These are representative sample records from Science.gov related to your search topic.
For comprehensive and current results, perform a real-time search at Science.gov.
1

Challenges for health care development in Croatia.  

PubMed

The main aim of the research done in this paper was to establish key challenges and perspectives for health care development in the Republic of Croatia in the next two decades. Empirical research was conducted in the form of semi-structured interviews involving 49 subjects, representatives of health care professionals from both, public and private sectors, health insurance companies, pharmaceutical companies, drug wholesalers, and non-governmental organisations (patient associations). The results have shown that key challenges and problems of Croatian health care can be divided into three groups: functioning of health care systems, health care personnel, and external factors. Research has shown that key challenges related to the functioning of health care are inefficiency, financial unviability, inadequate infrastructure, and the lack of system transparency. Poor governance is another limiting factor. With regard to health care personnel, they face the problems of low salaries, which then lead to migration challenges and a potential shortage of health care personnel. The following external factors are deemed to be among the most significant challenges: ageing population, bad living habits, and an increase in the number of chronic diseases. However, problems caused by the global financial crisis and consequential macroeconomic situation must not be neglected. Guidelines for responding to challenges identified in this research are the backbone for developing a strategy for health care development in the Republic of Croatia. Long-term vision, strategy, policies, and a regulatory framework are all necessary preconditions for an efficient health care system and more quality health services. PMID:23213924

Ostoji?, Rajko; Bilas, Vlatka; Franc, Sanja

2012-09-01

2

Future developments in health care performance management  

PubMed Central

This paper highlights the challenges of performance management in health care, wherein multiple different objectives have to be pursued. The literature suggests starting with quality performance, following the sand cone theory, but considering a multidimensional concept of health care quality. Moreover, new managerial approaches coming from an industrial context and adapted to health care, such as lean management and risk management, can contribute to improving quality performance. Therefore, the opportunity to analyze them arises from studying their overlaps and links in order to identify possible synergies and to investigate the opportunity to develop an integrated methodology enabling improved performance. PMID:24255600

Crema, Maria; Verbano, Chiara

2013-01-01

3

Health Care System Reforms in Developing Countries  

PubMed Central

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

Han, Wei

2012-01-01

4

Cultural Competence in Health Care: Implications for Human Resource Development  

Microsoft Academic Search

This paper reviews the need for cultural competence in health care, the barriers faced by health care professionals as they attempt to deliver culturally competent care, and the implications for human resource development initiatives. Already the most ethnically diverse country in the world, the US, is experiencing dramatic increases in its ethnic mix. As Taylor (2005) notes, these changing demographics

Rosemarie Angela Taylor; Mary V. Alfred

5

Education and health care in developing countries  

E-print Network

This thesis is a collection of three essays on education and health in developing countries. Chapter 1 shows that increasing perceived returns to education strengthens incentives for schooling when agents underestimate the ...

Nguyen, Trang V

2008-01-01

6

Global development challenges and health care reform.  

PubMed

Changes in the role of the state and private sector are seen as central to success of many health care reforms. The article argues for a more focused "stewardship" function of governments in securing equity, efficiency, and quality objectives through more effective policy making (steering), regulating, contracting, and ensuring that adequate financing arrangements are available for the whole population. At the same time, the author argues a strong case for greater private participation in providing health services (rowing). The article reviews related reform trends in health care financing, generation of inputs and service providers. It concludes that reforms often fail, not because of a flawed technical design, but because of other factors. These include a lack of political commitment to change, resistance from vested stakeholders who fear loosing some of their existing benefits, and a failure by policymakers to translate successful aspects of the reforms into something visible that ordinary people and the public can see with their own eyes when next they use the reformed services. PMID:11858008

Preker, A S

2001-01-01

7

Intercultural Competence in Health Care Developing Skills for Interculturally Competent Care  

Microsoft Academic Search

major challenge for today's health care providers around most of the world is that culturally diverse groups comprise the largest growing segment of the patient population. Individual health care choices and outcomes must be understandable to patients in terms of their own culture and experience. Thus, health care workers are faced with the need to develop intercultural competencies that allow

Rohini Anand; Indra Lahiri

8

Adult day health care evaluation study: methodology and implementation. Adult Day Health Care Evaluation Development Group.  

PubMed Central

The Adult Day Health Care Evaluation Study was developed in response to a congressional mandate to study the medical efficacy and cost effectiveness of the Adult Day Health Care (ADHC) effort in the Department of Veterans Affairs (VA). Four sites providing ADHC in VA facilities are participating in an ongoing randomized controlled trial. Three years of developmental work prior to the study addressed methodological issues that were problematic in previous studies. This developmental work resulted in the methodological approaches described here: (1) a patient recruitment process that actively recruits and screens all potential candidates using empirically developed admission criteria based on predictors of nursing home placement in VA; (2) the selection and development of measures of medical efficacy that assess a wide range of patient and caregiver outcomes with sufficient sensitivity to detect small but clinically important changes; and (3) methods for detailed, accurate, and efficient measurement of utilization and costs of health care within and outside VA. These approaches may be helpful to other researchers and may advance the methodological sophistication of long-term care program evaluation. PMID:1991678

Hedrick, S C; Rothman, M L; Chapko, M; Inui, T S; Kelly, J R; Ehreth, J

1991-01-01

9

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

Federal Register 2010, 2011, 2012, 2013

...Cooperative Agreement; Correctional Health Care Executive Curriculum Development...competency- based correctional health care executive curriculum to train two-person...services and personnel, correctional health care executives must judiciously...

2011-07-27

10

Economic development and the health care system in Hong Kong.  

PubMed

This article describes parallel developments of the Hong Kong economy and its health care system. The purpose is to illustrate how the Hong Kong health system evolved in response to external and internal pressures generated by economic prosperity. The Hong Kong system illustrates the importance of clear policy making in the face of these pressures. In particular, issues of investment, financing and distribution of health services are examined in relation to hospital cost control and service accessibility. In the past, health care costs in Hong Kong have been controlled at the expense of limited accessibility of health services. At present, Hong Kong policy-makers are faced with the challenge of maintaining a sharp focus on cost control as they face pressure to expand and improve health care coverage for the citizens. So far they have responded by emphasizing management efficiency through reorganization. It remains to be seen whether this strategy can be successful without passing increased health care costs to the consumers. PMID:10135878

Chu, D K

1994-06-01

11

Report on the International Conference on Emergency Health Care Development.  

PubMed Central

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

Dines, G B

1990-01-01

12

[Primary health care and the millennium development goals].  

PubMed

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

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

2012-01-01

13

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

PubMed

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

José, M V; Kumate, J; Barnard, A

1989-01-01

14

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

ERIC Educational Resources Information Center

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,…

Halfon, Neal; Russ, Shirley; Regalado, Michael

2005-01-01

15

Developing a health care strategy: a results-based approach.  

PubMed

In today's corporate environment, health care managers will be evaluated on performance--and forward-thinking companies are already quantifying their health care success. How this performance is defined and measured will differ from company to company, but shaping the definition and aligning it with the overall business strategy ensures success. PMID:10142764

Sperling, K L

1995-01-01

16

EUROAMERITEL `98 CONFERENCE ``Developing Cooperation in Telematics for Health Care and Education and Training''  

E-print Network

EUROAMERITEL `98 CONFERENCE ``Developing Cooperation in Telematics for Health Care and Education CONFERENCE ``Developing Cooperation in Telematics for Health Care and Education and Training'' June 8 th ­ 10 CONFERENCE ``Developing Cooperation in Telematics for Health Care and Education and Training'' June 8 th ­ 10

Miguel-Alonso, José

17

Women Veterans Health Care  

MedlinePLUS

... Health Care » Women Veterans Health Care Women Veterans Health Care Womens Health Women Veterans Health Care Home Program ... Breast Cancer Awareness Healthy Aging WVCC Women Veterans Health Care Did you know that women are the fastest ...

18

Lessons learned in developing community mental health care in Europe  

PubMed Central

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

SEMRAU, MAYA; BARLEY, ELIZABETH A.; LAW, ANN; THORNICROFT, GRAHAM

2011-01-01

19

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

PubMed Central

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

Berman, P.

2000-01-01

20

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

PubMed Central

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

2013-01-01

21

Community Health Development: A Strategy for Reinventing America’s Health Care System One Community at a Time  

Microsoft Academic Search

The purpose of this article is to propose a set of ideas for reinventing America’s health care system, one community at a\\u000a time. Community health development is proposed as a strategy and approach to population health improvement, the ultimate goal\\u000a of health care reform. The practice of community health development, particularly the partnership approach, provides guidance\\u000a about how this approach

Michael R. J. Felix; James N. Burdine; Monica L. Wendel; Angie Alaniz

2010-01-01

22

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

PubMed

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

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

2012-11-01

23

[Commodification of health care services for development: the case of Colombia].  

PubMed

This is a succinct analysis of the circular relationship between health and development and the changes occurring over recent decades regarding health care services production and delivery that have resulted in a new paradigm. From the late 1970s through the 1980s, three major, worldwide shifts occurred that changed health care services in Colombia and in other Latin American countries: the privatization of government entities, the commodification of health care services, and the failure of the Soviet model. Health care system reform in Colombia, considered by some experts to be a model, is an example of health care commodification that, 15 years later, has not achieved the coverage, nor the equity, nor the efficiency, nor the quality, that it should have. More so than the market, the problem has been with the market entities that seek disproportionate profits. A solution for this situation is to appeal to nonprofit organizations for the purchase and sale of health care services. PMID:19115549

Echeverri, Oscar

2008-09-01

24

What technologies for health care in developing countries?  

PubMed

In order to decide whether a health technology is suitable for introduction into a developing country it is first necessary to assess both it and the infrastructural conditions in which it would have to function. The present article examines the rationale for establishing national health technology assessment programmes and outlines how they might be conducted. PMID:1466744

Perry, S; Marx, E S

1992-01-01

25

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

ERIC Educational Resources Information Center

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…

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

26

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

SciTech Connect

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.

Engi, D. [Sandia National Labs., Albuquerque, NM (United States); Icerman, L. [Icerman & Associates, Santa Fe, NM (United States)

1995-06-01

27

The contribution of Primary Health Care Research, Evaluation and Development-supported research to primary health care policy and practice.  

PubMed

The importance of primary health care (PHC) research is well understood yet conducting this research can be challenging. Barriers include a lack of funding, support and opportunity. In 2000 the Australian government introduced the Primary Health Care Research, Evaluation and Development (PHCRED) Strategy to address the gap in high-quality research. One component of the strategy, the Research Capacity Building Initiative, provided funding to university departments of general practice and rural health, allowing them to expand their pool of researchers and produce more research relevant to policy and practice. This study investigates the impact of phase two of the PHCRED Strategy by analysing peer-reviewed publications from PHCRED-supported departments. Research output was recorded from 2006 to 2010 incorporating 661 publications in 212 journals. Rural departments often had fewer resources than urban departments yet demonstrated steady research contributions focusing on issues relevant to their community. Since its inception the PHCRED Strategy has enabled development of research capacity and contributed to the body of PHC knowledge. While PHC is a diverse field, reflected in the publications produced, the themes underlying much of this work were representative of current health reform and the priority areas and building blocks of the National PHC Strategy. PMID:23092638

Brown, Lynsey J; McIntyre, Ellen L

2014-01-01

28

Get Affordable Health Care  

MedlinePLUS

... icio.us Digg Facebook Google Bookmarks Get Affordable Health Care The Health Resources and Services Administration (HRSA) is ... and other care facilities to help people get health care they can afford. Health Centers Health centers provide ...

29

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

PubMed

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

Thornicroft, Graham; Tansella, Michele; Law, Ann

2008-01-01

30

Ethical dilemmas of health care in the developing nations.  

PubMed

Limited resources, widespread poverty, and the absence of health insurance pose daily ethical problems for Third World physicians, who must balance their roles as individual patient advocates against a desire to provide health care to the greatest number of children. Pakistan has a per capita income of Rs. 7,220 (US$ 380) per year, or Rs. 800 (US$ 32) per month. The annual population growth of the country is 3.1%, and approximately 360,000 infants are born each year in Karachi, the largest city in the country. The Aga Khan University Hospital, a private teaching institution, is the only hospital in Karachi with a Level III Neonatal Intensive Care Unit (NICU). The financial and medical data of 200 infants admitted to the NICU in 1988 were reviewed retrospectively, and compared with those of two specific subgroups. (1) Among 15 infants who underwent surgical intervention, the average total cost of hospitalization was Rs. 36,040 (US$ 1,900) per patient, with an average daily cost of Rs. 923 (US$ 49). The longest hospital stay was 6 months, for a child who had total colonic aganglionosis associated with a short gut syndrome. There were two deaths in this group. (2) Of the 21 premature neonates admitted having Idiopathic Respiratory Distress Syndrome (IRDS) during this period, the total hospitalization cost per patient was Rs. 23,260 (US$ 788), with a daily cost of Rs. 1,050 (US$ 55). Eleven patients required ventilatory support. There were 16 survivors. Among both groups, 6% of all revenues generated in the NICU were used to help families pay for the bills under a welfare scheme. PMID:2329461

Moazam, F; Lakhani, M

1990-04-01

31

Health Care Team  

MedlinePLUS

... Story About the NKF 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 ...

32

Health care assistants' role, function and development: results of a national survey.  

PubMed

Intensive care has developed as a speciality since the 1950s; during this time there have been major technological advances in health care provision leading to a rapid expansion of all areas of critical care. The ongoing problem of recruiting appropriately qualified nurses has affected staffing levels in many units and continues to be a national problem. For many, the answer lies in employing health care assistants to support the work of registered nurses. A key aim of the British Association of Critical Care Nurses is to promote the art and science of critical care nursing by providing representation for its members, by responding to political and professional change and by producing and publishing position statements. A primary component of the work surrounding the development of this second position statement was the gathering of contemporary information in relation to the role of health care assistants within critical care units throughout the UK, through a survey of 645 critical care units within the UK. At present the impact upon the role of the critical care nurse is not fully understood, with research in this area suggesting that although there is a role for the health care assistant in the critical care environment, this should only be undertaken with a full analysis of this impact upon the work of the registered nurse. PMID:12940689

Bowman, S; Bray, K; Leaver, G; Pilcher, T; Plowright, C; Stewart, L

2003-01-01

33

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

PubMed

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

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

2003-01-01

34

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

PubMed Central

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

ITO, HIROTO; SETOYA, YUTARO; SUZUKI, YURIKO

2012-01-01

35

International developments in adolescent health care: a story of advocacy and achievement  

Microsoft Academic Search

The contemporary health problems of young people occur within the context of the physical, social, cultural, economic, and political realities within which they live. There are commonalities and differences in this context among developed and developing countries, thus differing effects on the individual's personal as well as national development. Internationally, the origins and evolution of health care for adolescents can

David L Bennett; Roger S Tonkin

2003-01-01

36

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

PubMed Central

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

Briscoe, J

1984-01-01

37

Reflections from organization science on the development of primary health care research networks.  

PubMed

In the UK, policy changes in primary health care research and development have led to the establishment of primary care research networks. These organizations aim to increase research culture, capacity and evidence base in primary care. As publicly funded bodies, these networks need to be accountable. Organizational science has studied network organizations including why and how they develop and how they function most effectively. This paper draws on organizational science to reflect on why primary care research networks appear to be appropriate for primary care research and how their structures and processes can best enable the achievement of their aims. PMID:11604380

Fenton, E; Harvey, J; Griffiths, F; Wild, A; Sturt, J

2001-10-01

38

Elderly Self Care Education: A Low Technology Primary Health Care Option for Developing Countries  

Microsoft Academic Search

This article presents a number of perspectives on the curriculum building processes as well as the methodology and content of a self care training curriculum and Information packet that were prepared and field for the development of a model self care education program for older persons. Course content and topical areas are outlined, and various training agenda and educational materials

Lawrence K. Koseki; Sue E. Reid

1991-01-01

39

Model-driven Development of Mobile Personal Health Care Applications Abizer Khambati, John Grundy, James Warren and John Hosking  

E-print Network

Model-driven Development of Mobile Personal Health Care Applications Abizer Khambati, John Grundy, john}@ cs.auckland.ac.nz Abstract Personal health care applications on mobile devices allow patients to enhance their health via reminders, monitoring and feedback to health care providers. Engineering

Grundy, John

40

Lessons learned in developing community mental health care in North America  

PubMed Central

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

DRAKE, ROBERT E.; LATIMER, ERIC

2012-01-01

41

Managed Care and Service Capacity Development in a Public Mental Health System  

Microsoft Academic Search

Developing a continuum of care is considered to be one of the first steps in the process of implementing managed care strategies. This study summarizes the results of a final survey that focused on the ability of Colorado community mental health centers (CMHCs) to build service capacity and create new programs as a result of Medicaid capitation financing. Capitated agencies,

Edward Cohen; Joan R. Bloom

2000-01-01

42

The role and uptake of private health insurance in different health care systems: are there lessons for developing countries?  

PubMed Central

Background Social and national health insurance schemes are being introduced in many developing countries in moving towards universal health care. However, gaps in coverage are common and can only be met by out-of-pocket payments, general taxation, or private health insurance (PHI). This study provides an overview of PHI in different health care systems and discusses factors that affect its uptake and equity. Methods A representative sample of countries was identified (United States, United Kingdom, The Netherlands, France, Australia, and Latvia) that illustrates the principal forms and roles of PHI. Literature describing each country’s health care system was used to summarize how PHI is utilized and the factors that affect its uptake and equity. Results In the United States, PHI is a primary source of funding in conjunction with tax-based programs to support vulnerable groups; in the UK and Latvia, PHI is used in a supplementary role to universal tax-based systems; in France and Latvia, complementary PHI is utilized to cover gaps in public funding; in The Netherlands, PHI is supplementary to statutory private and social health insurance; in Australia, the government incentivizes the uptake of complementary PHI through tax rebates and penalties. The uptake of PHI is influenced by age, income, education, health care system typology, and the incentives or disincentives applied by governments. The effect on equity can either be positive or negative depending on the type of PHI adopted and its role within the wider health care system. Conclusion PHI has many manifestations depending on the type of health care system used and its role within that system. This study has illustrated its common applications and the factors that affect its uptake and equity in different health care systems. The results are anticipated to be helpful in informing how developing countries may utilize PHI to meet the aim of achieving universal health care. PMID:23494071

Odeyemi, Isaac AO; Nixon, John

2013-01-01

43

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

PubMed

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

Ariyoshi, Hiromi

2009-02-01

44

The scope of cell phones in diabetes management in developing country health care settings.  

PubMed

Diabetes has emerged as a major public health concern in developing nations. Health systems in most developing countries are yet to integrate effective prevention and control programs for diabetes into routine health care services. Given the inadequate human resources and underfunctioning health systems, we need novel and innovative approaches to combat diabetes in developing-country settings. In this regard, the tremendous advances in telecommunication technology, particularly cell phones, can be harnessed to improve diabetes care. Cell phones could serve as a tool for collecting information on surveillance, service delivery, evidence-based care, management, and supply systems pertaining to diabetes from primary care settings in addition to providing health messages as part of diabetes education. As a screening/diagnostic tool for diabetes, cell phones can aid the health workers in undertaking screening and diagnostic and follow-up care for diabetes in the community. Cell phones are also capable of acting as a vehicle for continuing medical education; a decision support system for evidence-based management; and a tool for patient education, self-management, and compliance. However, for widespread use, we need robust evaluations of cell phone applications in existing practices and appropriate interventions in diabetes. PMID:21722593

Ajay, Vamadevan S; Prabhakaran, Dorairaj

2011-05-01

45

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. ... ...

46

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

PubMed

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

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

2014-01-01

47

Health care technology assessment  

NASA Astrophysics Data System (ADS)

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.

Goodman, Clifford

1994-12-01

48

Leadership development in health care: a word of caution  

Microsoft Academic Search

Leadership development is seen as central to the modernisation agenda of the NHS. It has been identified in key policy documents and a range of leadership development programmes have been developed to meet this need. This paper reviews the evidence concerning leadership development in nursing. The conclusion reached is that leadership is only one element in the changes that need

Alistair Hewison; Maggie Griffiths

2004-01-01

49

Thinking Through Health Care Reform  

Microsoft Academic Search

Emotionality truly shapes critical thinking in the development of American health policy. President Obama has misgauged the\\u000a emotions and thoughts of the Nation and Congress about the health care reform bill. Most Americans don’t approve of the design\\u000a or impetus of health care legislation under the Obama administration. The enacted legislation provides health care insurance\\u000a for all Americans. However, health

Paul J. Flaer; Mustafa Z. Younis; Muhammed Alotaibi; Maha Al Hajeri

50

The Development of Diphosphonates as Significant Health Care Products.  

ERIC Educational Resources Information Center

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)

Francis, Marion D.; Centner, Rosemary L.

1978-01-01

51

Developing Inclusive Health and Social Care Policies for Older LGBT Citizens  

Microsoft Academic Search

SummaryCreating anti-oppressive practices in service provision that successfully remove barriers to the social inclusion of older lesbians, gay men, bisexuals and transgendered (LGBT) citizens has proven thus far tremendously difficult. The White Paper, Better Care, Higher Standards: A Charter for Long Term Care, (Department of Health, 1999) addresses the development of non-discriminatory services that treat users with dignity and respect,

Liam Concannon

2009-01-01

52

THE DEVELOPMENT AND USE OF A MODEL TO PREDICT SUSTAINABILITY OF CHANGE IN HEALTH CARE SETTINGS.  

PubMed

Innovations adopted through organizational change initiatives are often not sustained leading to diminished quality, productivity, and consumer satisfaction. Research explaining variance in the use of adopted innovations in health care settings is sparse, suggesting the need for a theoretical model to guide research and practice. In this article, we describe the development of a hybrid conjoint decision theoretic model designed to predict the sustainability of organizational change in health care settings. An initial test of the model's predictive validity using expert scored hypothetic profiles resulted in an r-squared value of .77. The test of this model offers a theoretical base for future research on the sustainability of change in health care settings. PMID:22262947

2011-01-01

53

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

PubMed

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

Erickson, David; Andrews, Nancy

2011-11-01

54

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 ...

55

Health care agents  

MedlinePLUS

... do not have a living will or an advanced directive, your health care agent will be the one ... organs, unless you've stated otherwise in your advance directive Before you choose a health care agent, you ...

56

Bursaries, writing grants and fellowships: a strategy to develop research capacity in primary health care  

PubMed Central

Background General practitioners and other primary health care professionals are often the first point of contact for patients requiring health care. Identifying, understanding and linking current evidence to best practice can be challenging and requires at least a basic understanding of research principles and methodologies. However, not all primary health care professionals are trained in research or have research experience. With the aim of enhancing research skills and developing a research culture in primary health care, University Departments of General Practice and Rural Health have been supported since 2000 by the Australian Government funded 'Primary Health Care Research Evaluation and Development (PHCRED) Strategy'. A small grant funding scheme to support primary health care practitioners was implemented through the PHCRED program at Flinders University in South Australia between 2002 and 2005. The scheme incorporated academic mentors and three types of funding support: bursaries, writing grants and research fellowships. This article describes outcomes of the funding scheme and contributes to the debate surrounding the effectiveness of funding schemes as a means of building research capacity. Methods Funding recipients who had completed their research were invited to participate in a semi-structured 40-minute telephone interview. Feedback was sought on acquisition of research skills, publication outcomes, development of research capacity, confidence and interest in research, and perception of research. Data were also collected on demographics, research topics, and time needed to complete planned activities. Results The funding scheme supported 24 bursaries, 11 writing grants, and three research fellows. Nearly half (47%) of all grant recipients were allied health professionals, followed by general practitioners (21%). The majority (70%) were novice and early career researchers. Eighty-nine percent of the grant recipients were interviewed. Capacity, confidence, and level of research skills in ten core areas were generally considered to have improved as a result of the award. More than half (53%) had presented their research and 32% had published or submitted an article in a peer-reviewed journal. Conclusion A small grant and mentoring scheme through a University Department can effectively enhance research skills, confidence, output, and interest in research of primary health care practitioners. PMID:17408497

Ried, Karin; Farmer, Elizabeth A; Weston, Kathryn M

2007-01-01

57

Demand-oriented and demand-driven health care: the development of a typology.  

PubMed

In most European countries, there is an increasing demand for demand-oriented and demand-driven approaches in the development of health care policy and the organization of health care services. Both approaches, in which the main focus is on 'the demand', are seen as counterparts of the supply-oriented approach, that has 'the supply' as point of departure. However, there is much confusion about the definition of the concepts. To identify the different views, and to examine to what extent there is consensus in the Netherlands about the concepts of demand-orientation and demand-driven care, a Delphi study was done among 26 experts; scientists, health care insurance companies, health care suppliers, the government, independent advisory bodies and client interest groups. The study resulted in a typology. The similarities and differences between the two concepts were demonstrated in five dimensions; responsibility, control, need-determination, formal embedment of vision in organization and choice. Furthermore, the typology was used to identify existing types of services as being either demand-oriented or demand-driven services. The typology provides an understanding of the similarities and differences between the two concepts, and appears to be a useful tool in identifying services to the extent that they are demand oriented or demand driven. PMID:17727554

Rijckmans, Madeleine; Garretsen, Henk; van de Goor, Ien; Bongers, Inge

2007-09-01

58

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

PubMed Central

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

Adeleye, Omokhoa Adedayo; Ofili, Antoinette Ngozi

2010-01-01

59

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 ...

60

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

PubMed Central

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

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

2014-01-01

61

Report of the Regional Plan Development Task Force on Primary Health Care Services. An Initial Plan for Western New York.  

National Technical Information Service (NTIS)

Recommendations are presented for the development of primary health care services and resources in the seven counties served by the Comprehensive Health Planning Council of Western New York. The recommendations are the product of an 18-month effort by the...

1975-01-01

62

The ethics of research related to health care in developing countries  

PubMed Central

The Ethics of Research Related to Health Care in Developing Countries by the Nuffield Council on Bioethics makes a number of innovative recommendations that depart from codes such as the Declaration of Helsinki. It recommends that standards of care might be relativised to the standard of that nation. It recommends that very good reasons need to be given for not giving post-trial access to medications but recognises that there may be justifiable instances of this. It is the view of the authors that these and other recommendations of the report are sensible pieces of advice given the complexities of the developing world. PMID:15082819

McMillan, J; Conlon, C

2004-01-01

63

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

PubMed Central

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

Ahgren, Bengt; Axelsson, Runo

2011-01-01

64

Hospital roommates and development of health care-onset Clostridium difficile infection.  

PubMed

There is potential for person-to-person transmission in Clostridium difficile outbreak settings. A limited number of studies have examined the role of hospital roommates in the development of nosocomial infections. This retrospective cohort study evaluated room cooccupancy and duration of exposure to roommates as predictors of health care-onset C difficile infection (CDI). Among roommates of patients with CDI, duration of room cooccupancy was significantly longer in those developing CDI. PMID:25278404

Echaiz, Jose F; Veras, Laura; Zervos, Marcus; Dubberke, Erik; Johnson, Laura

2014-10-01

65

CSCW-based system development methodology for health-care information systems.  

PubMed

Health-care organizations are now moving toward integrated delivery systems to provide high-quality care, as they are being held to an ever-increasing scope of accountabilities. Distributed applications such as telemedicine and electronic patient records (EPR) are seen as key requirements for the future to deliver cost effective and high-quality health-care services. This initiative would provide dynamic environments for health professionals to access patient information and thereby increase the decision-making capacities on patient care procedures. Although telemedicine applications and EPR contribute to the improvement of healthcare services, poor communication mechanisms and practices negatively impact on quality of service (QoS) in teamwork environments of patient care. Awareness and responsiveness are becoming important factors in dynamic group collaborative work environments in healthcare facilities. This paper reports on a detailed case study of group communication patterns in a patient service environment. Further, an ethnographic approach that addresses group communications patterns, identifies tools and techniques in light of Computer-Supported Collaborative Work (CSCW), which requires the application of a number of disciplines including sociology, organizational science, psychology, and computer science. In cooperative work environments, it is important to understand the activities of others for human interaction and communication in general. This is very important for future development of CSCW-based distributed architectures that focus on the challenges of improving QoS in healthcare environments. PMID:14611695

Weerakkody, Gamini; Ray, Pradeep

2003-01-01

66

Adherence and health care costs  

PubMed Central

Medication nonadherence is an important public health consideration, affecting health outcomes and overall health care costs. This review considers the most recent developments in adherence research with a focus on the impact of medication adherence on health care costs in the US health system. We describe the magnitude of the nonadherence problem and related costs, with an extensive discussion of the mechanisms underlying the impact of nonadherence on costs. Specifically, we summarize the impact of nonadherence on health care costs in several chronic diseases, such as diabetes and asthma. A brief analysis of existing research study designs, along with suggestions for future research focus, is provided. Finally, given the ongoing changes in the US health care system, we also address some of the most relevant and current trends in health care, including pharmacist-led medication therapy management and electronic (e)-prescribing. PMID:24591853

Iuga, Aurel O; McGuire, Maura J

2014-01-01

67

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

PubMed

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

Outreville, J François

2007-12-01

68

Health Care Indicators  

PubMed Central

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

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

1993-01-01

69

A smart phone/tablet based mobile health care system for developing countries.  

