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Sample records for health care development

  1. Developing primary health care.

    PubMed Central

    Jarman, B; Cumberlege, J

    1987-01-01

    Primary health care is best provided by a primary health care team of general practitioners, community nurses, and other staff working together from good premises and looking after the population registered with the practice. It encourages personal and continuing care of patients and good communication among the members of the team. Efforts should be made to foster this model of primary care where possible and also to evaluate its effectiveness. Community services that are not provided by primary care teams should be organised on a defined geographical basis, and the boundaries of these services should coincide as much as possible. Such arrangements would facilitate effective community care and health promotion and can be organised to work well with primary care teams. The patient's right to freedom of choice of a doctor, however, should be retained, as it adds flexibility to the rigidity of fixed geographically based services. PMID:3119003

  2. New developments concerning health care financial management.

    PubMed

    Drati, Nathan; Kleiner, Brian

    2005-01-01

    Managed care has become one of the leading developments in health care financial management, but ignorance and confusion surround its meaning and origins. Managed care seeks to reduced costs and increase profits while maintaining quality, yet the evidence that it is able to achieve these aims is mixed. The following analysis is a review of the events leading to the establishment of managed care and what it has become. Various terms and health care organizations involved in managed care are identified, with emphasis placed on the strengths and weaknesses of managed care programs. This analysis is performed to gain insight and better understanding of the direction health care financial management is headed in the 21st century. PMID:18972972

  3. Future developments in health care performance management.

    PubMed

    Crema, Maria; Verbano, Chiara

    2013-01-01

    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

  4. Future developments in health care performance management

    PubMed Central

    Crema, Maria; Verbano, Chiara

    2013-01-01

    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

  5. Health Care System Reforms in Developing Countries

    PubMed Central

    Han, Wei

    2012-01-01

    This article proposes a critical but non-systematic review of recent health care system reforms in developing countries. The literature reports mixed results as to whether reforms improve the financial protection of the poor or not. We discuss the reasons for these differences by comparing three representative countries: Mexico, Vietnam, and China. First, the design of the health care system reform, as well as the summary of its evaluation, is briefly described for each country. Then, the discussion is developed along two lines: policy design and evaluation methodology. The review suggests that i) background differences, such as social development, poverty level, and population health should be considered when taking other countries as a model; ii) although demand-side reforms can be improved, more attention should be paid to supply-side reforms; and iii) the findings of empirical evaluation might be biased due to the evaluation design, the choice of outcome, data quality, and evaluation methodology, which should be borne in mind when designing health care system reforms. PMID:25170464

  6. The development of integrated health care models in Scotland.

    PubMed

    Woods, K J

    2001-01-01

    Integrated health care is a key policy aim of Scotland's newly devolved government. 'Partnership working' is the mechanism that has been selected to achieve this goal. Three illustrative examples of health care integration models developed in Scotland are considered; system organisation and structure; Local Health Care Co-operatives (LHCCs); and Managed Clinical Networks. Using these examples the paper explores the nature of 'partnership' and asks if it can deliver integrated care. PMID:16896406

  7. Palliative care: a public health priority in developing countries.

    PubMed

    Webster, Ruth; Lacey, Judith; Quine, Susan

    2007-01-01

    Palliative care is an emerging specialist discipline worldwide with the majority of services located in developed countries. Developing countries, however, have higher incidences of cancer and AIDS and most of these patients would benefit from palliative care. While there is prominent coverage of this issue in the palliative care literature, there is limited coverage in the specialist public health literature, which suggests that the challenges of palliative care may not yet have been generally recognized as a public health priority, particularly in developing countries. The aim of this article is to introduce the topic of "Palliative care in developing countries" into the specialist public health literature to raise awareness and stimulate debate on this issue among public health professionals and health policy makers, thereby potentially facilitating establishment of palliative care services in developing countries. PMID:17363933

  8. Developing internet-based health services in health care organizations.

    PubMed

    Leskinen, Salme; Häyrinen, Kristiina; Saranto, Kaija; Ensio, Anneli

    2009-01-01

    It is often said that we are living in an information society and information technology (IT) is a normal part of life in many fields. But IT is not used effectively in health care. The purpose of this study was to survey what kind of Internet-based health services and related electronic services are offered to clients by the web-pages of health care organizations in Finland. PMID:19592945

  9. Microcomputer applications for primary health care in developing countries.

    PubMed

    Wilson, R G; Smith, D L

    1991-06-01

    This article explores some ways in which computer technology can be harnessed to strengthen primary health care planning and management, make more efficient use of scare health resources, and maximize the beneficial impact on health of local, district, and national health systems in both developing and developed countries. PMID:1907987

  10. Rural Health Care Access and Policy in Developing Countries.

    PubMed

    Strasser, Roger; Kam, Sophia M; Regalado, Sophie M

    2016-03-18

    Compared to their urban counterparts, rural and remote inhabitants experience lower life expectancy and poorer health status. Nowhere is the worldwide shortage of health professionals more pronounced than in rural areas of developing countries. Sub-Saharan Africa (SSA) includes a disproportionately large number of developing countries; therefore, this article explores SSA in depth as an example. Using the conceptual framework of access to primary health care, sustainable rural health service models, rural health workforce supply, and policy implications, this article presents a review of the academic and gray literature as the basis for recommendations designed to achieve greater health equity. An alternative international standard for health professional education is recommended. Decision makers should draw upon the expertise of communities to identify community-specific health priorities and should build capacity to enable the recruitment and training of local students from underserviced areas to deliver quality health care in rural community settings. PMID:26735432

  11. CHILDREN'S ENVIRONMENTAL HEALTH FOR HEALTH CARE PROVIDERS IN DEVELOPING COUNTRIES

    EPA Science Inventory

    Materials for building capacity in the health sector of developing countries on children's environmental health. includes a trainer's guide and harmonized guidance materials on assessing environmental exposure & risk as well as prevention, diagnosis and treatment.

  12. Developing Healthy Adolescents--A Progressive Health Care Partnership Program.

    ERIC Educational Resources Information Center

    Griesemer, Bernard A.; Hough, David L.

    1993-01-01

    A 1991 partnership coupling Southwest Missouri State University with Saint John's Regional Health Center spawned the Midwest Sports Medicine Center, originally designed to treat orthopedic injuries. Soon the center developed major educational initiatives, including SportsPACE, a program integrating health care programs into the secondary core…

  13. Designing primary health care teams for developing countries.

    PubMed Central

    Reisman, A; Duran, L

    1983-01-01

    A time-honored industrial engineering technique, job evaluation, which was developed to set rates for manual labor, was used in the design of new teams for delivering primary health care in Latin America. The technique was used both in writing job descriptions for new allied health personnel and in designing the curriculums needed to train the personnel. PMID:6856744

  14. The history of China's maternal and child health care development.

    PubMed

    Guo, Yan; Bai, Jing; Na, Heya

    2015-10-01

    The history of maternal and child health (MCH) development in China can be divided into six stages: before 1949 when the People's Republic of China was founded, traditional Chinese medicine shielded women's and children's health while modern medicine began to bud; 1949-1966, the MCH system was established and gradually improved; 1966-1976, the decade of the Cultural Revolution, the road to improve MCH twisted and turned along with the political instability; 1976-1990, especially after the "Reform" and "Opening Up", China's MCH care had been booming and the MCH status continued to improve with the rapid social and economic development; 1990-2008, with the booming economy, MCH care gained increasingly national and international attention. Through improving legislation and investment, China made great strides in the improvement of MCH. After 2009, the comprehensive health care reform laid an institutional basis for the development of MCH and promotion of health equity. PMID:26271835

  15. Recent developments in health care law: culture and controversy.

    PubMed

    Berry, Roberta M; Bliss, Lisa; Caley, Sylvia; Lombardo, Paul A; Wolf, Leslie E

    2013-03-01

    This article reviews recent developments in health care law, focusing on controversy at the intersection of health care law and culture. The article addresses: emerging issues in federal regulatory oversight of the rapidly developing market in direct-to-consumer genetic testing, including questions about the role of government oversight and professional mediation of consumer choice; continuing controversies surrounding stem cell research and therapies and the implications of these controversies for healthcare institutions; a controversy in India arising at the intersection of abortion law and the rights of the disabled but implicating a broader set of cross-cultural issues; and the education of U.S. health care providers and lawyers in the theory and practice of cultural competency. PMID:23180091

  16. Report on the International Conference on Emergency Health Care Development.

    PubMed Central

    Dines, G B

    1990-01-01

    Emergency medical services (EMS) provide rescue, field stabilization, transportation to medical facilities, and definitive care for persons experiencing medical emergencies. In order to advance worldwide development and refinement of EMS systems, and their integration with emergency preparedness and response programs, the International Conference on Emergency Health Care Development was held in Crystal City, Arlington, VA, August 15-19, 1989. The conference was supported by the Department of Health and Human Services and its Health Resources and Services Administration; the Department of Transportation and its National Highway Traffic and Safety Administration; and the Pan American Health Organization. Objectives of the conference were to clarify linkages between various levels of emergency response, to present methods for developing or improving EMS systems within societies with different resources, to demonstrate processes by which EMS systems have been developed, and to propose international emergency health care development goals. Topics included development of services in developing nations, case studies of underdeveloped countries' responses to natural disasters, and a method for updating disaster response through use of available medical resources. PMID:1968669

  17. Developing Electronic Cooperation Tools: A Case From Norwegian Health Care

    PubMed Central

    Mydske, Per Kristen

    2013-01-01

    Background Many countries aim to create electronic cooperational tools in health care, but the progress is rather slow. Objective The study aimed to uncover how the authoritys’ financing policies influence the development of electronic cooperational tools within public health care. Methods An interpretative approach was used in this study. We performed 30 semistructured interviews with vendors, policy makers, and public authorities. Additionally, we conducted an extensive documentation study and participated in 18 workshops concerning information and communication technology (ICT) in Norwegian health care. Results We found that the interorganizational communication in sectors like health care, that have undergone an independent development of their internal information infrastructure would find it difficult to create electronic services that interconnect the organizations because such connections would affect all interconnected organizations within the heterogenic structure. The organizations would, to a large extent, depend on new functionality in existing information systems. Electronic patient records play a central role in all parts of the health care sector and therefore dependence is established to the information systems and theirs vendors. The Norwegian government authorities, which run more than 80% of the Norwegian health care, have not taken extraordinary steps to compensate for this dependency–the government's political philosophy is that each health care institution should pay for further electronic patient record development. However, cooperational tools are complex due to the number of players involved and the way they are intertwined with the overall workflow. The customers are not able to buy new functionalities on the drawing table, while the electronic patient record vendors are not willing to take the economic risk in developing cooperational tools. Thus, the market mechanisms in the domain are challenged. We also found that public projects that were only financed for the first steps of project management could partially explain why many initiatives did not get past the initial planning and specification stages, but were stopped before further development could be made. Vendors were often unwilling to provide further own contribution without guaranteed return. Conclusions We propose that the authorities take a coordinating role and provide financial help for development of electronic cooperational tools for health because the regular market mechanisms are insufficient to push these developments to the market. It is, however, critical that the role of users be considered, and for users to decide which developments should go forward. PMID:23782708

  18. Lessons learned in developing community mental health care in Africa.

    PubMed

    Hanlon, Charlotte; Wondimagegn, Dawit; Alem, Atalay

    2010-10-01

    This paper summarizes the findings for the African Region of the WPA Task Force on Steps, Obstacles and Mistakes to Avoid in the Implementation of Community Mental Health Care. We present an overview of mental health policies, plans and programmes in the African region; a summary of relevant research and studies; a critical appraisal of community mental health service components; a discussion of the key challenges, obstacles and lessons learned, and some recommendations for the development of community mental health services in the African region. PMID:20975867

  19. Community Health Workers and Health Care Delivery: Evaluation of a Women's Reproductive Health Care Project in a Developing Country

    PubMed Central

    Wajid, Abdul; White, Franklin; Karim, Mehtab S.

    2013-01-01

    Background As part of the mid-term evaluation of a Women's Health Care Project, a study was conducted to compare the utilization of maternal and neonatal health (MNH) services in two areas with different levels of service in Punjab, Pakistan. Methods A cross-sectional survey was conducted to interview Married Women of Reproductive Age (MWRA). Information was collected on MWRA knowledge regarding danger signs during pregnancy, delivery, postnatal periods, and MNH care seeking behavior. After comparing MNH service utilization, the two areas were compared using a logistic regression model, to identify the association of different factors with the intervention after controlling for socio-demographic, economic factors and distance of the MWRA residence to a health care facility. Results The demographic characteristics of women in the two areas were similar, although socioeconomic status as indicated by level of education and better household amenities, was higher in the intervention area. Consequently, on univariate analysis, utilization of MNH services: antenatal care, TT vaccination, institutional delivery and use of modern contraceptives were higher in the intervention than control area. Nonetheless, multivariable analysis controlling for confounders such as socioeconomic status revealed that utilization of antenatal care services at health centers and TT vaccination during pregnancy are significantly associated with the intervention. Conclusions Our findings suggest positive changes in health care seeking behavior of women and families with respect to MNH. Some aspects of care still require attention, such as knowledge about danger signs and neonatal care, especially umbilical cord care. Despite overall success achieved so far in response to the Millennium Development Goals, over the past two decades decreases in maternal mortality are far from the 2015 target. This report identifies some of the key factors to improving MNH and serves as an interim measure of a national and global challenge that remains a work in progress. PMID:24086541

  20. Strategic business planning and development for competitive health care systems.

    PubMed

    Nauert, Roger C

    2005-01-01

    The health care industry has undergone enormous evolutionary changes in recent years. Competitive transitions have accelerated the compelling need for aggressive strategic business planning and dynamic system development. Success is driven by organizational commitments to farsighted market analyses, timely action, and effective management. PMID:18975726

  1. New developments in a consolidating health care industry.

    PubMed

    Taylor, D; Kleiner, B H

    1998-01-01

    The current health care industry has recently seen a great deal of consolidation in the form of mergers and acquisitions. These mergers and acquisitions invariably result in a loss of jobs. This paper focuses on two strategies that health care companies use to reduce workforce under these circumstances. Specifically, the paper will focus on the mergers between SmithKline Beckman and Beecham plc in the late 1980s, FHP Health Care and TakeCare Health Plans, and PacifiCare's recent acquisition of FHP Health-care. It will compare and contrast theory, strategy and practices of these six companies as they endeavoured to merge or acquire each other. PMID:10346310

  2. [Primary health care and the millennium development goals].

    PubMed

    Faye, A; Bob, M; Fall, A; Fall, C

    2012-01-01

    Member countries of the World Health Organization (WHO) met in Alma Ata (8-12 September 1978) to define and advocate the implementation of primary health care (PHC) worldwide, above all, in developing countries, which had a real need to review their strategies for meeting the health needs of their populations. They did not suspect that 20 years later the vision they displayed would remain undeniably relevant. Here we examine the similarities and points of convergence of their declaration about PHC with the Millennium Development Goals that seek today to reduce poverty across the world. An exhaustive and analytic literature review was conducted to collect those similarities. Further analysis of the definitions, objectives, principles and recommendations of the Alma Ata Declaration and the Millennium Declaration reveals multiple dependencies and fundamental points of similarity between these two representations. Almost all states have pledged to achieve the eight MDG by 2015: to eradicate extreme poverty and hunger, achieve universal primary education, promote gender equality and empower women, reduce child mortality, improve maternal health, combat HIV/AIDS, malaria and other diseases, ensure environmental sustainability, and develop a global partnership for development. The Alma Ata conference defined primary health care as essential health care, based on practical methods and techniques that are both scientifically sound and socially acceptable, universally accessible to all individuals and all families of the community, through their full participation and at a cost that the community and countries can afford at all stages of their development in the spirit of self-reliance and self-determination. It is an integral part of economic and social development. The following principles are involved in the achievement of both primary health care and the MDG: social equity, community participation, and intersectorality. Public health is an essential condition of poverty eradication and MDG achievement. Public health issues are central to the problem of sustainable development and must therefore remain the focus of attention. It is increasingly urgent to break the vicious circle created by the close correlation between environmental degradation, poor health, and poverty. PMID:22868717

  3. [Primary health care as an instrument of development in Mexico].

    PubMed

    José, M V; Kumate, J; Barnard, A

    1989-01-01

    A Primary Health Care (PHC) score is obtained by averaging thirteen indicators of PHC of each state of Mexico with data of 1985. Some correlations between the PHC score with other indicators of development, such as education and urbanism, are analyzed. The socioeconomic and educational status of women impinge directly in the processes of PHC. Based upon results of basic research some features of coverage and selectivity of PHC strategies are analyzed. PMID:2740944

  4. Running on empty: health care energy use in a developing country.

    PubMed

    Sumner, Steven A

    2010-11-01

    Health care systems require reliable energy for high-quality services. Rising fossil fuel prices globally limit the capacity of developing countries to provide continuous and essential health care services. Global health care projects should focus on energy innovation for health care use. PMID:21099078

  5. The Life Course Health Development Model: A Guide to Children's Health Care Policy and Practice

    ERIC Educational Resources Information Center

    Halfon, Neal; Russ, Shirley; Regalado, Michael

    2005-01-01

    As medical knowledge and treatments improve, pediatricians' role in promoting children's health continues to change. Genetics and early experiences may have long-term effects on health and development. Theoretical models that influence providers' decisions about the use of health-care resources are: the disease model, the neuromaturational model,

  6. The Life Course Health Development Model: A Guide to Children's Health Care Policy and Practice

    ERIC Educational Resources Information Center

    Halfon, Neal; Russ, Shirley; Regalado, Michael

    2005-01-01

    As medical knowledge and treatments improve, pediatricians' role in promoting children's health continues to change. Genetics and early experiences may have long-term effects on health and development. Theoretical models that influence providers' decisions about the use of health-care resources are: the disease model, the neuromaturational model,…

  7. Developing tomorrow's integrated community health systems: a leadership challenge for public health and primary care.

    PubMed

    Welton, W E; Kantner, T A; Katz, S M

    1997-01-01

    As the nation's health system moves away from earlier models to one grounded in population health and market-based systems of care, new challenges arise for public health professionals, primary care practitioners, health plan and institutional managers, and community leaders. Among the challenges are the need to develop creative concepts of organization and accountability and to assure that dynamic, system-oriented structures support the new kind of leadership that is required. Developing tomorrow's integrated community health systems will challenge the leadership skills and integrative abilities of public health professionals, primary care practitioners, and managers. These leaders and their new organizations must, in turn, assume increased accountability for improving community health. PMID:9184684

  8. Health Care Mentors: A Work-Based Approach to Developing the Health Care Workforce of Tomorrow. [Fourth Edition]. Career Exploration.

    ERIC Educational Resources Information Center

    GMS Partners, Inc. Silver Spring, MD.

    Designed as the final step in a carefully articulated work-readiness program, Mentors provides students interested in health care careers with an opportunity to develop superior employability skills, while striking a balance between work and school. The Mentors program links the school community, the student, and host organizations in a mutually…

  9. Developing the Cambridge palliative audit schedule (CAMPAS): a palliative care audit for primary health care teams.

    PubMed Central

    Rogers, M S; Barclay, S I; Todd, C J

    1998-01-01

    BACKGROUND: Problems with the provision of palliative care have been reported. Audit is one means of improving care. Earlier audits of primary care palliative care have been initiated by general practitioners (GPs) and are predominantly retrospective record reviews. Widely applicable methods for the audit of primary care palliative care do not exist. AIM: To develop relevant palliative care standards and to devise an audit schedule (the Cambridge palliative audit schedule, CAMPAS) suitable for monitoring palliative care in diverse primary care settings. METHOD: Primary health care team (PHCT) members collaborated at all stages. Reasonable outcomes and acceptable interventions for PHCTs were identified and standards developed. Each standard was constructed to ensure uniform interpretation, and CAMPAS was structured to collect data necessary for determining whether the standards were met. RESULTS: Over 50% of PHCTs (n = 20) in the health district were recruited and trained to use CAMPAS. A total of 876 contacts with 29 patients was recorded by PHCTs using CAMPAS. Considerable inter- and intra-PHCT variation was found in the achievement of the standards. CONCLUSIONS: The favourable participation rate suggests commitment to audit and improvement in patient care. Overall, the standards were reported to be suitable. Although 100% achievement of some standards may be unrealistic, the level of attainment for many suggests that it is possible. CAMPAS has been reported to be a useful structure for recording assessments and monitoring care, as well as a usable audit schedule. As an audit tool, it identified areas in need of improvement and facilitated feed-back to participants. Future audit is required to determine whether improvements in care have been effected. PMID:9692279

  10. Doctor of nursing practice program development: reengineering health care.

    PubMed

    Wall, Barbra M; Novak, Julie C; Wilkerson, Sharon A

    2005-09-01

    In this article, we describe the developmental process of a Doctor of Nursing Practice (DNP) program that uses interdisciplinary resources to create unique DNP curriculum opportunities. Other schools may benefit from this experience in the development of their own DNP programs. The program delivers an innovative curriculum from post-baccalaureate to doctorate, emphasizing health care engineering and interdisciplinary collaboration among faculty, hospitals, community leaders, and policymakers. This DNP program is uniquely situated to provide leadership in solving complex clinical problems through its partnership with the Regenstrief Center for Healthcare Engineering, the School of Pharmacy, the Homeland Security Institute, and the Center on Aging and the Life Course. Doctoral coursework, interdisciplinary collaboration, health care engineering/systems approaches, and new knowledge result in uniquely qualified providers. Post-baccalaureate students complete the university's Adult Nurse Practitioner program or its developing Pediatric Nurse Practitioner program during the first 2 years of the 4-year curriculum. A total of 83 post-baccalaureate credit hours include 1,526 hours of supervised clinical practice, a health policy residency, and cognate residencies in an area of specialization. The seven core competencies recommended by the American Association of Colleges of Nursing are incorporated into the curriculum. PMID:16220646

  11. Primary health care trading companies for sustainable development.

    PubMed

    Soeters, R; Nzala, S

    1994-01-01

    A programme of comprehensive primary health care in Zambia has been accompanied by the emergence of autonomous, non-profit trading and production companies that sell health-related goods to communities and health institutions and find markets for locally produced good. PMID:8141978

  12. Assessing & Developing Primary Care for Children: Reforms in Health Systems.

    ERIC Educational Resources Information Center

    Grason, Holly Allen, Ed.; Guyer, Bernard, Ed.

    This publication is a compilation of papers presented at an April 1994 workshop sponsored by the National Center for Education in Maternal and Child Health and the Bureau-funded Johns Hopkins Child and Adolescent Health Policy Center (CAHPC). The papers are as follows: (1) "Defining the Issues and Planning for Change: Health Care Systems, Primary

  13. Development and implementation of depression care along the health care continuum.

    PubMed

    Lock, J; Walsh, M

    1999-02-01

    Depression is a common cause of illness with significant social, vocational, and economic consequences. As one of the most treatable forms of mental illness, depression often is underrecognized and undertreated. The annual cost of depression to the United States economy is approximately $43.7 billion, with 55 percent (or $23.8 billion) accounting for missed work and lowered productivity. The prevalence rate of depression is estimated at 12-20 percent. The depressed patient utilizes two to three times more health services. There is little in the literature to demonstrate the care of the depressed person across the continuum in an integrated health care system. This article reviews the development and implementation of the treatment of depression care across multiple sites along the continuum. The care management depression team utilized the principles of performance improvement; Plan, Do, Check, Act framework for the initiative. PMID:9926675

  14. Developing a course to teach Spanish for health care professionals.

    PubMed

    Bloom, Melanie; Timmerman, Gayle M; Sands, Dolores

    2006-07-01

    To make the baccalaureate nursing curriculum more responsive to changing U.S. demographics, the School of Nursing at The University of Texas at Austin instituted a required course, titled Spanish for Health Care Professionals. This course, developed in collaboration with the University's Department of Spanish and Portuguese, focuses on conversational Spanish using the communicative language teaching approach, rather than grammar and medical terminology instruction. Class activities, along with course materials, are linked to nursing practice. Course assignments are designed to develop authentic communication in reading, writing, listening, speaking, and understanding culture, and students demonstrated oral and written linguistic gains in relation to their Spanish fluency and accuracy. Because the Hispanic population is now the largest minority group in the United States, this course will help nurses communicate with Spanish-speaking patients. PMID:16863107

  15. Lessons learned in developing community mental health care in Europe.

    PubMed

    Semrau, Maya; Barley, Elizabeth A; Law, Ann; Thornicroft, Graham

    2011-10-01

    This paper summarizes the findings for the European Region of the WPA Task Force on Steps, Obstacles and Mistakes to Avoid in the Implementation of Community Mental Health Care. The article presents a description of the region, an overview of mental health policies and legislation, a summary of relevant research in the region, a precis of community mental health services, a discussion of the key lessons learned, and some recommendations for the future. PMID:21991282

  16. Creonization of health care.

    PubMed

    Bulger, R J

    1990-01-01

    As prefigured in the Greek tragedy Antigone, one of the primary conflicts in contemporary health care is that between humane concern for the individual and concern for society at large and administrative rules. The computerization of the health care system and development of large data bases will create new forms of this conflict that will challenge the self-definition of health care and health care professionals. PMID:2394563

  17. Organization of ambulatory care provision: a critical determinant of health system performance in developing countries.

    PubMed Central

    Berman, P.

    2000-01-01

    Success in the provision of ambulatory personal health services, i.e. providing individuals with treatment for acute illness and preventive health care on an ambulatory basis, is the most significant contributor to the health care system's performance in most developing countries. Ambulatory personal health care has the potential to contribute the largest immediate gains in health status in populations, especially for the poor. At present, such health care accounts for the largest share of the total health expenditure in most lower income countries. It frequently comprises the largest share of the financial burden on households associated with health care consumption, which is typically regressively distributed. The "organization" of ambulatory personal health services is a critical determinant of the health system's performance which, at present, is poorly understood and insufficiently considered in policies and programmes for reforming health care systems. This article begins with a brief analysis of the importance of ambulatory care in the overall health system performance and this is followed by a summary of the inadequate global data on ambulatory care organization. It then defines the concept of "macro organization of health care" at a system level. Outlined also is a framework for analysing the organization of health care services and the major pathways through which the organization of ambulatory personal health care services can affect system performance. Examples of recent policy interventions to influence primary care organization--both government and nongovernmental providers and market structure--are reviewed. It is argued that the characteristics of health care markets in developing countries and of most primary care goods result in relatively diverse and competitive environments for ambulatory care services, compared with other types of health care. Therefore, governments will be required to use a variety of approaches beyond direct public provision of services to improve performance. To do this wisely, much better information on ambulatory care organization is needed, as well as more experience with diverse approaches to improve performance. PMID:10916916

  18. Development of Health Equity Indicators in Primary Health Care Organizations Using a Modified Delphi

    PubMed Central

    Wong, Sabrina T.; Browne, Annette J.; Varcoe, Colleen; Lavoie, Josée; Fridkin, Alycia; Smye, Victoria; Godwin, Olive; Tu, David

    2014-01-01

    Objective The purpose of this study was to develop a core set of indicators that could be used for measuring and monitoring the performance of primary health care organizations' capacity and strategies for enhancing equity-oriented care. Methods Indicators were constructed based on a review of the literature and a thematic analysis of interview data with patients and staff (n = 114) using procedures for qualitatively derived data. We used a modified Delphi process where the indicators were circulated to staff at the Health Centers who served as participants (n = 63) over two rounds. Indicators were considered part of a priority set of health equity indicators if they received an overall importance rating of>8.0, on a scale of 1–9, where a higher score meant more importance. Results Seventeen indicators make up the priority set. Items were eliminated because they were rated as low importance (<8.0) in both rounds and were either redundant or more than one participant commented that taking action on the indicator was highly unlikely. In order to achieve health care equity, performance at the organizational level is as important as assessing the performance of staff. Two of the highest rated “treatment” or processes of care indicators reflects the need for culturally safe and trauma and violence-informed care. There are four indicators that can be used to measure outcomes which can be directly attributable to equity responsive primary health care. Discussion These indicators and subsequent development of items can be used to measure equity in the domains of treatment and outcomes. These areas represent targets for higher performance in relation to equity for organizations (e.g., funding allocations to ongoing training in equity-oriented care provision) and providers (e.g., reflexive practice, skill in working with the health effects of trauma). PMID:25478914

  19. Health communication in primary health care -A case study of ICT development for health promotion

    PubMed Central

    2013-01-01

    Background Developing Information and Communication Technology (ICT) supported health communication in PHC could contribute to increased health literacy and empowerment, which are foundations for enabling people to increase control over their health, as a way to reduce increasing lifestyle related ill health. However, to increase the likelihood of success of implementing ICT supported health communication, it is essential to conduct a detailed analysis of the setting and context prior to the intervention. The aim of this study was to gain a better understanding of health communication for health promotion in PHC with emphasis on the implications for a planned ICT supported interactive health channel. Methods A qualitative case study, with a multi-methods approach was applied. Field notes, document study and focus groups were used for data collection. Data was then analyzed using qualitative content analysis. Results Health communication is an integral part of health promotion practice in PHC in this case study. However, there was a lack of consensus among health professionals on what a health promotion approach was, causing discrepancy in approaches and practices of health communication. Two themes emerged from the data analysis: Communicating health and environment for health communication. The themes represented individual and organizational factors that affected health communication practice in PHC and thus need to be taken into consideration in the development of the planned health channel. Conclusions Health communication practiced in PHC is individual based, preventive and reactive in nature, as opposed to population based, promotive and proactive in line with a health promotion approach. The most significant challenge in developing an ICT supported health communication channel for health promotion identified in this study, is profiling a health promotion approach in PHC. Addressing health promotion values and principles in the design of ICT supported health communication channel could facilitate health communication for promoting health, i.e. ‘health promoting communication’. PMID:23363566

  20. Health information technology in primary health care in developing countries: a literature review.

    PubMed Central

    Tomasi, Elaine; Facchini, Luiz Augusto; Maia, Maria de Fatima Santos

    2004-01-01

    This paper explores the debate and initiatives concerning the use of information technology (IT) in primary health care in developing countries. The literature from 1992-2002 was identified from searches of the MEDLINE, Latin American and Caribbean Health Science Literature Database (LILACS), Cochrane Library and Web of Science databases. The search identified 884 references, 350 of which were classified according to the scheme described by the Pan American Health Organization (PAHO). For the analysis of advantages, problems and perspectives of IT applications and systems, 52 articles were selected according to their potential contribution to the primary health-care processes in non-developed countries. These included: 10 on electronic patient registries (EPR), 22 on process and programmatic action evaluation and management systems (PPAEM) and 20 on clinical decision-support systems (CDS). The main advantages, limitations and perspectives are discussed. PMID:15640923

  1. [The economic-industrial health care complex and the social and economic dimension of development].

    PubMed

    Gadelha, Carlos Augusto Grabois; Costa, Laís Silveira; Maldonado, José

    2012-12-01

    The strategic role of health care in the national development agenda has been increasingly recognized and institutionalized. In addition to its importance as a structuring element of the Social Welfare State, health care plays a leading role in the generation of innovation - an essential element for competitiveness in knowledge society. However, health care's productive basis is still fragile, and this negatively affects both the universal provision of health care services and Brazil's competitive inclusion in the globalized environment. This situation suggests the need of a more systematic analysis of the complex relationships among productive, technological and social interests in the scope of health care. Consequently, it is necessary to produce further knowledge about the Economic-Industrial Health Care Complex due to its potential for contributing to a socially inclusive development model. This means reversing the hierarchy between economic and social interests in the sanitary field, thus minimizing the vulnerability of the Brazilian health care policy. PMID:23250391

  2. Incarcerated adolescents. The need for the development of professional ethical standards for institutional health care providers.

    PubMed

    Jameson, E J

    1989-11-01

    Large numbers of children are incarcerated in juvenile correctional facilities each year in the United States. These children suffer from a wide range of physical and psychiatric illnesses and are in critical need of professional health care services. This article summarizes the health care needs of these children and documents the ethical problems faced by health care professionals who work in juvenile institutions. The adequacy of current ethical standards as a source of guidance and support for institutional health care professionals is reviewed and a series of recommendations for the development of comprehensive health care standards is set forth. PMID:2691467

  3. Health care in China.

    PubMed

    Brown, M S; Burns, C E; Hellings, P J

    1984-05-01

    Maternal-child nurses are part of a growing number of Americans who have had the opportunity to visit China. An increased understanding of the history and of the health care practices of the Chinese people lends itself to an examination of American values and health practices. The insight developed may aid us as we seek to understand our own health care practices for women and children and to plan for the future in health care. PMID:6728348

  4. Enhancing rural economic development: crafting a health care revolving loan fund.

    PubMed

    Stewart, M Kathryn; Wojcik, Jan; Felix, Holly; Slayton, Deborah

    2002-11-01

    Community development efforts in economically depressed rural areas are often hampered by poor access to health care. One barrier to rural provider availability is the difficulty of obtaining capital for rural health care infrastructure development. Commercial lending institutions are limited in their ability to respond to these needs due to traditional lending criteria--creditworthiness, equity, experience, management ability, and profits or cash flow. This paper describes a rural health care revolving loan fund crafted to address these needs for capital while addressing the goal of improving health care access in rural Arkansas. The Arkansas Rural Health Revolving Loan Fund is a model for other states interested in two processes that work synergistically: (1) increasing access to capital to strengthen the rural primary health care infrastructure and (2) making health care more economically viable by integrating the fund's efforts with those of other community development initiatives. PMID:12407961

  5. Primary Health Care Experiences in the Developing World: Lessons for Canada?

    PubMed Central

    Robinson, Sheila A.

    1990-01-01

    Primary health care, as practised in many developing countries, is a set of guidelines for designing health strategies that are both appropriate to the health needs of the population and to cultural and socio-economic contexts. Four aspects of primary health care experience in developing countries may be relevant to Canadian health care: the integration of health and development, participation of the community in problem identification and program planning, the role of the community-based worker, and the use of health information. Canadian physicians may draw on this experience to address present challenges in our health system: providing health services to marginal groups, viewing health in a broader perspective, the escalating costs of health services, and increasing community involvement in planning health services. PMID:21249109

  6. Transnational health care: from a global terminology towards transnational health region development.

    PubMed

    Mainil, Tomas; Van Loon, Francis; Dinnie, Keith; Botterill, David; Platenkamp, Vincent; Meulemans, Herman

    2012-11-01

    Within European cross-border health care, recent studies have identified several types of international patients. Within the Anglo-Saxon setting, the specific terminology of medical tourism is used. The analytical purpose of the paper is to resolve this semantic difference by suggesting an alternative terminology, 'transnational health care' that is understood as a 'context-controlled and coordinated network of health services'. For demand-driven trans-border access seekers and cross-border access searchers, there is a need to opt for regional health-policy strategies. For supply-driven sending context actors and receiving context actors, there would be organizational benefits to these strategies. Applying the terminology of trans-border access seekers, cross-border access searchers, sending context and receiving context actors results in a transnational patient mobility typology of twelve types of international patients, based on the criteria of geographical distance, cultural distance and searching efforts, public/private/no cover and private/public provision of health services. Finally, the normative purpose of the paper is to encourage the use of this terminology to promote a policy route for transnational health regions. It is suggested that the development of transnational health regions, each with their own medical and supportive service characteristics, could enhance governmental context-controlled decision power in applying sustainable health destination management. PMID:22939046

  7. Identifying health care quality attributes.

    PubMed

    Ramsaran-Fowdar, Roshnee R

    2005-01-01

    Evaluating health care quality is important for consumers, health care providers, and society. Developing a measure of health care service quality is an important precursor to systems and organizations that value health care quality. SERVQUAL has been proposed as a broad-based measure of service quality that may be applicable to health care settings. Results from a study described in this paper verify SERVQUAL dimensions, but demonstrate additional dimensions that are specific to health care settings. PMID:16318013

  8. The Future of Home Health project: developing the framework for health care at home.

    PubMed

    Lee, Teresa; Schiller, Jennifer

    2015-02-01

    In addition to providing high-quality care to vulnerable patient populations, home healthcare offers the least costly option for patients and the healthcare system, particularly in postacute care. As the baby boom generation ages, policymakers are expressing concerns about rising costs, variation in home healthcare service use, and program integrity. The Alliance for Home Health Quality and Innovation seeks to develop a research-based strategic framework for the future of home healthcare for older Americans and those with disabilities. This article describes the initiative and invites readers to provide comments and suggestions. PMID:25654456

  9. Death with Dignity: The Developing Debate Among Health Care Professionals.

    PubMed

    Oakman, Brittany N; Campbell, Hope E; Runk, Lindsay M

    2015-06-01

    The right-to-die movement-known variously as death with dignity, physician-assisted suicide, or aid in dying-remains controversial. The recently publicized death of 29-year-old Brittany Maynard, who chose to end her life through physician-assisted suicide, forced many health care professionals to evaluate or re-evaluate their stance on the issue. Currently, only five states have aid-in-dying laws, but many others have bills under consideration. The legalized process for physician-assisted suicide has a strict set of procedures that physicians and patients must follow to ensure the competency and safety of all parties involved. Opposition against legalizing physician-assisted suicide encompasses more than simply moral, religious, or ethical differences. While some individuals believe that physician-assisted suicide gives patients autonomy in their end-of-life care, health care professionals also may have reservations about the liability of the situation. Pharmacists, in particular, play a pertinent role in the dispensing of, and counseling about, the medications used to assist patients in hastening their death. It is imperative that pharmacists be aware of the intended use of the particular medication so that they can make informed decisions about their participation and ensure that they perform all the necessary steps required to remain compliant with the laws or statutes in their jurisdiction. This practice places an increased burden on pharmacists to evaluate their opinion on the concept of death with dignity and whether or not they want to participate. PMID:26048466

  10. Health Care Technical Advisory Committee on Curriculum Development. Job Clusters, Competencies and Task Analysis.

    ERIC Educational Resources Information Center

    Northern Montana Coll., Havre. Montana Center for Vocational Education, Research, Curriculum and Personnel Development.

    This skills inventory for health care occupations was developed by a technical committee in Montana to assist in the development of model curricula and to address state labor market needs. The committee included employers from hospitals and other health care providers, members of trade and professional associations, and educators. The validated…

  11. Developing New Mexico Health Care Policy: An application of the Vital Issues Process

    SciTech Connect

    Engi, D.; Icerman, L.

    1995-06-01

    The Vital Issues Process, developed by the Sandia National Laboratories Strategic Technologies Department, was utilized by the Health Care Task Force Advisory Group to apply structure to their policy deliberations. By convening three expert panels, an overarching goal for the New Mexico health care system, seven desired outcomes, nine policy options, and 17 action items were developed for the New Mexico health care system. Three broadly stated evaluation criteria were articulated and used to produce relative rankings of the desired outcomes and policy options for preventive care and information systems. Reports summarizing the policy deliberations were submitted for consideration by the Health Care Task Force, a Joint Interim Committee of the New Mexico Legislature, charged with facilitating the development and implementation of a comprehensive health care delivery system for New Mexico. The Task Force reported its findings and recommendations to the Second Session of the 41st New Mexico State Legislature in January 1994.

  12. Development of a College Student's Mistrust of Health Care Organizations Scale

    ERIC Educational Resources Information Center

    Price, James H.; Kirchofer, Gregg M.; Khubchandani, Jagdish; Kleinfelder, JoAnn; Bryant, Michele

    2013-01-01

    Objective: The purpose of this study was to develop a College Student's Mistrust of Health Care Organizations (CSMHCO) scale and determine the relationship between medical mistrust with the use of a variety of health care services. Methods: A convenience sample of college students (n = 545) at 2 universities in the United States was recruited in…

  13. Development of a College Student's Mistrust of Health Care Organizations Scale

    ERIC Educational Resources Information Center

    Price, James H.; Kirchofer, Gregg M.; Khubchandani, Jagdish; Kleinfelder, JoAnn; Bryant, Michele

    2013-01-01

    Objective: The purpose of this study was to develop a College Student's Mistrust of Health Care Organizations (CSMHCO) scale and determine the relationship between medical mistrust with the use of a variety of health care services. Methods: A convenience sample of college students (n=545) at 2 universities in the United States was recruited in

  14. Steps, challenges and lessons in developing community mental health care

    PubMed Central

    THORNICROFT, GRAHAM; TANSELLA, MICHELE; LAW, ANN

    2008-01-01

    This paper summarises our own accumulated experience from developing community-orientated mental health services in England and Italy over the last 20-30 years. From this we have provisionally concluded that the following issues are central to the development of balanced mental health services: a) services need to reflect the priorities of service users and carers; b) evidence supports the need for both hospital and community services; c) services need to be provided close to home; d) some services need to be mobile rather than static; e) interventions need to address both symptoms and disabilities; and f) treatment has to be specific to individual needs. In this paper we consider ten key challenges that often face those trying to develop community-based mental health services: a) dealing with anxiety and uncertainty; b) compensating for a possible lack of structure in community services; c) learning how to initiate new developments; d) managing opposition to change within the mental health system; e) responding to opposition from neighbours; f) negotiating financial obstacles; g) avoiding system rigidities; h) bridging boundaries and barriers; i) maintaining staff morale; and j) creating locally relevant ser- vices rather than seeking “the right answer” from elsewhere. PMID:18560483

  15. Home Health Care

    MedlinePlus

    ... Page Resize Text Printer Friendly Online Chat Home Health Care Home health care helps older adults live independently for as long ... need for long-term nursing home care. Home health care may include occupational and physical therapy, speech therapy, ...

  16. Mental health care and average happiness: strong effect in developed nations.

    PubMed

    Touburg, Giorgio; Veenhoven, Ruut

    2015-07-01

    Mental disorder is a main cause of unhappiness in modern society and investment in mental health care is therefore likely to add to average happiness. This prediction was checked in a comparison of 143 nations around 2005. Absolute investment in mental health care was measured using the per capita number of psychiatrists and psychologists working in mental health care. Relative investment was measured using the share of mental health care in the total health budget. Average happiness in nations was measured with responses to survey questions about life-satisfaction. Average happiness appeared to be higher in countries that invest more in mental health care, both absolutely and relative to investment in somatic medicine. A data split by level of development shows that this difference exists only among developed nations. Among these nations the link between mental health care and happiness is quite strong, both in an absolute sense and compared to other known societal determinants of happiness. The correlation between happiness and share of mental health care in the total health budget is twice as strong as the correlation between happiness and size of the health budget. A causal effect is likely, but cannot be proved in this cross-sectional analysis. PMID:25091049

  17. Diabetes Connect: Developing a Mobile Health Intervention to Link Diabetes Community Health Workers With Primary Care.

    PubMed

    Cherrington, Andrea L; Agne, April A; Lampkin, Yolanda; Birl, Annie; Shelton, Tanya C; Guzman, Alfredo; Willig, James H

    2015-01-01

    Community health worker (CHW) interventions can help improve diabetes self-management and health outcomes. There is limited evidence on how to effectively integrate CHW programs with primary care efforts. Mobile health technology (mHealth) can connect CHWs to members of the health care team and enhance care. We tested a model for the integration of a CHW-delivered mHealth intervention to improve diabetes self-management. Seventy-two African American patients with diabetes were followed using the mHealth tool. This project partnered an academic institution, a safety-net clinic, and African American churches. The integration of mHealth technology into CHW programs was successfully achieved and readily accepted. PMID:26353025

  18. [Evolution and new perspectives of health care financing in developing countries].

    PubMed

    Audibert, Martine; Mathonnat, Jacky; de Roodenbeke, Eric

    2003-01-01

    Over the last twenty five years, the perspective of health care financing has dramatically changed in developing countries. In this context, it is worth reviewing the literature and the experiences in order to understand the major shifts on this topic. During the sixties, health care policies focused on fighting major epidemics. Programs were dedicated to reduce the threat to population health. Financing related to the mobilization of resources for these programs and most of them were not managed within national administrations. The success of these policies was not sustainable. After Alma Ata, primary health care became a priority but it took some years before the management of the health care district was introduced as a major topic. In the eighties, with the district policy and the Bamako Initiative, the economic approach became a major part of all health care policies. At that time, most of health care financing was related to cost recovery strategies. All the attention was then drawn on how it worked: Fee policies, distribution of revenues, efficient use of resources and so on. In the second half of the nineties, cost recovery was relegated to the back scene, health care financing policy then becoming a major front scene matter. Two major reasons may explain this change in perspective: HIV which causes a major burden on the whole health system, and fighting poverty in relation with debts reduction. In most developing countries, with high HIV prevalence, access to care is no longer possible within the framework of the ongoing heath care financing scheme. Health plays a major role in poverty reduction strategies but health care officials must take into account every aspect of public financing. New facts also have to be taken into account: Decentralization/autonomy policies, the growing role of third party payment and the rising number of qualified health care professionals. All these facts, along with a broader emphasis given to the market, introduce a need for a better management of resources through financing mechanisms. Some major reports from WHO and the World Bank are the landmarks of the evolution on how to approach health care financing: The 1993 World Bank report on investing in health, the 2000 WHO report on health in the world and the WHO report on macroeconomics and health. In this early millenium, there is a general agreement on some major aspects of health care financing such as: Lack of resources for financing health care; cost recovery as a part of any sustainable health care system; health as a public good needing some extended subsidies; protecting people from the burden of disease as a part of financing schemes; equity in relation with the public private mix at the center of many debates; financing as a key mechanism for the regulation of the whole health care system and not only as a resource mobilization; HIV in bringing up new problems clearly shows how all these matters are related. Health care financing is at the heart of ongoing questions on health care reforms. Although developing countries have low insurance coverage and weak modern medical care, they share the same questions as developed countries: How to promote technical and allocative efficiency? What place for incentives? What role for the public sector? How can market and contracting bring results? What progress through stewardship and better governance? PMID:15047437

  19. Lessons learned in developing community mental health care in East and South East Asia

    PubMed Central

    ITO, HIROTO; SETOYA, YUTARO; SUZUKI, YURIKO

    2012-01-01

    This paper summarizes the findings for the East and South East Asia Region of the WPA Task Force on Steps, Obstacles and Mistakes to Avoid in the Im-plementation of Community Mental Health Care. The paper presents a description of the region, an overview of mental health policies, a critical ap-praisal of community mental health services developed, and a discussion of the key obstacles and challenges. The main recommendations address the needs to campaign to reduce stigma, integrate care within the general health care system, prioritize target groups, strengthen leadership in policy mak-ing, and devise effective funding and economic incentives. PMID:23024679

  20. Lessons learned in developing community mental health care in East and South East Asia.

    PubMed

    Ito, Hiroto; Setoya, Yutaro; Suzuki, Yuriko

    2012-10-01

    This paper summarizes the findings for the East and South East Asia Region of the WPA Task Force on Steps, Obstacles and Mistakes to Avoid in the Im-plementation of Community Mental Health Care. The paper presents a description of the region, an overview of mental health policies, a critical ap-praisal of community mental health services developed, and a discussion of the key obstacles and challenges. The main recommendations address the needs to campaign to reduce stigma, integrate care within the general health care system, prioritize target groups, strengthen leadership in policy mak-ing, and devise effective funding and economic incentives. PMID:23024679

  1. Lessons learned in developing community mental health care in Latin American and Caribbean countries.

    PubMed

    Razzouk, Denise; Gregrio, Guilherme; Antunes, Renato; Mari, Jair D E Jesus

    2012-10-01

    This paper summarizes the findings for the Latin American and Caribbean countries of the WPA Task Force on Steps, Obstacles and Mistakes to Avoid in the Implementation of Community Mental Health Care. It presents an overview of the provision of mental health services in the region; describes key experiences in Argentina, Belize, Brazil, Chile, Cuba, Jamaica and Mexico; and discusses the lessons learned in developing community mental health care. PMID:23024680

  2. Developing a comprehensive electronic health record to enhance nursing care coordination, use of technology, and research.

    PubMed

    Rantz, Marilyn J; Skubic, Marjorie; Alexander, Greg; Popescu, Mihail; Aud, Myra A; Wakefield, Bonnie J; Koopman, Richelle J; Miller, Steven J

    2010-01-01

    As in acute care, use of health information technology in long-term care holds promise for increased efficiency, better accuracy, reduced costs, and improved outcomes. A comprehensive electronic health record (EHR), which encompasses all health care measures that clinicians want to use-both standard health care assessments and those acquired through emerging technology-is the key to improved, efficient clinical decision making. New technologies using sensors to passively monitor older adults at home are being developed and are commercially available. However, integrating the clinical information systems with passive monitoring data so that clinical decision making is enhanced and patient records are complete is challenging. Researchers at the University of Missouri (MU) are developing a comprehensive EHR to: (a) enhance nursing care coordination at TigerPlace, independent senior housing that helps residents age in place; (b) integrate clinical data and data from new technology; and (c) advance technology and clinical research. PMID:20047248

  3. Water supply and health in developing countries: selective primary health care revisited.

    PubMed Central

    Briscoe, J

    1984-01-01

    The inclusion of water supply and sanitation programs as a component of primary health care (PHC) has been questioned on the basis of calculations of the costs of these programs per infant death averted. In this paper the procedures used in these cost-effectiveness calculations are examined and found to be wanting. The calculations are misleading since gross rather than net costs have been used, and the health impact of these programs underestimated. It is also shown that the methodology used is biased against water supply and sanitation and other programs with multiple outputs. The time constraints facing mothers in implementing PHC programs, as well as the contribution of improved water supplies in alleviating these constraints are outlined. Data are presented to show that, if poor women in developing countries were to choose the mix of activities to be included in PHC programs, improved water supplies would frequently constitute part of that mix. PMID:6431836

  4. Assessment and implementation of health care priorities in developing countries; incompatible paradigms and competing social systems.

    PubMed

    Makhoul, N

    1984-01-01

    This paper addresses conceptual issues underlying the assessment and implementation of health care priorities in developing countries as practised by foreign development agencies coping with a potentially destabilizing unmet social demand. As such, these agencies mediate the gap between existing health care structures patterned around the narrow needs of the ruling classes and the magnitude of public ill-health mass movements thrive to eradicate with implications for capitalism at large. It is in this context that foreign agencies are shown to intervene for the re-assessment and implementation of health care priorities in developing countries with the objective of defending capitalism against the delegitimizing effects of its own development, specifically the persistence of mass disease. Constrained by this objective, the interpretations they offer of the miserable state of health prevailing in developing countries and how it could be improved remains ideological: it ranges between 'stage theory' and modern consumption-production Malthusianism. (a) Developing countries are entering into a new pattern of public health which derives from their unique location in the development of capitalism, more specifically in the new international division of labor. Their present position affects not only the pattern and magnitude of disease formation but also the effective alleviation of mass disease without an alteration in the mode of production itself. (b) In the context of under-development, increased productivity is at the necessary cost of public health. Orienting health care priorities in line with belief in the instrumentality of profit for eradicating the diseases of under-development is ideological and counterproductive. Public health improvement is basically incompatible with production-consumption Malthusianism from which the leading 'Basic Needs' orientation in the assessment and implementation of health care priorities derives. Marx said that "Countries of developing capitalism suffer not only from its development but also from its under-development". Rephrasing Marx, this paper points out that developing countries suffer not only from the under-development of capitalism but also from its development. PMID:6484624

  5. Progress in the development of integrated mental health care in Scotland.

    PubMed

    Woods, Kevin; McCollam, Allyson

    2002-01-01

    The development of integrated care through the promotion of 'partnership working' is a key policy objective of the Scottish Executive, the administration responsible for health services in Scotland. This paper considers the extent to which this goal is being achieved in mental health services, particularly those for people with severe and enduring mental illness. Distinguishing between the horizontal and vertical integration of services, exploratory research was conducted to assess progress towards this objective by examining how far a range of functional activities in Primary Care Trusts (PCTs) and their constituent Local Health Care Co-operatives (LHCCs) were themselves becoming increasingly integrated. All PCTs in Scotland were surveyed by postal questionnaire, and followed up by detailed telephone interviews. Six LHCC areas were selected for detailed case study analysis. A Reference Group was used to discuss and review emerging themes from the fieldwork. The report suggests that faster progress is being made in the horizontal integration of services between health and social care organisations than is the case for vertical integration between primary health care and specialist mental health care services; and that there are significant gaps in the extent to which functional activities within Trusts are changing to support the development of integrated care. A number of models are briefly considered, including the idea of 'intermediate care' that might speed the process of integration. PMID:16896397

  6. Eliciting health care priorities in developing countries: experimental evidence from Guatemala.

    PubMed

    Font, Joan Costa; Forns, Joan Rovira; Sato, Azusa

    2016-02-01

    Although some methods for eliciting preferences to assist participatory priority setting in health care in developed countries are available, the same is not true for poor communities in developing countries whose preferences are neglected in health policy making. Existing methods grounded on self-interested, monetary valuations that may be inappropriate for developing country settings where community care is provided through 'social allocation' mechanisms. This paper proposes and examines an alternative methodology for eliciting preferences for health care programmes specifically catered for rural and less literate populations but which is still applicable in urban communities. Specifically, the method simulates a realistic collective budget allocation experiment, to be implemented in both rural and urban communities in Guatemala. We report evidence revealing that participatory budget-like experiments are incentive compatible mechanisms suitable for revealing collective preferences, while simultaneously having the advantage of involving communities in health care reform processes. PMID:25841770

  7. Lessons learned in developing community mental health care in North America.

    PubMed

    Drake, Robert E; Latimer, Eric

    2012-02-01

    This paper summarizes the findings for North America of the WPA Task Force on Steps, Obstacles and Mistakes to Avoid in the Implementation of Community Mental Health Care. Community mental health has evolved over five decades in the United States and Canada. The United States has led the world in innovation and spending, but provide variable quality of care; Canada has steadily developed a more uniform public health system for less cost. Lessons learned from North America include: team-based approaches and other evidence-based practices, when implemented with high fidelity, can improve outcomes in routine mental health care settings; recovery ideology and peer support enhance care, though they have not been studied rigorously; effective community-based care for people with serious mental disorders is expensive. PMID:22295009

  8. 76 FR 44956 - Solicitation for a Cooperative Agreement; Correctional Health Care Executive Curriculum Development

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-27

    ... National Institute of Corrections Solicitation for a Cooperative Agreement; Correctional Health Care... care, restorative therapy, health information management, and medical specialty services, including... personnel, correctional health care executives must judiciously contract with community-based facilities...

