete, CINAHL, PsycINFO, and ATLA. Self-citations for the source journals ranged from 9% to 16%. Conclusions: Health care chaplaincy draws from a diverse body of inter-professional literature. Libraries wishing to provide access to journal literature to support health care chaplaincy at their institutions will be best able to do this by subscribing to databases and journals that cover medical, psychological, nursing, and religion- or spirituality-focused disciplines. PMID:23930090
Johnson, Emily; Dodd-McCue, Diane; Tartaglia, Alexander; McDaniel, Jennifer
This paper provides an introduction to Geographical Information Systems (GIS) and how they can be used. It reviews the current state of GIS use in health care before identifying the barriers to more pervasive use of GIS in health. Finally, it makes recommendations for the direction of health GIS research over the next decade and concludes with a call to action to health informatics researchers to stop ignoring a tool and methodology that has such immense potential for improving the health of our communities. PMID:22844644
Health care systems are under increasing pressure to cope with shifting demographics, the threat of chronic and noncommunicable disease, and rising health care costs. The uptake of innovations to meet these challenges and to advance medicine and health care delivery is not as rapid as the pace of change. Greater emphasis on the diffusion of innovation and greater understanding of the structural and organizational levers that can be used to facilitate systemwide improvement are essential. This article describes the results of a qualitative and quantitative study to assess the factors and behaviors that foster the adoption of health care innovation in eight countries: Australia, Brazil, England, India, Qatar, South Africa, Spain, and the United States. It describes the front-line cultural dynamics that must be fostered to achieve cost-effective and high-impact transformation of health care, and it argues that there is a necessity for greater focus on vital, yet currently underused, organizational action to support the adoption of innovation. PMID:25201655
Keown, Oliver P; Parston, Greg; Patel, Hannah; Rennie, Fiona; Saoud, Fathy; Al Kuwari, Hanan; Darzi, Ara
This work presents a development approach for mixed reality systems in health care. Although health-care service costs account for 5-15% of GDP in developed countries the sector has been remarkably resistant to the introduction of technology-supported optimizations. Digitalization of data storing and processing in the form of electronic patient records (EPR) and hospital information systems (HIS) is a first necessary step. Contrary to typical business functions (e.g., accounting or CRM) a health-care service is characterized by a knowledge intensive decision process and usage of specialized devices ranging from stethoscopes to complex surgical systems. Mixed reality systems can help fill the gap between highly patient-specific health-care services that need a variety of technical resources on the one side and the streamlined process flow that typical process supporting information systems expect on the other side. To achieve this task, we present a development approach that includes an evaluation of existing tasks and processes within the health-care service and the information systems that currently support the service, as well as identification of decision paths and actions that can benefit from mixed reality systems. The result is a mixed reality system that allows a clinician to monitor the elements of the physical world and to blend them with virtual information provided by the systems. He or she can also plan and schedule treatments and operations in the digital world depending on status information from this mixed reality.
We study gatekeeping physicians' referrals of patients to specialty care. We derive theoretical results when competition in the physician market intensifies. First, due to competitive pressure, physicians refer patients to specialty care more often. Second, physicians earn more by treating patients themselves, so refer patients to specialty care less often. We assess empirically the overall effect of competition with data from a 2008-2009 Norwegian survey, National Health Insurance Administration, and Statistics Norway. From the data we construct three measures of competition: the number of open primary physician practices with and without population adjustment, and the Herfindahl-Hirschman index. The empirical results suggest that competition has negligible or small positive effects on referrals overall. Our results do not support the policy claim that increasing the number of primary care physicians reduces secondary care. PMID:25544400
Godager, Geir; Iversen, Tor; Ma, Ching-To Albert
Context Massachusetts enacted health care reform in 2006 to expand insurance coverage and improve access to health care. The objective of our study was to compare trends in health status and the use of ambulatory health services before and after the implementation of health reform in Massachusetts relative to that in other New England states. Methods We used a quasi-experimental design with data from the Behavioral Risk Factor Surveillance System from 2001 to 2011 to compare trends associated with health reform in Massachusetts relative to that in other New England states. We compared self-reported health and the use of preventive services using multivariate logistic regression with difference-in-differences analysis to account for temporal trends. We estimated predicted probabilities and changes in these probabilities to gauge the differential effects between Massachusetts and other New England states. Finally, we conducted subgroup analysis to assess the differential changes by income and race/ethnicity. Findings The sample included 345,211 adults aged eighteen to sixty-four. In comparing the periods before and after health care reform relative to those in other New England states, we found that Massachusetts residents reported greater improvements in general health (1.7%), physical health (1.3%), and mental health (1.5%). Massachusetts residents also reported significant relative increases in rates of Pap screening (2.3%), colonoscopy (5.5%), and cholesterol testing (1.4%). Adults in Massachusetts households that earned up to 300% of the federal poverty level gained more in health status than did those above that level, with differential changes ranging from 0.2% to 1.3%. Relative gains in health status were comparable among white, black, and Hispanic residents in Massachusetts. Conclusions Health care reform in Massachusetts was associated with improved health status and the greater use of some preventive services relative to those in other New England states, particularly among low-income households. These findings may stem from expanded insurance coverage as well as innovations in health care delivery that accelerated after health reform. PMID:24320165
van der Wees, Philip J; Zaslavsky, Alan M; Ayanian, John Z
As energy expenditures continue their dramatic rise in the health-care industry, they absorb a larger portion of hospital budgets and prompt managers to seek ways to conserve energy and reduce consumption. Hospital managers, however, may be forced by capital constraints to choose between medical and energy conservation investments. The author examines some of the issues (including fairness, legal and financial impediments, and medical practices) involved in reducing health care costs. He makes practical suggestions for improving facility efficiency that include a strategy for energy management and a checklist of ideas. The case histories of 25 medical facilities illustrate conservation opportunities. 18 references, 34 figures, 3 tables. (DCK)
Hunt, V.D. (comp.)
This selective review describes recent literature and the author's experience with mental illness and mental health care, and the impact of cultural transformation on mental health in some Arab Islamic cultures, particularly in Egypt, Qatar and Kuwait. Traditional extended Arab families provide a structure for their members that may sometimes prevent and or compensate for the effects of parental loss and mental disability. The role of traditional families in the care of members and in medical decision-making is discussed. The impact of cultural change on Arab culture is also examined, as is the effect of intergenerational conflict in traditional families. PMID:19091731
Fakhr El-Islam, M
It is important to understand the needs of those veterans who are homeless. We describe characteristics of homeless male veterans\\u000a and factors associated with needing VA benefits from a two-city, community survey of 531 homeless adults. Overall, 425 were\\u000a male, of whom 127 were veterans (29.9%). Significantly more veterans had a chronic medical condition and two or more mental\\u000a health
Thomas P. O’Toole; Alicia Conde-Martel; Jeanette L. Gibbon; Barbara H. Hanusa; Michael J. Fine
This paper presents a new method for modeling health impacts caused by earthquake damage which allows for integrating key social impacts on individual health and health-care systems and for implementing these impacts in quantitative systemic seismic vulnerability analysis. In current earthquake casualty estimation models, demand on health-care systems is estimated by quantifying the number of fatalities and severity of injuries based on empirical data correlating building damage with casualties. The expected number of injured people (sorted by priorities of emergency treatment) is combined together with post-earthquake reduction of functionality of health-care facilities such as hospitals to estimate the impact on healthcare systems. The aim here is to extend these models by developing a combined engineering and social science approach. Although social vulnerability is recognized as a key component for the consequences of disasters, social vulnerability as such, is seldom linked to common formal and quantitative seismic loss estimates of injured people which provide direct impact on emergency health care services. Yet, there is a consensus that factors which affect vulnerability and post-earthquake health of at-risk populations include demographic characteristics such as age, education, occupation and employment and that these factors can aggravate health impacts further. Similarly, there are different social influences on the performance of health care systems after an earthquake both on an individual as well as on an institutional level. To link social impacts of health and health-care services to a systemic seismic vulnerability analysis, a conceptual model of social impacts of earthquakes on health and the health care systems has been developed. We identified and tested appropriate social indicators for individual health impacts and for health care impacts based on literature research, using available European statistical data. The results will be used to develop a socio-physical model of systemic seismic vulnerability that enhances the further understanding of societal seismic risk by taking into account social vulnerability impacts for health and health-care system, shelter, and transportation.
Kunz-Plapp, T.; Khazai, B.; Daniell, J. E.