PubMed

Increasing cost of health care in developing countries is placing heavy financial burden on its populations. With the advent of mobile and tablet technologies however, it is possible to reduce this burden to some extent through tele-healthcare. In this paper, authors describe their effort to design portable diagnostic devices that can communicate to smart phones and tablets there by making tele-healthcare possible. A possible architecture of their model is presented and components thereof discussed. PMID:24110769

Vaidya, Avinash S; Srinivas, M B; Himabindu, P; Jumaxanova, Daria

2013-01-01

70

The untold story: how the health care systems in developing countries contribute to maternal mortality.  

PubMed

This article attempts to put together evidence from maternal mortality studies in developing countries of how an inadequate health care system characterized by misplaced priorities contributes to high maternal mortality rates. Inaccessibility of essential health information to the women most affected, and the physical as well as economic and sociocultural distance separating health services from the vast majority of women, are only part of the problem. Even when the woman reaches a health facility, there are a number of obstacles to her receiving adequate and appropriate care. These are a result of failures in the health services delivery system: the lack of minimal life-saving equipment at the first referral level; the lack of equipment, personnel, and know-how even in referral hospitals; and worst of all, faulty patient management. Prevention of maternal deaths requires fundamental changes not only in resource allocation, but in the very structures of health services delivery. These will have to be fought for as part of a wider struggle for equity and social justice. PMID:1644513

Sundari, T K

1992-01-01

71

Developing a national mentorship scheme to enhance the contribution of clinical academics to health care.  

PubMed

Aim To provide a template for developing a national mentoring scheme to enhance the contribution practitioner researchers can make to the quality of health care in England. Background The authors describe the background to and organisation of a mentorship scheme to support those awarded National Institute for Health Research (NIHR) fellowships as part of the Clinical Academic Training (CAT) scheme for nurses, midwives and the allied health professionals in England. Data sources The paper draws on relevant policy documents to explain the development of the NIHR mentorship scheme. It also reviews the literature regarding mentoring in nursing and the health professions. Review methods The review was conducted systematically using keywords: mentorship, clinical academic careers, research, nursing research, clinical academic careers, evidence, health care. Databases included PubMed, CINAHL and Google Scholar. An integrated approach was adopted. Discussion Kirkpatrick's ( 2006 ) four-level evaluation model provided a framework to evaluate the scheme and explore the role of mentorship in supporting NIHR fellows. Preliminary findings from baseline and end-of-year evaluations revealed mentees' expectations of mentorship and its effects on their professional development. Developing a career as a clinical academic can be a challenging journey for novice researchers. In addition, there is a vital need to integrate research with clinical practice. Conclusion Mentoring appears valuable in enabling NIHR fellows to navigate the challenges of demanding clinical roles in England's National Health Service while making a high-level contribution to research. The importance of preparing mentors for their role is well documented in the literature but mentees also need preparation and guidance to manage this important relationship. Implications for research/practice The evaluation has implications for embedding similar schemes across nursing, midwifery and the allied health professions to promote capacity and leadership in clinical academic careers. This study has uniquely identified the need to support mentees as well as mentors in such programmes to ensure the optimal benefit of the programme reaches all participants. PMID:25423938

Byrne, Geraldine; Topping, Annie; Kendall, Sally; Golding, Berenice

2014-11-26

72

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

PubMed

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

Ahmed, Rukhsana; Bates, Benjamin R

2012-07-01

73

Health Care and Dependent Care Flexible  

E-print Network

Health Care and Dependent Care Flexible Spending Accounts Discovery Benefits, Inc. (866) 451 for certain health care and child care expenses with pre-tax dollars. FSA's may allow you to save money of money that is withheld from your pay on a pre-tax basis. Note: Health Care Reform extends medical FSA

74

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

PubMed Central

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

Pakenham-Walsh, Neil; Bukachi, Frederick

2009-01-01

75

Academic Health Centers and Health Care Reform.  

ERIC Educational Resources Information Center

A discussion of the role of academic health centers in health care reform efforts looks at the following issues: balancing academic objectivity and social advocacy; managing sometimes divergent interests of centers, faculty, and society; and the challenge to develop infrastructure support for reform. Academic health centers' participation in…

Miles, Stephen H.; And Others

1993-01-01

76

Health Care for College Students  

MedlinePLUS

... Health Care for College Students Ages & Stages Listen Health Care for College Students Article Body I'll be ... student health service before starting an exercise program. Health care on campus If you are going to live ...

77

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

PubMed Central

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

Leichsenring, Kai

2004-01-01

78

COMMENTARY A Framework for Health Care Organizations to Develop and Evaluate a Safety Scorecard  

E-print Network

within health care organizations. Boards of trustees have a fiduciary responsibility to ensure patient safety, and senior management is often charged with evaluating and improving patient safety. External agencies such as the Centers for Medicare & Medicaid Services (CMS), the Leapfrog Group, and the Joint Commission have developed measures to evaluate patient safety and quality of care. Many hospitals have responded to this heightened focus on patient safety by creating scorecards to evaluate and publicly report progress in improving quality and safety. Scorecards are attractive because hospital leaders and other interested parties can quickly obtain a broad overview of patient safety performance. These scorecards tend to include measures required by the CMS, The Joint Commission, and insurers, as well as measures developed by individual hospitals for local

Peter J. Pronovost; Sean M. Berenholtz; Dale M. Needham

79

[About the legal regulation of health care].  

PubMed

The adoption of the law "About foundations of population health care in the Russian Federation" in absence of concept of health care development determining the major targets and tasks of the sector gives rise in citizen incomprehension and rejection of innovations of health policy. To determine the vector of development of Russian health care as compared with Soviet system of health care the analysis of particular positions of the Federal law "On foundations of population health care" (2011) and the USSR law "On approval of foundations of legislation of USSR and Union republics on health care" (1969) is made. PMID:23634600

Yefremov, D V

2012-01-01

80

The Challenge of Developing Evidence-Based Genetics Health Care in Practice  

Microsoft Academic Search

Evidence-based genetics health care is the conscientious use of current best evidence in decision-making at the clinical,\\u000a administrative and policy-making levels. As knowledge generated from genomics research is integrated into medical care, the\\u000a needs for appropriate evidence become more complex. The challenges to evidence-based care include: a lack of policy-relevant\\u000a evidence in the domains of basic, clinical and health services

Brenda J. Wilson

2006-01-01

81

What is the health care product?  

PubMed

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

France, K R; Grover, R

1992-06-01

82

Health promotion through self-care and community participation: Elements of a proposed programme in the developing countries  

PubMed Central

Background The concepts of health promotion, self-care and community participation emerged during 1970s, primarily out of concerns about the limitation of professional health system. Since then there have been rapid growth in these areas in the developed world, and there is evidence of effectiveness of such interventions. These areas are still in infancy in the developing countries. There is a window of opportunity for promoting self care and community participation for health promotion. Discussion A broad outline is proposed for designing a health promotion programme in developing countries, following key strategies of the Ottawa Charter for health promotion and principles of self care and community participation. Supportive policies may be framed. Self care clearinghouses may be set up at provincial level to co-ordinate the programme activities in consultation with district and national teams. Self care may be promoted in the schools and workplaces. For developing personal skills of individuals, self care information, generated through a participatory process, may be disseminated using a wide range of print and audio-visual tools and information technology based tools. One such potential tool may be a personally held self care manual and health record, to be designed jointly by the community and professionals. Its first part may contain basic self care information and the second part may contain outlines of different personally-held health records to be used to record important health and disease related events of an individual. Periodic monitoring and evaluation of the programme may be done. Studies from different parts of the world indicate the effectiveness and cost-effectiveness of self care interventions. The proposed outline has potential for health promotion and cost reduction of health services in the developing countries, and may be adapted in different situations. Summary Self care, community participation and health promotion are emerging but dominant areas in the developed countries. Elements of a programme for health promotion in the developing countries following key principles of self care and community participation are proposed. Demonstration programmes may be initiated to assess the feasibility and effectiveness of this programme before large scale implementation. PMID:15086956

Bhuyan, Khanindra Kumar

2004-01-01

83

Evaluating primary health care and nutrition programs in the context of national development  

Microsoft Academic Search

This paper illustrates an evaluation model incorporating research techniques of both primary health care and social anthropology. The case in point is the Jamaican Government's Community Health Aide Programme, which employs over 1300 auxiliary health workers to serve the low-income population of the island. The study demonstrates a cardinal principle of the anthropological approach--a grounded and holistic understanding of the

Thomas J. Marchione

1984-01-01

84

Health care in Africa.  

PubMed

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

Brown, M S

1984-07-01

85

Asian American health care attitudes.  

PubMed

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

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

1999-01-01

86

Continuing Trends in Health and Health Care  

ERIC Educational Resources Information Center

Discusses current trends in health and health care, assesses significance of current data, and investigates causes and implications of the data for future health and health care. For journal availability, see SO 506 144. (Author/DB)

Wilson, Ronald W.; And Others

1978-01-01

87

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

PubMed

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

Moatti, Jean Paul

2008-12-01

88

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

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…

Janz, Jan; And Others

89

The Organization for Economic Cooperation and Development and Health Care Reform in the United States.  

PubMed

Among OECD nations, the United States is an outlier in having the highest per capita health care costs in a system that unnecessarily exposes many individuals to financial hardship, physical suffering, and even death. President Obama and Congress are currently involved in a process to reform the flawed health care system. The OECD has contributed to that process by releasing a paper, "Health Care Reform in the United States," which describes some of the problems that must be addressed, but then provides proposed solutions that omit consideration of a more equitable and efficient universal public insurance program. The same omission is taking place in Washington, DC. By reinforcing proposals that support the private insurance industry, the source of much of the waste and inequities in health care, the authors of the OECD paper have failed in their responsibility to inform on policies rather than politics. PMID:19927410

McCanne, Don R

2009-01-01

90

Health Care Economics  

Microsoft Academic Search

\\u000a “It was the best of times it was the worst of times.” How prophetic was Charles Dickens when applied to health care in America\\u000a today.1 We are currently experiencing unprecedented technologic and therapeutic advancements; however, these come at a tremendous\\u000a price. Health care expenditures have increased by double digits for the past decade, physician reimbursement has decreased\\u000a by over the

David A. Margolin; Lester Rosen

91

Mercury and health care  

PubMed Central

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

Rustagi, Neeti; Singh, Ritesh

2010-01-01

92

Health Information Systems for Primary Health Care: Thinking About Participation  

E-print Network

Health Information Systems for Primary Health Care: Thinking About Participation Elaine Byrne in supporting primary health care functioning, the design, development and implementation of these systems care, especially in the context of developing countries, a very challenging task. An important step

Sahay, Sundeep

93

Shared Primary Health Care  

PubMed Central

Primary health care delivery in large urban centers may be shared between family physicians and specialists. This study examined screening and health promotion interventions by obstetrician-gynecologists as part of an annual examination of asymptomatic women. Procedures most closely linked to gynecological practice were performed most frequently. PMID:21229004

Yaffe, Mark J.; Toop, Jo-Ann

1991-01-01

94

Controlling Health Care Costs  

ERIC Educational Resources Information Center

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…

Dessoff, Alan

2009-01-01

95

Engineering VA Health Care  

E-print Network

Engineering VA Health Care The Department of Veterans Affairs is offering a unique career engineers to be effective Healthcare Technology Program Managers in the Veterans Health Administration to serve a very special class of citizens ­ our nation's Veterans. Overview Program Description Roles

Adams, Mark

96

Establishment of primary health care in Vietnam.  

PubMed

Basic demographic and epidemiological data relevant to health problems in Vietnam are described in this paper. Existing health service arrangements are referred to, with particular emphasis on the strategy for development of primary health care. The establishment of the paediatric centre in Ho Chi Minh City is reported, and examples of its valuable work in primary health care development are described. PMID:2121182

Birt, C A

1990-08-01

97

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

PubMed

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

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

2011-05-01

98

Enhancing transgender health care.  

PubMed Central

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

Lombardi, E

2001-01-01

99

The Family Therapist as Health Care Consultant  

Microsoft Academic Search

Increasingly therapists are called upon to serve as consultants to health care organizations. The consultant is expected to assess the contribution a family systems therapy perspective can make. Among the areas considered are: the family as a health care agency; the place of direct family therapy treatment in health care; protection of the family at risk; the development of appropriate

Donald A. Bloch

1984-01-01

100

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

PubMed Central

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

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

2010-01-01

101

Health care in Armenia today.  

PubMed Central

Although one of the smallest of the new independent states of the former Soviet Union, the Republic of Armenia has an ancient tradition and a strong ethnic identification, greatly enhanced by the diaspora. In addition to the problems following the dissolution of the Soviet Union, Armenia has had to contend with a draining war in Nagorno-Karabakh and the after-effects of a devastating earthquake in 1988. Humanitarian efforts have ranged from emergency supply deliveries to longer-term sustainable health care partnerships. The United States government, through the Agency for International Development, has organized such partnerships, partially as a result of a multinational mission in 1992 and a subsequent hospital-to-hospital program developed by the American International Health Alliance. We describe the current state of health care in Armenia and some of the problems that need to be addressed to improve health care services to its citizens. PMID:8023481

Farmer, R G; Chobanian, A V

1994-01-01

102

Managing the health care market in developing countries: prospects and problems.  

PubMed

There is increasing interest in the prospects for managed market reforms in developing countries, stimulated by current reforms and policy debates in developed countries, and by perceptions of widespread public sector inefficiency in many countries. This review examines the prospects for such reforms in a developing country context, primarily by drawing on the arguments and evidence emerging from developed countries, with a specific focus on the provision of hospital services. The paper begins with a discussion of the current policy context of these reforms, and their main features. It argues that while current and proposed reforms vary in detail, most have in common the introduction of competition in the provision of health care, with the retention of a public monopoly of financing, and that this structure emerges from the dual goals of addressing current public sector inefficiencies while retaining the known equity and efficiency advantages of public health systems. The paper then explores the theoretical arguments and empirical evidence for and against these reforms, and examines their relevance for developing countries. Managed markets are argued to enhance both efficiency and equity. These arguments are analysed in terms of three distinct claims made by their proponents: that managed markets will promote increased provider competition, and hence, provider efficiency; that contractual relationships are more efficient than direct management; and that the benefits of managed markets will outweigh their costs. The analysis suggests that on all three issues, the theoretical arguments and empirical evidence remain ambiguous, and that this ambiguity is attributable in part to poor understanding of the behaviour of health sector agents within the market, and to the limited experience with these reforms. In the context of developing countries, the paper argues that most of the conditions required for successful implementation of these reforms are absent in all but a few, richer developing countries, and that the costs of these reforms, particularly in equity terms, are likely to pose substantial problems. Extensive managed market reforms are therefore unlikely to succeed, although limited introduction of particular elements of these reforms may be more successful. Developed country experience is useful in defining the conditions under which such limited reforms may succeed. There is an urgent need to evaluate the existing experience of different forms of contracting in developing countries, as well as to interpret emerging evidence from developed country reforms in the light of conditions in developing countries. PMID:10137740

Broomberg, J

1994-09-01

103

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

PubMed Central

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

2014-01-01

104

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

PubMed Central

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

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

2000-01-01

105

Promoting Child Development and Behavioral Health: Family Child Care Providers' Perspectives  

Microsoft Academic Search

IntroductionGiven the significant proportion of children in nonparental child care and the importance of early life experiences on development, interventions to improve a child care provider's ability to enhance a young child's development and behavior are essential. Such interventions require understanding of and responsiveness to the provider's self-perceived roles, responsibilities, and willingness to engage in such interventions, yet prior research

Marjorie S. Rosenthal; Angela A. Crowley; Leslie Curry

2009-01-01

106

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

Microsoft Academic Search

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:yywww.euro.centre.orgyprocarey). 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

Kai Leichsenring; Piazzale Stazione

2004-01-01

107

Capacity building in the health sector to improve care for child nutrition and development.  

PubMed

The effectiveness of interventions promoting healthy child growth and development depends upon the capacity of the health system to deliver a high-quality intervention. However, few health workers are trained in providing integrated early child-development services. Building capacity entails not only training the frontline worker, but also mobilizing knowledge and support to promote early child development across the health system. In this paper, we present the paradigm shift required to build effective partnerships between health workers and families in order to support children's health, growth, and development, the practical skills frontline health workers require to promote optimal caregiving, and the need for knowledge mobilization across multiple institutional levels to support frontline health workers. We present case studies illustrating challenges and success stories around capacity development. There is a need to galvanize increased commitment and resources to building capacity in health systems to deliver early child-development services. PMID:24571217

Yousafzai, Aisha K; Rasheed, Muneera A; Daelmans, Bernadette; Manji, Sheila; Arnold, Caroline; Lingam, Raghu; Muskin, Joshua; Lucas, Jane E

2014-01-01

108

Ethics and incentives: an evaluation and development of stakeholder theory in the health care industry.  

PubMed

This paper utilizes a qualitative case study of the health care industry and a recent legal case to demonstrate that stakeholder theory's focus on ethics, without recognition of the effects of incentives, severely limits the theory's ability to provide managerial direction and explain managerial behavior. While ethics provide a basis for stakeholder prioritization, incentives influence whether managerial action is consistent with that prioritization. Our health care examples highlight this and other limitations of stakeholder theory and demonstrate the explanatory and directive power added by the inclusion of the interactive effects of ethics and incentives in stakeholder ordering. PMID:12708454

Elms, Heather; Berman, Shawn; Wicks, Andrew C

2002-10-01

109

Values in health care.  

PubMed

The first part of the paper is concerned with the health care values of various groups; namely, those which are resource oriented, disease oriented, political decision-makers, organized sellers and purchasers of health care and patients. These groups are further divided according to selected political/ideological and socio-economic characteristics, essentially along capitalist and socialist lines. Some of the ways in which the values held by these groups are determined, formulated and, by implication at least, changed and the political, economic and other bases for some of their practical applications are identified. The second part of the paper focuses upon values in public health education and related practice. It is argued that to become more useful to the 'health of the public' the new public health worker will have to become more activist, assuming an adversarial stance toward the market economy in capitalist countries and oppressive governmental structures everywhere. A wider integration of knowledge concerning the effects of health of all types of economic, social and political practices is required; this, in turn, would contribute to the emergence of alternative forms of public health analysis and practice. The recognition of wider forms of public health leadership should follow, coupled with organizational changes directed at the greater participation of popular groupings in all types of public health activities. PMID:6484620

Gish, O

1984-01-01

110

Health care in Moscow.  

PubMed Central

In the Russian Federation privatisation is affecting the health care sector as much as it is industry and commerce. That the general public support the transfer of state clinics to the private sector is a mark of their dissatisfaction with the old state run system. Doctors too see better opportunities to practise good medicine and be paid better for doing so. In Moscow the health department has set up a commission to license all clinics providing treatment, which should ensure standards of safety, training, and equipment. The Russian Federation is also trying to establish a medical insurance system to cover its citizens for health care, but in Moscow and elsewhere its implementation has been delayed by arguments and bureaucracy. In the meantime the health of Muscovites remains poor, with a high incidence of birth defects, and illnesses among the young. Images p783-a PMID:8219954

Ryan, M

1993-01-01

111

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

PubMed Central

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

2013-01-01

112

Developing a community-based neonatal care intervention: a health facility assessment to inform intervention design.  

PubMed

Community-based interventions are an important way of improving health in low-income countries. A necessary prerequisite for the design of such interventions is an understanding of the local health system. This will inform intervention design, help ensure the community-intervention forms part of a continuum of care, and provide information about health system strengthening activities that may be necessary for success. Such formative research processes, however, are seldom reported in the literature. We present the results of a health facility assessment used in the design stage of Newhints, a community-based intervention to improve neonatal survival in rural Ghana. We illustrate the methodology, findings and how these were used to inform the design and implementation of Newhints. The assessment involved key informant interviews with staff members at seven health facilities within the study area, including a brief inventory of available drugs and equipment. The key informant interviews identified that practices and health promotion messages at the health facilities were not consistent with one of the key target behaviours of the Newhints intervention - thermal care through delayed infant bathing. Health workers were bathing neonates soon after delivery and also advising women to do the same, which is a potential cause of hypothermia for the newborn. We found that health centres other than large district hospitals were ill-equipped to treat serious complications of labour or illness in the newborn, which had implications for advice on health seeking behaviour within the intervention. As a result of the health facility assessment, it was deemed necessary to undertake both health worker training and sensitisation activities. We demonstrate that important information can be yielded from a relatively simple health facility assessment involving key informant interviews. PMID:21281331

Howe, Laura D; Manu, Alexander; Tawiah-Agyemang, Charlotte; Kirkwood, Betty R; Hill, Zelee

2011-03-01

113

Development and validation of a scale measuring satisfaction with maternal and newborn health care following childbirth.  

PubMed

To demonstrate the validity and internal consistency of a multi-item scale measuring women's satisfaction with health care received in the weeks following childbirth for both themselves and their newborns. Data are from 1,154 women delivering healthy singletons or twins recruited for a randomized trial. Satisfaction with care items were selected from prior research, including the previously validated Primary Care Satisfaction Survey for Women (PCSSW) and studies of postpartum care. After randomly splitting the sample (1:1) for cross-validation purposes, Exploratory (EFA) and Confirmatory factor analysis (CFA) on ordinal data using the WLSMV estimator available in the MPLUS statistical modeling program were conducted. A CFA was also conducted on available data at 2 weeks and 2 months after discharge in order to examine internal consistency at follow-up. A one factor model with 11 items was selected, with the main factor explaining 83% of total 11-item variation in the overall sample. The Cronbach's alpha for the final 11-item scale at baseline and follow-up time periods was 0.96. High correlations with overall trust in provider (Spearman rho = 0.78) and quality of healthcare (0.75) supported convergent validity. The baseline mean score was 47.9 with a standard deviation of 7.13 and a possible range of 11 (low) to 55 (high satisfaction). This validated scale is a new tool for measuring satisfaction with health care received during the postpartum period for mothers and their newborns. This tool will be useful in studies assessing quality of care and the outcomes of postpartum health care interventions, and it is the first tool to focus on care for the mother-baby unit. PMID:21626093

Camacho, Fabian T; Weisman, Carol S; Anderson, Roger T; Hillemeier, Marianne M; Schaefer, Eric W; Paul, Ian M

2012-07-01

114

Mental Health Care in Primary Care Settings  

Microsoft Academic Search

OBJECTIVE To assess family physicians' interactions with mental health professionals (MHPs), their satisfaction with the delivery of mental health care in primary health care settings, and their perceptions of areas for improvement. DESIGN Mailed survey. SETTING Province of Saskatchewan. PARTICIPANTS All FPs in Saskatchewan (N = 816) were invited to participate in the study; 31 were later determined to be

C. C. Doebbeling; Syed M. Shah

2004-01-01

115

Developing reflective health care practitioners: learning from experience in dental hygiene education.  

PubMed

Maintaining competence requires health care practitioners to remain current with research and implement practice changes. Having the capacity to reflect on practice experiences is a key skill, but reflective skills need to be taught and developed. This exploratory qualitative study examined the outcomes of a dental hygiene program requirement for developing reflective practitioners. Using a purposive convenience sample, students were solicited to participate in the study and submit reflective journals at the end of two terms. Eleven of twenty-six students participated in the study, providing sixty-four reflective entries that underwent qualitative thematic analysis. Using a reflective model, we identified themes, developed codes, and negotiated among ourselves to reach consensus. Results showed approximately two-thirds of the participants reached the central range as "reflectors" and most of the remaining fell within the lower range as "non-reflectors." We concluded that dental hygiene students reached similar levels of reflection to other groups and the triggers were varied, appropriate for early learners, and divided between positive and negative cues. However, the small sample represented less than one-half of the class, yielding a potentially biased sample. Therefore, we conclude that the findings provide a departure point for further research with a more cross-cutting sample in order to substantiate reflective educational requirements and validate these findings. PMID:21460268

Asadoorian, Joanna; Schönwetter, Dieter J; Lavigne, Salme E

2011-04-01

116

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

ERIC Educational Resources Information Center

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…

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

2012-01-01

117

Developing a Mobile Learning Solution for Health and Social Care Practice  

ERIC Educational Resources Information Center

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 &…

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

2010-01-01

118

Cultural Competence: Developing Policies To Address the Health Care Needs of Culturally Diverse Clientele  

Microsoft Academic Search

Home health care organizations striving to effectively serve their clientele may be experiencing barriers, one of which is serving a culturally and linguistically diverse population. The National Center for Cultural Competence (NCCC) identifies seven salient reasons in this article for incorporating cultural competence into organizational policy. The article provides an examplary definition that can be adapted and useful to home

Tawara D. Goode; Suganya Sockalingam

2000-01-01

119

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

PubMed Central

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

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

2013-01-01

120

Evaluating health care efficiency.  

PubMed

In this chapter we propose a three-pronged approach to assessing efficiency of health care, including financial performance, performance in the production of (intermediate) medical outcomes and performance relating medical outcomes to patient health outcomes. Throughout we use frontier models which can be estimated in a number of ways, including DEA, stochastic frontiers and index numbers. We illustrate the health outcomes model with an application to cataract surgery patients in Sweden and use DEA as our estimator. Again, other frontier estimation methods as well as index numbers could be employed to explore other procedures' effectiveness and overall performance of services and/or hospitals and clinics. PMID:19725364

Färe, Rolf; Grosskopf, Shawna; Lundström, Mats; Roos, Pontus

2008-01-01

121

Decentralisation of health care and its impact on health outcomes  

Microsoft Academic Search

This paper explores the impact of health care decentralisation on a characteristic of human development: the overall level of a population's health. While much of the literature on decentralisation in health care has stressed the advantages of sub national provision of health services, in the absence of a quantitative measure of the magnitude of the effect of decentralisation, there is

Dolores Jimenez; Peter C. Smith

122

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

PubMed

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

Owusu-Dapaa, Ernest

2014-04-01

123

Navigating the Health Care System  

MedlinePLUS

... Patients Patient Safety Measure Tools & Resources Pharmacy Health Literacy Center Surveys on Patient Safety Culture Quality Measure Tools & Resources Search Professional Resources Search ahrq.gov Health IT Health Information Technology Portfolio Comparative Effectiveness Effective Health Care Program ...

124

Developing and Testing a Web-Based Survey to Assess Educational Needs of Palliative and End-of-Life Health Care Professionals in Connecticut  

Microsoft Academic Search

Institute of Medicine reports have identified gaps in health care professionals' knowledge of palliative and end-of-life care, recommending improved education. Our purpose was to develop and administer a Web-based survey to identify the educational needs of multidisciplinary health care professionals who provide this care in Connecticut to inform educational initiatives. We developed an 80-item survey and recruited participants through the

Dena Schulman-Green; Elizabeth Ercolano; Sheryl LaCoursiere; Tony Ma; Mark Lazenby; Ruth McCorkle

2011-01-01

125

Developing a Textbook for Teaching Psychological Competencies to Health Care Practitioners  

Microsoft Academic Search

Allied health practitioners are required to gain expertise in the psycho-socio-emotional domain to assist them with effective delivery of services when working with clients. Although competencies have been developed for the prospective allied health disciplines, course content and method of training has yet to be determined. This author has developed a protocol, the Decision Making Model, to assist educators with

Victoria Bacon

2005-01-01

126

Parkland Health Care Campus  

E-print Network

Planning for Sustainability at the New Parkland Hospital November 8, 2011 Walter Jones, AIA, LEED, IFMA, CHD - Sr. Vice President, Facilities CATEE 2 0 1 1 Clean Air Through Energy Efficiency ESL-KT-11-11-19 CATEE 2011, Dallas..., Texas, Nov. 7 ? 9, 2011 Since 1894, Parkland has been Dedicated to the health and well-being of individuals and communities entrusted to our care Parkland Hospital Mission Statement By our actions, we will define the standards of excellence...

Jones, W., Sr.

2011-01-01

127

Environmental Health: Health Care Reform's Missing Pieces.  

ERIC Educational Resources Information Center

A series of articles that examine environmental health and discuss health care reform; connections between chlorine, chlorinated pesticides, and dioxins and reproductive disorders and cancers; the rise in asthma; connections between poverty and environmental health problems; and organizations for health care professionals who want to address…

Fadope, Cece Modupe; And Others

1994-01-01

128

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

PubMed Central

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

2014-01-01

129

Reform of Primary Health Care  

Microsoft Academic Search

Never before has American society undergone such dramatic and pervasive changes as those currently effecting national health care needs. New strategies to meet the health care needs created by societal changes must be identified. Consumers, employers, providers, and third-party payers are calling for more cost effective health care, better access and better quality. Simultaneously, the United States has a shortage

Jeanette Lancaster; Wade Lancaster

1995-01-01

130

Commensurate Ratings of Health Care.  