  9. Development and Applications of an Outcomes Assessment Framework for Care Management Programs in Learning Health Systems

    PubMed Central

    Wang, Lin; Kuntz-Melcavage, Kara; Forrest, Christopher B.; Lu, Yanyan; Piet, Leslie; Evans, Kathy; Uriyo, Maria; Sherry, Melissa; Richardson, Regina; Hawkins, Michelle; Neale, Donna

    2015-01-01

    Purpose: To develop and apply an outcomes assessment framework (OAF) for care management programs in health care delivery settings. Background: Care management (CM) refers to a regimen of organized activities that are designed to promote health in a population with particular chronic conditions or risk profiles, with focus on the triple aim for populations: improving the quality of care, advancing health outcomes, and lowering health care costs. CM has become an integral part of a care continuum for population-based health care management. To sustain a CM program, it is essential to assure and improve CM effectiveness through rigorous outcomes assessment. To this end, we constructed the OAF as the foundation of a systematic approach to CM outcomes assessment. Innovations: To construct the OAF, we first systematically analyzed the operation process of a CM program; then, based on the operation analysis, we identified causal relationships between interventions and outcomes at various implementation stages of the program. This set of causal relationships established a roadmap for the rest of the outcomes assessment. Built upon knowledge from multiple disciplines, we (1) formalized a systematic approach to CM outcomes assessment, and (2) integrated proven analytics methodologies and industrial best practices into operation-oriented CM outcomes assessment. Conclusion: This systematic approach to OAF for assessing the outcomes of CM programs offers an opportunity to advance evidence-based care management. In addition, formalized CM outcomes assessment methodologies will enable us to compare CM effectiveness across health delivery settings. PMID:25992387

  10. Progress in the development of integrated mental health care in Scotland

    PubMed Central

    Woods, Kevin; McCollam, Allyson

    2002-01-01

    Abstract The development of integrated care through the promotion of ‘partnership working’ is a key policy objective of the Scottish Executive, the administration responsible for health services in Scotland. This paper considers the extent to which this goal is being achieved in mental health services, particularly those for people with severe and enduring mental illness. Distinguishing between the horizontal and vertical integration of services, exploratory research was conducted to assess progress towards this objective by examining how far a range of functional activities in Primary Care Trusts (PCTs) and their constituent Local Health Care Co-operatives (LHCCs) were themselves becoming increasingly integrated. All PCTs in Scotland were surveyed by postal questionnaire, and followed up by detailed telephone interviews. Six LHCC areas were selected for detailed case study analysis. A Reference Group was used to discuss and review emerging themes from the fieldwork. The report suggests that faster progress is being made in the horizontal integration of services between health and social care organisations than is the case for vertical integration between primary health care and specialist mental health care services; and that there are significant gaps in the extent to which functional activities within Trusts are changing to support the development of integrated care. A number of models are briefly considered, including the idea of ‘intermediate care’ that might speed the process of integration. PMID:16896397

  11. Recent developments in the use of online resources and mobile technologies to support mental health care.

    PubMed

    Turvey, Carolyn L; Roberts, Lisa J

    2015-01-01

    This review describes recent developments in online and mobile mental health applications, including a discussion of patient portals to support mental health care. These technologies are rapidly evolving, often before there is systematic investigation of their effectiveness. Though there are some reviews of the effectiveness of mental health mobile apps, perhaps the more significant development is innovation in technology evaluation as well as new models of interprofessional collaboration in developing behavioural health technologies. Online mental health programs have a strong evidence base. Their role in population health strategies needs further exploration, including the most effective use of limited clinical staff resources. Patient portals and personal health records serve to enhance mental health treatment also, though concerns specific to mental health must be addressed to support broader adoption of portals. Provider concerns about sharing psychiatric notes with patients hinder support for portals. Health information exchange for mental health information requires thoughtful consent management strategies so mental health patients can benefit. Finally, the broad array of health information technologies may overwhelm patients. User-friendly, well-designed, patient-centred health information technology homes may integrate these functions to promote a holistic approach to care plans and overall wellness. Such technology homes have special security needs and require providers and patients to be well informed about how best to use these technologies to support behavioural health interventions. PMID:26523397

  12. Developing a composite index of spatial accessibility across different health care sectors: A German example.

    PubMed

    Siegel, Martin; Koller, Daniela; Vogt, Verena; Sundmacher, Leonie

    2016-02-01

    The evolving lack of ambulatory care providers especially in rural areas increasingly challenges the strict separation between ambulatory and inpatient care in Germany. Some consider allowing hospitals to treat ambulatory patients to tackle potential shortages of ambulatory care in underserved areas. In this paper, we develop an integrated index of spatial accessibility covering multiple dimensions of health care. This index may contribute to the empirical evidence concerning potential risks and benefits of integrating the currently separated health care sectors. Accessibility is measured separately for each type of care based on official data at the district level. Applying an Improved Gravity Model allows us to factor in potential cross-border utilization. We combine the accessibilities for each type of care into a univariate index by adapting the concept of regional multiple deprivation measurement to allow for a limited substitutability between health care sectors. The results suggest that better health care accessibility in urban areas persists when taking a holistic view. We believe that this new index may provide an empirical basis for an inter-sectoral capacity planning. PMID:26831039

  13. Using Mobile Health to Support the Chronic Care Model: Developing an Institutional Initiative

    PubMed Central

    Nundy, Shantanu; Dick, Jonathan J.; Goddu, Anna P.; Hogan, Patrick; Lu, Chen-Yuan E.; Solomon, Marla C.; Bussie, Arnell; Chin, Marshall H.; Peek, Monica E.

    2012-01-01

    Background. Self-management support and team-based care are essential elements of the Chronic Care Model but are often limited by staff availability and reimbursement. Mobile phones are a promising platform for improving chronic care but there are few examples of successful health system implementation. Program Development. An iterative process of program design was built upon a pilot study and engaged multiple institutional stakeholders. Patients identified having a “human face” to the pilot program as essential. Stakeholders recognized the need to integrate the program with primary and specialty care but voiced concerns about competing demands on clinician time. Program Description. Nurse administrators at a university-affiliated health plan use automated text messaging to provide personalized self-management support for member patients with diabetes and facilitate care coordination with the primary care team. For example, when a patient texts a request to meet with a dietitian, a nurse-administrator coordinates with the primary care team to provide a referral. Conclusion. Our innovative program enables the existing health system to support a de novo care management program by leveraging mobile technology. The program supports self-management and team-based care in a way that we believe engages patients yet meets the limited availability of providers and needs of health plan administrators. PMID:23304135

  14. Nursing and Health Care Reform: Implications for Curriculum Development.

    ERIC Educational Resources Information Center

    Bowen, Mary; Lyons, Kevin J.; Young, Barbara E.

    2000-01-01

    A survey of registered nurses who graduated in 1986 (n=50) and 1991 (n-58) revealed these opinions: insurance companies increasingly control patient care; workload and paperwork have increased; and there are fewer jobs and less job security. A significant number reported decreased job satisfaction. (SK)

  15. Management Development in Health Care: Exploring the Experiences of Clinical Nurse Managers

    ERIC Educational Resources Information Center

    Purcell, Laura; Milner, Brigid

    2005-01-01

    Purpose--The purpose of this paper is to investigate the dramatic reforms in the health service in recent years. Design/methodology/approach--Examines management development in health care, and explores the experiences of clinical nurse managers. Findings--Duplication of agencies and multiplication of roles have led to tensions in terms of both…

  16. Management Development in Health Care: Exploring the Experiences of Clinical Nurse Managers

    ERIC Educational Resources Information Center

    Purcell, Laura; Milner, Brigid

    2005-01-01

    Purpose--The purpose of this paper is to investigate the dramatic reforms in the health service in recent years. Design/methodology/approach--Examines management development in health care, and explores the experiences of clinical nurse managers. Findings--Duplication of agencies and multiplication of roles have led to tensions in terms of both

  17. Developing the Health Care Workforce: A Comparison of Two Work-Based Learning Models

    ERIC Educational Resources Information Center

    Brown, Barbara Alice; Harte, Jacqui; Warnes, Anne-Marie

    2007-01-01

    Purpose: The purpose of this paper is to share practice on how two approaches to work-based learning (WBL) are used to develop the knowledge and skills of health care staff with different levels of experience and educational attainment within the Department of Nursing and the Department of Allied Health Professions at a post-1992 university…

  18. Developing European guidelines for training care professionals in mental health promotion

    PubMed Central

    2012-01-01

    Background Although mental health promotion is a priority mental health action area for all European countries, high level training resources and high quality skills acquisition in mental health promotion are still relatively rare. The aim of the current paper is to present the results of the DG SANCO-funded PROMISE project concerning the development of European guidelines for training social and health care professionals in mental health promotion. Methods The PROMISE project brought together a multidisciplinary scientific committee from eight European sites representing a variety of institutions including universities, mental health service providers and public health organisations. The committee used thematic content analysis to filter and analyse European and international policy documents, scientific literature reviews on mental health promotion and existing mental health promotion programmes with regard to identifying quality criteria for training care professionals on this subject. The resulting PROMISE Guidelines quality criteria were then subjected to an iterative feedback procedure with local steering groups and training professionals at all sites with the aim of developing resource kits and evaluation tools for using the PROMISE Guidelines. Scientific committees also collected information from European, national and local stakeholder groups and professional organisations on existing training programmes, policies and projects. Results The process identified ten quality criteria for training care professionals in mental health promotion: embracing the principle of positive mental health; empowering community stakeholders; adopting an interdisciplinary and intersectoral approach; including people with mental health problems; advocating; consulting the knowledge base; adapting interventions to local contexts; identifying and evaluating risks; using the media; evaluating training, implementation processes and outcomes. The iterative feedback process produced resource kits and evaluation checklists linked with each of these quality criteria in all PROMISE languages. Conclusions The development of generic guidelines based on key quality criteria for training health and social care professionals in mental health promotion should contribute in a significant way to implementing policy in this important area. PMID:23270332

  19. Development and evaluation of a mental health care system at a Japanese company.

    PubMed

    Ariyoshi, Hiromi

    2009-02-01

    Compared with other industrialized countries, the suicide rate in Japan is high. The purpose of this research was to evaluate the mental health care offered at a newspaper facing organizational restructuring and with an aging work force. The Health and Safety Committee played a central role in the creation and application of a new mental health care system. This plan, developed to meet the on-site dynamics of the company, was based on the Ministry of Health, Labour and Welfare's "Guide for Workers' Mental Health Promotion in the Workplace" Executive officers' roles were defined at the directors' meetings, and the Health and Safety Committee held Listening Skills Seminars for executive personnel. As a result, the mental health care system functioned effectively and fostered the care of two presenting employees (i.e., one with slight depression with chronic lumbago and the other with alcohol dependency). In addition, the number of workers who took 4 or more days of sick leave decreased from 31 of 190 in 1996 to 5 of 108 in 2004, with no psychologically related absences. Moreover, the number of industrial injuries declined from 8 cases in 1996 to 0 cases in 2004, and no occupational deaths or early retirements occurred between the fiscal years of 1996 and 2004. As a result of this research at the company, a worksite where repeated large-scale organizational restructuring has occurred, the mental health care system functioned effectively and contributed to a decrease in the rate of sick leave taken by workers. PMID:19283934

  20. Respiratory Home Health Care

    MedlinePlus

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

  1. Home health care

    MedlinePlus

    ... and exercises, wound care, and daily living. Home health care nurses can help manage problems with your wound, ... Centers for Medicare and Medicaid Services. Home health care: what it is and what to expect. ... ...

  2. Developing a Comprehensive Animal Care Occupational Health and Safety Program at a Land-Grant Institution.

    PubMed

    Goodly, Lyndon J; Jarrell, Vickie L; Miller, Monica A; Banks, Maureen C; Anderson, Thomas J; Branson, Katherine A; Woodward, Robert T; Peper, Randall L; Myers, Sara J

    2016-01-01

    The Public Health Service Policy on the Humane Care and Use of Laboratory Animals and sound ethical practices require institutions to provide safe working environments for personnel working with animals; this mandate is achieved in part by establishing an effective animal care Occupational Health and Safety Program (OHSP). Land-grant institutions often face unique organizational challenges in fulfilling this requirement. For example, responsibilities for providing health and safety programs often have historically been dispersed among many different divisions scattered around the campus. Here we describe how our institutional management personnel overcame organizational structure and cultural obstacles during the formation of a comprehensive campus-wide animal care OHSP. Steps toward establishing the animal care OHSP included assigning overall responsibility, identifying all stakeholders, creating a leadership group, and hiring a fulltime Animal Care OHSP Specialist. A web-based portal was developed, implemented, and refined over the past 7 y and reflected the unique organizational structures of the university and the needs of our research community. Through this web-based portal, hazards are identified, risks are assessed, and training is provided. The animal care OHSP now provides easy mandatory enrollment, supports timely feedback regarding hazards, and affords enrollees the opportunity to participate in voluntary medical surveillance. The future direction and development of the animal care OHSP will be based on the research trends of campus, identification of emerging health and safety hazards, and ongoing evaluation and refinement of the program. PMID:26817980

  3. Health care in the Netherlands.

    PubMed

    van Weel, Chris; Schers, Henk; Timmermans, Arno

    2012-03-01

    This article analyzes Dutch experiences of health care reform--in particular in primary care--with emphasis on lessons for current United States health care reforms. Recent major innovations were the introduction of private insurance based on the principles of primary care-led health care and including all citizens irrespective of their financial, employment, or health status; introduction of primary care collaboratives for out-of-hour services and chronic disease management; and primary care team building, including practice nurses. These innovations were introduced on top of a strong primary care tradition of family practices with defined populations based on patient panels, practice-based research, evidence-based medicine, large-scale computerization, and strong primary care health informatics. Dutch health reform redirected payment to support introduction of innovative health plans and strengthening of primary care to respond to public health objectives. Five recommendations for US primary care follow from this Dutch experience: (1) a private insurance model is compatible with thriving primary care, but it must include all people, especially the most vulnerable in society, and espouse a primary care-led health care system; (2) patient panels or practice lists strengthen continuity of care and community orientation to focus on and respond to local needs; (3) reward collaboration within primary care and between primary care, hospital care, and public health; (4) stimulate primary care professionals to exert their passion and expertise through participation in primary care research and development; and (5) health informatics should be primary care based, preferably adopting the International Classification of Primary Care. With these recommendations, it will be possible for the United States to obtain better population health for its population. PMID:22403245

  4. Health care technology assessment

    NASA Astrophysics Data System (ADS)

    Goodman, Clifford

    1994-12-01

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

  5. Early Careerist Interest and Participation in Health Care Leadership Development Programs.

    PubMed

    Thompson, Jon M; Temple, April

    2015-01-01

    Health care organizations are increasingly embracing leadership development programs. These programs include a variety of specific activities, such as formally structured leadership development, as well as mentoring, personal development and coaching, 360-degree feedback, and job enlargement, in order to increase the leadership skills of managers and high-potential staff. However, there is a lack of information on how early careerists in health care management view these programs and the degree to which they participate. This article reports on a study undertaken to determine how early careerists working in health care organizations view leadership development programs and their participation in such programs offered by their employers. Study findings are based on a survey of 126 early careerists who are graduates of an undergraduate health services administration program. We found varying levels of interest and participation in specific leadership development activities. In addition, we found that respondents with graduate degrees and those with higher compensation were more likely to participate in selected leadership development program activities. Implications of study findings for health care organizations and early careerists in the offering of, and participation in, leadership development programs are discussed. PMID:26506297

  6. Mental health promotion in the health care setting: collaboration and engagement in the development of a mental health promotion capacity-building initiative.

    PubMed

    Horn, Michelle A; Rauscher, Alana B; Ardiles, Paola A; Griffin, Shannon L

    2014-01-01

    Health Compass is an innovative, multiphased project that aims to transform health care practice and shift organizational culture by building the capacity of Provincial Health Services Authority (PHSA) health care providers to further promote the mental health and well-being of patients and families accessing PHSA's health care services. Health Compass was developed within a health promotion framework, which involved collaboration and engagement with stakeholders across all partnering PHSA agencies. This approach led to the development of an educational and training resource that contributes to increased capacity for mental health promotion within the health care setting. Based on interviews with Health Compass' internal Project Team and findings from a Stakeholder Engagement Evaluation Report, this article outlines the participatory approach taken to develop the Health Compass Mental Health Promotion Resource and E-Learning Tool. A number of key facilitators for collaboration and engagement are discussed, which may be particularly applicable to the implementation of a mental health promotion program or initiative within a complex health care setting. PMID:23493801

  7. Workforce and Leader Development: Learning From the Baldrige Winners in Health Care.

    PubMed

    Arnold, Edwin W; Goodson, Jane R; Duarte, Neville T

    2015-01-01

    It is ironic that perhaps the only constant in health care organizations today is change. To compete successfully in health care and position an organization for high performance amid continuous change, it is very important for managers to have knowledge of the best learning and development practices of high-performing organizations in their industry. The rapid increases in the rate of technological change and geometric increases in knowledge make it virtually imperative that human resources are developed effectively. This article discusses the best learning and development practices among the Malcolm Baldrige National Quality Award winners in the health care industry since 2002 when the industry had its first award-winning organization. PMID:26217991

  8. The Development of Diphosphonates as Significant Health Care Products.

    ERIC Educational Resources Information Center

    Francis, Marion D.; Centner, Rosemary L.

    1978-01-01

    The historical development of the use of diphosphonates in detergents is presented as well as physical chemistry, physiological response, toxicology, and human clinical trials with these compounds. (BB)

  9. REACH-Meharry community-campus partnership: developing culturally competent health care providers.

    PubMed

    Fort, Jane G; McClellan, Linda

    2006-05-01

    An important national health care effort is elimination of racial and ethnic disparities in six specific conditions: infant mortality, cancer screening and management, cardiovascular disease, diabetes, human immunodeficiency virus infection, and child and adult immunizations. To address this concern, several health entities in Nashville, Tennessee responded to a grant initiative from the Centers for Disease Control and Prevention to develop a Racial and Ethnic Approaches to Community Health (REACH) demonstration project. The resulting award is the Nashville REACH 2010 Project, charged to develop sustainable methods to reduce and, in time, eliminate racial and ethnic disparities in cardiovascular disease and diabetes in the North Nashville community, where mortality rates of these diseases are substantially higher than in other parts of the county. As one of its many interests, the project included potential health care providers to receive and disseminate messages about disease prevention and health education. The present paper describes the community-campus partnership between the Nashville REACH 2010 project and the post-baccalaureate program of Meharry Medical College, a partnership that enfolded Meharry's pre-professional health care students into the community-based participatory service research project to increase the awareness and sensitivity of future minority health care providers to issues in minority and poor, underserved populations and to increase potential providers' familiarity with the processes involved in community-based participatory research. PMID:16809876

  10. Health Care Team

    MedlinePlus

    ... NKF Newsroom Contact Us You are here Home » Health Care Team Good health care is always a team effort - especially for people ... chronic kidney failure. Since each member of the health care staff contributes to your care, it is important ...

  11. Developing a preceptorship/mentorship model for home health care nurses.

    PubMed

    DeCicco, Julie

    2008-01-01

    Preceptorship and mentorship programs are used in the health care sector to educate nurses, enhance their leadership skills, and improve their quality of work life. Recognizing the importance of these initiatives, Saint Elizabeth Health Care sought funding to create an innovative model of preceptorship/mentorship that meets the unique needs of home health care nurses. The methods utilized included focus groups, key informant interviews, and a workflow analysis. Factors that influence preceptorship such as nursing workload, preceptor training and remuneration were examined to develop a new model that offers career enhancement and leadership opportunities for preceptors and mentors, and promotes a welcoming environment for preceptees. Reward and recognition programs were created for preceptors to acknowledge their leadership contribution at the front line. This study demonstrates how evidence and innovation were used to create a preceptorship/mentorship model to develop community nursing leaders of the future. PMID:18444063

  12. The development and implementation of an inter-professional simulation based pediatric acute care curriculum for ward health care providers.

    PubMed

    Kotsakis, Afrothite; Mercer, Karen; Mohseni-Bod, Hadi; Gaiteiro, Rose; Agbeko, Rachel

    2015-01-01

    An interprofessional, simulation based, acute care course for ward health care providers was developed and implemented with the objectives of teaching identification of deteriorating patients, practicing crisis resource management and basic life support skills, and using the SBAR (Situation Background Assessment Recommendation) communication tool. Thirty-eight physicians and 51 nurses attended the four separate courses. Nine questions on a 5-point Likert scale and two open-ended questions revealed that over 95% of respondents strongly agreed/agreed that facilitators encouraged active participation, lectures were presented in an interesting manner, and that simulations were useful for practical skills and for practicing communication. Open-ended questions revealed that participants felt more confident, understood the importance of communication, roles, teamwork and valued the day. Based on this evaluation, the program was regarded as feasible and acceptable to all health care providers. PMID:25421455

  13. Developing Crew Health Care and Habitability Systems for the Exploration Vision

    NASA Technical Reports Server (NTRS)

    Laurini, Kathy; Sawin, Charles F.

    2006-01-01

    This paper will discuss the specific mission architectures associated with the NASA Exploration Vision and review the challenges and drivers associated with developing crew health care and habitability systems to manage human system risks. Crew health care systems must be provided to manage crew health within acceptable limits, as well as respond to medical contingencies that may occur during exploration missions. Habitability systems must enable crew performance for the tasks necessary to support the missions. During the summer of 2005, NASA defined its exploration architecture including blueprints for missions to the moon and to Mars. These mission architectures require research and technology development to focus on the operational risks associated with each mission, as well as the risks to long term astronaut health. This paper will review the highest priority risks associated with the various missions and discuss NASA s strategies and plans for performing the research and technology development necessary to manage the risks to acceptable levels.

  14. Crossing the patient-centered divide: transforming health care quality through enhanced faculty development.

    PubMed

    Frankel, Richard M; Eddins-Folensbee, Florence; Inui, Thomas S

    2011-04-01

    In the report "Crossing the Quality Chasm," the Institute of Medicine asserted that patient-centered care is one of the six domains of quality. In this article, the authors consider how the patient- and relationship-centered components of quality can be achieved in all aspects of medical care. They suggest that faculty development in three key areas-mindful practice, formation, and training in communication skills-is necessary to achieve patient- and relationship-centeredness.The authors first review the philosophical and scientific foundations of patient-centered and relationship-centered care. They next describe and provide concrete examples to illustrate the underlying theory and practices associated with each of the three faculty development areas. They then propose five key areas for faculty development in patient- and relationship-centered care: (1) making it a central competency in all health care interactions, (2) developing a national curriculum framework, (3) requiring performance metrics for professional development, (4) partnering with national health care organizations to disseminate the curriculum framework, and (5) preserving face-to-face educational methods for delivering key elements of the curriculum. Finally, the authors consider the issues faced in faculty development today in light of the medical education issues Abraham Flexner identified more than a century ago. PMID:21346495

  15. The retailing of health care.

    PubMed

    Paul, T; Wong, J

    1984-01-01

    A number of striking parallels between recent developments in health care marketing and changes in the retailing industry exist. The authors have compared retailing paradigms to the area on health care marketing so strategists in hospitals and other health care institutions can gain insight from these parallels. Many of the same economic, demographic, technological and lifestyle forces may be at work in both the health care and retail markets. While the services or products offered in health care are radically different from those of conventional retail markets, the manner in which the products and services are positioned, priced or distributed is surprisingly similar. PMID:10270341

  16. Characteristics of health care organizations associated with learning and development: lessons from a pilot study.

    PubMed

    Nyström, Monica

    2009-01-01

    Characteristics of health care organizations associated with an ability to learn from experiences and to develop and manage change were explored in this study. Understanding of these characteristics is necessary to identify factors influencing success in learning from the past and achieving future health care quality objectives. A literature review of the quality improvement, strategic organizational development and change management, organizational learning, and microsystems fields identified 20 organizational characteristics, grouped under (a) organizational systems, (b) key actors, and (c) change management processes. Qualitative methods, using interviews, focus group reports, and archival records, were applied to find associations between identified characteristics and 6 Swedish health care units externally evaluated as delivering high-quality care. Strong support for a characteristic was defined as units having more than 4 sources describing the characteristic as an important success factor. Eighteen characteristics had strong support from at least 2 units. The strongest evidence was found for the following: (i) key actors have long-term commitment, provide support, and make sense of ambiguous situations; (ii) organizational systems encourage employee commitment, participation, and involvement; and (iii) change management processes are employed systematically. Based on the results, a new model of "characteristics associated with learning and development in health care organizations" is proposed. PMID:19851236

  17. Innovation in health care: developments in NHS trusts.

    PubMed

    Bower, D J

    1994-01-01

    Essential parts of the R&D in virtually all UK biomedical innovations are executed within teaching hospitals, which are undergoing major organizational changes as part of the ongoing NHS reforms. Examines the impact of the changing structural and regulatory environment on the process of biomedical innovation management of two groups of technologically novel projects with the NHS. Finds that regulatory changes were tending to centralize and formalize innovation management, but that end users were playing an active role in directing the course of new treatment development. Problems of allocation of R&D resources within teaching hospitals were still unresolved, although some evidence from the London teaching hospitals suggested that hospital managers were able to deal with conflicting demands where they perceived that research excellence could be an asset rather than a cost. PMID:10138786

  18. [The development of competences on primary health care: experience in the Huka-Katu project].

    PubMed

    Mestriner, Wilson; Mestriner, Soraya Fernandes; Bulgarelli, Alexandre Fávero; Mishima, Silvana Martins

    2011-01-01

    This article explores the possibility of integration in the learning process in health services network of the Native People Health Sub-system, an integrant part of the Brazilian Unified Health System. This leading role is present in several instances and stimulates changes in the health professional education. It also emphasizes that the pedagogical conception and the methodologies of the teaching-learning process are important themes for the development of competencies of new health professionals. The aim of this article is to present by means of a descriptive analysis, the context in which the preparatory process is developed for the optative stage "Huka-Katu project--FORP-USP in the Xingu" highlighting the development of cognitive aspects presented in the proposition of actions directed to the primary care. The required competencies for the practice of the surgeon dentist in the primary health care is the base for the construction of SUS, while these competencies should answer the needs for the articulation of practice and education in a perspective of health care. PMID:21503438

  19. Health Care Social Media: Expectations of Users in a Developing Country

    PubMed Central

    2013-01-01

    Background Affordability, acceptability, accommodation, availability, and accessibility are the five most important dimensions of access to health services. Seventy two percent of the Indian population lives in semi-urban and rural areas. The strong mismatched ratio of hospitals to patients, rising costs of health care, rapidly changing demographics, increasing population, and heightened demands in pricing for technological health care usage in emerging economies necessitate a unique health delivery solution model using social media. A greater disease burden lies in the health care delivery in developing country like India. This is due to the lack of health care infrastructure in the majority of semi-urban and rural regions. New techniques need to be introduced in these regions to overcome these issues. In the present scenario, people use social media from business, automobiles, arts, book marking, cooking, entertainment, and general networking. Developed and advanced countries like the United States have developed their communication system for many years now. They have already established social media in a number of domains including health care. Similar practice incidences can be used to provide a new dimension to health care in the semi-urban regions of India. Objective This paper describes an extended study of a previous empirical study on the expectations of social media users for health care. The paper discusses what the users of social media expect from a health care social media site. Methods Multiple regression analysis was used to determine the significance of the affect of four factors (privacy, immediacy, usability, and communication) on the usage of health care social media. Privacy, immediacy, usability, and communication were the independent variables and health care social media was the dependant variable. Results There were 103 respondents who used the online questionnaire tool to generate their responses. The results from the multiple regression analysis using SPSS 20 showed that the model is acceptable, with P=.011, which is statistically significant on a P<.05 level. The observed F value (2.082) in ANOVA was less than the given value in the F table (2.61), which allowed us to accept the hypothesis that the independent variables influence the dependant variable. The users of social media in India expect that they can best utilize social media through emergency service information. They want to be able to learn the operations of the social media site quickly and expect to know about health camps and insurance collaborations. However, people like to become friends with people with similar interests based on their interests identified. Conclusions Health care social media requires intelligent implementation in developing economies. It needs to cater to the expectations of the users. The people in India, especially those in urban and semi-urban regions, are very interested in accepting the system. PMID:25075239

  20. An hierarchical location-allocation model for primary health care delivery in a developing area.

    PubMed

    Hodgson, M J

    1988-01-01

    Location-allocation models can play an important role in making primary health care facilities more accessible to rural populations in the developing world. Traditional models, however, have failed to deal realistically with the fact that health care systems are hierarchical in nature, and that benefits and utilization decline with distance. In this paper, an hierarchical location-allocation model in which benefits accrue to facility level and decline exponentially with distance is presented as a possible approach to ameliorating problems of rural accessibility to health care in Third World settings. The model is subjected to sensitivity analysis with reference to data for Salcette Taluka, Goa, India. The analysis suggests that the traditional P-median model may be a much less appropriate solution to the problem than a simple strategy of locating facilities from the highest to the lowest level in centers of strictly decreasing population. PMID:3353747

  1. International health links: an evaluation of partnerships between health-care organizations in the UK and developing countries.

    PubMed

    Baguley, Dave; Killeen, Tim; Wright, John

    2006-07-01

    Increasingly, international health links are evolving between UK health-care institutions and those in developing countries, the core aims of which are to seek the transfer of ideas, knowledge, skills and training. This study aimed to evaluate established health links, what constitutes them and how they are supported. Benefits and challenges associated with the links, as perceived both by link coordinators in the UK and their overseas partners, were explored. Fourteen links between health-care organizations in the UK and those in developing countries were identified and interviews were successfully conducted with 22 link coordinators: 13 in the UK and nine in developing countries. The interviews indicated that health links offer mutual benefits to both partners in terms of shared skills and the promotion of global awareness. Links can act as important catalysts; stimulating increases in institutional capacity for research and training. They provide opportunities for personal and professional development of staff and promote the development of friendships and supportive networks between diverse communities. Many of the health links showed signs of evolving from uniprofessional links between individual institutions into broader, multidisciplinary community partnerships. The main challenges facing health links arise from cultural differences, funding problems, communication difficulties and bureaucracy. There was broad agreement that greater recognition of the value and importance of health links by the NHS and closer collaboration between government departments to provide support and resources could promote wider and more effective link partnerships. PMID:16884618

  2. Creating incentives to move upstream: developing a diversified portfolio of population health measures within payment and health care reform.

    PubMed

    Auerbach, John

    2015-03-01

    I examined the feasibility of developing a balanced portfolio of population health measures that would be useful within the current deliberations about health care and payment reform. My commentary acknowledges that an obstacle to the selection of population health metrics is the differing definitions of population health. Rather than choosing between these definitions, I identified five categories of indicators, ranging from traditional clinical care prevention interventions to those that measure investment in community-level nonclinical services, that in various combinations might yield the most promising results. I offer concrete examples of markers in each of the categories and show that there is a growing number of individuals eager to receive concrete recommendations and implement population health pilot programs. PMID:25602896

  3. Screening of Infants at Eight Months for Atypical Development in Primary Health Care in Southern Sweden

    ERIC Educational Resources Information Center

    Sivberg, Bengt; Lundqvist, Pia; Johanson, Ingmarie; Nordström, Berit; Persson, Bengt A.

    2016-01-01

    Screening studies of a population in primary health care are sparsely reported. The aim was to describe observed atypical behaviours that may be associated with autism spectrum conditions, in a population (n?=?4,329) of infants at eight months. Observations were performed by paediatric nurses. An observational instrument, named SEEK developed for…

  4. Professional Development in Law, Health Care, and Aging: A Model Fellowship Program.

    ERIC Educational Resources Information Center

    Kapp, Marshall B.

    2000-01-01

    Argues there is a growing need for a core of professionals with the education and sensitivities necessary to integrate the fields of law, health care, and gerontology. Paper describes a professional development fellowship program which attempts to address this need by having recently graduated attorneys assess, on a firsthand level, provisions of…

  5. Screening of Infants at Eight Months for Atypical Development in Primary Health Care in Southern Sweden

    ERIC Educational Resources Information Center

    Sivberg, Bengt; Lundqvist, Pia; Johanson, Ingmarie; Nordstrm, Berit; Persson, Bengt A.

    2016-01-01

    Screening studies of a population in primary health care are sparsely reported. The aim was to describe observed atypical behaviours that may be associated with autism spectrum conditions, in a population (n?=?4,329) of infants at eight months. Observations were performed by paediatric nurses. An observational instrument, named SEEK developed for

  6. Partnerships among community development, public health, and health care could improve the well-being of low-income people.

    PubMed

    Erickson, David; Andrews, Nancy

    2011-11-01

    Safe, vibrant neighborhoods are vital to health. The community development "industry"-a network of nonprofit service providers, real estate developers, financial institutions, foundations, and government-draws on public subsidies and other financing to transform impoverished neighborhoods into better-functioning communities. Although such activity positively affects the "upstream" causes of poor health, the community development industry rarely collaborates with the health sector or even considers health effects in its work. Examples of initiatives-such as the creation of affordable housing that avoids nursing home placement-suggest a strong potential for cross-sector collaborations to reduce health disparities and slow the growth of health care spending, while at the same time improving economic and social well-being in America's most disadvantaged communities. We propose a four-point plan to help ensure that these collaborations achieve positive outcomes and sustainable progress for residents and investors alike. PMID:22068396

  7. Vacation health care

    MedlinePlus

    ... and help you avoid problems. Talk to your health care provider or visit a travel clinic 4 - 6 ... If you are taking medicine, talk to your health care provider before leaving. Carry all medicines with you ...

  8. National Health Care Survey

    Cancer.gov

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

  9. Community participation in primary health care projects of the Muldersdrift Health and Development Programme.

    PubMed

    Barker, M; Klopper, H

    2007-06-01

    After numerous teething problems (1974-1994), the Department of Nursing Education of WITS University took responsibility for the Muldersdrift Health and Development Programme (MHDP). The nursing science students explored and implemented an empowerment approach to community participation. The students worked with MHDP health workers to improve health through community participation, in combination with primary health care (PHC) activities and the involvement of a variety of community groups. As the PHC projects evolved over time, the need arose to evaluate the level of community participation and how much community ownership was present over decision-making and resources. This led to the question "What was the level of community participation in PHC projects of the MHDP?" Based on the question the following objectives were set, i.e. (i) to evaluate the community participation in PHC initiatives; (ii) to provide the project partners with motivational affirmation on the level of community participation criteria thus far achieved; (iii) to indicate to participants the mechanisms that should still be implemented if they wanted to advance to higher levels of community participation; (iv) to evaluate the MHDP's implementation of a people-centred approach to community participation in PHC; and (v) the evaluation of the level of community participation in PHC projects in the MHDP. An evaluative, descriptive, contextual and quantitative research design was used. Ethical standards were adhered to throughout the study. The MHDP had a study population of twenty-three (N=23) PHC projects. A purposive sample of seven PHC initiatives was chosen according to specific selection criteria and evaluated according to the "Criteria to evaluate community participation in PHC projects" instrument (a quantitative tool). Structured group interviews were done with PHC projects' executive committee members. The Joint Management Committee's data was collected through mailed self-administered questionnaires. Validity and reliability were ensured according to strict criteria. Thereafter results were analysed and plotted on a radiating arm continuum. The following factors had component scores: organization, leadership, resources, management; needs and skills. A spider graph was produced after each factor's continuum was connected in a spoke figuration that brought them together at the base where participation was at its most narrow. The results are presented and a graph and discussion is provided on each of the PHC projects. The research results indicated that although community participation was broadened, there was minimal success in forcing a shift in power over decision-making and resources. This demonstrated that power over planning and resources should remain in the hands of the partners if community participation was to remain progressive and sustained. Results furthermore indicated that the people-centred approach to With regard to the Joint Management Committee's evaluation of community participation, it was concluded that power over decision-making and resources remained with health professionals rather than with the community, and that a people-centred approach had not been adopted. PMID:17703821

  10. Your Health Care Team

    MedlinePlus

    ... Size: A A A Listen En Español Your Health Care Team You You are the most important member of your health care team. After all, you are the one who ... are the first to notice any problems. Your health care team depends on you to talk to them ...

  11. National Health Care Skill Standards.

    ERIC Educational Resources Information Center

    National Consortium on Health Science and Technology Education, Okemos, MI.

    This document presents the National Health Care Skill Standards, which were developed by the National Consortium on Health Science and Technology and West Ed Regional Research Laboratory, in partnership with educators and health care employers. The document begins with an overview of the purpose and benefits of skill standards. Presented next are…

  12. Development of a periodic health examination form for the frail elderly in long-term care

    PubMed Central

    Siu, Henry Yu-Hin; White, Joy; Sergeant, Myles; Moore, Ainsley Elizabeth; Patterson, Christopher

    2016-01-01

    Abstract Objective To create an evidence-based periodic health examination (PHE) form geared to long-term care (LTC) residents. Design Two-phase study: literature review to develop a quantitative, cross-sectional, self-administered survey, and administration of the survey followed by a focus group. A PHE form for LTC residents was developed based on participants’ recommendations. Setting Hamilton, Ont. Participants A total of 106 health care professionals completed the survey; 10 LTC physicians participated in the focus group. Main outcome measures The items deemed most important and most likely to be performed during a PHE; themes from focus group discussions. Results Respondents’ top 4 most important PHE items were also the top 4 items they thought were most likely to be performed during a PHE in LTC: reviewing active health status, reviewing pain control, reviewing medications, and screening for falls. Thematic analysis from the focus group discussion generated 3 main themes: current physician perspectives on the existing annual health examination in LTC, conceptual ideas for the new PHE form, and physician perspectives on the optimization of care in LTC settings. The findings from the survey, along with the themes from the focus group, were incorporated to create a PHE form for LTC residents. Conclusion The proposed PHE form emphasizes tracking a patient’s functional course over time and combines evidence-based preventive health interventions and health assessments with what is clinically important for LTC.

  13. A Narrative Review of Recent Developments in Knowledge Translation and Implications for Mental Health Care Providers

    PubMed Central

    Goldner, Elliot M; Jenkins, Emily K; Fischer, Benedikt

    2014-01-01

    Objective: Attention to knowledge translation (KT) has increased in the health care field in an effort to improve uptake and implementation of potentially beneficial knowledge. We provide an overview of the current state of KT literature and discuss the relevance of KT for health care professionals working in mental health. Method: A systematic search was conducted using MEDLINE, PsycINFO, and CINAHL databases to identify review articles published in journals from 2007 to 2012. We selected articles on the basis of eligibility criteria and then added further articles deemed pertinent to the focus of our paper. Results: After removing duplicates, we scanned 214 review articles for relevance and, subsequently, we added 46 articles identified through hand searches of reference lists or from other sources. A total of 61 papers were retained for full review. Qualitative synthesis identified 5 main themes: defining KT and development of KT science; effective KT strategies; factors influencing the effectiveness of KT; KT frameworks and guides; and relevance of KT to health care providers. Conclusions: Despite limitations in existing evidence, the concept and practice of KT holds potential value for mental health care providers. Understanding of, and familiarity with, effective approaches to KT holds the potential to enhance providers’ treatment approaches and to promote the use of new knowledge in practice to enhance outcomes. PMID:24881165

  14. Continuing health care: the local development of policies and eligibility criteria.

    PubMed

    Lewis, Helen; Wistow, Gerald; Abbott, Stephen; Cotterill, Lesley

    1999-11-01

    In 1995 the Department of Health issued guidance on continuing health care following the health service commissioner's finding against Leeds Health Authority for failing to provide long-term care. Under this guidance, health authorities were required to agree continuing health care policies and eligibility criteria with fundholders and local authorities. This study sought to investigate the extent to which the drafting of local policies and criteria, within the framework of national guidance, led to consistency between health authorities. A structured content analysis was conducted of all the policies and eligibility criteria in three regions. In particular, it aimed to establish the comprehensiveness of local policies, the nature of local criteria, the consistency of each between authorities and with the guidance, the development of plans for reinvestment and the balance between institutional and domiciliary services. Only a minority of authorities were found to have identified investments in services, notwithstanding the requirement to do so in the guidance. In addition, most documents were not comprehensive in their coverage of client groups, with more information being provided about services for older people and those with mental health problems. Few policies contained action plans to translate general intentions about equity and consistency into practice. Eligibility criteria frequently took the form of descriptions of services and/or were so general that they would be difficult to apply in individual cases. Most documents contained no criteria for community health services. Whilst just over half of them included the aim of moving resources from acute to community sectors, they contained far more detail about institutionally based services and, for a number of reasons, appeared likely to reinforce the imbalance towards the latter. The documents analysed were part of an evolutionary process of understanding the contribution of effective continuing care to managing pressures on acute beds. Their impact on patients and their families must, however, await the findings from subsequent stages of this research. PMID:11560662

  15. Developing DNP students as adaptive leaders: a key strategy in transforming health care.

    PubMed

    Kendall-Gallagher, Deborah; Breslin, Eileen

    2013-01-01

    The success of graduates with a doctor of nursing practice (DNP) degree in transforming health care will depend significantly on their leadership ability to think strategically, innovate, and engage stakeholders in meaningful system improvement. Known as adaptive work, these graduates will need a portfolio of adaptive leadership skills that prepare them to move health care from a volume-driven to value-based system. This article describes development of a core DNP leadership course in a postmaster's point of entry DNP program at an academic health science center school of nursing. The course, designed as DNP students' initial step on their professional development journey to becoming adaptive leaders capable of driving transformative change, created an alternative lens for students to undertake strategic adaptive change initiatives within themselves and their organizations. PMID:24075257

  16. Systematic review of involving patients in the planning and development of health care

    PubMed Central

    Crawford, Mike J; Rutter, Deborah; Manley, Catherine; Weaver, Timothy; Bhui, Kamaldeep; Fulop, Naomi; Tyrer, Peter

    2002-01-01

    Objective To examine the effects of involving patients in the planning and development of health care. Data sources Published and grey literature. Study selection Systematic search for worldwide reports written in English between January 1966 and October 2000. Data extraction Qualitative review of papers describing the effects of involving patients in the planning and development of health care. Results Of 42 papers identified, 31 (74%) were case studies. Papers often described changes to services that were attributed to involving patients, including attempts to make services more accessible and producing information leaflets for patients. Changes in the attitudes of organisations to involving patients and positive responses from patients who took part in initiatives were also reported. Conclusions Evidence supports the notion that involving patients has contributed to changes in the provision of services across a range of different settings. An evidence base for the effects on use of services, quality of care, satisfaction, or health of patients does not exist. What is already known on this topicInvolving patients in planning and delivering health services is recommended as a means of improving the quality of servicesMethods for engaging with patients have been considered in depth, but the effects of involving patients are less clearWhat this study addsFew studies have explored the effects of involving patientsInvolving patients has contributed to changes in service provision, but the effects of these on quality of care have not been reported PMID:12458240

  17. Educating advanced level practice within complex health care workplace environments through transformational practice development.

    PubMed

    Hardy, Sally; Jackson, Carrie; Webster, Jonathan; Manley, Kim

    2013-10-01

    Over the past 20 years health care reform has influenced the development of advanced level practitioner roles and expectations. How advanced level practitioners work to survive the highly stimulating, yet sometimes overwhelming aspects of balancing high quality provision with political reform agendas, amidst economic constraint is considered. Transformational approaches (encompassing education and practice led service development) can provide, promote and 'provoke' a harnessing of complex issues workplace environment to produce creative solutions. Transformational Practice Development provides a structured, rigorous, systematic approach that practitioners, teams and health care consumers alike can utilise to achieve skills and attributes needed for successful innovation. The authors present case study materials from action orientated locally delivered Practice Development, as a complex strategic intervention approach to influence and promote advanced level practice expertise. Initiated through facilitation of transformational leadership, and resultant team based improvements, we present how strategic collaborative processes can harness work chaos and complexity to provide sustainable and productive workplace cultures of effectiveness. PMID:23453607

  18. Development of guidelines to facilitate improved support of South Asian carers by primary health care teams

    PubMed Central

    Katbamna, S; Baker, R; Ahmad, W; Bhakta, P; Parker, G

    2001-01-01

    Background—Evidence based guidelines are regarded as an appropriate basis for providing effective health care, but few guidelines incorporate the views of users such as carers. Aim—To develop guidelines to assist primary health care teams (PHCTs) in their work with carers within South Asian communities. Methods—The guidelines were drawn up by a development group consisting of members of teams in areas with South Asian communities (Leicester and Bradford). The teams were invited to make their recommendations based on a systematic review of literature on minority ethnic carers and the findings of a study of the needs and experiences of local South Asian carers. A grading system was devised to enable the teams and a group of expert peer reviewers to assess the quality of evidence in support of each recommendation. Results—The teams agreed seven recommendations, graded according to available evidence and strength of opinion. External peer review supported the PHCTs' interpretation of evidence and their recommendations. The recommendations included consideration of communication and information for carers, coordination of care within teams, and recognition by team members of the roles of carers and their cultural and religious beliefs. Conclusion—There are particular steps that PHCTs can take to improve their support of South Asian carers. It is possible to develop guidelines that take users' views into account and incorporate evidence from qualitative studies. Key Words: primary health care; South Asian carers; guidelines PMID:11533424

  19. Health care informatics.

    PubMed

    Siau, Keng

    2003-03-01

    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. This article offers a conceptual model for implementing new information systems, integrating internal data, and linking suppliers and patients. PMID:12670013

  20. Migration of health-care workers from developing countries: strategic approaches to its management.

    PubMed Central

    Stilwell, Barbara; Diallo, Khassoum; Zurn, Pascal; Vujicic, Marko; Adams, Orvill; Dal Poz, Mario

    2004-01-01

    Of the 175 million people (2.9% of the world's population) living outside their country of birth in 2000, 65 million were economically active. The rise in the number of people migrating is significant for many developing countries because they are losing their better-educated nationals to richer countries. Medical practitioners and nurses represent a small proportion of the highly skilled workers who migrate, but the loss for developing countries of human resources in the health sector may mean that the capacity of the health system to deliver health care equitably is significantly compromised. It is unlikely that migration will stop given the advances in global communications and the development of global labour markets in some fields, which now include nursing. The aim of this paper is to examine some key issues related to the international migration of health workers and to discuss strategic approaches to managing migration. PMID:15375449

  1. Strengthening Intersectoral Collaboration for Primary Health Care in Developing Countries: Can the Health Sector Play Broader Roles?

    PubMed Central

    Adeleye, Omokhoa Adedayo; Ofili, Antoinette Ngozi

    2010-01-01

    Many strategic challenges impeding the success of primary health care are rooted in weak strategic inputs, including intersectoral collaboration. Some encouraging evidence from programmes, projects, and studies suggests that intersectoral collaboration is feasible and useful. The strategy has the potential to fast-track the attainment of Millenium Development Goals. However, the strategy is not commonly utilised in developing countries. The health sector expects inputs from other sectors which may not necessarily subscribe to a shared responsibility for health improvement, whereas the public expects ‘‘health” from the health sector. Yet, the health sector rarely takes on initiatives in that direction. The sector is challenged to mobilise all stakeholders for intersectoral collaboration through advocacy and programming. Pilot projects are advised in order to allow for cumulative experience, incremental lessons and more supportive evidence. PMID:20454703

  2. Foreign direct investment in the health care sector and most-favoured locations in developing countries.

    PubMed

    Outreville, J François

    2007-12-01

    Given the growing importance of the health care sector and the significant development of trade in health services, foreign direct investment (FDI) in this sector has gathered momentum with the General Agreement on Trade in Services. Despite extensive case based research and publications in recent years on health care markets and the rise of private sectors, it is surprisingly difficult to find evidence on the relative importance of the largest multinational corporations (MNCs) operating in the health care sector. The objective of the paper is to identify some of the determinants of foreign investment of the largest MNCs operating in this industry. The list of the largest MNCs has been compiled using company websites and data is available for 41 developing economies for which at least two MNCs have an office (branch and/or affiliate). The results of this study have some important implications. They indicate that location-specific advantages of host countries, including good governance, do provide an explication of the internationalization of firms in some developing countries rather than others. PMID:17165075

  3. Developing Quality Indicators for Family Support Services in Community Team-Based Mental Health Care

    PubMed Central

    Olin, S. Serene; Kutash, Krista; Pollock, Michele; Burns, Barbara J.; Kuppinger, Anne; Craig, Nancy; Purdy, Frances; Armusewicz, Kelsey; Wisdom, Jennifer; Hoagwood, Kimberly E.

    2013-01-01

    Quality indicators for programs integrating parent-delivered family support services for children’s mental health have not been systematically developed. Increasing emphasis on accountability under the Affordable Care Act highlights the importance of quality-benchmarking efforts. Using a modified Delphi approach, quality indicators were developed for both program level and family support specialist level practices. These indicators were pilot tested with 21 community-based mental health programs. Psychometric properties of these indicators are reported; variations in program and family support specialist performance suggest the utility of these indicators as tools to guide policies and practices in organizations that integrate parent-delivered family support service components. PMID:23709287

  4. Local politicization of Primary Health Care as an instrument for development: a case study of community health workers in Zambia.

    PubMed

    Twumasi, P A; Freund, P J

    1985-01-01

    The integrated approach of the Primary Health Care Concept has obvious implications for development. In view of Zambia's commitment to Primary Health Care it is important to evaluate the effectiveness of present institutional frameworks and the problems that may arise in shifting towards community responsibility for the provision of health. It is often assumed that the Primary Health Care approach of working through the community should be free of serious implementation problems. However, experience from community participation projects in a wide variety fields carried out in many countries, including Zambia has shown that failure to account for local institutional arrangements and political interests has hindered success. This article presents the theoretical issues involved in community participation research, reviews relevant literature and presents a case study of a community health worker in Western Province, Zambia. The case study derives from an on-going UNICEF/Government of Zambia sponsored project which is monitoring and evaluating the impact of child health and nutrition services in rural areas. The study illustrates some of the problems encountered by a CHW because of clashes with local political interests. An alternative model is proposed which if implemented can help alleviate and/or avoid these types of conflicts. PMID:4012349

  5. Health Care Indicators

    PubMed Central

    Donham, Carolyn S.; Maple, Brenda T.; Letsch, Suzanne W.