In most settings, a 'public' health service refers to a service which belongs to the state. The term 'private' is used when health care is delivered by individuals and/or institutions not administered by the state. In this paper it is argued that such a distinction, which is based on the institutional or administrative identity of the health care provider, is not adequate because it takes for granted that the nature of this identity automatically determines the nature of the service delivered to the population. A different frame of classification between public and private health services is proposed: one which is based on the purpose the health service pursues and on the outputs it yields. A set of five operational criteria to distinguish between health services guided by a public or private purpose is presented. This alternative classification is discussed in relation to a variety of existing situations in sub-Saharan Africa (Mali, Uganda, Zimbabwe). It is hoped that it can be used as a tool in the hands of the health planner in order to bring more rationality in the current altercation between the public and the private health care sector. PMID:10173400
Giusti, D; Criel, B; De Béthune, X
As health policy emphasizes the use of private sector mechanisms to pursue public sector goals, health services research needs to develop stronger conceptual frameworks for the interpretation of empirical studies of health care markets and organizations. Organizational relationships should not be interpreted exclusively in terms of competition among providers of similar services but also in terms of relationships among providers of substitute and complementary services and in terms of upstream suppliers and downstream distributors. This article illustrates the potential applicability of transactions cost economics, agency theory, and organizational economics more broadly to horizontal and vertical markets in health care. Examples are derived from organizational integration between physicians and hospitals and organizational conversions from nonprofit to for-profit ownership. PMID:11327173
Robinson, J C
Contraception, cervical cancer screening, human papillomavirus (HPV) vaccination, sexually transmitted infection (STI) screening, and menstrual disorders are issues that need to be addressed in all reproductive-aged women, including those with a history of solid organ transplantation. There are specific considerations that may alter routine care in this population. Due to teratogenic immunosuppressive medications, highly effective contraception is important to planning or appropriately timing pregnancy. Estrogen-containing methods (pill, patch, and ring) may be contraindicated. Immunosuppression is also a consideration when screening for and treating STIs including precancerous conditions of the cervix. This chapter will provide a framework to address the specific gynecologic needs of women with a history of solid organ transplantation. PMID:25450188
Krajewski, Colleen; Sucato, Gina
The need for alternative strategies in providing personal health services in the community is discussed in relation to Israel, which has a widespread network of community-based curative clinics and preventive family health centers. Community-oriented primary health care (C-OPHC) is the major alternative strategy, which has been developed and evaluated by the Hadassah Teaching and Research Health Center in Kiryat Hayovel, a neighborhood of Jerusalem. The case for adapting this C-OPHC approach throughout the country is presented in a review of existing primary health care services. PMID:6885360
Kark, S L; Kark, E
In this article, the author presents an update of Herman's article ["Changes in Patterns of Health Care," "School Health Review," 1(9-14)1969] that focuses on the changes in patterns of health care. He discusses the poverty, insurance, and access to medical care as well as the quality of medical care for adults and minors. He stresses that…
Sofalvi, Alan J.
Purpose: The purpose of this pilot study was to determine the reasons for which migrant agricultural workers in Pennsylvania seek health care. Methods: Participants were individuals 14 years of age and over, actively involved in agricultural labor and presenting for medical care at 6 migrant health care centers. Bilingual health care providers…
Henning, George F.; Graybill, Marie; George, John
Discusses the impact of health care reform on child-care centers and child-care employees. Topics covered include requirements to provide health insurance for all employees; subsidies for businesses with fewer than 50 employees; subsidies for low income employees; family coverage; health are costs for 2 working parents; and costs to day-care…
Data are presented describing expenditures for personal health services in Michigan from 1977 to 1981. The rapid growth in expenditures is illustrated, as well as the rates of growth in expenditures, for major categories of health services. Personal health expenditures are defined as payments for care directly provided to patients: specifically,…
Michigan State Office of Health and Medical Affairs, Lansing.
Smartphone use in health care work settings presents both opportunities and challenges. The benefits could be severely undermined if abuse and overuse are not kept in check. This practice-focused research paper examines the current panorama of health software applications. Findings from existing research are consolidated to elucidate the level and effects of distraction in health care work settings due to smartphone use. A conceptual framework for crafting guidelines to regulate the use of smartphones in health care work settings is then presented. Finally, specific guidelines are delineated to assist in creating policies for the use of smartphones in a health care workplace. PMID:22969308
Gill, Preetinder S; Kamath, Ashwini; Gill, Tejkaran S
Abstract United States health care is engaged in an ambitious project to make its clinical and administrative records “100% electronic.” Substantial benefits are expected in both clinical care delivery and medical research (especially for public health surveillance and outcomes/effectiveness studies). Substantial costs also potentially accrue, beyond the large outlays for an expanded computer and telecommunications infrastructure. Privacy and confidentiality are obviously at risk if such systems cannot be made secure. Limited empirical evidence currently available suggests health information systems security may not be very good, at least in the “average” institutional setting. Privacy-focused critics of electronic record-keeping are sometimes accused of taking Luddite stands, insufficiently attentive to IT's benefits. It may also be fair to worry about a certain Panglossian tendency in “industry” commentary, insufficiently attentive to potential problems. Better federal and state laws structuring health data use will help; the industry must also attend more candidly to the technical uncertainties. PMID:9223032
Health care and today's medical and technical achievements and approved standards of treatment provide comprehensive quality, safety and traceability of medical procedures respecting the principles of health protection. Continuous education improves the quality of nursing health care and increases the effectiveness of patient care, consequently maintaining and enhancing patient safety. Patient health problems impose the need of appropriate, planned and timely nursing care and treatment. In providing quality nursing care, attention is focused on the patient and his/her needs in order to maintain and increase their safety, satisfaction, independence and recovery or peaceful death, so the health and nursing practices must be systematized, planned and based on knowledge and experience. Health and nursing care of patients at risk of developing acute and chronic wounds or already suffering from some form of this imply preventive measures that are provided through patient education, motivation, monitoring, early recognition of risk factors and causes, and reducing or removing them through the prescribed necessary medical treatment which is safe depending on the patient health status. Except for preventive measures, nursing care of patients who already suffer from some form of acute or chronic wounds is focused on the care and treatment of damaged tissue by providing appropriate and timely diagnosis, timely and proper evaluation of the wound and patient general status, knowledge and understanding of the wide range of local, oral and parenteral therapy and treatment, aiming to increase patient safety by preventing progression of the patient general condition and local wound status and reducing the possibility of developing infection or other complications of the underlying disease. In the overall patient management, through nursing process, medical interventions are implemented and aimed to maintain and optimize health status, prevent complications of existing diseases and conditions, provide appropriate wound treatment, increase satisfaction, reduce pain, increase mobility, reduce and eliminate aggravating factors, and achieve a satisfactory functional and aesthetic outcome. Many scientific researches and knowledge about the pathophysiological processes of wound formation and healing are currently available. Modern achievements can accelerate independence, reduce pain and encourage faster wound healing, thus it is important to continuously develop awareness, knowledge and experience, along with the treatment to achieve, maintain and enhance the quality of health care and patient safety. PMID:25326985
Fumi?, Nera; Marinovi?, Marin; Brajan, Dolores
The Interactive Telemedicine Systems (ITS) system was specifically developed to address the ever widening gap between our medical care expertise and our medical care delivery system. The frustrating reality is that as our knowledge of how to diagnose and treat medical conditions has continued to advance, the system to deliver that care has remained in an embryonic stage. This has resulted in millions of people being denied their most basic health care needs. Telemedicine utilizes an interactive video system integrated with biomedical telemetry that allows a physician at a base station specialty medical complex or teaching hospital to examine and treat a patient at multiple satellite locations, such as rural hospitals, ambulatory health centers, correctional institutions, facilities caring for the elderly, community hospital emergency departments, or international health facilities. Based on the interactive nature of the system design, the consulting physician at the base station can do a complete history and physical examination, as if the patient at the satellite site was sitting in the physician's office. This system is described.
Sanders, Jay H.
Young and healthy undergraduates in health education were not predisposed to learn the complex sprawl of topics in a required course on U.S. Health Care. An online simulation of health care reform was used to encourage student learning about health care and participating in health care reform. Students applied their understanding of high costs,…
This paper reveals the dynamics of hierarchical medical pluralism through a comparative analysis of the health care systems in three Chinese societies (the China mainland, Taiwan and Hong Kong). It is argued that the hierarchical relationships among medical traditions within a national society should be studied in terms of structural superiority (power, prestige and wealth) and functional strength (distribution and
Rance P. L. Lee
Blue Shield of California recognized it could realize business gains by implementing solutions that would streamline health care administration. It began looking for opportunities to apply the Internet to the core business and defining which of those services would benefit quickly from implementation. It selected Internet technology from Healtheon Corp., a Silicon Valley startup in Palo Alto, California. PMID:10177285
This research focused on the mental health issues at adult day centers and used a cluster analysis to profile older persons who received these services. The sample included 280 participants who attended adult day care. The data were collected from intake files using a biopsychosocial framework to guide the selection of variables from January 1, 1999 to December 31, 2000.
Virginia E Richardson; Holly Dabelko; Tom Gregoire
The health care industry operates in the margin between market competition and social welfare programs. Violations of business ethics on the market side add considerably to costs. When the inefficient use of resources and market distortions due to power and ignorance as well as legal and subsidized monopolies are added, increased costs can approach $100 billion. Modest remedies are suggested. PMID:8282546
Garrett, T M; Klonoski, R J; Baillie, H W
This instructor's guide contains 65 lessons designed to aid teachers in presenting a course in basic nursing procedures for students studying for careers as health care assistants. Lesson plans consist of a scope, objectives, suggested supplementary teaching and learning items; references, an introduction, a lesson outline, handouts, evaluation…
Missouri Univ., Columbia. Instructional Materials Lab.
Designed for use in community colleges, technical colleges, and technical institutes, this manual contains a course for teaching emergency care skills to both licensed practical and registered nurses employed in occupational health. The manual consists of three sections. In section 1 the need for the course, its content, objectives, length,…
North Carolina State Dept. of Community Colleges, Raleigh. Occupational Information Center.