ERIC Educational Resources Information Center

Proposes a new descriptive item statistic, the mean cumulative logit, for scoring ratings of health care at the population level. Demonstrates the advantages of the method using data from the Consumer Assessment of Health Plans Study and shows that the perceived quality of health care is greater for fee-for-service plans than managed care plans in…

Bectel, Gordon G.

2001-01-01

131

Child Care Health Connections, 2002.  

ERIC Educational Resources Information Center

This document is comprised of the six 2002 issues of a bimonthly newsletter on children's health for California's child care professionals. The newsletter provides information on current and emerging health and safety issues relevant to child care providers and links the health, safety, and child care communities. Regular features include columns…

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

2002-01-01

132

Consumerism in Health Care Services  

ERIC Educational Resources Information Center

Discusses the current trend toward a corporate health care system in which services are often paid for by a third party (insurance company or government). Says this results in the consumer's loss of control over the quality and type of health care rendered. Recommends adoption of a federated health care system. (GC)

Carmichael, Lynn P.

1977-01-01

133

National Health Care Skill Standards.  

ERIC Educational Resources Information Center

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…

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

134

Sick Care vs Health Care: The Crisis in US Health  

Microsoft Academic Search

Increasingly, the United States is challenging conventional wisdom that wealth = health. Current estimates put US health care spending at approximately 15% of gross domestic product (GDP), the highest in the world(1), but the health system fails to deliver efficient, effective, and equitable health services. Overall, there is a systemic problem: a huge gap between the care that everyone should

White African; Hispanic White African

2007-01-01

135

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

PubMed

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

Braun, M

2003-12-01

136

Health care reforms in Poland.  

PubMed

This paper examines the shape of the recently reformed health care system in Poland. Until December 31,1998 everyone had access to free health care and the medical institutions were financed by the State. Since January 1, 1999, under the provisions of the Universal Health Insurance Act, hospitals became independent from the State budget and gained more financial resources for their activities. 17 regional health insurance funds contract for medical services with hospitals and individual practices. Most services provided to the insured are paid by the funds that receive premiums, but some are still financed from the State budget. The revised legislation on Medical Care Establishments intended to create a better management of health care institutions and administrative control over the quality of care. The system has been severely criticised: it is too bureaucratic, there are too many insurance funds, patients have experienced problems with access to health care, particularly to special treatment or to treatment available outside the area of the health insurance fund to which the patient belongs. The new Minister for Health suggested that the 17 funds should be replaced by 5 "health funds" that would finance health care and be closely connected to the local government answerable for their activities. This paper will deal with the scope of health care packages, the conditions of provision of health services, obligations of health care providers, patient rights, and the quality of health care. PMID:15685913

Baginska, Ewa

2004-01-01

137

Using DRGs in developing referral policies for coronary care within a local health district.  

PubMed

This paper presents the results of a study into some specific aspects of the management of coronary heart disease within one district health authority. In particular, it is concerned with the appropriate balance of inpatient coronary care between the district general hospital and community hospitals in the light of current and potential changes in the clinical management of coronary cases. The study is an example of a multidisciplinary approach to local health planning which is beginning to emerge within the Exeter Health District, the methodology of which may be applicable to client groups within the medical specialties other than coronary cases, such as strokes or respiratory disorders. It also illustrates the use of spatial analysis and diagnosis-related groups in local planning. PMID:10313468

Bailey, T C; Glaskin, A; Knowles, D; Kirby, B

1989-01-01

138

The importance of health literacy in the development of 'Self Care'' cards for community pharmacies in Ireland  

PubMed Central

Objective 'Self Care’'cards play a significant role in delivering health education via community pharmacies in Australia and New Zealand. The primary objective of this study was to evaluate whether such an initiative could have a similar impact in an Irish context. The secondary objective was to understand the importance of health literacy to this initiative. Methods Ten cards were developed for the Irish healthcare setting and trialed as a proof of concept study. The pilot study ran in ten community pharmacies in the greater Cork area for a six-month period. Using a mixed methods approach (Questionnaires & focus group) staff and patient reactions to the initiative were obtained. Concurrent to the pilot study, readability scores of cards (Flesch-Kincaid, Fry, SMOG methods) and the Rapid Estimate of Adult Literacy in Medicine (REALM) health literacy screening tool was administered to a sample of patients. Results 88.7% of patient respondents (n=53) liked the concept of the 'Self Care’' cards and 83% of respondents agreed that the use of the card was beneficial to their understanding of their ailment. Focus groups with Pharmacy staff highlighted the importance of appropriate training for the future development of this initiative. An emerging theme from designing the cards was health literacy. The pilot 'Self Care’'cards were pitched at too high a literacy level for the general Irish public to understand as determined by readability score methods. It was found that 19.1% of a sample population (n=199) was deemed to have low health literacy skills. Conclusions The 'Self Care’'initiative has the potential to be Pharmacy’s contribution to health education in Ireland. The initiative needs to be cognizant of the health literacy framework that equates the skills of individuals to the demands placed upon them. PMID:24155830

Coughlan, Diarmuid; Sahm, Laura; Byrne, Stephen

139

Environmental scanning and the health care manager.  

PubMed

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

Layman, Elizabeth J; Bamberg, Richard

2005-01-01

140

The Medicaid Managed Care Program. In To Improve Health and Health Care, vol. IX  

Microsoft Academic Search

In the 1990s, insurance companies and employers began to rely on managed care to control costs, and state governments followed suit by adopting managed care in Medicaid programs. To deal with the challenges associated with developing effective state Medicaid managed care programs, the Robert Wood Johnson Foundation developed the Medicaid Managed Care Initiative in 1995 to help states, health plans,

Marsha R. Gold; Justin S. White; Erin Fries Taylor

2005-01-01

141

Target Audience: Health care professionals  

E-print Network

(palliative care, chronic ill- ness), child welfare, and do- mestic violence. Valerie is an AssistantTarget Audience: Health care professionals Workshop Facilitator: Valerie Spironello, MSW, RSW Valerie has been a social worker for over 20 years working in a variety of settings including health care

Haykin, Simon

142

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

PubMed

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

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

1999-01-01

143

Attending unintended transformations of health care infrastructure  

PubMed Central

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

Wentzer, Helle; Bygholm, Ann

2007-01-01

144

Developing a measure of provider adherence to improve the implementation of behavioral health services in primary care: a Delphi study  

PubMed Central

Background The integration of behavioral health services into primary care is increasingly popular, yet fidelity of implementation in this area has been infrequently assessed due to the few measurement tools available. A sentinel indicator of fidelity of implementation is provider adherence, or utilization of prescribed procedures and engagement in model-specific behaviors. This study aimed to develop the first self-report measure of behavioral health provider adherence for co-located, collaborative care, a commonly adopted model of behavioral health service delivery in primary care. Methods A preliminary 56-item measure was developed by the research team to represent critical components of adherence among behavioral health providers. To ensure the content validity of the measure, a modified Delphi study was conducted using a panel of co-located, collaborative care model experts. During three rounds of emailed surveys, panel members provided qualitative feedback regarding item content while rating each item’s relevance for behavioral health provider practice. Items with consensus ratings of 80% or greater were included in the final adherence measure. Results The panel consisted of 25 experts representing the Department of Veterans Affairs, the Department of Defense, and academic and community health centers (total study response rate of 76%). During the Delphi process, two new items were added to the measure, four items were eliminated, and a high level of consensus was achieved on the remaining 54 items. Experts identified 38 items essential for model adherence, six items compatible (although not essential) for model adherence, and 10 items that represented prohibited behaviors. Item content addressed several domains, but primarily focused on behaviors related to employing a time-limited, brief treatment model, the scope of patient concerns addressed, and interventions used by providers. Conclusions This study yielded the first content valid self-report measure of critical components of collaborative care adherence for use by behavioral health providers in primary care. Although additional psychometric evaluation is necessary, this measure may assist implementation researchers in clarifying how provider behaviors contribute to clinical outcomes. This measure may also assist clinical stakeholders in monitoring implementation and identifying ways to support frontline providers in delivering high quality services. PMID:23406425

2013-01-01

145

Developmentally and Culturally Appropriate Screening in Primary Care: Development of the Behavioral Health Checklist  

PubMed Central

Objective?To evaluate the construct validity of the Behavioral Health Checklist (BHCL) for children aged from 4 to 12 years from diverse backgrounds.?Method?The parents of 4–12-year-old children completed the BHCL in urban and suburban primary care practices affiliated with a tertiary-care children’s hospital. Across practices, 1,702 were eligible and 1,406 (82.6%) provided consent. Children of participating parents were primarily non-Hispanic black/African American and white/Caucasian from low- to middle-income groups. Confirmatory factor analyses examined model fit for the total sample and subsamples defined by demographic characteristics.?Results?The findings supported the hypothesized 3-factor structure: Internalizing Problems, Externalizing Problems, and Inattention/Hyperactivity. The model demonstrated adequate to good fit across age-groups, gender, races, income groups, and suburban versus urban practices.?Conclusion?The findings provide strong evidence of the construct validity, developmental appropriateness, and cultural sensitivity of the BHCL when used for screening in primary care. PMID:23978505

Koshy, Anson J.; Watkins, Marley W.; Cassano, Michael C.; Wahlberg, Andrea C.; Mautone, Jennifer A.; Blum, Nathan J.

2013-01-01

146

Health Care Costing: Data, Methods, Future Directions  

Cancer.gov

Health Services and Economics Branch staff have collaborated with colleagues at the Agency for Healthcare Research and Quality (AHRQ), the Department of Veterans Affairs (VA), and Emory University to develop a supplement to the journal Medical Care. The supplement, published in July 2009, examines a broad array of methodologic issues related to health care cost estimation. The supplement's papers are led by experts in health economics, epidemiology, health services research, and biostatistics.

147

Health care of youth aging out of foster care.  

PubMed

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

2012-12-01

148

Integrated networks and health care provider cooperatives: new models for rural health care delivery and financing.  

PubMed

Minnesota's 1994 health care reform legislation authorized the establishment of community integrated service networks (CISNs) and health care provider cooperatives, which were envisioned as new health care delivery models that could be successfully implemented in rural areas of the state. Four CISNs are licensed, and three organizations are incorporated as health care provider cooperatives. Many of the policy issues Minnesota has faced regarding the development of CISNs and health care provider cooperatives in rural areas are similar to those raised by current Medicare reform proposals. PMID:9143900

Casey, M M

1997-01-01

149

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

PubMed

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

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

150

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

PubMed

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

Amara, Ahmed Hassan; Aljunid, Syed Mohamed

2014-01-01

151

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

PubMed Central

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

Beacham, Barbara L.; Deatrick, Janet A.

2013-01-01

152

The development and psychometric properties of a new scale to measure mental illness related stigma by health care providers: The opening minds scale for Health Care Providers (OMS-HC)  

PubMed Central

Background Research on the attitudes of health care providers towards people with mental illness has repeatedly shown that they may be stigmatizing. Many scales used to measure attitudes towards people with mental illness that exist today are not adequate because they do not have items that relate specifically to the role of the health care provider. Methods We developed and tested a new scale called the Opening Minds Scale for Health Care Providers (OMS-HC). After item-pool generation, stakeholder consultations and content validation, focus groups were held with 64 health care providers/trainees and six people with lived experience of mental illness to develop the scale. The OMS-HC was then tested with 787 health care providers/trainees across Canada to determine its psychometric properties. Results The initial testing OMS-HC scale showed good internal consistency, Cronbach’s alpha?=?0.82 and satisfactory test-retest reliability, intraclass correlation?=?0.66 (95% CI 0.54 to 0.75). The OMC-HC was only weakly correlated with social desirability, indicating that the social desirability bias was not likely to be a major determinant of OMS-HC scores. A factor analysis favoured a two-factor structure which accounted for 45% of the variance using 12 of the 20 items tested. Conclusions The OMS–HC provides a good starting point for further validation as well as a tool that could be used in the evaluation of programs aimed at reducing mental illness related stigma by health care providers. The OMS-HC incorporates various dimensions of stigma with a modest number of items that can be used with busy health care providers. PMID:22694771

2012-01-01

153

Space technology in remote health care  

NASA Technical Reports Server (NTRS)

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.

Belasco, N.

1974-01-01

154

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

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…

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

155

"Cloud" health-care workers.  

PubMed Central

Certain bacteria dispersed by health-care workers can cause hospital infections. Asymptomatic health-care workers colonized rectally, vaginally, or on the skin with group A streptococci have caused outbreaks of surgical site infection by airborne dispersal. Outbreaks have been associated with skin colonization or viral upper respiratory tract infection in a phenomenon of airborne dispersal of Staphylococcus aureus called the "cloud" phenomenon. This review summarizes the data supporting the existence of cloud health-care workers. PMID:11294715

Sherertz, R. J.; Bassetti, S.; Bassetti-Wyss, B.

2001-01-01

156

Health care revival renews, rekindles, and revives.  

PubMed

In a Black community in Boston, Mass, a community health center developed a faith-based initiative to improve the health of community residents. In partnership with a steering committee composed of community health advocates, church leaders, and community leaders, the community health center planned and implemented annual Health Care Revival meetings at which screening activities and dissemination of health information are integrated with inspirational singing and scripture readings. The success of the Health Care Revival initiative is demonstrated by an increased use of community health center services after each revival meeting, by participants' evaluations, and by an increase in the number of community health improvement projects begun as a direct result of the Health Care Revival initiative. PMID:11818285

Lawson, Erma; Young, Azzie

2002-02-01

157

eHealth: extending, enhancing, and evolving health care.  

PubMed

eHealth holds the promise of revolutionizing health care by improving its efficiency; extending and enhancing its reach; energizing and engaging its practitioners and their patients; and in the process, democratizing, decentralizing, and even partially demystifying the practice of medicine. In emerging and developing countries, the use of eHealth and smart health-care planning has the potential to expand access to necessary treatments and prevention services that can serve as underpinnings of rapid economic development. In developed countries, the application of eHealth promises to restructure the business model of health-care delivery, while at the same time improving and personalizing the quality of care received. This article reviews the past, present, and future of eHealth in an effort to illuminate the potential of its impact. PMID:23683088

Meier, Carlos A; Fitzgerald, Maria C; Smith, Joseph M

2013-01-01

158

Gypsies and health care.  

PubMed Central

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

Sutherland, A

1992-01-01

159

Progress in health care, progress in health?  

Microsoft Academic Search

This paper examines the potential impact of changes in medical care on changing population health in Lithuania, Hungary and Romania, with west Germany included for comparison. We used the concept of deaths from certain causes that should not occur in the presence of timely and effective health care (amenable mortality) and calculated the contribution of changes in mortality from these

Ellen Nolte; Martin McKee; Rembrandt D. Scholz

2004-01-01

160

Health care's move toward differentiation.  

PubMed

As the basis of competition changes, so will the focus of the health care industry's senior managers. The author believes that health plans that differentiate their product offerings, in the eyes of their customers, will be most successful. PMID:10164789

Kaminsky, R

1997-02-01

161

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

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

2013-01-01

162

Space age health care delivery  

NASA Technical Reports Server (NTRS)

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

Jones, W. L.

1977-01-01

163

Health care reform and rural mental health: Severe mental illness  

Microsoft Academic Search

Service needs of rural severely mentally ill and strengths of rural communities are addressed. Health care reform policy development at present appears to neglect the seriously mentally ill in general and rural services specifically. Examples of strategies to meet the needs for health care, psychiatric treatment, psychosocial rehabilitation and appropriate housing are described. The advantages and drawbacks of such efforts

Catherine F. Kane; Jacqueline M. Ennis

1996-01-01

164

Health Care for Gulf War Veterans  

MedlinePLUS

... Toll Free Numbers VA » Health Care » Public Health » Military Exposures » Gulf War Veterans' Illnesses » Benefits » Health Care ... Veterans Public Health Public Health Public Health Home Military Exposures Military Exposures Home 4 Ways to Find ...

165

An introduction to China's health care system.  

PubMed

The Chinese health care system was originally a highly centralized one. It had great success in improving the people's health. The county-township-village three-tier health care system has contributed much to rural primary health care, and has set an example of primary health care to the developing nations. In the 1980s, this system experienced transformations along with the changes of the country's administrative system and economic policy. The transformations are characterized by the disintegration of the rural cooperative medical service, by the decentralization of township hospitals from county to township governments, by official permission for private practice, by the implementation of the personal responsibility system in health institutions, by the health security reform, and by the development of health insurance in rural areas. The long-existing health administrative problems which were aggravated in the last decade are the rural-urban differences in resource allocation and the large proportion of people without health security. With the increase of medical service prices in recent years due to the inflation of the whole economy, it is believed that the cost of health care will create an economic burden to the low-income, fee-for-service paying individuals and will further affect the health of the population. In the process of the national economic reform, it is an important and difficult task for the health administrators to adjust the health care system promptly and properly. Only by continuously carrying forward good traditions, correcting mistakes and consistently persisting in health reform, can China further raise its health care to a new, prosperous stage. PMID:2056096

Liu, X Z; Wang, J L

1991-01-01

166

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

PubMed Central

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

2012-01-01

167

Contagious Ideas from Health Care  

ERIC Educational Resources Information Center

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…

Chaffee, Ellen

2009-01-01

168

Multicultural Health Care in Practice  

Microsoft Academic Search

This study presents a first assessment of the challenges faced by Dutch health care providers dealing with the increasing cultural diversity in Dutch society. Qualitative interviews with 24 Dutch caregivers and policy-makers point to a number of important difficulties encountered when confronted with the growing diversity of patient populations. The study focuses explicitly on the challenges health care providers perceive

Gert Olthuis; Godelieve van Heteren

2003-01-01

169

Prospects for Health Care Reform.  

ERIC Educational Resources Information Center

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)

Kastner, Theodore

1992-01-01

170

The ORIGINS of Primary Health Care and SELECTIVE Primary Health Care  

PubMed Central

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

Cueto, Marcos

2004-01-01

171

Service quality in health care.  

PubMed

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

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

1999-02-17

172

Quality of health care and patient satisfaction in liver disease: The development and preliminary results of the QUOTE-Liver questionnaire  

Microsoft Academic Search

BACKGROUND: Consensus on how to adequately measure patient satisfaction with health care is limited, and has led to the development of many questionnaires with various methodological problems. The objective of this study was to develop a liver disease- and care-specific patient satisfaction instrument on the basis of previously tested methodology in patient satisfaction measurement, the so called QUOTE- series: Quality

Jolie J Gutteling; Robert A de Man; Busschbach van J. J; Anne-Sophie E Darlington

2008-01-01

173

The national health care imperative.  

PubMed

In summary, the nation's health care system is in serious need of reform. It is expensive and woefully inefficient. Millions of people are excluded from coverage, while others receive limited or second-class care. For those millions who suffer serious chronic problems that require long-term care, there is virtually no help. There is no help for the family whose loved one suffers from Alzheimer's disease. There is no help for the family whose child is born with cerebral palsy or epilepsy. There is no help for the middle-aged father, disabled in an automobile accident. Providing good care to all Americans is not a matter of money. America currently spends some 13% of its gross national product on health care, and yet the health statistics of Americans are the worst in the industrialized world. What America needs is a comprehensive system of health care that includes both acute and long-term care. Congress must take action to restore health care as a basic constitutional right of all Americans. Coverage for long-term care must be included within the context of any new national health care program. Funding for such a program should come from the most progressive tax that the Congress can fashion, which to this point is the federal income tax. Although there is an appropriate role for private insurance, it should function as a supplement to rather than as a substitute for a new national program. There are several other elements that are key to a national health care program: Home care must be the first line of any national long-term care program.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:10106451

Halamandaris, V J

1990-03-01

174

Teens, technology, and health care.  

PubMed

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

Leanza, Francesco; Hauser, Diane

2014-09-01

175

Health Professionals' Knowledge of Women's Health Care.  

ERIC Educational Resources Information Center

Survey responses from 71 health professionals, benchmarking data from 8 hospitals, continuing education program evaluations, and focus groups with nursing, allied health, and primary care providers indicated a need for professional continuing education on women's health issues. Primary topic needs were identified. The data formed the basis for…

Beatty, Rebecca M.

2000-01-01

176

Selectivity within primary health care.  

PubMed

While great strides have been made in improving socioeconomic conditions in the developing world, prospects for health for all remain remote. Resources are few, and difficult decisions must be made concerning the priorities for their use. This paper addresses several topics involved in making these choices including the methods for determining priorities and ensuring effectiveness of resource use. First, prioritizing. Information is needed concerning the prevalence, mortality, morbidity, feasibility and cost of control for each disease of importance in the area under consideration. Second, the use of technology. In discussion of health care some have denigrated the concentration many programs have placed on specific methods and technologies. Nevertheless, technological advances, while some have had detrimental results, have often led to improved living conditions; for example, improved seed and fertilizer use, improved water pumps, family planning efforts. These technologies required a larger investment in management, financial and communication systems. Health interventions are frequently more various and complex than these and need a similar support system for impact. However there are many shortcomings in health services; the paper looks at some of these learnt through experience, and concludes that the lack of impact on health of large scale health programs that have provided selective interventions is probably related to an inadequate recognition of the importance of community and political involvement and of the necessary social, cultural, financial, management and administrative underpinnings. PMID:3388068

Walsh, J A

1988-01-01

177

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

PubMed

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

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

2013-01-01

178

Soviet health care and perestroika.  

PubMed Central

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

Schultz, D S; Rafferty, M P

1990-01-01

179

Primary health care in India--plans.  

PubMed

In India a draft Health Policy has been formulated with the following objectives: to improve and expand the health care delivery system to make primary health care services available to each individual; to make people conscious of their health needs and to encourage their involvement and participation in the planning and implementation of the health programs; to improve the standards of environmental sanitation and personal hygiene leading to reduction in the incidence of diseases and a healthier life; to improve maternal and child health services and to create such services; to control and eradicate common communicable and infectious desease; and to lower by about 50% maternal and infant mortality rates and other mortality rates. To achieve the general objectives, it is proposed to use certain specific indicators to plan and monitor the health programs. The indicators proposed, which are outlined, fall into the categories of health status indicators and indicators for provision of health services. The main objective of primary health care will be to provide better health care services to the rural areas and urban slums. The population will be encouraged both individually and collectively to participate in the development of health. The government and the medical profession will help the people to realize their responsibility by providing a large band of health volunteers from among the community itself to take care of the basic health needs of the community. There will be a more equitable distribution of health resources, and, to correct past imbalances, preferential allocations will be made for developing health facilities in rural areas. The primary emphasis will be on preventive, promotive, and rehabilitative aspects of health which will be integrated with functions and responsibilities of all these institutions which currently are providing only curative services. In providing primary health care, full advantage will be taken of the traditional methods and techniques which are scientifically sound, familiar and acceptable to the community, and easy to adopt. Primary health care will form an integral part of the health system. At this time 5739 primary health centers are operating in India, each covering a population of between 80,000-125,000. Primary health care to the rural population will be backed up by proper referral services. PMID:7183715

Saigal, M D

1982-09-01

180

China's health care sector in transition: resources, demand and reforms  

Microsoft Academic Search

Economic development and reforms have had profound impacts on China's health care sector. As a resul, the health care sector in China is in transition. This report reviews the major changes, and the possible policy response to these changes in China's health care sector. It discusses resource availability in the Chinese health sector, and analyses the trend of household demand

Yanrui Wu

1997-01-01

181

Spring 2014 CAN WE FIX HEALTH CARE?  

E-print Network

Spring 2014 CAN WE FIX HEALTH CARE? HEALTH ECONOMICS & POLICY 1 Dr. Katie Fitzpatrick UCOR1630 in health care policy. You will analyze health-related issues in the news, create and interpret graphical- plexity of the health care system and an appreciation of the tradeoffs in health care policy. Course

Carter, John

182

Health care reform in Russia  

Microsoft Academic Search

The break-up of the former Soviet Union has created a greater realisation of the health and health care deficiencies of what are now independent states and the need for reform. The purpose of these two papers is to describe these deficiencies and set the scene for the establishment of some form of national health insurance in Russia and the other

O P Schepin; V Yu Semenov; Igor Sheiman

1992-01-01

183

Final Report on the Development of a Baccalaureate External Degree Program in Health Services Administration With a Major in Long Term Care Administration.  

ERIC Educational Resources Information Center

A project undertaken at the Graduate School of Public Health of the University of Pittsburgh to develop an undergraduate external degree program in health services administration with a major in long-term care administration is described. Program activities were designed to: develop a work plan, identify the parameters of knowledge and skills…

Kleppick, Annabelle L.; And Others

184

[Renewing primary health care in the Americas].  

PubMed

At the 2003 meeting of the Directing Council of the Pan American Health Organization (PAHO), the PAHO Member States issued a mandate to strengthen primary health care (Resolution CD44. R6). The mandate led in 2005 to the document "Renewing Primary Health Care in the Americas. A Position Paper of the Pan American Health Organization/WHO [World Health Organization]," and it culminated in the Declaration of Montevideo, an agreement among the governments of the Region of the Americas to renew their commitment to primary health care (PHC). Scientific data have shown that PHC, regarded as the basis of all the health systems in the Region, is a key component of effective health systems and can be adapted to the range of diverse social, cultural, and economic conditions that exist. The new, global health paradigm has given rise to changes in the population's health care needs. Health services and systems must adapt to address these changes. Building on the legacy of the International Conference on Primary Health Care, held in 1978 in Alma-Ata (Kazakhstan, Union of Soviet Socialist Republics), PAHO proposes a group of strategies critical to adopting PHC-based health care systems based on the principles of equity, solidarity, and the right to the highest possible standard of health. The main objective of the strategies is to develop and/or strengthen PHC-based health systems in the entire Region of the Americas. A substantial effort will be required on the part of health professionals, citizens, governments, associations, and agencies. This document explains the strategies that must be employed at the national, subregional, Regional, and global levels. PMID:17565795

Macinko, James; Montenegro, Hernán; Nebot Adell, Carme; Etienne, Carissa

2007-01-01

185

Health care system factors affecting end-of-life care.  

PubMed

The field of palliative care in the United States developed in response to a public health crisis--namely, poor quality of life for patients with serious illness and their families--and most palliative care research to date has been appropriately focused on identifying patient and family needs and identifying gaps in the current health care system and in the education of our health care professionals. Research has also begun to develop and evaluate new interventions and systems to address these care gaps. Preliminary studies suggest modest benefits of an array of programs designed to deliver palliative care services. These benefits include improved pain and other symptoms, increased family satisfaction, and lower hospital costs. Unfortunately, the validity and reliability of these findings are limited by important methodological weaknesses including small sample sizes, poorly described and nongeneralizable interventions, diverse and nonstandardized outcome measures, and poor study designs (i.e., lack of appropriate control groups, nonblinded designs). Comprehensive and rigorous research is needed to evaluate the effect of well-delineated and generalizable palliative care structures and processes on important clinical and use outcomes. Large multisite studies that have adequate power to detect meaningful differences in clinical and use outcomes, and that use well-defined and generalizable structures and evidence-based care processes, well-defined uniform outcome measures, and analyses that link the outcomes of interest to individual components of the interventions, are needed to guide further development of the field. PMID:16499472

Morrison, R Sean

2005-01-01

186

Managing Home Health Care (For Parents)  

MedlinePLUS

Intensive Health Care at Home Kids can need intensive health care at home after they have been in the hospital ... dolls to help you practice different procedures. Home Health Care Assistance The hospital social worker can help families ...

187

Reflections on curative health care in Nicaragua.  

PubMed Central

Improved health care in Nicaragua is a major priority of the Sandinista revolution; it has been pursued by major reforms of the national health care system, something few developing countries have attempted. In addition to its internationally recognized advances in public health, considerable progress has been made in health care delivery by expanding curative medical services through training more personnel and building more facilities to fulfill a commitment to free universal health coverage. The very uneven quality of medical care is the leading problem facing curative medicine now. Underlying factors include the difficulty of adequately training the greatly increased number of new physicians. Misdiagnosis and mismanagement continue to be major problems. The curative medical system is not well coordinated with the preventive sector. Recent innovations include initiation of a "medicina integral" residency, similar to family practice. Despite its inadequacies and the handicaps of war and poverty, the Nicaraguan curative medical system has made important progress. PMID:2705603

Slater, R G

1989-01-01

188

Introducing Multiprofessional Team Practice and Community-Based Health Care Services into the Curriculum: A Challenge for Health Care Educators  

Microsoft Academic Search

As our health care system changes, our educational curriculum for health care providers needs to be redesigned and focused on the delivery of multiprofessional, community-centered, and primary I prevention health care. This article describes the development and outcome of several multiprofessional courses that have been offered across curricula in the Schools of Medicine, Nursing, Professional Psychology, and Allied Health. Multiprofessional

Mary R. Talen; Margaret Clark Graham; Gordon Walbroehl

1994-01-01

189

Report Identifies Game Changers for U.S. Health Care  

MedlinePLUS

... enable JavaScript. Report Identifies Game Changers for U.S. Health Care Recent innovations, developments may transform direction of patient ... recent events expected to alter the delivery of health care and use of medicines over the next decade. ...