    1993-01-01

    This regular feature of the journal includes a discussion of each of the following four topics: community hospital statistics; employment, hours, and earnings in the private health sector; health care prices; and national economic indicators. These statistics are valuable in their own right 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:25372574

  6. Developments for a growing Japanese patient population: facilitating new technologies for future health care.

    PubMed

    Kato, Harubumi; Nishimura, Toshihide; Ikeda, Norihiko; Yamada, Tesshi; Kondo, Tadashi; Saijo, Nagahiro; Nishio, Kazuto; Fujimoto, Junichiro; Nomura, Masaharu; Oda, Yoshiya; Lindmark, Bertil; Maniwa, Jiro; Hibino, Hitoshi; Unno, Michiaki; Ito, Toshinori; Sawa, Yoshiki; Tojo, Hiromasa; Egawa, Shin; Edula, Goutham; Lopez, Mary; Wigmore, Murray; Inase, Naohiko; Yoshizawa, Yasuyuki; Nomura, Fumio; Marko-Varga, György

    2011-05-16

    Lung cancer, COPD and cardiovascular diseases are highlighted as some of the most common disease that cause mortality, and for that reason are the most active areas for drug development. This perspective paper overviews the urgent need to develop a health care system for a rapidly growing patient population in Japan, including forthcoming demands on clinical care, expecting outcomes, and economics. There is an increasing requirement to build on the strengths of the current health care system, thereby delivering urgent solutions for the future. There is also a declaration from the Ministry of Health, Labour and Welfare (MHLW), to develop new biomarker diagnostics, which is intended for patient stratification, aiding in diagnostic phenotype selection for responders to drug treatment of Japanese patients. This perspective was written by the panel in order to introduce novel technologies and diagnostic capabilities with successful implementation. The next generation of personalized drugs for targeted and stratified patient treatment will soon be available in major disease areas such as, lifestyle-related cancers, especially lung cancers with the highest mortality including a predisposing disorder chronic obstructive pulmonary disease, cardiovascular disease, and other diseases. Mass spectrometric technologies can provide the "phenotypic fingerprint" required for the concept of Personalized Medicine. Mass spectrometry-driven target biomarker diagnoses in combination with high resolution computed tomography can provide a critical pathway initiative facilitated by a fully integrated e-Health infrastructure system. We strongly recommend integrating validated biomarkers based on clinical proteomics, medical imaging with clinical care supported by e-Health model to support personalized treatment paradigms to reduce mortality and healthcare costs of chronic and co-morbid diseases in the elderly population of Japan. PMID:21184850

  7. Caring for Kids: Useful Information and Hard-to-Find Facts about Child Health and Development.

    ERIC Educational Resources Information Center

    Keener, Patricia A.

    With input and recommendations from physicians, health care professionals, and parents, this book for parents, grandparents, and child caregivers provides numerous interesting facts, pages of useful information, and listings of resources to guide and inform anyone who cares for children. Section 1, on child health care, provides a brief history of…

  8. Caring for Kids: Useful Information and Hard-to-Find Facts about Child Health and Development.

    ERIC Educational Resources Information Center

    Keener, Patricia A.

    With input and recommendations from physicians, health care professionals, and parents, this book for parents, grandparents, and child caregivers provides numerous interesting facts, pages of useful information, and listings of resources to guide and inform anyone who cares for children. Section 1, on child health care, provides a brief history of

  9. Risk perception during information system development in non-profit health care organizations.

    PubMed

    Vimarlund, V; Timpka, T; Ljunggren, M

    1998-09-01

    The perception of risk exposure among design team members during the early phases of information system development projects can provide valuable strategic information for clinical organizations. To develop a typology of perceived risks during information system development projects in health care, interviews were performed with key team members from a specialist clinic, primary health care, and an informatics research group, during the requirements specification. Phenomenological data analysis and secondary integration of the results in available theories were performed. System objectives, the user requirements definition procedure, the communication pattern between design team members and project management were found to be perceived as the main risk areas. In the secondary analysis, the technical factors, identified as preventing a maximization of the use of the resources, were lack of informatics knowledge among economic decision makers and differences between customers and suppliers regarding their views on the nature of system design. During the implementation of a given strategy, decision makers may consider the requests of their own sponsors in the first place and maximize the use of the project resources in the second place. Informatics knowledge plays a key role in risk perception during the development of an information system in health care. Political considerations by team members are important to take into regard, since these may influence technical and economic decisions. PMID:9787632

  10. Gamma delta T cell responses associated with the development of tuberculosis in health care workers.

    PubMed

    Ordway, Diane J; Pinto, Luisa; Costa, Leonor; Martins, Marta; Leandro, Clara; Viveiros, Miguel; Amaral, Leonard; Arroz, Maria J; Ventura, Fernando A; Dockrell, Hazel M

    2005-03-01

    This study evaluated T cell immune responses to purified protein derivative (PPD) and Mycobacterium tuberculosis (Mtb) in health care workers who remained free of active tuberculosis (HCWs w/o TB), health care workers who went on to develop active TB (HCWs w/TB), non-health care workers who were TB free (Non-HCWs) and tuberculosis patients presenting with minimal (Min TB) or advanced (Adv TB) disease. Peripheral blood mononuclear cells (PBMC) were stimulated with Mtb and PPD and the expression of T cell activation markers CD25+ and HLA-DR+, intracellular IL-4 and IFN-gamma production and cytotoxic responses were evaluated. PBMC from HCWs who developed TB showed decreased percentages of cells expressing CD8+CD25+ in comparison to HCWs who remained healthy. HCWs who developed TB showed increased gammadelta TCR+ cell cytotoxicity and decreased CD3+gammadelta TCR- cell cytotoxicity in comparison to HCWs who remained healthy. PBMC from TB patients with advanced disease showed decreased percentages of CD25+CD4+ and CD25+CD8+ T cells that were associated with increased IL-4 production in CD8+ and gammadelta TCR+ phenotypes, in comparison with TB patients presenting minimal disease. TB patients with advanced disease showed increased gammadelta TCR+ cytotoxicity and reduced CD3+gammadelta TCR- cell cytotoxicity. Our results suggest that HCWs who developed TB show an early compensatory mechanism involving an increase in lytic responses of gammadelta TCR+ cells which did not prevent TB. PMID:15708307

  11. Multilateral Boundary Spanners: Creating Virtuous Cycles in the Development of Health Care Networks.

    PubMed

    Patru, Daniela; Lauche, Kristina; van Kranenburg, Hans; Ziggers, Gerrit Willem

    2015-12-01

    Understanding how health care networks achieve their goals is critical for managers and researchers alike. Our study addresses this issue by applying qualitative methods to retrospectively study the involvement of boundary spanners in the setup and implementation of a health care network in the Netherlands. We found that boundary spanners who acted multilaterally, that is, both within and across organizations, could successfully represent their organizations' interests at the network level and implement the required intraorganizational developments. By acting multilaterally, these boundary spanners generated virtuous cycles in the development of the network, whereby their successful actions supported the actions of their subordinates in setting up and implementing network agreements. In contrast, boundary spanners who had not been acting multilaterally before the network's kickoff were insufficiently prepared to enact their network-related tasks, and only successfully did so once they began operating both within and across organizations. PMID:26067578

  12. A decade of integration and collaboration: the development of integrated health care in Sweden 2000–2010

    PubMed Central

    Ahgren, Bengt; Axelsson, Runo

    2011-01-01

    Introduction The recent history of integrated health care in Sweden is explored in this article, focusing on the first decade of the 2000s. In addition, there are some reflections about successes and setbacks in this development and challenges for the next decade. Description of policy and practice The first efforts to integrate health care in Sweden appeared in the beginning of the 1990s. The focus was on integration of intra-organisational processes, aiming at a more cost-effective health care provision. Partly as a reaction to the increasing economism at that time, there was also a growing interest in quality improvement. Out of this work emerged the ‘chains of care’, integrating all health care providers involved in the care of specific patient groups. During the 2000s, many county councils have also introduced inter-organisational systems of ‘local health care’. There has also been increasing collaboration between health professionals and other professional groups in different health and welfare services. Discussion and conclusion Local health care meant that the chains of care and other forms of integration and collaboration became embedded in a more integrative context. At the same time, however, policy makers have promoted free patient choice in primary health care and also mergers of hospitals and clinical departments. These policies tend to fragment the provision of health care and have an adverse effect on the development of integrated care. As a counterbalance, more efforts should be put into evaluation of integrated health care, in order to replace political convictions with evidence concerning the benefits of such health care provision. PMID:21677844

  13. Health care in Brazil.

    PubMed Central

    Haines, A

    1993-01-01

    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

  14. User-Centered Design of Health Care Software Development: Towards a Cultural Change.

    PubMed

    Stanziola, Enrique; Uznayo, María Quispe; Ortiz, Juan Marcos; Simón, Mariana; Otero, Carlos; Campos, Fernando; Luna, Daniel

    2015-01-01

    Health care software gets better user efficiency, efficacy and satisfaction when the software is designed with their users' needs taken into account. However, it is not trivial to change the practice of software development to adopt user-centered design. In order to produce this change in the Health Informatics Department of the Hospital Italiano de Buenos Aires, a plan was devised and implemented. The article presents the steps of the plan, shows how the steps were carried on, and reflects on the lessons learned through the process. PMID:26262073

  15. Historical analysis of the development of health care facilities in Kerala State, India.

    PubMed

    Kutty, V R

    2000-03-01

    Kerala's development experience has been distinguished by the primacy of the social sectors. Traditionally, education and health accounted for the greatest shares of the state government's expenditure. Health sector spending continued to grow even after 1980 when generally the fiscal deficit in the state budget was growing and government was looking for ways to control expenditure. But growth in the number of beds and institutions in the public sector had slowed down by the mid-1980s. From 1986-1996, growth in the private sector surpassed that in the public sector by a wide margin. Public sector spending reveals that in recent years, expansion has been limited to revenue expenditure rather than capital, and salaries at the cost of supplies. Many developments outside health, such as growing literacy, increasing household incomes and population ageing (leading to increased numbers of people with chronic afflictions), probably fueled the demand for health care already created by the increased access to health facilities. Since the government institutions could not grow in number and quality at a rate that would have satisfied this demand, health sector development in Kerala after the mid-1980s has been dominated by the private sector. Expansion in private facilities in health has been closely linked to developments in the government health sector. Public institutions play by far the dominant role in training personnel. They have also sensitized people to the need for timely health interventions and thus helped to create demand. At this point in time, the government must take the lead in quality maintenance and setting of standards. Current legislation, which has brought government health institutions under local government control, can perhaps facilitate this change by helping to improve standards in public institutions. PMID:10731241

  16. [Health care insurance for Africa].

    PubMed

    Schellekens, O P; Lindner, M E; van Esch, J P L; van Vugt, M; Rinke de Wit, T F

    2007-12-01

    Long-term substantial development aid has not prevented many African countries from being caught in a vicious circle in health care: the demand for care is high, but the overburdened public supply of low quality care is not aligned with this demand. The majority of Africans therefore pay for health care in cash, an expensive and least solidarity-based option. This article describes an innovative approach whereby supply and demand of health care can be better aligned, health care can be seen as a value chain and health insurance serves as the overarching mechanism. Providing premium subsidies for patients who seek health care through private, collective African health insurance schemes stimulates the demand side. The supply of care improves by investing in medical knowledge, administrative systems and health care infrastructure. This initiative comes from the Health Insurance Fund, a unique collaboration of public and private sectors. In 2006 the Fund received Euro 100 million from the Dutch Ministry of Foreign Affairs to implement insurance programmes in Africa. PharmAccess Foundation is the Fund's implementing partner and presents its first experiences in Africa. PMID:18179087

  17. Developing the DESCARTE Model: The Design of Case Study Research in Health Care.

    PubMed

    Carolan, Clare M; Forbat, Liz; Smith, Annetta

    2016-04-01

    Case study is a long-established research tradition which predates the recent surge in mixed-methods research. Although a myriad of nuanced definitions of case study exist, seminal case study authors agree that the use of multiple data sources typify this research approach. The expansive case study literature demonstrates a lack of clarity and guidance in designing and reporting this approach to research. Informed by two reviews of the current health care literature, we posit that methodological description in case studies principally focuses on description of case study typology, which impedes the construction of methodologically clear and rigorous case studies. We draw from the case study and mixed-methods literature to develop the DESCARTE model as an innovative approach to the design, conduct, and reporting of case studies in health care. We examine how case study fits within the overall enterprise of qualitatively driven mixed-methods research, and the potential strengths of the model are considered. PMID:26336896

  18. Development of scales to assess patients' perception of physicians' cultural competence in health care interactions.

    PubMed

    Ahmed, Rukhsana; Bates, Benjamin R

    2012-07-01

    This study describes the development of scales to measure patients' perception of physicians' cultural competence in health care interactions and thus contributes to promoting awareness of physician-patient intercultural interaction processes. Surveys were administrated to a total of 682 participants. Exploratory factor analyses were employed to assess emergent scales and subscales to develop reliable instruments. The first two phases were devoted to formative research and pilot study. The third phase was devoted to scale development, which resulted in a five-factor solution to measure patient perception of physicians' cultural competence for patient satisfaction. PMID:22477717

  19. Information needs of health care workers in developing countries: a literature review with a focus on Africa

    PubMed Central

    Pakenham-Walsh, Neil; Bukachi, Frederick

    2009-01-01

    Health care workers in developing countries continue to lack access to basic, practical information to enable them to deliver safe, effective care. This paper provides the first phase of a broader literature review of the information and learning needs of health care providers in developing countries. A Medline search revealed 1762 papers, of which 149 were identified as potentially relevant to the review. Thirty-five of these were found to be highly relevant. Eight of the 35 studies looked at information needs as perceived by health workers, patients and family/community members; 14 studies assessed the knowledge of health workers; and 8 looked at health care practice. The studies suggest a gross lack of knowledge about the basics on how to diagnose and manage common diseases, going right across the health workforce and often associated with suboptimal, ineffective and dangerous health care practices. If this level of knowledge and practice is representative, as it appears to be, it indicates that modern medicine, even at a basic level, has largely failed the majority of the world's population. The information and learning needs of family caregivers and primary and district health workers have been ignored for too long. Improving the availability and use of relevant, reliable health care information has enormous potential to radically improve health care worldwide. PMID:19356239

  20. Academic Health Centers and Health Care Reform.

    ERIC Educational Resources Information Center

    Miles, Stephen H.; And Others

    1993-01-01

    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…

  1. Developing a tool for mapping adult mental health care provision in Europe: the REMAST research protocol and its contribution to better integrated care

    PubMed Central

    Amaddeo, Francesco; Gutiérrez-Colosía, Mencia R.; Salazzari, Damiano; Gonzalez-Caballero, Juan Luis; Montagni, Ilaria; Tedeschi, Federico; Cetrano, Gaia; Chevreul, Karine; Kalseth, Jorid; Hagmair, Gisela; Straßmayr, Christa; Park, A-La; Sfetcu, Raluca; Wahlbeck, Kristian; Garcia-Alonso, Carlos

    2015-01-01

    Introduction Mental health care is a critical area to better understand integrated care and to pilot the different components of the integrated care model. However, there is an urgent need for better tools to compare and understand the context of integrated mental health care in Europe. Method The REMAST tool (REFINEMENT MApping Services Tool) combines a series of standardised health service research instruments and geographical information systems (GIS) to develop local atlases of mental health care from the perspective of horizontal and vertical integrated care. It contains five main sections: (a) Population Data; (b) the Verona Socio-economic Status (SES) Index; (c) the Mental Health System Checklist; (d) the Mental Health Services Inventory using the DESDE-LTC instrument; and (e) Geographical Data. Expected results The REMAST tool facilitates context analysis in mental health by providing the comparative rates of mental health service provision according to the availability of main types of care; care placement capacity; workforce capacity; and geographical accessibility to services in the local areas in eight study areas in Austria, England, Finland, France, Italy, Norway, Romania and Spain. Discussion The outcomes of this project will facilitate cooperative work and knowledge transfer on mental health care to the different agencies involved in mental health planning and provision. This project would improve the information to users and society on the available resources for mental health care and system thinking at the local level by the different stakeholders. The techniques used in this project and the knowledge generated could eventually be transferred to the mapping of other fields of integrated care. PMID:27118959

  2. Equity in health care.

    PubMed

    La Rosa-Salas, Virginia; Tricas-Sauras, Sandra

    2008-01-01

    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

  3. Rural Health and Spiritual Care Development: A Review of Programs across Rural Victoria, Australia.

    PubMed

    Carey, Lindsay B; Hennequin, Christine; Krikheli, Lillian; O'Brien, Annette; Sanchez, Erin; Marsden, Candace R

    2016-06-01

    Given declining populations in rural areas and diminishing traditional religious support, this research explores whether spiritual care education programs would be beneficial for and appreciated by those working in rural health and/or community organizations. An overview of literature identified three dominant rural health issues affecting the provision of spiritual care in rural areas, namely the disparity between rural and urban areas in terms of resources, the lack of access to services, plus the need for education and training within rural areas. Spiritual Health Victoria Incorporated (Victoria, Australia) sought to address these issues with the implementation of a variety of spiritual education programs within rural areas. Results of an evaluation of these programs are presented specifying participant demographics, reasons why participants attended, their evaluation of the program and any recommendations for future programs. In overall terms, the results indicated that at least 90 % of participants favorably rated their attended program as either 'very good' or 'good' and indicated that the main reason for their attendance was to develop their own education and/or practice of spiritual care within their rural context for the benefit of local constituents. Several recommendations are made for future programs. PMID:26350290

  4. Developing integrated health and social care services for older persons in Europe

    PubMed Central

    Leichsenring, Kai

    2004-01-01

    Abstract Purpose This paper is to distribute first results of the EU Fifth Framework Project ‘Providing integrated health and social care for older persons—issues, problems and solutions’ (PROCARE—http://www.euro.centre.org/procare/). The project's first phase was to identify different approaches to integration as well as structural, organisational, economic and social-cultural factors and actors that constitute integrated and sustainable care systems. It also served to retrieve a number of experiences, model ways of working and demonstration projects in the participating countries which are currently being analysed in order to learn from success—or failure—and to develop policy recommendations for the local, national and European level. Theory The paper draws on existing definitions of integrated care in various countries and by various scholars. Given the context of an international comparative study it tries to avoid providing a single, ready-made definition but underlines the role of social care as part and parcel of this type of integrated care in the participating countries. Methods The paper is based on national reports from researchers representing ten organisations (university institutes, consultancy firms, research institutes, the public and the NGO sector) from 9 European countries: Austria, Denmark, Finland, France, Germany, Greece, Italy, the Netherlands, and the UK. Literature reviews made intensive use of grey literature and evaluation studies in the context of at least five model ways of working in each country. Results As a result of the cross-national overview an attempt to classify different approaches and definitions is made and indicators of relative importance of the different instruments used in integrating health and social care services are provided. Conclusions The cross-national overview shows that issues concerning co-ordination and integration of services are high on the agenda in most countries. Depending on the state of service development, various approaches and instruments can be observed. Different national frameworks, in particular with respect to financing and organisation, systemic development, professionalisation and professional cultures, basic societal values (family ethics), and political approaches have to be taken into account during the second phase of PROCARE during which transversal and transnational analysis will be undertaken based on an in-depth analysis of two model ways of working in each country. Discussion Far from a European vision concerning integrated care, national health and social care systems remain—at best—loosely coupled systems that are facing increasing difficulties, given the current challenges, in particular in long-term care for older persons: increasing marketisation, lack of managerial knowledge (co-operation, co-ordination), shortage of care workers and a general trend towards down-sizing of social care services continue to hamper the first tentative pathways towards integrated care systems. PMID:16773149

  5. Lean health care.

    PubMed

    Hawthorne, Henry C; Masterson, David J

    2013-01-01

    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

  6. The Women's Health Care Empowerment Model as a Catalyst for Change in Developing Countries.

    PubMed

    Mitroi, Lavinia R; Sahak, Medina; Sherzai, Ayesha Z; Sherzai, Dean

    2016-03-01

    Women's empowerment has been attempted through a number of different fields including the realms of politics, finance, and education, yet none of these domains are as promising as health care. Here we review preliminary work in this domain and introduce a model for women's empowerment through involvement in health care, titled the "women's health care empowerment model." Principles upon which our model is built include: acknowledging the appropriate definition of empowerment within the cultural context, creating a women's network for communication, integrating local culture and tradition into training women, and increasing the capability of women to care for their children and other women. PMID:24945243

  7. The role of wages in the migration of health care professionals from developing countries

    PubMed Central

    Vujicic, Marko; Zurn, Pascal; Diallo, Khassoum; Adams, Orvill; Dal Poz, Mario R

    2004-01-01

    Several countries are increasingly relying on immigration as a means of coping with domestic shortages of health care professionals. This trend has led to concerns that in many of the source countries especially within Africa the outflow of health care professionals is adversely affecting the health care system. This paper examines the role of wages in the migration decision and discusses the likely effect of wage increases in source countries in slowing migration flows. This paper uses data on wage differentials in the health care sector between source country and receiving country (adjusted for purchasing power parity) to test the hypothesis that larger wage differentials lead to a larger supply of health care migrants. Differences in other important factors affecting migration are discussed and, where available, data are presented. There is little correlation between the supply of health care migrants and the size of the wage differential between source and destination country. In cases where data are available on other factors affecting migration, controlling for these factors does not affect the result. At current levels, wage differentials between source and destination country are so large that small increases in health care wages in source countries are unlikely to affect significantly the supply of health care migrants. The results suggest that non-wage instruments might be more effective in altering migration flows. PMID:15115549

  8. Adolescent health care in Brazil.

    PubMed

    Silber, T J

    1984-01-01

    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

  9. Development and piloting of a plan for integrating mental health in primary care in Sehore district, Madhya Pradesh, India

    PubMed Central

    Shidhaye, Rahul; Shrivastava, Sanjay; Murhar, Vaibhav; Samudre, Sandesh; Ahuja, Shalini; Ramaswamy, Rohit; Patel, Vikram

    2016-01-01

    Background The large treatment gap for mental disorders in India underlines the need for integration of mental health in primary care. Aims To operationalise the delivery of the World Health Organization Mental Health Gap Action Plan interventions for priority mental disorders and to design an integrated mental healthcare plan (MHCP) comprising packages of care for primary healthcare in one district. Method Mixed methods were used including theory of change workshops, qualitative research to develop the MHCP and piloting of specific packages of care in a single facility. Results The MHCP comprises three enabling packages: programme management, capacity building and community mobilisation; and four service delivery packages: awareness for mental disorders, identification, treatment and recovery. Challenges were encountered in training primary care workers to improve identification and treatment. Conclusions There are a number of challenges to integrating mental health into primary care, which can be addressed through the injection of new resources and collaborative care models. PMID:26447172

  10. Development and piloting of a plan for integrating mental health in primary care in Sehore district, Madhya Pradesh, India.

    PubMed

    Shidhaye, Rahul; Shrivastava, Sanjay; Murhar, Vaibhav; Samudre, Sandesh; Ahuja, Shalini; Ramaswamy, Rohit; Patel, Vikram

    2016-01-01

    BackgroundThe large treatment gap for mental disorders in India underlines the need for integration of mental health in primary care.AimsTo operationalise the delivery of the World Health Organization Mental Health Gap Action Plan interventions for priority mental disorders and to design an integrated mental healthcare plan (MHCP) comprising packages of care for primary healthcare in one district.MethodMixed methods were used including theory of change workshops, qualitative research to develop the MHCP and piloting of specific packages of care in a single facility.ResultsThe MHCP comprises three enabling packages: programme management, capacity building and community mobilisation; and four service delivery packages: awareness for mental disorders, identification, treatment and recovery. Challenges were encountered in training primary care workers to improve identification and treatment.ConclusionsThere are a number of challenges to integrating mental health into primary care, which can be addressed through the injection of new resources and collaborative care models. PMID:26447172

  11. Development of a psychometrically valid training needs analysis instrument for use with primary health care teams.

    PubMed

    Hicks, C; Hennessy, D; Barwell, F

    1996-11-01

    The growing demand for professional updating and training within the health service has created a proliferation of post-registration courses, many of which fail to reach the appropriate personnel or the real training objectives of the participants and their managers. One reason behind this problem relates to the fact that many such courses are constructed and delivered in a haphazard way, without systematic reference to the direct and indirect consumers of the educational programmes. A more rational approach to post-experience provision of this sort might involve the methodical collection of information regarding the training needs of target health professional populations. Such a data base would afford a global overview of competencies and deficiencies, both within and between individuals. From this the content, level and focus of training could be customized to meet the reported needs, thereby streamlining the commissioning process to enhance efficiency and effectiveness. Previous attempts to rationalize provision through the prior use of training needs analysis instruments have been compromised by the shortcomings of the analysis tool. This study, then, was an attempt to redress this problem, using a training needs analysis instrument developed along traditional psychometric principles. The tool was intended to be used with primary health care teams because of the increasing role this sector of the health service will play in the future delivery of care, although this would not preclude its use with other health care professionals (following appropriate modification), since the principles behind its construction and format are transferable. The instrument has demonstrable construct, content and face validity and significant reliability. Moreover, preliminary investigations suggest that it also has criterion validity in the areas tested. These findings suggest that the instrument is unique of its kind. Early use of the tool has demonstrated its value in a variety of ways, such as in team building exercises and skill mix reviews as well as in precise and effective commissioning of training and education in a range of areas. PMID:10162523

  12. The Health Care Home Model: Primary Health Care Meeting Public Health Goals

    PubMed Central

    Greene, Danielle

    2012-01-01

    In November 2010, the American Public Health Association endorsed the health care home model as an important way that primary care may contribute to meeting the public health goals of increasing access to care, reducing health disparities, and better integrating health care with public health systems. Here we summarize the elements of the health care home (also called the medical home) model, evidence for its clinical and public health efficacy, and its place within the context of health care reform legislation. The model also has limitations, especially with regard to its degree of involvement with the communities in which care is delivered. Several actions could be undertaken to further develop, implement, and sustain the health care home. PMID:22515874

  13. Low-Cost Rural Health Care and Health Manpower Training. An Annotated Bibliography with Special Emphasis on Developing Countries. Volume 4.

    ERIC Educational Resources Information Center

    Delaney, Frances M., Comp.

    This fourth volume in a bibliography series on low-cost rural health care contains 700 entries covering the 1960's-1970's and focusing on developing countries. The bibliography is organized under five major subject headings: reference works, organization and planning, implementation of primary health care, training and utilization of primary…

  14. Remodeling health care.

    PubMed

    Sprinkle, R H

    1994-01-01

    Standard models of patient demand for health care and health care suppliers' response to that demand imply that some manner of manipulation of the prices faced by patients must be chief among the mechanisms of systemic cost control. However convenient econometrically, these standard models cannot reflect the complexity of patient demand behavior, and they say little about the predominant causes of health-care cost escalation. This paper describes a richer Jevonian political-economic model that sensibly portrays patient demand and physician and corporate supply behaviors and suggests a range of cost-controlling and care-enhancing compensatory steps, some professional, some societal. This new model implies that reformers in the United States could take respectful advantage of the fundamentally self-regulating nature of patient demand for health care by shifting their attention away from its further discouragement and toward the modulation of other factors. PMID:8014422

  15. Development of an Algorithm to Identify Pregnancy Episodes in an Integrated Health Care Delivery System

    PubMed Central

    Hornbrook, Mark C; Whitlock, Evelyn P; Berg, Cynthia J; Callaghan, William M; Bachman, Donald J; Gold, Rachel; Bruce, F Carol; Dietz, Patricia M; Williams, Selvi B

    2007-01-01

    Objective To develop and validate a software algorithm to detect pregnancy episodes and maternal morbidities using automated data. Data Sources/Study Setting Automated records from a large integrated health care delivery system (IHDS), 1998–2001. Study Design Through complex linkages of multiple automated information sources, the algorithm estimated pregnancy histories. We evaluated the algorithm's accuracy by comparing selected elements of the pregnancy history obtained by the algorithm with the same elements manually abstracted from medical records by trained research staff. Data Collection/Extraction Methods The algorithm searched for potential pregnancy indicators within diagnosis and procedure codes, as well as laboratory tests, pharmacy dispensings, and imaging procedures associated with pregnancy. Principal Findings Among 32,847 women with potential pregnancy indicators, we identified 24,680 pregnancies occuring to 21,001 women. Percent agreement between the algorithm and medical records review on pregnancy outcome, gestational age, and pregnancy outcome date ranged from 91 percent to 98 percent. The validation results were used to refine the algorithm. Conclusions This pregnancy episode grouper algorithm takes advantage of databases readily available in IHDS, and has important applications for health system management and clinical care. It can be used in other settings for ongoing surveillance and research on pregnancy outcomes, pregnancy-related morbidities, costs, and care patterns. PMID:17362224

  16. Health-Care Hub

    ERIC Educational Resources Information Center

    Bowman, Darcia Harris

    2004-01-01

    The Broad Acres clinic is one of 1,500 school-based health centers nationwide that bring a wide range of medical, nutritional, and mental-health care to millions of students and their families. The centers provide an important safety net for children and adolescents--particularly the more than 10 million today who lack health insurance, according…

  17. Modernization and development: impact on health care decision-making in Uganda.

    PubMed

    Singh, Debra Anne Kaur; Earnest, Jaya; Lample, May

    2015-01-01

    Uganda has faced numerous challenges over the past 50 years from overcoming political conflict and civil unrest, to rapid population growth, to combating the HIV epidemic and ever-growing health needs. Women in Uganda have had a major role to play in the health of families and communities. The researchers' purpose in this study, undertaken in rural Uganda, was to a) identify a people-centered definition of development, b) compare it to the process of modernization, and c) investigate how these processes have changed the role women play in decision-making, in areas directly and indirectly related to their health and that of their families. Twenty-two men and women participated in focus group discussion and completed questionnaires. Based on our analysis of discussions it appears that both modernization and development have impacted health positively and negatively. Key themes distilled from interviews included that modernization has led to the breakdown of families; increased maternal responsibility for children; diminished land and economic resources; and an erosion of cultural values and practices that had previously provided stability for the society. In terms of development, women play an increasing role in decision-making processes in the household and are gaining increasing respect for their expertise in a number of areas, notably health care. We propose a movement of grassroots discourse on modernization. Development, and its effect on health, is necessary if the positive aspects of Ugandan culture and those of similar emerging societies are not to be lost (International Covenant on Economic, Social and Cultural Rights, 1966). PMID:23862662

  18. Health care in Africa.

    PubMed

    Brown, M S

    1984-07-01

    This is the third and last article reporting professional exchange tours between American nurses and nurses of other countries. In this article, the health care system of Kenya is discussed and comparisons made between this system and our own. Out of this comparison come several insights into our own way of doing things and possibilities for improving them. "Health Care in the Soviet Union" appeared in the April 1984 issue of The Nurse Practitioner. "Health Care in China" appeared in the May 1984 issue of the journal. PMID:6462542

  19. Health Care Shadows: A Unique Opportunity for Health Care Exploration and the Development of Standard-Based Skills. [Fourth Edition]. Career Exploration.

    ERIC Educational Resources Information Center

    Health Resources and Services Administration (DHHS/PHS), Rockville, MD. Bureau of Primary Health Care.

    Shadows is an individualized, hands-on, real-world career experience that provides students with a structured look at the future world of work in health care. The program helps students build a bridge between school-based learning and established health care skills standards. Shadows focuses on expanding the student's horizons beyond the classroom…

  20. What is the health care product?

    PubMed

    France, K R; Grover, R

    1992-06-01

    Because of the current competitive environment, health care providers (hospitals, HMOs, physicians, and others) are constantly searching for better products and better means for delivering them. The health care product is often loosely defined as a service. The authors develop a more precise definition of the health care product, product line, and product mix. A bundle-of-elements concept is presented for the health care product. These conceptualizations help to address how health care providers can segment their market and position, promote, and price their products. Though the authors focus on hospitals, the concepts and procedures developed are applicable to other health care organizations. PMID:10119211

  1. Asian American health care attitudes.

    PubMed

    Perttula, W; Lowe, D; Quon, N S

    1999-01-01

    This paper describes the results of a survey of health care attitudes of a sample of respondents primarily of Asian American background. The importance of bilingualism, Asian background, age, and other attributes of a physician are discussed with relation to subgroups in the sample. The relative importance of the influence of doctors, family, and friends on the choice of physician and health care facility are also presented. The findings may help with the development of effective market segmentation and improved health care service to the Asian American community. PMID:10538733

  2. The viability of the concept of a primary health care team in developing countries.

    PubMed

    Boerma, T

    1987-01-01

    The concept of a team approach in primary health care (PHC) is an integral part of the overall PHC strategy and is advocated at many occasions. Its theoretical advantages are multiple, even though very few sound studies exist on the effectiveness of PHC team. The viability of the concept of PHC teams is affected by two groups of factors. The first group is related to (health) manpower problems in developing countries with its underlying economic causes. The second group of factors is associated with the viability of the PHC concept in general. This pertains to decentralization, intersectoral collaboration and community participation which all affect the viability of the concept of PHC teams. PMID:3686105

  3. The health care information directive

    PubMed Central

    2001-01-01

    Background Developments in information technology promise to revolutionise the delivery of health care by providing access to data in a timely and efficient way. Information technology also raises several important concerns about the confidentiality and privacy of health data. New and existing legislation in Europe and North America may make access to patient level data difficult with consequent impact on research and health surveillance. Although research is being conducted on technical solutions to protect the privacy of personal health information, there is very little research on ways to improve individuals power over their health information. This paper proposes a health care information directive, analogous to an advance directive, to facilitate choices regarding health information disclosure. Results and Discussion A health care information directive is described which creates a decision matrix that combines the ethical appropriateness of the use of personal health information with the sensitivity of the data. It creates a range of possibilities with in which individuals can choose to contribute health information with or without consent, or not to contribute information at all. Conclusion The health care information directive may increase individuals understanding of the uses of health information and increase their willingness to contribute certain kinds of health information. Further refinement and evaluation of the directive is required. PMID:11331535

  4. Development and implementation of training for interdisciplinary research in primary health care.

    PubMed

    Stewart, Moira; Reid, Graham; Brown, Judith Belle; Burge, Fred; Dicenso, Alba; Watt, Susan; McWilliam, Carol; Beaulieu, Marie-Dominique; Meredith, Leslie

    2010-06-01

    The authors describe a national training program in Canada focusing on research in primary health care (PHC). The program, sponsored by the Canadian Institutes of Health Research's Strategic Training in Health Research Program, is called Transdisciplinary Understanding and Training on Research-Primary Health Care (TUTOR-PHC); it began in 2002 and is funded to continue until 2015. The purpose-built curriculum has two main goals: (1) to build a cadre of skilled, independent researchers to enhance the evidence base for PHC practice and policy and (2) to increase the interdisciplinary focus in PHC research. The program consists of three elements: (1) a three-day on-site symposium, (2) four online workshops (three weeks each), and (3) two online interdisciplinary discussion groups (seven weeks each). Participants develop PHC research skills during in-person and online workshops. They gain knowledge of and experience in interdisciplinary PHC research through participation in interdisciplinary discussion groups and by observing mentor interactions. Both the symposium and the online components involve a variety of interactive education approaches. The 77 graduates from across Canada represent 14 disciplines, most commonly family medicine, nursing, epidemiology, psychology, social work, and sociology. Graduates of the program publish at a high rate and are building their careers in PHC research. The structure of TUTOR-PHC encourages not only skill development and content uptake but also the exchange of tacit knowledge. The complete program leads to a synthesis of skills, knowledge, personal communication abilities, and cross-discipline curiosity, creating a well-rounded collaborative PHC researcher. PMID:20505396

  5. Children with Special Health Needs in School: Developing an Individualized Educational Program (IEP) and an Individualized Health Care Plan (IHCP).

    ERIC Educational Resources Information Center

    Janz, Jan; And Others

    This paper considers ways to help children with special health needs by utilizing the Individualized Education Program (IEP) and the Individualized Health Care Plan (IHCP). Results of a study which found a lack of necessary health information in school documents is summarized. The school nurse is seen as a pivotal person in the identification and…

  6. International health care spending.

    PubMed

    Schieber, G J; Puollier, J P

    1986-01-01

    Trends in health are reviewed for the member countries of the Organization for Economic Cooperation and Development (OECD) covering the following: the basic difficulties inherent in international comparative studies; the absolute levels of health expenditures in 1984; the levels and rates of growth of the health share in the gross domestic product (GDP) and the public share of total health expenditures; the elasticities of real health expenditures to real GDP for the 1960-75, 1975-84, and 1960-84 time periods; growth in health expenditures for the largest 7 OECD countries in terms of growth in population, health prices, health care prices in excess of overall prices, and utilization/intensity of services per person. International comparisons are a problem due to differences in defining the boundaries of the health sector, the heterogeneity of data, and methodological problems arising from comparing different economic, demographic, cultural, and institutional structures. The most difficult problem in international comparisons of health expenditures is lack of appropriate measures of health outcome. Exhibit 1 contains per capita health expenditures denominated in US dollars based on GDP purchasing power parities for 21 OECD countries for 1984. Per capita health expenditures ranged from less than $500 in Greece, Portugal, and Spain to over $1400 in Sweden and the US, with an OECD average of $871. After adjusting for price level differences, there still appears to be a greater than 3-fold difference in the "volume" of services consumed across the OECD countries. To determine if per capita health expenditures are related to a country's wealth as measured by its per capita GDP, the relationship between per capita health expenditures and per capita GDP for the 21 countries were examined for 1984. The data points and the "best fitting" trend line indicate a statistically significant relationship in which each $100 difference in per capita GDP is associated with a $10.50 difference in per capita health expenditures. The calculated elasticity is 1.4 indicating that each 10% difference in per capita GDP is associated with a 14% difference in per capita health expenditures. The analysis indicates that variations in per capita GDP, alone, are associated with 7 of the variation in per capita health spending. In 1984, health spending in the 18 OECD countries (for which data were consistently available for all 6 different years) was on average 7.5% of GDP. The US had the highest GDP share (10.7%) and Greece had the lowest (4.6%). The average elasticity of 16 of the 18 countries as a group substantially exceeded 1.0 for the 1960-84 period, as well as the 1960-75 (1.6) and 1975-84 (1.3) subperiods. Thus, real health spending increased 60% faster than the real GDP between 1960-84 and between 1960-75 and 30% faster between 1975-84. PMID:3098657

  7. [The economics of health care in developing countries: what the fight against the AIDS epidemics has changed].

    PubMed

    Moatti, Jean Paul

    2008-12-01

    Since the start of the new century, development aid targeted on health care has seen an unprecedented rise, driven by the fight against AIDS. This article shows how this struggle has been accompanied with a renewal of the economic paradigms governing international action in favour of health care in developing countries: the idea that an improvement in health care constitutes an unavoidable prerequisite to macroeconomic growth, rather than a consequence; the insistence on the founding of mechanisms for health insurance to finance the costs of health care, rather than covering the costs at the point of use by the health care users; a concern to impose price differentials for access to medicine in developing countries, and to introduce flexibility in the regulation of international intellectual property law; the priority to vertical programmes targeted on certain illnesses, thought to act as levers for a global reinforcement of health care systems. This article discusses the pertinence of these new paradigms in light of the evolution of the AIDS/HIV epidemic, and the international context. PMID:19027697

  8. Cultural affiliation and the importance of health care attributes. Marketers can develop segmentation strategies for targeted patient groups.

    PubMed

    Dolinsky, A L; Stinerock, R

    1998-01-01

    Culturally based values are known to influence consumer purchase decisions, but little is known about how those values affect health care choices. To rectify that situation and provide health care marketers with a framework for developing culturally based segmentation strategies, the authors undertook an exploratory research project in which Hispanic-, African-, and Anglo-Americans were asked to rate the importance of 16 different health care attributes. Those attributes can be grouped under five categories: quality of physician, quality of nurses and other medical staff, economic issues, access to health care, and nonmedically related experiential aspects. Survey responses identified distinct differences in the importance attached to the various attributes by the three cultural groups. The study also looks at the impact of six demographic and social characteristics on the evaluations made by each cultural group. Those characteristics are educational level, gender, age, health status, marital status, and number of people living in the household. PMID:10179392

  9. Selective primary health care: an interim strategy for disease control in developing countries.

    PubMed

    Walsh, J A; Warren, K S

    1979-11-01

    Priorities among the infectious diseases affecting the three billion people in the less developed world have been based on prevalence, morbidity, mortality and feasibility of control. With these priorities in mind a program of selective primary health care is compared with other approaches and suggested as the most cost-effective form of medical intervention in the least developed countries. A flexible program delivered by either fixed or mobile units might include measles and diphtheria-pertussis-tetanus vaccination, treatment for febrile malaria and oral rehydration for diarrhea in children, and tetanus toxoid and encouragement of breast feeding in mothers. Other interventions might be added on the basis of regional needs and new developments. For major diseases for which control measures are inadequate, research is an inexpensive approach on the basis of cost per infected person per year. PMID:114830

  10. Evaluation of an Interprofessional Continuing Professional Development Initiative in Primary Health Care

    ERIC Educational Resources Information Center

    Curran, Vernon; Sargeant, Joan; Hollett, Ann

    2007-01-01

    Introduction: Interest in collaborative care approaches and in interprofessional education (IPE) to prepare providers for interprofessional collaboration is increasing and particularly so in the field of primary health care. Although evidence for the effectiveness of IPE is mixed, Barr et al. (2005) have proposed a useful framework for evaluating…

  11. Health care in Sarawak's jungles.

    PubMed

    Chen, P C

    1989-01-01

    A primary health care system is being developed in Baram District, Sarawak, Malaysia, for the benefit of the Penans, who, until recently, were largely nomadic. Many of them are now attempting to adopt a settled mode of existence, and this in itself creates special health problems because the people lack the skills needed for living in one place. Substantial progress has already been achieved in mother and child care and in immunization coverage. PMID:2610830

  12. Mercury and health care.

    PubMed

    Rustagi, Neeti; Singh, Ritesh

    2010-08-01

    Mercury is toxic heavy metal. It has many characteristic features. Health care organizations have used mercury in many forms since time immemorial. The main uses of mercury are in dental amalgam, sphygmomanometers, and thermometers. The mercury once released into the environment can remain for a longer period. Both acute and chronic poisoning can be caused by it. Half of the mercury found in the atmosphere is human generated and health care contributes the substantial part to it. The world has awakened to the harmful effects of mercury. The World Health Organization and United Nations Environmental Programme (UNEP) have issued guidelines for the countries' health care sector to become mercury free. UNEP has formed mercury partnerships between governments and other stakeholders as one approach to reducing risks to human health and the environment from the release of mercury and its compounds to the environment. Many hospitals are mercury free now. PMID:21120080

  13. The Assessment of Adult Health Care Orientations: Development and Preliminary Validation of the Multidimensional Health Profile–Health Functioning Index (MHP-H) in a National Sample

    PubMed Central

    Karoly, Paul; Ruehlman, Linda S.; Lanyon, Richard I.

    2005-01-01

    This paper describes the development and preliminary validation of the Multidimensional Health Profile–Health Functioning Index (MHP-H), a 69-item self-report instrument designed to assess a variety of behaviors, perceptions, attitudes, and beliefs presumed to influence health status and the pursuit of lay and professional health care. The MHP-H briefly measures adult health history, health habits, health care utilization, health beliefs and attitudes, and response to illness (help-seeking behaviors). A national sample of adults (N = 673) was assessed, comprising 3 age groupings (18–32, 33–50, and 51–89) crossed with gender and then further subdivided into several subsamples for purposes of reliability and validity assessment. In addition, a group of spouse “key informants” was also recruited. Preliminary validation of single-item indicators as well as confirmatory factor analyses of multi-item scales was achieved. The present findings support the psychometric and practical utility of the MHP-H and warrant its use by health psychologists in a variety of research and applied settings. PMID:16429609

  14. Developing mental health-care quality indicators: toward a common framework

    PubMed Central

    Fisher, Carl Erik; Spaeth-Rublee, Brigitta; Alan Pincus, Harold

    2013-01-01

    Objective Inconsistent performance measurement schemes hinder attempts to make international comparisons about mental health-care quality. This report describes a project undertaken by an international collaborative group that aims to develop a common framework of measures that will allow for international comparisons of mental health system performance. Design Representatives from each country submitted reports of quality measurement initiatives in mental health. Indicators were reviewed, and all measurable indicators were compiled and organized. Sample Twenty-nine programs from 11 countries and two cross-national programs submitted reports. Methods Indicators were evaluated according to measurable inclusion criteria. Results These methods yielded 656 total measures that were organized into 17 domains and 80 subdomains. Conclusions No single program contained indicators in all domains, highlighting the need for a comprehensive, shared scheme for international measurement. By collecting and organizing measures through an inductive compilation of existing programs, the present study has generated a maximally inclusive basis for the creation of a common framework of international mental health quality indicators. PMID:23175534

  15. Development and Validation of the Chinese Health Literacy Scale for Chronic Care

    PubMed Central

    Leung, Angela Yee Man; Cheung, Mike Kwun Ting; Lou, Vivian Wei Qun; Chan, Felix Hon Wai; Ho, Celina Kit Yee; Do, Tsui Ling; Chan, Sophia Siu Chee; Chi, Iris

    2013-01-01

    This study aims to develop and test the psychometric properties of the Chinese Health Literacy Scale for Chronic Care (CHLCC). This is a methodological study with a sample of 262 patients 65 years of age and older who had chronic illnesses. Pearson's correlation, independent sample t tests, and analyses of variance were used. The CHLCC showed a significant positive correlation with Chinese literacy levels (r = 0.80; p < .001) but was negatively correlated with age (r = −0.31; p < .001). Respondents who were male (t = 4.34; p < .001) and who had reached Grade 12 or higher in school (F = 51.80; p < .001) had higher CHLCC scores than did their counterparts. Individuals with high levels of health literacy had fewer hospitalizations than did their counterparts (β = −0.31; incidence rate ratio = 0.73; p < .05). The CHLCC also displayed good internal reliability (Cronbach's α = 0.91) and good test-retest reliability (intraclass correlation coefficient = 0.77; p < .01). The CHLCC is a valid and reliable measure for assessing health literacy among Chinese patients with chronic illness. The scale could be used by practitioners before implementing health promotion and education. PMID:24093357

  16. Informing the development of services supporting self-care for severe, long term mental health conditions: a mixed method study of community based mental health initiatives in England

    PubMed Central

    2012-01-01

    Background Supporting self-care is being explored across health care systems internationally as an approach to improving care for long term conditions in the context of ageing populations and economic constraint. UK health policy advocates a range of approaches to supporting self-care, including the application of generic self-management type programmes across conditions. Within mental health, the scope of self-care remains poorly conceptualised and the existing evidence base for supporting self-care is correspondingly disparate. This paper aims to inform the development of support for self-care in mental health by considering how generic self-care policy guidance is implemented in the context of services supporting people with severe, long term mental health problems. Methods A mixed method study was undertaken comprising standardised psychosocial measures, questionnaires about health service use and qualitative interviews with 120 new referrals to three contrasting community based initiatives supporting self-care for severe, long term mental health problems, repeated nine months later. A framework approach was taken to qualitative analysis, an exploratory statistical analysis sought to identify possible associations between a range of independent variables and self-care outcomes, and a narrative synthesis brought these analyses together. Results Participants reported improvement in self-care outcomes (e.g. greater empowerment; less use of Accident and Emergency services). These changes were not associated with level of engagement with self-care support. Level of engagement was associated with positive collaboration with support staff. Qualitative data described the value of different models of supporting self-care and considered challenges. Synthesis of analyses suggested that timing support for self-care, giving service users control over when and how they accessed support, quality of service user-staff relationships and decision making around medication are important issues in supporting self-care in mental health. Conclusions Service delivery components – e.g. peer support groups, personal planning – advocated in generic self-care policy have value when implemented in a mental health context. Support for self-care in mental health should focus on core, mental health specific qualities; issues of control, enabling staff-service user relationships and shared decision making. The broad empirical basis of our research indicates the wider relevance of our findings across mental health settings. PMID:22769593

  17. Integrating mental health into chronic care in South Africa: the development of a district mental healthcare plan

    PubMed Central

    Petersen, Inge; Fairall, Lara; Bhana, Arvin; Kathree, Tasneem; Selohilwe, One; Brooke-Sumner, Carrie; Faris, Gill; Breuer, Erica; Sibanyoni, Nomvula; Lund, Crick; Patel, Vikram

    2016-01-01

    Background In South Africa, the escalating prevalence of chronic illness and its high comorbidity with mental disorders bring to the fore the need for integrating mental health into chronic care at district level. Aims To develop a district mental healthcare plan (MHCP) in South Africa that integrates mental healthcare for depression, alcohol use disorders and schizophrenia into chronic care. Method Mixed methods using a situation analysis, qualitative key informant interviews, theory of change workshops and piloting of the plan in one health facility informed the development of the MHCP. Results Collaborative care packages for the three conditions were developed to enable integration at the organisational, facility and community levels, supported by a human resource mix and implementation tools. Potential barriers to the feasibility of implementation at scale were identified. Conclusions The plan leverages resources and systems availed by the emerging chronic care service delivery platform for the integration of mental health. This strengthens the potential for future scale up. PMID:26447176

  18. Controlling Health Care Costs

    ERIC Educational Resources Information Center

    Dessoff, Alan

    2009-01-01

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

  19. Supporting Immigrant Family Strengths: Promoting Optimal Health, Health Care, and Development

    ERIC Educational Resources Information Center

    Brotanek, Jane M.; Rocha, Lisa Oglesby; Flores, Glenn

    2008-01-01

    An extensive literature documents that a lower level of acculturation is associated with better health outcomes among U.S. immigrants, despite the many hardships these families face. It is likely that cultural practices and strong family networks contribute to this phenomenon, which has been termed the "healthy immigrant effect". This article…

  20. Enhancing transgender health care.

    PubMed Central

    Lombardi, E

    2001-01-01

    As awareness of transgender men and women grows among health care educators, researchers, policymakers, and clinicians of all types, the need to create more inclusive settings also grows. Greater sensitivity and relevant information and services are required in dealing with transgender men and women. These individuals need their identities to be recognized as authentic, they need better access to health care resources, and they need education and prevention material appropriate to their experience. In addition, a need exists for activities designed to enhance understanding of transgender health issues and to spur innovation. PMID:11392924

  1. Lessons learned in developing community mental health care in Australasia and the South Pacific.

    PubMed

    McGeorge, Peter

    2012-06-01

    This paper summarizes the findings for the Australasia and Pacific Region of the WPA Task Force on Steps, Obstacles and Mistakes to Avoid in the Implementation of Community Mental Health Care. We present an overview of mental health services in the region; discuss policies, plans and programmes; chart progress towards achieving community-oriented services, and detail the lessons learned. PMID:22654946

  2. Developing personal values: trainees' attitudes toward strikes by health care providers.

    PubMed

    Li, Su-Ting T; Srinivasan, Malathi; Der-Martirosian, Claudia; Kravitz, Richard L; Wilkes, Michael S

    2011-05-01

    Worldwide, health care providers use strikes and job actions to influence policy. For health care providers, especially physicians, strikes create an ethical tension between an obligation to care for current patients (e.g., to provide care and avoid abandonment) and an obligation to better care for future patients by seeking system improvements (e.g., improvements in safety, to access, and in the composition and strength of the health care workforce). This tension is further intensified when the potential benefit of a strike involves professional self-interest and the potential risk involves patient harm or death. By definition, trainees are still forming their professional identities and values, including their opinions on fair wages, health policy, employee benefits, professionalism, and strikes. In this article, the authors explore these ethical tensions, beginning with a discussion of reactions to a potential 2005 nursing strike at the University of California, Davis, Medical Center. The authors then propose a conceptual model describing factors that may influence health care providers' decisions to strike (including personal ethics, personal agency, and strike-related context). In particular, the authors explore the relationship between training level and attitudes toward taking a job action, such as going on strike. Because trainees' attitudes toward strikes continue to evolve during training, the authors maintain that open discussion around the ethics of health care professionals' strikes and other methods of conflict resolution should be included in medical education to enhance professionalism and systems-based practice training. The authors include sample case vignettes to help initiate these important discussions. PMID:21436671

  3. Conditional Disease Development extracted from Longitudinal Health Care Cohort Data using Layered Network Construction.