This paper describes a project redesigning psychiatric services for children and adolescents, introducing a new decentralized model into the ordinary structures of health care services in Finnmark, the northernmost county of Norway, using mobile phone technology. We apply a design perspective which can help us to focus on the notion of microstructure of design that includes task, design, and artifact
Synnøve Thomassen Andersen; Arild Jansen
Nursing faces new opportunities and challenges as part ofthe government's initiative to introduce Payment by Results. These opportunities arise from increasing demands to work effectively in an environment of intensive customer demand and expectation. The challenge for all nurses is to continue to deliver quality health care while keeping pace with changes to services and organisational responsiveness. I t is
Paul Linsley; John Hurley
The aim of this paper is to measure and to correct for the potential incomparability of responses to the SHARE survey on health care responsiveness. A parametric approach based on the use of anchoring vignettes is applied to cross-sectional data (2006-2007) in eleven European countries. More than 7,000 respondents aged 50 years old and over were…
Sirven, Nicolas; Santos-Eggimann, Brigitte; Spagnoli, Jacques
At our University, the Faculty of Health, Social Care and Education has delivered a variety of undergraduate and postgraduate courses via flexible distance learning for many years. Distance learning can be a lonely experience for students who may feel isolated and unsupported. However e-learning provides an opportunity to use technology to…
Physician migration is a complex and multifaceted phenomenon that is intimately intertwined with medical education. Imbalances in the production of physicians lead to workforce shortages and surpluses that compromise the ability to deliver adequate and equitable health care to large parts of the world's population. In this overview, we address a…
Norcini, John J.; Mazmanian, Paul E.
The lead article discusses the results of a series of experiments in rural Alaska in which telemedicine was used to improve the delivery of health care to isolated populations. The author, Dennis Foote, also discusses the implications of these experiments for planning telemedicine systems in other areas. Satellite communication and a centralized…
Development Communication Report, 1977
April 1, 2012 (or on site registration available) Physician Medical Resident Nurse Practitioner3rd Annual Ethics in Health Care: Perspectives and Applications Taking Your Pulse: Coping Panel Discussion and Case Study Tuesday, May 1, 2012 8:30 am--12:00 noon Virginia Mason Medical Center
Egypt and Cuba are both lower-middle income countries with a history of socialist rule, which have embarked on economic liberalization since the 1990s. Cuba has achieved exemplary health status whereas health status in Egypt is lower than could be expected for its level of income. In this article, health care financing mechanisms in both countries are analysed on their effectiveness, efficiency, and equity, with the objective of identifying the determinants of success in the Cuban health system from which valuable lessons for current health reforms in Egypt may be derived. PMID:16761679
Gericke, C A
International cancer care efforts are focusing increasingly on why cancer typically is diagnosed at later stages in the developing world. In Middle Eastern countries, cancer usually is diagnosed at a more advanced stage of disease. For example, in Palestine, 42% of cases were reported stage III and 18% were stage IV. Receiving a cancer diagnosis and seeking treatment is influenced by cultural values and how the community views cancer. Healthcare providers need to understand the disparities and the influence of those disparities on health outcomes. This article is constructed using the Culture Care Theory,which depicts the importance of culture on the health behavior of the individual, and will focus on how cultural values of Palestinian patients with cancer and their families affect attitudes toward and decisions about cancer care. PMID:21624863
Saca-Hazboun, Hanan; Glennon, Catherine A
Limited physical access to primary health care is a major factor contributing to the poor health of populations in developing countries, particularly in mountain areas with rugged topography, harsh climates and extensive socioeconomic barriers. Assessing physical access to primary health care is an important exercise for health care planners and policy makers. The development of geographic information system (GIS) technology
Baker Perry; Wil Gesler
Health plans paid by capitation have an incentive to distort the quality of services they offer to attract profitable and to deter unprofitable enrollees. We characterize plans' rationing as a "shadow price" on access to various areas of care and show how the profit maximizing shadow price depends on the dispersion in health costs, individuals' forecasts of their health costs, the correlation between use in different illness categories, and the risk adjustment system used for payment. These factors are combined in an empirically implementable index that can be used to identify the services that will be most distorted by selection incentives. PMID:11186848
Frank, R G; Glazer, J; McGuire, T G
Discussions of health care delivery and payment reforms have largely been silent about how behavioral health could be incorporated into reform initiatives. This paper draws attention to four patient populations defined by the severity of their behavioral health conditions and insurance status. It discusses the potentials and limitations of three prominent models promoted by the Affordable Care Act to serve populations with behavioral health conditions: the Patient Centered Medical Home, the Health Home initiative within Medicaid, and the Accountable Care Organization. To incorporate behavioral health into health reform, policymakers and practitioners may consider embedding in the reform efforts explicit tools – accountability measures and payment designs – to improve access to and quality of care for patients with behavioral health needs. PMID:23188486
Bao, Yuhua; Casalino, Lawrence P.; Pincus, Harold Alan
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. PMID:22235150
A health care revolution is under way, and doctors must be part of it. But many are deeply anxious and angry about the transformation, fearing loss of autonomy, respect, and income. Given their resistance, how can health system Leaders engage them in redesigning care? In this article, Dr. Thomas H. Lee, Press Ganey's chief medical officer, and Dr. Toby Cosgrove, the CEO of the Cleveland Clinic, describe a framework they've developed for encouraging buy-in. Adapting Max Weber's "typology of motives," and applying behavioral economics and other motivational principles, they describe four tactics leadership must apply in concert: engaging doctors in a noble shared purpose; addressing their economic self-interest; leveraging their desire for respect; and appealing to their sense of tradition. Drawing from experiences at the Mayo Clinic, Geisinger Health System, Partners HealthCare, the Cleveland Clinic, Ascension Health, and others, the authors show how the four motivational levers work together to bring this critical group of stakeholders on board. PMID:25051859
Lee, Thomas H; Cosgrove, Toby
The Johns Hopkins University's Bloomberg School of Public Health has participated in the OpenCourseWare program for a number of years, and this course is one of their most recent offerings. Created by Henry Taylor and Henry Perry, these course materials introduce "students to the origins, concepts, and development of community-based primary health care through case studies from both developing and developed countries." On this course site, visitors can read through the syllabus, examine the course schedule, and look over the lecture materials. In the lecture materials area, visitors will find lecture slides and their corresponding audio files. Some of the topics covered here include the roots of community-based primary health care and women's empowerment in Afghanistan. Finally, visitors can check out some of the course readings, which are offered in the pdf format.
The amount of health care data in our world has been exploding, and the ability to store, aggregate, and combine data and then use the results to perform deep analyses have become ever more important. "Big data," large pools of data that can be captured, communicated, aggregated, stored, and analyzed, are now part of every sector and function of the global economy. While most research into big data thus far has focused on the question of their volume, there is evidence that the business and economic possibilities of big data and their wider implications are important for consideration. It is even offering the possibility that health care data could become the most valuable asset over the next 5 years as "secondary use" of electronic health record data takes off. PMID:23454988
Harper, Ellen M
This study examines the impact of major health insurance reform on payments made in the health care sector. We study the prices of services paid to physicians in the privately insured market during the Massachusetts health care reform. The reform increased the number of insured individuals as well as introduced an online marketplace where insurers compete. We estimate that, over the reform period, physician payments increased at least 11 percentage points relative to control areas. Payment increases began around the time legislation passed the House and Senate-the period in which their was a high probability of the bill eventually becoming law. This result is consistent with fixed-duration payment contracts being negotiated in anticipation of future demand and competition. PMID:25497755
Dunn, Abe; Shapiro, Adam Hale
Although debate continues over estimates of the amount of preventable medical harm that occurs in health care, there seems to be a consensus that health care is not as safe and reliable as it might be. It is often assumed that copying and adapting the success stories of nonmedical industries, such as civil aviation and nuclear power, will make medicine as safe as these industries. However, the solution is not that simple. This article explains why a benchmarking approach to safety in high-risk industries is needed to help translate lessons so that they are usable and long lasting in health care. The most important difference among industries lies not so much in the pertinent safety toolkit, which is similar for most industries, but in an industry's willingness to abandon historical and cultural precedents and beliefs that are linked to performance and autonomy, in a constant drive toward a culture of safety. Five successive systemic barriers currently prevent health care from becoming an ultrasafe industrial system: the need to limit the discretion of workers, the need to reduce worker autonomy, the need to make the transition from a craftsmanship mindset to that of equivalent actors, the need for system-level (senior leadership) arbitration to optimize safety strategies, and the need for simplification. Finally, health care must overcome 3 unique problems: a wide range of risk among medical specialties, difficulty in defining medical error, and various structural constraints (such as public demand, teaching role, and chronic shortage of staff). Without such a framework to guide development, ongoing efforts to improve safety by adopting the safety strategies of other industries may yield reduced dividends. Rapid progress is possible only if the health care industry is willing to address these structural constraints needed to overcome the 5 barriers to ultrasafe performance. PMID:15867408
Amalberti, René; Auroy, Yves; Berwick, Don; Barach, Paul
In this contribution we will look at how the traditional European social security conventions shape the fundamental right to health care. As to the instruments under investigation we focus upon the regional agreements that have been enacted within the framework of the Council of Europe. More specifically we will discuss how the (Revised) Social Charter and the minimum standard setting instrument (Code) give expression to the right to access to health care. This overview is then complemented by an analysis of recent case law of the European Court of Human Rights. The latter Court is indeed increasingly screening the national social security rules on their compatibility with the fundamental rights, as they are enshrined in the European Convention on Human Rights. Hence we will dwell upon the potential impact of this case law on the right to access health care. In the conclusions we will compare the three instruments regarding their legal interpretation of the right to health care. PMID:19004379
This study assessed the usefulness and relevance of the information, which had been provided by the Ministry of Health for use in community health centers. Furthermore, this identified the needs of health professionals in terms of relevant information for providing health care to the elderly in the community health centers. A total of 105 questionnaires were administered to 35 doctors and 70 health care workers. The overall response rate of the 105 questionnaires sent out was 80%. Findings revealed that the overall opinion expressed by the health professionals was that the information leaflets, in general, were good. However, some gaps existed between the information provided by the Ministry of Health and the information needs perceived by health professionals working in community health centers for providing health care to the elderly. The majority commented that pertinent information on health problems related to hypertension, arthritis, and heart disease needed to be added. Furthermore, effective pre-testing of the prepared information materials with the target groups before their production and distribution may lessen such gaps or deficiencies. Recommendations to ensure appropriate information are also given and presented in this article. PMID:12322445
Sakti, G M; Boldy, D P
Purpose. This article describes a project undertaken as part of the Organization for Economic Co-operation and Development (OECD)'s Healthcare Quality Indicator (HCQI) Project, which aimed to develop a set of quality indicators representing the domains of primary care, prevention and health promotion, and which could be used to assess the performance of primary care systems. Methods. Existing quality indicators from
MARTIN MARSHALL; NIEK KLAZINGA; SHEILA LEATHERMAN; CHARLIE HARDY; ECKHARD BERGMANN; LUIS PISCO; SOEREN MATTKE; JAN MAINZ
Background: The use of regular mental health care by migrant groups in the Netherlands nowadays is on a level comparable with that of indigenous Dutch citizens. However, when need is taken into\\u000aaccount, there is still a gap between migrant groups and indigenous citizens. As migrants tend to use other sources of care, such as (religious) healers or other practitioners
G. T. Koopmans; M. Foets; W. Devillé
The author conducted a field study in 1993 to evaluate the effectiveness of four projects that were training traditional health practitioners (THPs) to provide primary health care (PHC) services in Ghana, Mexico, and Bangladesh. The study, funded by a grant from the World Health Organization, Division of Strengthening Health Services, concluded that incorporating trained THPs in PHC programmes can be cost effective in providing essential and culturally relevant health services to communities. The main objective of the study was to evaluate how effective the training projects were and to determine what impacts they might have upon the communities served. A qualitative field evaluation was performed using data collected from project documents, observations, and field interviews with a selection of health agency staff, THPs, and community members. A summary of results is presented from the four field studies. For details refer to the full report. PMID:9204727
One-third of U. S. adults do not have adequate health literacy to manage their health care needs; and low health literacy is a major concern due to its association with poor health outcomes, high health care costs, and health communication problems. Low health literacy is a potential driver of health disparities, and its alleviation is central to…
Liechty, Janet M.