190

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

PubMed

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

Anyinam, C A

1989-01-01

191

Politics, jobs and workforce development : the role of workforce intermediaries in building career pathways within Boston's health care industry  

E-print Network

This research study examines the role that workforce intermediaries within Boston play in creating career pathways for economically disadvantaged, under-skilled residents in the local health care industry. Using a case ...

Hutson, Malo

2006-01-01

192

Development of quality indicators for monitoring outcomes of frail elderly hospitalised in acute care health settings: Study Protocol  

PubMed Central

Background Frail older people admitted to acute care hospitals are at risk of a range of adverse outcomes, including geriatric syndromes, although targeted care strategies can improve health outcomes for these patients. It is therefore important to assess inter-hospital variation in performance in order to plan and resource improvement programs. Clinical quality outcome indicators provide a mechanism for identifying variation in performance over time and between hospitals, however to date there has been no routine use of such indicators in acute care settings. A barrier to using quality indicators is lack of access to routinely collected clinical data. The interRAI Acute Care (AC) assessment system supports comprehensive geriatric assessment of older people within routine daily practice in hospital and includes process and outcome data pertaining to geriatric syndromes. This paper reports the study protocol for the development of aged care quality indicators for acute care hospitals. Methods/Design The study will be conducted in three phases: 1. Development of a preliminary inclusive set of quality indicators set based on a literature review and expert panel consultation, 2. A prospective field study including recruitment of 480 patients aged 70 years or older across 9 Australian hospitals. Each patient will be assessed on admission and discharge using the interRAI AC, and will undergo daily monitoring to observe outcomes. Medical records will be independently audited, and 3. Analysis and compilation of a definitive quality indicator set, including two anonymous voting rounds for quality indicator inclusion by the expert panel. Discussion The approach to quality indicators proposed in this protocol has four distinct advantages over previous efforts: the quality indicators focus on outcomes; they can be collected as part of a routinely applied clinical information and decision support system; the clinical data will be robust and will contribute to better understanding variations in hospital care of older patients; The quality indicators will have international relevance as they will be built on the interRAI assessment instrument, an internationally recognised clinical system. PMID:22014061

2011-01-01

193

Accreditation Association for Ambulatory Health Care  

MedlinePLUS

... HIPAA compliance Federal and State Regulations/Legislative Resources Health Care Resources Press Releases Contact Us Find a Health Care Organization Accreditation Programs General information Application for survey ...

194

Helping You Choose Quality Behavioral Health Care  

MedlinePLUS

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

195

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

Describes the essential features of a health care system that can meet the special needs of children in out-of-home care. Discusses some of the major recent changes brought about by welfare and health care reform. Notes that it remains to be seen whether the quality of services will improve as a result of these reforms. (Author)

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

1999-01-01

196

Respiratory Home Health Care  

MedlinePLUS

... patients and caregivers to perform on a routine basis. Use a liquid soap and lots of warm ... care equipment should be cleaned on a regular basis. Besides washing with a mild detergent and rinsing ...

197

Faculty of Health and Medical Sciences School of Health & Social Care  

E-print Network

to relevant policy. Faculty of Health and Medical Sciences School of Health and Social Care T: +44 (0) 1483Faculty of Health and Medical Sciences School of Health & Social Care Learning Through Professional to develop independent learners who are able to address the complexities of modern health and social care

Doran, Simon J.

198

A Microeconometric Model of the Demand for Health Care and Health Insurance in Australia  

Microsoft Academic Search

This paper develops a model for interdependent demand for health insurance and health care under uncertainty to throw light on the issue of insurance-induced distortions in the demand for health care services. The model is used to empirically analyze the determinants of the choice of health insurance type and seven types of health care services using micro-level data from the

A. C. Cameron; P. K. Trivedi; Frank Milne; J. Piggott

1988-01-01

199

Development and Evaluation of CAHPS® Questions to Assess the Impact of Health Information Technology on Patient Experiences with Ambulatory Care  

PubMed Central

Background Little is known about whether health information technology (HIT) affects patient experiences with health care. Objective To develop HIT questions that assess patients care experiences not evaluated by existing ambulatory CAHPS measures. Research Design We reviewed published articles and conducted focus groups and cognitive testing to develop survey questions. We collected data, using mail and the internet, from patients of 69 physicians receiving care at an academic medical center and two regional integrated delivery systems in late 2009 and 2010. We evaluated questions and scales about HIT using factor analysis, item-scale correlations, and reliability (internal consistency and physician-level) estimates. Results We found support for three HIT composites: doctor use of computer (2 items), e-mail (2 items), and helpfulness of provider’s website (4 items). Corrected item-scale correlations were 0.37 for the two doctor use of computer items and 0.71 for the two e-mail items, and ranged from 0.50 to 0.60 for the provider’s website items. Cronbach’s alpha was high for e-mail (0.83) and provider’s website (0.75), but only 0.54 for doctor use of computer. As few as 50 responses per physician would yield reliability of 0.70 for e-mail and provider’s website. Two HIT composites, doctor use of computer (p<0.001) and provider’s website (p=0.02), were independent predictors of overall ratings of doctors. Conclusions New CAHPS HIT items were identified that measure aspects of patient experiences not assessed by the CAHPS C&G 1.0 survey. PMID:23064271

McInnes, D. Keith; Brown, Julie A.; Hays, Ron D.; Gallagher, Patricia; Ralston, James D.; Hugh, Mildred; Kanter, Michael; Serrato, Carl A.; Cosenza, Carol; Halamka, John; Ding, Lin; Cleary, Paul D.

2012-01-01

200

Agents of Change for Health Care Reform  

ERIC Educational Resources Information Center

It is widely recognized throughout the health care industry that the United States leads the world in health care spending per capita. However, the chilling dose of reality for American health care consumers is that for all of their spending, the World Health Organization ranks the country's health care system 37th in overall performance--right…

Buchanan, Larry M.

2007-01-01

201

Identification of items which predict later development of depression in primary health care  

Microsoft Academic Search

To improve recognition and treatment of depression in primary care it would be advantageous to have criteria for identification\\u000a of later depression. Only a few studies were performed on primary care samples to examine risk factors for new depressive\\u000a episodes. These were mostly cross-sectional and did not include psychiatric symptoms as possible predictors. This is the first\\u000a one-year-follow-up study investigating

Katrin Barkow; Reinhard Heun; T. Bedirhan Üstün; Wolfgang Maier

2001-01-01

202

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

PubMed

Integration between traditional and contemporary health care in a host nation can be beneficial to nation- and capacity-building and, subsequently, to the overall health of the society. "Traditional" health care in this sense refers to the indigenous health care system in the host nation, which includes characteristic religious or cultural practices, whereas "contemporary" health care is also known as "conventional" or "Westernized"; integration is a synchronization of these two health care forms. However, the choice of integration depends on the political and cultural situation of the nation in which the Department of Defense health care personnel are intervening. Thus, cultural awareness training is essential to ensure the success of missions related to global health and in promoting a health care system that is most beneficial to the society. The present study attempts to show the benefits of both cultural training and health care integration, and how adequately evaluating their efficacy has been problematic. The author proposes that determinants of this efficacy are better documentation collection, extensive predeployment cultural awareness and sensitivity training, and extensive after-action reports for future development. PMID:23756013

Facchini, Rose E

2013-05-01

203

Health Care Resource Guide  

E-print Network

, and children, simple diagnostic tests, medical assistance, limited immunizations, sports physicals, DOT Program 13 Project Access 14 Riverstone Family Health Clinic 15-16 Shriners Hospital for Children

Collins, Gary S.

204

Health Care Spending: Context and Policy  

Microsoft Academic Search

[Excerpt] The United States spends a large and growing share of national income on health care. In 2007, health spending is expected to approach $2.3 trillion and account for more than 16% of gross domestic product (GDP). We spend substantially more than other developed countries, both per capita and as a share of GDP. However, given our wealth, such spending

Jennifer Jenson

2007-01-01

205

Health care reform and changes: the Malaysian experience.  

PubMed

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

Merican, Mohd Ismail; bin Yon, Rohaizat

2002-01-01

206

Help Yourself to Health Care.  

ERIC Educational Resources Information Center

A booklet on health care for limited English speakers provides information on choosing the right doctor, buying medicine, paying the bill, and the individual's role in maintaining his or her health. Cartoons, questions and puzzles concerning the message in cartoons and narrative passages, checklists about an individual's personal habits related to…

Snyder, Sarah

207

A controlled before-after trial of structured diabetes care in primary health centres in a newly developed country  

Microsoft Academic Search

Objective. To evaluate the long-term impact of a structured approach to improving the quality of diabetes care in general prac- tice in the United Arab Emirates. Design. Controlled before-after trial within a health district with three primary health centres (PHCs) in the intervention group and the six remaining serving as controls. Outcomes and adherence to guidelines were measured over the

RICHARD L. REED; ANTHONY D. REVEL; ANNE O. CARTER; HUSSEIN F. SAADI; EARL V. DUNN

2005-01-01

208

Primary health care for whom? Village perspectives from Nepal  

Microsoft Academic Search

Over the last decade, many developing nations have embraced Primary Health Care (PHC) within their national health plans. PHC, in contrast to earlier approaches to national health development, emphasizes community participation and basic health care for the poorer segments of society. The research reported here finds that in the enthusiasm for the PHC concept in Nepal, important sociocultural processes have

Linda Stone

1986-01-01

209

MIS for Health Care Human Resource Management: A Case  

Microsoft Academic Search

Human resources (HR) represent a key resource for the health care system in any coun try. Its development and management are considered vital for establishing a sustain able health system infrastructure. A human resources management information system (MIS) is essential for sound planning and management of a health system. This paper briefly discusses the conceptual development of health care human

Basu Ghosh

2000-01-01

210

Determinants of Children's Primary Health Care Use  

Microsoft Academic Search

We review factors that influence children's use of primary health care services. Predictors of pediatric health care use include child health status, child mental health, parent and family functioning, demographic characteristics, and access to health care services. Health services research is marked by inconsistencies due to varying approaches to measurement, population sampling, and analysis, and models that do not incorporate

David M. Janicke; Jack W. Finney

2000-01-01

211

Health care workers and researchers traveling to developing-world clinical settings: disease transmission risk and mitigation.  

PubMed

With the recent emphasis on funding and training opportunities for global health and humanitarian aid and the increased interest in the field, many health care workers and medical researchers are traveling from resource-replete to resource-limited settings. This type of travel brings unique disease risks not routinely considered for the business or vacationing traveler. This review provides practical advice for this special population of travelers, targeted to specific health care-related risks (needlestick, hemorrhagic fever viruses, severe viral respiratory disease, and tuberculosis), with suggestions for risk mitigation. PMID:21039283

Kortepeter, Mark G; Seaworth, Barbara J; Tasker, Sybil A; Burgess, Timothy H; Coldren, Rodney L; Aronson, Naomi E

2010-12-01

212

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

ERIC Educational Resources Information Center

Outlines access to health care for children in out-of-home care under current law, reviews how health care access for these children would be affected by President Clinton's health care reform initiative, and proposes additional measures that could be considered to improve access and service coordination for children in the child welfare system.…

Halfon, Neal; And Others

1994-01-01

213

HealthCare.gov  

MedlinePLUS

... MD 21244 Whitehouse.gov USA.gov × Get Email/Text Updates Learn more about new health insurance options ... Northern Mariana Islands Puerto Rico Virgin Islands For Text Messages Optional Privacy Policy Subscription Complete! Now that ...

214

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

SciTech Connect

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.

Al-Khatib, Issam A. [Institute of Environmental and Water Studies, Birzeit University, P.O. Box 14, Birzeit, Ramallah, West Bank (Palestinian Territory, Occupied)], E-mail: ikhatib@birzeit.edu; Sato, Chikashi [Department of Civil and Environmental Engineering, Idaho State University, Pocatello, Idaho (United States)

2009-08-15

215

REST-Style Architecture and the Development of Mobile Health Care Solutions  

E-print Network

Nicholson1 , , Lin Wan1 , 1 Axolotl Corp., 160 West Santa Clara Street, Suite 1000 San Jose, CA 95113, USA {fandry, lwan, dnicholson}@axolotl.com Abstract. The growing demand for mobile applications in the health

Andry, François

216

Latino Adults’ Access to Mental Health Care  

PubMed Central

Since the early 1980s, epidemiological studies using state-of-the-art methodologies have documented the unmet mental health needs of Latinos adults in the U.S. and Puerto Rico. This paper reviews 16 articles based on seven epidemiological studies, examines studies methodologies, and summarizes findings about how Latino adults access mental health services. Studies consistently report that, compared to non-Latino Whites, Latinos underutilize mental health services, are less likely to receive guideline congruent care, and rely more often on primary care for services. Structural, economic, psychiatric, and cultural factors influence Latinos’ service access. In spite of the valuable information these studies provide, methodological limitations (e.g., reliance on cross-sectional designs, scarcity of mixed Latino group samples) constrict knowledge about Latinos access to mental health services. Areas for future research and development needed to improve Latinos’ access and quality of mental health care are discussed. PMID:16598658

Cabassa, Leopoldo J.; Zayas, Luis H.; Hansen, Marissa C.

2008-01-01

217

Flat Medicine? Exploring Trends in the Globalization of Health Care  

Microsoft Academic Search

Abstract Trailing nearly every other industry, health care is finally globalizing. Highly trained and experienced,expatriate health care professionals are returning to their home,countries from training in the West or are staying home,to work,in newly developed,corporate health care delivery systems that can compete,quite favorably with less-than-perfect providers in Europe and North America. In turn, these health care systems are attracting patients

Robert K. Crone

2008-01-01

218

Developing 'robust performance benchmarks' for the next Australian Health Care Agreement: the need for a new framework  

PubMed Central

If the outcomes of the recent COAG meeting are implemented, Australia will have a new set of benchmarks for its health system within a few months. This is a non-trivial task. Choice of benchmarks will, explicitly or implicitly, reflect a framework about how the health system works, what is important or to be valued and how the benchmarks are to be used. In this article we argue that the health system is dynamic and so benchmarks need to measure flows and interfaces rather than simply cross-sectional or static performance. We also argue that benchmarks need to be developed taking into account three perspectives: patient, clinician and funder. Each of these perspectives is critical and good performance from one perspective or on one dimension doesn't imply good performance on either (or both) of the others. The three perspectives (we term the dimensions patient assessed value, performance on clinical interventions and efficiency) can each be decomposed into a number of elements. For example, patient assessed value is influenced by timeliness, cost to the patient, the extent to which their expectations are met, the way they are treated and the extent to which there is continuity of care. We also argue that the way information is presented is important: cross sectional, dated measures provide much less information and are much less useful than approaches based on statistical process control. The latter also focuses attention on improvement and trends, encouraging action rather than simply blame of poorer performers. PMID:18439247

Duckett, Stephen J; Ward, Michael

2008-01-01

219

Faculty of Health and Medical Sciences School of Health & Social Care  

E-print Network

Faculty of Health and Medical Sciences School of Health & Social Care Care of Older People Module School of Health and Social Care T: +44 (0) 1483 684505 F: +44 (0) 1483 686736 E: postreg their knowledge of the multifaceted nature of holistic care of older people. Practitioners will be able to develop

Doran, Simon J.

220

UNIVERSITY OF CONNECICUT HEALTH CENTER CORRECTIONAL MANAGED HEALTH CARE  

E-print Network

UNIVERSITY OF CONNECICUT HEALTH CENTER CORRECTIONAL MANAGED HEALTH CARE POLICY AND PROCEDURES SERVICES Effective Date: 04/01/01 POLICY: University of Connecticut Health Center (UCHC), Correctional Managed Health Care (CMHC) shall ensure that newly admitted inmates to Connecticut Department

Oliver, Douglas L.

221

Optimization of preventive health care facility locations  

Microsoft Academic Search

BACKGROUND: Preventive health care programs can save lives and contribute to a better quality of life by diagnosing serious medical conditions early. The Preventive Health Care Facility Location (PHCFL) problem is to identify optimal locations for preventive health care facilities so as to maximize participation. When identifying locations for preventive health care facilities, we need to consider the characteristics of

Wei Gu; Xin Wang; S. Elizabeth McGregor

2010-01-01

222

Health practices of critical care nurses.  

PubMed

Little is known about the health practices of critical care nurses (CCNs). Because their health behaviors may influence their inclinations to counsel patients, it is important that CCNs engage in a healthy lifestyle and serve as health exemplars. The purpose of this survey was to describe the health practices of 499 CCNs. Data were gathered by questionnaires that elicited information regarding smoking habits, oral health and dietary practices, energy expenditure, seat belt use, alcohol consumption, and health surveillance behaviors. This article is a sequel to a previous manuscript that reported findings relative to the smoking practices of CCNs. Results of the study suggest that the CCNs surveyed were not fulfilling their roles as health exemplars. Although some reported favorable health practices, many indicated habits that were less than desirable. These data document the need to develop strategies for improving the health behaviors of CCNs, thereby protecting their future health. Ultimately, these strategies may benefit their patients. PMID:1592608

Haughey, B P; Kuhn, M A; Dittmar, S S; Wu, Y W

1992-05-01

223

The Ethical Self-Fashioning of Physicians and Health Care Systems in Culturally Appropriate Health Care  

Microsoft Academic Search

Diverse advocacy groups have pushed for the recognition of cultural differences in health care as a means to redress inequalities\\u000a in the U.S., elaborating a form of biocitizenship that draws on evidence of racial and ethnic health disparities to make claims\\u000a on both the state and health care providers. These efforts led to federal regulations developed by the U.S. Office

Susan J. Shaw; Julie Armin

2011-01-01

224

FastStats: Home Health Care  

MedlinePLUS

... and Territorial Data NCHS Home FastStats Home Home Health Care Data are for the U.S. Number of current ... diabetes, 11 percent of discharges (2007) Source: Home Health Care and Discharged Hospice Care Patients: United States, 2000 ...

225

Health Care Reform and Alzheimer's Disease  

MedlinePLUS

... care and research. Subscribe now Medicare and the health care reform law Drug rebates for seniors At a ... Detection of possible cognitive impairment under Medicare The health care reform law created a new Medicare benefit to ...

226

The behaviour, development, and health of the young child: implications for care.  

PubMed Central

Children with recurrent physical illnesses such as infections of the ears and chest are more likely than average to have developmental and behavioural disorders as well. Specialist skills are needed for the assessment and management of these disorders; the belief that "the child will grow out of it" is rarely correct. Any reorganisation of the child health services should take account of the need for children with developmental and behavioural disorders to be treated within the community by doctors and other health workers with the appropriate skills. PMID:6190531

Bax, M; Hart, H; Jenkins, S

1983-01-01

227

National Lesbian Health Care Survey: Implications for Mental Health Care  

Microsoft Academic Search

This article presents demographic, lifestyle, and mental health information about 1,925 lesbians from all 50 states who participated as respondents in the National Lesbian Health Care Survey (1984–1985), the most comprehensive study on U.S. lesbians to date. Over half the sample had had thoughts about suicide at some time, and 18% had attempted suicide. Thirty-seven percent had been physically abused

Judith Bradford; Caitlin Ryan; Esther D. Rothblum

1994-01-01

228

Making better use of health care information.  

PubMed

Effective use of health care information holds the promise of improved care and reduced health costs. A number of challenges must, however, be met. Incentives for using information must be introduced. A code of practice for using patient data to allay confidentiality concerns is needed. An institution is needed to accelerate the development of health information standards. Awareness must be raised about the opportunities provided by more effective use of information. Champions are needed to create the required information-intensive infrastructures. PMID:10131593

Aspden, P

1994-02-01

229

Advanced practice nursing in performing arts health care.  

PubMed

Performing arts medicine is a growing health care profession specializing in the needs of performing artists. As part of the performing arts venue, the dancer, a combination of athlete and artist, presents with unique health care needs requiring a more collaborative and holistic health care program. Currently there are relatively few advanced practice nurses (APNs) who specialize in performing arts health care. APNs, with focus on collaborative and holistic health care, are ideally suited to join other health care professionals in developing and implementing comprehensive health care programs for the performing artist. This article focuses on the dancer as the client in an APN practice that specializes in performing arts health care. PMID:20644180

Weslin, Anna T; Silva-Smith, Amy

2010-06-01

230

Optimizing Burn Treatment in Developing Low- and Middle-Income Countries with Limited Health Care Resources (Part 1)  

PubMed Central

Summary In developing countries burn injuries are much more common than in the USA and Europe or other affluent developed countries, due to poverty, overcrowding, and illiteracy, and are associated with higher mortality rates. The high incidence makes burns an endemic health hazard in these countries. Over 90% of burn-related fatalities occur in developing or low- and middle-income countries (LMICs), with south-east Asia alone accounting for over half of fire-related deaths. Management of burns and their sequelae even in the well-equipped, modern burn units of advanced affluent societies remains demanding despite advances in surgical techniques and development of tissue-engineered biomaterials available to these burn centres. Undoubtedly, in a developing country with limited resources and inaccessibility to sophisticated skills and technologies, management of burns constitutes a major challenge. The present review of the literature analyses the challenges facing burn management in LMICs and explores probable modalities to optimize burn management in these countries. The review will be published in three parts. Part I will present the epidemiology of burn injuries and challenges for management in LMICs. Part II will be about management of burn injuries in LMICs and Part III will discuss strategies for proper prevention and burn care in LMICs. PMID:21991167

Atiyeh, B.; Masellis, A.; Conte, C.

2009-01-01

231

Faculty of Health and Medical Sciences School of Health & Social Care  

E-print Network

policy and provision in an innovative manner. Specific Aims To enable registered health careFaculty of Health and Medical Sciences School of Health & Social Care Learning through Professional to develop independent learners who are able to address the complexities of modern health and social care

Doran, Simon J.

232

Faculty of Health and Medical Sciences School of Health & Social Care  

E-print Network

Faculty of Health and Medical Sciences School of Health & Social Care Development of Clinical mentor. Faculty of Health and Medical Sciences School of Health and Social Care T: +44 (0) 1483 684505 F of clinical judgment, discretion and decision making and empower them to deliver high quality care

Doran, Simon J.

233

Bereavement photography for children: program development and health care professionals' response.  

PubMed

Reports of in-hospital bereavement photography focus largely on stillborns and neonates. Empiric data regarding the implementation of bereavement photography in pediatrics beyond the neonatal period and the impact of such programs on healthcare professionals (HCPs) is lacking. The authors describe the implementation of a pediatric intensive care unit (PICU) bereavement photography program and use questionnaire data from HCPs to describe HCPs' reflections on the program and to identify program barriers. From July 2007 through April 2070, families of 59 (36%) of the 164 patients who died in the PICU participated in our bereavement photography program. Forty questionnaires from 29 HCPs caring for 39 participating patients/families indicated that families seemed grateful for the service (n = 34; 85%) and that the program helped HCPs feel better about their role (n = 30; 70%). Many HCPs disagreed that the program consumed too much of his/her time (n = 34; 85%) and that the photographer made his/her job difficult (n = 37; 92.5%). Qualitative analysis of responses to open-ended questions revealed 4 categories: the program's general value; positive aspects of the program; negative aspects of the program; and suggestions for improvements. Implementing bereavement photography in the PICU is feasible though some barriers exist. HCPs may benefit from such programs. PMID:24520925

Michelson, Kelly Nicole; Blehart, Kathleen; Hochberg, Todd; James, Kristin

2013-07-01

234

Health Care Reform: A Values Debate.  

ERIC Educational Resources Information Center

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)

Popko, Kathleen

1992-01-01

235

Consumer-directed health care and case management: Part 1.  

PubMed

Consumer-directed health care (CDH) is here. A quick look at the current health care market shows that CDH is quickly gaining a foothold. Most health plans either already offer some type of a plan or are in the midst of developing one for the next enrollment period. Early adopter health plans have gained significant market traction, gaining new employer clients on the basis of a consumer-directed health care strategy. PMID:16061162

Gupta, Amit

2005-01-01

236

Finding Low-Cost Mental Health Care  

MedlinePLUS

... Teens > Mind > Mental Health > Finding Low-Cost Mental Health Care Print A A A Text Size What's in ... if you're concerned about paying for mental health care. Lots of people need help and worry that ...

237

Health Care Procedure Considerations and Individualized Health Care Plans  

ERIC Educational Resources Information Center

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

Heller, Kathryn Wolff; Avant, Mary Jane Thompson

2011-01-01

238

Homeless persons and health care.  

PubMed

Health care is generally unavailable for the homeless. This heterogeneous group of men and women, including long-term street dwellers, residents of shelters, the chronically mentally ill, the economically debased, and alienated youth, are subject to a broad range of acute and chronic diseases, intensified by unsuitable living conditions, stress, and sociopathic behavior. Trauma, pulmonary tuberculosis, infestations, and peripheral vascular disease are common problems among the homeless; incomplete and fragmentary medical care permits exacerbation of chronic disorders. Outreach programs imaginatively constructed by teams of physicians, nurses, and social workers can effectively reestablish and maintain health services for these disenfranchised persons. PMID:3511826

Brickner, P W; Scanlan, B C; Conanan, B; Elvy, A; McAdam, J; Scharer, L K; Vicic, W J

1986-03-01

239

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

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

2014-01-01

240

Health disparities among health care workers.  

PubMed

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

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

2010-01-01

241

Health care financing: recent experience in Africa.  

PubMed

The economic realities of health sector development in Africa has been analyzed in this paper. Both the global and national macroeconomic context has been defined. Given the available data, it is clear that most African countries face increasingly serious economic realities, such as slow or even declining economic growth (per capita), a depressed food production situation, severe balance of payments crises, and increasing dependence on external financial assistance. Given the limited but increasingly available 1981 and 1982 data, the economic situation in many countries is more constrained than those indicated by the data contained in this paper. In this context, the potential competitive situation facing governmental health care systems was reviewed. In addition, the diversity in the sources of health expenditures between countries in Africa was highlighted. These data provide clear evidence that governments clearly do not finance the entire health care system and that individual payment for service in many countries represent an important source of revenue for many care providers in various health care systems operating in any given country. The potential for governments to finance either an expansion of or improvements to the government component of their health care systems is then reviewed. The highlights of this analysis include the following points. First, the tax structure in many African countries is highly dependent on export and import duties, which in turn creates dependency on sustained foreign demand for exports.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:6422557

Dunlop, D W

1983-01-01

242

Developing a model of source-specific interpersonal conflict in health care.  

PubMed

Nurses work in complex social environments, and conflict may arise with fellow coworkers, their supervisor, physicians or the patients and family they care for. Although much research has documented the negative effects of conflict on nurses, no research to date has examined the comparative effect that conflict from all four sources can have on nurses. The purpose of this study is to test a model of workplace conflict where the negative effect of conflict on nurses will be experienced via emotional exhaustion. We test the mediator model by analysing the cross-sectional data collected within one hospital (N1=182) and cross-validating those results in a second hospital (N2=161). The pattern of results was largely consistent across the two samples indicating support for a mediated model of workplace conflict for physician, supervisor and patient. Conflict with other nurses, however, did not have a relationship with either emotional exhaustion or other personal and organizational outcomes. The theoretical and practical implications of the current findings, as well as the limitations and future research directions, are discussed. PMID:22259160

Guidroz, Ashley M; Wang, Mo; Perez, Lisa M

2012-02-01

243

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

ERIC Educational Resources Information Center

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…

Alinier, Guillaume

2011-01-01

244

Expanding the Scope of Faculty Educator Development for Health Care Professionals  

ERIC Educational Resources Information Center

Although many medical institutions offer faculty development in education, this does not provide the in-depth knowledge of the science of teaching required for medical education research and careers in medical education. This paper describes our expanding faculty development activities at Cincinnati Children's Hospital Medical Center (CCHMC) that…

Lewis, Kadriye O.; Baker, Raymond C.

2009-01-01

245

take care of What Matters Health Family  

E-print Network

your receipts! Health care account max of $2500; child day care account max of $5000 Convenienttake care of What Matters Health · Family · Finances · Future Medical Coverage Penn State offers plans allow you freedom of choice of health care providers both in and out of network. PPO Blue plan

Lee, Dongwon

246

Health care and the transcendent  

Microsoft Academic Search

This paper examines the values implicit in health care providers serving dying persons. It studies why providers should form a relationship with the dying person that is more human, less mechanistic, and less directed to that person as an economic unit or as a “case” of this or that disease. Much of the literature on the dying makes such suggestions

Clyde Nabe

1989-01-01

247

Spirituality, health care, and bioethics  

Microsoft Academic Search

This article explores the relationship of spirituality to health care and bioethics in terms of the need and efforts of people to make sense of their lives in the face of illness, injury, or impending death. Moving beyond earlier associations with specific religious traditions, spirituality has come to designate the way in which people can integrate their experiences with their

Maureen Muldoon; Norman King

1995-01-01

248

Health care insolvency and bankruptcy.  