    PubMed

    Kannan, Venkateshan; Swartz, Fredrik; Kiani, Narsis A; Silberberg, Gilad; Tsipras, Giorgos; Gomez-Cabrero, David; Alexanderson, Kristina; Tegnèr, Jesper

    2016-01-01

    Health care data holds great promise to be used in clinical decision support systems. However, frequent near-synonymous diagnoses recorded separately, as well as the sheer magnitude and complexity of the disease data makes it challenging to extract non-trivial conclusions beyond confirmatory associations from such a web of interactions. Here we present a systematic methodology to derive statistically valid conditional development of diseases. To this end we utilize a cohort of 5,512,469 individuals followed over 13 years at inpatient care, including data on disability pension and cause of death. By introducing a causal information fraction measure and taking advantage of the composite structure in the ICD codes, we extract an effective directed lower dimensional network representation (100 nodes and 130 edges) of our cohort. Unpacking composite nodes into bipartite graphs retrieves, for example, that individuals with behavioral disorders are more likely to be followed by prescription drug poisoning episodes, whereas women with leiomyoma were more likely to subsequently experience endometriosis. The conditional disease development represent putative causal relations, indicating possible novel clinical relationships and pathophysiological associations that have not been explored yet. PMID:27211115

  4. Health care entrepreneurship: financing innovation.

    PubMed

    Grazier, Kyle L; Metzler, Bridget

    2006-01-01

    Entrepreneurship is often described as the ability to create new ventures from new or existing concepts, ideas and visions. There has been significant entrepreneurial response to the changes in the scientific and social underpinnings of health care services delivery. However, a growing portion of the economic development driving health care industry expansion is threatened further by longstanding use of financing models that are suboptimal for health care ventures. The delayed pace of entrepreneurial activity in this industry is in part a response to the general economy and markets, but also due to the lack of capital for new health care ventures. The recent dearth of entrepreneurial activities in the health services sector may also due to failure to consider new approaches to partnerships and strategic ventures, despite their mutually beneficial organizational and financing potential. As capital becomes more scarce for innovators, it is imperative that those with new and creative ideas for health and health care improvement consider techniques for capital acquisition that have been successful in other industries and at similar stages of development. The capital and added expertise can allow entrepreneurs to leverage resources, dampen business fluctuations, and strengthen long term prospects. PMID:16583848

  5. Czechoslovakia's changing health care system.

    PubMed Central

    Raffel, M W; Raffel, N K

    1992-01-01

    Before World War II, Czechoslovakia was among the most developed European countries with an excellent health care system. After the Communist coup d'etat in 1948, the country was forced to adapt its existing health care system to the Soviet model. It was planned and managed by the government, financed by general tax money, operated in a highly centralized, bureaucratic fashion, and provided service at no direct charge at the time of service. In recent years, the health care system had been deteriorating as the health of the people had also been declining. Life expectancy, infant mortality rates, and diseases of the circulatory system are higher than in Western European countries. In 1989, political changes occurred in Czechoslovakia that made health care reform possible. Now health services are being decentralized, and the ownership of hospitals is expected to be transferred to communities, municipalities, churches, charitable groups, or private entities. Almost all health leaders, including hospital directors and hospital department heads, have been replaced. Physicians will be paid according to the type and amount of work performed. Perhaps the most important reform is the establishment of an independent General Health Care Insurance Office financed directly by compulsory contributions from workers, employers, and government that will be able to negotiate with hospitals and physicians to determine payment for services. PMID:1454975

  6. Private health care provision in developing countries: a preliminary analysis of levels and composition.

    PubMed

    Hanson, K; Berman, P

    1998-09-01

    While the importance of the private sector in providing health services in developing countries is now widely acknowledged, the paucity of data on numbers and types of providers has prevented systematic cross-country comparisons. Using available published and unpublished sources, we have assembled data on the number of public and private health care providers for approximately 40 countries. This paper presents some results of the analysis of this database, looking particularly at the determinants of the size and structure of the private health sector. We consider two different types of dependent variable: the absolute number of private providers (measured here as physicians and hospital beds), and the public-private composition of provision. We examine the relationship between these variables and income and other socioeconomic characteristics, at the national level. We find that while income level is related to the absolute size of the private sector, the public-private mix does not seem to be related to income. After controlling for income, certain socioeconomic characteristics, such as education, population density, and health status are associated with the size of the private sector, though no causal relationship is posited. Further analysis will require more complete data about the size of the private sector, including the extent of dual practice by government-employed physicians. A richer story of the determinants of private sector growth would incorporate more information about the institutional structure of health systems, including provider payment mechanisms, the level and quality of public services, the regulatory structure, and labour and capital market characteristics. Finally, a normative analysis of the size and growth of the private sector will require a better understanding of its impact on key social welfare outcomes. PMID:10187592

  7. Filovirus emergence and vaccine development: a perspective for health care practitioners in travel medicine.

    PubMed

    Sarwar, Uzma N; Sitar, Sandra; Ledgerwood, Julie E

    2011-05-01

    Recent case reports of viral hemorrhagic fever in Europe and the United States have raised concerns about the possibility for increased importation of filoviruses to non-endemic areas. This emerging threat is concerning because of the increase in global air travel and the rise of tourism in central and eastern Africa and the greater dispersion of military troops to areas of infectious disease outbreaks. Marburg viruses (MARV) and Ebola viruses (EBOV) have been associated with outbreaks of severe hemorrhagic fever involving high mortality (25-90% case fatality rates). First recognized in 1967 and 1976 respectively, subtypes of MARV and EBOV are the only known viruses of the Filoviridae family, and are among the world's most virulent pathogens. This article focuses on information relevant for health care practitioners in travel medicine to include, the epidemiology and clinical features of filovirus infection and efforts toward development of a filovirus vaccine. PMID:21208830

  8. Filovirus Emergence and Vaccine Development: A Perspective for Health Care Practitioners in Travel Medicine

    PubMed Central

    Sarwar, Uzma N.; Sitar, Sandra; Ledgerwood, Julie E.

    2010-01-01

    Recent case reports of viral hemorrhagic fever in Europe and the United States have raised concerns about the possibility for increased importation of filoviruses to non-endemic areas. This emerging threat is concerning because of the increase in global air travel and the rise of tourism in central and eastern Africa and the greater dispersion of military troops to areas of infectious disease outbreaks. Marburg viruses (MARV) and Ebola viruses (EBOV) have been associated with outbreaks of severe hemorrhagic fever involving high mortality (25 – 90% case fatality rates). First recognized in 1967 and 1976 respectively, subtypes of MARV and EBOV are the only known viruses of the Filoviridae family, and are among the world’s most virulent pathogens. This article focuses on information relevant for health care practitioners in travel medicine to include, the epidemiology and clinical features of filovirus infection and efforts toward development of a filovirus vaccine. PMID:21208830

  9. Primary care and health reform.

    PubMed

    Calman, Neil S; Golub, Maxine; Shuman, Saskia

    2012-01-01

    Skyrocketing health care costs are burdening our people and our economy, yet health care indicators show how little we are achieving with the money we spend. Federal and state governments, along with public-health experts and policymakers, are proposing a host of new initiatives to find solutions. The Patient Protection and Affordable Care Act is designed to address both the quality and accessibility of health care, while reducing its cost. This article provides an overview of models supported by the Affordable Care Act that address one or more goals of the "Triple Aim": better health care for individuals, better health outcomes in the community, and lower health care costs. The models described below rely on the core principles of primary care: comprehensive, coordinated and continuous primary care; preventive care; and the sophisticated implementation of health information technology designed to promote communication between health care providers, enhance coordination of care, minimize duplication of services, and permit reporting on quality. These models will support better health care and reduced costs for people who access health care services but will not address health outcomes in the community at large. Health care professionals, working in concert with community-based organizations and advocates, must also address conditions that influence health in the broadest sense to truly improve the health of our communities and reduce health care costs. PMID:22976358

  10. Competency assessment and development among health-care leaders: results of a cross-sectional survey.

    PubMed

    Yarbrough Landry, Amy; Stowe, Michael; Haefner, James

    2012-05-01

    In light of the challenges involved in leading a health care organization, it is important that the executives and managers charged with doing so are competent in a variety of areas. However, leading at all organizational levels does not necessarily require the same levels and types of competencies. The purpose of this research is to determine how well competency training works in health care organizations, and to obtain a better understanding of the competencies needed for leaders at different points of their careers and at various organizational levels. Ten health care management competency domains thought to positively influence job performance for health care executives are presented. The study seeks to answer four hypotheses related to self-perceptions of competencies and training opportunities at various hierarchical levels. A survey method was used to sample a subset of the healthcare executive population in the USA, based on three variables of interest, competency training opportunities, self-reported level of competency and hierarchical level. A series of Kruskal-Wallis and Mann-Whitney U tests were conducted to identify perceived differences in both competency level and training opportunities among respondents of various hierarchical levels. The most significant result of our research is that competency training is effective in health care organizations. The implications and need for additional research are discussed. PMID:22673697

  11. The development of mental health services within primary care in India: learning from oral history

    PubMed Central

    2014-01-01

    Background In India very few of those who need mental health care receive it, despite efforts of the 1982 National Mental Health Programme and its district-level component the District Mental Health Programme (DMHP) to improve mental health care coverage. Aims To explore and unpack the political, cultural and other historical reasons for the DMHP’s failures and successes since 1947 (post-independence era), which may highlight issues for today’s current primary mental health care policy and programme. Methods Oral history interviews and documentary sourcing were conducted in 2010–11 with policy makers, programme managers and observers who had been active in the creation of the NMHP and DMHP. Results The results suggest that the widely held perception that the DMHP has failed is not entirely justified, insofar that major hurdles to the implementation of the plan have impacted on mental health coverage in primary care, rather than faults with the plan itself. These hurdles have been political neglect, inadequate leadership at central, state and district levels, inaccessible funding and improperly implemented delivery of services (including poor training, motivation and retention of staff) at district and community levels. Conclusion At this important juncture as the 12th Five Year Plan is in preparation, this historical paper suggests that though the model may be improved, the most important changes would be to encourage central and state governments to implement better technical support, access to funds and to rethink the programme leadership at national, state and district levels. PMID:25089154

  12. Collaboration between traditional practitioners and primary health care staff in South Africa: developing a workable partnership for community mental health services.

    PubMed

    Campbell-Hall, Vicky; Petersen, Inge; Bhana, Arvin; Mjadu, Sithembile; Hosegood, Victoria; Flisher, Alan J

    2010-09-01

    The majority of the black African population in South Africa utilize both traditional and public sector Western systems of healing for mental health care. There is a need to develop models of collaboration that promote a workable relationship between the two healing systems. The aim of this study was to explore perceptions of service users and providers of current interactions between the two systems of care and ways in which collaboration could be improved in the provision of community mental health services. Qualitative individual and focus group interviews were conducted with key health care providers and service users in one typical rural South African health sub-district. The majority of service users held traditional explanatory models of illness and used dual systems of care, with shifting between treatment modalities reportedly causing problems with treatment adherence. Traditional healers expressed a lack of appreciation from Western health care practitioners but were open to training in Western biomedical approaches and establishing a collaborative relationship in the interests of improving patient care. Western biomedically trained practitioners were less interested in such an arrangement. Interventions to acquaint traditional practitioners with Western approaches to the treatment of mental illness, orientation of Western practitioners towards a culture-centred approach to mental health care, as well as the establishment of fora to facilitate the negotiation of respectful collaborative relationships between the two systems of healing are required at district level to promote an equitable collaboration in the interests of improved patient care. PMID:20940271

  13. Benchmarks of fairness for health care reform: a policy tool for developing countries.

    PubMed Central

    Daniels, N.; Bryant, J.; Castano, R. A.; Dantes, O. G.; Khan, K. S.; Pannarunothai, S.

    2000-01-01

    Teams of collaborators from Colombia, Mexico, Pakistan, and Thailand have adapted a policy tool originally developed for evaluating health insurance reforms in the United States into "benchmarks of fairness" for assessing health system reform in developing countries. We describe briefly the history of the benchmark approach, the tool itself, and the uses to which it may be put. Fairness is a wide term that includes exposure to risk factors, access to all forms of care, and to financing. It also includes efficiency of management and resource allocation, accountability, and patient and provider autonomy. The benchmarks standardize the criteria for fairness. Reforms are then evaluated by scoring according to the degree to which they improve the situation, i.e. on a scale of -5 to 5, with zero representing the status quo. The object is to promote discussion about fairness across the disciplinary divisions that keep policy analysts and the public from understanding how trade-offs between different effects of reforms can affect the overall fairness of the reform. The benchmarks can be used at both national and provincial or district levels, and we describe plans for such uses in the collaborating sites. A striking feature of the adaptation process is that there was wide agreement on this ethical framework among the collaborating sites despite their large historical, political and cultural differences. PMID:10916911

  14. The German Central Health Fund-recent developments in health care financing in Germany.

    PubMed

    Göpffarth, Dirk; Henke, Klaus-Dirk

    2013-03-01

    In 2009, Germany's Statutory Health Insurance System underwent a major financing reform. A uniform contribution rate set by government was introduced. Sickness funds retain only limited autonomy in charging additional premiums. A dynamic subsidy from general revenue was introduced. The aims of the reform were: (1) intensifying competition, (2) gearing competition towards quality and efficiency, and (3) increasing financial sustainability. This article describes the reform, presents the experiences made, and evaluates whether the policy aims have been met. Experiences have been mixed: on the one hand, the new arrangement showed a high level of flexibility in dealing with the severe recession in 2009. On the other hand, the new system of price differentiation has proven to be dysfunctional. Payments to sickness funds are based on predictions. But predictions have been of limited accuracy, and this has led to an accumulation of liquidity in the system. Price competition has been effectively eliminated. The intended surge in quality and product competition failed to appear, as sickness funds remain concerned mainly with their short term financial outlook. SHI finance has become more linked to the federal budget, leading to a higher level of political interventions. These arrangements will need a new reform - probably after the next general election in autumn 2013. PMID:23200602

  15. Aiming to improve the quality of primary mental health care: developing an intervention for underserved communities

    PubMed Central

    2014-01-01

    Background The purpose of the study was to improve the quality of primary mental healthcare in underserved communities through involvement with the wider primary care team members and local community agencies. Methods We developed training intended for all GP practice staff which included elements of knowledge transfer, systems review and active linking. Seven GP Practices in four localities (North West England, UK) took part in the training. Qualitative evaluation was conducted using thirteen semi-structured interviews and two focus groups in six of the participating practices; analysis used principles of Framework Analysis. Results Staff who had engaged with the training programme reported increased awareness, recognition and respect for the needs of patients from under-served communities. We received reports of changes in style and content of interactions, particularly amongst receptionists, and evidence of system change. In addition, the training program increased awareness of – and encouraged signposting to - community agencies within the practice locality. Conclusions This study demonstrates how engaging with practices and delivering training in a changing health care system might best be attempted. The importance of engaging with community agencies is clear, as is the use of the AMP model as a template for further research. PMID:24741996

  16. What does practice development (PD) offer mental health-care contexts? A comparative case study of PD methods and outcomes.

    PubMed

    McCauley, K; Cross, W; Moss, C; Walsh, K; Schofield, C; Handley, C; Fitzgerald, M; Hardy, S

    2014-10-01

    Practice development (PD) in mental health nursing has been progressing over the last decade; however, the level and impact of PD activity in the field of mental health remains poorly understood outside localized project impact. More specific reporting and comparative analysis of PD outcomes will improve this situation. In response, this paper presents three case scenarios from work taking place in Australia and New Zealand, as working examples of how PD methodologies have been applied within mental health practice settings. Using a comparative framework that captures the contributing assumptions, practices, processes and conditions imperative to effective PD work within a mental health-care context, three case vignettes are reviewed. The critical question driving this paper is 'what mental health-care services does PD offer in terms of transformational change approaches and the promotion of effective workplace cultures?' Conditions considered necessary for successful PD initiatives within mental health contexts are explored such as how PD converges and diverges with mental health-related theories, plus where and how PD activity best integrates with the specific elements associated with mental health-care provision. The findings are further reviewed in line with reports of PD outcomes from other fields of health care. PMID:24698157

  17. Recent developments in false claims enforcement: a minefield for health care providers.

    PubMed

    Whitaker, Glenn V; Walton, Victor A

    2007-01-01

    Actions under the False Claims Act represent potentially billions of dollars in damages returned to the state and federal governments each year for fraud recovery. Over the past several years, health care providers have been the target of about half of the FCA suits filed and have paid out an even greater percentage of the damages recovered. Because of the enumerable opportunities for fraud, waste, and abuse in the health care industry, it will likely continue to be a prominent target of FCA suits. Key provisions of the Deficit Reduction Act of 2005, effective on January 1, 2007, will only increase the reach of the FCA. Providers beware. PMID:19175229

  18. [Health care financing models].

    PubMed

    Giermaziak, Wojciech; Kamiński, Jarosław

    2012-12-01

    The functioning of health care depends mainly on the level and method of financing. Countries choose between different models. Bismarck's model is financing based mainly on the contributions that are obligatory for employers and employees, decentralized model of managing and contracting services. Beveridge's model is financed mostly from the government taxes, it allows contributing to the cost of benefits for patients and participation by private sector. Residual model is based on the optional and private health insurances, supplemented only by National Health Service. Siemaszko's model in his assumption is based on the financing of benefits by the state budget, provides permanent control of the state and equal access to all the benefits for citizens. Choice of a specific financing model entails certain impact on all of the system's participants. The purpose of this article is to introduce subject of health care financing based on the literature and the authors' own thoughts. PMID:23437697

  19. Silence, shame and abuse in health care: theoretical development on basis of an intervention project among staff.

    PubMed

    Wijma, Barbro; Zbikowski, Anke; Brüggemann, A Jelmer

    2016-01-01

    As health care exists to alleviate patients' suffering it is unacceptable that it inflicts unnecessary suffering on patients. We therefore have developed and evaluated a drama pedagogical model for staff interventions using Forum Play, focusing on staff's experiences of failed encounters where they have perceived that the patient felt abused. In the current paper we present how our preliminary theoretical framework of intervening against abuse in health care developed and was revised during this intervention.During and after the intervention, five important lessons were learned and incorporated in our present theoretical framework. First, a Forum Play intervention may break the silence culture that surrounds abuse in health care. Second, organizing staff training in groups was essential and transformed abuse from being an individual problem inflicting shame into a collective responsibility. Third, initial theoretical concepts "moral resources" and "the vicious violence triangle" proved valuable and became useful pedagogical tools during the intervention. Four, the intervention can be understood as having strengthened staff's moral resources. Five, regret appeared to be an underexplored resource in medical training and clinical work.The occurrence of abuse in health care is a complex phenomenon and the research area is in need of theoretical understanding. We hope this paper can inspire others to further develop theories and interventions in order to counteract abuse in health care. PMID:26922381

  20. Health care agents

    MedlinePlus

    ... working well. A health care proxy is a legal paper that you fill out. You can get ... Kapp MB. Ethical and legal issues. In: Duthie EH, Katz PR, Malone ML, eds. Practice of Geriatrics . 4th ed. Philadelphia, PA: Elsevier Saunders; 2007:chap ...

  1. Accelerating the development of an information ecosystem in health care, by stimulating the growth of safe intermediate processing of health information (IPHI).

    PubMed

    Liyanage, Harshana; Liaw, Siaw-Teng; de Lusignan, Simon

    2012-01-01

    Health care, in common with many other industries, is generating large amounts of routine data, data that are challenging to process, analyse or curate, so-called 'big data'. A challenge for health informatics is to make sense of these data. Part of the answer will come from the development of ontologies that support the use of heterogeneous data sources and the development of intermediate processors of health information (IPHI). IPHI will sit between the generators of health data and information, often the providers of health care, and the managers, commissioners, policy makers, researchers, and the pharmaceutical and other healthcare industries. They will create a health ecosystem by processing data in a way that stimulates improved data quality and potentially healthcare delivery by providers of health care, and by providing greater insights to legitimate users of data. Exemplars are provided of how a health ecosystem might be encouraged and developed to promote patient safety and more efficient health care. These are in the areas of how to integrate data around the unsafe use of alcohol and to explore vaccine safety. A challenge for IPHI is how to ensure that their processing of data is valid, safe and maintains privacy. Development of the healthcare ecosystem and IPHI should be actively encouraged internationally. Governments, regulators and providers of health care should facilitate access to health data and the use of national and international comparisons to monitor standards. However, most importantly, they should pilot new methods of improving quality and safety through the intermediate processing of health data. PMID:23710772

  2. Health Care Workforce Development in Rural America: When Geriatrics Expertise Is 100 Miles Away

    ERIC Educational Resources Information Center

    Tumosa, Nina; Horvath, Kathy J.; Huh, Terri; Livote, Elayne E.; Howe, Judith L.; Jones, Lauren Ila; Kramer, B. Josea

    2012-01-01

    The Geriatric Scholar Program (GSP) is a Department of Veterans Affairs' (VA) workforce development program to infuse geriatrics competencies in primary care. This multimodal educational program is targeted to primary care providers and ancillary staff who work in VA's rural clinics. GSP consists of didactic education and training in geriatrics…

  3. Bridging the Human Resource Gap in Primary Health Care Delivery Systems of Developing Countries With mHealth: Narrative Literature Review

    PubMed Central

    2013-01-01

    Background Mobile health (mHealth) has the potential to solve human resource issues in the health care sector. mHealth is of particular interest in developing countries, where widespread mobile networks and access to devices are connecting people like never before. Objective The aim of this paper was to review published and unpublished literature, field projects, and pilot studies on mHealth usage in overcoming shortage of human health resources in developing countries. Methods A narrative literature review was undertaken using an iterative approach in extracting literature focused on mHealth and human health resources of low-income countries, especially India. The present review has undertaken comprehensive coverage of the work on related field projects that have been either published, accepted for publication, or pilot tested. Results This review presented the use of mHealth across various dimensions of primary health care, including data collection, disease surveillance, health education, supervision, monitoring, and feedback. Field studies of fast, error-free data collection and transmission using mHealth were also documented. New apps for supervision, monitoring, and utilization of innovative health education tools were documented in the current review. Practical limitations of mHealth and challenges set forth in developing countries included issues of data security, cost constraints, health provider privacy, and technical barriers. Conclusions In the present review, we have documented a few mHealth projects that contribute to the proficient use of human resources. These projects pave the path for the efficient utilization of mHealth, offering solutions to emerging human resource challenges and simultaneously revamping the health care delivery in resource-limited settings. PMID:25099436

  4. Problem analysis: application in the development of market strategies for health care organizations.

    PubMed

    Martin, J

    1988-03-01

    The problem analysis technique is an approach to understanding salient customer needs that is especially appropriate under complex market conditions. The author demonstrates the use of the approach in segmenting markets and conducting competitive analysis for positioning strategy decisions in health care. PMID:10286259

  5. A game-based strategy for the staff development of home health care nurses.

    PubMed

    Popil, Inna; Dillard-Thompson, Darlene

    2015-05-01

    This article describes gaming, an interactive teaching strategy that promotes active learning. An evaluation study conducted with home health care nurses tested the use of a game as a teaching tool. The study evaluated learning outcomes and learners' level of engagement and satisfaction with an educational game as a teaching method. PMID:25955422

  6. Developing a Mobile Learning Solution for Health and Social Care Practice

    ERIC Educational Resources Information Center

    Taylor, J. D.; Dearnley, C. A.; Laxton, J. C.; Coates, C. A.; Treasure-Jones, T.; Campbell, R.; Hall, I.

    2010-01-01

    In this article we share our experiences of a large-scale five-year innovative programme to introduce mobile learning into health and social care (H&SC) practice placement learning and assessment that bridges the divide between the university classroom and the practice setting in which these students learn. The outputs are from the Assessment &…

  7. Brentwood Community Health Care Assessment

    PubMed Central

    Goodman, Melody S.; Gonzalez, Maria; Gil, Sandra; Si, Xuemei; Pashoukos, Judith L.; Stafford, Jewel D.; Ford, Elsa; Pashoukos, Dennis A.

    2015-01-01

    Background The Community Alliance for Research Empowering Social Change (CARES) is an academic–community research partnership designed to train community members on research methods and develop the infrastructure for community-based participatory research (CBPR) to examine and address racial/ethnic health disparities. The Brentwood Community Health Assessment (BCHA) was developed through a CBPR pilot project grant from CARES. Objectives The purpose of the BCHA is to assess health care utilization and identify existing barriers to health care access among a multi-ethnic community in the Hamlet of Brentwood, New York. Methods Using CBPR approaches, the community–academic research partnership develop the study design and survey instrument. Trained Bilingual (English/Spanish) data collectors verbally administered surveys door-to-door to residents of Brentwood from October 2010 to May 2011. Inclusion criteria required participants to be at least 18 years of age and speak either English or Spanish. Results Overall, 232 residents completed the BCHA; 49% were male, 66% Hispanic, 13% non-Hispanic White, 13% non-Hispanic Black, 29% had less than a high school education, and 33% were born in United States. The assessment results revealed that most residents are able to access health care when needed and the most significant barriers to health care access are insurance and cost. Conclusions We describe the community–academic partnered process used to develop and implement the BCHA and report assessment findings; the community-partnered approach improved data collection and allowed access into one of Suffolk County’s most vulnerable communities. PMID:24859100

  8. The Partnered Research Center for Quality Care: Developing Infrastructure to Support Community-partnered Participatory Research in Mental Health

    PubMed Central

    Lizaola, Elizabeth; Schraiber, Ron; Braslow, Joel; Kataoka, Sheryl; Springgate, Benjamin F.; Wells, Kenneth B.; Jones, Loretta

    2013-01-01

    Evidence-based programs have been shown to improve functioning and mental health outcomes, especially for vulnerable populations. However, these populations face numerous barriers to accessing care including lack of resources and stigma surrounding mental health issues. In order to improve mental health outcomes and reduce health disparities, it is essential to identify methods for reaching such populations with unmet need. A promising strategy for reducing barriers and improving access to care is Community Partnered Participatory Research (CPPR). Given the power of this methodology to transform the impact of research in resource-poor communities, we developed an NIMH-funded Center, the Partnered Research Center for Quality Care, to support partnerships in developing, implementing, and evaluating mental health services research and programs. Guided by a CPPR framework, center investigators, both community and academic, collaborated in all phases of research with the goal of establishing trust, building capacity, increasing buy-in, and improving the sustainability of interventions and programs. They engaged in two-way capacity-building, which afforded the opportunity for practical problems to be raised and innovative solutions to be developed. This article discusses the development and design of the Partnered Research Center for Quality Care and provides examples of partnerships that have been formed and the work that has been conducted as a result. PMID:22352082

  9. Phytotherapy in primary health care

    PubMed Central

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

    2014-01-01

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

  10. The historical development of health care law and bioethics in England and Wales: a symbiotic relationship?

    PubMed

    Owusu-Dapaa, Ernest

    2014-04-01

    The paper explores the backward and forward linkage between HCL and bioethics. Indeed, the relationship between the two is so close that it can be considered one of symbiosis. This is particularly the case when an account is taken of how HCL and bioethics positively benefitted from each other in diverse ways during their development into their present status as discrete disciplines. In the first place, the aftermath of the Second World War, such as the Nuremberg trial and unprecedented medical experiment scandals in the 1960s/70s fuelled the increasing participation of lay scholars in exploring and critiquing medical ethics which culminated in the emergence ofbioethics.2 This in turn facilitated the evolution of HCL as a discipline, since academic lawyers involved in early bioethical discourse developed interest in exploring the interface between law and bioethics at the same time that society was waking up to the ethical implications of medical advances. As HCL emerged as a discrete discipline, it consolidated the status of bioethics as a field of inquiry by projecting the relevance of the latter in adjudication of novel cases with significant slippery moral undertones. Thus, the chicken and egg paradox finds a perfect reflection in the emergence of health care law and bioethics in England and Wales. PMID:24946511

  11. Developing and testing an instrument for identifying performance incentives in the Greek health care sector

    PubMed Central

    Paleologou, Victoria; Kontodimopoulos, Nick; Stamouli, Aggeliki; Aletras, Vassilis; Niakas, Dimitris

    2006-01-01

    Background In the era of cost containment, managers are constantly pursuing increased organizational performance and productivity by aiming at the obvious target, i.e. the workforce. The health care sector, in which production processes are more complicated compared to other industries, is not an exception. In light of recent legislation in Greece in which efficiency improvement and achievement of specific performance targets are identified as undisputable health system goals, the purpose of this study was to develop a reliable and valid instrument for investigating the attitudes of Greek physicians, nurses and administrative personnel towards job-related aspects, and the extent to which these motivate them to improve performance and increase productivity. Methods A methodological exploratory design was employed in three phases: a) content development and assessment, which resulted in a 28-item instrument, b) pilot testing (N = 74) and c) field testing (N = 353). Internal consistency reliability was tested via Cronbach's alpha coefficient and factor analysis was used to identify the underlying constructs. Tests of scaling assumptions, according to the Multitrait-Multimethod Matrix, were used to confirm the hypothesized component structure. Results Four components, referring to intrinsic individual needs and external job-related aspects, were revealed and explain 59.61% of the variability. They were subsequently labeled: job attributes, remuneration, co-workers and achievement. Nine items not meeting item-scale criteria were removed, resulting in a 19-item instrument. Scale reliability ranged from 0.782 to 0.901 and internal item consistency and discriminant validity criteria were satisfied. Conclusion Overall, the instrument appears to be a promising tool for hospital administrations in their attempt to identify job-related factors, which motivate their employees. The psychometric properties were good and warrant administration to a larger sample of employees in the Greek healthcare system. PMID:16970823

  12. Macrodynamic trends in health care: a distribution and retailing perspective.

    PubMed

    Gould, S J

    1988-01-01

    Recent macrodynamic developments have created a turbulent health care environment. A distribution and retailing perspective can provide related knowledge and experience for health care providers PMID:3384652

  13. Total quality in health care.

    PubMed

    Brannan, K M

    1998-05-01

    Quality is at the top of American consumers' demand list, and consequently American manufacturing companies have been forced to assign priority to the development of high-quality products. To improve the quality of what they offer, many manufacturers use the management philosophy known as total quality management (TQM), and now the service sector is following in their footsteps. The health care industry is a good example of a service industry that can benefit greatly from TQM, and it is the purpose of this article to show how a health care provider can implement TQM and evaluate its effects. PMID:10178544

  14. Collaboration between a US Academic Institution and International Ministry of Health to develop a culturally appropriate palliative care navigation curriculum.

    PubMed

    Fernandes, Ritabelle; Riklon, Sheldon; Langidrik, Justina R; Williams, Shellie N; Kabua, Neiar

    2014-12-01

    Implementation lessons: (1) The development and testing of a culturally appropriate palliative care navigation curriculum for countries facing high cancer and non-communicable diseases burden requires collaboration with the local Ministry of Health. (2) Lay volunteers from non-governmental and faith-based organizations are potential candidates to provide patient navigation services. PMID:26250636

  15. Health Care in Mozambique

    PubMed Central

    Williams, Betsy

    1992-01-01

    Mozambique has been in a state of near civil war since 1980, which has prevented the country from providing any health care at all to most of its rural citizens. Medications are scarce, and the range of diagnostic tools is limited. The health clinics treat illnesses that include severe anemia, tuberculosis, malnutrition, sexually transmitted diseases, and injuries that are a result of the war, but the biggest killer of all remains malaria. Imagesp1131-ap1131-bp1131-cp1132-ap1132-bp1133-ap1133-b PMID:21221330

  16. Care for the Health Care Provider.

    PubMed

    Kunin, Sharon Brown; Kanze, David Mitchell

    2016-03-01

    Pretravel care for the health care provider begins with an inventory, including the destination, length of stay, logistical arrangements, type of lodging, food and water supply, team members, personal medical needs, and the needs of the community to be treated. This inventory should be created and processed well in advance of the planned medical excursion. The key thing to remember in one's planning is to be a health care provider during one's global health care travel and not to become a patient oneself. This article will help demonstrate the medical requirements and recommendations for such planning. PMID:26900113

  17. Understanding your health care costs

    MedlinePlus

    ... This is the payment you make for certain health care provider visits and prescriptions. It is a set ... about lower-cost facilities and medicines. Understanding your health care costs can help you save money when managing ...

  18. Developments in managing mental health care: a review of the literature.

    PubMed

    Hall, Julie; Callaghan, Patrick

    2008-12-01

    The aim of this paper is to critically review the different approaches used to manage mental health care. Underpinning this aim is a literature review carried out using systematic approaches that clarifies how various frameworks are used and experienced. Responding consciously to policy, politics, and economic change there are a number of approaches that coexist without an explicit view as to whether they are useful tools kit or a phenomena that are, in-fact, less positive. Nevertheless experience to date suggests that clear lessons can be learned before practices become more widely adopted across health communities. PMID:19052943

  19. Environmental Health: Health Care Reform's Missing Pieces.

    ERIC Educational Resources Information Center

    Fadope, Cece Modupe; And Others

    1994-01-01

    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…

  20. Improving home health care for the Navajo.

    PubMed

    Boyle, J S; Szymanski, M T; Szymanski, M E

    1992-01-01

    Home health care clients on the Navajo reservation present complex nursing problems that require interventions that are culturally sensitive. A collaborative project was developed that used the skills of researchers, clinicians, and members of the Navajo culture to develop culturally appropriate nursing care. Traditional life themes, values, and beliefs of the Navajo related to health and illness are described with examples of how the project facilitated home health care for Navajo clients. PMID:1293518

  1. Health and development.

    PubMed

    Damiba, P C

    1989-01-01

    Health is determined by a complex of factors. Health status depends on development. Prevention of disease is as important as cure. There are difficulties with integration of health care and development, but no all are scientific and technical. Integrated health action is often done in the form of pilot studies, but they are likely to fail. To air for health through development is an ethical and political necessity as well as an economic one. Health expenditure cannot be increased without limit. Health status is not determined solely by the development of public health services. Public health leaders should help with development planning activities. Priority should be given to preventive medicine, and rural populations. Multidisciplinary health workers should be trained. Research should be applied to the specific problems of African health. The concept of health care integrated with development is being promoted by the UN development Program (UNDP) associated with the World Health Organization (WHO). UNDP hopes to strengthen the links between its Regional Office for Africa and the WHO Regional Office for Africa. A WHO Liaison Officer at the local office of UNDP in Brazzaville has been established. The development of a broader strategy on the general health and development theme would involve health workers in programs. The health sector can no longer maintain its earlier performance, or even sustain past achievements. Primary health care programs should be adequately financed. PMID:2637717

  2. Health care clinics in Cambodia.

    PubMed

    Wollschlaeger, K

    1995-04-01

    Under the Pol Pot Khmer Rouge regime, most physicians with clinical experience were either killed or fled the country. The few practitioners who managed to survive were forced to hide their knowledge; much of that knowledge and experience is now lost. As part of a general process of national rehabilitation, Cambodia has trained since the 1980s hundreds of physicians and physician assistants. There were 700 physicians, 1300 physician assistants, and 4000 nurses in the country by 1992. Problems do, however, remain with medical education in Cambodia. In particular, the medical texts and lectures are in French, a language which very few of the younger generation speak; instructional texts are designed to meet the needs of developing nations, not a rehabilitating one like Cambodia; emphasis is upon curative health care, hospitals, and vertical programs instead of primary and preventive health care; Cambodian physicians are used to a system based upon the division of patients by ability to pay instead of by age, disease, or need; corruption has grown as the cost of living has outstripped the level of official salaries; and there is neither professional contact, feedback, nor program evaluation within health care programs. The authors is a resident in obstetrics and gynecology at the University of Chicago who worked at two clinics during a stay in Phnom Penh. She recommends that instead of simply training more doctors, these training-related problems should be addressed, including a revision of the curriculum to include both primary health care medicine and psychiatry. Moreover, people in Cambodia need to be taught the importance of preventive health care, which should then reduce the number of visits to physicians. This process will be accomplished more effectively with the cooperation of physicians, the government, nongovernmental organizations, and international organizations associated with health care. PMID:7787486

  3. Child Care Health Connections, 2002.

    ERIC Educational Resources Information Center

    Guralnick, Eva, Ed.; Zamani, Rahman, Ed.; Evinger, Sara, Ed.; Dailey, Lyn, Ed.; Sherman, Marsha, Ed.; Oku, Cheryl, Ed.; Kunitz, Judith, Ed.

    2002-01-01

    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…

  4. National Health Care Skill Standards.

    ERIC Educational Resources Information Center

    Far West Lab. for Educational Research and Development, San Francisco, CA.

    This booklet contains draft national health care skill standards that were proposed during the National Health Care Skill Standards Project on the basis of input from more than 1,000 representatives of key constituencies of the health care field. The project objectives and structure are summarized in the introduction. Part 1 examines the need for…

  5. Development and validation of an electronic frailty index using routine primary care electronic health record data

    PubMed Central

    Clegg, Andrew; Bates, Chris; Young, John; Ryan, Ronan; Nichols, Linda; Ann Teale, Elizabeth; Mohammed, Mohammed A.; Parry, John; Marshall, Tom

    2016-01-01

    Background: frailty is an especially problematic expression of population ageing. International guidelines recommend routine identification of frailty to provide evidence-based treatment, but currently available tools require additional resource. Objectives: to develop and validate an electronic frailty index (eFI) using routinely available primary care electronic health record data. Study design and setting: retrospective cohort study. Development and internal validation cohorts were established using a randomly split sample of the ResearchOne primary care database. External validation cohort established using THIN database. Participants: patients aged 65–95, registered with a ResearchOne or THIN practice on 14 October 2008. Predictors: we constructed the eFI using the cumulative deficit frailty model as our theoretical framework. The eFI score is calculated by the presence or absence of individual deficits as a proportion of the total possible. Categories of fit, mild, moderate and severe frailty were defined using population quartiles. Outcomes: outcomes were 1-, 3- and 5-year mortality, hospitalisation and nursing home admission. Statistical analysis: hazard ratios (HRs) were estimated using bivariate and multivariate Cox regression analyses. Discrimination was assessed using receiver operating characteristic (ROC) curves. Calibration was assessed using pseudo-R2 estimates. Results: we include data from a total of 931,541 patients. The eFI incorporates 36 deficits constructed using 2,171 CTV3 codes. One-year adjusted HR for mortality was 1.92 (95% CI 1.81–2.04) for mild frailty, 3.10 (95% CI 2.91–3.31) for moderate frailty and 4.52 (95% CI 4.16–4.91) for severe frailty. Corresponding estimates for hospitalisation were 1.93 (95% CI 1.86–2.01), 3.04 (95% CI 2.90–3.19) and 4.73 (95% CI 4.43–5.06) and for nursing home admission were 1.89 (95% CI 1.63–2.15), 3.19 (95% CI 2.73–3.73) and 4.76 (95% CI 3.92–5.77), with good to moderate discrimination but low calibration estimates. Conclusions: the eFI uses routine data to identify older people with mild, moderate and severe frailty, with robust predictive validity for outcomes of mortality, hospitalisation and nursing home admission. Routine implementation of the eFI could enable delivery of evidence-based interventions to improve outcomes for this vulnerable group. PMID:26944937

  6. Equity in health care in Namibia: developing a needs-based resource allocation formula using principal components analysis

    PubMed Central

    Zere, Eyob; Mandlhate, Custodia; Mbeeli, Thomas; Shangula, Kalumbi; Mutirua, Kauto; Kapenambili, William

    2007-01-01

    Background The pace of redressing inequities in the distribution of scarce health care resources in Namibia has been slow. This is due primarily to adherence to the historical incrementalist type of budgeting that has been used to allocate resources. Those regions with high levels of deprivation and relatively greater need for health care resources have been getting less than their fair share. To rectify this situation, which was inherited from the apartheid system, there is a need to develop a needs-based resource allocation mechanism. Methods Principal components analysis was employed to compute asset indices from asset based and health-related variables, using data from the Namibia demographic and health survey of 2000. The asset indices then formed the basis of proposals for regional weights for establishing a needs-based resource allocation formula. Results Comparing the current allocations of public sector health car resources with estimates using a needs based formula showed that regions with higher levels of need currently receive fewer resources than do regions with lower need. Conclusion To address the prevailing inequities in resource allocation, the Ministry of Health and Social Services should abandon the historical incrementalist method of budgeting/resource allocation and adopt a more appropriate allocation mechanism that incorporates measures of need for health care. PMID:17391533

  7. [Workflow involving preventive health care promotes the economic development of a company].

    PubMed

    Braun, M

    2003-12-01

    Today's working society obviously develops from industrial production to knowledge-intensive service. In service-oriented working conditions, the importance of the human being as a main performer of economic success increases. Thus, the development leads to a changing spectrum of occupational health risks. Together with socio-demographic developments, individual strain-oriented health disorders connected to one's occupation might endanger an enterprise's capacity of performance and innovation as well as its sustainable enterprise development. Only healthy, motivated and qualified employees are able and ready to keep their creative and customer-oriented potential harnessed and thereby work to the best of their ability. Consequently, occupational health gains a more important role within the enterprise. Although in many enterprises the benefit contribution of preventive work design has not yet been considered that relevant, enterprises have realised that a preventive health-oriented work design might help to better manage current business challenges. An up-to-date definition of health includes the goals of health improvement, personality development as well as a comprehensive well-being. Health is a prerequisite and result of a productive reflection upon the conditions and challenges of work. Business practice shows that a preventive work design should involve an economic benefit for the enterprise. If occupational health is seen as a characteristic of quality and a prerequisite for sustainable enterprise development, economic potentials of preventive work designs will expand considerably. PMID:14685920

  8. Developing a good practice model to evaluate the effectiveness of comprehensive primary health care in local communities

    PubMed Central

    2014-01-01

    Background This paper describes the development of a model of Comprehensive Primary Health Care (CPHC) applicable to the Australian context. CPHC holds promise as an effective model of health system organization able to improve population health and increase health equity. However, there is little literature that describes and evaluates CPHC as a whole, with most evaluation focusing on specific programs. The lack of a consensus on what constitutes CPHC, and the complex and context-sensitive nature of CPHC are all barriers to evaluation. Methods The research was undertaken in partnership with six Australian primary health care services: four state government funded and managed services, one sexual health non-government organization, and one Aboriginal community controlled health service. A draft model was crafted combining program logic and theory-based approaches, drawing on relevant literature, 68 interviews with primary health care service staff, and researcher experience. The model was then refined through an iterative process involving two to three workshops at each of the six participating primary health care services, engaging health service staff, regional health executives and central health department staff. Results The resultant Southgate Model of CPHC in Australia model articulates the theory of change of how and why CPHC service components and activities, based on the theory, evidence and values which underpin a CPHC approach, are likely to lead to individual and population health outcomes and increased health equity. The model captures the importance of context, the mechanisms of CPHC, and the space for action services have to work within. The process of development engendered and supported collaborative relationships between researchers and stakeholders and the product provided a description of CPHC as a whole and a framework for evaluation. The model was endorsed at a research symposium involving investigators, service staff, and key stakeholders. Conclusions The development of a theory-based program logic model provided a framework for evaluation that allows the tracking of progress towards desired outcomes and exploration of the particular aspects of context and mechanisms that produce outcomes. This is important because there are no existing models which enable the evaluation of CPHC services in their entirety. PMID:24885812

  9. For-Profit/Nonprofit Differences in Center-Based Child Care Quality: Results from the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development

    ERIC Educational Resources Information Center

    Sosinsky, Laura Stout; Lord, Heather; Zigler, Edward

    2007-01-01

    In secondary analyses of National Institute of Child Health and Human Development Study of Early Child Care and Youth Development data, multiple indicators of quality (caregiver wages and turnover; child/staff ratio; caregiver education and professionalism; positive caregiving) were compared between child care centers by sector…

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

    PubMed Central

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

    2015-01-01

    Background Although many cancer survivors could benefit from supportive care, they often do not utilize such services. Previous studies have shown that patient-reported outcomes (PROs) could be a solution to meet cancer survivors’ needs, for example through an eHealth application that monitors quality of life and provides personalized advice and supportive care options. In order to develop an effective application that can successfully be implemented in current health care, it is important to include health care professionals in the development process. Objective The aim of this study was to investigate health care professionals’ perspectives toward follow-up care and an eHealth application, OncoKompas, in follow-up cancer care that monitors quality of life via PROs, followed by automatically generated tailored feedback and personalized advice on supportive care. Methods Health care professionals involved in head and neck cancer care (N=11) were interviewed on current follow-up care and the anticipated value of the proposed eHealth application (Step 1). A prototype of the eHealth application, OncoKompas, was developed (Step 2). Cognitive walkthroughs were conducted among health care professionals (N=21) to investigate perceived usability (Step 3). Interviews were recorded, transcribed verbatim, and analyzed by 2 coders. Results Health care professionals indicated several barriers in current follow-up care including difficulties in detecting symptoms, patients’ perceived need for supportive care, and a lack of time to encourage survivors to obtain supportive care. Health care professionals expected the eHealth application to be of added value. The cognitive walkthroughs demonstrated that health care professionals emphasized the importance of tailoring care. They considered the navigation structure of OncoKompas to be complex. Health care professionals differed in their opinion toward the best strategy to implement the application in clinical practice but indicated that it should be incorporated in the HNC cancer care pathway to ensure all survivors would benefit. Conclusions Health care professionals experienced several barriers in directing patients to supportive care. They were positive toward the development and implementation of an eHealth application and expected it could support survivors in obtaining supportive care tailored to their needs. The cognitive walkthroughs revealed several points for optimizing the application prototype and developing an efficient implementation strategy. Including health care professionals in an early phase of a participatory design approach is valuable in developing an eHealth application and an implementation strategy meeting stakeholders’ needs. PMID:26489918

  11. [Reembursing health-care service provider networks].

    PubMed

    Binder, A; Braun, G E

    2015-03-01

    Health-care service provider networks are regarded as an important instrument to overcome the widely criticised fragmentation and sectoral partition of the German health-care system. The first part of this paper incorporates health-care service provider networks in the field of health-care research. The system theoretical model and basic functions of health-care research are used for this purpose. Furthermore already established areas of health-care research with strong relations to health-care service provider networks are listed. The second part of this paper introduces some innovative options for reimbursing health-care service provider networks which can be regarded as some results of network-oriented health-care research. The origins are virtual budgets currently used in part to reimburse integrated care according to §§ 140a ff. SGB V. Describing and evaluating this model leads to real budgets (capitation) - a reimbursement scheme repeatedly demanded by SVR-Gesundheit (German governmental health-care advisory board), for example, however barely implemented. As a final step a direct reimbursement of networks by the German sickness fund is discussed. Advantages and challenges are shown. The development of the different reimbursement schemes is partially based on models from the USA. PMID:25625796

  12. Primary health care in developing countries: overcoming operational, technical, and social barriers.

    PubMed

    Chen, L C

    1986-11-29

    An analysis of survey data from Matlab, Bangladesh, suggests that the provision of primary health care is a more complex process than is reflected by current strategies. The Bangladesh experience indicates that single-outcome indicators (e.g., deaths averted) for assessing the effect of health measures, while necessary for comparing the cost-effectiveness of various approaches, rarely encapsulate all the aims of an intervention. For example, in the year after the introduction in Matlab of modern contraception and tetanus immunization for pregnant women, the intervention population had ab0ut a 25% lower crude birth and death rate, yet little difference was observed in infant mortality rates. Policies aimed at contering single diseases may cause factors such as nutrition, which has important biosocial interactions with infection, to be undervalued. Rather than viewing childhood morality in relation to specific diseases--an approach that promotes an emphsis on tchnology--childhood mortality should be seen as the result of sequential insults accumulated over time. the reluctance of eligible women to accept tetanus vaccine and the greater utilization of diarrhea treatment services for male than female children are examples of the significance of the demand factor. Also needed is improved knowledge of the interaction between the structure of health care delivery systems and a population's political economy. Public investments for primary health care in India have been targeted to large-scale public systems operated by a bureaucracy biased toward procedure rather than performance. Finally, future research should incorporate the strengths of both the natural and the social sciencs. PMID:2878141

  13. Perspectives in Western health care.

    PubMed

    Hattinga Verschure, J C

    1985-01-01

    Eleven trends in health care and society are described and used in the construction of a future scenario for health care in Western society: 1) involution in the field of specialist medicine; 2) an epidemiologic shift from acute illness to chronic impairment; 3) more self care and mutual care; 4) more self-responsibility in health maintenance; 5) de-institutionalization; 6) changing personal values and goals; 7) revival of emotional life; 8) new appraisal of dying; 9) towards a participative society; 10) uncoupling the health care wages; 11) the emergence of a "dual strata" society. In such a society, the medical dominance in the health care system will regress. Health maintenance based on more competent self care and social networks, and similar approaches to care for patients with chronic illness, will balance a more restricted medical intervention system. PMID:10275593

  14. Developing IntegRATE: a fast and frugal patient-reported measure of integration in health care delivery

    PubMed Central

    Elwyn, Glyn; Thompson, Rachel; John, Roshen; Grande, Stuart W

    2015-01-01

    Background Efforts have been made to measure integration in health care delivery, but few existing instruments have adopted a patient perspective, and none is sufficiently generic and brief for administration at scale. We sought to develop a brief and generic patient-reported measure of integration in health care delivery. Methods Drawing on both existing conceptualisations of integrated care and research on patients’ perspectives, we chose to focus on four distinct domains of integration: information sharing, consistent advice, mutual respect and role clarity. We formulated candidate items and conducted cognitive interviews with end users to further develop and refine the items. We then pilot-tested the measure. Results Four rounds of cognitive interviews were conducted (n = 14) and resulted in a four-item measure that was both relevant and understandable to end users. The pilot administration of the measure (n = 15) further confirmed the relevance and interpretability of items and demonstrated that the measure could be completed in less than one minute. Conclusions This new measure, IntegRATE, represents a patient-reported measure of integration in health care delivery that is conducive to use in both routine performance monitoring and research. The psychometric properties of the measure will be assessed in the next stage of development. PMID:26034467

  15. Integrating mental health into chronic care in South Africa: the development of a district mental healthcare plan.

    PubMed

    Petersen, Inge; Fairall, Lara; Bhana, Arvin; Kathree, Tasneem; Selohilwe, One; Brooke-Sumner, Carrie; Faris, Gill; Breuer, Erica; Sibanyoni, Nomvula; Lund, Crick; Patel, Vikram

    2016-01-01

    BackgroundIn South Africa, the escalating prevalence of chronic illness and its high comorbidity with mental disorders bring to the fore the need for integrating mental health into chronic care at district level.AimsTo develop a district mental healthcare plan (MHCP) in South Africa that integrates mental healthcare for depression, alcohol use disorders and schizophrenia into chronic care.MethodMixed methods using a situation analysis, qualitative key informant interviews, theory of change workshops and piloting of the plan in one health facility informed the development of the MHCP.ResultsCollaborative care packages for the three conditions were developed to enable integration at the organisational, facility and community levels, supported by a human resource mix and implementation tools. Potential barriers to the feasibility of implementation at scale were identified.ConclusionsThe plan leverages resources and systems availed by the emerging chronic care service delivery platform for the integration of mental health. This strengthens the potential for future scale up. PMID:26447176

  16. Change management in health care.

    PubMed

    Campbell, Robert James

    2008-01-01

    This article introduces health care managers to the theories and philosophies of John Kotter and William Bridges, 2 leaders in the evolving field of change management. For Kotter, change has both an emotional and situational component, and methods for managing each are expressed in his 8-step model (developing urgency, building a guiding team, creating a vision, communicating for buy-in, enabling action, creating short-term wins, don't let up, and making it stick). Bridges deals with change at a more granular, individual level, suggesting that change within a health care organization means that individuals must transition from one identity to a new identity when they are involved in a process of change. According to Bridges, transitions occur in 3 steps: endings, the neutral zone, and beginnings. The major steps and important concepts within the models of each are addressed, and examples are provided to demonstrate how health care managers can actualize the models within their health care organizations. PMID:18510142

  17. Betting against health care.

    PubMed

    Appleby, C

    1996-06-20

    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

  18. Guidelines for Analysis of Indigeneous and Private Health Care Planning in Developing Countries. International Health Planning Methods Series, Volume 6.