Background: Until date, the importance of maternal health care services in reducing maternal mortality and morbidity has received a significant recognition. Most of the maternal deaths can be prevented if women have access to basic antenatal, natal and postnatal care. However, uptake of maternal health care services is far from universal even in settings where they are extensively available. Aim: The aim of this study is to assess the pattern and identify underlying factors on maternal health care utilization in rural areas of Bareilly. Subjects and Methods: This was a cross-sectional study was conducted during June-December 2011. Six villages were selected by convenience out of 99 villages in Bhojipura Block of Bareilly district, Uttar Pradesh to cover maximum number of women. All currently married women aged between 15 and 49 years who had delivered a child within last 1 year were interviewed by house-to-house survey and comprised the study unit. Their socioeconomic and demographic characteristics, reproductive history and knowledge of specific obstetric complications were taken. The information was gathered on various aspects of maternal-care utilization. In analyzing data, both bivariate and multivariate analyses were employed, using the Microsoft Excel and SPSS for Windows, Version 15.0 (SPSS Inc., Chicago, Illinois,USA). Results: Most (88.6%; 343/387) of pregnancies had registration for antenatal care (ANC). Majority (69.7%; 239/343) of them were registered between 16 and 24 weeks. Only 28.5% (110/343) of women received ANC from a private doctor. Maternal health care service utilization from health personnel was significantly associated with age at marriage ?18 years, family size ?3, birth order ?2, nuclear family and higher socio-economic status. Most of the pregnancy related complications were found among women aged >30 years, with birth order ?3, having birth interval <24 months, among Muslims, working mothers and among those belonging to joint family. Mother's education and husband's occupation were found to be strong predictors for the utilization of maternal health care using the logistic regression. Conclusion: Utilization of maternal health care services is high. However this can be improved by community based education program. PMID:24971219
Srivastava, A; Mahmood, SE; Mishra, P; Shrotriya, VP
Healthcare-associated infections are an important cause of morbidity and mortality among hospitalized patients worldwide. Transmission of health care associated pathogens generally occurs via the contaminated hands of health care workers. Hand hygiene has long been considered one of the most important infection control measures to prevent health care-associated infections. For generations, hand washing with soap and water has been considered a measure of personal hygiene. As early as 1822, a French pharmacist demonstrated that solutions containing chlorides of lime or soda could eradicate the foul odor associated with human corpses and that such solutions could be used as disinfectants and antiseptics. This paper provides a comprehensive review of data regarding hand washing and hand antisepsis in healthcare settings. In addition, it provides specific recommendations to uphold improved hand-hygiene practices and reduce transmission of pathogenic microorganisms to patients and personnel in healthcare settings. This article also makes recommendations and suggests the significance of hand health hygiene in infection control. PMID:20427920
Mani, Ameet; Shubangi, A M; Saini, Rajiv
The global population has now exceeded 7 billion, and forests and other resources around the world are being irreversibly depleted for energy, food, shelter, material goods, and drugs to accommodate population needs. For most of the world's population, plants, based on many well-established systems of medicine, in either crude or extract form, represent the foundation of primary health care for the foreseeable future. Contemporary harvesting methods for medicinal plants are severely depleting these critical indigenous resources. However, maintaining and enhancing the availability of quality medicinal agents on a sustainable basis is an unappreciated public health care concept. To accomplish these goals for future health care, and restore the health of the Earth, a profound paradigm shift is necessary: ALL medicinal agents should be regarded as a sustainable commodity, irrespective of their source. Several approaches to enhancing the availability of safe and efficacious plant-based medicinal agents will be presented including integrated strategies to manifest the four pillars (information, botany, chemistry, and biology) for medicinal plant quality control. These integrated initiatives involve information systems, DNA barcoding, metabolomics, biotechnology, nanotechnology, in-field analysis of medicinal plants, and the application of new detection techniques for the development of medicinal plants with enhanced levels of safe and reproducible biological agents. PMID:21308611
Cordell, Geoffrey A
Addressed especially to community pediatricians, but also useful to other health workers, this manual discusses aspects of day care that require a physician's attention. Chapter I historically traces the positive effect of a nurturing environment upon the development of the infant and child, covering the period from the early 1900s to the present.…
Deitch, Selma R., Ed.
Mexican Americans differ from Anglo Americans in their types of health problems, relation to the American health care system, and responses to health care. Mexican Americans tend to underutilize available health resources because of fear of discrimination, perception of health workers as government representatives, and language and cultural…
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... Information Clinical Trials Resources and Publications How do health care providers diagnose osteogenesis imperfecta (OI)? Skip sharing on ... Page Content If OI is moderate or severe, health care providers usually diagnose it during prenatal ultrasound at ...
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Discusses inevitability of health care reform in United States, considers the reform process itself, and explains the plan of the President's Task Force on National Health Care Reform. Also considers the prospects for Congressional response to reform proposals. (NB)
Keigher, Sharon M.
...under this subpart. (b) Determination of health care provider eligibility for the Healthcare Connect Fund. Health care providers in the Healthcare Connect Fund may certify to the eligibility of particular sites at any time...
Health Care Reform: What School Mental Health Professionals Need to Know On March 23, 2010, President Obama signed comprehensive health care reform, the Patient Protection and Affordable Care Act (ACA), into law (P.L. 111-148). This major reform to health care certainly has had and will continue to have
Weber, David J.