PubMed

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

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

1998-08-01

249

The "Assistant Practitioner" as "Associate Professional"? Professional Development of Intermediate Roles in Health and Social Care and Education  

ERIC Educational Resources Information Center

Recent years have seen the health and social care and education sectors subject to a range of policy initiatives which have been characterised by a concern for "modernisation" and restructuring of the workforce which has resulted in a reappraisal and so-called "professionalisation" of many existing previously lowskill roles. This has resulted in…

Edmond, Nadia; Aranda, Kay; Gaudoin, Rosemary; Law, Kate

2012-01-01

250

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

ERIC Educational Resources Information Center

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…

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

2011-01-01

251

Managed consumerism in health care.  

PubMed

The future of market-oriented health policy and practice lies in "managed consumerism," a blend of the patient-centric focus of consumer-driven health care and the provider-centric focus of managed competition. The optimal locus of incentives will vary among health services according to the nature of the illness, the clinical technology, and the extent of discretion in utilization. A competitive market will manifest a variety of comprehensive and limited benefit designs, broad and narrow contractual networks, and single-and multispecialty provider organizations. PMID:16284020

Robinson, James C

2005-01-01

252

Towards an alternative economics of health care.  

PubMed

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

Hodgson, Geoffrey M

2009-01-01

253

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

ERIC Educational Resources Information Center

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…

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

2014-01-01

254

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

ERIC Educational Resources Information Center

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…

Davis, Paul F.; And Others

255

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

PubMed Central

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

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

256

Improving oral health and oral health care delivery for children.  

PubMed

National and state-level evidence has documented ongoing disparities in children's health and utilization of oral health care services, prompting a re-examination of factors associated with poor oral health and low use of oral health services. These efforts have yielded a wide array of proposals for improving children's oral health and oral health care delivery. This paper offers a perspective on the current context of efforts to improve children's oral health and oral health care delivery. PMID:21485933

Crall, James J

2011-02-01

257

Health care and higher education. The time diary approach for management development.  

PubMed

Discusses a project which aimed to determine the employee development needs of Plymouth Polytechnic and Derriford Hospital NHS senior technicians. Using the time diary approach, it revealed employer and employee variance in opinions over desired managerial competences and variance in the training needs for the two organizations. In the case of NHS technicians it was possible to define areas where provision of a new training scheme would be beneficial. Their counterparts in higher education revealed a much lower degree of interest in the provision of external assistance to develop their managerial skills further. Concludes that the Polytechnic would need to implement structural changes to the work environment before introducing any new training schemes for technical staff. PMID:10130854

Chaston, I; Badger, B; Mangles, T

1993-01-01

258

Learning and development dimensions of a pan-Canadian primary health care capacity-building project  

Microsoft Academic Search

Purpose – The purpose of this paper is to use a descriptive case study to establish how collaboration, innovation and knowledge-management strategies have scaled-up learning and development in rural, remote and other resource-constrained Canadian delivery settings. Design\\/methodology\\/approach – Intervention design was realized through a one-time, collaborative, national capacity-building project. A project portfolio of 72 sub-projects, initiatives and strategic activities was

Michael Aherne; José L. Pereira

2008-01-01

259

Financing the health care Internet.  

PubMed

Internet-related health care firms have accelerated through the life cycle of capital finance and organizational destiny, including venture capital funding, public stock offerings, and consolidation, in the wake of heightened competition and earnings disappointments. Venture capital flooded into the e-health sector, rising from $3 million in the first quarter of 1998 to $335 million two years later. Twenty-six e-health firms went public in eighteen months, raising $1.53 billion at initial public offering (IPO) and with post-IPO share price appreciation greater than 100 percent for eighteen firms. The technology-sector crash hit the e-health sector especially hard, driving share prices down by more than 80 percent for twenty-one firms. The industry now faces an extended period of consolidation between e-health and conventional firms. PMID:11192423

Robinson, J C

2000-01-01

260

Agent-based health care management An Agent-based Approach to Health Care Management  

E-print Network

Agent-based health care management 1 An Agent-based Approach to Health Care Management Jun Huang1, London WC2A 3PX, UK. Abbreviated title: Agent-based health care management Complete Mailing Address. London E1 4NS UK #12;Agent-based health care management 2 Abstract The provision of medical care

Mascardi, Viviana

261

Health care in China: improvement, challenges, and reform.  

PubMed

Over the past 2 decades, significant progress has been made in improving the health-care system and people's health conditions in China. Following rapid economic growth and social development, China's health-care system is facing new challenges, such as increased health-care demands and expenditure, inefficient use of health-care resources, unsatisfying implementation of disease management guidelines, and inadequate health-care insurance. Facing these challenges, the Chinese government carried out a national health-care reform in 2009. A series of policies were developed and implemented to improve the health-care insurance system, the medical care system, the public health service system, the pharmaceutical supply system, and the health-care institution management system in China. Although these measures have shown promising results, further efforts are needed to achieve the ultimate goal of providing affordable and high-quality care for both urban and rural residents in China. This article not only covers the improvement, challenges, and reform of health care in general in China, but also highlights the status of respiratory medicine-related issues. PMID:23381317

Wang, Chen; Rao, Keqin; Wu, Sinan; Liu, Qian

2013-02-01

262

Health Care in Europe for Women with Genital Mutilation  

Microsoft Academic Search

The increasing number of immigrants from African countries practicing female genital mutilation (FGM) has raised concern in Europe. Health care professionals have developed three main responses: (1) technical guidelines for clinical management; (2) codes of conduct on quality of care; and (3) specialised health services for medical and psychological care and counselling. Much remains to be done, however, to ensure

Els Leye; Richard A. Powell; Gerda Nienhuis; Patricia Claeys; Marleen Temmerman

2006-01-01

263

The value of pharmacists in health care.  

PubMed

The American health care system is concerned about the rise of chronic diseases and related resource challenges. Management of chronic disease traditionally has been provided by physicians and nurses. The growth of the care management industry, in which nurses provide remote telephonic monitoring and coaching, testifies to the increasing need for care management and to the value of nonphysician clinicians. However, this model is challenged by a number of factors, including low enrollment and the growing shortage of nurses. The challenges to the traditional model are causing policy makers and payers to consider innovative models. One such model includes the pharmacist as an essential provider of care. Not only is the number of pharmacists growing, but they are playing an ever broader role in a variety of settings. This article broadly surveys the current state of pharmacist provision of care management services and highlights the increasingly proactive role played by Walgreen Co. toward this trend, using recently conducted research. Pharmacists are making a noticeable impact on and contribution to the care of chronic diseases by improving adherence to medications, a key factor in the improvement of outcomes. Literature also suggests that pharmacies are increasingly encouraging, expanding, and highlighting the role and contributions of their professional pharmacists. Although the role of the pharmacist in chronic care management is still developing, it is likely to grow in the future, given the needs of the health care system and patients. PMID:22313438

Patwardhan, Avinash; Duncan, Ian; Murphy, Patricia; Pegus, Cheryl

2012-06-01

264

Health care policy and cancer survivorship.  

PubMed

The United States and the European Union (EU) vary widely in approaches to ensuring affordable health care coverage for our respective populations. Such variations stem from differences in the political systems and beliefs regarding social welfare. These variations are also reflected in past and future initiatives to provide high quality cancer survivorship care. The United States spends considerably more on health care compared to most European countries, often with no proven benefit. In the United States, individuals with chronic illnesses, such as cancer survivors, often experience difficulties affording insurance and maintaining coverage, a problem unknown to EU countries with national health insurance. This article reviews health policy development over time for the United States and EU and the impact for cancer survivors. For the United States, the impact of the Affordable Care Act on improving access to affordable care for cancer survivors is highlighted. For the EU, the importance of multiple-morbidity disease management, cancer plan development, and pan-European data collection for monitoring cancer outcomes is addressed. Given predicted workforce shortages and ever-increasing numbers of aging cancer survivors on both sides of the Atlantic, sharing lessons learned will be critical. PMID:23695931

Virgo, Katherine S; Bromberek, Julia L; Glaser, Adam; Horgan, Denis; Maher, Jane; Brawley, Otis W

2013-06-01

265

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

ERIC Educational Resources Information Center

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)

Wells, M. B.; Turner, S.; Martin, D. M.; Roy, A.

1997-01-01

266

Faculty of Health and Medical Sciences School of Health & Social Care  

E-print Network

Faculty of Health and Medical Sciences School of Health & Social Care Post Anaesthetic Care Module and Social Care T: +44 (0) 1483 684505 F: +44 (0) 1483 686736 E: postreg_admin@surrey.ac.uk http://www2 to the Post-Anaesthetic Care area of the operating department to enable them to develop the skills required

Doran, Simon J.

267

Counseling and Mental Health Care in Palestine  

ERIC Educational Resources Information Center

The authors provide a brief overview of counseling and mental health care in Palestine, including their history and a summary of their current status. Finally, a discussion is presented of future trends in the development of the profession with regard to recent changes in the region.

Shawahin, Lamise; Ciftci, Ayse

2012-01-01

268

School Health Primary Care Programs in Community and Migrant Health Centers and Health Care for the Homeless Projects. Directory.  

ERIC Educational Resources Information Center

This directory identifies 254 Community and Migrant Health Centers (C/MHC) and Health Care for the Homeless (HCH) programs in 10 regions of the United States that, in response to local requests and with mostly local resources, developed either school-based or school-linked health programs. Each listing provides information under the following…

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

269

Consumer Attitudes toward Health and Health Care: A Differential Perspective.  

ERIC Educational Resources Information Center

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)

Gould, Stephen J.

1988-01-01

270

Partners HealthCare Center for Connected Health.  

PubMed

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

Ternullo, Joseph; Jethwani, Kamal; Lane, Susan; Myint-U, Khinlei; Havasy, Robert; Carter, Michael; Kvedar, Joseph

2013-05-01

271

From PALSA PLUS to PALM PLUS: adapting and developing a South African guideline and training intervention to better integrate HIV/AIDS care with primary care in rural health centers in Malawi  

PubMed Central

Background Only about one-third of eligible HIV/AIDS patients receive anti-retroviral treatment (ART). Decentralizing treatment is crucial to wider and more equitable access, but key obstacles are a shortage of trained healthcare workers (HCW) and challenges integrating HIV/AIDS care with other primary care. This report describes the development of a guideline and training program (PALM PLUS) designed to integrate HIV/AIDS care with other primary care in Malawi. PALM PLUS was adapted from PALSA PLUS, developed in South Africa, and targets middle-cadre HCWs (clinical officers, nurses, and medical assistants). We adapted it to align with Malawi's national treatment protocols, more varied healthcare workforce, and weaker health system infrastructure. Methods/Design The international research team included the developers of the PALSA PLUS program, key Malawi-based team members and personnel from national and district level Ministry of Health (MoH), professional associations, and an international non-governmental organization. The PALSA PLUS guideline was extensively revised based on Malawi national disease-specific guidelines. Advice and input was sought from local clinical experts, including middle-cadre personnel, as well as Malawi MoH personnel and representatives of Malawian professional associations. Results An integrated guideline adapted to Malawian protocols for adults with respiratory conditions, HIV/AIDS, tuberculosis, and other primary care conditions was developed. The training program was adapted to Malawi's health system and district-level supervision structure. PALM PLUS is currently being piloted in a cluster-randomized trial in health centers in Malawi (ISRCTN47805230). Discussion The PALM PLUS guideline and training intervention targets primary care middle-cadre HCWs with the objective of improving HCW satisfaction and retention, and the quality of patient care. Successful adaptations are feasible, even across health systems as different as those of South Africa and Malawi. PMID:21791048

2011-01-01

272

Transitions: From Pediatric to Adult Health Care  

MedlinePLUS

... Businesses & Schools > Transitions Transitions From Pediatric to Adult Health Care Transitioning from teenage years to adulthood can be ... management and make more independent judgments about their health care needs. NDEP has assembled the materials below to ...

273

CDC Vital Signs: Making Health Care Safer  

MedlinePLUS

... About CDC.gov . Vital Signs Share Compartir Making Health Care Safer Stop Infections from Lethal CRE Germs Now ... CRE infections on your state's Notifiable Diseases list. Health Care CEOs/Medical Officers can Require and strictly enforce ...

274

New health policies on Primary Health Care in Greece  

Microsoft Academic Search

Introduction. Modern views about health and its medical, sanitary and financial components impose the reorganization of the health care system and its direction towards regional decentralization and primary health care. Political strategies in Greece have been turned towards this direction years ago. Aim. Present review aimed at presenting the importance of Primary Health Care, describing its organizational and functional framework

Theodoula Adamakidou; Athena Kalokerinou

2010-01-01

275

Judaism, justice, and access to health care.  

PubMed

This paper develops the traditional Jewish understanding of justice (tzedakah) and support for the needy, especially as related to the provision of medical care. After an examination of justice in the Hebrew Bible, the values and institutions of tzedakah in Rabbinic Judaism are explored, with a focus on legal codes and enforceable obligations. A standard of societal responsibility to provide for the basic needs of all, with a special obligation to save lives, emerges. A Jewish view of justice in access to health care is developed on the basis of this general standard, as well as explicit discussion in legal sources. Society is responsible for the securing of access to all health care needed by any individual. Elucidation of this standard of need and corresponding societal obligations, and the significance of the Jewish model for the contemporary United States, are considered. PMID:10113824

Mackler, A L

1991-06-01

276

Pharmacy and the health-care environment.  

PubMed

The current revolution in the delivery of health care is examined, possibilities for the future are considered, and preparations for meeting the challenges of the future are discussed. The main elements in the revolution involve changes in the economic, business, and technological aspects of health-care delivery. The economic influences have included diagnosis-related groups (DRGs) and the Gramm-Rudman-Hollings legislation as it affects Medicare. Hospitals and hospital pharmacists have had to look closely at their own involvement and take measures to cut costs. The care of the elderly and the indigent and the issue of malpractice will require particular attention. Diversification and incorporation have brought many changes. Among them are the blurring of the traditional roles of pharmacy practice, as evidenced, for example, in the area of home health care. The changes made possible by technology are inseparable from the other current trends, and they add another dimension to health-care considerations--that of moral choices. Furthermore, pharmacy practitioner organizations will have to develop strategies for controlling the destiny of the profession in a corporate atmosphere. Pharmacists can achieve their full potential as society's drug therapy experts if they are flexible and creative enough to apply, in this new environment, the basic principles for which the profession has long stood. PMID:3728477

Oddis, J A

1986-06-01

277

Organizational economics and health care markets.  

PubMed Central

As health policy emphasizes the use of private sector mechanisms to pursue public sector goals, health services research needs to develop stronger conceptual frameworks for the interpretation of empirical studies of health care markets and organizations. Organizational relationships should not be interpreted exclusively in terms of competition among providers of similar services but also in terms of relationships among providers of substitute and complementary services and in terms of upstream suppliers and downstream distributors. This article illustrates the potential applicability of transactions cost economics, agency theory, and organizational economics more broadly to horizontal and vertical markets in health care. Examples are derived from organizational integration between physicians and hospitals and organizational conversions from nonprofit to for-profit ownership. PMID:11327173

Robinson, J C

2001-01-01

278

Consumer-driven health care: the future is now.  

PubMed

Given that managed care seems to have run its course, employers are forced to deal with escalating health care costs by reducing benefits and lowering pay--or are they? Why not bring the power of the responsible, informed consumer to health care? Consumer-driven health care offers a new, economically rational direction that can simultaneously address the needs of both employers and employees. This article reviews the factors leading to the need for consumer-driven health care and describes the characteristics and benefits of its current and next generations of development. PMID:15146749

Bachman, Ronald E

2004-01-01

279

Awakening child consumerism in health care.  

PubMed

Consumer participation, especially among children and their families, is requisite in bargaining assertively for quality care in today's health care industry. The emergence of self-care behaviors must be evoked, cultivated, and embraced during childhood in order to nurture a discriminating attitude toward health care ventures. PMID:1574366

Pittman, K P

1992-01-01

280

Catholic health care: future blueprint.  

PubMed

Every Catholic hospital is influenced by one of two models of behavior, the private-business model and the public-service model. Which model eventually dominates an organization's actions is determined by the behavior of its leaders--sponsors, trustees, executive managers, and physicians. Since these internal forces are more likely than are external forces to determine an organization's course, Catholic health care leaders must consciously decide which value they wish to embrace. They also must improve their ability to forecast and influence the future, beginning with the creation of an independent national commission formed to assess the status of Catholic health care. Religious institutes, seeking collaboration and dialogue among themselves, should play a key role in implementing such a commission's recommendations. The Catholic health care systems that emerge in the future as a result of long-range planning and a value-driven philosophy will be multicongregational rather than owned by a single religious institute, fewer in number and larger in scope, and influential on a regional level. They will be expected to participate in networking with local non-Catholic providers and to integrate finance and delivery. PMID:10279352

Connors, E J

1986-11-01

281

Families, Managed Care, & Children's Mental Health.  

ERIC Educational Resources Information Center

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…

McManus, Marilyn C., Ed.

1996-01-01

282

Competitor analysis in health care marketing.  

PubMed

Health care providers increasingly are relying upon marketing as a means of overcoming growing competition. Competition-oriented marketing necessitates a comprehensive analysis of the competitive setting, a task which the health care marketing literature has generally given little attention. Herein the concept, perspective and tools of competitor analysis are borrowed from strategic planning and adapted for use in health care marketing. PMID:10299944

Salvatore, T

1984-01-01

283

Confucian Trust, Market and Health Care Reform  

Microsoft Academic Search

Health care systems in the world are beset by a common problem. The problem to frame a moral basis for health care policy that provides all citizens with basic coverage, encourages innovation, contains costs, and supports commitment to trust and responsibility which can guarantee the reliable function of the market and the ethical behaviour of health care professionals. This paper

Julia Tao

284

Communicating in Multicultural Health Care Organizations.  

ERIC Educational Resources Information Center

This paper investigates the multicultural demands of health care delivery by examining the role of organizational communication in promoting effective multicultural relations in modern health care systems. The paper describes the multicultural make-up of modern health care systems--noting, for example that providers from different professional…

Kreps, Gary L.; Kunimoto, Elizabeth

285

Mental Health Consultation in Child Care and  

E-print Network

Mental Health Consultation in Child Care and Early Childhood Settings Opportunities to Expand-922-1300 · www.cpeip.fsu.edu #12;Mental Health Consultation in Child Care and Early Childhood Settings ....................................... 27 Strategies for Implementing Early Childhood Mental Health Consultation in Child Care

McQuade, D. Tyler

286

ARTEMIS: a collaborative framework for health care.  

PubMed

Patient centered healthcare delivery is an inherently collaborative process. This involves a wide range of individuals and organizations with diverse perspectives: primary care physicians, hospital administrators, labs, clinics, and insurance. The key to cost reduction and quality improvement in health care is effective management of this collaborative process. The use of multi-media collaboration technology can facilitate timely delivery of patient care and reduce cost at the same time. During the last five years, the Concurrent Engineering Research Center (CERC), under the sponsorship of DARPA (Defense Advanced Research Projects Agency, recently renamed ARPA) developed a number of generic key subsystems of a comprehensive collaboration environment. These subsystems are intended to overcome the barriers that inhibit the collaborative process. Three subsystems developed under this program include: MONET (Meeting On the Net)--to provide consultation over a computer network, ISS (Information Sharing Server)--to provide access to multi-media information, and PCB (Project Coordination Board)--to better coordinate focussed activities. These systems have been integrated into an open environment to enable collaborative processes. This environment is being used to create a wide-area (geographically distributed) research testbed under DARPA sponsorship, ARTEMIS (Advance Research Testbed for Medical Informatics) to explore the collaborative health care processes. We believe this technology will play a key role in the current national thrust to reengineer the present health-care delivery system. PMID:8130536

Reddy, R; Jagannathan, V; Srinivas, K; Karinthi, R; Reddy, S M; Gollapudy, C; Friedman, S

1993-01-01

287

Health and Social Care Is Health and Social Care right for me?  

E-print Network

Health and Social Care Is Health and Social Care right for me? Are you are interested in caring for a specialised degree in medicine, nursing or social work? If yes, then Health and Social Care could be the subject for you. You will need good time management skills as well as a passion for care in order to get

Harman, Neal.A.

288

Contribution of Primary Care to Health Systems and Health  

PubMed Central

Evidence of the health-promoting influence of primary care has been accumulating ever since researchers have been able to distinguish primary care from other aspects of the health services delivery system. This evidence shows that primary care helps prevent illness and death, regardless of whether the care is characterized by supply of primary care physicians, a relationship with a source of primary care, or the receipt of important features of primary care. The evidence also shows that primary care (in contrast to specialty care) is associated with a more equitable distribution of health in populations, a finding that holds in both cross-national and within-national studies. The means by which primary care improves health have been identified, thus suggesting ways to improve overall health and reduce differences in health across major population subgroups. PMID:16202000

Starfield, Barbara; Shi, Leiyu; Macinko, James

2005-01-01

289

Beneficence, justice, and health care.  

PubMed

This paper argues that societal duties of health promotion are underwritten (at least in large part) by a principle of beneficence. Further, this principle generates duties of justice that correlate with rights, not merely "imperfect" duties of charity or generosity. To support this argument, I draw on a useful distinction from bioethics and on a somewhat neglected approach to social obligation from political philosophy. The distinction is that between general and specific beneficence; and the approach from political philosophy has at times been called equality of concern. After clarifying the distinction and setting out the basis of the equality of concern view, I argue that the result is a justice-based principle of "specific" beneficence that should be reflected in a society's health policy. I then draw on this account to criticize, refine, and extend some prominent health care policy proposals from the bioethics literature. PMID:24783323

Kelleher, J Paul

2014-03-01

290

Health Literacy and Communication Quality in Health Care Organizations  

Microsoft Academic Search

The relationship between limited health literacy and poor health may be due, in part, to poor communication quality within health care delivery organizations. We explored the relationship between health literacy status and receiving patient-centered communication in clinics and hospitals serving communication-vulnerable patient populations. Thirteen health care organizations nationwide distributed a survey to 5929 patients. All patients completed seven items assessing

Matthew K. Wynia; Chandra Y. Osborn

2010-01-01

291

Health Care Reform and the Academic Health Center.  

ERIC Educational Resources Information Center

A discussion of the implications of health care reform for academic health centers (a complex of institutions which educate health professionals) looks at problems in the current system, the role of academic health centers in the current system, financial pressures, revenue sources other than patient care, impact on health research, and human…

Kimmey, James R.

1994-01-01

292

Development and Initial Validation of a Questionnaire to Measure Hearing Parents' Perceptions of Health Care Professionals' Advice  

ERIC Educational Resources Information Center

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…

Day, Lori A.; Brice, Patrick

2013-01-01

293

Personnel for Health Care: Case Studies of Educational Programmes. Public Health Papers No. 70.  

ERIC Educational Resources Information Center

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…

Katz, F. M., Ed.; Fulop, T., Ed.

294

Basic Health Care. Instructor's Teaching Guide.  

ERIC Educational Resources Information Center

The curriculum for the training of the entry level health workers (referred to as nursing aid, assistant, or basic health care worker) is organized with a modular approach and designed within the framework of a humanistic learning growth model. Module 1, The Health Core, provides basic education for any health care worker. Module 2, The Patient…

Miami-Dade Community Coll., FL.

295

Health Care: A Brave New World.  

PubMed

The current U.S. health care system, with both rising costs and demands, is unsustainable. The combination of a sense of individual entitlement to health care and limited acceptance of individual responsibility with respect to personal health has contributed to a system which overspends and underperforms. This sense of entitlement has its roots in a perceived right to health care. Beginning with the so-called moral right to health care (all life is sacred), the issue of who provides health care has evolved as individual rights have trumped societal rights. The concept of government providing some level of health care ranges from limited government intervention, a 'negative right to health care' (e.g., prevention of a socially-caused, preventable health hazard), to various forms of a 'positive right to health care'. The latter ranges from a decent minimum level of care to the best possible health care with access for all. We clarify the concept of legal rights as an entitlement to health care and present distributive and social justice counter arguments to present health care as a privilege that can be provided/earned/altered/revoked by governments. We propose that unlike a 'right', which is unconditional, a 'privilege' has limitations. Going forward, expectations about what will be made available should be lowered while taking personal responsibility for one's health must for elevated. To have access to health care in the future will mean some loss of personal rights (e.g., unhealthy behaviors) and an increase in personal responsibility for gaining or maintaining one's health. PMID:23494290

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

2013-03-14

296

Internet and Your Health 1 UC Irvine Health Care Facilitator  

E-print Network

Internet and Your Health 1 UC Irvine Health Care Facilitator Internet and Your Health of diseases, from arthritis to warts as well as information on managed care. The Internet should regulations, advocacy and advice on managed care problems. 4. www.medicare.gov - The official government web

Burke, Peter

297

New perspectives on health and health care policy  

Microsoft Academic Search

Health care reform has been the primary focus of policymakers for much of the past year, culminating with the Patient Protection and Affordable Care Act that was signed into law by President Obama on March 23, 2010. The vigorous national debate on the act has highlighted the importance of innovative, high-quality research on health and health care policy.

Darren Lubotsky; Bhashkar Mazumder; Zach Seeskin

2010-01-01

298

Improving Access to Health Care: School-Based Health Centers.  

ERIC Educational Resources Information Center

This article explores an approach for better serving the complete health care needs of children, specifically, the efficacy of school-based health centers (SBHCs) to provide a service delivery mechanism capable of functioning as a medical home for children, providing primary care for both their physical and behavioral health care needs. The…

Dowden, Shauna L.; Calvert, Richard D.; Davis, Lisa; Gullotta, Thomas P.

299

Health Care Reform: Opportunities for Improving Adolescent Health.  

ERIC Educational Resources Information Center

Health care reform represents a major step toward achieving the goal of improved preventive and primary care services for all Americans, including children and adolescents. Adolescence is a unique developmental age district from both childhood and adulthood with special vulnerabilities, health concerns, and barriers to accessing health care. It is…

Irwin, Charles E., Jr., Ed.; And Others

300

Telematics for rural health care practitioners  

NASA Astrophysics Data System (ADS)

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

Greenfield, Robert H.; Kardaun, Jan W. P. F.

1990-06-01

301

Oral health care for hospitalized children.  

PubMed

Oral health care may be the greatest unmet health need of children in the U.S. Half of the children in the U.S. suffer from tooth decay by 8 years of age. The consequences of poor oral health are many, including mouth pain, inability to chew and eat, abscess and soft tissue infection, diminished self-esteem, and impaired school performance. Numerous medical conditions, such as asthma and diabetes, and developmental disabilities, such as cerebral palsy and autism, have associated oral health implications. Oral health care is often neglected by nondental health providers. Nurses are in a unique position to contribute to the improvement of this national health problem by promoting oral health care among hospitalized children and their families. A hospital program for oral health care is proposed, including assessment of teeth and gingiva, ensuring oral care for all, as well as oral health education as part of patient education. PMID:22132567

Blevins, Jo Young

2011-01-01

302

Establishing health care performance standards in an era of consumerism.  

PubMed

As the US health care system begins to reengineer itself to address the need for quality improvement, it also is being actively reshaped by the expectations of consumers. The confluence of these forces requires a new approach to setting health care performance standards. The National Quality Forum (NQF) has been established as a private, not-for-profit, open membership, public benefit corporation for the purposes of developing consensus about standardized health care performance measures, reporting mechanisms, and a national strategy for health care quality improvement. The NQF has broad representation from all segments of the health care industry and provides an equitable way of addressing the disparate priorities of health care's many stakeholders. Agreement and implementation of standardized health care performance measures and achievement of quality improvement in the emerging era of consumerism will be facilitated by (1) establishing national goals for health care quality; (2) embracing public policy that recognizes the complementary roles of quality improvement, cost control, and improved access; (3) giving greater priority to measuring and reporting the performance of those aspects of the health care system that directly affect consumers; (4) focusing on creating a health care culture of excellence; and (5) promoting the active collaboration of all stakeholders. PMID:11559267

Kizer, K W

2001-09-12

303

Developing Integrated Care: Towards a development model for integrated care  

Microsoft Academic Search

The thesis adresses the phenomenon of integrated care. The implementation of integrated care for patients with a stroke or dementia is studied. Because a generic quality management model for integrated care is lacking, the study works towards building a development model for integrated care. Based on a systematic approach in which a literature study, a delphi study, a concept mapping

M. M. N. Minkman

2012-01-01

304

Health care management in workers' compensation.  

PubMed

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

Nikolaj, S; Boon, B

1998-01-01

305

Indian Health Service: Standards of Care for Adults with Type 2 Diabetes.  

National Technical Information Service (NTIS)

In 1986, the Indian Health Service (IHS) Division of Diabetes developed its first IHS Standards of Care for Diabetes. For over 20 years, these guidelines have helped health care professionals provide excellence in diabetes care to American Indians and Ala...