    ERIC Educational Resources Information Center

    Scrimshaw, Susan

    This guidebook is both a practical tool and a source book to aid health planners assess the importance, extent, and impact of indigenous and private sector medical systems in developing nations. Guidelines are provided for assessment in terms of: use patterns; the meaning and importance to users of various available health services; and ways of…

  19. Environmental scanning and the health care manager.

    PubMed

    Layman, Elizabeth J; Bamberg, Richard

    2005-01-01

    Health care managers and supervisors work in an environment of major changes and ongoing turbulence. Basic terms and strategic approaches are described to enable managers and supervisors to better understand the process of environmental scanning in the turbulent health care environment. Drawing from multiple disciplines, the information allows health care managers and supervisors to improve their skills as environmental scanners as they develop and implement strategic plans in this environment. PMID:16131929

  20. Measuring renewed expertise for integrated care among health- and social-care professionals: Development and preliminary validation of the ICE-Q questionnaire.

    PubMed

    van der Aa, Maartje J; van den Broeke, Jennifer R; Stronks, Karien; Busschers, Wim B; Plochg, Thomas

    2016-01-01

    Accumulations of health and social problems challenge current health systems. It is hypothesized that professionals should renew their expertise by adapting generalist, coaching, and population health orientation capacities to address these challenges. This study aimed to develop and validate an instrument for evaluating this renewal of professional expertise. The (Dutch) Integrated Care Expertise Questionnaire (ICE-Q) was developed and piloted. Psychometric analysis evaluated item, criterion, construct, and content validity. Theory and an iterative process of expert consultation constructed the ICE-Q, which was sent to 616 professionals, of whom 294 participated in the pilot (47.7%). Factor analysis (FA) identified six areas of expertise: holistic attitude towards patients (Cronbach's alpha [CA] = 0.61) and considering their social context (CA = 0.77), both related to generalism; coaching to support patient empowerment (CA = 0.66); preventive action (CA = 0.48); valuing local health knowledge (CA = 0.81); and valuing local facility knowledge (CA = 0.67) point at population health orientation. Inter-scale correlations ranged between 0.01 and 0.34. Item-response theory (IRT) indicated some items were less informative. The resulting 26-item questionnaire is a first tool for measuring integrated care expertise. The study process led to a developed understanding of the concept. Further research is warranted to improve the questionnaire. PMID:26789936

  1. Women Veterans Health Care: Frequently Asked Questions

    MedlinePlus

    ... Care » Program Overview » Outreach Materials » FAQs Women Veterans Health Care Menu Menu Womens Health Women Veterans Health Care ... Who can I call for more help? What health care services are available to women Veterans? A full ...

  2. Access to health care

    PubMed Central

    Fortin, Martin; Maltais, Danielle; Hudon, Catherine; Lapointe, Lise; Ntetu, Antoine Lutumba

    2005-01-01

    OBJECTIVE To explore access to health care for patients presenting with multiple chronic conditions and to identify barriers and factors conducive to access. DESIGN Qualitative study with focus groups. SETTING Family practice unit in Chicoutimi (Saguenay), Que. PARTICIPANTS Twenty-five male and female adult patients with at least four chronic conditions but no cognitive disorders or decompensating conditions. METHODS For this pilot study, only three focus group discussions were held. MAIN FINDINGS The main barriers to accessing follow-up appointments included long waits on the telephone, automated telephone-answering systems, and needing to attend at specific times to obtain appointments. The main barriers to specialized care were long waiting times and the need to get prescriptions and referrals from family physicians. Factors reported conducive to access included systematic callbacks and the personal involvement of family physicians. Good communication between family physicians and specialists was also perceived to be an important factor in access. CONCLUSION Systematic callbacks, family physicians’ personal efforts to obtain follow-up visits, and better physician-specialist communication were all suggested as ways to improve access to care for patients with multiple chronic conditions. PMID:16926944

  3. Health care and equity in India.

    PubMed

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

    2011-02-01

    In India, despite improvements in access to health care, inequalities are related to socioeconomic status, geography, and gender, and are compounded by high out-of-pocket expenditures, with more than three-quarters of the increasing financial burden of health care being met by households. Health-care expenditures exacerbate poverty, with about 39 million additional people falling into poverty every year as a result of such expenditures. We identify key challenges for the achievement of equity in service provision, and equity in financing and financial risk protection in India. These challenges include an imbalance in resource allocation, inadequate physical access to high-quality health services and human resources for health, high out-of-pocket health expenditures, inflation in health spending, and behavioural factors that affect the demand for appropriate health care. Use of equity metrics in monitoring, assessment, and strategic planning; investment in development of a rigorous knowledge base of health-systems research; development of a refined equity-focused process of deliberative decision making in health reform; and redefinition of the specific responsibilities and accountabilities of key actors are needed to try to achieve equity in health care in India. The implementation of these principles with strengthened public health and primary-care services will help to ensure a more equitable health care for India's population. PMID:21227492

  4. Development of an online information and support resource for adolescent idiopathic scoliosis patients considering surgery: perspectives of health care providers

    PubMed Central

    2010-01-01

    Background Adolescents with idiopathic scoliosis who are considering spinal surgery face a major decision that requires access to in-depth information and support. Unfortunately, most online resources provide incomplete and inconsistent information and minimal social support. The aim of this study was to develop an online information and support resource for adolescent idiopathic scoliosis (AIS) patients considering spinal surgery. Prior to website development, a user-based needs assessment was conducted. The needs assessment involved a total of six focus groups with three stakeholder groups: (1) post-operative AIS patients or surgical candidates (10-18 years) (n = 11), (2) their parents (n = 6) and (3) health care providers (n = 11). This paper reports on the findings from focus groups with health care providers. Methods Focus group methodology was used to invite a range of perspectives and stimulate discussion. During audio-recorded focus groups, an emergent table of website content was presented to participants for assessment of relevance, viability and comprehensiveness in targeting global domains of need. Specifically, effective presentation of content, desired aspects of information and support, and discussions about the value of peer support and the role of health professionals were addressed. Focus group transcripts were then subject to content analysis through a constant comparative review and analysis. Results Two focus groups were held with health care providers, consisting of 5 and 6 members respectively. Clinicians provided their perceptions of the information and support needs of surgical patients and their families and how this information and support should be delivered using internet technology. Health care providers proposed four key suggestions to consider in the development of this online resource: (1) create the website with the target audience in mind; (2) clearly state the purpose of the website and organize website content to support the user; (3) offer a professionally-moderated interactive support component; and (4) ensure accessibility of website information and support by considering the age, gender, reading level and geographic location of potential users. Conclusions Health care providers collectively identified the need for the development of an online information and support resource for adolescents considering surgery for AIS and their families and described the proposed website as a positive and needed adjunct to current clinical care. PMID:20587057

  5. [Health care units image development on the market of medical services].

    PubMed

    Kemicer-Chmielewska, Ewa; Karakiewicz, Beata

    2010-01-01

    The cause for this document is to present a deliberation on public health facility image development on the medical services market. Marketization of the health service, growing awareness of Polish citizens and their expectation of high service quality as well as increased competition in the healthcare system market is the reason why health unit managers need to put a lot of strength and effort in sustaining or improving the image of the facility they run. Such action gives a chance for obtaining a competitive advantage. PMID:21469289

  6. Using relationship marketing to develop and sustain nurse loyalty: a case of a rural health care institution.

    PubMed

    Peltier, J W; Boyt, T; Westfall, J

    1999-01-01

    The prosperity of a health care organization is contingent on its ability to compete for and retain a high quality staff of "loyal" nurses. Although the benefits of maintaining a loyal nursing staff are obvious, turnover in the health care industry is dangerously high. One solution for reducing turnover is to develop and sustain a loyal nursing staff. The purpose of this article is to apply customer-oriented marketing theories and practices to better understand how strong nurse-provider relationships can be developed and maintained over time. The authors first examine relationship marketing literature as it applies to nurse relationship and management issues. Second, a framework for conceptualizing internal marketing efforts devoted to enhancing nursing staff satisfaction and retention in tested. Finally, strategies for practicing relationship marketing will be provided. PMID:10848197

  7. Attending unintended transformations of health care infrastructure

    PubMed Central

    Wentzer, Helle; Bygholm, Ann

    2007-01-01

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

  8. Development and Pilot Evaluation of a Tablet-Based Application to Improve Quality of Care in Child Mental Health Treatment

    PubMed Central

    Bunnell, Brian E; Andrews III, Arthur R; Davidson, Tatiana M; Hanson, Rochelle F; Danielson, Carla Kmett; Saunders, Benjamin E; Soltis, Kathryn; Yarian, Caleb; Chu, Brian; Adams, Zachary W

    2015-01-01

    Background Children need access to high quality mental health care. Effective treatments now exist for a wide range of mental health conditions. However, these interventions are delivered with variable effectiveness in traditional mental health service settings. Innovative solutions are needed to improve treatment delivery quality and effectiveness. Objective The aim of this study was to develop a scalable, sustainable technology-based approach to improve the quality of care in child mental health treatment. Methods A tablet-based resource was developed with input from mental health training experts, mental health providers, and patients. A series of qualitative data collection phases (ie, expert interviews, patient and provider focus groups, usability testing) guided the initial concept and design of the resource, and then its refinement. The result was an iPad-based “e-workbook” designed to improve child engagement and provider fidelity in implementation of a best-practice treatment. We are currently conducting a small scale randomized controlled trial to evaluate the feasibility of e-workbook facilitated child mental health treatment with 10 providers and 20 families recruited from 4 local community-based mental health clinics. Results Usability and focus group testing yielded a number of strong, favorable reactions from providers and families. Recommendations for refining the e-workbook also were provided, and these guided several improvements to the resource prior to initiating the feasibility trial, which is currently underway. Conclusions This study aimed to develop and preliminarily evaluate a tablet-based application to improve provider fidelity and child engagement in child mental health treatment. If successful, this approach may serve as a key step toward making best-practice treatment more accessible to children and families. As various technologies continue to increase in popularity worldwide and within the health care field more specifically, it is essential to rigorously test the usability, feasibility, acceptability, and effectiveness of novel health technology solutions. It is also essential to ensure that patients and providers drive decision making that supports the development of these resources to ensure that they can be seamlessly integrated into practice. Trial Registration Clinicaltrials.gov NCT01915160; https://clinicaltrials.gov/ct2/show/NCT01915160 (Archived by WebCite at http://www.webcitation.org/6cPIiQDpu) PMID:26717906

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

    PubMed

    2012-12-01

    Youth transitioning out of foster care face significant medical and mental health care needs. Unfortunately, these youth rarely receive the services they need because of lack of health insurance. Through many policies and programs, the federal government has taken steps to support older youth in foster care and those aging out. The Fostering Connections to Success and Increasing Adoptions Act of 2008 (Pub L No. 110-354) requires states to work with youth to develop a transition plan that addresses issues such as health insurance. In addition, beginning in 2014, the Patient Protection and Affordable Care Act of 2010 (Pub L No. 111-148) makes youth aging out of foster care eligible for Medicaid coverage until age 26 years, regardless of income. Pediatricians can support youth aging out of foster care by working collaboratively with the child welfare agency in their state to ensure that the ongoing health needs of transitioning youth are met. PMID:23184106

  10. Transformational leadership in health care.

    PubMed

    Trofino, J

    1995-08-01

    One of the most important evolutionary forces in transforming health care is the shift from management to leadership in nursing. The transformational leader will be the catalyst for expanding a holistic perspective, empowering nursing personnel at all levels and maximizing use of technology in the movement beyond even patient-centered health care to patient-directed health outcomes. PMID:7630599

  11. CHACO outreach project: the development of a primary health care-based medical genetic service in an Argentinean province.

    PubMed

    Barreiro, C Z; Bidondo, M P; Garrido, J A; Deurloo, J; Acevedo, E; Luna, A; Gutiérrez, E; Dellamea, C A; Picón, C; Torres, K; De Castro, M F; Torrado, M V; Teiber, M L; Kassab, S; Elmeaudy, P; Rodriguez, J

    2013-07-01

    Dissemination of knowledge in genetics to be applied in medicine has created a growing need for capacity building in health care workers. The CAPABILITY ARGENTINA outreach project protocol was designed as a model to introduce genetics in areas without genetic services. Our aim was for genetic health care to become part of primary care in an Argentine province lacking genetic services. The program was innovative as professionals from the referral center (Garrahan Hospital S.A.M.I.C.) traveled to remote areas to train professionals through problem-based education. A logical framework was designed for a local needs assessment. Teaching materials (Powerpoint presentations, printed syllabus, and CD) and a web page were developed. A demonstration project was carried out in the Province of Chaco, Argentina. A total of 485 health workers were trained. The number of consultations increased significantly in participating areas comparing before and after the training period. To support this increase, a complementary project was set up from a public hospital sponsored from within Argentina to build a cytogenetic laboratory in the capital of the Province of Chaco. The model was improved for reproduction in other areas in Argentina. CAPABILITY ARGENTINA is a capacity building model for training of primary care professionals in genetics that may be applied to other medical specialties. The outcomes of the programme have a direct impact on clinical practice. PMID:23904211

  12. Noncommunicable diseases among urban refugees and asylum-seekers in developing countries: a neglected health care need

    PubMed Central

    2014-01-01

    With the increasing trend in refugee urbanisation, growing numbers of refugees are diagnosed with chronic noncommunicable diseases (NCDs). However, with few exceptions, the local and international communities prioritise communicable diseases. The aim of this study is to review the literature to determine the prevalence and distribution of chronic NCDs among urban refugees living in developing countries, to report refugee access to health care for NCDs and to compare the prevalence of NCDs among urban refugees with the prevalence in their home countries. Major search engines and refugee agency websites were systematically searched between June and July 2012 for articles and reports on NCD prevalence among urban refugees. Most studies were conducted in the Middle East and indicated a high prevalence of NCDs among urban refugees in this region, but in general, the prevalence varied by refugees’ region or country of origin. Hypertension, musculoskeletal disease, diabetes and chronic respiratory disease were the major diseases observed. In general, most urban refugees in developing countries have adequate access to primary health care services. Further investigations are needed to document the burden of NCDs among urban refugees and to identify their need for health care in developing countries. PMID:24708876

  13. Noncommunicable diseases among urban refugees and asylum-seekers in developing countries: a neglected health care need.

    PubMed

    Amara, Ahmed Hassan; Aljunid, Syed Mohamed

    2014-01-01

    With the increasing trend in refugee urbanisation, growing numbers of refugees are diagnosed with chronic noncommunicable diseases (NCDs). However, with few exceptions, the local and international communities prioritise communicable diseases. The aim of this study is to review the literature to determine the prevalence and distribution of chronic NCDs among urban refugees living in developing countries, to report refugee access to health care for NCDs and to compare the prevalence of NCDs among urban refugees with the prevalence in their home countries. Major search engines and refugee agency websites were systematically searched between June and July 2012 for articles and reports on NCD prevalence among urban refugees. Most studies were conducted in the Middle East and indicated a high prevalence of NCDs among urban refugees in this region, but in general, the prevalence varied by refugees' region or country of origin. Hypertension, musculoskeletal disease, diabetes and chronic respiratory disease were the major diseases observed. In general, most urban refugees in developing countries have adequate access to primary health care services. Further investigations are needed to document the burden of NCDs among urban refugees and to identify their need for health care in developing countries. PMID:24708876

  14. Care for nutrition and development.

    PubMed

    Engle, P L; Pelto, G; Bentley, P

    2000-09-01

    Optimal growth and development depend not only on food quality and availability, on access to health care services and a healthy environment but also on the care provided to the child especially during the first few years of life. Care refers to the actions and practices of caregivers on a day to day basis that translate food, heakh care, and water and sanitation supplies into good growth and development of children. It includes behaviours such as feeding, sanitation and hygiene, home health practices, preparing food for children, and providing psychosocial support for development. Families also are responsible for providing care for girls in the family and women. Care requires resources--both skills and capabilities, as well as economic resources. Some resources are easily recognised, such as education of the caregiver, but others are less often seen, including time of the caregiver, motivation of caregiver and male family members, organisational resources such as child care centres, and the caregiver's ability to influence decisions about child care. It must be noted that the poorer the family, the more risks for children in the environment. Therefore, the poorer the environment, the more important a role care has in children's survival, growth and development. Implications for health care providers include assessing the care practices in the home, and resources for care when making recommendations; supporting positive practices already being performed in order to empower the caregiver; checking the understanding and recall of the caregiver; and finally, recognising that all children, regardless of gender, ethnicity, case, economic level, etc, have a right to good nutrition and health care in order to develop to their fullest potential under the Convention for the Rights of the Child, acceded to by India in 1992. PMID:11291785

  15. Information Technology Outside Health Care

    PubMed Central

    Tuttle, Mark S.

    1999-01-01

    Non-health-care uses of information technology (IT) provide important lessons for health care informatics that are often overlooked because of the focus on the ways in which health care is different from other domains. Eight examples of IT use outside health care provide a context in which to examine the content and potential relevance of these lessons. Drawn from personal experience, five books, and two interviews, the examples deal with the role of leadership, academia, the private sector, the government, and individuals working in large organizations. The interviews focus on the need to manage technologic change. The lessons shed light on how to manage complexity, create and deploy standards, empower individuals, and overcome the occasional “wrongness” of conventional wisdom. One conclusion is that any health care informatics self-examination should be outward-looking and focus on the role of health care IT in the larger context of the evolving uses of IT in all domains. PMID:10495095

  16. Development and psychometric properties of a scale for measuring internal participation from a patient and health care professional perspective

    PubMed Central

    2013-01-01

    Background Effective patient-centred health care requires internal participation, which is defined as interprofessional patient-centred teamwork. Many scales are designed for measuring teamwork from the perspective of one type of health care professional (e.g. physician or nurse), rather than for the use for all health care professionals as well as patients. Hence, this papers purpose is to develop a scale for measuring internal participation from all relevant perspectives and to check its psychometric properties. Methods In a multicentre cross-sectional study, a 6-item Internal Participation Scale (IPS) was developed and administered to 661 health care professionals (staff) and 1419 patients in 15 rehabilitation clinics to test item characteristics, acceptance, reliability (internal consistency) and construct validity. Additionally, we performed an exploratory factor analysis (EFA) to determine the factorial structure and explained variance. Confirmatory factor analysis (CFA) was used to verify the theoretically assumed one-dimensional factorial structure. Results A total of 275 health care professionals and 662 patients participated, and the complete data sets of 272 staff members and 536 patients were included in the final analysis. The discrimination index was above .4 for all items in both samples. Internal consistency was very good, with Cronbachs alpha equalling .87 for the staff and .88 for the patient sample. EFA supported a one-dimensional structure of the instrument (explained variance: 61.1% (staff) and 62.3% (patients)). CFA verified the factorial structure, with the factor loadings exceeding .4 for five of six items in both samples. Global goodness-of-fit indices indicated a good model fit, with a Tucker-Lewis index (TLI) of .974 (staff) and .976 (patients) and a comparative fit index (CFI) of .988 (staff) and .989 (patients). The root mean square error of approximation (RMSEA) amounted to .068 for the patient sample and .069 for the staff sample. There is evidence of construct validity for both populations. Conclusions The analysis of the scales psychometric properties resulted in good values. The scale is a promising instrument to assess internal participation from the perspective of both patients and staff. Further research should investigate the scales psychometric properties in other interprofessional health care settings to examine its generalizability as well as its sensitivity to change. PMID:24083632

  17. Gypsies and health care.

    PubMed Central

    Sutherland, A

    1992-01-01

    Gypsies in the United States are not a healthy group. They have a high incidence of heart disease, diabetes mellitus, and hypertension. When they seek medical care, Gypsies often come into conflict with medical personnel who find their behavior confusing, demanding, and chaotic. For their part, Gypsies are often suspicious of non-Gypsy people and institutions, viewing them as a source of disease and uncleanliness. Gypsy ideas about health and illness are closely related to notions of good and bad fortune, purity and impurity, and inclusion and exclusion from the group. These basic concepts affect everyday life, including the way Gypsies deal with eating and washing, physicians and hospitals, the diagnosis of illness, shopping around for cures, and coping with birth and death. PMID:1413769

  18. Flourishing in Health Care.

    PubMed

    Edgar, Andrew; Pattison, Stephen

    2016-06-01

    The purpose of this paper is to offer an account of 'flourishing' that is relevant to health care provision, both in terms of the flourishing of the individual patient and carer, and in terms of the flourishing of the caring institution. It is argued that, unlike related concepts such as 'happiness', 'well-being' or 'quality of life', 'flourishing' uniquely has the power to capture the importance of the vulnerability of human being. Drawing on the likes of Heidegger and Nussbaum, it is argued that humans are at once beings who are autonomous and thereby capable of making sense of their lives, but also subject to the contingencies of their bodies and environments. To flourish requires that one engages, imaginatively and creatively, with those contingencies. The experience of illness, highlighting the vulnerability of the human being, thereby becomes an important experience, stimulating reflection in order to make sense of one's life as a narrative. To flourish, it is argued, is to tell a story of one's life, realistically engaging with vulnerability and suffering, and thus creating a framework through which one can meaningful and constructively go on with one's life. PMID:26846370

  19. Health care organization drug testing.

    PubMed

    Brooks, J P; Dempsey, J

    1992-09-01

    Health care managers are being required to respond to the growing concerns of the public about alcohol and drug use in the health care workplace. To this end, the following recommendations are offered. A drug testing policy should be developed with input from and support of employees and unions. "For cause" testing should be used because it results in more definitive results and better employee acceptance. Unless there are compelling reasons for random testing, "for cause" testing is the preferable method. All levels of employees and the medical staff should be subject to the drug-testing policy. Rehabilitation rather than punishment should be emphasized in dealing with employees with alcohol and drug problems. PMID:10120030

  20. Health care problems of the young child in a developing ecological context.

    PubMed

    Harfouche, J K

    1979-01-01

    Due to a lack of health statistics regarding both children and women of childbearing age, the health needs of young children in developing nations are essentially unknown. The health of the mother is intimately related to that of the child, since low birth weight caused by intrauterine growth retardation is believed to be of significance for the health and development of the child until age 11. Mothers in rural areas of developing nations may suffer because of poor nutrition, excessive pregnancies at short intervals, prolonged lactation, and heavy farm work. Mothers in the peri-urban sector may be worse off because, being in nuclear families, they lack support from other women during pregnancy and childbirth. In some rural areas in developing nations as many as 1/2 of all deaths occur in infants and children under age 5. Birth weight is the most important single indicator of intrauterine development and needs to be recorded on the birth certificate of every neonate. Low birth weight is of public health significance because it is associated with a high rate of perinatal mortality, morbidity, and subclinical damage and because it tends to result in a pool of children suffering from malnutrition. In infants and young children the risk of death is closely related to the socioeconomic conditions under which they live. The young child is vulnerable to the stresses associated with modifications in the social-cultural environment, and to those related to the changes in family structure that are occurring in many areas of the world. Women in many societies are now taking a more active part in political, economic, and social life. This trend affects child-rearing practices and the roles of parents. Societies are developing a wide range of adaptive measures -- legislative, educational, protective, supportive -- to assist the working mother, but there are complex problems involved in implementing these measures in different cultures. PMID:314352

  1. Health and Disability: Partnerships in Health Care

    ERIC Educational Resources Information Center

    Tracy, Jane; McDonald, Rachael

    2015-01-01

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

  2. Health and Disability: Partnerships in Health Care

    ERIC Educational Resources Information Center

    Tracy, Jane; McDonald, Rachael

    2015-01-01

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

  3. Health Care Autonomy in Children with Chronic Conditions: Implications for Self Care and Family Management

    PubMed Central

    Beacham, Barbara L.; Deatrick, Janet A.

    2013-01-01

    Synopsis Health care autonomy typically occurs during late adolescence but health care providers and families often expect children with chronic health conditions to master self-care earlier. Few studies have examined the development of health care autonomy as it pertains to self-care and family management. This review will link the three concepts and discuss implications for families and health care providers. Case studies are provided as exemplars to highlight areas where intervention and research is needed. PMID:23659815

  4. Types of health care providers

    MedlinePlus

    ... types of health care providers: Nurse practitioners Physician assistant profession ... family planning. NPs can prescribe medications. A physician assistant (PA) can provide a wide range of services ...

  5. Space technology in remote health care

    NASA Technical Reports Server (NTRS)

    Belasco, N.

    1974-01-01

    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.

  6. Can consumer choice replace trust in the National Health Service in England? Towards developing an affective psychosocial conception of trust in health care.

    PubMed

    Fotaki, Marianna

    2014-11-01

    Trust has long been regarded as a vitally important aspect of the relationship between health service providers and patients. Recently, consumer choice has been increasingly advocated as a means of improving the quality and effectiveness of health service provision. However, it is uncertain how the increase of information necessary to allow users of health services to exercise choice, and the simultaneous introduction of markets in public health systems, will affect various dimensions of trust, and how changing relations of trust will impact upon patients and services. This article employs a theory-driven approach to investigate conceptual and material links between choice, trust and markets in health care in the context of the National Health Service in England. It also examines the implications of patient choice on systemic, organisational and interpersonal trust. The article is divided into two parts. The first argues that the shift to marketisation in public health services might lead to an over-reliance on rational-calculative aspects of trust at the expense of embodied, relational and social attributes. The second develops an alternative psychosocial conception of trust: it focuses on the central role of affect and accounts for the material and symbolic links between choice, trust and markets in health care. PMID:25470326

  7. Managed care and reproductive health.

    PubMed

    Cohen, S S; Williams, D R

    1998-01-01

    Managed care poses special challenges to midwives providing reproductive health care. This is owing to the sensitive nature of issues surrounding reproductive health and aspects of managed care that may impede a woman's ability to obtain continuous, confidential, and comprehensive care from the provider of her choice. Variations across payers (ie, Medicare, Medicaid, and commercial insurers) regarding covered benefits and reimbursement of midwifery services also may create obstacles. Furthermore, some physicians and managed care organizations are embracing policies that threaten the ability of midwives to function as primary health care providers for women. Despite these hurdles, midwives have the potential to remain competitive in the new marketplace. This article underscores the importance of being knowledgeable about legislation and policy issues surrounding the financing of midwifery services, quality performance measurement for HMOs as they pertain to reproductive health, and discussions regarding which clinicians should be defined as primary care providers. PMID:9674347

  8. Principles of Development of Model Health Care Programmes. Report on a WHO Meeting. (Turku, Finland, May 3-6, 1982). EURO Reports and Studies 96.

    ERIC Educational Resources Information Center

    World Health Organization, Copenhagen (Denmark). Regional Office for Europe.

    A report is given of the work of a group convened by the World Health Organization (WHO) to address the issues related to the development of Model Health Care Programs (MHCPs), and to apply the principles thus identified to the case of a specific health problem--low back pain. A discussion of the principles of the development of MHCPs includes…

  9. Lesbian and bisexual health care.

    PubMed Central

    Mathieson, C. M.

    1998-01-01

    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

  10. MyCare Card Development: portable GUI framework for the personal electronic health record device.

    PubMed

    Rybynok, V O; Kyriacou, P A; Binnersley, J; Woodcock, A

    2011-01-01

    In most emergency situations, health professionals rely on patients to provide information about their medical history. However, in some cases patients might not be able to communicate this information, and in most countries an online integrated patient record system has not been adopted yet. Therefore, in order to address this issue the ongoing project MyCare Card (MyC², www.myc2.org) has been established. The aim of this project is to design, implement, and evaluate a prototype patient held electronic health record device. Due to the wide range of user requirements, the device, its communication interface, and its software have to be compatible with many common platforms and operating systems. Thus, this paper is addressing one of the software compatibility matters-the cross-platform GUI implementation. It introduces a portable object-oriented GUI framework, suitable for a declarative layout definition, components customization, and fine model-view code separation. It also rationalizes the hardware and software solutions selected for this project implementation. PMID:21062683

  11. Health care ethics and health law in the Dutch discussion on end-of-life decisions: a historical analysis of the dynamics and development of both disciplines.

    PubMed

    Kater, Loes; Houtepen, Rob; De Vries, Raymond; Widdershoven, Guy

    2003-12-01

    Over the past three or four decades, the concept of medical ethics has changed from a limited set of standards to a broad field of debate and research. We define medical ethics as an arena of moral issues in medicine, rather than a specific discipline. This paper examines how the disciplines of health care ethics and health care law have developed and operated within this arena. Our framework highlights the aspects of jurisdiction (Abbott) and the assignment of responsibilities (Gusfield). This theoretical framework prompted us to study definitions and changing responsibilities in order to describe the development and interaction of health care ethics and health law. We have opted for the context of the Dutch debate about end-of-life decisions as a relevant case study. We argue that the specific Dutch definition of euthanasia as 'intentionally taking the life of another person by a physician, upon that person's request' can be seen as the result of the complex jurisdictional process. This illustrates the more general conclusion that the Dutch debate on end-of-life decisions and the development of the two disciplines must be understood in terms of mutual interaction. PMID:15948335

  12. Community-Based Participatory Development of a Community Health Worker Mental Health Outreach Role to Extend Collaborative Care in Post-Katrina New Orleans

    PubMed Central

    Wennerstrom, Ashley; Vannoy, Steven D.; Allen, Charles E.; Meyers, Diana; O'Toole, Elizabeth; Wells, Kenneth B.; Springgate, Benjamin F.

    2013-01-01

    Objectives The REACH NOLA Mental Health Infrastructure and Training Project (MHIT) aimed to reduce disparities in access to and quality of services for depression and posttraumatic stress disorder (PTSD) in post-Katrina New Orleans by developing a mental health outreach role for community health workers (CHWs) and case managers as a complement to the collaborative care model for depression treatment. Intervention Community agency leaders, academics, healthcare organizations, and CHWs engaged in a community participatory process to develop a CHW training program. Design A review of qualitative data including semi-structured interviews, project team conference calls, email strings, and meeting minutes was conducted to document CHW input into training and responses to implementation. Results CHW contributions resulted in a training program focused on community engagement, depression screening, education, referral assistance, collaboration with clinical teams, and self-care. CHWs reported use of screening tools, early client successes in spite of challenges with client engagement, increase in networking and collaboration with other community agencies and providers, and ongoing community hurricane recovery issues. Conclusions This intervention development approach and model may be used to address post-disaster mental health disparities and as a complement to traditional implementation of collaborative care. PMID:22352080

  13. Space age health care delivery

    NASA Technical Reports Server (NTRS)

    Jones, W. L.

    1977-01-01

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

  14. Health care-associated pneumonia.

    PubMed

    Amin, Alpesh; Kollef, Marin H

    2010-06-01

    Traditionally, pneumonia developing in patients who receive health care services in the outpatient environment, such as nursing homes, long-term care facilities, and dialysis centers, has been classified and treated as community-acquired pneumonia (CAP). Recent studies, however, have shown that this type of infection, known as health care-associated pneumonia (HCAP) is distinct from CAP in terms of its epidemiology and etiology, and increases the risk for infection with multidrug-resistant (MDR) pathogens. A review of available clinical data about HCAP was conducted to determine effective empiric treatment strategies and improve clinical outcomes. Analysis of multi-institutional clinical data showed that mortality associated with HCAP is higher than with CAP, suggesting that patients with HCAP may have been treated as hospitalized patients with CAP and received inappropriate initial empiric antibiotic treatment. All patients presenting to the hospital with suspected HCAP or CAP should be evaluated for their underlying risk of infection with MDR pathogens. Because HCAP may be similar to hospital-acquired pneumonia (HAP) both clinically and etiologically, it should be treated as HAP until culture data become available. A greater recognition of HCAP as a new class of pneumonia with a distinct epidemiologic, microbiologic, and clinical profile should lead physicians to initiate appropriate empiric antibiotic therapy more often, thereby improving the likelihood for optimal clinical outcomes and patient care. PMID:20499775

  15. Applying economic principles to health care.

    PubMed Central

    Scott, R. D.; Solomon, S. L.; McGowan, J. E.

    2001-01-01

    Applying economic thinking to an understanding of resource use in patient care is challenging given the complexities of delivering health care in a hospital. Health-care markets lack the characteristics needed to determine a "market" price that reflects the economic value of resources used. However, resource allocation in a hospital can be analyzed by using production theory to determine efficient resource use. The information provided by hospital epidemiologists is critical to understanding health-care production processes used by a hospital and developing economic incentives to promote antibiotic effectiveness and infection control. PMID:11294724

  16. Involving stakeholders in health services research: developing Alberta's resident classification system for long-term care facilities.

    PubMed

    Charles, C; Schalm, C; Semradek, J

    1994-01-01

    Little attention has been directed in Canada to identifying stakeholders at the administrative policy level to whom relevant health services research information can be targeted. This article describes a case study in which key stakeholders (long-term care facility owners, operators, and care providers) were explicitly defined not only as targets of original research information to inform administrative public policy but also as collaborators in the research process and dissemination of results. The research involved development of a classification system to measure resident care requirements in the province's nursing homes and auxiliary hospitals. The classification system formed the basis of a new government administrative policy for allocating public funds to these facilities based on levels of care. The authors describe the rationale for involving stakeholders in the research process, the role of stakeholders as collaborators, and lessons learned from the Alberta experience. Examples are presented of how stakeholders can contribute to the health services research process and outcome: by providing experiential knowledge related to the research outcome, anticipating and overcoming potential problems with policy implementation, facilitating policy-oriented learning across stakeholder groups, assisting in the transfer of research information to wider stakeholder audiences, and promoting acceptance for policy change. PMID:7896472

  17. Making Connections: Ideas for Curriculum Development in the Tertiary Education of Health Care Workers Involved in Caring for People Living with HIV/AIDS.

    ERIC Educational Resources Information Center

    Elsey, Barry; Mills, Patricia

    This report synthesizes the findings of a week of focused group discussions during which Australian health care workers currently caring for people with human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) and tertiary educators involved in designing/delivering curricula in various health and social disciplines shared their…

  18. Modeling Health Care Policy Alternatives

    PubMed Central

    Ringel, Jeanne S; Eibner, Christine; Girosi, Federico; Cordova, Amado; McGlynn, Elizabeth A

    2010-01-01

    Background Computer models played an important role in the health care reform debate, and they will continue to be used during implementation. However, current models are limited by inputs, including available data. Aim We review microsimulation and cell-based models. For each type of model, we discuss data requirements and other factors that may affect its scope. We also discuss how to improve models by changing data collection and data access procedures. Materials and Methods We review the modeling literature, documentation on existing models, and data resources available to modelers. Results Even with limitations, models can be a useful resource. However, limitations must be clearly communicated. Modeling approaches could be improved by enhancing existing longitudinal data, improving access to linked data, and developing data focused on health care providers. Discussion Longitudinal datasets could be improved by standardizing questions across surveys or by fielding supplemental panels. Funding could be provided to identify causal parameters and to clarify ranges of effects reported in the literature. Finally, a forum for routine communication between modelers and policy makers could be established. Conclusion Modeling can provide useful information for health care policy makers. Thus, investing in tools to improve modeling capabilities should be a high priority. PMID:21054371

  19. Task Force on Health Care.

    PubMed

    1993-09-01

    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

  20. Culturally sensitive care for elderly immigrants through ethnic community health workers: design and development of a community based intervention programme in the Netherlands

    PubMed Central

    2013-01-01

    Background In Western countries, health and social welfare facilities are not easily accessible for elderly immigrants and their needs are suboptimally addressed. A transition is needed towards culturally sensitive services to overcome barriers to make cure and care accessible for elderly immigrants. We developed an intervention programme in which ethnic community health workers act as liaisons between immigrant elderly and local health care and social welfare services. In this study we evaluate the effectiveness and the implementation of this intervention programme. Methods/design In a quasi experimental design, the effectiveness of introduction of community health workers, health needs assessment, and follow-up intervention programme will be evaluated in three (semi) urban residential areas in the Netherlands and compared with a control group. Community health workers are selected from local ethnic communities and trained for the intervention. Data on health perception, quality of life, and care consumption are collected at baseline and after the intervention programme. Elderly’s informal care givers are included to examine caregiver burden. The primary outcome is use of health care and social welfare facilities by the elderly. Secondary outcomes are quality of life and functional impairments. The target number of participants is 194 immigrant elderly: 97 for the intervention group and 97 for the control group. Implementation of the intervention programme will be examined with focus groups and data registration of community health worker activities. Discussion This study can contribute to the improvement of care for elderly immigrants by developing culturally sensitive care whereby they actively participate. To enable a successful transition, proper identification and recruitment of community health workers is required. Taking this into account, the study aims to provide evidence for an approach to improve the care and access to care for elderly immigrants. Once proven effective, the community health worker function can be further integrated into the existing local health care and welfare system. Trial registration Trial registration number: ISRCTN89447795 PMID:23497392

  1. Health care for children in foster care.

    PubMed

    Bean, Andrea; Gamino, Laura; Pierce, Priscilla; Shropshire, Deborah; Wallace, Kristina

    2004-09-01

    Every month 6,600 children in Oklahoma live under the custody of the state, most as result of being abused or neglected by their own families. The state provides medical care to these children via the Medicaid program. The American Academy of Pediatrics(AAP) has set forth a guideline for optimal care of these children. We discuss the current Oklahoma health care system for foster children and suggest changes that may move Oklahoma in the direction of the AAP recommendations. A more uniform, organized medical system may not only meet a foster child's medical needs but may also provide a degree of continuity to an otherwise discontinuous process. PMID:15540570

  2. Telemedicine in primary health care.

    PubMed

    Kastania, Anastasia

    2008-01-01

    Here, the possibilities to build integrated primary health care telemedicine services are presented accompanied with available epistemic criteria for quality evaluation purposes. Given that the cost of sanitary care is increasing continuously the telemedicine approach is a challenge for providing quality care and at low cost to the rural citizens. PMID:18305330

  3. Congress enacts health care reform.

    PubMed

    2010-03-01

    Health care reform at last: After nearly a century of effort by Presidents from Theodore Roosevelt on down, the Congress finally agreed on and President Barack Obama signed into law a system that covers most Americans, regulates sharp insurance practices, and embraces a paradigm shift from acute institutionally focused care to chronic disease management based on home and community-based care. PMID:20465039

  4. Health planning and health care for the poor: the internal ethic of public health.

    PubMed

    Erwin, P C

    1996-01-01

    Health planning involves assessing health care needs of a defined population, setting priorities, then developing, implementing,m and evaluating programs that address priority needs. The concepts of health planning are central to the 1988 report of the Institute of Medicine on the Future of Public Health, which defined the three core functions of public health as assessment, policy development, and assurance. Generally, when health planning is instituted, poor people are identified as having the poorest health status and the greatest need. An internal ethic is therefore created for public health to focus on the health care needs of those in poverty. This internal ethic of public health health can become the driving force for reforming the present U.S. health care system. A reformed health care system would be guided by the principle of care according to need, which not only has a basis in health planning, but in social justice as well. PMID:10158562

  5. Implementation of Advanced Health Care Technology into Existing Competency-Based Health Care Program. Final Report.

    ERIC Educational Resources Information Center

    Klemovage, Shirley

    A project was undertaken to develop new curriculum materials that could be incorporated into an existing health assistant program to cover recent advances in health care technology. Area physicians' offices were toured and meetings were held with administrators of local hospitals in order to discover what kinds of advances in health care

  6. Foster Care and Child Health.

    PubMed

    McDavid, Lolita M

    2015-10-01

    Children in foster care need more from health providers than routine well-child care. The changes in legislation that were designed to prevent children from languishing in foster care also necessitate a plan that works with the child, the biological family, and the foster family in ensuring the best outcome for the child. This approach acknowledges that most foster children will return to the biological family. Recent research on the effect of adverse childhood experiences across all socioeconomic categories points to the need for specifically designed, focused, and coordinated health and mental health services for children in foster care. PMID:26318955

  7. Pharmacists' Role in Health Care

    ERIC Educational Resources Information Center

    Maronde, Robert F.

    1977-01-01

    Pharmacists' contribution to the health care of the future in the future in the U.S. may have to be in the context of increasing the efficiency and effectiveness of health-care delivery. It is from the area of drug therapy, now poorly administered, that the pharmacist will have to justify his role in a cost-effective manner. (Author/LBH)

  8. Prospects for Health Care Reform.

    ERIC Educational Resources Information Center

    Kastner, Theodore

    1992-01-01

    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)

  9. Contagious Ideas from Health Care

    ERIC Educational Resources Information Center

    Chaffee, Ellen

    2009-01-01

    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…

  10. Development and psychometric properties the Barriers to Access to Care Evaluation scale (BACE) related to people with mental ill health

    PubMed Central

    2012-01-01

    Background Many people with mental illness do not seek or delay seeking care. This study aimed to develop, and provide an initial validation of, a comprehensive measure for assessing barriers to access to mental health care including a ‘treatment stigma’ subscale, and to present preliminary evidence about the prevalence of barriers experienced by adults currently or recently using secondary mental health services in the UK. Methods The Barriers to Access to Care Evaluation scale (BACE) was developed from items in existing scales, systematic item reduction, and feedback from an expert group. It was completed in an online survey by 117 individuals aged 18 and over who had received care from secondary mental health services in the past 12 months. Internal consistency, test-retest reliability, convergent validity (correlation of treatment stigma subscale with the Stigma Scale for Receiving Psychological Help (SSRPH) and with the Internalised Stigma of Mental Illness Scale (ISMI)), respondent opinion and readability were assessed. Results The BACE items were found to have acceptable test-retest reliability as all but one of the items exceeded the criterion for moderate agreement. The treatment stigma subscale had acceptable test-retest-reliability and good internal consistency. As hypothesised the subscale was significantly positively correlated with the SSRPH and the ISMI demonstrating convergent validity. The developmental process ensured content validity. Respondents gave the BACE a median rating of 8 on the 10-point quality scale. Readability scores indicated the measure can be understood by the average 11 to 12 year-old. The most highly endorsed barrier was ‘concern that it might harm my chances when applying for jobs’. The scale was finalised into a 30-item measure with a 12-item treatment stigma subscale. Conclusions There is preliminary evidence demonstrating the reliability, validity and acceptability of the BACE. It can be used to ascertain key barriers to access to mental health care which may help to identify potential interventions to increase care seeking and service use. Further research is needed to establish its factor analytic structure and population norms. PMID:22546012

  11. Service quality in health care.

    PubMed

    Kenagy, J W; Berwick, D M; Shore, M F

    1999-02-17

    Although US health care is described as "the world's largest service industry," the quality of service--that is, the characteristics that shape the experience of care beyond technical competence--is rarely discussed in the medical literature. This article illustrates service quality principles by analyzing a routine encounter in health care from a service quality point of view. This illustration and a review of related literature from both inside and outside health care has led to the following 2 premises: First, if high-quality service had a greater presence in our practices and institutions, it would improve clinical outcomes and patient and physician satisfaction while reducing cost, and it would create competitive advantage for those who are expert in its application. Second, many other industries in the service sector have taken service quality to a high level, their techniques are readily transferable to health care, and physicians caring for patients can learn from them. PMID:10029131

  12. Biosensors in Health Care: The Milestones Achieved in Their Development towards Lab-on-Chip-Analysis

    PubMed Central

    Patel, Suprava; Nanda, Rachita; Sahoo, Sibasish; Mohapatra, Eli

    2016-01-01

    Immense potentiality of biosensors in medical diagnostics has driven scientists in evolution of biosensor technologies and innovating newer tools in time. The cornerstone of the popularity of biosensors in sensing wide range of biomolecules in medical diagnostics is due to their simplicity in operation, higher sensitivity, ability to perform multiplex analysis, and capability to be integrated with different function by the same chip. There remains a huge challenge to meet the demands of performance and yield to its simplicity and affordability. Ultimate goal stands for providing point-of-care testing facility to the remote areas worldwide, particularly the developing countries. It entails continuous development in technology towards multiplexing ability, fabrication, and miniaturization of biosensor devices so that they can provide lab-on-chip-analysis systems to the community. PMID:27042353

  13. Mental health services in Army primary care: the need for a collaborative health care agenda.

    PubMed

    Engel, C C; Kroenke, K; Katon, W J

    1994-03-01

    Epidemiologic studies have shown that more than half of mentally ill patients in the United States receive their psychiatric care exclusively in primary care settings. This fraction may be even higher in the military due to concern over possible occupational repercussions resulting from use of specialty psychiatric care and specialist shortages. Collaboration between generalists and mental health care specialists could potentially improve mental health care delivery and reduce psychiatric disability for a large segment of the Army population who have a psychiatric disorder but may not seek specialty care. Collaborative efforts can reinforce military generalists' essential gate-keeping function, thereby decreasing unnecessary medical utilization and health care costs. The authors review the problems associated with mental health care delivery in primary care and provide examples of collaborative models previously studied or currently being explored. A four-part Army Primary Care-Mental Health Services Agenda is proposed, consisting of: (1) coordinated research including primary care-mental health services research and community-based epidemiologic studies; (2) formation of a primary care-mental health services advisory committee for aiding with policy and program development; (3) graduate and continuing medical education in primary care-mental health services emphasizing interdisciplinary collaborative skills; and (4) clinical implementation of feasible collaborative interdisciplinary mental health care models adapted to the range of unique Army primary care settings. The main goal of the Army Primary Care-Mental Health Services Agenda is to improve access to Army mental health care in the most efficacious and cost-effective way and to help minimize the organizational impact of disability related to psychosocial distress. PMID:8041464

  14. Health care's service fanatics.

    PubMed

    Merlino, James I; Raman, Ananth

    2013-05-01

    The Cleveland Clinic has long had a reputation for medical excellence. But in 2009 the CEO acknowledged that patients did not think much of their experience there and decided to act. Since then the Clinic has leaped to the top tier of patient-satisfaction surveys, and it now draws hospital executives from around the world who want to study its practices. The Clinic's journey also holds Lessons for organizations outside health care that must suddenly compete by creating a superior customer experience. The authors, one of whom was critical to steering the hospital's transformation, detail the processes that allowed the Clinic to excel at patient satisfaction without jeopardizing its traditional strengths. Hospital leaders: Publicized the problem internally. Seeing the hospital's dismal service scores shocked employees into recognizing that serious flaws existed. Worked to understand patients' needs. Management commissioned studies to get at the root causes of dissatisfaction. Made everyone a caregiver. An enterprisewide program trained everyone, from physicians to janitors, to put the patient first. Increased employee engagement. The Clinic instituted a "caregiver celebration" program and redoubled other motivational efforts. Established new processes. For example, any patient, for any reason, can now make a same-day appointment with a single call. Set patients' expectations. Printed and online materials educate patients about their stays--before they're admitted. Operating a truly patient-centered organization, the authors conclude, isn't a program; it's a way of life. PMID:23898737

  15. Teens, technology, and health care.

    PubMed

    Leanza, Francesco; Hauser, Diane

    2014-09-01

    Teens are avid users of new technologies and social media. Nearly 95% of US adolescents are online at least occasionally. Health care professionals and organizations that work with teens should identify online health information that is both accurate and teen friendly. Early studies indicate that some of the new health technology tools are acceptable to teens, particularly texting, computer-based psychosocial screening, and online interventions. Technology is being used to provide sexual health education, medication reminders for contraception, and information on locally available health care services. This article reviews early and emerging studies of technology use to promote teen health. PMID:25124206

  16. Can health care teams improve primary care practice?

    PubMed

    Grumbach, Kevin; Bodenheimer, Thomas

    2004-03-10

    In health care settings, individuals from different disciplines come together to care for patients. Although these groups of health care personnel are generally called teams, they need to earn true team status by demonstrating teamwork. Developing health care teams requires attention to 2 central questions: who is on the team and how do team members work together? This article chiefly focuses on the second question. Cohesive health care teams have 5 key characteristics: clear goals with measurable outcomes, clinical and administrative systems, division of labor, training of all team members, and effective communication. Two organizations are described that demonstrate these components: a private primary care practice in Bangor, Me, and Kaiser Permanente's Georgia region primary care sites. Research on patient care teams suggests that teams with greater cohesiveness are associated with better clinical outcome measures and higher patient satisfaction. In addition, medical settings in which physicians and nonphysician professionals work together as teams can demonstrate improved patient outcomes. A number of barriers to team formation exist, chiefly related to the challenges of human relationships and personalities. Taking small steps toward team development may improve the work environment in primary care practices. PMID:15010447

  17. Leadership models in health care - a case for servant leadership.

    PubMed

    Trastek, Victor F; Hamilton, Neil W; Niles, Emily E

    2014-03-01

    Our current health care system is broken and unsustainable. Patients desire the highest quality care, and it needs to cost less. To regain public trust, the health care system must change and adapt to the current needs of patients. The diverse group of stakeholders in the health care system creates challenges for improving the value of care. Health care providers are in the best position to determine effective ways of improving the value of care. To create change, health care providers must learn how to effectively lead patients, those within health care organizations, and other stakeholders. This article presents servant leadership as the best model for health care organizations because it focuses on the strength of the team, developing trust and serving the needs of patients. As servant leaders, health care providers may be best equipped to make changes in the organization and in the provider-patient relationship to improve the value of care for patients. PMID:24486078

  18. Business models for health care decision support.

    PubMed

    Gaughan, Phil

    2003-01-01

    CareScience, Inc. is a public company (NASDAQ: CARE) that originated ten years ago to commercialize risk adjustment and complication predictions developed by the Wharton School of Business and the University of Pennsylvania School of Medicine. Over the past decade, the company has grown to approximately 200 clients and 150 employees. Among the "firsts" recorded by the company, CareScience was the first to offer a clinical decision support system as an Application Service Provider (ASP), the first to offer peer-to-peer clinical data sharing among health care provider organizations and practitioners (Santa Barbara Care Data Exchange), and the first to provide a care management outsourcing arrangement. PMID:15455839

  19. Development of an Algorithm to Classify Colonoscopy Indication from Coded Health Care Data

    PubMed Central

    Adams, Kenneth F.; Johnson, Eric A.; Chubak, Jessica; Kamineni, Aruna; Doubeni, Chyke A.; Buist, Diana S.M.; Williams, Andrew E.; Weinmann, Sheila; Doria-Rose, V. Paul; Rutter, Carolyn M.