This article provides an overview of the current Chinese health care system with particular emphasis on rural-urban differences. China's post-1978 economic reforms, although they improved general living standards, created some unintended consequences, as evidenced by the disintegration of the rural cooperative medical system and the sharp reduction in the number of "barefoot doctors", both of which were essential elements in the improvement of health status in rural China. The increase in the elderly population and their lack of health insurance and pensions will also place enormous pressure on services for their care. These changes have disproportionately affected the rural health care system, leaving the urban system basically intact, and have contributed to the rural-urban disparity in health care. Based on recent data the article compares current rural-urban differences in health care policy, systems, resources, and outcomes, and proposes potential solutions to reduce them. PMID:8313490
Background Effective access measures are intended to reflect progress toward universal health coverage. This study proposes an operative approach to measuring effective access: in addition to the lack of financial protection, the willingness to make out-of-pocket payments for health care signifies a lack of effective access to pre-paid services. Methods Using data from a nationally representative health survey in Mexico, effective access at the individual level was determined by combining financial protection and effective utilization of pre-paid health services as required. The measure of effective access was estimated overall, by sex, by socioeconomic level, and by federal state for 2006 and 2012. Results In 2012, 48.49% of the Mexican population had no effective access to health services. Though this represents an improvement since 2006, when 65.9% lacked effective access, it still constitutes a major challenge for the health system. Effective access in Mexico presents significant heterogeneity in terms of federal state and socioeconomic level. Conclusions Measuring effective access will contribute to better target strategies toward universal health coverage. The analysis presented here highlights a need to improve quality, availability, and opportuneness (location and time) of health services provision in Mexico. PMID:24758691
IMPORTANCE Cigarette smoking adds an estimated $100 billion in annual incremental direct health care costs nationwide. Cigarette smoking increases complication risk in surgical patients, but the potential effects of smoking status on perioperative health care costs are unclear. OBJECTIVE To test the hypothesis that current and former smoking at the time of admission for inpatient surgery, compared with never smoking, are independently associated with higher incremental health care costs for the surgical episode and the first year after hospital discharge. DESIGN, SETTING, AND PARTICIPANTS This population-based, propensity-matched cohort study, with cohort membership based on smoking status (current smokers, former smokers, and never smokers) was performed at Mayo Clinic in Rochester (a tertiary care center) and included patients at least 18 years old who lived in Olmsted County, Minnesota, for at least 1 year before and after the index surgery. EXPOSURE Undergoing an inpatient surgical procedure at Mayo Clinic hospitals between April 1, 2008, and December 31, 2009. MAIN OUTCOMES AND MEASURES Total costs during the index surgical episode and 1 year after hospital discharge, with the latter standardized as costs per month. Costs were measured using the Olmsted County Healthcare Expenditure and Utilization Database, a claims-based database including information on medical resource use, associated charges, and estimated economic costs for patients receiving care at the 2 medical groups (Mayo Clinic and Olmsted Medical Center) that provide most medical services within Olmsted County, Minnesota. RESULTS Propensity matching resulted in 678 matched pairs in the current vs never smoker grouping and 945 pairs in the former vs never smoker grouping. Compared with never smokers, adjusted costs for the index hospitalization did not differ significantly for current or former smokers. However, the adjusted costs in the year after hospitalization were significantly higher for current and former smokers based on regression analysis (predicted monthly difference of $400 [95% CI, $131-$669] and $273 [95% CI, $56-$490] for current and former smokers, respectively). CONCLUSIONS AND RELEVANCE Compared with never smokers, health care costs during the first year after hospital discharge for an inpatient surgical procedure are higher in both former and current smokers, although the cost of the index hospitalization is not affected by smoking status. PMID:24382595
Warner, David O.; Borah, Bijan J.; Moriarty, James; Schroeder, Darrell R.; Shi, Yu; Shah, Nilay D.
This white paper explains the strong roles that nursing can play in using information technology (IT) to improve healthcare delivery in rural areas. The authors describe current challenges to providing care in rural areas, and how technology innovations can help rural communities to improve their health and health care. To maximize benefits, rural stakeholders (as individuals and groups) must collaborate
Judith A. Effken; Patricia A. Abbott
The training and utilization of non-professional Primary Health Care Workers (PHCW's) is currently a major strategy for meeting the minimal health needs of the four-fifths of the world's population without permanent access to care. Increasingly, however, in countries where the wealth is in the hands of the few, PHCW's are become victims of political violence. Because the implementation of the
The Veterans Health Administration (VHA) provides care to over eight million Veterans and operates over 1,700 sites of care distributed across twenty-one regional networks in the United States. Health care providers within ...
Purpose: To describe annual care transition patterns across residential and health care settings and assess consistency in care transition patterns across years. Design and Methods: This retrospective cohort study used the Medicare Current Beneficiary Survey (2000-2005). The sample comprised beneficiaries aged 65 years and older (N = 57,684…
Sato, Masayo; Shaffer, Thomas; Arbaje, Alicia I.; Zuckerman, Ilene H.
Research objectives: This dissertation examines the state of development of each of the eight core electronic health record (EHR) functionalities as described by the IOM and describes how the current state of these functionalities limit quality improvement efforts in ambulatory care settings. There is a great deal of literature describing both the…
West, Christopher E.
Background: This paper considers a range of issues related to the financing of health care system and relevant government policies in Iran. Methods: This study used mixed methods. A systematic literature review was undertaken to identify relevant publications. This was supplemented by hand searching in books and journals, including government publications. The issues and uncertainties identified in the literature were explored in detail through semi-structured interviews with key informants. These were triangulated with empirical evidence in the form of the literature, government statistics and independent expert opinions to validate the views expressed in the interviews. Results: The systematic review of published literature showed that no previous publication has addressed issues relating to the financing of healthcare services in Iran. However, a range of opinion pieces outlined issues to be explored further in the interviews. Such issues summarised into four main categories. Conclusion: The health care market in Iran has faced a period in which financial issues have enhanced managerial complexity. Privatization of health care services would appear to be a step too far in assisting the system to confront its challenges at the current time. The most important step toward solving such challenges is to focus on a feasible, relevant and comprehensive policy, which optimises the use of health care resources in Iran. PMID:23113205
Davari, M; Haycox, A; Walley, T
During the last two decades, biomedical informatics (BMI) has become a critical component in biomedical research and health care delivery, as evidenced by two recent phenomena. One, as discussed in the article by Bernstam and colleagues in this issue, has been the introduction of Clinical and Translational Science Awards. Perhaps even more important has been the recent, arguably long overdue, emphasis on deployment of health information technology (IT) nationally. BMI utilizes IT and computer science as tools and methods for improving data acquisition, data management, data analysis, and knowledge generation, but it is driven by a focus on applications based in deep understanding of the science and practice, problems, interactions, culture, and milieu of biomedicine and health. Building from Bernstam and colleagues' distinction between BMI and other IT disciplines, the authors discuss the evolving role of BMI professionals as individuals uniquely positioned to work within the human and organizational context and culture in which the IT is being applied. The focus is not on the IT but on the combination--the interactions of IT systems, human beings, and organizations aimed at achieving a particular purpose. There has never been a time when the need for individuals well trained in BMI--those who understand the complexities of the human, social, and organizational milieu of biomedicine and health--has been more critical than it is now, as the nation seeks to develop a national infrastructure for biomedicine and health care, and as these fields seek to broadly deploy IT wisely and appropriately. PMID:19550167
Greenes, Robert A; Shortliffe, Edward H
FEATURE AT A GLANCE: The use of new technologies to improve patient care is becoming increasingly common for the health care professional. However, these initiatives often fail be cause health care organizations lack sufficient guidance as to their implementation. New technologies often are deployed without careful consideration, and users are faced with the dilemma of relying on “band-aid” solutions for
Katherine A. Wilson; Davin Pavlas; Joseph Sharit; Eduardo Salas
This paper describes the views of primary care providers about treating depression among adult Medicaid patients and their experiences with managed behavioral health care. It also shows the outcomes of an intervention project that provides a care manager to facilitate connections among PCPs, patients, and behavioral health providers. Despite widespread initiatives to improve depression management in primary care and to
Carole C. Upshur
This document is comprised of the six 1999 issues of a bimonthly newsletter providing information on young children's health and safety for California's child care professionals. Regular features include a column on infant/toddler concerns, a question-answer column regarding medical and health issues, a nutrition column, and resources for child…
Walery, Nancy, Ed.; Evinger, Sara, Ed.; Dailey, Lyn, Ed.; Sherman, Marsha, Ed.; Zamani, Rahman, Ed.
Supplier Relationship Management (SRM) plays an important role in the reduction of costs and the optimization of performance in industrial enterprises. Despite enormous investments in innovation, the health care sector has not experienced fundamental change yet. However, increased market dynamics and the implementation of economic principles will force health service providers to optimize cost structures as well as effectiveness and
T. Mettler; P. Rohner
OBJECTIVE: To determine the effect on a cohort of family physicians of health care system reforms in Ontario and the relationship of reforms to their career satisfaction. DESIGN: Follow-up survey in 1999 of a cohort initially studied in 1993, posing many of the original questions along with some new ones. Four focus groups of other Ontario family physicians. SETTING: Family practices in Ontario. PARTICIPANTS: All family physicians who had received certification after completing a family medicine residency between 1989 and 1991 and were practising in Ontario in 1993. This report addresses only those members of the cohort who continued to practise family medicine in Ontario (N = 236). Four focus groups with a total of 27 family physicians. MAIN OUTCOME MEASURES: Reaction to health care system reforms. Perceived effect of reforms on practice. Current perception of quality of health care system and level of career satisfaction and changes in these variables since 1993. RESULTS: Response rate was 53% of original cohort. Only three of 13 selected health reforms were believed to have had a favourable effect. Physicians reported lower levels of satisfaction with their careers. Overall quality of the health care system was perceived by both respondents and focus group members to have declined. Several difficulties affected practice and personal life. CONCLUSION: Family physicians viewed the effect of health care reforms negatively and were significantly less satisfied with their careers than they were in 1993. Better consultation with stakeholders before implementation of reforms is needed to ensure that these stakeholders understand the likely effects of these reforms. PMID:11570303
Cohen, M.; Ferrier, B.; Woodward, C. A.; Brown, J.