2009-01-01

306

How can we improve the quality of health care in Japan?  

Microsoft Academic Search

The World Health Report 2000 placed Japan first for overall health system attainment: a surprising development considering that, aside from discussing excessive expenditure, health care professionals and the Health Ministry have paid little attention recently to the quality of health care. Japan's free access policy and the universal health care system have actually fostered a very relaxed attitude toward evaluation.

Masahiro Hirose; Yuichi Imanaka; Tatsuro Ishizaki; Edward Evans

2003-01-01

307

Caring for Pretoddlers. Staff Development Series, Military Child Care Project.  

ERIC Educational Resources Information Center

Ideas for working with 1-year-old children are provided in this staff development module for the caregiver or teacher in a military child care center. Sections of the module describe what "pretoddlers" are like and provide guidelines for facilitating their physical, socioemotional, and language development. The final section discusses health and…

Scavo, Marlene; And Others

308

[The right to health care services under Quebec law].  

PubMed

The main goal of the Canada Health Act is to guarantee that Canadian residents have reasonable access to a comprehensive and universal health care plan. However, reduced federal funding for health care and increases in health care costs due to technical and scientific developments have created unprecedented financial pressures on provincial health care systems. The right to health care, once perceived as one of the pillars of Canadian society, may be imperiled. This article will provide a detailed analysis of the nature and scope of the right to health care from mainly a legal, but also from a political, perspective. Based on the premises that the Canada Health Act is basically a financial agreement between the Federal and provincial governments and that it does not enshrine a substantive right on which individuals may claim services, the author explores the nature and scope of this right under Québec legislation. Indeed, the Québec Health and Social Services Act has, since the 1960s, included various provisions that establish a right of access to health care services. This right, however, is fraught with regulatory, organizational and financial limits. The first part of this paper examines relevant regulation from an historical perspective, highlighting the relationships between federal and Québec provincial legislation. In the second part, the author explores exhaustively the principal provisions relevant to the right to health care. This entails the analysis of administrative regulations as well as of the responsibilities of the various provincial, regional, institutional and professional authorities involved. Ultimately, as this study will demonstrate, the availability of health care services depends more on a vague process than on a legal right to health care. This conclusion is further confirmed by the analysis of the adjudication process of patient complaints provided under the Québec Health and Social Services Act and by the limited case law on the right of access to services. Even though judges are generally favorable to patients claims, court interventions remain ad hoc and a posteriori. But if the right of access to health care seems limited, its scope is nonetheless important. The right to health care acts as an obstacle to the current dismantling of health care services and to government withdrawal from this field. It also places limits on abusive, arbitrary and discriminatory decision-making and obliges public authorities to take into closer consideration patients' rights in formulating its health care policy and budgets. This protective role of the right to health care is currently illustrated by the politicians' insistence that the ongoing health care reform is not affecting the quality or quantity of available services. PMID:14746067

Sprumont, D

1998-01-01

309

Strengthening of primary health care: key to deliver inclusive health care.  

PubMed

Inequity and poverty are the root causes of ill health. Access to quality health services on an affordable and equitable basis in many parts of the country remains an unfulfilled aspiration. Disparity in health care is interpreted as compromise in 'Right to Life.' It is imperative to define 'essential health care,' which should be made available to all citizens to facilitate inclusivity in health care. The suggested methods for this include optimal utilization of public resources and increasing public spending on health care. Capacity building through training, especially training of paramedical personnel, is proposed as an essential ingredient, to reduce cost, especially in tertiary care. Another aspect which is considered very important is improvement in delivery system of health care. Increasing the role of 'family physician' in health care delivery system will improve preventive care and reduce cost of tertiary care. These observations underlie the relevance and role of Primary health care as a key to deliver inclusive health care. The advantages of a primary health care model for health service delivery are greater access to needed services; better quality of care; a greater focus on prevention; early management of health problems; and cumulative improvements in health and lower morbidity as a result of primary health care delivery. PMID:23873190

Yeravdekar, Rajiv; Yeravdekar, Vidya Rajiv; Tutakne, M A; Bhatia, Neeta P; Tambe, Murlidhar

2013-01-01

310

Open Source, Open Standards, and Health Care Information Systems  

PubMed Central

Recognition of the improvements in patient safety, quality of patient care, and efficiency that health care information systems have the potential to bring has led to significant investment. Globally the sale of health care information systems now represents a multibillion dollar industry. As policy makers, health care professionals, and patients, we have a responsibility to maximize the return on this investment. To this end we analyze alternative licensing and software development models, as well as the role of standards. We describe how licensing affects development. We argue for the superiority of open source licensing to promote safer, more effective health care information systems. We claim that open source licensing in health care information systems is essential to rational procurement strategy. PMID:21447469

2011-01-01

311

Collaborative Partnerships in Health, Medicine & Social Care  

E-print Network

Collaborative Partnerships in Health, Medicine & Social Care Launch Conference Lancaster University and Social Care. By leading the establishment of a Hub partnership approach, involving NHS Trusts and other and globally in Health, Medicine and Social Care. Guest Speakers will include: Dr Louise Wood (Head

Meju, Max

312

Prospective Medicine: The Next Health Care Transformation  

Microsoft Academic Search

The introduction of science into the practice of medicine in the early 20th century was a transforming event for the profession. Now, breakthroughs in science and know how make it possible to transform care once again and to fix the broken U.S. health care system. To realize this poten- tial, new models of prospective health care must be created and

Ralph Snyderman; R. Sanders Williams

2003-01-01

313

Primary Health Care in Canada: Systems in Motion  

PubMed Central

Context: During the 1980s and 1990s, innovations in the organization, funding, and delivery of primary health care in Canada were at the periphery of the system rather than at its core. In the early 2000s, a new policy environment emerged. Methods: This policy analysis examines primary health care reform efforts in Canada during the last decade, drawing on descriptive information from published and gray literature and from a series of semistructured interviews with informed observers of primary health care in Canada. Findings: Primary health care in Canada has entered a period of potentially transformative change. Key initiatives include support for interprofessional primary health care teams, group practices and networks, patient enrollment with a primary care provider, financial incentives and blended-payment schemes, development of primary health care governance mechanisms, expansion of the primary health care provider pool, implementation of electronic medical records, and quality improvement training and support. Conclusions: Canada's experience suggests that primary health care transformation can be achieved voluntarily in a pluralistic system of private health care delivery, given strong government and professional leadership working in concert. PMID:21676023

Hutchison, Brian; Levesque, Jean-Frederic; Strumpf, Erin; Coyle, Natalie

2011-01-01

314

Health and Pre-Professional Health care is currently Canada's  

E-print Network

Health and Pre-Professional Health care is currently Canada's second-largest service industry. In addition to traditional health-related roles (e.g., physician, nurse, dentist, pharmacist), a wealth of new health care careers are opening as a result of recent scientific, medical and technological advances

315

[Primary health care essential attributes and the family health strategy].  

PubMed

The essential attributes of Primary Health Care are attention at first contact, longitudinality, completeness and coordination, and the derived attributes are family and community orientation and cultural competence. This paper discusses the presence of such attributes in Family Health Strategy, a political and governmental proposal to change the health care model in the context of the Unified Health System in Brazil. PMID:24092323

Oliveira, Maria Amélia de Campos; Pereira, Iara Cristina

2013-09-01

316

Using appreciative inquiry to transform health care.  

PubMed

Amid tremendous changes in contemporary health care stimulated by shifts in social, economic and political environments, health care managers are challenged to provide new structures and processes to continually improve health service delivery. The general public and the media are becoming less tolerant of poor levels of health care, and health care professionals need to be involved and supported to bring about positive change in health care. Appreciative inquiry (AI) is a philosophy and method for promoting transformational change, shifting from a traditional problem-based orientation to a more strength-based approach to change, that focuses on affirmation, appreciation and positive dialog. This paper discusses how an innovative participatory approach such as AI may be used to promote workforce engagement and organizational learning, and facilitate positive organizational change in a health care context. PMID:24099230

Trajkovski, Suza; Schmied, Virginia; Vickers, Margaret; Jackson, Debra

2013-08-01

317

Health Sciences Center Department of Internal Medicine Employee Health Promotion Program Health Care Provider Report  

E-print Network

Health Sciences Center Department of Internal Medicine Employee Health Promotion Program Health Care Provider Report Dear Health Care Provider: Your patient, ______________________________, has applied for enrollment in a fitness program sponsored by the University of New Mexico, Employee Health

New Mexico, University of

318

Information Systems; Modern Health Care and Medical Information.  

ERIC Educational Resources Information Center

To effectively handle changes in health policy and health information, new designs and applications of automation are explored. Increased use of computer-based information systems in health care could serve as a means of control over the costs of developing more comprehensive health service, with applications increasing not only the automation of…

Brandejs, J. F., And Others

1975-01-01

319

Student Internships: Mutual Benefits in Osteoporosis Health Care and Research  

Microsoft Academic Search

Health care professionals and teachers speak of targeting a younger population (children and adolescents) in the need for education about building bone health. West Chester University has one of the largest and most sophisticated Schools of Health and Kinesiology (Physical Education) and is developing students who will be future health teachers throughout America. Very often, graduating students have a difficult

Albert J. Giovenella; Susan M. Repmann; John A. Abruzzo

1997-01-01

320

Medicine and health care: implications for health sciences library practice.  

PubMed Central

The American health care system is experiencing a period of unprecedented change. This paper identifies and discusses the major changes in patient care, research, control of the health care system, and medical education, and their implications for health sciences librarians. These changes have resulted in new demands for effective information delivery and a broader health sciences library clientele. There are both challenges and opportunities for health sciences librarians as they respond to information pressures of the current health care environment and anticipate future needs. PMID:3708196

Hafner, A W; Schwarz, M R

1986-01-01

321

"Race" and Community Care. "Race," Health and Social Care Series.  

ERIC Educational Resources Information Center

This collection offers a wide-ranging introduction to contemporary issues surrounding the health care needs of members of minority ethnic communities within the framework of community care in Britain. The following chapters consider state welfare, minority communities, family structures, and social change: (1) "'Race' and Community Care: An…

Ahmad, Waqar I. U., Ed.; Atkin, Karl, Ed.

322

Guide to Assessing Patient Needs and Planning Nursing Care. A Reference for Nurses in Health Care Facilities.  

National Technical Information Service (NTIS)

Guidelines are presented for use by nurses in health care facilities in the assessment of patient needs and the development of nursing care plans. Nursing care is viewed as a continuing process of observing, evaluating, reporting, and recording physiologi...

M. Ayers, M. E. Adams, M. O'Boyle

1972-01-01

323

Work ability in health care workers  

Microsoft Academic Search

Work Ability Index was used as a complementary tool for the periodical health surveillance of health care workers in order to evaluate their functional working capacity and to plan more appropriate preventive and compensatory measures. 867 health care workers of both sexes (337 men, 530 women), aged between 23 and 65 years and with a work experience from 0.5 to

G. Costa; S. Sartori; B. Bertoldo; D. Olivato; G. Antonacci; V. Ciuffa; F. Mauli

2005-01-01

324

Correctional Managed Health Care CMHC ANNUAL REPORT  

E-print Network

The Connecticut Department of Correction (CDOC) historically provided health services to inmates directly, using provide compassionate and clinically appropriate health care to inmates within the DOC correctionalCorrectional Managed Health Care CMHC ANNUAL REPORT July 2011 - June 2012 Introduction Correctional

Oliver, Douglas L.

325

Native-American elders. Health care status.  

PubMed

This article reviews current data relevant to the health care status of elderly Native Americans, a population cohort encompassing American Indians and Alaskan Natives/Aleutians. Several topics are addressed, including the history of Native American health policy, heart disease, diabetes mellitus, cancer, oral health, nutrition, long-term care, and the circumstances of urban Native American elders. PMID:7720023

Rousseau, P

1995-02-01

326

Medical rationing as a health care strategy  

Microsoft Academic Search

Notes the problem of rising health care costs in the USA. Considers a highly controversial solution to this problem, which is to consider health care as a scarce resource and to ration access to it. Whether rationing is done by age, ability to pay, or a cost-benefit analysis, the very concept contradicts the US belief in the right to health

Gay Wayland; Brian H. Kleiner

1997-01-01

327

Special Issue: The Family and Health Care.  

ERIC Educational Resources Information Center

Discusses research and interventions related to family health care. Topics include health promotion; risk behaviors; vulnerability and illness onset; choosing health care systems; stress; caregiving and coping; family counseling; and family responses to Alzheimer's Disease, pediatric cancer, cystic fibrosis, diabetes, and obesity. (JAC)

Doherty, William J., Ed.; McCubbin, Hamilton I., Ed.

1985-01-01

328

Healing, Medical Care, and Health Service Organizations  

Microsoft Academic Search

This paper reviews the reasons for disappointing health results from U.S. medical care, and prescribes val- ues for health service organizations (HSOs) that will provide a foundation for better medicine. Although the United States spends more money that any other country in the world on medical care, it ranks twenty-sixth in major indicators of population health. One reason for this

William E. Lafferty

2004-01-01

329

The Montana Model: Integrated Primary Care and Behavioral Health in a Family Practice Residency Program  

ERIC Educational Resources Information Center

To address the local health care needs of both patients and primary care providers in Montana, an integrated primary care and behavioral health family practice clinic was developed. In this paper we describe our experience with integrating mental health and substance abuse services into a primary care setting (a community health center) while…

Oakley, Claire; Moore, Douglas; Burford, Duncan; Fahrenwald, Roxanne; Woodward, Kathryn

2005-01-01

330

Cuban Intervention in South African Health Care Service Provision  

Microsoft Academic Search

This article considers the reasons for, and implications of, Cuban development assistance being provided to the South African health care system. The provision of skilled Cuban doctors to South Africa has been a feature of post-apartheid health care services. Under a series of bilateral agreements, over 450 Cuban doctors have taken placements in South Africa and over 250 South African

Daniel Hammett

2007-01-01

331

Quality-of-care challenges for rural health.  

PubMed

The purpose of this article is to examine the issue of quality of care in rural America and to help others examine this issue in a way that is consistent with the very real challenges faced by rural communities in ensuring the availability of adequate health services. Rural citizens have a right to expect that their local health care meets certain basic standards. Unless rural providers can document that the quality of local health care meets objective external standards, third-party payers might refuse to contract with rural providers, and increasingly sophisticated consumers might leave their communities for basic medical care services. To improve the measurement of health care quality in a rural setting, a number of issues specific to the rural environment must be addressed, including small sample sizes (volume and outcome issues), limited data availability, the ability to define rural health service areas, rural population preferences and the lower priority of formal quality-of-care assessment in shortage areas. Several current health policy initiatives have substantial implications for monitoring and measuring the quality of rural health services. For example, to receive community acceptance and achieve fiscal stability, critical access hospitals (CAHs) must be able to document that the care they provide is at least comparable to that of their predecessor institutions. The expectations for quality assurance activities in CAHs should consider their limited institutional resources and community preferences. As managed care extends from urban areas, there will be an inevitable collision between the ability to provide care and the ability to measure quality. As desirable as it might be to have a national standard for health care quality, this is not an attainable goal. The spectrum and content of rural health care are different from the spectrum and content of care provided in large cities. Accrediting agencies, third-party carriers and health insurance purchasers need to develop rural health care quality standards that are practical, useful and affordable. PMID:10981369

Moscovice, I; Rosenblatt, R

2000-01-01

332

Community health centers as primary providers of health care  

Microsoft Academic Search

In their essay, Shelly Raymer Duncan and Cinthia L. Deye examine the experience of community health centers as primary providers\\u000a of health care. These centers provide quality health care for their clientele and operate in an efficient manner. The authors\\u000a argue that community health centers are a viable mechanism for the provision of comprehensive quality primary care for underserved\\u000a persons.

Shelly Raymer Duncan; Cinthia L. Deye

2006-01-01

333

Page 1 of 11 HEALTH CARE COLLEGES  

E-print Network

, Communication Disorders, Dentistry, Nursing, Physician Assistant Studies, Public Health, Radiation Sciences degree of trust between the professional and the individuals he or she serves. Each health profession has"). The health care colleges are: Dentistry, Health Sciences, Medicine, Nursing, Pharmacy, and Public Health

Hayes, Jane E.

334

The importance of health information technology in care coordination and transitional care.  

PubMed

Care coordination and transitional care services are strategically important for achieving the priorities of better care, better health, and reduced costs embodied in the National Strategy for Quality Improvement in Health Care (National Quality Strategy [NQS]). Some of the most vulnerable times in a person’s care occur with changes in condition as well as movement within and between settings of care. The American Academy of Nursing (AAN) believes it is essential to facilitate the coordination of care and transitions by using health information technology (HIT) to collect, share, and analyze data that communicate patient-centered information among patients, families, and care providers across communities. HIT makes information accessible, actionable, timely, customizable, and portable. Rapid access to information also creates efficiencies in care by eliminating redundancies and illuminating health history and prior care. The adoption of electronic health records (EHRs) and information systems can enable care coordination to be more effective but only when a number of essential elements are addressed to reflect the team-based nature of care coordination as well as a focus on the individual’s needs and preferences. To that end, the AAN offers a set of recommendations to guide the development of the infrastructure, standards, content, and measures for electronically enabled care coordination and transitions in care as well as research needed to build the evidence base to assess outcomes of the associated interventions. PMID:24409517

Cipriano, Pamela F; Bowles, Kathryn; Dailey, Maureen; Dykes, Patricia; Lamb, Gerri; Naylor, Mary

2013-01-01

335

[Communication between health care professionals and patients].  

PubMed

In recent years, a wide variety of health-related issues make the headlines almost everyday: the shortage of physicians, an increase in elderly patients, a difficulty in maintaining emergency pediatric care services (due to the declining birthrate), the capacity of the existing emergency medical services, medical malpractice, and the H1N1 influenza vaccine. In Japan, there has been an increasing demand for health care with an emphasis on quality over quantity based the viewpoint of health care recipients, instead of providers. Since 1995, when the obligation of informed consent was adopted, there has been an improvement, although still insufficient, in patient-oriented medical services, including attitudes towards patients. A clinical laboratory technician is required to conduct a clinical examination in a prompt and accurate manner, based on a physician's instructions written on the examination slip. Based on the results of the examination, the physician determines the diagnosis and informs the patient of it, which means that clinical laboratory technicians support the QOL of patients indirectly. Patients sometimes ask about the purpose, methods, and results of a clinical examination, prior to, following, or during its implementation. In hospitals with recently developed complex, advanced equipment for clinical examination, physicians and laboratory technicians place orders for examinations without providing any detailed explanation to patients. Patients feel very anxious and nervous wondering what clinical examination they are going to undergo, and demand an adequate explanation of the test from laboratory technicians. However, patients are often dissatisfied with their manner and remarks, such as "The attending physician will give you the results in detail", and make complaints in some cases. As a provider of health care services, clinical laboratory technicians have a responsibility to meet their patients' demands. It is very important for clinical laboratory technicians to provide patients with an explanation in a caring and considerate manner, making it simple and easy-to-understand as long as it does not contradict the laws and results of an examination. PMID:20662272

Ohara, Yoshiko

2010-06-01

336

Empowering patients to direct their health care  

Microsoft Academic Search

The American health care system has changed dramatically during the past 50 years. We no longer live in the days of cradle-to-grave care by a single family practice doctor who knew us and our medical history like the back of his hand. Health care is far more fluid and fast-paced; we often change insurance companies and primary care physicians. We

Rebecca S Busch

2003-01-01

337

Active, Medical Documents in Health Care  

Microsoft Academic Search

Distributed and heterogeneous information systems can be observed in health care. In order to implement the vision of seamless\\u000a health care, the boundaries of institutions need to be closed. Furthermore, information needs to be provided to the members\\u000a of the health care team according to the principle of information logistics for the effective and efficient support of treatment\\u000a processes. Since

Andreas Schweiger; Helmut Krcmar

338

Consumer Financial Issues in Health Care  

Microsoft Academic Search

While government officials, health care providers, and insurers debate the cause and cure of high and rising health care costs,\\u000a consumers face the daunting task of making critical health care decisions for themselves and family members in a complex market.\\u000a This chapter describes the characteristics of and key players in that market. Reasons given in the academic and popular press

Deanna L. Sharpe

339

Barriers to health care for street youth.  

PubMed

This study investigates the barriers to health care faced by runaway adolescents. A convenience sample of 89 street youth located through community agencies was surveyed to elicit their perceptions of barriers to care. Results indicated that these youth experience a wide range of barriers to health care, both objective and subjective. They also experience fears with regard to receiving health care, many of which seem developmental in nature. The relative isolation of these youth compounds the objective barriers they face, yet many overcame these barriers and received needed care. PMID:9358291

Geber, G M

1997-11-01

340

Capital investment strategies in health care systems.  

PubMed

Capital investment decisions are among the most important decisions made by firms. They determine the firm's capacity for providing services and commit the firm's cash for an extended period of time. Interviews with chief financial officers of leading health care systems reveal capital investment strategies that generally follow the recommendations of modern finance theory. Still, there is substantial variation in capital budgeting techniques, methods of risk adjustment, and the importance of qualitative considerations in investment decision making. There is also variation in delegation of investment decision making to operating units and methods of performance evaluation. Health care systems face the same challenges as other organizations in developing and implementing capital investment strategies that use consistent methods for evaluation of projects that have inconsistent aims and outcomes. PMID:10845384

Reiter, K L; Smith, D G; Wheeler, J R; Rivenson, H L

2000-01-01

341

[Guideline 'Overweight' for child health care].  

PubMed

The '5th National Growth Study' indicates that the percentage of overweight children in the Netherlands has risen from 9-12% in 1997 to 13-15% in 2009. Child Health Care is a unique setting for promotion of development, growth and behaviour of children, in which tailored prevention can be offered. Detection of overweight in children and intervention by Child Health Care takes place in a multidisciplinary setting linking general practitioners, paediatricians, dieticians, teachers, physiotherapists, pedagogues and psychologists. For overweight children, a change plan is created based on exercise, playing outside, having breakfast every day, as little as possible sweetened beverages and fast-food, and less time spent in front of the television or computer, with fewer energy-rich snacks. As recommended in the Dutch CBO guideline 'Obesity', obese children are referred to a general practitioner or paediatrician. PMID:23343730

Kist-van Holthe, Joana E; Bulk-Bunschoten, Anneke M W; Renders, Carry M; L'Hoir, Monique; Kuijpers, Ton; HiraSing, Remy A

2013-01-01

342

Health system challenges to integration of mental health delivery in primary care in Kenya- perspectives of primary care health workers  

PubMed Central

Background Health system weaknesses in Africa are broadly well known, constraining progress on reducing the burden of both communicable and non-communicable disease (Afr Health Monitor, Special issue, 2011, 14-24), and the key challenges in leadership, governance, health workforce, medical products, vaccines and technologies, information, finance and service delivery have been well described (Int Arch Med, 2008, 1:27). This paper uses focus group methodology to explore health worker perspectives on the challenges posed to integration of mental health into primary care by generic health system weakness. Methods Two ninety minute focus groups were conducted in Nyanza province, a poor agricultural region of Kenya, with 20 health workers drawn from a randomised controlled trial to evaluate the impact of a mental health training programme for primary care, 10 from the intervention group clinics where staff had received the training programme, and 10 health workers from the control group where staff had not received the training). Results These focus group discussions suggested that there are a number of generic health system weaknesses in Kenya which impact on the ability of health workers to care for clients with mental health problems and to implement new skills acquired during a mental health continuing professional development training programmes. These weaknesses include the medicine supply, health management information system, district level supervision to primary care clinics, the lack of attention to mental health in the national health sector targets, and especially its absence in district level targets, which results in the exclusion of mental health from such district level supervision as exists, and the lack of awareness in the district management team about mental health. The lack of mental health coverage included in HIV training courses experienced by the health workers was also striking, as was the intensive focus during district supervision on HIV to the detriment of other health issues. Conclusion Generic health system weaknesses in Kenya impact on efforts for horizontal integration of mental health into routine primary care practice, and greatly frustrate health worker efforts. Improvement of medicine supplies, information systems, explicit inclusion of mental health in district level targets, management and supervision to primary care are likely to greatly improve primary care health worker effectiveness, and enable training programmes to be followed by better use in the field of newly acquired skills. A major lever for horizontal integration of mental health into the health system would be the inclusion of mental health in the national health sector reform strategy at community, primary care and district levels rather than just at the higher provincial and national levels, so that supportive supervision from the district level to primary care would become routine practice rather than very scarce activity. Trial registration Trial registration ISRCTN 53515024 PMID:24079756

2013-01-01

343

Justice, welfare and health care.  

PubMed Central

Miss Telfer offers a new analysis, classifying health care into four systems, only one of which, the "laissez-faire" type, is unlikely to be acceptable today. The other three systems are defined here as "liberal humanitarian", "liberal socialist" and "pure socialist." Each is analysed for its content and for the views of its protagonists and antagonists. On these issues no dogma is proclaimed as the author says she has sought to "bring out some of the principles at issue in any discussion of the rights and wrongs of socialized medicine". This journal is surely the proper place for such a discussion as the worlds of the politician, of the economist, of the doctor and of the patient come to a point in the philosophies behind the aspect of medical ethics exemplified in the provision of medical services by the state. Miss Telfer also glances down the byways of the medicine of the market place. PMID:966258

Telfer, E.

1976-01-01

344

Effective health care corporate compliance.  

PubMed

The pace and intensity of oversight and investigation of health care organizations has greatly increased at all levels. Well run organizations with ethical management committed to following all laws and regulations are still at risk for compliance violations and punitive penalties. Under the Federal Sentencing Guidelines, organizations with an "effective" corporate compliance program may receive reduced penalties. The seven components of an effective program as defined in the guidelines are: (1) Standards and procedures; (2) oversight responsibilities; (3) employee training; (4) monitoring and auditing; (5) reporting systems; (6) enforcement and discipline; and (7) response and prevention. Lack of a compliance program needlessly exposes the organization to an avoidable risk of damage from non-compliance--whether intentional or not. Moreover, an effective program can contribute to the efficient operation of the organization and be a key piece of its corporate culture. PMID:10947465

Saum, T B; Byassee, J

2000-01-01

345

Status of Emergency Obstetric Care in Six Developing Countries Five Years before the MDG Targets for Maternal and Newborn Health  

PubMed Central

Background Ensuring women have access to good quality Emergency Obstetric Care (EOC) is a key strategy to reducing maternal and newborn deaths. Minimum coverage rates are expected to be 1 Comprehensive (CEOC) and 4 Basic EOC (BEOC) facilities per 500,000 population. Methods and Findings A cross-sectional survey of 378 health facilities was conducted in Kenya, Malawi, Sierra Leone, Nigeria, Bangladesh and India between 2009 and 2011. This included 160 facilities designated to provide CEOC and 218 designated to provide BEOC. Fewer than 1 in 4 facilities aiming to provide CEOC were able to offer the nine required signal functions of CEOC (23.1%) and only 2.3% of health facilities expected to provide BEOC provided all seven signal functions. The two signal functions least likely to be provided included assisted delivery (17.5%) and manual vacuum aspiration (42.3%). Population indicators were assessed for 31 districts (total population?=?15.7 million). The total number of available facilities (283) designated to provide EOC for this population exceeded the number required (158) a ratio of 1.8. However, none of the districts assessed met minimum UN coverage rates for EOC. The population based Caesarean Section rate was estimated to be <2%, the maternal Case Fatality Rate (CFR) for obstetric complications ranged from 2.0–9.3% and still birth (SB) rates ranged from 1.9–6.8%. Conclusions Availability of EOC is well below minimum UN target coverage levels. Health facilities in the surveyed countries do not currently have the capacity to adequately respond to and manage women with obstetric complications. To achieve MDG 5 by 2015, there is a need to ensure that the full range of signal functions are available in health facilities designated to provide CEOC or BEOC and improve the quality of services provided so that CFR and SB rates decline. PMID:23236357

Ameh, Charles; Msuya, Sia; Hofman, Jan; Raven, Joanna; Mathai, Matthews; van den Broek, Nynke

2012-01-01

346

Religion, Spirituality and Your Mental Health Care  

MedlinePLUS

Religion, Spirituality and Your Mental Health Care Quick Links Facts for Families - Numerical List Facts for Families - Keyword (Alphabetical) Facts for Families No. 107; Updated December 2012 Click ...

347

The Health and Social Care Act 2008.  