    2015-01-01

    Introduction: Electronic health data are potentially valuable resources for evaluating colonoscopy screening utilization and effectiveness. The ability to distinguish screening colonoscopies from exams performed for other purposes is critical for research that examines factors related to screening uptake and adherence, and the impact of screening on patient outcomes, but distinguishing between these indications in secondary health data proves challenging. The objective of this study is to develop a new and more accurate algorithm for identification of screening colonoscopies using electronic health data. Methods: Data from a case-control study of colorectal cancer with adjudicated colonoscopy indication was used to develop logistic regression-based algorithms. The proposed algorithms predict the probability that a colonoscopy was indicated for screening, with variables selected for inclusion in the models using the Least Absolute Shrinkage and Selection Operator (LASSO). Results: The algorithms had excellent classification accuracy in internal validation. The primary, restricted model had AUC= 0.94, sensitivity=0.91, and specificity=0.82. The secondary, extended model had AUC=0.96, sensitivity=0.88, and specificity=0.90. Discussion: The LASSO approach enabled estimation of parsimonious algorithms that identified screening colonoscopies with high accuracy in our study population. External validation is needed to replicate these results and to explore the performance of these algorithms in other settings. PMID:26290883

  20. The ORIGINS of Primary Health Care and SELECTIVE Primary Health Care

    PubMed Central

    Cueto, Marcos

    2004-01-01

    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

  1. Soviet health care and perestroika.

    PubMed

    Schultz, D S; Rafferty, M P

    1990-02-01

    Health and health care in the Soviet Union are drawing special attention during these first years of perestroika, Mikhail Gorbachev's reform of Soviet political and economic life. This report briefly describes the current state of Soviet health and medical care, Gorbachev's plans for reform, and the prospects for success. In recent years the Soviet Union has experienced a rising infant mortality rate and declining life expectancy. The health care system has been increasingly criticized for its uncaring providers, low quality of care, and unequal access. The proposed measures will increase by 50 percent the state's contribution to health care financing, encourage private medicine on a small scale, and begin experimentation with capitation financing. It seems unlikely that the government will be able to finance its share of planned health improvements, or that private medicine, constrained by the government's tight control, will contribute much in the near term. Recovery of the Soviet economy in general as well as the ability of health care institutions to gain access to Western materials will largely determine the success of reform of the Soviet health care system. PMID:2297064

  2. [Transforming health systems based on primary care].

    PubMed

    Durán-Arenas, Luis; Salinas-Escudero, Guillermo; Granados-García, Víctor; Martínez-Valverde, Silvia

    2012-01-01

    Access to health services is a social basic determinant of health in Mexico unlike what happens in developed countries. The demand for health services is focused on primary care, but the design meets only the supply of hospital care services. So it generates a dissonance between the needs and the effective design of health services. In addition, the term affiliation refers to population contributing or in the recruitment process, that has been counted as members of these social security institutions (SS) and Popular Insurance (SP). In the case of Instituto Mexicano del Seguro Social (IMSS) three of four contributors are in contact with health services; while in the SP, this indicator does not exist. Moreover, the access gap between health services is found in the health care packages so that members of the SS and SP do not have same type of coverage. The question is: which model of health care system want the Mexicans? Primary care represents the first choice for increasing the health systems performance, as well as to fulfill their function of social protection: universal access and coverage based on needs, regardless whether it is a public or private health insurance. A central aspect for development of this component is the definition of the first contact with the health system through the creation of a primary health care team, led by a general practitioner as the responsible of a multidisciplinary health team. The process addresses the concepts of primary care nursing, consumption of inputs (mainly medical drugs), maintenance and general services. Adopting a comprehensive strategy that will benefit all Mexicans equally and without discrimination, this primary care system could be financed with a total operating cost of approximately $ 22,809 million by year. PMID:23254714

  3. [The implication of primary health care programs].

    PubMed

    Martin, J

    1979-01-01

    A meeting of UNICEF and WHO sponsors at the international conference on primary health care held at Alma Ata in the Soviet Republic of Kazakstan in September of 1978 served to summarize some major points regarding the importance and the nature of primary health care in developing countries. The conference emphasized that primary health care should not be viewed as a second-class medical service system for the poor in developing nations, but rather, the first point of contact between the individual and the health system within an awareness-building process integral to development. Such services should be available and accessible to all members of the community through acceptable means and at a cost which the community and the country can meet. With respect to primary health care programs' design and administration, it was concluded that service should be provided by a team of health care personnel working together with other disciplines and organizations involved in overall national socioeconomic development efforts. The primary health care program requires a substantial share of health resources, and may need a larger share of the total health budget allocations in many countries, perhaps at the expense of hospital and surgical services which do not reach the mass population. This proposition is substantiated by the fact that primary health care is more cost-effective than hospital-based medicine. Pilot programs so far have achieved a dramatic decrease in mortality rates, notably among high risk groups such as preschool age children and mothers. Adequate program design will also require changes in the traditional medical education of doctors and nurses who must not only be technically competent, but also socially and sociologically aware in order to adequately respond to popular needs. A greater stress on community participation was also recommended; the success of village health committees in the past being cited as exemplary in not only dealing with health problems, but also in achieving general community development and solidarity. PMID:12336064

  4. The impact of vouchers on the use and quality of health care in developing countries: a systematic review.

    PubMed

    Brody, Carinne Meyer; Bellows, Nicole; Campbell, Martha; Potts, Malcom

    2013-01-01

    One approach to delivering healthcare in developing countries is through voucher programmes, where vouchers are distributed to a targeted population for free or subsidised health care. Using inclusion/exclusion criteria, a search of databases, key journals and websites review was conducted in October 2010. A narrative synthesis approach was taken to summarise and analyse five outcome categories: targeting, utilisation, cost efficiency, quality and health outcomes. Sub-group and sensitivity analyses were also performed. A total of 24 studies evaluating 16 health voucher programmes were identified. The findings from 64 outcome variables indicates: modest evidence that vouchers effectively target specific populations; insufficient evidence to determine whether vouchers deliver healthcare efficiently; robust evidence that vouchers increase utilisation; modest evidence that vouchers improve quality; no evidence that vouchers have an impact on health outcomes; however, this last conclusion was found to be unstable in a sensitivity analysis. The results in the areas of targeting, utilisation and quality indicate that vouchers have a positive effect on health service delivery. The subsequent link that they improve health was found to be unstable from the data analysed; another finding of a positive effect would result in robust evidence. Vouchers are still new and the number of published studies is limiting. PMID:23336251

  5. Health care governance in the UK National Health Service.

    PubMed

    Wilson, Jo H

    2004-01-01

    The NHS Plan sets out a challenging agenda for modernising the UK National Health Service (NHS), governing the organisation's performance and improving and extending service provision. Good health care governance is an essential prerequisite for all modernisation effort. This article will explore the responsibilities and implications for health care boards, managers and clinical staff in providing assurances for health care governance. Health care organisation directors, executive and non-executive, all share responsibility for the direction and control of the organisation. They are required to act in the best interest of the patients, staff and the general public and have statutory obligations to provide safe systems of work under the Health and Safety Regulations. Each director has a role in ensuring openness, being honest and acting with integrity, taking responsibility for their own personal learning and development, constructively challenge and develop strategy and ensuring the probity of the organisation's activities. PMID:15566273

  6. Going public: reflections on developing the DöBra research program for health-promoting palliative care in Sweden

    PubMed Central

    Lindqvist, Olav; Tishelman, Carol

    2016-01-01

    Introduction: Public health approaches to end-of-life (EoL) research and care are relatively rare in Sweden, and health-promoting palliative care (HPPC) remains a foreign concept for most. We recently consolidated our HPPC endeavors into a cohesive research program, DöBra, to promote constructive change and awareness to support better quality of life and death among the general population, in specific sub-groups, and in interventions directed to professional groups caring for dying individuals, their friends and families. Objectives: In this article, we aim to share ideas, experiences, and reflections from the early stages of this research program, particularly in relation to how we try to work with new ‘publics’, to contribute to the development of HPPC as a new research field. Methods and Results: We discuss some considerations which arise in the Swedish context, and present the underlying ideas and approaches used in the research program, with examples of their application. HPPC, based on ideas from new public health, is essential as an umbrella for the DöBra program. Action research, experience-based co-design, and knowledge exchange, all aim to bring together a variety of stakeholders to exchange ideas and expertise, and co-create experience-based evidence through knowledge generation, dissemination, and sharing. Discussion: In reflecting on what we have learned about publics and partnerships in EoL research to date, we question distinctions made between professionals and publics, concluding that including publics in public health research, means also including ourselves and making public many of the reflections, the mistakes, and the experiences we all have, to foster collective learning. PMID:27134417

  7. Cost Sharing, Health Care Expenditures, and Utilization: An International Comparison.

    PubMed

    Perkowski, Patryk; Rodberg, Leonard

    2016-01-01

    Health systems implement cost sharing to help reduce health care expenditure and utilization by discouraging the use of unnecessary health care services. We examine cost sharing in 28 countries in the Organisation for Economic Co-operation and Development from 1999 through 2009 in the areas of medical care, hospital care, and pharmaceuticals. We investigate associations between cost sharing, health care expenditures, and health care utilization and find no significant association between cost sharing and health care expenditures or utilization in these countries. PMID:26545706

  8. Health Care for the Homeless.

    ERIC Educational Resources Information Center

    Altman, Drew; And Others

    1989-01-01

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

  9. Health Care in Rural America.

    ERIC Educational Resources Information Center

    Ahearn, Mary C.

    Nonmetropolitan and totally rural areas have greater unmet health needs and fewer health resources than urban areas. Blacks, American Indians, migrants, and Appalachians have specialized rural health care needs as a result of cultural isolation, poverty, and discrimination. The reversal of the rural to urban population migration has increased the…

  10. A CLAS act? Community-based organizations, health service decentralization and primary care development in Peru. Local Committees for Health Administration.

    PubMed

    Iwami, Michiyo; Petchey, Roland

    2002-12-01

    In 1994 Peru embarked on a programme of health service reform, which combined primary care development and community participation through Local Committees for Health Administration (CLAS). They are responsible for carrying out local health needs assessments and identifying unmet health needs through regular household surveys. These enable them to determine local health provision and tailor services to local requirements. CLAS build on grassroots self-help circles that developed during the economic and political crises of the 1980s, and in which women have been prominent. However, they function under a 3 year contract with the Ministry of Health and within a framework of centrally determined guidelines and regulations. These reforms were implemented in the context of neo-liberal economic policies, which stressed financial deregulation and fiscal and monetary restraint, and were aimed at reducing foreign indebtedness and inflation. We evaluate the achievements of the CLAS and analyse the relationship between health and economic policy in Peru, with the aid of two contrasting models of the role of the state - 'agency' and 'stewardship'. We argue that Peru's experience holds valuable lessons for other countries seeking to foster community involvement. These include the need for community capacity building and partnership between community organizations and state (and other civil) agencies. PMID:12546199

  11. Development, implementation, and pilot study of a sentinel network ("The Watchtowers") for monitoring emergency primary health care activity in Norway

    PubMed Central

    Hansen, Elisabeth Holm; Hunskaar, Steinar

    2008-01-01

    Background In Norway there is a shortage of valid health activity statistics from the primary care out-of-hours services and the pre-hospital emergency health care system. There is little systematic information available because data registration is lacking or is only recorded periodically, and definitions of variables are not consistent. Method A representative sample of Norwegian municipalities and out-of-hours districts was contracted to establish a sentinel network, "The Watchtowers", and procedures were developed for collecting continuous data from out-of-hours services. All contacts, either per telephone or direct attendance, are recorded during day and night. The variables are registered in a computer program developed by the National Centre for Emergency Primary Health Care, and sent by email in Excel-file format to the Centre on a monthly basis. Results The selection process yielded a group of 18 municipalities, with a fair degree of representativeness for Norwegian municipalities as a whole. The sample has 212,921 inhabitants, which constitutes 4.6% of the total Norwegian population. During a pilot period lasting three months the Watchtowers recorded all individual contacts. The procedures for registration, submitting and checking data worked satisfactorily. There was little data missing, and during the last three months of 2006 a total of 23,346 contacts were registered. Conclusion We have been able to establish a sentinel network with a fair degree of representativeness for Norwegian out-of-hours districts and municipalities. The data collected reflect national activities from casualty clinics in Norway. Such data are useful for both research and system improvements. PMID:18366754

  12. Health-care market robust.

    PubMed

    Merkel, Jayne

    2004-01-01

    Construction of health care facilities hit an all-time high in 2002 totalling about $16 billion of work. As baby boomers age health care construction will soar, because seniors are the largest consumers of health care The top five firms--Perkins & Will, HDR, HKS, NBBJ, and Ellerbe Becket--monopolize about 20 percent of the work. H.R. 1 increases Medicare payments to rural hospitals by $25 billion over 10 years--so help is on the way for facilities that are languishing. PMID:15077503

  13. Health care and equity in India

    PubMed Central

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

    2011-01-01

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

  14. A Health Services Framework of Spiritual Care

    PubMed Central

    Daaleman, Timothy P.

    2012-01-01

    Aims To introduce a health services framework of spiritual care that addresses the empirical and applied issues surrounding spirituality and nursing practice. Background Despite over 20 years of study, the concept of spirituality is still under development, which limits application to nursing practice. Methods Three studies using a health services framework are reviewed: (1) a survey study of dying patients and family that describes the providers, types, and outcomes of spiritual care; (2) an exploratory study of the process of spiritual care; and (3) a multi-level study of the structure and outcomes of spiritual care in long-term care facilities. Results Spiritual care recipients identify family or friends (41%), clergy (17%), and health care providers (29%) as spiritual care providers. The most frequently reported type of spiritual care was help in coping with illness (87%). Just over half (55%) of spiritual care recipients were very satisfied or somewhat satisfied with the care that they received. The processes of spiritual care involved: (1) presence, or the deliberate ideation and purposeful action of providing care that went beyond medical treatment; (2) opening eyes, or the process by which providers became aware of their patient’s storied humanity and the individualized experience of their current illness, and; (3) co-creating, which was a mutual and fluid activity between patients, family members, and care providers that began with an affirmation of the patient’s life experience and led to the generation of a holistic care plan that focused on maintaining the patient’s humanity and dignity. In long term care facilities, decedents who received spiritual care were perceived as receiving better overall care in the last month of life, when compared with those decedents who did not receive spiritual care. In addition, among those receiving support for their spiritual needs, care was rated more highly among those who received support from facility staff, such as nurses, than those who did not; no differences were observed based on the presence of other sources of support. Conclusions A health services framework provides a holistic view of spiritual care, one that is consistent with integrated nursing models. Implications for Nursing Management By focusing on the structure, process, and outcome elements of spiritual care within organizational settings, nursing management can develop feasible approaches to implement, improve, and evaluate the delivery of this unique type of care. PMID:23151104

  15. Doctors' roles in primary health care.

    PubMed

    Piyaratn, P

    1982-10-01

    Doctors in developing countries where the majority of the population live in rural areas are facing difficult adjustments of their roles to attain health for all of the rural population. In Thailand, doctors directing remote district hospitals act as the focal points of other health care facilities serving the entire population of the districts. To supplement the existing governmental health service network and in accordance with principles of primary health care, community primary health care volunteers are being developed to expand service coverage to rural communities. These lead to changes in doctors' roles. Doctors are required to be not only competent clinicians but also good managers of health promotive and preventive programmes, effective hospital administrators, competent trainers and qualified researchers. They must not only work within the hospital but also support the health personnel and activities of the entire district, and in particular the community primary health care workers. However, as it is now, they are graduates of traditional medical schools, whose educational programmes do not equip them adequately for their emerging new roles in rural hospitals. Reorientation of the existing health system, including its health personnel, is needed. The critical factor in such a process is the development of appropriate attitudes at all levels of health services. This is a difficult but challenging task, as it involves long established medical institutions which hold firmly to old traditions and values. PMID:7179451

  16. Selective primary health care: strategies for control of disease in the developing world. XVI. Chagas' disease.

    PubMed

    Marsden, P D

    1984-01-01

    Despite much research, specific chemotherapy for Chagas' disease remains problematic, and prophylaxis by vaccination seems remote. A significant proportion of today's positive seroreactive patients will burden tomorrow's hospital services with persistent cardiac failure, arrhythmias requiring pacemaker implantation, and megasyndromes requiring corrective surgical procedures. Yet the control of transmission to humans in many endemic areas is feasible by programs of residual insecticide spraying and subsequent vigilance and, in some instances, house improvement, i.e., measures to combat domiciliated vector bugs. The success of such programs will vary, depending on the dominant bug vector and degree of development of the country's public health services. The fact that the Brazilian government voted a large sum of money in 1983 for bug control by the Ministry of Health enforces this view. Transmission of Trypanosoma cruzi to humans could decrease considerably in the next decade in Brazil as a result of this program. There is, however, still a need for research to define the cheapest ways of interrupting transmission in different epidemiologic situations so that the maximum number of people at risk can be reached with the funds available, for the children infected today may be hospital patients of the future for whom little can be done. PMID:6084284

  17. The Hillbrow Primary Health Care Project.

    PubMed

    Rawat, H

    1996-03-01

    This article describes the Hillbrow Primary Health Care Project for Health Personnel Education and Primary Health Care in Greater Johannesburg, South Africa. The project aims to influence health by forming a partnership between the community, the services and training institutions, and appropriate health personnel education. The partnership also aims to develop and implement comprehensive primary health care services in Hillbrow, targeted to the needs of the underserved. The goal is to empower the community to promote health and participate in the management of health services in order to improve community-based training of health personnel. The partners included the University of Witwatersrand and the B.G. Alexandra Nursing College, its faculty, and its medical and nursing students. Other service partners include the Greater Johannesburg Transitional Metropolitan Council's Directorate of Health, Housing, and Urbanization and Departments of Community Health and Environmental Health. 45% of the governing group are community members from various community organizations. The needs assessment identified priority areas as women's health, environmental health, youth, and the elderly and disabled. The community needs pre and postnatal and delivery services. Citizens needs to be mobilized around environmental health issues in the inner city and the education of environmental health officers. Youth need a center with sports facilities. The project's future efforts will include establishment of an effective governance structure, program boundaries and strategies, and the means for long-term sustainability. PMID:12178493

  18. Health Care Robotics: A Progress Report

    NASA Technical Reports Server (NTRS)

    Fiorini, Paolo; Ali, Khaled; Seraji, Homayoun

    1997-01-01

    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.

  19. [An epidemiologic study of health care seeking behavior of children under 5 years of age by sex in developing countries].

    PubMed

    Tursz, A; Crost, M

    1999-10-01

    Since the end of the 1970's, excess mortality among girls, from the end of the neonatal period until the age of 4 years, has been observed in some South Asian countries. Explanatory hypotheses for this situation have in fact noted differences by sex in food allocation and in care during illness. In some North African and sub-Saharan countries in Africa, mortality data suggest the same type of phenomenon, but less reliable statistics and a lack of data analysis by sex on use of health services does not really allow clarification of the problem. The objective of this study was to analyse health seeking behaviour by sex and to identify explanatory factors for any differences found. A cross sectional study of 1560 consultations of under-5 children was carried out in 6 university and regional hospitals in 3 African countries: Algeria (the zones of Aïn Taya and Tigzirt); Togo (the zones of Lomé, Atakpamé and Kara) and the Congo (Brazzaville). Results confirm the existence of discrimination against girls. In ways which vary according to zones, and in comparison to boys, observations of girls show: under-representation among outpatients (29% in Tigzirt, 40% in Kara), especially when they have many siblings, of which some are sisters; longer duration of the development of symptoms before first resort (leading to increased severity of symptoms); less investment in health care; detrimental feeding practices. Higher SES of the father plays a favourable role, especially for girls, and children of both sexes benefit when the mother has a good educational level. The large regional differences demonstrate the complex interaction among explanatory factors: rurality, problems of access to the hospital, low economic level, low social status of women. This research opens the way so that, in Africa, research will no longer be carried out on health seeking behaviour and utilisation of health services without examining separately the situation of boys and girls, and analysing the possible causes of any differences. PMID:10575716

  20. Information Technology for Children's Health and Health Care

    PubMed Central

    Shiffman, Richard N.; Spooner, S. Andrew; Kwiatkowski, Kelly; Brennan, Patricia Flatley

    2001-01-01

    In September 2000, the Agency for Healthcare Quality and Research and the American Academy of Pediatrics Center for Child Health Research sponsored a meeting of experts and knowledgeable stakeholders to identify 1) the special information needs of pediatric care and 2) health service research questions related to the use of information technology in children's health care. Technologies that support the care of children must address issues related to growth and development, children's changing physiology, and the unique diseases of children and interventions of pediatric care. Connectivity and data integration are particular concerns for child health care workers. Consumer health information needs for this population extend beyond the needs of one individual to the needs of the family. Recommendations of the attendees include rapid implementation of features in electronic health information systems that support pediatric care and involvement of child health experts in policy making, standards setting, education, and advocacy. A proposed research agenda should address both effectiveness and costs of information technology, with special consideration for the needs of children, the development and evaluation of clinical decision support in pediatric settings, understanding of the epidemiology of iatrogenic injury in childhood, supplementation of vocabulary standards with pediatrics-specific terminology, and improvement in health care access for children, using telemedicine. PMID:11687562

  1. Five Steps to Safer Health Care

    MedlinePlus

    ... to Safer Health Care Five Steps to Safer Health Care: Patient Fact Sheet This information is for reference ... safety is one of the Nation's most pressing health care challenges. A 1999 report by the Institute of ...

  2. HealthCare.gov

    MedlinePlus

    ... Incarcerated people Transgender people Site Search Search Need health insurance? See if you qualify You can enroll in ... keep you healthy May 19 Graduating? You have health insurance options See More Footer Resources About the Affordable ...

  3. [Which reasons may hinder Integrated Health Care from spreading as regular health care provision in cardiology?].

    PubMed

    Gottwik, M

    2006-01-01

    Integrated Health Care may possibly be a training field for efficient patient and case management between different providers involved. In the medium term, those instruments should be developed further so that they are no longer merely tools for cost containment, risk transfer to the providers side and competition for the good risks in health care. In the present state Integrated Health Care--as many other new regulations--means a displacement of money from health care to administration. All participants are urged to check their contracts that the benefit for patients exceeds the price of the paper. PMID:16598572

  4. Rural health care: redefining access.

    PubMed

    Collins, Chris

    2015-01-01

    The population and demographics of rural America are shifting once again. As our nation's unprecedented health care reform unfolds, it is becoming clear that rural communities have unique strengths, and capitalizing on these strengths can position them well for this health care transformation. Equally important are the distinct challenges that--with careful planning, attention, and resources--can be transformed into opportunities to thrive in the new health care environment. The North Carolina Institute of Medicine's Task Force on Rural Health recently published a report that highlights the strengths and challenges of rural communities [1]. In order to fully leverage these opportunities, we must continue to acknowledge the fundamental importance of access to basic health care, while also broadening our discussion to collectively tackle the additional components necessary to create healthy, thriving rural communities. As we reexamine the needs of rural communities, we should broaden our discussions to include an expansion of the types of access that are necessary for strengthening rural health. Collaboration, successful recruitment and retention, availability of specialty services, quality care, and cost effectiveness are some of the issues that must come into discussions about access to services. With this in mind, this issue of the NCMJ explores opportunities to strengthen the health of North Carolina's rural communities. PMID:25621473

  5. Priority setting in developing countries health care institutions: the case of a Ugandan hospital

    PubMed Central

    Kapiriri, Lydia; Martin, Douglas K

    2006-01-01

    Background Because the demand for health services outstrips the available resources, priority setting is one of the most difficult issues faced by health policy makers, particularly those in developing countries. However, there is lack of literature that describes and evaluates priority setting in these contexts. The objective of this paper is to describe priority setting in a teaching hospital in Uganda and evaluate the description against an ethical framework for fair priority setting processes – Accountability for Reasonableness. Methods A case study in a 1,500 bed national referral hospital receiving 1,320 out patients per day and an average budget of US$ 13.5 million per year. We reviewed documents and carried out 70 in-depth interviews (14 health planners, 40 doctors, and 16 nurses working at the hospital). Interviews were recorded and transcribed. Data analysis employed the modified thematic approach to describe priority setting, and the description was evaluated using the four conditions of Accountability for Reasonableness: relevance, publicity, revisions and enforcement. Results Senior managers, guided by the hospital strategic plan make the hospital budget allocation decisions. Frontline practitioners expressed lack of knowledge of the process. Relevance: Priority is given according to a cluster of factors including need, emergencies and patient volume. However, surgical departments and departments whose leaders "make a lot of noise" are also prioritized. Publicity: Decisions, but not reasons, are publicized through general meetings and circulars, but this information does not always reach the frontline practitioners. Publicity to the general public was through ad hoc radio programs and to patients who directly ask. Revisions: There were no formal mechanisms for challenging the reasoning. Enforcement: There were no mechanisms to ensure adherence to the four conditions of a fair process. Conclusion Priority setting decisions at this hospital do not satisfy the conditions of fairness. To improve, the hospital should: (i) engage frontline practitioners, (ii) publicize the reasons for decisions both within the hospital and to the general public, and (iii) develop formal mechanisms for challenging the reasoning. In addition, capacity strengthening is required for senior managers who must accept responsibility for ensuring that the above three conditions are met. PMID:17026761

  6. Reflections on curative health care in Nicaragua.

    PubMed Central

    Slater, R G

    1989-01-01

    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

  7. A Web-Based, Hospital-Wide Health Care-Associated Bloodstream Infection Surveillance and Classification System: Development and Evaluation

    PubMed Central

    Tseng, Yi-Ju; Wu, Jung-Hsuan; Lin, Hui-Chi; Chen, Ming-Yuan; Ping, Xiao-Ou; Sun, Chun-Chuan; Shang, Rung-Ji; Sheng, Wang-Huei; Lai, Feipei; Chang, Shan-Chwen

    2015-01-01

    Background Surveillance of health care-associated infections is an essential component of infection prevention programs, but conventional systems are labor intensive and performance dependent. Objective To develop an automatic surveillance and classification system for health care-associated bloodstream infection (HABSI), and to evaluate its performance by comparing it with a conventional infection control personnel (ICP)-based surveillance system. Methods We developed a Web-based system that was integrated into the medical information system of a 2200-bed teaching hospital in Taiwan. The system automatically detects and classifies HABSIs. Results In this study, the number of computer-detected HABSIs correlated closely with the number of HABSIs detected by ICP by department (n=20; r=.999 P<.001) and by time (n=14; r=.941; P<.001). Compared with reference standards, this system performed excellently with regard to sensitivity (98.16%), specificity (99.96%), positive predictive value (95.81%), and negative predictive value (99.98%). The system enabled decreasing the delay in confirmation of HABSI cases, on average, by 29 days. Conclusions This system provides reliable and objective HABSI data for quality indicators, improving the delay caused by a conventional surveillance system. PMID:26392229

  8. Development of a triage engine enabling behavior recognition and lethal arrhythmia detection for remote health care system.

    PubMed

    Sugano, Hiroto; Hara, Shinsuke; Tsujioka, Tetsuo; Inoue, Tadayuki; Nakajima, Shigeyoshi; Kozaki, Takaaki; Namkamura, Hajime; Takeuchi, Kazuhide

    2011-01-01

    For ubiquitous health care systems which continuously monitor a person's vital signs such as electrocardiogram (ECG), body surface temperature and three-dimensional (3D) acceleration by wireless, it is important to accurately detect the occurrence of an abnormal event in the data and immediately inform a medical doctor of its detail. In this paper, we introduce a remote health care system, which is composed of a wireless vital sensor, multiple receivers and a triage engine installed in a desktop personal computer (PC). The middleware installed in the receiver, which was developed in C++, supports reliable data handling of vital data to the ethernet port. On the other hand, the human interface of the triage engine, which was developed in JAVA, shows graphics on his/her ECG data, 3D acceleration data, body surface temperature data and behavior status in the display of the desktop PC and sends an urgent e-mail containing the display data to a pre-registered medical doctor when it detects the occurrence of an abnormal event. In the triage engine, the lethal arrhythmia detection algorithm based on short time Fourier transform (STFT) analysis can achieve 100 % sensitivity and 99.99 % specificity, and the behavior recognition algorithm based on the combination of the nearest neighbor method and the Naive Bayes method can achieve more than 71 % classification accuracy. PMID:22254766

  9. Day care health risks

    MedlinePlus

    ... virus. It is spread by poor or no hand washing after going to the bathroom or changing a ... and then preparing food. In addition to good hand washing, day care staff and children should get the ...

  10. Will Boeing Change Health Care?

    PubMed

    Stempniak, Marty

    2015-12-01

    Big employers like Boeing and Intel are directly contracting with hospitals in an effort to control health care prices. Some hospital CEOs see direct contracting as the future, while others wonder how they can participate. PMID:26837134

  11. Model Child Care Health Policies.

    ERIC Educational Resources Information Center

    Aronson, Susan; Smith, Herberta

    Drawn from a review of policies at over 100 child care programs nationwide, the model health policies presented in this report are intended for adaptation and selective use by out-of-home child care facilities. Following an introduction, the report presents model policy forms with blanks for adding individualized information for the following…

  12. [Corruption and health care system].

    PubMed

    Marasović Šušnjara, Ivana

    2014-06-01

    Corruption is a global problem that takes special place in health care system. A large number of participants in the health care system and numerous interactions among them provide an opportunity for various forms of corruption, be it bribery, theft, bureaucratic corruption or incorrect information. Even though it is difficult to measure the amount of corruption in medicine, there are tools that allow forming of the frames for possible interventions. PMID:26016214

  13. The priority of health care.

    PubMed

    Green, R M

    1983-11-01

    The economic recession, the mounting costs of medical technology, and the weakening of public support for welfare state ideals have led to philosophical qualification of the right of equal access to health care by writers like Norman Daniels and Lawrence Stern. Green rejects their arguments and reiterates the claim that a Rawlsian theory of justice provides an appropriate way of thinking about the right to health care, which should be treated on a par with basic civil liberties. PMID:6655385

  14. Corporate moral responsibility in health care.

    PubMed

    Wilmot, S

    2000-01-01

    The question of corporate moral responsibility--of whether it makes sense to hold an organisation corporately morally responsible for its actions, rather than holding responsible the individuals who contributed to that action--has been debated over a number of years in the business ethics literature. However, it has had little attention in the world of health care ethics. Health care in the United Kingdom (UK) is becoming an increasingly corporate responsibility, so the issue is increasingly relevant in the health care context, and it is worth considering whether the specific nature of health care raises special questions around corporate moral responsibility. For instance, corporate responsibility has usually been considered in the context of private corporations, and the organisations of health care in the UK are mainly state bodies. However, there is enough similarity in relevant respects between state organisations and private corporations, for the question of corporate responsibility to be equally applicable. Also, health care is characterised by professions with their own systems of ethical regulation. However, this feature does not seriously diminish the importance of the corporate responsibility issue, and the importance of the latter is enhanced by recent developments. But there is one major area of difference. Health care, as an activity with an intrinsically moral goal, differs importantly from commercial activities that are essentially amoral, in that it narrows the range of opportunities for corporate wrongdoing, and also makes such organisations more difficult to punish. PMID:11079341

  15. The social costs of the International Monetary Fund's adjustment programs for poverty: the case of health care development in Ghana.

    PubMed

    Anyinam, C A

    1989-01-01

    A primary health care (PHC) strategy was adopted in Ghana in 1978, but the civilian government at the time failed to implement the program designed to achieve health for all Ghanaians. In 1982, the revolutionary military government under Rawlings indicated its commitment to the full implementation of the PHC program. In this article, the author seeks to examine the extent to which the Economic Recovery Program initiated by the Rawlings' regime, its policy of decentralization and mobilization of the masses, and its promise to institute some fundamental organizational and structural changes in the health care delivery system, are contributing to the process of achieving "health for all" Ghanaians. PMID:2753581

  16. Delivering Health Care and Mental Health Care Services to Children in Family Foster Care after Welfare and Health Care Reform.

    ERIC Educational Resources Information Center

    Simms, Mark D.; Freundlich, Madelyn; Battistelli, Ellen S.; Kaufman, Neal D.

    1999-01-01

    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)

  17. How Do Health Care Providers Diagnose Cushing's Syndrome?

    MedlinePlus

    ... Information Clinical Trials Resources and Publications How do health care providers diagnose Cushing’s syndrome? Skip sharing on social ... easily recognized when it is fully developed, but health care providers try to diagnose and treat it well ...

  18. [Informatics in the Croatian health care system].

    PubMed

    Kern, Josipa; Strnad, Marija

    2005-01-01

    Informatization process of the Croatian health care system started relatively early. Computer processing of data of persons not covered by health insurance started in 1968 in Zagreb. Remetinec Health Center served as a model of computer data processing (CDP) in primary health care and Sveti Duh General Hospital in inpatient CDP, whereas hospital administration and health service were first introduced to Zagreb University Hospital Center and Sestre Milosrdnice University Hospital. At Varazdin Medical Center CDP for health care services started in 1970. Several registries of chronic diseases have been established: cancer, psychosis, alcoholism, and hospital registries as well as pilot registries of lung tuberculosis patients and diabetics. Health statistics reports on healthcare services, work accidents and sick-leaves as well as on hospital mortality started to be produced by CDP in 1977. Besides alphanumeric data, the modern information technology (IT) can give digital images and signals. Communication in health care system demands a standardized format of all information, especially for telemedicine. In 2000, Technical Committee for Standardization in Medical Informatics was founded in Croatia, in order to monitor the activities of the International Standardization Organization (ISO) and Comite Européen de Normalisation (CEN), and to implement their international standards in the Croatian standardization procedure. The HL7 Croatia has also been founded to monitor developments in the communication standard HL7. So far, the Republic of Croatia has a number of acts regulating informatization in general and consequently the informatization of the health care system (Act on Personal Data Confidentiality, Act on Digital Signature, Act of Standardization) enacted. The ethical aspect of data security and data protection has been covered by the Code of Ethics for medical informaticians. It has been established by the International Medical Informatics Association (IMIA), and the Croatian Society of Medical Informatics (CSMI) has translated it into Croatian and published it on its website. Based on a survey of medical staff attitudes toward health care system informatization, the Croatian health system appears to be ready for informatization. The only requirement is that the present and future health care providers have appropriate medical informatics education, proper computer equipment at their workplace, and an opportunity to participate in the development and/or improvement of the health information system. One of the EU health strategy priorities is the improvement of health information and knowledge. It means that integrated health information systems are required, i.e. systems able to provide key information on health and health care system to the politicians, health professionals and public in general. PMID:16095187

  19. The Australian health care system.

    PubMed

    Samman, S; Plant, A J

    1996-01-01

    Medicare is Australia's universal system of health insurance, which is based on the principles of equity. It provides free accommodation and treatment in public hospitals and entitlement to medical services. Laboratories receive reimbursement from Medicare if they are accredited. Hospital funding may be directly funded, whereas in some States the funding is through structures such as Health Areas. There are increasing moves to determine the hospital share of funding based on the number and types of hospital cases. To lower the cost of Medicare, the Federal Government is considering reforms including those which will allow private health insurers to negotiate with doctors and hospitals. Some of the major issues facing the health care system are: (1) how best to deliver care to Aboriginal Australians, (2) overspending, particularly in high-technology medicine, and (3) provision of health care for the small but significant number of Australians who do not live in major metropolitan centers. PMID:10160066

  20. Agents of Change for Health Care Reform

    ERIC Educational Resources Information Center

    Buchanan, Larry M.

    2007-01-01

    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…

  1. Innovating in health care management education: development of an accelerated MBA and MPH degree program at Yale.

    PubMed

    Pettigrew, Melinda M; Forman, Howard P; Pistell, Anne F; Nembhard, Ingrid M

    2015-03-01

    Increasingly, there is recognition of the need for individuals with expertise in both management and public health to help health care organizations deliver high-quality and cost-effective care. The Yale School of Public Health and Yale School of Management began offering an accelerated Master of Business Administration (MBA) and Master of Public Health (MPH) joint degree program in the summer of 2014. This new program enables students to earn MBA and MPH degrees simultaneously from 2 fully accredited schools in 22 months. Students will graduate with the knowledge and skills needed to become innovative leaders of health care organizations. We discuss the rationale for the program, the developmental process, the curriculum, benefits of the program, and potential challenges. PMID:25706023

  2. Developing Dental Students' Awareness of Health Care Disparities and Desire to Serve Vulnerable Populations Through Service-Learning.

    PubMed

    Behar-Horenstein, Linda S; Feng, Xiaoying; Roberts, Kellie W; Gibbs, Micaela; Catalanotto, Frank A; Hudson-Vassell, Charisse M

    2015-10-01

    Service-learning in dental education helps students integrate knowledge with practice in an underserved community setting. The aim of this study was to explore how a service-learning experience affected a small group of dental students' beliefs about cultural competence, professionalism, career development, desire to practice in a community service setting, and perceptions about access and disparities issues. Prior to beginning their first year of dental school, five first-year dental students at one U.S. dental school participated in a six-week service-learning program in which they interned at one of three at-risk settings in order to experience health care delivery there. After the program, 60 reflective writing assignments completed by the participants were analyzed using grounded theory methods; interviews with the students were used to corroborate the findings from that analysis. Seven themes identified in the journal reflections and interview findings showed enhanced awareness of social health care issues and patient differences, as well as a social justice orientation and desire to address disparities. Building on this study, future research should explore the curricular components of service-learning programs to ensure students receive ample opportunity to reflect upon their experiences in order to integrate previously held assumptions with their newfound knowledge. PMID:26427778

  3. Education leadership in the clinical health care setting: a framework for nursing education development.

    PubMed

    Mockett, Lynda; Horsfall, Janine; O'Callaghan, Wendy

    2006-12-01

    This paper describes how a new framework for clinical nursing education was introduced at Counties Manukau District Health Board (CMDHB), New Zealand. The project was initiated in response to the significant legislative and post registration nursing education changes within New Zealand. The journey of change has been a significant undertaking, and has required clear management, strong leadership, perseverance and understanding of the organisation's culture. The approach taken to managing the change had four stages, and reflects various change management models. The first stage, the identification process, identified the impetus for change. Creating the vision is the second stage and identified what the change would look like within the organisation. To ensure success and to guide the process of change a realistic and sustainable vision was developed. Implementing the vision was the third stage, and discusses the communication and pilot phase of implementing the nursing education framework. Stage four, embedding the vision, explores the process and experiences of changing an education culture and embedding the vision into an organisation. The paper concludes by discussing the importance of implementing robust, consistent, strategic and collaborative processes--that reflect and evaluate best educational nursing practice. PMID:17028073

  4. Health care becomes an industry.

    PubMed

    Rastegar, Darius A

    2004-01-01

    The delivery of health care is in the process of "industrialization" in that it is undergoing changes in the organization of work which mirror those that began in other industries a century ago. This process is characterized by an increasing division of labor, standardization of roles and tasks, the rise of a managerial superstructure, and the degradation (or de-skilling) of work. The consolidation of the health care industry, the fragmentation of physician roles, and the increasing numbers of nonphysician clinicians will likely accelerate this process. Although these changes hold the promise of more efficient and effective health care, physicians should be concerned about the resultant loss of autonomy, disruption of continuity of care, and the potential erosion of professional values. PMID:15053287

  5. Health Care Becomes an Industry

    PubMed Central

    Rastegar, Darius A.

    2004-01-01

    The delivery of health care is in the process of “industrialization” in that it is undergoing changes in the organization of work which mirror those that began in other industries a century ago. This process is characterized by an increasing division of labor, standardization of roles and tasks, the rise of a managerial superstructure, and the degradation (or de-skilling) of work. The consolidation of the health care industry, the fragmentation of physician roles, and the increasing numbers of nonphysician clinicians will likely accelerate this process. Although these changes hold the promise of more efficient and effective health care, physicians should be concerned about the resultant loss of autonomy, disruption of continuity of care, and the potential erosion of professional values. PMID:15053287

  6. Health care's 100 most wired.

    PubMed

    Solovy, A; Serb, C

    1999-02-01

    They're wired all right, and America's 100 most techno-savvy hospitals and health systems share one more thing: a commitment to using technology to link with employees, patients, suppliers, and insurers. "We want to be a health care travel agency for our community," says one chief information officer. "And we see Internet technology as a key." PMID:10081454

  7. Health care in rural areas.

    PubMed

    Nath, L M

    1994-02-01

    In India, although the health care system infrastructure is extensive, the people often regard government facilities as family planning (FP) centers instead of primary health care centers. This problem has been compounded by the separation of health care and FP at all stages, even down to the storage of the same medication in two different locations depending upon whether it is to be used for "health" or for "FP." In rural areas where the government centers are particularly desolate, the community has chosen to erect its own health care system of private practitioners of all sorts and qualifications. Even in rural areas where a comprehensive health service is provided, with each household visited regularly by health workers, and where this service has resulted in a lowering of the crude death rate from 14.6 to 7 and the maternal mortality rate from 4.7 to 0.5/1000, people depend upon practitioners of various types. Upon analysis, it was discovered that the reason for using this multiplicity of practitioners had nothing to do with the level of satisfaction with the government service or with the accessibility of the services. Rather, when ill, the people make a diagnosis and then go to the proper place for treatment. If, for instance, they believe their malady was caused by the evil eye, they consult a magico-religious practitioner. These various types of practitioners flourish in areas with the best primary health care because they fulfill a need not met by the primary health care staff. If government agencies work with the local practitioners and afford them the proper respect, their skills can be upgraded in selected areas and the whole community will benefit. PMID:12288590

  8. Financial burden of health care expenditures: Turkey.

    PubMed

    Sulku, S Nur; Bernard, D Minbay

    2012-01-01

    In this study, we examine whether and to what extent the health insurance system in Turkey provided adequate protection against high out of pocket expenditures in the period prior to "The Health Transformation Programme". Furthermore, we examine the distribution of out of pocket expenditures by demographic characteristics, poverty status, health service type, access to health care and self-reported health status. We employ the 2002/03 National Household Health Expenditure Survey data to analyze financial burden of health care expenditure. Following the literature, we define high burdens as expenses above 10 and 20% of income. We find that 19% of the nonelderly population were living in families spending more than 10% of family income and that 14% of the nonelderly population were living in families spending more than 20% of family income on health care. Furthermore, the poor and those living in economically less developed regions had the greatest risk of high out of pocket burdens. The risk of high financial burdens varied by the type of insurance among the insured due to differences in benefits among the five separate public schemes that provided health insurance in the pre-reform period. Our results are robust to three alternative specifications of the burden measure and including elderly adults in the sample population. We see that prior to the reforms there were not adequate protection against high health expenditures. Our study provides a baseline against which policymakers can measure the success of the health care reform in terms of providing financial protection. PMID:23113149

  9. Health disparities and health care financing: restructuring the American health care system.

    PubMed

    Diggs, Schnequa N

    2012-01-01

    For more than seven decades there has been a systematic disregard for the health needs of certain groups of individuals. Discrepancies in treatment and privilege based on race/ethnicity, gender, sexual orientation, class, and socio-economic status have been significant players in any portrait of American health care and have helped frame considerations of those who deserve and those undeserving of quality health care. Continuous incidences of inequitable health care practices strongly suggest a need for drastic changes in our current health care system. Although growing interest in social inequalities in health preside, health policy makers struggle to find appropriate intervention strategies to alleviate health disparities. The purpose of this article is to depict a clearer portrait of the American health care system within the context of health disparities and recognize intervention strategies to reduce/eliminate health care disparities. This article concludes with suggestions on how to refinance the American health care system based on equality principles. PMID:22894023

  10. Health care seeking for childhood diarrhea in developing countries: evidence from seven sites in Africa and Asia.

    PubMed

    Nasrin, Dilruba; Wu, Yukun; Blackwelder, William C; Farag, Tamer H; Saha, Debasish; Sow, Samba O; Alonso, Pedro L; Breiman, Robert F; Sur, Dipika; Faruque, Abu S G; Zaidi, Anita K M; Biswas, Kousick; Van Eijk, Anna Maria; Walker, Damian G; Levine, Myron M; Kotloff, Karen L

    2013-07-01

    We performed serial Health Care Utilization and Attitudes Surveys (HUASs) among caretakers of children ages 0-59 months randomly selected from demographically defined populations participating in the Global Enteric Multicenter Study (GEMS), a case-control study of moderate-to-severe diarrhea (MSD) in seven developing countries. The surveys aimed to estimate the proportion of children with MSD who would present to sentinel health centers (SHCs) where GEMS case recruitment would occur and provide a basis for adjusting disease incidence rates to include cases not seen at the SHCs. The proportion of children at each site reported to have had an incident episode of MSD during the 7 days preceding the survey ranged from 0.7% to 4.4% for infants (0-11 months of age), from 0.4% to 4.7% for toddlers (12-23 months of age), and from 0.3% to 2.4% for preschoolers (24-59 months of age). The proportion of MSD episodes at each site taken to an SHC within 7 days of diarrhea onset was 15-56%, 17-64%, and 7-33% in the three age strata, respectively. High cost of care and insufficient knowledge about danger signs were associated with lack of any care-seeking outside the home. Most children were not offered recommended fluids and continuing feeds at home. We have shown the utility of serial HUASs as a tool for optimizing operational and methodological issues related to the performance of a large case-control study and deriving population-based incidence rates of MSD. Moreover, the surveys suggest key targets for educational interventions that might improve the outcome of diarrheal diseases in low-resource settings. PMID:23629939

  11. Health care reform and professionalism.

    PubMed

    Wennberg, J E

    1994-01-01

    With its emphasis on consumer choice of health plans, the current health care debate neglects a more fundamental crisis: changes in the traditional physician-patient relationship. This paper discusses how this relationship is being redefined and what it means for professionals in the future, particularly in the context of managed competition. The paper asserts that the final health reform plan must address flaws in the scientific and ethical basis of clinical practice. It calls for a flexible workforce policy that promotes shared decision making, lifetime learning, professional commitment to improved quality of care, a national evaluation program, and organizations to coordinate these efforts. PMID:7960088

  12. Women as providers of health care.

    PubMed

    1983-01-01

    Societies depend heavily on women for health care, yet women's own health needs are frequently neglected, their contributions to health development undervalued, and their working conditions ignored. The increasing recognition of the need for universally accessible primary health care and of people's right and duty to participate individually and collectively in their own care makes it vital to critically examine the role and status of women in its provision. A question which arises is whether the low status and prestige accorded to primary health stems from the fact that it is primarily women who provided it, or, rather, are women the main providers of such care because it is still regarded as unprestigious work and therefore to be left largely to women. Whatever the answer, the status and prestige of primary health care and the workers who provide it must be raised. To help address the problems and devise some solutions, the World Health Organization (WHO) convened consultations in 1980 and 1982. At the 1st consultation, priority issues concerning women as health care providers were identified and suggestions made for case studies and on analyses on specific issues. These were to be carried out in 17 developing and developed countries. The 2nd consultation brought together policy analysts and decision makers from the countries concerned who examined the findings and proposed concrete activities at the international and the national level. It became clear that any comprehensive strategy designed to raise the status of women who provide health care and make their workload less onerous must focus on the following elements: educational and training; attitudes about women; health education; policies and opportunities for employment; support systems; and infrastructure development. These elements are discussed separately here, yet it should be remembered that the participants in the consultation continually stressed their interdependence. Education of women for health work must be seen in the context of the type and length of the general education that they receive. The recruitment of women to training programs will require special efforts. Once women's self-esteem increases they are likely to receive more respect and consideration from men. To acquire this self-esteem, women must organize and support each other. Changes are called for in the attitudes towards each other of health care providers working in the formal and nonformal sectors. To provide health education for women is to train health educators for the community. Every plan for national development must include employment policies and strategies for their implementation. PMID:6649593

  13. Redefining competition in health care.

    PubMed

    Porter, Michael E; Teisberg, Elizabeth Olmsted

    2004-06-01

    The U.S. health care system is in bad shape. Medical services are restricted or rationed, many patients receive poor care, and high rates of preventable medical error persist. There are wide and inexplicable differences in costs and quality among providers and across geographic areas. In well-functioning competitive markets--think computers, mobile communications, and banking--these outcomes would be inconceivable. In health care, these results are intolerable, with life and quality of life at stake. Competition in health care needs to change, say the authors. It currently operates at the wrong level. Payers, health plans, providers, physicians, and others in the system wrangle over the wrong things, in the wrong locations, and at the wrong times. System participants divide value instead of creating it. (And in some instances, they destroy it.) They shift costs onto one another, restrict access to care, stifle innovation, and hoard information--all without truly benefiting patients. This form of zero-sum competition must end, the authors argue, and must be replaced by competition at the level of preventing, diagnosing, and treating individual conditions and diseases. Among the authors' well-researched recommendations for reform: Standardized information about individual diseases and treatments should be collected and disseminated widely so patients can make informed choices about their care. Payers, providers, and health plans should establish transparent billing and pricing mechanisms to reduce cost shifting, confusion, pricing discrimination, and other inefficiencies in the system. And health care providers should be experts in certain conditions and treatments rather than try to be all things to all people. U.S. employers can also play a big role in reform by changing how they manage their health benefits. PMID:15202288

  14. The Native Telehealth Outreach and Technical Assistance Program: A Community-Based Approach to the Development of Multimedia-Focused Health Care Information

    ERIC Educational Resources Information Center

    Dick, Rhonda Wiegman; Manson, Spero M.; Hansen, Amy L.; Huggins, Annie; Trullinger, Lori

    2007-01-01

    The development and dissemination of culturally relevant health care information has traditionally taken a "top-down" approach. Governmental funding agencies and research institutions have too often dictated the importance and focus of health-related research and information dissemination. In addition, the digital divide has affected rural…

  15. THE NEOLIBERAL TURN IN AMERICAN HEALTH CARE.

    PubMed

    Gaffney, Adam

    2015-01-01

    Leaving millions both uninsured and underinsured, the Affordable Care Act does not create a system of universal health care in the United States. To understand its shortcomings, we have to understand it as part of a historic shift in the political economy of American health care. This "neoliberal turn" began as a reaction against the welfare state as it expanded during the New Deal and post-World War II period. What began as a movement associated with philosophers like Friedrich Hayek ultimately had a powerful impact via the attraction of powerful corporate sponsors and political supporters, and it was to historically transform American health care thought and organization. In health policy circles, for example, it can be seen in a rising emphasis on "moral hazard," overuse, and cost sharing above a concern with universalism and equity. It was likewise manifested by the corporatization of the health maintenance organization and the rise of the "consumer-driven" health care movement. By the time of the health care reform debate, the influence of corporate "stakeholders" was to prove predominant. These developments, however, must be construed as connected parts of a much larger political transformation, reflected in rising inequality and privatization, occurring both domestically and internationally. PMID:26460446

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

    PubMed

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

    2016-03-01

    The changes in the demographic and epidemiologic profiles of the Brazilian population and the need to rethink the health care model have led many countries like Brazil to consider Home Care (HC) as a care strategy. However, there is a gap between the supply of HC services, the demand for care and the health needs manifested by the population. Thus, this article analyzes scientific output regarding the status of the relation between supply, demand and the needs related to home health care. This work is based on an integrative review of the literature in the following databases: Cumulative Index to Nursing and Allied Health Literature (CINAHL), Latin America and the Caribbean Literature on Health and Science (Lilacs), Medical Literature Analysis and Retrieval System Online (Medline) and Web of Science. Despite the fact that few articles refer to the issue in question, there is evidence indicating that health demands and needs are seldom taken into account either in a quantitative or qualitative approach when developing the organization of HC services. The analysis would indicate that there is a national and international deficit in the supply of HC services considering the demand for health care and needs currently prevailing. PMID:26960102

  17. Health Care Provider Initiative Strategic Plan

    ERIC Educational Resources Information Center

    National Environmental Education & Training Foundation, 2012

    2012-01-01

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

  18. Health care reform and changes: the Malaysian experience.

    PubMed

    Merican, Mohd Ismail; bin Yon, Rohaizat

    2002-01-01

    Health care reform is an intentional, sustained and systematic process of structural change to one or more health subsystems to improve efficiency, effectiveness, patient choices and equity. Health care all over the world is continuously reforming with time. Health care reform has become an increasingly important agenda for policy change in both developed and developing countries including Malaysia. This paper provides an overview of the Malaysian health care system, its achievements, and issues and challenges leading to ongoing reform towards a more efficient and equitable health care system that possess a better quality of life for the population. PMID:12597513

  19. National Health Care Reform, Medicaid, and Children in Foster Care.

    ERIC Educational Resources Information Center

    Halfon, Neal; And Others

    1994-01-01

    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.…

  20. Political violence and Eritrean health care.

    PubMed

    Sabo, L E; Kibirige, J S

    1989-01-01

    In both colonial and post-colonial eras, the creation of nation states has often been accompanied by conflict and violence in Third World countries, particularly if such attempts have ignored previously existing cultural, religious and/or ethical differences. The illegitimacy of national state construction becomes even more apparent when the attempt is associated with conflicting geopolitical interests of the 'super-powers', as is in the case of the Horn of Africa. The 27 years of armed struggle of Eritrea to free itself from Ethiopian domination is a consequence of previous and continuing attempts to create a nation state serve the interests of the ex-colonialists and 'super-powers' at the expense of the needs and desires of the people. Throughout the 27 years of struggle with its inevitable disruption of civilian life and service provisions, Eritrea has continued to develop a needs-based health care system. The Eritrean People's Liberation Front (EPLF) has developed a health care system which directly involves the people themselves. Through careful selection of priorities and a national allocation system for the distribution of scarce resources, it has provided remarkably effective emergency services, primary care and preventive health services. Such an approach has avoided the errors committed by many other Third World countries who, through copying modern western medical care systems, developed secondary and tertiary medical care facilities which were irrelevant to the health care needs of the vast majority of their populations. PMID:2711219

  1. Solid health care waste management status at health care centers in the West Bank - Palestinian Territory

    SciTech Connect

    Al-Khatib, Issam A. Sato, Chikashi

    2009-08-15

    Health care waste is considered a major public health hazard. The objective of this study was to assess health care waste management (HCWM) practices currently employed at health care centers (HCCs) in the West Bank - Palestinian Territory. Survey data on solid health care waste (SHCW) were analyzed for generated quantities, collection, separation, treatment, transportation, and final disposal. Estimated 4720.7 m{sup 3} (288.1 tons) of SHCW are generated monthly by the HCCs in the West Bank. This study concluded that: (i) current HCWM practices do not meet HCWM standards recommended by the World Health Organization (WHO) or adapted by developed countries, and (ii) immediate attention should be directed towards improvement of HCWM facilities and development of effective legislation. To improve the HCWM in the West Bank, a national policy should be implemented, comprising a comprehensive plan of action and providing environmentally sound and reliable technological measures.