Menopause has often been described as a time of loss and decay in the lay and medical literature. The present research aims at defining women's perception of themselves and their health care needs in this period of life. Through a community-based sample of women, participative assessments were performed and their conclusions contrasted with the opinions of male and female gynecologists. Though both groups coincided concerning the relevance of loneliness, partnership, beauty and the "empty nest" syndrome, several items showed a marked difference between both groups. Gynecologists tended to perceive women as much more striving for an active sex-life, depressed, lacking projects for the future and worried about their health care than they actually were. Women, instead, stressed the relevance of menopause as a life crisis laden with opportunities for self-accomplishment and positive changes in life-style towards greater autonomy. PMID:8735901
Defey, D; Storch, E; Cardozo, S; Díaz, O; Fernández, G
Conducted in mid-July, this Washington Post/Henry J. Kaiser Foundation survey is the second in a series examining voters' attitudes on policy issues in relation to the ongoing presidential campaign. The survey is designed to compare the attitudes of issue-oriented voters and compare them to those of registered voters in general. Not surprisingly, those respondents identified as particularly oriented to health care and Medicare issues tended to believe that Gore and the Democrats would do a better job on these issues; but the general electorate did not demonstrate the traditional belief in a Democratic advantage on social issues, citing, for instance, Bush as more likely than Gore to stand up to special interests in the health care field. The results are posted in .pdf format.
Maternal reactions to child health care services were examined for 1143 Christchurch children during the period birth to three years. The majority of mothers were well satisfied with the service provided by their family doctor. Over half the mothers who reported problems with their family doctor did so because of perceived inadequacies in the doctor's management and treatment. Dissatisfaction with the doctor did not vary with maternal social background. Mothers were less satisfied with the Plunket nurse, with 25 percent feeling neutral or dissatisfied. Major areas of conflict between mothers and Plunket nurses concerned feeding regimes and weight gains. Dissatisfaction with the Plunket nurse was most common amongst young mothers and single mothers. While 24 percent of mothers would have liked some reduction in medical consultation fees for children, by a small majority mothers were opposed to or neutral about free medical consultations for children. A large majority of mothers favoured some form of compulsory system of routine child health care. PMID:6948193
Fergusson, D M; Beautrais, A L; Shannon, F T
Background Health care networks are widely used and accepted as an organizational form that enables integrated care as well as dealing with complex matters in health care. However, research on the governance of health care networks lags behind. The research aim of our study is to explore the type and importance of governance structure and governance mechanisms for network effectiveness. Methods The study has a multiple case study design and covers 22 health care networks. Using a configuration view, combinations of network governance and other network characteristics were studied on the level of the network. Based on interview and questionnaire data, network characteristics were identified and patterns in the data looked for. Results Neither a dominant (or optimal) governance structure or mechanism nor a perfect fit among governance and other characteristics were revealed, but a number of characteristics that need further study might be related to effective networks such as the role of governmental agencies, legitimacy, and relational, hierarchical, and contractual governance mechanisms as complementary factors. Conclusions Although the results emphasize the situational character of network governance and effectiveness, they give practitioners in the health care sector indications of which factors might be more or less crucial for network effectiveness. PMID:23800334
The author believes that interactive media (the Internet and the World Wide Web) and associated applications used to access those media (portals, browsers, specialized Web-based applications) will result in a substantial, positive, and measurable impact on medical care faster than any previous information technology or communications tool. Acknowledging the dynamic environment, the author classifies "pure" digital health care companies into three business service areas: content, connectivity, and commerce. Companies offering these services are attempting to tap into a host of different markets within the health care industry including providers, payers, pharmaceutical and medical products companies, employers, distributors, and consumers. As the fastest growing medium in history, and given the unique nature of health care information and the tremendous demand for content among industry professionals and consumers, the Internet offers a more robust and targeted direct marketing opportunity than traditional media. From the medical consumer's standpoint (i.e., the patient) the author sees the Internet as performing five critical functions: (1) Disseminate information, (2) Aid informed decision making, (3) Promote health, (4) Provide a means for information exchange and support--the community concept, and (5) Increase self-care and manage demand for health services, lowering direct medical costs. The author firmly submits the Web will provide overall benefits to the health care economy as health information consumers manage their own health problems that might not directly benefit from an encounter with a health professional. Marrying the Internet to other interactive technologies, including voice recognition systems and telephone-based triage lines among others, holds the promise of reducing unnecessary medical services. PMID:10848396
Frank, S R
??Increasing lifestyle-related ill health, escalating health care costs, expanding health inequalities within and between nations, and an aging population are challenges facing governments globally. Governments,… (more)
This final rule establishes regulations for contracting with community-based treatment facilities in the Health Care for Homeless Veterans (HCHV) program of the Department of Veterans Affairs (VA). The HCHV program assists certain homeless veterans in obtaining treatment from non-VA community-based providers. The final rule formalizes VA's policies and procedures in connection with this program and clarifies that veterans with substance use disorders may qualify for the program. PMID:21894657
Drug and biological product development is a global, massive, complex enterprise that entails health care systems, disease\\u000a knowledge, drug knowledge, research experiences (basic and clinical research with many disciplines, technologies, and processes),\\u000a personnel\\/professional affairs, business and marketing practices, public relations, legal and regulatory issues, and global\\u000a business, cultural, and medical factors. This chapter is intended to provide some background context
Ronald P. Evens
Corporate America has decided to stop bellyaching about the cost and quality of the health care it helps buy for its employees. Now it's taking concrete action. Large employers such as Wal-Mart, Oracle, Cisco, BP America and many, many others are pressuring providers to meet performance standards, adopt information technology and transform the efficiency of their operations. Big Business wants value for its buck, and it's now putting money where its mouth is. PMID:17302135
This article enters the debate concerning comprehensive versus selective primary health care by focusing on UNICEF's 'child survival revolution'. It is argued that UNICEF is dangerously mistaken in believing that its present emphasis on selective primary health care is a precursor or 'leading edge' of comprehensive primary health care. The approach of UNICEF--diffusion of a package of technologies by campaigns
Explores the status of health care coverage, or lack of coverage, for children and for working families, noting President Clinton's budget plans for improved access, and the implications of managed health care. Suggests that until policymakers devise a solution that will contain skyrocketing health care costs, many American families will continue…
Office) to Congress in 2004, annual health care expenditures were approaching two trillion dollars, which than $60 billion, of the US's annual health care expenditure was lost due to outright fraud. OtherA survey on statistical methods for health care fraud detection Jing Li & Kuei-Ying Huang
...47 CFR Part 54 Rural Health Care Universal Service Support Mechanism; Proposed...02-60; FCC 10-125] Rural Health Care Universal Service Support Mechanism AGENCY...improve the quality and delivery of health care, and addresses each of the major...
Health Care Provider Value Chain Lukasz Kawczynski, Marco Taisch Department of Management health care system. This paper aims to propose a value definition and a value chain model within the health care. In order to define value patients and experts were surveyed. The proposed definition offers
Introduction to Health and Social Care (ID:250) Outline This is a day event which will be designed will be given short talks from different staff about the various health and social care courses on offer details Learning outcomes: Â· The different health and social care courses offered at Swansea University
... 2010-07-01 false Provision of health care. 17.901 Section 17.901...DEPARTMENT OF VETERANS AFFAIRS MEDICAL Health Care Benefits for Certain Children of...Birth Defects § 17.901 Provision of health care. (a) Spina bifida. VA...
ICT has an impact on many aspects of health care. The most important are accessibility to health care services by citizens, economical aspect and quality of care aspect. The main goal is to provide access for the citizen at any time and in any place. eHealth can certainly provide such an access especially in the regions where physician may not
Technological changes affecting the health care industry spurred the development and implementation of a curriculum to upgrade the skills of Philadelphia health care workers in written communication, mathematics, computer literacy, oral and listening communication, and issues surrounding their union employment in the health care field. The…
Philadelphia Hospital and Health Care-District 1199C, PA.
...02-60; FCC 11-101] Rural Health Care Support Mechanism AGENCY: Federal...adopts an interim rule permitting health care providers that are located in a...funding commitment from the rural health care program prior to July 1,...
Dr. Davis' presentation includes a brief overview of space flight and the lessons learned for health care in microgravity. He will describe the development of policy for health care for international crews. He will conclude his remarks with a discussion of an integrated health care system.
Davis, Jeffrey R.
This study examined physicians' attitude, involvement, and perceived barriers with the health care proxy. A cross sectional, correlational design was used to survey practicing physicians (N = 70). Physicians had positive attitudes toward the health care proxy and indicated that the most significant barriers to health care proxy completion were…
Heyman, Janna C.; Sealy, Yvette M.
Psychologists practice in an increasingly diverse range of health care delivery systems. The following guidelines are intended to assist psychologists, other health care providers, administrators in health care delivery systems, and the public to conceptualize the roles and responsibilities of psychologists in these diverse contexts. These…
American Psychologist, 2013
This research investigated variables that influenced hassles with the health care system among 320 informal caregivers of the chronically ill. Caregivers of the chronically ill usually have considerable contact with the health care system. The research shifted the focus from strain in the caregiver-recipient dyad to hassles with the health care…
Keith, Pat M.
Reviews the changes managed health care has brought to the delivery and use of medical services and recommends specific steps that will make the existing system more responsive to the needs of children. Systemwide health care reforms must give children stable medical care that emphasizes preventive health and developmental services. (SLD)
Deal, Lisa W.; Shiono, Patricia H.; Behrman, Richard E.
This collection consists of four papers dealing with the delivery of health care in the People's Republic of China. The papers resulted from a study tour of the Chinese health care system in June 1980. Included in the volume are the following papers: "A Comparison of Selected Aspects of the Health Care Systems of the Socialist Federal Republic of…
Attwood, Madge, Ed.