PubMed

Several inquiry reports have shown that there is still a need to further improve health and social care and strengthen public confidence in these services. The reports have particularly emphasized the need for stricter regulation of health and adult social care providers and the need to use statutory powers to ensure compliance with quality and safety standards.This article outlines how the provisions of the Health and Social Care Act 2008 aim to address this need to further regulate quality and safety standards in health and social care. PMID:21240085

Griffith, Richard; Tengnah, Cassam

2010-12-01

348

Health Care-Acquired Viral Respiratory Diseases  

PubMed Central

Health care–associated viral respiratory infections, common among hospitalized children, also occur among adults and institutionalized persons and result in increased patient morbidity, mortality, and health care costs. Approximately 20% of patients with health care–associated pneumonia have viral respiratory infections, with 70% of these infections caused by adenovirus, influenza virus, parainfluenza virus, and respiratory syncytial virus (RSV).1 These infections typically reflect the level of viral activity within the community.1,2 This article focuses on the epidemiology, transmission, and control of health care–associated RSV and influenza virus. PMID:21316002

Goins, William P.; Talbot, H. Keipp; Talbot, Thomas R.

2014-01-01

349

Health care and human rights.  

PubMed

On April 6, 1995, in New Delhi, India, demonstrators with the group AIDS Bhedbhav Virodhi Andolan (ABVA) protested against the death of an AIDS patient in Calcutta due to medical negligence. They observed two minutes of silence in the memory of Dipak Biswas and carried signs stating Fight AIDS Not AIDS Patients, AIDS Patients Have Human Rights, and Wake Up, National Human Rights Commission. The demonstrators also submitted a memorandum to the Chairman of the National Human Rights Commission and a 26-page report entitled Who's Afraid of AIDS drafted by the Drug Action Forum and the Health Services Association. The report accuses three well-known medical institutions in Calcutta for insensitive treatment of Dipak, and it brings to light the subsequent victimization of his family following his death. Dipak's brother was dismissed from his job. His mother and sister were forced to leave the area. Some important health care questions and human rights issues the report brings up include: despite the commitment of the central and state governments to provide treatment to AIDS patients, AIDS patients tend not to receive care; hospital personnel from top management down are unaware of WHO guidelines on the management of AIDS patients and of the ethical norms concerning confidentiality; and AIDS patients and their families have no one to help them with treatment or with the social stigma. In the case of Dipak, hospital personnel did not tell his family that he had AIDS but told the press and members of the funeral party, who declined to touch his body. ABVA promotes AIDS-related human rights issues, such as the rights of gays, sex workers, prisoners, international travelers, and professional blood donors. The group documents inappropriate practices. For example, some companies practice arbitrary blood testing of employees and prospective recruits without their informed consent. They then fire or refuse to hire persons found to be HIV positive. PMID:12319587

Balasubrahmanyan, V

1995-01-01

350

Monitoring Health Care for Children with Chronic Conditions in a Managed Care Environment  

Microsoft Academic Search

Objective: Children with chronic health conditions face special issues in their interactions with managed care. These children often require additional and more varied services than do other children. Managed care plans increasingly include these children, especially with the growth of Medicaid managed care. This article examines the special issues facing children with chronic conditions and develops strategies for monitoring their

James M. Perrin; Karen Kuhlthau; Deborah Klein Walker; Ruth E. K. Stein; Paul W. Newacheck; Steven L. Gortmaker

1997-01-01

351

Integrating mental health into primary health care in Zambia: a care provider's perspective  

PubMed Central

Background Despite the 1991 reforms of the health system in Zambia, mental health is still given low priority. This is evident from the fragmented manner in which mental health services are provided in the country and the limited budget allocations, with mental health services receiving 0.4% of the total health budget. Most of the mental health services provided are curative in nature and based in tertiary health institutions. At primary health care level, there is either absence of, or fragmented health services. Aims The aim of this paper was to explore health providers' views about mental health integration into primary health care. Methods A mixed methods, structured survey was conducted of 111 health service providers in primary health care centres, drawn from one urban setting (Lusaka) and one rural setting (Mumbwa). Results There is strong support for integrating mental health into primary health care from care providers, as a way of facilitating early detection and intervention for mental health problems. Participants believed that this would contribute to the reduction of stigma and the promotion of human rights for people with mental health problems. However, health providers felt they require basic training in order to enhance their knowledge and skills in providing health care to people with mental health problems. Recommendations It is recommended that health care providers should be provided with basic training in mental health in order to enhance their knowledge and skills to enable them provide mental health care to patients seeking help at primary health care level. Conclusion Integrating mental health services into primary health care is critical to improving and promoting the mental health of the population in Zambia. PMID:20653981

2010-01-01

352

Organization and financing of mental health care in Poland  

Microsoft Academic Search

Organization of care: Health care is provided to patients with mental disorders by the state health care facilities as well as by social help agencies. Mental health care services are provided mostly by mental health facilities and partly by primary care units. Outpatient clinics, separate for psychiatric patients and substance abusers, are the most numerous mental health care units, amounting

Wanda Langiewicz; Elzbieta Slupczynska-Kossobudzka

2000-01-01

353

Development and pretesting of an electronic learning module to train health care professionals on the use of the Pediatric Respiratory Assessment Measure to assess acute asthma severity  

PubMed Central

BACKGROUND: Severity-specific guidelines based on the Pediatric Respiratory Assessment Measure (PRAM), a validated clinical score, reduce pediatric asthma hospitalization rates. OBJECTIVE: To develop, pretest the educational value of and revise an electronic learning module to train health care professionals on the use of the PRAM. METHODS: The respiratory efforts of 32 children with acute asthma were videotaped and pulmonary auscultation was recorded. A pilot module, composed of a tutorial and 18 clinical cases, was developed in French and English. Health care professionals completed the module and provided feedback. The performance of participants, case quality and difficulty, and learning curve were assessed using the Rasch test; quantitative and qualitative feedback served to revise the module. RESULTS: Seventy-two participants (19 physicians, 22 nurses, four respiratory therapists and 27 health care trainees) with a balanced distribution across self-declared expertise (26% beginner, 35% competent and 39% expert) were included. The accuracy of experts was superior to beginners (OR 1.79, 1.15 and 2.79, respectively). Overall performance significantly improved between the first and latter half of cases (P<0.001). Participants assessed the module to be clear (96%), relevant (98%), realistic (94%) and useful (99%) to learn the PRAM. The qualitative/quantitative analysis led to the deletion of three cases, modification of remaining cases to further enhance quality and reordering within three levels of difficulty. DISCUSSION: Using rigorous educational methods, an electronic module was developed to teach health care professionals on use of the PRAM score. Using the back-translation technique, both French and English versions were developed and validated simultaneously. The pilot module comprised a tutorial and three case-scenario sections, and was tested on a target audience of physicians, nurses, respiratory therapists and medical trainees. CONCLUSION: The final electronic learning module met the clarity and quality requirements of a good teaching tool, with a demonstrated learning effect and high appreciation by health care professionals. Available in French and English, it is offered to facilitate implementation of PRAM-based acute pediatric asthma guidelines. PMID:24046819

Lehr, Anab R; McKinney, Martha L; Gouin, Serge; Blais, Jean-Guy; Pusic, MV; Ducharme, Francine M

2013-01-01

354

The rural health care system in China.  

PubMed

The implementation strategy for health for all (HFA) in China is presented as a targeted effort toward the rural population which makes up 900 million of the total 1160 million population. The WHO objective of HFA by 2000 was accepted by China in 1983 and 1986. Socioeconomic development has improved considerably since 1949. Targets were established 1) to double the 1980 gross national product (GNP) and guarantee food, clothing, and shelter between 1981 and 1990; 2) to quadruple the 1980 GNP between 1991 and 2000, and 3) to attain the average income per capita of medium-developed countries. The political system is the Communist Party of China (CPC). The Chinese People's Political Consultative Conference, which is comprised of members of the CPC and other individuals from democratic and other organizations, fills an advisory role. The National People's Congress is the highest organ of state power and serves to legislate, supervise, and make decisions in some matters including personnel. The Standing Committee exercises state power when the Congress is not in session. It is a 1-chamber system (state administration, judicial system, and chamber system) and members of the People's Congress do not resign. Since 1949, the health system has grown to 209,000 medical and health institutions, 2.6 million hospital beds, 4.9 million medical and health workers, an average life expectancy that has increased from 35 years to 69 years, an infant mortality rate that has declined from 20% to 5.1% from 20%, and a maternal mortality that has declined from 150/10,000 to 9.4/10,000. Diseases such as cholera and smallpox have been eliminated and other diseases such as malaria and goiter have been brought under control. A cooperative medical and health care system which was established in the 1960s was replaced with a fee system in the 1980s, which has led to medical care problems for the rural poor. At present there is a rural medical insurance system and a cooperative health system with 3 tiers (health clinic, township hospital, and county professional hospitals). In 1990, there were village clinics in 87% of the villages. In 1990, central government and local management are implementing the objectives stated in 1) Program Objectives of Global Goals for Health by 2000 in Rural Areas, 2) Management Procedures for Primary Health Care, and 3) Evaluation Standards of Health for All by 2000. Implementation began in 1989-90, and stage 2 is to begin in 1991-95, and stage 3 in 1996-2000. The problems that will be encountered are investment, population growth, and personnel training. PMID:12285735

Xian, H G

1992-06-01

355

Reimbursement for school nursing health care services: position statement.  

PubMed

Children come to school with a variety of health conditions, varying from moderate health issues to multiple, severe chronic health illnesses that have a profound and direct impact on their ability to learn. The registered professional school nurse (hereinafter referred to as school nurse) provides medically necessary services in the school setting to improve health outcomes and promote academic achievement. The nursing services provided are reimbursable services in other health care settings, such as hospitals, clinics, and home care settings. The National Association of School Nurses (NASN) believes that school nursing services that are reimbursable nursing services in other health care systems should also be reimbursable services in the school setting, while maintaining the same high quality care delivery standards. Traditionally, local and state tax revenues targeted to fund education programs have paid for school nursing health services. School nurses are in a strategic position to advocate for improving clinical processes to better fit with community health care providers and to align reimbursements with proposed changes. Restructuring reimbursement programs will enable health care funding streams to assist in paying for school nursing services delivered to students in the school setting. Developing new innovative health financing opportunities will help to increase access, improve quality, and reduce costs. The goal is to promote a comprehensive and cost-effective health care delivery model that integrates schools, families, providers, and communities. PMID:25272416

Lowe, Janet; Cagginello, Joan; Compton, Linda

2014-09-01

356

Consumer information needs in a competitive health care environment.  

PubMed

The role of information in facilitating choice in a competitive health care marketplace is clearly pivotal, but it is also complex and occasionally problematic. Although it is clear that information is critical to the competitive approach, less clear is the relationship between the availability of appropriate information and the exercise of informed choice, a relationship that is obscured in the tangle of influences that affect the use and delivery of medical care. Nonetheless, the centralized and standardized collection, review, and dissemination of relevant health care data remain the keys to predicting--and avoiding--adverse outcomes in the development of health care policy. PMID:10311937

Varner, T; Christy, J

1986-01-01

357

Assessing business leaders' perspectives on health care issues.  

PubMed

The survey results reported here shed light on how CEOs perceive various health care issues in general, and factors and proposed solutions regarding uncompensated or indigent care, in specific. The problem of indigent care has reached such dimensions that various legislative remedies are being sought, such as the Indigent Health Care Trust Fund and mandated health insurance coverage. Although the uninsured are not being denied health care, the cost of such care is rising far above that which can continue to be absorbed by hospitals and other providers. Thus, something must be done, legislatively or otherwise. In sponsoring this survey the VHA sought to gather information that would guide and facilitate their response to the problem of financing the cost of indigent health care. The CEO responses: (1) indicate the need for an education program; (2) provide support for legislative proposals; and, (3) highlight areas which need further investigation. Business leaders need to be informed as to the true causes of increasingly high health care costs, with the increasing role of indigent health care cost clearly illustrated, as well as other key areas of concern such as technology, unnecessary medical procedures, and malpractice suits. Hospital associations could develop comparative fact sheets addressing perceptions, misconceptions, and the actual causes of increased health care costs. This informational advertising campaign could eventually be broadened to encompass some of the issues which need further consideration, such as hospital inefficiency and who should pay for indigent health care. The respondent's support for and responsiveness to tax incentives to encourage employers to provide more health care coverage, and CEO support for the Indigent Health Care Trust Fund, should be used to shape legislative proposals. The CEOs' perception of the importance of health care (being third in priority out of eight key current issues) should aid the VHA in their efforts to gain the needed legislative attention to the problems of health care cost. The recognition by the CEOs' of the need for hospital profitability and their desire for limited regulation should also provide support for VHA legislative proposals. Several areas which need further investigation and consideration include: hospital inefficiency, who should pay for indigent care, part-time employees without insurance, cost and availability of health insurance coverage, and equal access to quality care. The widely held belief that hospitals are inefficient needs to be addressed.(ABSTRACT TRUNCATED AT 400 WORDS) PMID:10105852

McDermott, D R; Brinkman, L H

1990-01-01

358

[E-health--challenge for health care system].  

PubMed

E-health and systems related to the electronic patient record (EPR) are seen as important factors in the development of the health care System. In 2004 European Commission had adopted e-Health Action Plan, which indicated the development directions of European e-Health. In Poland, the main development trends and Government course of actions in this regard, are contained in the document Computerization plan "e-Health Poland" 2009-2015. The European Commission defines e-Health as an application of tools and services, information and communication technologies in healthcare. EPR is a collection of patient data that are stored in a certain place and it is possible to access them. E-health and EPR are closely related to the concept of interoperability. Denmark is one of the countries in which the information services and information technology in healthcare is mostly used. The introduction of ERP involves a lot of positive effects. Using the ERP, stored data can be optimally used by both physicians and patients. However, also risks associated with data security need to be considered. Furthermore, the Polish law defines in great detail the issues associated with creating, storing and sharing medical records (1). According to the Act from 17 February 2005, concerning the computerization of public service activities, it possible to keep medical documentation in electronically form. PMID:21735846

Buczak-Stec, Elzbieta; Lemanowicz, Katarzyna; Mazurek, Marcin

2011-01-01

359

Effects of prenatal care on child health at age 5.  

PubMed

The broad goal of contemporary prenatal care is to promote the health of the mother, child, and family through the pregnancy, delivery, and the child's development. Although the vast majority of mothers giving birth in developed countries receive prenatal care, past research has not found compelling evidence that early or adequate prenatal care has favorable effects on birth outcomes. It is possible that prenatal care confers health benefits to the child that do not become apparent until after the perinatal period. Using data from a national urban birth cohort study in the US, we estimate the effects of prenatal care on four markers of child health at age 5-maternal-reported health status, asthma diagnosis, overweight, and height. Prenatal care, defined a number of different ways, does not appear to have any effect on the outcomes examined. The findings are robust and suggest that routine health care encounters during the prenatal period could potentially be used more effectively to enhance children's health trajectories. However, future research is needed to explore the effects of prenatal care on additional child health and developmental outcomes as well as the effects of preconceptional and maternal lifetime healthcare on child health. PMID:22374319

Noonan, Kelly; Corman, Hope; Schwartz-Soicher, Ofira; Reichman, Nancy E

2013-02-01

360

Effects of Prenatal Care on Child Health at Age 5  

PubMed Central

Objectives The broad goal of contemporary prenatal care is to promote the health of the mother, child, and family through the pregnancy, delivery, and the child’s development. Although the vast majority of mothers giving birth in developed countries receive prenatal care, past research has not found compelling evidence that early or adequate prenatal care has favorable effects on birth outcomes. It is possible that prenatal care confers health benefits to the child that do not become apparent until after the perinatal period. Methods Using data from a national urban birth cohort study in the U.S., we estimate the effects of prenatal care on four markers of child health at age 5—maternal-reported health status, asthma diagnosis, overweight, and height. We implement a number of different strategies to address the issue of potential omitted variables bias as well as a large number of specification checks to validate the findings. Results and Conclusions Prenatal care, defined a number of different ways, does not appear to have any effect on the outcomes examined. The findings are robust and suggest that routine health care encounters during the prenatal period could potentially be used more effectively to enhance children’s health trajectories. However, future research is needed to explore the effects of prenatal care on additional child health and developmental outcomes as well as the effects of preconceptional and maternal lifetime helathcare on child health. PMID:22374319

Noonan, Kelly; Corman, Hope; Schwartz-Soicher, Ofira; Reichman, Nancy E.

2012-01-01

361

At the Intersection of Health, Health Care and Policy doi: 10.1377/hlthaff.2013.1432  

E-print Network

At the Intersection of Health, Health Care and Policy doi: 10.1377/hlthaff.2013.1432 , , no. (2014 and services, complements do- mestic resources to finance health systems and supply basic health care):Health Affairs With Recipients' Disease Burden Global Health Development Assistance Remained Steady

Tipple, Brett

362

Hurdles to health: immigrant and refugee health care in Australia  

Microsoft Academic Search

Refugees and asylum seekers face a number of barriers to accessing health care and improved health status. These include language difficulties, financial need and unemployment, cultural differ- ences, legal barriers and a health workforce with generally low awareness of issues specific to refugees. Importantly, current Australian govern- ment migration and settlement policy also impacts on access to health and health

Sally B Murray; Sue A Skull

2005-01-01

363

Children with Special Health Care Needs: Impact of Health Care Expenditures on Family Financial Burden  

Microsoft Academic Search

We investigated the relationship between health care expenditures for Special Health Care Needs (SHCN) children and family\\u000a perception of financial burden. Using 2005\\/2006 National Survey of Children with Special Health Care Needs data, a multivariate\\u000a logistic regression model was used to estimate the relationship between the SHCN child’s health care expenditure and perceived\\u000a financial burden, while controlling for family and

Lisa C. Lindley; Barbara A. Mark

2010-01-01

364

A new model for health care delivery  

PubMed Central

Background The health care delivery system in the United States is facing cost and quality pressures that will require fundamental changes to remain viable. The optimal structures of the relationships between the hospital, medical school, and physicians have not been determined but are likely to have a large impact on the future of healthcare delivery. Because it is generally agreed that academic medical centers will play a role in the sustainability of this future system, a fundamental understanding of the relative contributions of the stakeholders is important as well as creativity in developing novel strategies to achieve a shared vision. Discussion Core competencies of each of the stakeholders (the hospital, the medical school and the physicians) must complement the others and should act synergistically. At the same time, the stakeholders should determine the common core values and should be able to make a meaningful contribution to the delivery of health care. Summary Health care needs to achieve higher quality and lower cost. Therefore, in order for physicians, medical schools, and hospitals to serve the needs of society in a gratifying way, there will need to be change. There needs to be more scientific and social advances. It is obvious that there is a real and urgent need for relationship building among the professionals whose duty it is to provide these services. PMID:19335920

Kepros, John P; Opreanu, Razvan C

2009-01-01

365

Complementary and alternative health care in Israel  

PubMed Central

The paper explores the patterns of coexistence of alternative/complementary health care (CAM) and conventional medicine in Israel in the cultural, political, and social contexts of the society. The data are drawn from over ten years of sociological research on CAM in Israel, which included observation, survey research, and over one hundred in-depth interviews with a variety of CAM practitioners - many with bio-medical credentials - and with policy makers in the major medical institutions. The analysis considers the reasons for CAM use, number of practitioners, the frequency of CAM use and some of its correlates, and how CAM is regulated. The structure of the relationship between the conventional health care system and CAM is discussed in the public sector, which provides two-thirds of CAM services, and in the private sector, which provides about one-third. The history of the development of these structures and some of the dilemmas of their operation are discussed. A number of policy issues are considered against this background: regulation and licensing, CAM in primary care, reimbursement for CAM treatment, and the inclusion of CAM in education and training for the health professions. PMID:22913721

2012-01-01

366

Improving Access to Health Care Among New Zealand's Maori Population  

PubMed Central

The health status of indigenous peoples worldwide varies according to their unique historical, political, and social circumstances. Disparities in health between Maoris and non-Maoris have been evident for all of the colonial history of New Zealand. Explanations for these differences involve a complex mix of components associated with socioeconomic and lifestyle factors, availability of health care, and discrimination. Improving access to care is critical to addressing health disparities, and increasing evidence suggests that Maoris and non-Maoris differ in terms of access to primary and secondary health care services. We use 2 approaches to health service development to demonstrate how Maori-led initiatives are seeking to improve access to and quality of health care for Maoris. PMID:16507721

Ellison-Loschmann, Lis; Pearce, Neil

2006-01-01

367

Investing in Primary Health Care Achieving better health care in the community  

E-print Network

Investing in Primary Health Care Achieving better health care in the community #12;Images by Nasir of primary care and this investment has been more than matched by considerable national research funding to Oxford of some of the UK's top primary care senior scientists by attracting a large number of junior

Oxford, University of

368

Developing a strategic marketing plan for physical and occupational therapy services: a collaborative project between a critical access hospital and a graduate program in health care management.  

PubMed

The purpose of this study was to develop a marketing plan for the Physical and Occupational Therapy (PT/OT) department at a Critical Access Hospital (CAH). We took the approach of understanding and analyzing the rural community and health care environment, problems faced by the PT/OT department, and developing a strategic marketing plan to resolve those problems. We used hospital admissions data, public and physician surveys, a SWOT analysis, and tools to evaluate alternative strategies. Lack of awareness and negative perception were key issues. Recommended strategies included building relationships with physicians, partnering with the school district, and enhancing the wellness program. PMID:23924224

Kash, Bita A; Deshmukh, A A

2013-01-01

369

China's public health-care system: facing the challenges.  

PubMed Central

The severe acute respiratory syndrome (SARS) crisis in China revealed not only the failures of the Chinese health-care system but also some fundamental structural deficiencies. A decentralized and fragmented health system, such as the one found in China, is not well-suited to making a rapid and coordinated response to public health emergencies. The commercial orientation of the health sector on the supply-side and lack of health insurance coverage on the demand-side further exacerbate the problems of the under-provision of public services, such as health surveillance and preventive care. For the past 25 years, the Chinese Government has kept economic development at the top of the policy agenda at the expense of public health, especially in terms of access to health care for the 800 million people living in rural areas. A significant increase in government investment in the public health infrastructure, though long overdue, is not sufficient to solve the problems of the health-care system. China needs to reorganize its public health system by strengthening both the vertical and horizontal connections between its various public health organizations. China's recent policy of establishing a matching-fund financed rural health insurance system presents an exciting opportunity to improve people's access to health care. PMID:15500285

Liu, Yuanli

2004-01-01

370

Diversity, Health, and the State of Patient Care in the US Health Care System  

Microsoft Academic Search

The current supplement adds to a growing body of literature by examining factors related to quality of health care with an emphasis on patient-centered care in the context of the Latino population. Despite being the largest of the racial\\/ethnic groups within the US, we have only begun to explore Latino perspectives on health and health care and the ways in

Hayden B. Bosworth; Ronnie D. Horner

2009-01-01

371

The Health Care Labor Shortage: Report of the Health Care Labor Shortage Work Group.  

ERIC Educational Resources Information Center

A work group consisting of representatives of public agencies, education, the health care industry, and unions and professional associations was formed to examine education and training issues related to the shortage of health care workers in Washington state. The group concluded that the shortage of available workers in many health care

Washington State Workforce Training and Education Coordinating Board, Olympia.

372

Health care reform and job satisfaction of primary health care physicians in Lithuania  

Microsoft Academic Search

BACKGROUND: The aim of this research paper is to study job satisfaction of physicians and general practitioners at primary health care institutions during the health care reform in Lithuania. METHODS: Self-administrated anonymous questionnaires were distributed to all physicians and general practitioners (N = 243, response rate – 78.6%), working at Kaunas primary health care level establishments, in October – December

Ilona Buciuniene; Aurelija Blazeviciene; Egle Bliudziute

2005-01-01

373

Is it appropriate, or ethical, to use health data collected for the purpose of direct patient care to develop computerized predictive decision support tools?  

PubMed

The increasing use of clinical decision support systems (CDSS) to assist clinicians in decision-making is pushing the limits of information technology. The emergence of Electronic Health Records (EHR) coupled with enriched health information standards such as HL7 CDA, SNOMED, ICD-10 and LOINC have provided a rich environment for massive data collection and analysis by healthcare providers. This immense increase in data collection has also provided a gateway for the application of various data mining techniques on clinical datasets so as to measure health status (i.e. function, comfort and likelihood of dying) of patients. In measuring health status, many clinicians have opted to use CDSS to assist in decision-making and enhance clinical experience. However, even as the use of CDSS in clinicians' office continues to grow, the question that remains in the minds of many patients and the general public is whether it is appropriate, or ethical, for researchers to use health data collected for the purpose of direct patient care to develop computerized predictive decision support tool. In this paper, a systematic review is used to highlight the relevant technical barriers and ethical issues surrounding the secondary use of health data in developing CDSS. PMID:19380924

Bonney, Wilfred

2009-01-01

374

Learning Health Care Systems: Leading Through Research  

PubMed Central

The Health Maintenance Organization Research Network (HMORN), a consortium of 19 health care delivery systems with integrated research centers, held their 18th annual conference in Seattle, Washington from April 29 to May 2, 2012. Group Health Research Institute hosted the conference, “Learning health care systems: Leading through research”. The 2012 theme was chosen to reflect the critical role of collaboration among researchers, clinicians and health systems to improve health care nationally. Over 500 researchers and health care professionals participated in this conference. Representatives from the NCI, NHLBI, NIMH, and PCORI met with researchers to advance the quality and breadth of public domain research in HMOs. In this article we summarize information about the HMORN and its 18th annual conference. PMID:22904375

Newton, Katherine M.; Larson, Eric B.

2012-01-01

375

Segmenting the mental health care market.  

PubMed

The authors report the results of a segmentation study of the mental health care market. A random sample of 387 residents of a western city were interviewed by telephone. Cluster analysis of the data identified six market segments. Each is described according to the mental health care services to which it is most sensitive. Implications for targeting the segments are discussed. PMID:10104017

Stone, T R; Warren, W E; Stevens, R E

1990-03-01

376

A Guide to Adolescent Health Care EPSDT.  

ERIC Educational Resources Information Center

This document provides guidelines for individuals giving health care to adolescents through the Early and Periodic Screening, Diagnosis and Treatment (EPSDT) Program. Chapter One briefly indicates needs of adolescents and outlines legal aspects of health care for adolescents such as age of majority, informed consent, confidentiality, disclosure of…

Health Care Financing Administration (DHEW), Washington, DC.

377

Teaching Primary Health Care: An Interdisciplinary Approach.  

ERIC Educational Resources Information Center

Nursing and radiology students (n=15) at the University of Malta who completed an interdisciplinary module on primary health care reported they found the theoretical material applicable to practice; the module enabled them to learn about their potential role in primary health care. (SK)

Bezzina, Paul; Keogh, Johann J.; Keogh, Mariana

1998-01-01

378

Flashpoint in HealthCare Reform  

Microsoft Academic Search

Health care is an explosive flashpoint in U.S. politics this year more than ever. By 2013, Americans will either be headed, however slowly and fitfully, toward virtually universal access to decent health care or most of us will be struggling to use dwindling public vouchers to purchase ever more expensive private insurance. These alternate futures reflect what will happen if

Theda Skocpol

2012-01-01

379

Financial management in leading health care systems.  

PubMed

To understand better the financial management practices and strategies of modern health care organizations, we conducted interviews with chief financial officers (CFOs) of several leading health care systems. In this introduction, we present an overview of the project and summary responses on corporate financial structures and strategic challenges facing CFOs. PMID:10845383

Smith, D G; Wheeler, J R; Rivenson, H L; Reiter, K L

2000-01-01

380

Health Care Provider Physical Activity Prescription Intervention  

ERIC Educational Resources Information Center

Purpose: To examine the feasibility and impact of a health care provider’s (HCP) physical activity (PA) prescription on the PA of patients on preventive care visits. Methods: Consenting adult patients completed health and PA questionnaires and were sequentially assigned to intervention groups. HCPs prescribed PA using a written prescription only…

Josyula, Lakshmi; Lyle, Roseann

2013-01-01

381

Educating primary care clinicians about health disparities  

Microsoft Academic Search

Racial and ethnic health disparities inarguably exist in the United States. It is important to educate primary care clinicians regarding this topic because they have the ability to have an impact in the reduction of health disparities. This article presents the evidence that disparities exist, how clinicians contribute to these disparities, and what primary care clinicians can do to reduce

Roberto Cardarelli; Ana L Chiapa

2007-01-01

382

On Changing Indian Eligibility for Health Care.  

ERIC Educational Resources Information Center

Analyzes empirical data from one service area in Oklahoma as an illustration of the likely effects of proposed restrictions limiting eligibility of Native Americans for Indian Health Service care. Findings indicate dwindling support for Indian health care and negative impact on future Indian population. (PS)

Bashushur, Rashid; And Others

1987-01-01

383

Service quality in health care setting  

Microsoft Academic Search

Purpose – This paper attempts to explore the concept of service quality in a health care setting. Design\\/methodology\\/approach – This paper probes the definition of service quality from technical and functional aspects for a better understanding on how consumers evaluate the quality of health care. It adopts the conceptual model of service quality frequently used by the most researchers in

Wan Edura Wan Rashid; Hj. Kamaruzaman Jusoff

2009-01-01

384

Many Faces: Addressing Diversity in Health Care  

Microsoft Academic Search

Diversity. The changing demographics and economics of our growing multicultural world, and the long-standing disparities in the health status of people from culturally diverse backgrounds has challenged health care providers and organizations to consider cultural diversity as a priority. The purpose of this article is to present a model that will be helpful in providing culturally competent care. The concept

Josepha Campinha-Bacote

385

science And society Universal health care, genomic  

E-print Network

medicine. Indian J. Nat. Products 19, 16­23 (2003). 12. Patwardhan, B., Vaidya, A. & Chorghade, M. Ayurvedascience And society Universal health care, genomic medicine and Thailand: investing in today.AmajorfuturechallengewillbeforThailand to integrate genomic medicine in its relatively young universal health-care system. One of Thailand

Cai, Long

386

Improving Health Care for Assisted Living Residents  

Microsoft Academic Search

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

Robert L. Kane; John R. Mach

387

Health and medical care in Ethiopia.  