  2. Training Health Care Paraprofessionals

    ERIC Educational Resources Information Center

    Linton, Corinne B.

    1977-01-01

    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.…

  3. Health Care Information Systems.

    ERIC Educational Resources Information Center

    Banks, Jane L.; And Others

    1987-01-01

    The first of eight articles discusses the current state of the sensitive but unclassified information controversy. A series of six articles then explores the use of integrated information systems in the area of health services. Current trends in document management are provided in the last article. (CLB)

  4. Coverage and development of specialist palliative care services across the World Health Organization European Region (2005–2012): Results from a European Association for Palliative Care Task Force survey of 53 Countries

    PubMed Central

    Centeno, Carlos; Lynch, Thomas; Garralda, Eduardo; Carrasco, José Miguel; Guillen-Grima, Francisco; Clark, David

    2015-01-01

    Background: The evolution of the provision of palliative care specialised services is important for planning and evaluation. Aim: To examine the development between 2005 and 2012 of three specialised palliative care services across the World Health Organization European Region – home care teams, hospital support teams and inpatient palliative care services. Design and setting: Data were extracted and analysed from two editions of the European Association for Palliative Care Atlas of Palliative Care in Europe. Significant development of each type of services was demonstrated by adjusted residual analysis, ratio of services per population and 2012 coverage (relationship between provision of available services and demand services estimated to meet the palliative care needs of a population). For the measurement of palliative care coverage, we used European Association for Palliative Care White Paper recommendations: one home care team per 100,000 inhabitants, one hospital support team per 200,000 inhabitants and one inpatient palliative care service per 200,000 inhabitants. To estimate evolution at the supranational level, mean comparison between years and European sub-regions is presented. Results: Of 53 countries, 46 (87%) provided data. Europe has developed significant home care team, inpatient palliative care service and hospital support team in 2005–2012. The improvement was statistically significant for Western European countries, but not for Central and Eastern countries. Significant development in at least a type of services was in 21 of 46 (46%) countries. The estimations of 2012 coverage for inpatient palliative care service, home care team and hospital support team are 62%, 52% and 31% for Western European and 20%, 14% and 3% for Central and Eastern, respectively. Conclusion: Although there has been a positive development in overall palliative care coverage in Europe between 2005 and 2012, the services available in most countries are still insufficient to meet the palliative care needs of the population. PMID:26231421

  5. Integrated Crew Health Care System for Space Flight

    NASA Technical Reports Server (NTRS)

    Davis, Jeffrey R.

    2007-01-01

    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.

  6. Primary care: can it solve employers' health care dilemma?

    PubMed

    Sepulveda, Martin-J; Bodenheimer, Thomas; Grundy, Paul

    2008-01-01

    Employers are beginning to recognize that investing in the primary care foundation of the health care system may help address their problems of rising health care costs and uneven quality. Primary care faces a crisis as a growing number of U.S. medical graduates are avoiding primary care careers because of relatively low reimbursement and an unsatisfying work life. Yet a strong primary care sector has been associated with reduced health care costs and improved quality. Through the Patient-Centered Primary Care Collaborative and other efforts, some large employers are engaged in initiatives to strengthen primary care. PMID:18180490

  7. A right to health care.

    PubMed

    Eleftheriadis, Pavlos

    2012-01-01

    What does it mean to say that there is a right to health care? Health care is part of a cooperative project that organizes finite resources. How are these resources to be distributed? This essay discusses three rival theories. The first two, a utilitarian theory and an interst theory, are both instrumental, in that they collapse rights to good states of affairs. A third theory, offered by Thomas Pogge, locates the question within an institutional legal context and distinguishes between a right to health care that results in claimable duties and other dimensions of health policy that do not. Pogge's argument relies on a list of "basic needs," which itself, however, relies on some kind of instrumental reasoning. The essay offers a reconstruction of Pogge's argument to bring it in line with a political conception of a right to health care. Health is a matter of equal liberty and equal citizenship, given our common human vulnerability. If we are to live as equal members in a political community, then our institutions need to create processes by which we are protected from the kinds of suffering that would make it impossible for us to live as equal members. PMID:22789045

  8. Prevention in Poland: health care system reform.

    PubMed Central

    Sheahan, M D

    1995-01-01

    Despite the political and economic reforms that have swept Eastern Europe in the past 5 years, there has been little change in Poland's health care system. The Ministry of Health and Social Welfare has targeted preventive care as a priority, yet the enactment of legislation to meet this goal has been slow. The process of reform has been hindered by political stagnation, economic crisis, and a lack of delineation of responsibility for implementing the reforms. Despite the delays in reform, recent developments indicate that a realistic, sustainable restructuring of the health care system is possible, with a focus on preventive services. Recent proposals for change have centered on applying national goals to limited geographic areas, with both local and international support. Regional pilot projects to restructure health care delivery at a community level, local health education and disease prevention initiatives, and a national training program for primary care and family physicians and nurses are being planned. Through regionalization, an increase in responsibility for both the physician and the patient, and redefinition of primary health care and the role of family physicians, isolated local movements and pilot projects have shown promise in achieving these goals, even under the current budgetary constraints. PMID:7610217

  9. Development and preliminary validation of the 'Caring for Country' questionnaire: measurement of an Indigenous Australian health determinant

    PubMed Central

    Burgess, Christopher P; Berry, Helen L; Gunthorpe, Wendy; Bailie, Ross S

    2008-01-01

    Background 'Caring for Country' is defined as Indigenous participation in interrelated activities with the objective of promoting ecological and human health. Ecological services on Indigenous-owned lands are belatedly attracting some institutional investment. However, the health outcomes associated with Indigenous participation in 'caring for country' activities have never been investigated. The aims of this study were to pilot and validate a questionnaire measuring caring for country as an Indigenous health determinant and to relate it to an external reference, obesity. Methods Purposively sampled participants were 301 Indigenous adults aged 15 to 54 years, recruited during a cross-sectional program of preventive health checks in a remote Australian community. Questionnaire validation was undertaken with psychometric tests of internal consistency, reliability, exploratory factor analysis and confirmatory one-factor congeneric modelling. Accurate item weightings were derived from the model and used to create a single weighted composite score for caring for country. Multiple linear regression modelling was used to test associations between the caring for country score and body mass index adjusting for socio-demographic factors and health behaviours. Results The questionnaire demonstrated adequate internal consistency, test-retest validity and proxy-respondent validity. Exploratory factor analysis of the 'caring for country' items produced a single factor solution that was confirmed via one-factor congeneric modelling. A significant and substantial association between greater participation in caring for country activities and lower body mass index was demonstrated. Adjusting for socio-demographic factors and health behaviours, an inter-quartile range rise in caring for country scores was associated with 6.1 Kg and 5.3 Kg less body weight for non-pregnant women and men respectively. Conclusion This study indicates preliminary support for the validity of the caring for country concept and a questionnaire designed to measure it. This study also highlights the importance of investigating Indigenous-asserted health promotion activities. Further studies in similar populations are merited to test the generalisability of this questionnaire and to explore associations with other important Indigenous health outcomes. PMID:19094240

  10. Health care technology in the United Kingdom.

    PubMed

    Spiby, J

    1994-01-01

    The UK National Health Service (NHS) is based on the principle that everyone is entitled to any kind of medical treatment for any condition, free of charge. The NHS is funded primarily from general tax revenues. The health service is presently in the middle of a profound change in philosophy and practice. Health authorities have been given specific responsibility for identifying their population's health needs and for using public money to buy services under a specific contract so as to meet those needs. Health care technology assessment (TA) has also developed very rapidly in the UK recently. While the limited budgets of the NHS have controlled expenditures for health care, there has not been a coherent policy for technology development until very recently. During the past decade, awareness of the concepts of appropriateness, effectiveness, and cost-benefit analysis have moved to center stage on the agenda of policy makers. A new R&D strategy in the NHS is emphasizing technology assessment as an aid to choice and management of technology. The increased necessity for making choices, and the increasing availability of results from health care TA, seem to indicate that such research will have an increasing impact on health care and its management. PMID:10139494

  11. Coping with health care reform.

    PubMed

    van Eyk, H; Baum, F; Houghton, G

    2001-01-01

    This paper describes the evaluation of a case study of health service reform in southern Adelaide. A mail survey, interviews and focus groups were used to gain an understanding of health care providers' perceptions and experiences of reform. The paper discusses lessons learnt about health service reform and its impact on people working in the health system. It finds that continual change that is not based on a well-articulated vision is likely to lead to 'reform fatigue' and low morale. An action research approach can be used by researchers to help managers and staff understanding the context in which reform is happening, and thus give support to organisational learning. PMID:11496464

  12. Understanding managed behavioral health care.

    PubMed

    Hoge, M A; Thakur, N M; Jacobs, S

    2000-06-01

    Managed care can be understood from an historical perspective as a reaction to perceived abuses by providers or an extension of earlier efforts to manage care in the public sector. It can be viewed as a young and emerging force--a fourth party to the health care transaction--that is rapidly progressing through a series of generations that redefine the approach to organizing and delivering services. And finally, because managed care emerges with so many faces, consumers and providers can perhaps best understand its implementation in a specific state or community by examining the multiple dimensions, such as those outlined herein, on which these initiatives vary. Until the forms and functions are more uniform, no simple definition of managed care will exist. PMID:10909105

  13. Universal health care: the changing international discourse.

    PubMed

    Bisht, Ramila

    2013-01-01

    Nearly 34 years ago, in 1978 in the face of a looming crisis in the health of the world's populations and rising health inequality, 134 countries came together to sign the historic Alma Ata Declaration where the idea of primary health care as the chosen path to "Health for All" was formulated. However even before the declaration and more so since, countries have diverse interpretations of Universalism, each setting it in the context of its own health care model. These have ranged from the minimalist to the more comprehensive welfare state. Today, as health statistics reveal, the crisis has deepened, not only in the developing world but also in the developed world. It is important to debate the nature of the crisis and understand current policy initiatives and their ideological legitimations. The paper attempts to trace, clarify and account for the shifts in international discourse on universal health care (UHC). It argues that the idea of UHC is still with us, but there have occurred substantial shifts in discourse and meaning, shaped by changing international and national contexts and social forces impinging on health systems. The current concept of universal health coverage has only a notional allusion to universality of Alma Ata and disregards its fundamental principles. It concludes that the shifts are detrimental and its value in promoting health for all is likely to be severely limited. PMID:24351385

  14. Managing motivation and developing job satisfaction in the health care work environment.

    PubMed

    Timmreck, T C

    2001-09-01

    Motivation relies on internal/intrinsic and external factors to stimulate work-related behavior. This article presents an overview of Herzberg's motivation-hygiene theory and reports on the results of a study of 99 health service midmanagers. The participants completed a survey asking whether they believe in motivational factors and if they use them. Several of Herzberg's motivational factors were included (achievement, recognition, work itself, responsibility, advancement) plus several other motivational factors including money/pay, self-interest, seek a higher standard of living. Negative factors included guilt, threats, power, and control. This article presents motivation factors, such as achievement, recognition, work itself, responsibility, advancement, growth, self-interest, pay, and belief in successful outcome, that were presented to 99 mid-level health services administrators. PMID:11556553

  15. Health Care Performance Indicators for Health Information Systems.

    PubMed

    Hyppönen, Hannele; Ronchi, Elettra; Adler-Milstein, Julia

    2016-01-01

    Health Information Systems (HISs) are expected to have a positive impact on quality and efficiency of health care. Rapid investment in and diffusion of HISs has increased the importance of monitoring the adoption and impacts of them in order to learn from the initiatives, and to provide decision makers evidence on the role of HISs in improving health care. However, reliable and comparable data across initiatives in various countries are rarely available. A four-phase approach is used to compare different HIS indicator methodologies in order to move ahead in defining HIS indicators for monitoring effects of HIS on health care performance. Assessed approaches are strong on different aspects, which provide some opportunities for learning across them but also some challenges. As yet, all of the approaches do not define goals for monitoring formally. Most focus on health care structural and process indicators (HIS availability and intensity of use). However, many approaches are generic in description of HIS functionalities and context as well as their impact mechanisms on health care for HIS benchmarking. The conclusion is that, though structural and process indicators of HIS interventions are prerequisites for monitoring HIS impacts on health care outputs and outcomes, more explicit definition is needed of HIS contexts, goals, functionalities and their impact mechanisms in order to move towards common process and outcome indicators. A bottom-up-approach (participation of users) could improve development and use of context-sensitive HIS indicators. PMID:27198102

  16. Changing health-care systems.

    PubMed

    Holthof, B

    1995-01-01

    Many governments are encouraging competition for resources between health centres in an attempt to reduce costs and improve the quality of services. However, opponents to managed care believe that this will create more administrative costs and reduce patient choice. So-called purchasing organizations are being established to direct patients to the most cost-effective care. Assessing performance is complicated as very sick or difficult-to-treat patients are likely to be more costly. Statistical techniques can be used to clarify the impact of risk factors, such as smoking, on the outcome of care. PMID:18611652

  17. Health Care Procedure Considerations and Individualized Health Care Plans

    ERIC Educational Resources Information Center

    Heller, Kathryn Wolff; Avant, Mary Jane Thompson

    2011-01-01

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

  18. Sustainable health care for Canada.

    PubMed

    Maxwell, J; Angus, D; Albert, T

    1995-01-01

    Sustainable Health Care For Canada is a synthesis of the research findings of the Cost-Effectiveness of the Canadian Health Care System Project initiated by the Economic Council of Canada. Upon the council's closing, the team moved to become part of the Queen's-University of Ottawa Economic Projects to complete the research. During the project, 18 working papers were produced, in addition to the research report and the synthesis report. In this article, the authors provide an overview of this large-scale research program and highlight some of its key findings. PMID:10140965

  19. Personalized health care: from theory to practice.

    PubMed

    Snyderman, Ralph

    2012-08-01

    The practice of medicine stands at the threshold of a transformation from its current focus on the treatment of disease events to an emphasis on enhancing health, preventing disease and personalizing care to meet each individual's specific health needs. Personalized health care is a new and strategic approach that is driven by personalized health planning empowered by personalized medicine tools, which are facilitated by advances in science and technology. These tools improve the capability to predict health risks, to determine and quantify the dynamics of disease development, and to target therapeutic approaches to the needs of the individual. Personalized health care can be implemented today using currently available technologies and know-how and thereby provide a market for the rational introduction of new personalized medicine tools. The need for early adoption of personalized health care stems from the necessity to reduce the egregious and wasteful burden of preventable chronic diseases, which is not effectively addressed by our current approach to care. PMID:22180345

  20. Implementation of Advanced Health Care Technology into Existing Competency-Based Health Care Program. Final Report.

    ERIC Educational Resources Information Center

    Klemovage, Shirley

    A project was undertaken to develop new curriculum materials that could be incorporated into an existing health assistant program to cover recent advances in health care technology. Area physicians' offices were toured and meetings were held with administrators of local hospitals in order to discover what kinds of advances in health care…

  1. DRGs: the counterrevolution in financing health care.

    PubMed

    Dolenc, D A; Dougherty, C J

    1985-06-01

    The authors predict that the Diagnosis Related Group (DRG) system for prospective reimbursement of hospitals under Medicare, also used by several state Medicaid programs, will almost certainly be adopted in some version by private health insurers. Their thesis is that such a drastic alteration in health care economics will reduce access to care, compromise its quality, impede the development of new medical technologies, and accelerate the takeover of American medicine by large, for-profit corporations. Dolenc and Dougherty argue for an alternative system based on the assumption that health care is a right, not a commodity. In the interim they propose modifications in the DRG scheme to protect access to care by vulnerable groups and to subsidize non-profit hospitals by taxing for-profit ones. PMID:3926717

  2. Health Care Reform: A Values Debate.

    ERIC Educational Resources Information Center

    Popko, Kathleen

    1992-01-01

    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)

  3. Developing a comprehensive approach to risk management of musculoskeletal disorders in non-nursing health care sector employees.

    PubMed

    Oakman, Jodi; Macdonald, Wendy; Wells, Yvonne

    2014-11-01

    This study of selected jobs in the health care sector explored a range of physical and psychosocial factors to identify those that most strongly predicted work-related musculoskeletal disorders (WMSD) risk. A self-report survey was used to collect data on physical and psychosocial risk factors from employees in three health care organisations in Victoria, Australia. Multivariate analyses demonstrated the importance of both psychosocial and physical hazards in predicting WMSD risk and provides evidence for risk management of WMSDs to incorporate a more comprehensive and integrated approach. Use of a risk management toolkit is recommended to address WMSD risk in the workplace. PMID:24998863

  4. Health disparities among health care workers.

    PubMed

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

    2010-01-01

    In this article we describe the process of an interdisciplinary case study that examined the social contexts of occupational and general health disparities among health care workers in two sets of New England hospitals and nursing homes. A political economy of the work environment framework guided the study, which incorporated dimensions related to market dynamics, technology, and political and economic power. The purpose of this article is to relate the challenges encountered in occupational health care settings and how these could have impacted the study results. An innovative data collection matrix that guided small-group analysis provided a firm foundation from which to make design modifications to address these challenges. Implications for policy and research include the use of a political and economic framework from which to frame future studies, and the need to maintain rigor while allowing flexibility in design to adapt to challenges in the field. PMID:19940090

  5. An integrated health care system's approach to development of a process to collect patient functional outcomes on total joint replacement procedures.

    PubMed

    Topel, Amy M; Schini, Cynthia A

    2014-01-01

    Health care organizations are challenged to find ways to measure not only process of care but also outcomes of care. Gundersen Health System's Orthopaedic Surgery Department in the La Crosse, Wisconsin area developed a process to collect outcomes of care for patients having hip or knee arthroplasty procedures and planned to use these data to determine impact on patients' lives. The Hip Osteoarthritis Outcomes Score and Knee Osteoarthritis Outcomes Score, adapted from the widely used Western Ontario and McMaster Universities Osteoarthritis Index, were collected preoperatively and at 1 year postoperatively. From these data, the health system determined that patients were experiencing significant improvement in 4 of 5 scales. Further recommendations include evaluating the impact of patients' age, sex, and preoperative body mass index on outcomes, as well as evaluating the impact of more patient involvement in goal setting on recovery time and functional outcomes. PMID:23687238

  6. Improving Educational Preparation for Transcultural Health Care.

    ERIC Educational Resources Information Center

    Le Var, Rita M. H.

    1998-01-01

    Nurses and health care professionals must be prepared for transcultural health care because society is becoming increasingly multicultural and current health services are not meeting the needs of minority ethnic groups in Britain. (SK)

  7. Good Health Before Pregnancy: Preconception Care

    MedlinePlus

    ... Login Join Pay Dues Follow us: Women's Health Care Physicians Contact Us My ACOG ACOG Departments Donate ... Patients About ACOG Good Health Before Pregnancy: Preconception Care Home For Patients Search FAQs Good Health Before ...

  8. Health Care in the United States [and] Health Care Issues: A Lesson Plan.

    ERIC Educational Resources Information Center

    Lewis, John; Dempsey, Joanne R.

    1984-01-01

    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…

  9. Fitch ratings. Health care special report.

    PubMed

    2003-01-01

    Fitch Ratings continues to believe that the current and projected personnel shortages, especially among registered nurses (RNs). present one of the greatest operating challenges for health care providers nationwide. As noted in Fitch Research on "Health Care Staffing Shortage," dated June 21, 2001 (available on Fitch's web site at www.fitchratings. com), staffing is an area that is creating enormous expense inflation for health care providers and presenting one of the biggest areas of uncertainty in assessing an organization's credit quality. Shortages are becoming increasingly widespread, affecting health care providers in urban and rural areas regardless of size. Since health care is a labor intensive business, salary and benefit costs are key determinants of profitability. Fitch believes the attention given to the nursing shortage and potential looming crisis has created a sense of urgency, with many hospitals developing innovative strategies for work force development. In addition, federal, state, and local governments are creating programs and/or providing financial support to help alleviate shortages. Yet, the benefits of many of these initiatives may not be realized for many years, and Fitch expects health care providers to continue experiencing inflating salary and benefit expenses with growing temporary staffing usage and competitive pressure to increase overall compensation. Fitch believes managing labor costs is critical to achieving profitability, especially as the ability to increase revenue diminishes. Fitch believes the nursing shortage will continue to represent an area of extreme expense pressure for health care providers for years to come. Imbalanced supply and demand, which is expected to worsen as retiring nurses outstrip replacements, should create financial strain for many providers in an industry that is gearing up to meet the aging population's anticipated demand for more services. Fitch plans to closely monitor management strategies for dealing with vacancy and turnover rates, as well as trends in agency spending, to determine financial implications among its rated portfolio. PMID:14528733

  10. Virtual health care center in Georgia

    PubMed Central

    Schrader, Thomas; Kldiashvili, Ekaterina

    2008-01-01

    Application of telemedicine systems to cover distant geographical areas has increased recently. However, the potential usefulness of similar systems for creation of national networks does not seem to be widely appreciated. The article describes the "Virtual Health Care Knowledge Center in Georgia" project. Its aim was the set up of an online integrated web-based platform to provide remote medical consultations and eLearning cycles. The project "Virtual Health Care Knowledge Center in Georgia" was the NATO Networking Infrastructure Grant dedicated for development of telemedicine in non-NATO countries. The project implemented a pilot to organize the creation of national eHealth network in Georgia and to promote the use of innovative telemedicine and eLearning services in the Georgian healthcare system. In June 2007 it was continued under the NATO Networking Infrastructure Grant "ePathology – Virtual Pathology Center in Georgia as the Continuation of Virtual Health Care Center". PMID:18673518

  11. Using workshops to develop theories of change in five low and middle income countries: lessons from the programme for improving mental health care (PRIME)

    PubMed Central

    2014-01-01

    Background The Theory of Change (ToC) approach has been used to develop and evaluate complex health initiatives in a participatory way in high income countries. Little is known about its use to develop mental health care plans in low and middle income countries where mental health services remain inadequate. Aims ToC workshops were held as part of formative phase of the Programme for Improving Mental Health Care (PRIME) in order 1) to develop a structured logical and evidence-based ToC map as a basis for a mental health care plan in each district; (2) to contextualise the plans; and (3) to obtain stakeholder buy-in in Ethiopia, India, Nepal, South Africa and Uganda. This study describes the structure and facilitator’s experiences of ToC workshops. Methods The facilitators of the ToC workshops were interviewed and the interviews were recorded, transcribed and analysed together with process documentation from the workshops using a framework analysis approach. Results Thirteen workshops were held in the five PRIME countries at different levels of the health system. The ToC workshops achieved their stated goals with the contributions of different stakeholders. District health planners, mental health specialists, and researchers contributed the most to the development of the ToC while service providers provided detailed contextual information. Buy-in was achieved from all stakeholders but valued more from those in control of resources. Conclusions ToC workshops are a useful approach for developing ToCs as a basis for mental health care plans because they facilitate logical, evidence based and contextualised plans, while promoting stakeholder buy in. Because of the existing hierarchies within some health systems, strategies such as limiting the types of participants and stratifying the workshops can be used to ensure productive workshops. PMID:24808923

  12. Developing High-Fidelity Health Care Simulation Scenarios: A Guide for Educators and Professionals

    ERIC Educational Resources Information Center

    Alinier, Guillaume

    2011-01-01

    The development of appropriate scenarios is critical in high-fidelity simulation training. They need to be developed to address specific learning objectives, while not preventing other learning points from emerging. Buying a patient simulator, finding a volunteer to act as the patient, or even obtaining ready-made scenarios from another simulation

  13. Developing High-Fidelity Health Care Simulation Scenarios: A Guide for Educators and Professionals

    ERIC Educational Resources Information Center

    Alinier, Guillaume

    2011-01-01

    The development of appropriate scenarios is critical in high-fidelity simulation training. They need to be developed to address specific learning objectives, while not preventing other learning points from emerging. Buying a patient simulator, finding a volunteer to act as the patient, or even obtaining ready-made scenarios from another simulation…

  14. Women and access to health care.

    PubMed

    Puentes-Markides, C

    1992-08-01

    This paper is concerned with access to health care for women in developing countries, with specific reference to Latin American and Caribbean countries. It reviews the available literature on the concept of access as it relates to other variables such as accountability, affordability and acceptability of health services, taking into consideration the effects of the generalized socio-economic crisis that has affected most countries during the last decade, as well as equity objectives. Various approaches to defining variables affecting access to health care appear in the literature reviewed. While some of them indicate that ability to pay for services act as a major determinant of access to health care, others point to behavioral issues related to motivation, health seeking behavior or perception of illness as a deterrent to women in the low socioeconomic strata, while others indicate that sociocultural issues, such as values, education, religion or demographic variables related to age, influence access to health care. The paper concludes with some comments on policies and strategies for securing access to health and healthcare, indicating the need to move away from traditional solutions including framing gender-based health differences in status and access adequately, promoting and strengthening social participation of women in policy making. PMID:1381522

  15. Experiences of Followers in the Development of the Leader-Follower Relationship in Long-Term Health Care: A Phenomenological Study

    ERIC Educational Resources Information Center

    Lucia, David

    2010-01-01

    This descriptive phenomenological study explored the perceptions and experiences of followers in the development of the leader-follower relationship, within a long-term health care environment. This study is also framed within the disciplinary context of human resource development (HRD). This study addressed the research question, "During your…

  16. Mental health care in Cambodia.

    PubMed Central

    Somasundaram, D. J.; van de Put, W. A.

    1999-01-01

    An effort is being made in Cambodia to involve grass-roots personnel in the integration of the care of the mentally ill into a broad framework of health services. This undertaking is examined with particular reference to the work of the Transcultural Psychosocial Organization. PMID:10212521

  17. Health care insolvency and bankruptcy.

    PubMed

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

    1998-08-01

    Bankruptcy is an event that is often considered a business' worst nightmare. Debt, lawyers, and the U.S. government can lead to the eventual destruction of a business. This article shows how declaring bankruptcy can be a helpful instrument in continuing a successful venture in the health care marketplace. PMID:10182242

  18. Child Poverty and the Health Care System.

    PubMed

    Racine, Andrew D

    2016-04-01

    The persistence of child poverty in the United States and the pervasive health consequences it engenders present unique challenges to the health care system. Human capital theory and empirical observation suggest that the increased disease burden experienced by poor children originates from social conditions that provide suboptimal educational, nutritional, environmental, and parental inputs to good health. Faced with the resultant excess rates of pediatric morbidity, the US health care system has developed a variety of compensatory strategies. In the first instance, Medicaid, the federal-state governmental finance system designed to assure health insurance coverage for poor children, has increased its eligibility thresholds and expanded its benefits to allow greater access to health services for this vulnerable population. A second arm of response involves a gradual reengineering of health care delivery at the practice level, including the dissemination of patient-centered medical homes, the use of team-based approaches to care, and the expansion of care management beyond the practice to reach deep into the community. Third is a series of recent experiments involving the federal government and state Medicaid programs that includes payment reforms of various kinds, enhanced reporting, concentration on high-risk populations, and intensive case management. Fourth, pediatric practices have begun to make use of specific tools that permit the identification and referral of children facing social stresses arising from poverty. Finally, constituencies within the health care system participate in enhanced advocacy efforts to raise awareness of poverty as a distinct threat to child health and to press for public policy responses such as minimum wage increases, expansion of tax credits, paid family leave, universal preschool education, and other priorities focused on child poverty. PMID:27044708

  19. The role of physicians and medical organizations in the development, analysis, and implementation of health care policy.

    PubMed

    Beyer, David C; Mohideen, Najeeb

    2008-07-01

    Health policy is developed in the United States through a complicated interplay of governmental and private agencies and businesses, physician organizations, and societies as well as a host of other private ventures. The end result is rarely precisely what any individual or group may desire as the consequences of any action are never entirely predictable. There are many pathways to influence policy development within this system, and many of these are influenced by physicians as individuals and through organized medical societies. Opportunities abound to constructively engage the system, and it is important that physicians operating within this system understand where and how they may influence policy development. Changes are made or considered on a daily basis that impact patient's access to care, implementation and access to technological and biological innovation, reporting requirements, insurance, physician's reimbursement, and so on. This article reviews the most important channels by which physician input is incorporated in the system. The role of specialty societies, general medical societies, Congress, and Centers for Medicare and Medicaid Services are reviewed. The role of other players will also be addressed to show the many routes by which policy may evolve. Much of the discussion revolves around reimbursement because reimbursement often determines the availability and use of procedures and technology for our patients. PMID:18513628

  20. Relationships between discrimination in health care and health care outcomes among four race/ethnic groups.

    PubMed

    Benjamins, Maureen R; Whitman, Steven

    2014-06-01

    Discrimination has been found to be detrimental to health, but less is known about the influence of discrimination in health care. To address this, the current study (1) compared levels of racial/ethnic discrimination in health care among four race/ethnic groups; (2) determined associations between this type of discrimination and health care outcomes; and (3) assessed potential mediators and moderators as suggested by previous studies. Multivariate logistic regression models were used within a population-based sample of 1,699 White, African American, Mexican, and Puerto Rican respondents. Overall, 23% of the sample reported discrimination in health care, with levels varying substantially by race/ethnicity. In adjusted models, this type of discrimination was associated with an increased likelihood of having unmet health care needs (OR = 2.48, CI = 1.57-3.90) and lower odds of perceiving excellent quality of care (OR = 0.43, CI = 0.28-0.66), but not with the use of a physician when not sick or use of alternative medicine. The mediating role of mental health factors was inconsistently observed and the relationships were not moderated by race/ethnicity. These findings expand the literature and provide preliminary evidence that can eventually inform the development of interventions and the training of health care providers. PMID:23456249

  1. Collaborative Learning with Screen-Based Simulation in Health Care Education: An Empirical Study of Collaborative Patterns and Proficiency Development

    ERIC Educational Resources Information Center

    Hall, L. O.; Soderstrom, T.; Ahlqvist, J.; Nilsson, T.

    2011-01-01

    This article is about collaborative learning with educational computer-assisted simulation (ECAS) in health care education. Previous research on training with a radiological virtual reality simulator has indicated positive effects on learning when compared to a more conventional alternative. Drawing upon the field of Computer-Supported

  2. Collaborative Learning with Screen-Based Simulation in Health Care Education: An Empirical Study of Collaborative Patterns and Proficiency Development

    ERIC Educational Resources Information Center

    Hall, L. O.; Soderstrom, T.; Ahlqvist, J.; Nilsson, T.

    2011-01-01

    This article is about collaborative learning with educational computer-assisted simulation (ECAS) in health care education. Previous research on training with a radiological virtual reality simulator has indicated positive effects on learning when compared to a more conventional alternative. Drawing upon the field of Computer-Supported…

  3. Developing a Performance Management System for a Federal Public Health Program: The Ryan White CARE ACT Titles I and II.

    ERIC Educational Resources Information Center

    Kates, Jennifer; Marconi, Katherine; Mannle, Thomas E., Jr.

    2001-01-01

    Describes an approach to introducing performance measurement into a large federal health program, the Ryan White Comprehensive AIDS Resources Emergency (CARE) Act, in response to the government Performance and Results Act. Also discusses characteristics of the HIV/AIDS epidemic that present unique challenges for performance measurement. (SLD)

  4. Measuring satisfaction with health care in young persons with inflammatory bowel disease -an instrument development and validation study

    PubMed Central

    2014-01-01

    Background Patient satisfaction is a relevant prognostic factor in young persons with chronic disease and may be both age and disease specific. To assess health care quality from the patient’s view in young persons with inflammatory bowel disease, an easy to use, valid, reliable and informative specific instrument was needed. Methods All parts of the study were directed at persons with inflammatory bowel disease aged 15 to 24 (“youth”). A qualitative internet patient survey was used to generate items, complemented by a physician survey and literature search. A 2nd internet survey served to reduce items based on perceived importance and representativeness. Following pilot testing to assess ease of use and face validity, 150 respondents to a postal survey in patients from a paediatric clinical registry were included for validation analyses. Construct validity was assessed by relating summary scores to results from global questions on satisfaction with care using ANOVA. To assess test-retest reliability using intraclass correlation coefficients (ICC), a subset of patients were assessed twice within 3 months. Results 302 persons with IBD and 55 physicians participated in the item generating internet survey, resulting in 3,954 statements. After discarding redundancies 256 statements were presented in the 2nd internet survey. Of these, 32 items were retained. The resulting instrument assesses both the perceived relevance (importance) of an item as well as the performance of the care giver for each item for calculation of a summary satisfaction score (range 0 to 1). Sensibility testing showed good acceptance for most items. Construct validity was good, with mean scores of 0.63 (0.50 to 0.76), 0.71 (0.69 to 0.74) and 0.81 (0.79 to 0.83) for no, some and good global satisfaction (ANOVA, p < 0.001). Test-retest reliability was satisfactory (ICC 0.6 to 0.7). Conclusions We developed an easy to use, patient oriented, valid instrument to assess satisfaction with care in young persons with IBD for use in survey research. PMID:24581043

  5. Selected Child Development and Health Care Outcomes of the CEDEN Parent-Child Program: Interim Report.

    ERIC Educational Resources Information Center

    Davis, Paul F.; And Others

    This paper discusses CEDEN's Parent-Child Program (PCP) and its external evaluation. The program promotes healthy child development among multi-problem, predominantly young families living at or below the poverty level in Austin, Texas. The goals of the PCP are to teach low-income parents in a culturally appropriate manner to encourage their…

  6. Developing Positive Attitudes toward Interprofessional Collaboration among Students in the Health Care Professions

    ERIC Educational Resources Information Center

    Park, Juyoung; Hawkins, Michele; Hamlin, Elwood; Hawkins, Wesley; Bamdas, Jo Ann M.

    2014-01-01

    This study examined whether attitudes toward interprofessional collaboration (Physician-Nurse, Physician-Social Worker, Nurse-Social Worker) held by medical, social work, and nursing students changed after completing an interprofessional curriculum consisting of (a) Interprofessional Education Development Session and (b) the Senior Aging and…

  7. Towards an alternative economics of health care.

    PubMed

    Hodgson, Geoffrey M

    2009-01-01

    It is argued here that an economics centred on subjective utility-maximization is unsuitable for the analysis and policy grounding of health care provision. To some extent, the peculiarities of health care have been recognized by mainstream health economists, who sometimes abandon Paretian welfare considerations to focus on needs instead. This article examines important peculiarities of health care that are relatively neglected in the literature. Some of these concern health care needs: while health itself is a universal need, needs for health care provision are largely involuntary, varied, and idiosyncratic. These issues have important consequences for the planning of health care systems and the extent of transaction costs in any market-based system. These factors, combined with the inherent dynamism of modern health care needs and capabilities, create an opening for alternative approaches to health care economics. PMID:19099619

  8. Inequalities in health care use and expenditures: empirical data from eight developing countries and countries in transition.

    PubMed Central

    Makinen, M.; Waters, H.; Rauch, M.; Almagambetova, N.; Bitran, R.; Gilson, L.; McIntyre, D.; Pannarunothai, S.; Prieto, A. L.; Ubilla, G.; Ram, S.

    2000-01-01

    This paper summarizes eight country studies of inequality in the health sector. The analyses use household data to examine the distribution of service use and health expenditures. Each study divides the population into "income" quintiles, estimated using consumption expenditures. The studies measure inequality in the use of and spending on health services. Richer groups are found to have a higher probability of obtaining care when sick, to be more likely to be seen by a doctor, and to have a higher probability of receiving medicines when they are ill, than the poorer groups. The richer also spend more in absolute terms on care. In several instances there are unexpected findings. There is no consistent pattern in the use of private providers. Richer households do not devote a consistently higher percentage of their consumption expenditures to health care. The analyses indicate that intuition concerning inequalities could result in misguided decisions. It would thus be worthwhile to measure inequality to inform policy-making. Additional research could be performed using a common methodology for the collection of data and applying more sophisticated analytical techniques. These analyses could be used to measure the impact of health policy changes on inequality. PMID:10686733

  9. WikiBuild: a new application to support patient and health care professional involvement in the development of patient support tools.

    PubMed

    Archambault, Patrick Michel

    2011-01-01

    Active patient and public involvement as partners in their own health care and in the development of health services is key to achieving a health care system that is responsive to patients' needs and values. It promotes better use of the health care system, and improves health outcomes, quality of life and patient satisfaction. By involving patients and health care professionals as partners in the creation and updating of patient health support tools, wikis--highly accessible, interactive vehicles of communication--have the potential to empower users to implement these support tools in daily life. Acknowledging the potential of wikis, and recognizing that they capitalize on the free and open access to information, scientists, opinion leaders and patient advocates have suggested that wikis could help decision-making constituencies improve the delivery of health care. They might also decrease its cost and improve access to knowledge within developing countries. However, little is known about the efficacy of wikis in helping to attain these goals. There is also a need to know more about the intention of patients and health care workers to use wikis, in what circumstances and what factors will influence their use of wikis. In this issue of the Journal of Medical Internet Research, Gupta et al describe how they developed and tested a new wiki-inspired application to improve asthma care. The researchers involved patients with asthma, primary care physicians, pulmonologists and certified asthma educators in the construction of an asthma action plan. Their paper--entitled "WikiBuild: a new online collaboration process for multistakeholder tool development and consensus building"--is the first description of a wiki-inspired technology built to involve patients and health care professionals in the development of a patient support tool. This innovative study has made important contributions toward how wikis could be generalized to involve multiple stakeholders in the development of other knowledge translation tools such as clinical practice guidelines or decision aids. More specifically, Gupta et al have uncovered potential action mechanisms toward increasing usage of these tools by patients and health care professionals. These are decreasing hierarchical influences, increasing usability and adapting a tool to local context. More research is now needed to determine if the use of the resulting wiki-developed plan will actually be higher than a plan developed using other methods. Furthermore, there is also a need to assess the intention of participants to continue using wiki-based processes on an ongoing basis. It is in this dynamic and continuous retroaction loop that the support tool users--both patients and health care professionals--can adapt and improve the product after its real-life shortcomings are revealed and as new evidence becomes available. As such, a wiki would be more than a simple patient support development tool, but could also become a dynamic and interactive repository and delivery tool that would facilitate ongoing and sustainable patient and professional engagement. PMID:22155746

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

    PubMed Central

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

    2016-01-01

    Transition to adult services for children and youth with special health care needs (CYSHCN) has emerged as an important event in the life course of individuals with disabilities. Issues that interfere with efficient transition to adult health care include the perspectives of stakeholders, age limits on pediatric service, complexity of health conditions, a lack of experienced healthcare professionals in the adult arena, and health care financing for chronic and complex conditions. The purposes of this study were to develop a definition of successful transition and to identify determinants that were associated with a successful transition. The 2007 Survey of Adult Transition and Health dataset was used to select variables to be considered for defining success and for identifying predictors of success. The results showed that a small percentage of young adults who participated in the 2007 survey had experienced a successful transition from their pediatric care. PMID:23160763

  11. Development of a belt-type wearable sensor system with multi-function for home health care

    NASA Astrophysics Data System (ADS)

    Ban, Yunho; Choi, Samjin; Jiang, Zhongwei; Park, Chanwon

    2005-12-01

    Some reports show that the physiological information measured in hospital is not enough without the one measured in home. The physiological information monitored in home, therefore, is strongly required recently. The goal of this research is to develop a wearable and tractable sensor system for detecting biomedical signals such as cardiac rhythm, respiration, body movement, and percentage of body fat (%BF) and for home health care. A belt type sensor for this purpose is developed, which consists of sensing materials of PVDF film and conductive fabrics. Also several data processing techniques, such as the discrete wavelet transform, cross correlation and adaptive filtering method, were introduced to eliminate noises and base wandering and to extract the specified components. The ECG and respiration signals obtained by the proposed belt type sensor system gave good agreements with commercial medical system. Furthermore, the body fat (%BF) measurement based on the four-electrode BIA was also built in the belt sensor. The body fat was calculated by measuring the body impedance from the belt type sensor and compared with the predicted %BF measured by the commercial adipometer (TBF-607). The results validated also the efficiency of the belt type sensor system.

  12. Requiring Influenza Vaccination for Health Care Workers

    PubMed Central

    Anikeeva, Olga; Rogers, Wendy

    2009-01-01

    Annual influenza vaccination for health care workers has the potential to benefit health care professionals, their patients, and their families by reducing the transmission of influenza in the health care setting. Furthermore, staff vaccination programs are cost-effective for health care institutions because of reduced staff illness and absenteeism. Despite international recommendations and strong ethical arguments for annual influenza immunization for health care professionals, staff utilization of vaccination remains low. We have analyzed the ethical implications of a variety of efforts to increase vaccination rates, including mandatory influenza vaccination. A program of incentives and sanctions may increase health care worker compliance with fewer ethical impediments than mandatory vaccination. PMID:19008501

  13. Space technology in remote health care

    NASA Technical Reports Server (NTRS)

    Pool, Sam L.

    1991-01-01

    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.

  14. Meanings of care in health promotion.

    PubMed

    Falcón, Gladys Carmela Santos; Erdmann, Alacoque Lorenzini; Backes, Dirce Stein

    2008-01-01

    The objective of the study is to understand the meaning built by students and professors on health promotion in the teaching and learning process of health care in Nursing. It is a qualitative study using ground theory as a methodological reference. Data was collected through interviews, with three samples groups, 13 students and four professors, by classroom observation, and through meetings with nursing professors. The central subject resulting from this analysis was: constructing teaching and learning in order, disorder and self organization for a new way of caring promoting health. The teaching/learning process directed at health promotion develops in a stage of crisis, going from a state of order to a state of disorder that is uncertain and contradictory regarding what society understands about health. PMID:18695816

  15. The development of health care data warehouses to support data mining.

    PubMed

    Lyman, Jason A; Scully, Kenneth; Harrison, James H

    2008-03-01

    Clinical data warehouses offer tremendous benefits as a foundation for data mining. By serving as a source for comprehensive clinical and demographic information on large patient populations, they streamline knowledge discovery efforts by providing standard and efficient mechanisms to replace time-consuming and expensive original data collection, organization, and processing. Building effective data warehouses requires knowledge of and attention to key issues in database design, data acquisition and processing, and data access and security. In this article, the authors provide an operational and technical definition of data warehouses, present examples of data mining projects enabled by existing data warehouses, and describe key issues and challenges related to warehouse development and implementation. PMID:18194718

  16. Health Gain through Screening--Coronary Heart Disease and Stroke: Developing Primary Health Care Services for People with Intellectual Disability.

    ERIC Educational Resources Information Center

    Wells, M. B.; Turner, S.; Martin, D. M.; Roy, A.

    1997-01-01

    A study of 120 British adults with intellectual disability found they had higher risk factors of developing coronary heart disease and stroke than the general population. There was a greater incidence of obesity and considerably lower physical activity levels than the general population. Several also had abnormal cholesterol readings. (CR)

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

    ERIC Educational Resources Information Center

    Perez-Escamilla, Rafael

    2010-01-01

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

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

    ERIC Educational Resources Information Center

    Perez-Escamilla, Rafael

    2010-01-01

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

  19. Conditional shared confidentiality in mental health care.

    PubMed

    Liégeois, Axel; Eneman, Marc

    2015-05-01

    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

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

    PubMed

    Shaw, Susan J; Armin, Julie

    2011-06-01

    Diverse advocacy groups have pushed for the recognition of cultural differences in health care as a means to redress inequalities in the U.S., elaborating a form of biocitizenship that draws on evidence of racial and ethnic health disparities to make claims on both the state and health care providers. These efforts led to federal regulations developed by the U.S. Office of Minority Health requiring health care organizations to provide Culturally and Linguistically Appropriate Services. Based on ethnographic research at workshops and conferences, in-depth interviews with cultural competence trainers, and an analysis of postings to a moderated listserv with 2,000 members, we explore cultural competence trainings as a new type of social technology in which health care providers and institutions are urged to engage in ethical self-fashioning to eliminate prejudice and embody the values of cultural relativism. Health care providers are called on to re-orient their practice (such as habits of gaze, touch, and decision-making) and to act on their own subjectivities to develop an orientation toward Others that is "culturally competent." We explore the diverse methods that cultural competence trainings use to foster a health care provider's ability to be self-reflexive, including face-to-face workshops and classes and self-guided on-line modules. We argue that the hybrid formation of culturally appropriate health care is becoming detached from its social justice origins as it becomes rationalized by and more firmly embedded in the operations of the health care marketplace. PMID:21553151

  1. Network solutions for home health care applications.

    PubMed

    Herzog, Almut; Lind, Leili

    2003-01-01

    The growing number of the elderly in industrialised countries is increasing the pressure on respective health care systems. This is one reason for recent trends in the development and expansion of home health care organisations. With Internet access available to everyone and the advent of wireless technologies, advanced telehomecare is a possibility for a large proportion of the population. In the near future, one of the authors plans to implement a home health care infrastructure for patients with congestive heart failure and patients with chronic obstructive pulmonary disease. The system is meant to support regular and ad-hoc measurements of medical parameters in patient homes and transmission of measurement data to the home health care provider. In this paper we look at network technologies that connect sensors and input devices in the patient home to a home health care provider. We consider wireless and Internet technologies from functional and security-related perspectives and arrive at a recommendation for our system. Security and usability aspects of the proposed network infrastructures are explored with special focus on their impact on the patient home. PMID:12697950

  2. An integrated doctoral educational model for developing researchers in health care strategic management.

    PubMed

    Payne, G T; Nix, T; Hoffman, J; Blair, J D

    2001-01-01

    Doctoral education varies according to how students that graduate from a particular program are prepared for various type of careers. PhD programs principally work to develop researchers; researchers produce and disseminate new knowledge in a given area of expertise. This manuscript looks specifically at a PhD program designed to produce researchers in healthcare strategic management. This program is based in a business school and builds on general business principles to produce strategists that do research in the healthcare context. The business school program (type B) will be analyzed according to the areas (or potential areas) of research done by its graduates. The different areas are shown in a table where one axis is research content (i.e., specifically what the functional area of research is) and the other axis is publication outlet (i.e., what journal the research is disseminated in). Advantages of the type B program are compared to advantages of a PhD program based in a healthcare administration or healthcare management school (type H program) in terms of publications in these different areas. PMID:11764845

  3. Project #138. Coronary Care Education of Health Care Team. Final Report.

    ERIC Educational Resources Information Center

    Saint Joseph Hospital, MO.

    The goal of this project was to develop, establish, and implement a system for the educational development of health care team members of the St. Joseph region in emergency and coronary care. Programs, curricula, and evaluation methodology were devised for four levels of critical care personnel: R.N.s emphasizing emergency and coronary care;…

  4. [Evolution of primary health care in Spain].

    PubMed

    Martínez Riera, José Ramón

    2012-12-01

    Coinciding with the celebration of the 35th anniversary of the journal of nursing, invented in 1977, conducted a systematic review of all issues published (371) to identify items (222) and news (94) related to primary care health. Events are arranged temporarily and refer to accompanying the evolution of primary care model. The Analysis Shows the evolution of primary care, since its inception in 1978, has been reflected in the type of articles and the content of news published, be an excellent indicator of its development and contribution for the nurses. PMID:23390875

  5. Metrics for assessing improvements in primary health care.

    PubMed

    Stange, Kurt C; Etz, Rebecca S; Gullett, Heidi; Sweeney, Sarah A; Miller, William L; Jaén, Carlos Roberto; Crabtree, Benjamin F; Nutting, Paul A; Glasgow, Russell E

    2014-01-01

    Metrics focus attention on what is important. Balanced metrics of primary health care inform purpose and aspiration as well as performance. Purpose in primary health care is about improving the health of people and populations in their community contexts. It is informed by metrics that include long-term, meaning- and relationship-focused perspectives. Aspirational uses of metrics inspire evolving insights and iterative improvement, using a collaborative, developmental perspective. Performance metrics assess the complex interactions among primary care tenets of accessibility, a whole-person focus, integration and coordination of care, and ongoing relationships with individuals, families, and communities; primary health care principles of inclusion and equity, a focus on people's needs, multilevel integration of health, collaborative policy dialogue, and stakeholder participation; basic and goal-directed health care, prioritization, development, and multilevel health outcomes. Environments that support reflection, development, and collaborative action are necessary for metrics to advance health and minimize unintended consequences. PMID:24641561

  6. Integrating Primary Oral Health Care into Primary Care.

    ERIC Educational Resources Information Center

    Isman, Robert E.