The research was undertaken to determine the trends in the amount and the structure of the health care expenditures in Croatia from 2000 to 2013. It is based on routinely collected and publicly available data, The Annual Reports of the Croatian Health Insurance Fund and OECD data. The income of Croatian Health Insurance Fund (CHIF) increased by 66.9%, while total expenditures increased by 62.1%. The fastest growth of expenditure is noticed in expenditures on health care. The hospital and specialist-consultant services have the highest expenditures. Furthermore, the fastest growth is that of other expenses, from 7% of total health care expenditures in 2000, to 26.7% in 2013; which can partly be interpreted as part of hospital care expenses. In the contrast, total expenditures for primary health care decreased, from 22% in 2002, to 13.1% in 2013. The publicly available data are not sufficient enough to drown up any specific conclusions about the underlying reasons for such distribution of the costs. PMID:25643543
Brodari?, Zvjezdana; Keglevi?, Mladenka Vrci?
To analyze the extent of academic interest in quality improvement (QI) initiatives in medical practice, annual publication trends for the most well-known QI methodologies being used in health care settings were analyzed. A total of 10 key medical- and business-oriented library databases were examined: PubMed, Ovid MEDLINE, EMBASE, CINAHL, PsycINFO, ISI Web of Science, Scopus, the Cochrane Central Register of Controlled Trials, ABI/INFORM, and Business Source Complete. A total of 13 057 articles were identified that discuss at least 1 of 10 well-known QI concepts used in health care contexts, 8645 (66.2%) of which were classified as original research. "Total quality management" was the only methodology to demonstrate a significant decline in publication over time. "Continuous quality improvement" was the most common topic of study across all publication years, whereas articles discussing Lean methodology demonstrated the largest growth in publication volume over the past 2 decades. Health care QI publication volume increased substantially beginning in 1991. PMID:24101680
Sun, Gordon H; MacEachern, Mark P; Perla, Rocco J; Gaines, Jean M; Davis, Matthew M; Shrank, William H
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, etc., which gives a special emphasis on public health aspects of information, especially in the field of medicine and health care. The authors of this paper discuss the role and practical importance of social networks in improving the health and solving of health problems without the physical entrance into the health care system. Social networks have their advantages and disadvantages, benefits and costs, especially when it comes to information which within the network set unprofessional people from unreliable sources, without an adequate selection. The ethical aspect of the norms in this segment is still not adequately regulated, so any sanctions for the unauthorized and malicious use of social networks in private and other purposes in order to obtain personal gain at the expense of individuals or groups (sick or healthy, owners of certain businesses and companies, health organizations and pharmaceutical manufacturers, etc.), for which there is still no global or European codes and standards of conduct. Cyber crime is now one of the mostly present types of crime in modern times, as evidenced by numerous scandals that are happening both globally and locally. PMID:23922516
Masic, Izet; Sivic, Suad; Toromanovic, Selim; Borojevic, Tea; Pandza, Haris
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, etc., which gives a special emphasis on public health aspects of information, especially in the field of medicine and health care. The authors of this paper discuss the role and practical importance of social networks in improving the health and solving of health problems without the physical entrance into the health care system. Social networks have their advantages and disadvantages, benefits and costs, especially when it comes to information which within the network set unprofessional people from unreliable sources, without an adequate selection. The ethical aspect of the norms in this segment is still not adequately regulated, so any sanctions for the unauthorized and malicious use of social networks in private and other purposes in order to obtain personal gain at the expense of individuals or groups (sick or healthy, owners of certain businesses and companies, health organizations and pharmaceutical manufacturers, etc.), for which there is still no global or European codes and standards of conduct. Cyber crime is now one of the mostly present types of crime in modern times, as evidenced by numerous scandals that are happening both globally and locally. PMID:23922516
Masic, Izet; Sivic, Suad; Toromanovic, Selim; Borojevic, Tea; Pandza, Haris
As US populations become increasing diverse, healthcare professionals are facing a heightened challenge to provide cross-cultural care. To date, medical education around the world has developed specific curricula on cultural competence training in acknowledgement of the importance of culturally sensitive and grounded services. This article proposes to move forward by integrating the concept of cultural humility into current trainings, in which we believe, is vital in complementing the current model, and better prepare future professionals to address health challenges with culturally appropriate care. Based on the works of Chinese philosophers, cultural values and the contemporary Chinese immigrants' experience, we hereby present the QIAN (Humbleness) curriculum: the importance of self-Questioning and critique, bi-directional cultural Immersion, mutually Active-listening, and the flexibility of Negotiation. The principles of the QIAN curriculum reside not only between the patient and the healthcare professional dyad, but also elicit the necessary support of family, health care system as well as the community at large. The QIAN curriculum could improve practice and enhance the exploration, comprehension and appreciation of the cultural orientations between healthcare professionals and patients which ultimately could improve patient satisfaction, patient-healthcare professional relationship, medical adherence and the reduction of health disparities. QIAN model is highly adaptable to other cultural and ethnic groups in multicultural societies around the globe. Incorporating its framework into the current medical education may enhance cross-cultural clinical encounters. PMID:21161680
Chang, E-shien; Simon, Melissa; Dong, XinQi
This article provides an overview of the U.S. health care system and recent proposals for health system reform. Prepared for a 15-nation comparative study for the Organization for Economic Cooperation and Development (OECD), the article summarizes descriptive data on the financing, utilization, access, and supply of U.S. health services; analyzes health system cost growth and trends; reviews health reforms adopted in the 1980s; and discusses proposals in the current health system reform debate. PMID:10124436
De Lew, Nancy; Greenberg, George; Kinchen, Kraig
It is well known that gender is a determinant of health, but less understood is whether differences in health status attributable to gender can be mitigated through the implementation of primary health care. Primary health care, notably distinct from primary care, refers to a wide-ranging approach to the delivery of a comprehensive variety of health services.This article traces the similarities
MARCIA HILLS; JENNIFER MULLETT
Background Adequate care for individuals living with chronic illnesses calls for a healthcare system redesign, moving from acute, disease-centered to patient-centered models. The aim of this study was to identify Belgian stakeholders’ perceptions on the strengths, weaknesses, opportunities and threats of the healthcare system for people with chronic diseases in Belgium. Methods Four focus groups were held with stakeholders from the micro and meso level, in addition to two interviews with stakeholders who could not attend the focus group sessions. Data collection and the discussion were based on the Chronic Care model. Thematic analysis of the transcripts allowed for the identification of the strengths, weaknesses, opportunities and threats of the current health care system with focus on chronic care. Results Informants stressed the overall good quality of the acute health care system and the level of reimbursement of care as an important strength of the current system. In contrast, the lack of integration of care was identified as one of the biggest weaknesses of today’s health care system, along with the unclear definitions of the roles and functions of health professionals involved in care processes. Patient education to support self-management exists for patients with diabetes and/or terminal kidney failure but not for those living with other or multiple chronic conditions. The current overall fee-for-service system is a barrier to integrated care, as are the lack of incentives for integrated care. Attending multidisciplinary meetings, for example, is underfinanced to date. Finally, clinical information systems lack interoperability, which further impedes the information flow across settings and disciplines. Conclusion Our study’s methods allowed for the identification of problematic domains in the health system for people living with chronic conditions. These findings provided useful insights surrounding perceived priorities. This methodology may inspire other countries faced with the challenge of drafting reforms to tackle the issue of chronic care. PMID:24742204
Summary The four cornerstones of value-driven health care are health information technology standards, quality standards, price standards and incentives. Value-driven health care seeks to directly link quality health care to reimbursement. The four cornerstones of this movement are health information technology standards, quality standards, price standards and incentives. These standards and the how purchasers plan to implement them are summarized. PMID:18514951
Carlos, Ruth C.
The present paper is derived from a larger survey which examined the perceptions of recently qualified health care professionals' experience on evidence-based practice, team working and cancer care. This study reports solely on the findings relating to cancer care. The perceptions of recently qualified professionals in relation to their initial educational input on issues such as confidence, anxiety, communication skills and practice in cancer care as well as adequacy of support, professional supervision and use of reflection were gathered using a cross-sectional postal survey design. A total of 50 graduates from each professional category in nursing, occupational therapy, physiotherapy, and social work were sampled yielding a total sample of 200. Eighty-five questionnaires were returned yielding a response rate of 43%. Twenty-eight (33%) respondents stated that they were currently involved in working with people with cancer. These were as follows: 5 nurses, 8 physiotherapists, 9 occupational therapists and 6 social workers. Despite the low response rate, the findings suggest that health care professionals' educational input and experiences of working with people with cancer were overall positive; for example, in the respondents' confidence, communication skills, decrease in anxiety and application of knowledge gained in classroom to professional practice. Moreover, most respondents learnt about caring for cancer patients through practice rather than classroom teaching. A high percentage (i.e. 64%;18) across all groups felt supported when caring for people with cancer and reported receiving professional supervision as well as being able to actively reflect on their practice. The implications for education and practice were discussed particularly as there have been few studies conducted in relation to the specific needs and collaborative learning of these health care professional groups. PMID:17126078
Copp, Gina; Caldwell, Kay; Atwal, Anita; Brett-Richards, Madeline; Coleman, Kate
The main aim of this paper is to present the current statistics and situation of health care system in Georgia; the changes in the transition period within the society and the health care system. Also presented are the efforts from the Government and the Ministry of Labour, Health and Social Affairs of Georgia in the way of numerous initiatives and action in order to improve quality care of patients and sustain the health care system. This paper described the institutional framework, process, content and implementation of health and health care policies in Georgia in the context of predictive, preventive and personalised medicine. PMID:23442219
The main aim of this paper is to present the current statistics and situation of health care system in Georgia; the changes in the transition period within the society and the health care system. Also presented are the efforts from the Government and the Ministry of Labour, Health and Social Affairs of Georgia in the way of numerous initiatives and action in order to improve quality care of patients and sustain the health care system. This paper described the institutional framework, process, content and implementation of health and health care policies in Georgia in the context of predictive, preventive and personalised medicine. PMID:23442219
A family-centered approach to health care for children with special health care needs (CSHCN) is widely acknowledged as the ideal model of service delivery, but less is known about the actual practice of family-centered care (FCC), especially from the viewpoints of parents and health care professionals. This cross-sectional research compared…
Bellin, Melissa H.; Osteen, Philip; Heffernan, Caitlin; Levy, Judy M.; Snyder-Vogel, Mary E.