    1993-01-01

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

  7. Health care financing for severe developmental disabilities.

    PubMed

    Birenbaum, A; Guyot, D; Cohen, H J

    1990-01-01

    The 1985-86 data from 308 children and young adults under age 25 with autism and from 326 with severe or profound mental retardation can be compared to national data from the 1980 MNCUES and the 1987 NMES because the methods are similar. These data provide detailed answers to the questions, what health care services are used? what are the expenses? Who pays them? Until now, the absence of comprehensive national data had hindered the development of new approaches to financing the care of children with serious, lifelong conditions. These data permit policymakers to take into account the needs and expenditures for severely developmentally disabled children when reforming the health care financing system. None of the children or young adults had expenditures in excess of $50,000, and very few reached the upper $20,000s. For children with autism the average annual health care expenditure was about $1,000 and about $1,700 for young adults, compared to the $414 average for all American children. They received an average of four physician visits annually, slightly above the U.S. average for children. Their hospitalization rate was twice the average for children. Hospitalization accounted for one-third the health care expenditures among children with autism, but for two-thirds among young adults. For children and young adults with severe retardation the average expenditure on health care was about $4,000, due to the physical impairments in two thirds of the children. They averaged about 12 physician visits annually, falling to 8 among young adults. Children were hospitalized about eight times the national rate, and young adults about twice. Among severely retarded children and young adults living at home, hospitalization accounted for over half the health care expenses, but for only one third for those in residential placement. Unfortunately, preventive and habilitative services were but a tiny fraction of health care expenditures and were demonstrably underutilized. Only 60% of these children had routine dental examinations within the last 12 months, a worse record than the average child. For the individuals whose primary physicians judged that they would benefit from physical or speech therapy, less than one quarter were receiving them. Care for seriously, chronically disabled children places great burdens on immediate family members. Only 20% of the severely retarded youngsters from age 10 to 24 could be left alone at home, even for a few minutes, and only 30% of the autistic ones. These developmental disabilities create needs for personal care and family support that traditionally have not been considered health services.(ABSTRACT TRUNCATED AT 400 WORDS) PMID:1703621

  8. Why are employers prodding health-care providers to adopt new management systems?: reducing the cost of health care.

    PubMed

    De Feo, Joseph A

    2004-01-01

    Increasingly concerned about the escalating costs of health-care insurance coverage, the quality of health-care delivery, and the escalating costs of delivering clinical services, employers are taking action. They are prodding health-care providers and insurers to adopt breakthrough management systems aimed at reducing costs related to poorly performing services and processes--and at the same time improving clinical outcomes. Doing this will require all members of the health-care value chain to work together to improve each and every process and procedure, whether clinical or administrative. This development presents formidable challenges to all health-care providers, insurers, employees, and patients. PMID:15085703

  9. An Intersectoral Response to Children with Complex Health Care Needs

    ERIC Educational Resources Information Center

    Young, Wendy; Earle, Jasmin; Dadebo, Mark

    2004-01-01

    The purpose of this paper is to stimulate debate on how to define and enact public responsibility to children with complex health care needs and their families. We present a program, developed using the Auditor General's framework for accountability that involves Community Care Access Centres, schools and Saint Elizabeth Health Care, a complex…

  10. Evaluating Multidisciplinary Education in Health Care.

    ERIC Educational Resources Information Center

    Pirrie, Anne; Wilson, Valerie; Elsegood, John; Hall, John; Hamilton, Sheila; Harden, Ronald; Lee, Diana; Stead, Joan

    A 2-year study evaluated students' and course organizers' perceptions of the effectiveness of multidisciplinary education (ME) in health care and factors that facilitate or inhibit its development. The study had three phases: a survey of ME provision in the United Kingdom; 42 qualitative interviews and focus groups in 14 sites; and data feedback.…

  11. Counseling and Mental Health Care in Palestine

    ERIC Educational Resources Information Center

    Shawahin, Lamise; Ciftci, Ayse

    2012-01-01

    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.

  12. Costs and coverage. Pressures toward health care reform.

    PubMed Central

    Lee, P R; Soffel, D; Luft, H S

    1992-01-01

    Signs of discontent with the health care system are growing. Calls for health care reform are largely motivated by the continued increase in health care costs and the large number of people without adequate health insurance. For the past 20 years, health care spending has risen at rates higher than the gross national product. As many as 35 million people are without health insurance. As proposals for health care reform are developed, it is useful to understand the roots of the cost problem. Causes of spiraling health care costs include "market failure" in the health care market, expansion in technology, excessive administrative costs, unnecessary care and defensive medicine, increased patient complexity, excess capacity within the health care system, and low productivity. Attempts to control costs, by the federal government for the Medicare program and then by the private sector, have to date been mostly unsuccessful. New proposals for health care reform are proliferating, and important changes in the health care system are likely. PMID:1441510

  13. Toward justice in health care.

    PubMed

    Bayer, R; Callahan, D; Caplan, A L; Jennings, B

    1988-05-01

    The demands of equity and efficiency require a program of universal health insurance in the United States through which all workers will be provided by their employers with health insurance for themselves and their dependents, unemployment will no longer result in the loss of health insurance protection, and federal standards for Medicaid eligibility will be instituted. Issues raised by the assessment of insurance coverage and establishment of uniform standards are discussed within the context of the ethical foundations of medical necessity, schemes for sharing the burden of cost, and the conflict between technological advances and the limitation of resources. Cost containment measures now most prominently on the public agenda represent an unfortunate trend toward exacerbating inequalities by making the patient the main cost container. Moral priority must be given to remedying the patterns of inequality that characterize the American health care system. PMID:3281480

  14. Health Care Politics and Policy

    PubMed Central

    Marmor, Theodore Richard

    2013-01-01

    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 [1]. 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

  15. The development of graphic symbols for medical symptoms to facilitate communication between health care providers and receivers.

    PubMed

    Moriyama, M; Harnisch, D L; Matsubara, S

    1994-12-01

    Since there are a variety of communication barriers in health care settings in Japan, a study was designed to improve communication by the use of graphic symbols. At the beginning of this study, graphic symbols were developed to correspond to 26 basic symptoms. Seventy-six subjects voluntarily evaluated the comprehensibility of these symbols: nursing students (n = 29), manual sign language interpreters (n = 24), hearing impaired subjects with normal (n = 10), limited (n = 11), and minimal (n = 2) literacy abilities. The comprehension by each respondent of each symbol was compared with that of the authors. On the average, numbers of the matching meanings were 24.9 +/- 1.36 (mean +/- S.D.) for students, 24.5 +/- 1.77 for interpreters, 23.4 +/- 2.22, and 21.5 +/- 3.01 for the first two groups of the hearing impaired. Among the 26 symbols, 10 showed high levels of the matching rates (> 90%) for all groups. These symbols were considered to be effective alternatives to verbal expression. Further refinements of the graphic symbols were suggested to suppress the differences in interpretation of the remainder of the symbols. During this study, colleagues and subjects suggested cognitive strategies to clarify and enhance the meaning of the graphic symbols such as (a) the subtraction of excessive information, (b) the addition of further information, and (c) the simplification of the setting by minimizing social and cultural bias. PMID:7537392

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

    ERIC Educational Resources Information Center

    Gould, Stephen J.

    1988-01-01

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

  17. The Native Telehealth Outreach and Technical Assistance Program: a community-based approach to the development of multimedia-focused health care information.

    PubMed

    Dick, Rhonda Wiegman; Manson, Spero M; Hansen, Amy L; Huggins, Annie; Trullinger, Lori

    2007-01-01

    The development and dissemination of culturally relevant health care information has traditionally taken a "top-down" approach. Governmental funding agencies and research institutions have too often dictated the importance and focus of health-related research and information dissemination. In addition, the digital divide has affected rural communities in such a way that their members often do not possess the knowledge or experience necessary to use technological resources. And, even when they do, their skills may be limited, adequate only for implementing applications and programs designed by others who live and work outside of these communities. This need became the driving force in the creation of the Native Telehealth Outreach and Technical Assistance Program. The goal of the program is to equip Native community members, at both the lay and professional levels, with the means to use technology to address tribal health care needs. The transfer of relevant technical knowledge and skills enables participants to develop projects which enhance the community-wide dissemination of health care information. Nine community health advocates and professionals participated in the initial cohort. Eight of the participants successfully developed multimedia-based projects including Web sites, interactive CD-ROMs, and video focusing on a variety of health concerns. At the conclusion of the 18-month program period, projects were disseminated throughout rural communities. The NTOTAP staff continues to evaluate the use of these projects and their benefits within the rural communities. PMID:17874365

  18. Health care financing and the sustainability of health systems.

    PubMed

    Liaropoulos, Lycourgos; Goranitis, Ilias

    2015-01-01

    The economic crisis brought an unprecedented attention to the issue of health system sustainability in the developed world. The discussion, however, has been mainly limited to "traditional" issues of cost-effectiveness, quality of care, and, lately, patient involvement. Not enough attention has yet been paid to the issue of who pays and, more importantly, to the sustainability of financing. This fundamental concept in the economics of health policy needs to be reconsidered carefully. In a globalized economy, as the share of labor decreases relative to that of capital, wage income is increasingly insufficient to cover the rising cost of care. At the same time, as the cost of Social Health Insurance through employment contributions rises with medical costs, it imperils the competitiveness of the economy. These reasons explain why spreading health care cost to all factors of production through comprehensive National Health Insurance financed by progressive taxation of income from all sources, instead of employer-employee contributions, protects health system objectives, especially during economic recessions, and ensures health system sustainability. PMID:26369417

  19. Partners HealthCare Center for Connected Health.

    PubMed

    Ternullo, Joseph; Jethwani, Kamal; Lane, Susan; Myint-U, Khinlei; Havasy, Robert; Carter, Michael; Kvedar, Joseph

    2013-05-01

    This article reviews the history, current status, and future plans of the Partners HealthCare Center for Connected Health (the Center). Established in 1995 by Harvard Medical School teaching hospitals, the Center develops strategies to move healthcare from the hospital and doctor's office into the day-to-day lives of patients. It leverages information technology to help manage chronic conditions, maintain health and wellness, and improve adherence to prescribed regimen, patient engagement, and clinical outcomes. Since inception, it has served over 30,000 patients. The Center's core functions include videoconference-based real-time virtual visits, home vital sign monitoring, store-and-forward online consultations, social media, mobile technology, and other novel methods of providing care and enabling health and wellness remotely and independently of traditional time and geographic constraints. It offers a wide range of services, programs, and research activities. The Center comprises over 40 professionals with various technical and professional skills. Internally within Partners HealthCare, the role of the Center is to collaborate, guide, advise, and support the experimentation with and the deployment and growth of connected health technologies, programs, and services. Annually, the Center engages in a deliberative planning process to guide its annual research and operational agenda. The Center enjoys a diversified revenue stream. Funding sources include institutional operating budget/research funds from Partners HealthCare, public and private competitive grants and contracts, philanthropic contributions, ad hoc funding arrangements, and longer-term contractual arrangements with third parties. PMID:23330595

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

    PubMed

    Bender, Bruce G

    2014-04-01

    Many Americans are failing to engage in both the behaviors that prevent and those that effectively manage chronic health conditions, including pulmonary disorders, cardiovascular conditions, diabetes, and cancer. Expectations that health care providers are responsible for changing patients' health behaviors often do not stand up against the realities of clinical care that include large patient loads, limited time, increasing co-pays, and restricted access. Organizations and systems that might share a stake in changing health behavior include employers, insurance payers, health care delivery systems, and public sector programs. However, although the costs of unhealthy behaviors are evident, financial resources to address the problem are not readily available. For most health care organizations, the return on investment for developing behavior change programs appears highest when addressing treatment adherence and disease self-management, and lowest when promoting healthy lifestyles. Organizational strategies to improve adherence are identified in 4 categories: patient access, provider training and support, incentives, and information technology. Strategies in all 4 categories are currently under investigation in ongoing studies and have the potential to improve self-management of many chronic health conditions. PMID:24152056

  1. Many Manly Men Avoid Needed Health Care

    MedlinePlus

    ... fullstory_158551.html Many Manly Men Avoid Needed Health Care Gender stereotypes can have dangerous consequences, research suggests ... traditional masculine ideals were less likely to seek health care, more likely to downplay symptoms, and had worse ...

  2. How Do Health Care Providers Diagnose Endometriosis?

    MedlinePlus

    ... Information Clinical Trials Resources and Publications How do health care providers diagnose endometriosis? Skip sharing on social media ... under a microscope, to confirm the diagnosis. 1 Health care providers may also use imaging methods to produce ...

  3. Accreditation Association for Ambulatory Health Care

    MedlinePlus

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

  4. How Do Health Care Providers Diagnose Pheochromocytoma?

    MedlinePlus

    ... Information Clinical Trials Resources and Publications 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 ...

  5. Savings account for health care costs

    MedlinePlus

    ... can set aside tax-exempt money for your health care expenses. This means you will pay no or ... offers reimbursement for those expenses when you use health care. HRAs can be set up for any type ...

  6. How Do Health Care Providers Diagnose Vulvodynia?

    MedlinePlus

    ... Information Clinical Trials Resources and Publications 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 ...

  7. How Do Health Care Providers Diagnose Hypoparathyroidism?

    MedlinePlus

    ... 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 ...

  8. The Cultural Geography of Health Care Delivery.

    ERIC Educational Resources Information Center

    Gesler, Wilbert M.

    1987-01-01

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

  9. Job satisfaction in health-care organizations

    PubMed Central

    Bhatnagar, Kavita; Srivastava, Kalpana

    2012-01-01

    Job satisfaction among health-care professionals acquires significance for the purpose of maximization of human resource potential. This article is aimed at emphasizing importance of studying various aspects of job satisfaction in health-care organizations. PMID:23766585

  10. CDC Vital Signs: Making Health Care Safer

    MedlinePlus

    ... safety efforts happening across the state. Health care facility CEOs/administrators can: Implement systems to alert receiving ... Germs spread between patients and across health care facilities. Antibiotic resistance is a threat. Nightmare germs called ...

  11. Passion in today's health care leaders.

    PubMed

    Piper, Llewellyn E

    2005-01-01

    Passion in today's health care leaders is essential as health care organizations face increasing demands for survival. Leaders in health care have been educated, selected, promoted, and retained based on their analytical and creativity skills. Today's health care leaders must also have emotional intelligence. Emotional intelligence is primal for passion. Emotional intelligence, which leads to passion, is crucial to the survivability of today's health care organizations. In order for health care organizations to go from good to great, the leader must inspire followers through passion. This article encourages health care leaders to gain awareness of emotional intelligence and to use emotional intelligence as part of their leadership to inspire passion. Through passion, leaders and followers become more motivated to accomplish the health care mission of serving others. PMID:15825818

  12. Resource measurement by health care providers.

    PubMed

    Suver, J D; Neumann, B R

    1986-01-01

    The need to use health care resources effectively and efficiently has led to increased interest in developing a "should cost" approach to performance measurement. The development of appropriate standards and the separation of fixed costs into surrogate variable and capacity components can provide a useful tool for managers to measure performance. This article develops a framework for evaluating the utilization of fixed costs in providing output. PMID:10280908

  13. Trends in the distribution of health care financing across developed countries: the role of political economy of states.

    PubMed

    Calikoglu, Sule

    2009-01-01

    Since the 1980s, major health care reforms in many countries have focused on redefining the boundaries of government through increasing emphasis on private sources of finance and delivery of health care. Apart from managerial and financial choices, the reliance on private sources reflects the political character of a country. This article explores whether the public-private mix of health care financing differs according to political traditions in a sample of 18 industrialized countries, analyzing a 30-year period. The results indicate that despite common trends in all four political traditions during the study period, the overall levels of expenditure and the rates of growth in public and private expenditures were different. Christian democratic countries had public expenditure levels as high as those in social democracies, but high levels of private expenditure differentiated them from the social democracies. Christian democratic countries also relied on both private insurance and out-of-pocket payments, while private insurance expenditures were very limited in social democratic countries. The level of public spending increased at much higher rates among ex-authoritarian countries over the 30 years, bringing these countries to the level of liberal countries by 2000. PMID:19326779

  14. Health and indigenous development.

    PubMed

    D'souza, M

    1993-06-01

    The benefits of using alternative medicine in remote rural areas is discussed with specific references to a tribal area in the district of Dhule of Maharashtra state, India, among the Bhils, Koknas, and Vanjaras. Those involved in the development of health care in the area believe that the tribal people have been exploited in education, health, and agriculture and have shown remarkable endurance in withstanding the effects of a profit seeking society. Private profit-seeking allopathic practitioners exploited the trust of the tribal people until 1985, when the allopathic approach to health care was abandoned. The local medicine men, the Vaidus, were asked to teach 3 health workers to identify roots, develop medicines from plants, and prepare and administer simple herbal remedies for common illnesses. This training was conducted at the Academy of Development Sciences in Kashele, Maharashtra. After the training was completed, each health worker was assigned 10 villages near Nandurbar. Each health worker contacted the Vaidus of each village and exchanged information. The revival of traditional knowledge was also reinforced by the preparation and showing a slides of various medicinal plants in the areas among the 30 villages. Workshops were also conducted along the Vaidus, who were open to exchanging information as long as it was not misused or practiced for personal gain. The Vaidus believed that the person administering treatment had to be honest, have respect for plants, know how to diagnose the illness, and be able to administer the remedy correctly. As a consequence, in the case of Shri Chunnilal Rupsingh of Vadzakhan village, the traditional application of Aloe barbadensis for an infected wound on his hand proved to be the best option. The treatment, available at the private clinic in Nandurbar a considerable distance from the village, was expensive and required multiple return trips. Health care problems of women still need to be addressed; the maintenance of herbal and medicinal gardens is being encouraged. PMID:12318298

  15. [The health care system in Morocco].

    PubMed

    Archane, M I

    1994-04-01

    At present, Morocco is looking into ways and means for the setting up of a health system liable to satisfy the requirements of the end of this century while taking into account the socio-economic constraints. The current health system comprises three sectors: a public sector consisting of the structures of the ministry of public Health together with those of the Health services of the Royal Armed Forces, a semipublic sector, and a private sector. The health system has been undeniably instrumental in the improvement of the health standards in independent Morocco. One figure is evidence enough of that: mortality rate dropped from 160% in 1956 to 57.4% in 1993. This score, however, does not make up for the inadequacies of the system: insufficient human and material means, uneven geographic distribution of health cover and a very limited health insurance. In order to remedy this situation, a health system development program is to be elaborated in the next few months. With the aim of improving the quality and the geographic expansion of the health cover, this program rests upon a number of fundamental principles: progressively generalized compulsory health insurance, improved health cover in the rural area, and a greater commitment to health matters on the part of local elected councils. The financing of the program will rely on health insurance revenues and the budget of the public Health ministry. The latter item will be devoted to the development of health infrastructures and, prior to generalized compulsory health insurance, to the financing of health-care for the poorest. PMID:8076199

  16. Organizational economics and health care markets.

    PubMed Central

    Robinson, J C

    2001-01-01

    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

  17. Empowering women and health care.

    PubMed

    Shiva, M

    1993-02-01

    Women health workers have made great contributions to the health of their community for many years. In India, women physicians have established some hospitals, e.g., Christian Medical Colleges in Ludhiana and Vellore. Some such hospitals operate in remote areas to serve the poor and the suffering. Women health workers of Jamkhed, Deen Bandhu of Pachod, have proved that village women can improve the health status of their community, particularly that of women and children, if they receive encouragement to learn health care skills In India, community health care lies mainly with women (e.g., nursing personnel and in rural areas). Yet, despite their competence and experience, few become physicians, health project directors, and administrators because the society continues to be patriarchal and discriminates against females. Women need to become empowered to ensure equal opportunities for training and promotion and equal wages for equal work. In Bangladesh, use of bicycles to visit houses allows women paramedical workers from Gonasasthya Kendra, Sawar, freedom and imparts confidence. People must identify customs, practices, laws, attitudes, religious misrepresentations, and policies that discriminate against women and then oppose them. They should set these changes in motion at home, in villages, and from district to national, and even global levels. In India, society blames the mother for having a girl, but the man donates the chromosome determining sex. In Gandhigram, a woman physician and her peers have effected an apparent change in attitude toward the birth of a girl. Now the people confer equal happiness to her birth as they do to a boy's birth. Yet, female infanticides still occur in some villages of Salem District of Tamil Nadu. Sex determination tests often lead to abortion of female fetuses. Once a woman marries she has no right to her maternal home and often suffers from domestic violence. Many people resist legislation to grant women more rights, e.g., property rights. Various media promote women's empowerment. PMID:12286352

  18. Families, Managed Care, & Children's Mental Health.

    ERIC Educational Resources Information Center

    McManus, Marilyn C., Ed.

    1996-01-01

    This theme issue of a bulletin on family support and children's mental health focuses on managed care and the impact on children who are in need of mental health services. Articles include: "Private Sector Managed Care and Children's Mental Health" (Ira S. Lourie and others); "Just What Is Managed Care?" (Chris Koyanagi); "Managed Behavioral…

  19. The development of the Quality Indicator for Rehabilitative Care (QuIRC): a measure of best practice for facilities for people with longer term mental health problems

    PubMed Central

    2011-01-01

    Background Despite the progress over recent decades in developing community mental health services internationally, many people still receive treatment and care in institutional settings. Those most likely to reside longest in these facilities have the most complex mental health problems and are at most risk of potential abuses of care and exploitation. This study aimed to develop an international, standardised toolkit to assess the quality of care in longer term hospital and community based mental health units, including the degree to which human rights, social inclusion and autonomy are promoted. Method The domains of care included in the toolkit were identified from a systematic literature review, international expert Delphi exercise, and review of care standards in ten European countries. The draft toolkit comprised 154 questions for unit managers. Inter-rater reliability was tested in 202 units across ten countries at different stages of deinstitutionalisation and development of community mental health services. Exploratory factor analysis was used to corroborate the allocation of items to domains. Feedback from those using the toolkit was collected about its usefulness and ease of completion. Results The toolkit had excellent inter-rater reliability and few items with narrow spread of response. Unit managers found the content highly relevant and were able to complete it in around 90 minutes. Minimal refinement was required and the final version comprised 145 questions assessing seven domains of care. Conclusions Triangulation of qualitative and quantitative evidence directed the development of a robust and comprehensive international quality assessment toolkit for units in highly variable socioeconomic and political contexts. PMID:21362167

  20. ARTEMIS: a collaborative framework for health care.

    PubMed

    Reddy, R; Jagannathan, V; Srinivas, K; Karinthi, R; Reddy, S M; Gollapudy, C; Friedman, S

    1993-01-01

    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

  1. Practical Applications of Confidentiality Rules to Health Care Transition Instruction

    ERIC Educational Resources Information Center

    Repetto, Jeanne B.; Gibson, Robert W.; Lubbers, Joyce H.; Gritz, Sheila; Reiss, John

    2008-01-01

    The increase in the number of students with disabilities and special health care needs and their need for health care transition (HCT) creates opportunity for education and health services professionals to work together. In response to this opportunity, the authors developed an HCT teaching module for 6th to 12th graders. A concern that surfaced…

  2. Measures of Readiness to Transition to Adult Health Care for Youth With Chronic Physical Health Conditions: A Systematic Review and Recommendations for Measurement Testing and Development

    PubMed Central

    Daniel, Lauren C.; Brumley, Lauren D.; Barakat, Lamia P.; Wesley, Kimberly M.; Tuchman, Lisa K.

    2014-01-01

    Objective Review measures of readiness to transition to adult-oriented care for youth with chronic physical health conditions. Methods Identified measures via online searches and reference lists and reviewed methods of development, theoretical underpinnings, characteristics, and psychometrics. Measures were classified according to American Psychological Association Division 54 Evidence-Based Assessment (EBA) Task Force criteria. Strengths and weaknesses of reviewed measures were described. Results 56 measures were identified, of which 10 met inclusion criteria for this review. 6 were disease specific and 4 were generic. Some psychometric properties were reported for each; none reported predictive validity for transition outcomes. According to EBA criteria, the 10 measures met criteria for “promising” assessment. Conclusions Measurement development in transition readiness is still an underdeveloped area. Measures require further testing and new measures are needed. Recommendations include testing measures with larger and diverse samples, ground measures in theory, test psychometrics, and involve multiple stakeholders in measure development. PMID:24891440

  3. Carbon-constrained health care enterprise.

    TOXLINE Toxicology Bibliographic Information

    Gell M

    2010-02-01

    RATIONALE: The health economy is a significant part of a national economy accounting typically for about 8% of GDP spent. As national economies respond to the dual challenges of severe economic turbulence on the global scale and climate change mitigation, the health economy is coming under increasing pressure to respond. Indications for sharp reductions in budgets and reductions in greenhouse gas emissions, such as carbon dioxide, are widespread.AIMS: In this paper an analysis is undertaken of the diverse forces acting on a typical health care enterprise. The forces, both economic and carbon related, are investigated in terms of their effects through the enterprise and across its boundaries on the supply, demand and waste sides. The overall aim is to show how the enterprise and whole supply chains may flip synchronously into a low-carbon evolutionary pathway.OBJECTIVES: By illustrating how different elements of the health care enterprise may respond to these developments, diverse opportunities for cost reduction, carbon reduction and product (goods and services) development are identified. These opportunities involve a variety of waste reduction and energy and materials conservation measures as well as new ways of collaborating with other enterprises going through similar transformations. The overall objective is to show that the carbon-constrained health care enterprise and the low-carbon health economy in which it sits may broaden its role in the coming decades to include a degree of responsibility for the health of the environment. This broader role is likely to supplement and entangle with the traditional role of the health economy, currently focused narrowly on human health, and lead to extensive organisational transformation, and infrastructure and product developments.

  4. [Costs of maternal-infant care in an institutionalized health care system].

    PubMed

    Villarreal Ríos, E; Salinas Martínez, A M; Guzmán Padilla, J E; Garza Elizondo, M E; Tovar Castillo, N H; García Cornejo, M L

    1998-01-01

    Partial and total maternal and child health care costs were estimated. The study was developed in a Primary Care Health Clinic (PCHC) and a General Hospital (GH) of a social security health care system. Maternal and child health care services, type of activity and frequency utilization during 1995, were defined; cost examination was done separately for the PCHC and the GH. Estimation of fixed cost included departmentalization, determination of inputs, costs, basic services disbursements, and weighing. These data were related to depreciation, labor period and productivity. Estimation of variable costs required the participation of field experts; costs corresponded to those registered in billing records. The fixed cost plus the variable cost determined the unit cost, which multiplied by the of frequency of utilization generated the prenatal care, labor and delivery care, and postnatal care cost. The sum of these three equaled the maternal and child health care cost. The prenatal care cost was $1,205.33, the labor and delivery care cost was $3,313.98, and the postnatal care was $559.91. The total cost of the maternal and child health care corresponded to $5,079.22. Cost information is valuable for the health care personnel for health care planning activities. PMID:9528219

  5. Game Maturity Model for Health Care.

    PubMed

    de Boer, Jan C; Adriani, Paul; van Houwelingen, Jan Willem; Geerts, A

    2016-04-01

    This article introduces the Game Maturity Model for the healthcare industry as an extension to the general Game Maturity Model and describes the usage by two case studies of applied health games. The Game Maturity Model for healthcare provides a practical and value-adding method to assess existing games and to determine strategic considerations for application of applied health games. Our forecast is that within 5 years the use and development of applied games will have a role in our daily lives and the way we organize health care that will be similar to the role social media has today. PMID:26859720

  6. Health care reform: possibilities & opportunities for primary care.

    PubMed

    Wexler, Randy; Hefner, Jennifer; Welker, Mary Jo; McAlearney, Ann Scheck

    2014-06-01

    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

  7. Medicare, health care reform, and older adults.

    PubMed

    McCracken, Ann L

    2010-12-01

    Nurses will play a key role in health care reform, educating and engaging consumers, providing input into and monitoring implementation, and assisting organizations with transition to new policies. As the largest group of professional health care providers, nurses must be key players in the actualization of health care reform. This article addresses how The Patient Protection and Affordable Care Act of 2010 and the Health Care and Education Reconciliation Act of 2010 will affect the solvency of Medicare, what older adults will gain, effects on quality and effectiveness of care, cost reduction, changes in taxes, and the key provisions of special interest to nurses. PMID:21117526

  8. Flipping primary health care: A personal story.

    PubMed

    Mate, Kedar S; Salinas, Gilbert

    2014-12-01

    There is considerable interest in ideas borrowed from education about "flipping the classroom" and how they might be applied to "flipping" aspects of health care to reach the Triple Aim of improved health outcomes, improved experience of care, and reduced costs. There are few real-life case studies of "flipping health care" in practice at the individual patient level. This article describes the experience of one of the authors as he experienced having to "flip" his primary health care. We describe seven inverted practices in his care, report outcomes of this experiment, describe the enabling factors, and derive lessons for patient-centered primary care redesign. PMID:26250637

  9. Medicare and health care reform.

    PubMed

    Moon, M

    1994-01-01

    Although Medicare constitutes one of the most popular programs of the federal government, even its most ardent supporters would likely agree that improvements could be made and likely should be part of any package of comprehensive health care reform. While some changes could be made as stand-alone reforms, it would be better to integrate changes for the under 65-population with those for the Medicare program. For example, cost-containment strategies would work best if they applied to the population as a whole rather than creating differences that lead to cost-shifting and possible discrimination across groups. The generosity of services covered also ought to be balanced between Medicare and whatever happens elsewhere. This would allow Medicare's cost-sharing structure to be less severe in terms of hospital and skilled nursing care, for example. Finally, while it is tempting to use reductions in spending on Medicare as a means for helping to finance other expansions, the impact of such changes needs to be carefully assessed before assuming that they would create no lasting problems. This essay examines some of the options and likely consequences for Medicare as part of comprehensive health reform. PMID:10186858

  10. Toward the Development of a Lupus Interactive Navigator to Facilitate Patients and Their Health Care Providers in the Management of Lupus: Results of Web-Based Surveys

    PubMed Central

    Neville, Carolyn; DaCosta, Deborah; Rochon, Murray; Eng, Davy

    2014-01-01

    Background Systemic lupus erythematosus is an inflammatory autoimmune disease associated with high morbidity and unacceptable mortality. Information and management tools are needed to help persons with lupus cope with their illness and facilitate health care providers in the delivery of care. Objective The objective of the study was to assess the needs and find solutions to support persons with lupus and their health care providers. Methods Web-based surveys were distributed across Canada to persons with lupus and their relatives (n=3119), rheumatologists (n=517), and arthritis health professionals (AHPs) (n=226) by Lupus Canada, the Canadian Rheumatology Association, and the Arthritis Health Professions Association, respectively. Results The survey sample comprised 665 (21.3%) persons with lupus, 98 (19.0%) rheumatologists, and 74 (32.7%) AHPs. Among the participants with lupus, 92.4% were female, the average age was 46.8 (SD 12.7) years, 79.2% were Caucasian, and 58.8% were employed. All Canadian provinces and territories were represented. The majority (43.3%) of respondents were from Ontario. Mean disease duration was 10.2 (SD 9.5) years, and 41.9% rated their global assessment as fair or poor. There was high agreement between lupus participants and health care providers regarding disease-specific information topics. All groups rated topics related to lupus, fatigue, medications, and stress as most important. Ratings differed among lupus participants and their health care providers regarding perceived helpfulness of some of the patient tools, such as the option to view test results. Needs differed for persons with lupus based on age, sex, depression, stress, and disease activity. Differences in health care provider needs were based on amount of experience in treating lupus. Conclusions Information and support tools needed for persons with lupus and their health care providers were identified. These results will help guide us in the development of a Web-based Lupus Interactive Navigator as an intervention tool to help persons with lupus self-manage their disease and to facilitate heath care providers in clinical management. PMID:25533760

  11. Health Care Reform and the Academic Health Center.

    ERIC Educational Resources Information Center

    Kimmey, James R.

    1994-01-01

    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…

  12. Development and Initial Validation of a Questionnaire to Measure Hearing Parents' Perceptions of Health Care Professionals' Advice

    ERIC Educational Resources Information Center

    Day, Lori A.; Brice, Patrick

    2013-01-01

    This study reports the development of The Hearing Parents' Perceptions of Health Professionals' Advice Questionnaire (HPP/HPQ). This questionnaire was designed to investigate the impact of the advice and information that parents receive from health professionals during the time when their child's hearing loss is identified and how parents, in

  13. How prenatal care can improve maternal health.

    PubMed

    1993-01-01

    Prenatal care aims to preserve the health of the fetus and mother. It screens for indications of illness or pregnancy-related complications and tries to prevent them from becoming emergencies. Sufficient referral services are needed for prenatal screening to be effective. Women and their families must be motivated to go to them promptly. Often prenatal care is the first time women receive any medical care. Thus, quality care is imperative so women will again request medical care when necessary. Prenatal care providers must ask women about signs and symptoms of placenta previa and placental abruptio. They should also tell them about the gravity of hemorrhaging in late pregnancy. Referral facilities must have operative capabilities and be able to provide adequate transfusion to treat severe hemorrhage. Health workers must prevent and treat anemia in pregnant women to improve their chances of recovery from blood loss; they must also measure blood pressure and periodically test for proteinuria and edema to diagnose preeclampsia, eclampsia, and hypertension. Health workers must screen women at high risk for cephalopelvic disproportion (e.g. by assessing, height, foot size, and age) and for a malpositioned fetus and multiple pregnancies (e.g. via abdominal examination). They must also educate mothers about the importance of hygienic delivery and provide sanitary delivery kits. Unhygienic delivery conditions and untreated sexually transmitted diseases (STDs) can cause puerperal sepsis. STDs can also have other adverse effects such as ectopic pregnancy and blindness, death, or retardation of the fetus/ infant. STD screening could prevent needless suffering in many women; 5-15% of pregnant women in some developing countries have syphilis. Prenatal care should include screening for urinary tract infections which can cause preterm delivery and low birth weight. Antibiotics can treat these infections. Some pregnant women have infectious diseases which may undetected without prenatal care. PMID:12286437

  14. Health care reform--where ADA stands.

    PubMed

    Finn, S C; Gallagher, A

    1993-09-01

    Few issues have galvanized the American public as dramatically as health care reform. Virtually everyone agrees that health care costs, quality, and accessibility require close examination and a prescription for change. Not everyone, however, agrees on the exact nature of this change. It is extremely important that we awaken the public and our policy makers to the vital role nutrition plays in the health care system. ADA is dedicated to this effort. Stay tuned as the health care reform plan unfolds. This effort is likely to be long term and will require your commitment, dedication, and energy to make nutrition services in health care reform a reality. PMID:8360412

  15. A telemedicine health care delivery system

    NASA Technical Reports Server (NTRS)

    Sanders, Jay H.

    1991-01-01

    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.

  16. Improving America's health care system by investing in information technology.

    PubMed

    Coye, Molly Joel; Bernstein, William S

    2003-01-01

    Large-scale investment in health care information technology (IT) infrastructure will not take place without leadership by the federal government. But how the federal government supports the financing of health care IT is critical. Health care IT development has multiple aspects, but it is fundamentally a problem of community infrastructure development. A policy approach that has had consistent success in financing our country's essential physical infrastructure in transportation and environmental protection will be well suited to fostering health care IT infrastructure as well. We propose the creation of a health care IT revolving loan fund program to invest public dollars in health care IT infrastructure projects through community-level nonprofit lending agencies. PMID:12889750

  17. The challenges of developing an instrument to assess health provider motivation at primary care level in rural Burkina Faso, Ghana and Tanzania

    PubMed Central

    Prytherch, Helen; Leshabari, Melkidezek T.; Wiskow, Christiane; Aninanya, Gifty A.; Kakoko, Deodatus C.V.; Kagoné, Moubassira; Burghardt, Juliane; Kynast-Wolf, Gisela; Marx, Michael; Sauerborn, Rainer

    2012-01-01

    Background The quality of health care depends on the competence and motivation of the health workers that provide it. In the West, several tools exist to measure worker motivation, and some have been applied to the health sector. However, none have been validated for use in sub-Saharan Africa. The complexity of such tools has also led to concerns about their application at primary care level. Objective To develop a common instrument to monitor any changes in maternal and neonatal health (MNH) care provider motivation resulting from the introduction of pilot interventions in rural, primary level facilities in Ghana, Burkina Faso, and Tanzania. Design Initially, a conceptual framework was developed. Based upon this, a literature review and preliminary qualitative research, an English-language instrument was developed and validated in an iterative process with experts from the three countries involved. The instrument was then piloted in Ghana. Reliability testing and exploratory factor analysis were used to produce a final, parsimonious version. Results and discussion This paper describes the actual process of developing the instrument. Consequently, the concepts and items that did not perform well psychometrically at pre-test are first presented and discussed. The final version of the instrument, which comprises 42 items for self-assessment and eight for peer-assessment, is then shown. This is followed by a presentation and discussion of the findings from first use of the instrument with MNH providers from 12 rural, primary level facilities in each of the three countries. Conclusions It is possible to undertake work of this nature at primary health care level, particularly if the instruments are kept as straightforward as possible and well introduced. However, their development requires very lengthy preparatory periods. The effort needed to adapt such instruments for use in different countries within the region of sub-Saharan Africa should not be underestimated. PMID:23043816

  18. An ethical framework for rationing health care.

    PubMed

    Jecker, N S; Pearlman, R A

    1992-02-01

    This paper proposes an ethical framework for rationing publicly-financed health care. We begin by classifying alternative rationing criteria according to their ethical basis. We then examine the ethical arguments for four rationing criteria. These alternatives include rationing high technology services, non-basic services, services to patients who receive the least medical benefit, and services that are not equally available to all. We submit that a just health care system will not limit basic health care to persons unable to pay for it. Furthermore, justice in health care requires limiting publicly-financed non-basic health care, striving for equality in access to basic health care, and relying on medical benefit to ration non-basic health care. PMID:1545186

  19. Health care: a brave new world.

    PubMed

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

    2015-03-01

    The current U.S. health care system, with both rising costs and demands, is unsustainable. The combination of a sense of individual entitlement to health care and limited acceptance of individual responsibility with respect to personal health has contributed to a system which overspends and underperforms. This sense of entitlement has its roots in a perceived right to health care. Beginning with the so-called moral right to health care (all life is sacred), the issue of who provides health care has evolved as individual rights have trumped societal rights. The concept of government providing some level of health care ranges from limited government intervention, a 'negative right to health care' (e.g., prevention of a socially-caused, preventable health hazard), to various forms of a 'positive right to health care'. The latter ranges from a decent minimum level of care to the best possible health care with access for all. We clarify the concept of legal rights as an entitlement to health care and present distributive and social justice counter arguments to present health care as a privilege that can be provided/earned/altered/revoked by governments. We propose that unlike a 'right', which is unconditional, a 'privilege' has limitations. Going forward, expectations about what will be made available should be lowered while taking personal responsibility for one's health must for elevated. To have access to health care in the future will mean some loss of personal rights (e.g., unhealthy behaviors) and an increase in personal responsibility for gaining or maintaining one's health. PMID:23494290

  20. The changing face of health care consumers.

    PubMed

    2001-01-01

    Caring for a diverse pool of patients is an ongoing challenge for health care practitioners and marketers. Communication difficulties and cultural misunderstandings still stand in the way and keep members of some minority populations from getting the health care they need. To better serve these groups, it's crucial to learn more about patients' values, needs, and expectations. Fortunately, opportunities abound for health care marketers to learn about and effectively target these still largely underserved populations. PMID:11763652

  1. Health Care Reform: Opportunities for Improving Adolescent Health.

    ERIC Educational Resources Information Center

    Irwin, Charles E., Jr., Ed.; And Others

    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…

  2. Personnel for Health Care: Case Studies of Educational Programmes. Public Health Papers No. 70.

    ERIC Educational Resources Information Center

    Katz, F. M., Ed.; Fulop, T., Ed.

    Innovations in the training of community health personnel that emphasize the importance of the development of health personnel able and willing to serve the community by providing health care, promoting health, preventing disease, and caring for those in need are examined. The need for effective and efficient training programs relevant to present…

  3. Personnel for Health Care: Case Studies of Educational Programmes. Public Health Papers No. 70.

    ERIC Educational Resources Information Center

    Katz, F. M., Ed.; Fulop, T., Ed.

    Innovations in the training of community health personnel that emphasize the importance of the development of health personnel able and willing to serve the community by providing health care, promoting health, preventing disease, and caring for those in need are examined. The need for effective and efficient training programs relevant to present

  4. Telematics for rural health care practitioners

    NASA Astrophysics Data System (ADS)

    Greenfield, Robert H.; Kardaun, Jan W. P. F.

    1990-06-01

    The " crisis" in rural health care i. e. the decreasing number of practitioners is partially caused by the increasing use of technology in health care. Health care practitioners in rural Canada are progressively finding their practice more difficult because of their isolation from the population centers housing many of the services and supplies needed in the modern practice of medicine. The centralization of these supplies and services results from the increasing use of technology in medicine. It is uneconomical to place expensive equipment highly trained technicians and consultants and well-stocked and current information sources in rural locations where they are underutilized. Thus over the years the increasing use of technology makes rural practice more difficult and less attractive in comparison to an urban practice that can easily and cheaply employ the benefits of technology and expert consultation. The Saskatchewan situation is examined using data collected by the authors and compared to other rural areas reported in the literature. The ways that computer communications can help alleviate this situation are explained and illustrated through a review of North American telematics activities. Telematic services for physicians are developing in North America. This is in synergy with the increasing ownership of computers by physicians. We contrast the Canadian scene with the American. Telematics is a technological approach that can be employed to reduce the isolation of rural health care practitioners. It can provide

  5. Controversies in faith and health care.

    PubMed

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

    2015-10-31

    Differences in religious faith-based viewpoints (controversies) on the sanctity of human life, acceptable behaviour, health-care technologies and health-care services contribute to the widespread variations in health care worldwide. Faith-linked controversies include family planning, child protection (especially child marriage, female genital mutilation, and immunisation), stigma and harm reduction, violence against women, sexual and reproductive health and HIV, gender, end-of-life issues, and faith activities including prayer. Buddhism, Christianity, Hinduism, Islam, Judaism, and traditional beliefs have similarities and differences in their viewpoints. Improved understanding by health-care providers of the heterogeneity of viewpoints, both within and between faiths, and their effect on health care is important for clinical medicine, public-health programmes, and health-care policy. Increased appreciation in faith leaders of the effect of their teachings on health care is also crucial. This Series paper outlines some faith-related controversies, describes how they influence health-care provision and uptake, and identifies opportunities for research and increased interaction between faith leaders and health-care providers to improve health care. PMID:26159392

  6. Designing the experience of health care.

    PubMed

    Whitney, Patrick

    2008-01-01

    New ideas and information services will be best served when they are examined from both the users' and the corporate perspective. It is imperative to identify what best serves the needs of the user while understanding the corporate context that would allow these products/services to be sustainable. The desired result is for users to feel included and become more active and involved in their lives and to be able to do so at a reasonable, sustainable price point. This collaboration is illustrated by several examples of health care product development including the development of a medication management system for patients and a diet assistance program for cardiac patients. In these examples, success is dependent on a solid relationship between people who have the methods to understand users and to develop products and people who have knowledge of the health care field and understand it in a business context. PMID:18430677

  7. Implementing a teenage health service in primary care.

    PubMed

    Green, Elizabeth; Larcombe, J; Horbury, I

    The health of teenagers is currently a priority of the NHS, with many schemes and projects being developed. There are documented difficulties for teenagers in accessing health care, especially within general practice. This article describes the development and evaluation of a tailor-made clinic in the primary care setting. PMID:16209395

  8. Transformation of health care in China.

    PubMed

    Hsiao, W C

    1984-04-01

    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

  9. The dominant influence of social context on CEO learning in health care: a challenge to traditional management continuing education and development.

    PubMed

    Chapman, Thomas W; Confessorre, Sharon

    2002-01-01

    Little is known about their learning preferences of the health care industry's most senior executives, particularly CEOs. This paper focuses on the "powerful mechanisms for CEO learning" made available to health care managers through "exclusive learning groups." By meeting ad hoc or regularly under the auspices of such organizations as The Aspen Institute, the American College of Health Care Executives, Healthcare Research and Development, Inc., and other professional and commercial organizations, CEOs come together to discuss the challenges and dilemmas of their jobs. This paper reports on a two-part research effort to determine why CEO exclusive learning groups are so effective. A survey of 70 CEOs in health care-related organizations and in-depth interviews with 8 CEOs reveals that CEOs use exclusive learning group sessions as social learning vehicles, as opportunities to create secondary-level executive networks, as mechanisms for achieving a competitive advantage, and as safe, confidential environments to try out new ideas, seek information, and build relationships. PMID:12625648

  10. Health care rationing and the ethics of publicity

    NASA Astrophysics Data System (ADS)

    Winslow, Gerald R.

    1995-10-01

    The need to set reasonable limits on expenditures for health care has led to increased discussion of rationing. Given the fact that no single vision of justice will dominate the allocation of health care, it is becoming increasingly important to establish open, democratic procedures for setting limits. Public awareness of the need for limits and public participation in establishing the limits is essential to the development of a just health care system.

  11. Community Health, Community Care, Community Support: Proceedings of the Invitational Conference on Innovative Childhood Care and Development Support Programs (Amsterdam, Netherlands, September 1996).

    ERIC Educational Resources Information Center

    Hanrahan, Marian, Ed.; Prinsen, Bert, Ed.

    The development of community-based programs to support inexperienced parents through home visits by experienced mothers, who are in turned facilitated by child health and development professionals, has become an increasingly common approach in Europe and the United States. This edited volume presents proceedings from an invitational conference on…

  12. Health care management in workers' compensation.

    PubMed

    Nikolaj, S; Boon, B

    1998-01-01

    A high-performing, effective health care delivery system is critical to the recovery of injured workers within a workers' compensation insurance system. Timely and effective health care has the potential to minimize indemnity costs and therefore contribute to the insurer's financial state. While costs remain a concern to insurers, cost-containment initiatives within the health care arena have evolved from a strict "deep discount" approach to more sophisticated health care strategies that follow managed care-style models. In the future, health care strategies are likely to become more integrated within the business operations of workers' compensation insurance systems. The next evolution of health care strategy within workers' compensation will likely include consensus-based contracts with providers that stipulate the role and function of each party while reinforcing a continuous improvement mindset. It is probable that a component of this evolving system will include shared risk and reimbursement that is based on performance. Insurers who begin to evaluate the true impact of a comprehensive health care strategy will find it necessary and advantageous to modify their business relationship with health care providers. Those who are able to articulate a business strategy that capitalizes on the skills of the health care community are likely to gain a competitive advantage. Most importantly, this bridging of intellectual capacity across the insurance and health care domains will result in a delivery system that is valued by, and contributes to, its key participants--the employers and the injured workers. PMID:9589449

  13. On reducing information asymmetry in U.S. health care.

    PubMed

    Mascarenhas, Oswald A J; Kesavan, Ram; Bernacchi, Michael D

    2013-01-01

    Information asymmetry is a significant issue facing the U.S. health care system. In this article, we investigate some methods of reducing this asymmetry. We trace the information asymmetry using the "wicked problem" of the health care distribution system. An information asymmetry reduction method requiring joint responsibilities among health care stakeholders is developed. It is argued that information asymmetry is a contributor to enormous health care inflation. Hence, any reduction in such asymmetry will reduce health care costs. Concepts from both signaling and corrective justice theories are integrated in this article to help reduce the information asymmetry that exists in the U.S. health care system. Getting health care costs in line with other "advanced" nations, is the long-term solution to the wicked problem that currently exists in the U.S. health care system. There is an immediate need for a centralized health care database with adequate provisions for individual privacy. Both processes as well as an outcome-based control system are essential for reducing information asymmetries in the U.S. health care system. PMID:24308415

  14. Integrating the 3Ds--social determinants, health disparities, and health-care workforce diversity.

    PubMed

    LaVeist, Thomas A; Pierre, Geraldine

    2014-01-01

    The established relationships among social determinants of health (SDH), health disparities, and race/ethnicity highlight the need for health-care professionals to adequately address SDH in their encounters with patients. The ethnic demographic transition slated to occur during the next several decades in the United States will have numerous effects on the health-care sector, particularly as it pertains to the need for a more diverse and culturally aware workforce. In recent years, a substantial body of literature has developed, exploring the extent to which diversity in the health-care workforce may be used as a tool to eliminate racial/ethnic disparities in health and health care in the U.S. We explore existing literature on this topic, propose a conceptual framework, and identify next steps in health-care policy for reducing and eliminating health disparities by addressing SDH and diversification of the health-care workforce. PMID:24385659

  15. [Elderly care in the supplementary health system].

    PubMed

    Veras, Renato Peixoto; Caldas, Célia Pereira; Araújo, Denizar Viana; Mendes, Rosana Kuschniere Walter

    2008-01-01

    The purpose of this study was to identify and analyze the assistance provided to the elderly by the supplementary health care system. Information was collected from interviews with managers of chronic diseases management programs and/or of specific programs in this area. Information was organized in cases and analyzed. Eleven companies operating private health plans in the cities of Rio de Janeiro and Sao Paulo were investigated. A general care model for the elderly was defined for the analysis. This model consists in a proposal for a care and assistance system hierarchically organized according to the deterioration of the functional capacity of the elderly (levels of dependence). None of the six companies that had health plans for the elderly already implemented provided full assistance to all enrolled seniors. There are major differences in the stage of development of their programs. Four companies had already implemented plans and two companies had plans in development. Even with the teams of managers and professionals working on some level within the advocated model, none of these companies followed any logic of integrated care and monitoring in all stages of the ageing process in accordance with the degree of dependence of the associate. PMID:18813610

  16. Equity in health care utilization in Chile.

    PubMed

    Núñez, Alicia; Chi, Chunhuei

    2013-01-01

    One of the most extensive Chilean health care reforms occurred in July 2005, when the Regime of Explicit Health Guarantees (AUGE) became effective. This reform guarantees coverage for a specific set of health conditions. Thus, the purpose of this study is to provide timely evidence for policy makers to understand the current distribution and equity of health care utilization in Chile.The authors analyzed secondary data from the National Socioeconomic Survey (CASEN) for the years 1992-2009 and the 2006 Satisfaction and Out-of-Pocket Payment Survey to assess equity in health care utilization using two different approaches. First, we used a two-part model to estimate factors associated with the utilization of health care. Second, we decomposed income-related inequalities in medical care use into contributions of need and non-need factors and estimated a horizontal inequity index.Findings of this empirical study include evidence of inequities in the Chilean health care system that are beneficial to the better-off. We also identified some key factors, including education and health care payment, which affect the utilization of health care services. Results of this study could help researchers and policy makers identify targets for improving equity in health care utilization and strengthening availability of health care services accordingly. PMID:23937894

  17. Equity in health care utilization in Chile

    PubMed Central

    2013-01-01

    One of the most extensive Chilean health care reforms occurred in July 2005, when the Regime of Explicit Health Guarantees (AUGE) became effective. This reform guarantees coverage for a specific set of health conditions. Thus, the purpose of this study is to provide timely evidence for policy makers to understand the current distribution and equity of health care utilization in Chile. The authors analyzed secondary data from the National Socioeconomic Survey (CASEN) for the years 1992–2009 and the 2006 Satisfaction and Out-of-Pocket Payment Survey to assess equity in health care utilization using two different approaches. First, we used a two-part model to estimate factors associated with the utilization of health care. Second, we decomposed income-related inequalities in medical care use into contributions of need and non-need factors and estimated a horizontal inequity index. Findings of this empirical study include evidence of inequities in the Chilean health care system that are beneficial to the better-off. We also identified some key factors, including education and health care payment, which affect the utilization of health care services. Results of this study could help researchers and policy makers identify targets for improving equity in health care utilization and strengthening availability of health care services accordingly. PMID:23937894

  18. [European evolution of the copayment in health costs: possible developments and reorganization proposals for Italian health care system. The role of additional kind of assistance].

    PubMed

    Mastrobuono, Isabella; Visconti, G; Sorbara, D; Labate, G

    2012-01-01

    The ticket, once considered just dissuasive or control instrument, has become citizens sharing of the costs of activities, services and performance of NHS. The difficult economic situation, that applies the main European countries, is leading in Italy to an increase measures of copayment. The use of over-sharing may drive, however, to important consequences in terms of equity, efficiency and cost containment of health. Copayment does not reduce the overall burden of spending, because often counterbalanced by a concomitant increase in private spending. In fact, Italian private expenditure on health "out of pocket" is the highest in Europe and more Italians discover the "low cost health care." The Authors propose to limite the introduction of new ticket or exacerbate the existing, focusing on the adherence of citizens to health and social integrative funds, that are now present on the national scene with about 5 million of members. PMID:23064088

  19. Engaging doctors in the health care revolution.

    PubMed

    Lee, Thomas H; Cosgrove, Toby

    2014-06-01

    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

  20. Ethics, economics, and public financing of health care

    PubMed Central

    Hurley, J.

    2001-01-01

    There is a wide variety of ethical arguments for public financing of health care that share a common structure built on a series of four logically related propositions regarding: (1) the ultimate purpose of a human life or human society; (2) the role of health and its distribution in society in advancing this ultimate purpose; (3) the role of access to or utilisation of health care in maintaining or improving the desired level and distribution of health among members of society, and (4) the role of public financing in ensuring the ethically justified access to and utilisation of health care by members of society. This paper argues that economics has much to contribute to the development of the ethical foundations for publicly financed health care. It focuses in particular on recent economic work to clarify the concepts of access and need and their role in analyses of the just distribution of health care resources, and on the importance of economic analysis of health care and health care insurance markets in demonstrating why public financing is necessary to achieve broad access to and utilisation of health care services. Key Words: Ethics • economics • health care financing PMID:11479353