Written for trainers of day care staff, this guide provides help in communicating to day care personnel the information presented in "Health in Day Care: A Manual for Day Care Providers," originally developed by a division of the Massachusetts Department of Health and adapted for national use by the Georgetown University Child Development Center.…
Pokorni, Judith L.; Kaufmann, Roxane K.
The National Conference of Catholic Bishops has argued for significant government involvement in health care in order to assure respect for what they regard as the right to health care. Critics charge that the bishops are wrong because health care is not a right. In this article, it is argued that these critics are correct in their claim that health care is not a right. However, it is also argued that the premise that health care is not a right does not imply that the market is the most equitable and just system for providing health care. Natural law arguments in the tradition of Roman Catholic social teaching lead to the conclusion that a just and prosperous society has a moral obligation to provide health care even if there is no such right. Further, there are strong moral grounds for concluding that the bishops are correct in their claim that health care ought not to be considered a market commodity. It is argued that if health care ought not to be considered a commodity, then national health insurance is the best available alternative for fulfilling the social obligation to distribute health care resources justly and fairly at this time in American history. The bishops' case for government involvement can be made on the strength of the Catholic tradition in theological argumentation, independent of the claim that health care is a right. PMID:11654657
Sulmasy, Daniel P
Trust in health care providers and the health care system are essential. This study examined factors associated with trust in providers and distrust in the health care system among minority HIV-positive and -negative women.Interviews were conducted and laboratory tests performed with 102 women from the Women's Interagency HIV Study Bronx site. Interviews collected information about trust in providers, distrust in
C. O. Cunningham; N. L. Sohler; L. Korin; W. Gao; K. Anastos
The counseling profession has increasingly identified with health care ideology. The logical justifications for this transition are critically examined. Ideological and practical consequences of the health care transition are also considered. The author concludes that the usual ways of justifying the transition to health care are insufficient and…
Hansen, James T.
New payment methods designed to incentivize more efficient care delivery are accelerating the movement of health care providers into organized provider groups. More efficient health care delivery requires explicit structuring of care delivery processes around teams of clinicians working toward common patient care goals. Provider organizations accepting new payment methods will need to design and implement compensation systems that provide incentives for team-based care. While lessons from studies performed both outside and inside health care provide some guidance on designing and implementing team-based incentives, organized delivery systems face several significant barriers to designing and implementing them. PMID:23448116
Blumenthal, Daniel M.; Song, Zirui; Jena, Anupam B.; Ferris, Timothy
Faculty of Health and Medical Sciences School of Health & Social Care Public Health Assessment are to: Explore and critically evaluate approaches to assessing public health and critique and discretion in public health practice, programme management and service development. Module Content
Doran, Simon J.
Examines ethics in the health care industry from the perspectives of investors, employees, patients, competitors and the environment. Ethical behaviour in the health care industry is essential and desirable; however, determining which behavioural actions are ethical and which are unethical is difficult. Although never will everyone agree on specific ethical standards, everyone should agree that setting ethical standards is vital. Therefore, administrators of health care institutions and health care providers should work together to establish codes of ethics which define boundaries for ethical behaviours in the health care industry. PMID:10157835
Wells, B; Spinks, N
Background The incentivization of UK primary care through the Quality and Outcomes Framework (QOF) has released an unprecedented supply of data that in theory could aid health equity audit and reduce health inequalities. The current system allows for 'exception reporting' whereby patients can be excluded from calculation of payment for reasons such as failure to attend review. We speculated that
L. A. Sigfrid; C. Turner; D. Crook; S. Ray
Supply-side solutions to health-care provision dominate the South African debate about health care. These solutions are often premised on views that health resources are too concentrated in the private health sector – which supposedly serves only a small minority of the population – and thus public sector provision needs to be expanded. We argue that this rests on a lack
Roy Havemann; Servaas van der Berg
Neighborhood social and physical contexts have the ability to impact health and health behaviors of residents. One neighborhood characteristic that remains underexamined in the research is access to health care resources. This research examines potential (geographical) access to primary health care in the city of Mississauga, Ontario, Canada. A modification of the two-step floating catchment area method that better suits
Scott Bell; Kathi Wilson; Laura Bissonnette; Tayyab Shah
The aim of this review is to summarize the contextual, clinical and health system challenges to the delivery of health care for diabetes in Africa. Planners need to allocate sufficient resources in a context where resources for health in general are insufficient. Choices need to be made between different options for health care within this context and mechanisms are required
David R. Whiting; Louise Hayes; Nigel C. Unwin
The frequency of health care use is crucial for adolescent well-being and health systems. The present study was the first to test a set of variables in a representative sample of Greek adolescents in order to identify factors that predict health care use and contribute to improving health service planning. Questionnaires were administered to a…
Giannakopoulos, George; Tzavara, Chara; Dimitrakaki, Christine; Ravens-Sieberer, Ulrike; Tountas, Yannis
Today's healthcare systems are facing huge challenges related to the aging of population, availability of resources, development and availability of new technology and individual empowerment. A Microsoft Healthcare belief is that people are the key to success, whether success is measured by healthy patients or a healthy bottom line, that knowledge is a strong enabler of transformation of healthcare delivery, that IT is an agent of change and last, but equally important, Health IT needs to be available to many, not just some. The article will provide some arguments about heath IT contribution and Microsoft vision regarding the future of delivery of health care. PMID:18953120
The general election in the United Kingdom in May 2010 resulted in the election of a new government, a coalition between Conservative and Liberal Democrat parties. Six weeks after the election, a white paper, "Equity and Excellence: Liberating the NHS," that proposed profound changes to the structure and organization of the health service was published. The change that generated the most discussion was the proposal that general practitioners be placed at the center of the system and given control of about 80% of the National Health Service's £100 billion budget. The proposals were greeted with considerable concern by many health care professionals, patient representatives, and the media. In response, the government organized an independent review, and proposals have been altered in response. This article outlines the current organization of the National Health Service, the rationale for change, and government proposals. PMID:21969345
O'Flynn, Norma; Potter, Jonathan
The demand for health care outcomes assessment is increasing, driven by the proliferation of managed care as a form of health care financing. Providers, consumers, and payers can use health care outcomes to improve the efficiency and quality of care, spur performance improvement, and demonstrate accountability. This review introduces health outcomes and focuses on one particular outcome—pediatric health-related quality of
Michael Seid; James W. Varni; Jenifer R. Jacobs
Uncertainty appears to typify the experience of living with dementia. With an uncertain illness trajectory and unpredictable levels of deterioration and stability in symptoms, people with a diagnosis of dementia may live with uncertainty and anxiety and find it hard to make plans or decisions for their future. People with memory problems and caregivers seeking a diagnosis of dementia may also potentially find themselves navigating a labyrinth-like maze of services, practitioners, assessments, and memory tests, with limited understanding of test scores and little information about what support is available. In this context of uncertainty, the apparent clarity and certainty of a “dementia care pathway” may be attractive. However, the term “dementia care pathway” has multiple and overlapping meanings, which can potentially give rise to further confusion if these are ill-defined or a false consensus is presumed. This review distinguishes four meanings: 1) a mechanism for the management and containment of uncertainty and confusion, useful for the professional as well as the person with dementia; 2) a manual for sequencing care activities; 3) a guide to consumers, indicating eligibility for care activities, or a guide to self-management for dementia dyads, indicating the appropriateness of care activities; and 4) a manual for “walking with” the person. Examples of these approaches are presented from UK dementia services with illustrations of existing care pathways and associated time points, specifically focusing on: 1) early symptom identification and first service encounters, 2) assessment process, 3) diagnostic disclosure, 4) postdiagnostic support, and 5) appropriate interventions. We review the evidence around these themes, as well as discuss service pathways and referral routes used by some services in England and internationally. We conclude that the attraction of the term “care pathway” is seductive, but caution is needed in taking shared understandings for granted. PMID:25506210
Samsi, Kritika; Manthorpe, Jill
...certification of the existence of a serious health condition to substantiate a claim for benefits; and (5) A health care provider listed above who...to diagnose and treat physical or mental health...
...certification of the existence of a serious health condition to substantiate a claim for benefits; and (5) A health care provider listed above who...to diagnose and treat physical or mental health...
...certification of the existence of a serious health condition to substantiate a claim for benefits; and (5) A health care provider listed above who...to diagnose and treat physical or mental health...
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