PubMed

Ethiopia is a country of 45 million people in northeast Africa. With a stagnant, agriculture-based economy and a per capita gross national product of $110 in 1984, it is one of the world's poorest nations. 70% of the children are mildly to severely malnourished, and 25.7% of children born alive die before the age of 5. Life expectancy is 41 years. The population is growing at the rate of 2.9%/year, but only 2% of the people use birth control. After the 1974 revolution, the socialist government nationalized land and created 20,000 peasant associations and kebeles (urban dwellers' associations), which are the units of local government. The government has set ambitious goals for development in all sectors, including health, but famine, near famine, forced resettlement programs, and civil war have prevented any real progress from being made. The government's approach to health care is based on an emphasis on primary health care and expansion of rural health services, but the Ministry of Health is allocated only 3.5% of the national budget. Ethiopia has 3 medical schools -- at Addis Ababa, Gondar, and the Jimma Institute of Health Sciences. Physicians are government employees but also engage in private practice. A major problem is that a large proportion of medical graduates emigrate. Ethiopia has 87 hospitals with 11,296 beds, which comes to 1 bed per 3734 people. There are 1949 health stations and 141 health centers, but many have no physician, and attrition among health workers is high due to lack of ministerial support. Health care is often dispensed legally or illegally by pharmacists. Overall, there is 1 physician for 57,876 people, but in the southwest and west central Ethiopia 1 physician serves between 200,000 and 300,000 people. In rural areas, where 90% of the population lives, 85% live at least 3 days by foot from a rural health unit. Immunization of 1-year olds against tuberculosis, diphtheria-pertussis-tetanus, poliomyelitis, and measles is 11, 6, 6, and 12% respectively. Infectious diseases dominate the medical scene in Ethiopia. In 1984, tuberculosis accounted for 11.2% of hospital admissions and 12.2% of deaths. The leading cause of childhood mortality in 1984 was diarrhea (45%). Malaria, trypanosomiasis, schistosomiasis, leishmaniasis, and meningococcal meningitis are endemic. Intestinal parasitism is rampant, and the nationwide prevalence of leprosy is 3/1000. Venereal diseases were the 9th most common cause of hospital outpatient visits in 1984, but AIDS is rare. The leading noninfectious diseases are rheumatic and syphilitic heart disease, hypertension, diabetes mellitus, hepatoma, and elephantiasis. Ethiopia has the highest number of cases of nonfilarial elephantiasis -- an estimated 350,000 cases -- in the world. Aside from a large influx of money, the most necessary changes to improve the health system are lowering the salaries of doctors and nurses, reorienting physician training toward primary health care, increasing the quality of existing health services, more efficient management, and better coordination between the Ministry of Health and the voluntary organizations. PMID:3419456

Hodes, R M; Kloos, H

1988-10-01

388

Chater 4 Roles of Child Health-Care Providers Roles of Child Health-Care  

E-print Network

screening, as recommended. 4. Provide family lead education. 5. Provide diagnostic and follow-up testing-up care, child health-care providers should per- form blood lead testing when children have unexplained-Care Providers 2. Give anticiator gbidance. During prenatal care and during preventive care at 3-6 months

389

Catholic health care: rationale for ministry.  

PubMed

This essay attempts to describe contemporary Catholic sponsored health care in the United States and to describe the purpose and structure of these particular Christian charitable organizations within the broader society. As health care has become more complex, critics claim that there is not a need for Catholic sponsored health care any longer. The author attempts to evaluate critically whether Catholic health care has a place in contemporary society. He reviews some salient biblical, ecclesial, and justice teachings of the Church to demonstrate why religious institutional presence is still needed. The author reviews contemporary health care structures to show how this is accomplished. He also uncovers additional issues which need to be addressed in order for these charitable institutions to carry on the ministry of the Church, to shape social structures, and to proclaim the reign of God. PMID:11657996

Brodeur, Dennis

1999-04-01

390

The promise of Lean in health care.  

PubMed

An urgent need in American health care is improving quality and efficiency while controlling costs. One promising management approach implemented by some leading health care institutions is Lean, a quality improvement philosophy and set of principles originated by the Toyota Motor Company. Health care cases reveal that Lean is as applicable in complex knowledge work as it is in assembly-line manufacturing. When well executed, Lean transforms how an organization works and creates an insatiable quest for improvement. In this article, we define Lean and present 6 principles that constitute the essential dynamic of Lean management: attitude of continuous improvement, value creation, unity of purpose, respect for front-line workers, visual tracking, and flexible regimentation. Health care case studies illustrate each principle. The goal of this article is to provide a template for health care leaders to use in considering the implementation of the Lean management system or in assessing the current state of implementation in their organizations. PMID:23274021

Toussaint, John S; Berry, Leonard L

2013-01-01

391

Children with Special Health Care Needs  

Microsoft Academic Search

The health care model presented in this paper is a non-linear, systems approach to service delivery. The model was a by-product of three ethnic-specific conferences that were convened to discuss strategies for improving access to care and the quality of services provided to children with special health care needs (CSHCN) from diverse cultural backgrounds. The model evolved as insights regarding

Theora Evans; Ann Garwick

2002-01-01

392

Application of lean thinking to health care: issues and observations  

PubMed Central

Background Incidents and quality problems are a prime cause why health care leaders are calling to redesign health care delivery. One of the concepts used is lean thinking. Yet, lean often leads to resistance. Also, there is a lack of high quality evidence supporting lean premises. In this paper, we present an overview of lean thinking and its application to health care. Development, theory and application of lean thinking to health care Lean thinking evolved from a tool designed to improve operational shop-floor performance at an automotive manufacturer to a management approach with both operational and sociotechnical aspects. Sociotechnical dynamics have until recently not received much attention. At the same time a balanced approach might lead to a situation where operational and sociotechnial improvements are mutually reinforcing. Application to health care has been limited and focussed mainly on operational aspects using original lean tools. A more integrative approach would be to pay more attention to sociotechnical dynamics of lean implementation efforts. Also, the need to use the original lean tools may be limited, because health care may have different instruments and tools already in use that are in line with lean thinking principles. Discussion We believe lean thinking has the potential to improve health care delivery. At the same time, there are methodological and practical considerations that need to be taken into account. Otherwise, lean implementation will be superficial and fail, adding to existing resistance and making it more difficult to improve health care in the long term. PMID:19696048

Joosten, Tom; Bongers, Inge; Janssen, Richard

2009-01-01

393

The Pacific Island Health Care Project  

PubMed Central

Introduction/Background: US Associated/Affiliated Pacific Islands (USAPI) include three freely associated states: Marshall Islands, Federated States of Micronesia, Palau, and three Territories: American Samoa, Guam, and Commonwealth of the Northern Mariana Islands. Objective: The Pacific Island Health Care Project (PIHCP) provides humanitarian medical referral/consultation/care to >500,000 indigenous people of these remote islands. Methods: In the mid-1990s, we developed a simple store-and-forward program to link the USAPI with Tripler Army Medical Center. This application allowed image attachment to email consultations. Results: More than 8000 Pacific Islanders have benefited from the program. Three thousand Pacific Islanders prior to telemedicine (1990–1997) and since store-and-forward telemedicine (1997-present), the PIHCP has helped an additional 5000. Records post dynamically and are stored in an archival database. Conclusion: The PIHCP is the longest running telemedicine program in the world delivering humanitarian medical care. It has bridged the Developing World of the remote Pacific Islands with advanced medical and surgical care available at a major US military teaching hospital. (The opinions expressed here are those of the author and not that of the Army, Department of Defense, or the US Government.) PMID:25353012

Person, Donald Ames

2014-01-01

394

Correctional health care: implications for public health policy.  

PubMed Central

"Correctional Health Care: Implications for Public Health Policy" is the first in a series of articles that examines the special health care needs of persons who are incarcerated in America's correctional facilities. The intent of the series is to gain a better understanding about the unmet health needs of incarcerated persons, the importance of addressing the health service delivery system in correctional facilities, and the implications that may arise from neglecting to address these health issues on health outcomes for individual detainees and society at-large when detainees transition back into the community. This article provides a descriptive overview of the corrections population, their sociodemographics, health care needs, and health concerns that are in need of improvement. This article also offers recommendations for public policy consideration to improve the overall health of inmates and society at large. PMID:12069208

Adams, Diane L.; Leath, Brenda A.

2002-01-01

395

Correctional health care: implications for public health policy.  

PubMed

"Correctional Health Care: Implications for Public Health Policy" is the first in a series of articles that examines the special health care needs of persons who are incarcerated in America's correctional facilities. The intent of the series is to gain a better understanding about the unmet health needs of incarcerated persons, the importance of addressing the health service delivery system in correctional facilities, and the implications that may arise from neglecting to address these health issues on health outcomes for individual detainees and society at-large when detainees transition back into the community. This article provides a descriptive overview of the corrections population, their sociodemographics, health care needs, and health concerns that are in need of improvement. This article also offers recommendations for public policy consideration to improve the overall health of inmates and society at large. PMID:12069208

Adams, Diane L; Leath, Brenda A

2002-05-01

396

Transforming Care Delivery through Health Information Technology  

PubMed Central

The slow but progressive adoption of health information technology (IT) nationwide promises to usher in a new era in health care. Electronic health record systems provide a complete patient record at the point of care and can help to alleviate some of the challenges of a fragmented delivery system, such as drug-drug interactions. Moreover, health IT promotes evidence-based practice by identifying gaps in recommended treatment and providing clinical decision-support tools. In addition, the data collected through digital records can be used to monitor patient outcomes and identify potential improvements in care protocols. Kaiser Permanente continues to advance its capability in each of these areas. PMID:23596377

Wheatley, Benjamin

2013-01-01

397

Home Health Care: What It Is and What to Expect  

MedlinePLUS

... You are here: Plan of care Share Home health care: what it is and what to expect What is home health care? Home health care is a wide range of ... agency listed. What should you expect from home health care? Doctor’s orders are needed to start care. Once ...

398

The Total Health Care Audit System: a systematic methodology for clinical practice evaluation and development in NHS provider organizations.  

PubMed

Writing in Medical Education in 1982, Fowkes (1982) noted the lack of general agreement within the medical profession on methods of audit, a deficiency previously articulated by Shaw (1980) and later emphasized by McIntyre (1985). More recently, a study by Black & Thompson (1993) of consultant and junior medical staff in four London district general hospitals revealed that 'many doctors did not understand how to undertake audit', and major research by both Hopkins (1993, 1994) and Buttery et al. (1994) described a multiplicity of methodological deficiencies in the general approaches to audit adopted by clinicians since the promulgation of the White Paper definition in 1989. Soundness of methodological approach is fundamental to securing the success of clinical audit within Provider organizations and is thus central to the generation of measurable improvements in the quality of clinical care being delivered to patients. It is therefore disturbing that methodological deficiencies may still be observed in general approaches to audit (Buttery et al. 1994), with no author yet recommending a formal system for critical inquiry into clinical practice. It was the recognition of the unsatisfactory nature of this situation which led us to develop a system aimed at assessing, in a critical fashion, the quality of the totality of care dispensed within NHS provider organizations. The system is presented here for the first time. PMID:9238575

Miles, A; Bentley, P; Price, N; Polychronis, A; Grey, J; Asbridge, J

1996-02-01

399

Marketing Communications Plan for Coventry Health Care of Kansas, Inc.  

E-print Network

Graduate students at the University of Kansas worked closely with Coventry Health Care of Kansas, Inc. (CHC Kansas) to develop a strategic marketing communications plan for the organization. The primary goal of the marketing ...

Kelly, Sarah; Kim, Sungtae; Mowder, Alicia; Smith, Carmen; Vaughn, Joshua

2012-05-08

400

Vaccine perceptions among Oregon health care providers.  

PubMed

Health care providers exert a significant influence on parental pediatric vaccination decisions. We conducted hour-long interviews with traditional and alternative health care providers in which we explored a range of associations between vaccination perceptions and practice. A key finding was that the Health Belief Model constructs of perceived susceptibility to and severity of either an illness or an adverse vaccine event partially explained health care provider (HCP) beliefs about the risks or benefits of vaccination, especially among alternative care providers. Low or high perceived susceptibility to a vaccine-preventable disease (VPD) or of the severity of a given VPD affects whether an HCP will promote or oppose pediatric vaccination recommendations. Beyond these perceptions, health and vaccination beliefs are affected by the contextual factors of personal experience, group norms, immunology beliefs, and beliefs about industry and government. Building powerful affective heuristics might be critical to balancing the forces that defeat good public health practices. PMID:23964059

Bean, Sandra J; Catania, Joseph A

2013-09-01

401

Meeting new health care challenges with a proven innovation: nurse-managed health care clinics.  

PubMed

Beginning in January 2014, millions of Americans will enroll in health insurance plans under the Affordable Care Act. Some of these individuals were obtaining health care in safety net health clinics, emergency departments, or urgent care centers; many were going without needed care and will be new to the health care system. In addition to these newly insured, the ranks of older Americans and persons in need of chronic disease management will be on the rise. The way in which health care is delivered will have to change in order for the health care workforce to meet the demand for their services without sacrificing quality or access. Nurse practitioners and registered nurses have the education and skills to provide health promotion, disease prevention, and chronic disease management services that will make up a sizable portion of the demand. Amending state practice acts so that the authority to practice matches the ability to practice and opening provider panels to advanced practice nurses will provide opportunities to establish or expand sustainable nurse-led primary care practices in health care shortage areas. Along with these changes, models of health care delivery that incorporate differentiated practice roles and shared interprofessional responsibility for providing care will maximize the capacity of the system to provide the health care that people need. PMID:24569758

Link, Denise G; Perry, Diane; Cesarotti, Evelyn L

2014-01-01

402

Migrant farmworker children: Health status, barriers to care, and nursing innovations in health care delivery  

Microsoft Academic Search

Migrant farmworkers are one of the most health care-impoverished populations in the United States. Mobility, hazardous occupations, cultural diversity, and low socioeconomic status place migrants, and particularly migrant children, at high risk for inadequate health care and preventable health problems. This article presents a synthesis of the existing research on migrant demographics, major health risks, and geographic, financial, and cultural

Marni E Gwyther; Melinda Jenkins

1998-01-01

403

Health care consolidation and the changing health care marketplace. A review of the literature and issues.  

PubMed

This Issue Brief examines the academic literature and issues in consolidation of the hospital sector in the context of responses to changes in the competitive environment. It analyzes the motivations for consolidation as well as its effects. Hospital merger activity has increased dramatically in recent years. The current wave of mergers is primarily a reaction to a competitive environment that is placing a greater emphasis on controlling costs and forcing high-cost providers out of the market. The growth of managed care has placed considerable pressure on providers of health care and, in particular, on hospitals. The evolution of insurance companies' behavior helps explain the recent hospital consolidation movement. As managed care has become the dominant type of coverage in the last decade, insurance companies have become more active in trying to control costs--a reversion to their previous practices before the advent of managed care. Insurance companies have placed cost constraints on providers, both in the early years of health insurance and currently, when there are strong competitive forces. Hospitals claim that their primary merger motives are improving efficiency and the quality of care. The empirical evidence on this claim is mixed. Vertical integration (between suppliers and buyers of health care services, such as between hospitals and physicians) has appealed to hospitals because of their need to obtain more patients. More research is needed to explore the effects of vertical integration in the health care sector. In one of the more significant recent legal rulings, the U.S. Justice Department lost a 1997 case challenging the merger of two hospitals in the New York City metropolitan area. This, along with other recent losses by the antitrust authorities, does not bode well for the government's ability to prevent hospital mergers in metropolitan areas. It is difficult to generalize on an appropriate antitrust policy for hospital mergers. Hospital consolidation is likely to continue at a rapid pace. Since some developments may reduce the cost of employee benefits while others may increase the cost of these benefits, the final effect on the provision of health care benefits by employers is uncertain. Employers must pay close attention to the hospital consolidation movement because it will lead to important changes in the provision of health care benefits. PMID:10622866

Goldberg, L G

1999-10-01

404

Health and Ambulatory Care Use Among Native American Veterans  

Microsoft Academic Search

In 1995, the Veterans Health Administration reorganized its health services structure to emphasize ambulatory care. Successful health care planning and improving access to ambulatory care services now depends upon a better understanding of health care needs and outpatient services. Because the veteran population is heterogeneous, it is important to understand the health, access issues, and utilization of ambulatory care services

Valentine M. Villa; Nancy D. Harada; Anh-Luu T. Huynh-Hohnbaum

2010-01-01

405

The effects of expanding primary care access for the uninsured: implications for the health care workforce under health reform.  

PubMed

The Patient Protection and Affordable Care Act seeks to improve health equity in the United States by expanding Medicaid coverage for adults who are uninsured and/or socioeconomically disadvantaged; however, when millions more become eligible for Medicaid in 2014, the health care workforce and care delivery systems will be inadequate to meet the care needs of the U.S. population. To provide high-quality care efficiently to the expanded population of insured individuals, the health care workforce and care delivery structures will need to be tailored to meet the needs of specific groups within the population.To help create a foundation for understanding the use patterns of the newly insured and to recommend possible approaches to care delivery and workforce development, the authors describe the 13-year-old experience of the Virginia Coordinated Care program (VCC). The VCC, developed by Virginia Commonwealth University Health System in Richmond, Virginia, is a health-system-sponsored care coordination program that provides primary and specialty care services to patients who are indigent. The authors have categorized VCC patients from fiscal year 2011 by medical complexity. Then, on the basis of the resulting utilization data for each category over the next fiscal year, the authors describe the medical needs and health behaviors of the four different patient groups. Finally, the authors discuss possible approaches for providing primary, preventive, and specialty care to improve the health of the population while controlling costs and how adoption of the approaches might be shaped by care delivery systems and educational institutions. PMID:24128619

Dow, Alan W; Bohannon, Arline; Garland, Sheryl; Mazmanian, Paul E; Retchin, Sheldon M

2013-12-01

406

Managing complaints in health and social care.  

PubMed

An important aspect of allowing patients to take control of their health care is the introduction of new procedures for dealing with complaints. This article examines the concepts that underpin the new Department of Health regulations on complaints management and what they will mean for health and social care professionals. It also explains why these regulations focus on restorative justice rather than blame when adverse events occur. PMID:20432639

Holmes-Bonney, Kathy

2010-04-01

407

Afghanistan's national strategy for improving quality in health care  

PubMed Central

Quality problem or issue When the Ministry of Public Health (MoPH) of the Islamic Republic of Afghanistan began reconstructing the health system in 2003, it faced serious challenges. Decades of war had severely damaged the health infrastructure and the country's ability to deliver health services. Initial assessment A national health resources assessment in 2002 revealed huge structural and resource disparities fundamental to improving health care. For example, only 9% of the population was able to access basic health services, and about 40% of health facilities had no female health providers, severely constraining access of women to health care. Multiple donor programs and the MoPH had some success in improving quality, but questions about sustainability, as well as fragmentation and poor coordination, existed. Plan of action In 2009, MoPH resolved to align and accelerate quality improvement efforts as well as build structural and skill capacity. Implementation The MoPH established a new quality unit within the ministry and undertook a year-long consultative process that drew on international evidence and inputs from all levels of the health system to developed a National Strategy for Improving Quality in Health Care consisting of a strategy implementation framework and a five-year operational plan. Lessons Learned Even in resource-restrained countries, under the most adverse circumstances, quality of health care can be improved at the front-lines and a consensual and coherent national quality strategy developed and implemented. PMID:23485422

Rahimzai, Mirwais; Amiri, Mirwais; Burhani, Nadera Hayat; Leatherman, Sheila; Hiltebeitel, Simon; Rahmanzai, Ahmed Javed

2013-01-01

408

Health care reform and the primary care workforce bottleneck.  

PubMed

To establish and sustain the high-performing health care system envisioned in the Affordable Care Act (ACA), current provisions in the law to strengthen the primary care workforce must be funded, implemented, and tested. However, the United States is heading towards a severe primary care workforce bottleneck due to ballooning demand and vanishing supply. Demand will be fueled by the "silver tsunami" of 80 million Americans retiring over the next 20 years and the expanded insurance coverage for 32 million Americans in the ACA. The primary care workforce is declining because of decreased production and accelerated attrition. To mitigate the looming primary care bottleneck, even bolder policies will be needed to attract, train, and sustain a sufficient number of primary care professionals. General internists must continue their vital leadership in this effort. PMID:22042605

Schwartz, Mark D

2012-04-01

409

Petroleum and health care: evaluating and managing health care's vulnerability to petroleum supply shifts.  

PubMed

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

Hess, Jeremy; Bednarz, Daniel; Bae, Jaeyong; Pierce, Jessica

2011-09-01

410

Mental Health under National Health Care Reform: The Empirical Foundations.  

ERIC Educational Resources Information Center

Reviews research pertinent to mental health services under health care reform proposals. Examines redistributional impact of inclusion of outpatient mental health benefits, optimal benefit packages, and findings that mental health services lower medical utilization costs. Argues that extending minimalist model of time-limited benefits to national…

Hudson, Christopher G.; DeVito, Jo Anne

1994-01-01

411

The containment of cost of health care.  

PubMed

The cost of health care services has become increasingly important to society. Although hospital physicians are traditionally not involved in cost calculation and cost containment, they bear the consequences of budget restrictions. Since 1987, the reimbursement for clinical laboratories in Belgian hospitals has changed towards an envelope based system. Clinical biologists became aware that new resources can only be obtained mainly through cost reductions. But to contain cost, one must understand how it is generated. Activity based costing (ABC) is a new technique developed for strategic management in the industry. By analyzing the cost of all activities involved in the production process, this technique is very well suited to calculate cost in service organizations like medical departments. Using the principles of ABC, we performed a detailed analysis of the cost of a microbiology laboratory, determining the full cost as well as the proportion of each cost sorts (materials, labor, ...) for each laboratory test. This analysis illustrates that cost can effectively be calculated in a hospital department and guide doctors in the evaluation of alternative medical techniques, investments in automation, and the decision on medical priorities. In our opinion, cost containment of hospital care must start from within each medical department. Responsibility and participation of physicians in the discussion on budget allocation are essential in the process of cost containment of the hospital health care. PMID:8686402

Gordts, B

1996-04-01

412

Health care delivery in a sleep center.  

PubMed

This report presents and describes measures developed for the tracking of care provided to patients referred for evaluation to a sleep clinic and center in a U.S. federal health facility. We provide qualitative and quantitative indicators, tracked for a two-year period of time, for system management, information flow, measures of consultation and subsequent identification of apneic activity (Respiratory Disturbance Index > 10) and treatment for sleep apnea, and the satisfaction with diagnostic testing and treatment. Measures of laboratory efficiency were generally stable, except for the time from the clinic visit to PSG and the time from PSG interpretation to the final written report. We have some evidence that patient satisfaction with CPAP/BiLevel care may vary with a change in a home health care provider. Also, there was a surprisingly high rate of replacement of masks during nasal CPAP therapy. Results indicate the feasibility of such an approach and identify certain areas for improvement in process and communication relevant to the management of sleep disordered breathing. PMID:19412711

Rosenbalm, T E; Redline, S; Rosenberg, C; Disch, A; McFadden, G; Stohl, K P

1997-03-01

413

The Cuban health care system and factors currently undermining it.  

PubMed

This paper explores the dynamics of health and health care in Cuba during a period of severe crisis by placing it within its economic, social, and political context using a comparative historical approach. It outlines Cuban achievements in health care as a consequence of the socialist transformations since 1959, noting the full commitment by the Cuban state, the planned economy, mass participation, and a self-critical, working class perspective as crucial factors. The roles of two external factors, the U.S. economic embargo and the Council of Mutual Economic Cooperation (CMEA), are explored in shaping the Cuban society and economy, including its health care system. It is argued that the former has hindered health efforts in Cuba. The role of the latter is more complex. While the CMEA was an important source for economic growth, Cuban relations with the Soviet bloc had a damaging effect on the development of socialism in Cuba. The adoption of the Soviet model of economic development fostered bureaucracy and demoralization of Cuban workers. As such, it contributed to two internal factors that have undermined further social progress including in health care: low productivity of labor and the growth of bureaucracy. While the health care system is still consistently supported by public policy and its structure is sound, economic crisis undermines its material and moral foundations and threatens its achievements. The future of the current Cuban health care system is intertwined with the potentials for its socialist development. PMID:7593738

Nayeri, K

1995-08-01

414

Mobile Health Means Better Health Care for All  

E-print Network

Abstract — Electronic health (eHealth) is an essential tool for improving healthcare delivery and patient care. Although the healthcare industry is information-intensive, it suffers from a high degree of fragmentation which results in inefficiency. There are four key steps in fixing this inefficiency. First, the healthcare industry should adopt Information and Communication Technology (ICT) systems that can allow effective health information management. When used effectively, health ICT systems, such as Electronic Health Record (EHR), Electronic Medical Record (EMR), and Personal Health Record (PHR) can significantly improve health information sharing and patient care. Second, as patients are viewed as partners and participants in their care, PHR systems can enhance the healthcare delivery by engaging patients in their care process. Also, with today’s

Israel R. Kabashiki

415

Achieving population health in accountable care organizations.  

PubMed

Although "population health" is one of the Institute for Healthcare Improvement's Triple Aim goals, its relationship to accountable care organizations (ACOs) remains ill-defined and lacks clarity as to how the clinical delivery system intersects with the public health system. Although defining population health as "panel" management seems to be the default definition, we called for a broader "community health" definition that could improve relationships between clinical delivery and public health systems and health outcomes for communities. We discussed this broader definition and offered recommendations for linking ACOs with the public health system toward improving health for patients and their communities. PMID:23678910

Hacker, Karen; Walker, Deborah Klein

2013-07-01

416

Health Services and Health Care Providers  

MedlinePLUS

... these professionals are familiar with the issues that college students often face, such as stress, chronic health conditions, ... for any illnesses. If for some reason your college doesn't have student health services, an administrator at your school should ...

417

Developing a national primary care-based early warning system for health protection--a surveillance tool for the future? Analysis of routinely collected data.  

PubMed

The increasing threat of infections with pandemic potential such as influenza has focussed attention on the information needed to inform those managing a pandemic. The Health Protection Agency, Nottingham University and EMIS have developed a new national health protection surveillance system using QRESEARCH, an established primary care-derived database, to provide timely and local information on trends in community illness and prescribing. This article describes the first year of the surveillance project. Data on consultations and prescribing were extracted from routinely generated computerized consultation records between November 2004 and December 2005. Weekly consultation and prescribing rates for a range of conditions including influenza-like illness and prescription of anti-viral drugs for influenza and vomiting were developed as 'key indicators'. These indicators were presented in a weekly bulletin showing data to strategic health authority level for use by those working in public health. The particular value of this scheme is the ability to produce timely data on illness to local level and to link prescribing to morbidity. The data were used 'real time' to reassure about lack of illness following the Buncefield Fuel Depot incident. This scheme is being further developed to provide daily local influenza-related information needed in an influenza pandemic. PMID:17158478

Smith, Gillian; Hippisley-Cox, Julia; Harcourt, Sally; Heaps, Mike; Painter, Mike; Porter, Alex; Pringle, Mike

2007-03-01

418

Using Digital Crumbs from an Electronic Health Record to Identify, Study and Improve Health Care Teams  

PubMed Central

We have developed a novel approach, the Digital Crumb Investigator, for using data collected as a byproduct of Electonic Health Record (EHR) use to help define care teams and care processes. We are developing tools and methods to utilize these routinely collected data to visualize and quantify care networks across acute care and ambulatory settings We have chosen a clinical care domain where clinicians use EHRs in their offices, on the maternity wards and in the neonatal intensive care units as a test paradigm for this technology. The tools and methods we deliver should readily translate to other health care settings that collect behind-the-scenes electronic metadata such as audit trails. We believe that by applying the methods of social networking to define clinical relationships around a patient’s care we will enable new areas of research into the usage of EHRs to promote patient safety and other improvements in care. PMID:22195103

Gray, James E; Feldman, Henry; Reti, Shane; Markson, Larry; Lu, Xiaoning; Davis, Roger B.; Safran, Charles A

2011-01-01

419

Appendix: Health Care Systems The provision of high-quality health care in the United States and globally will challenge  

E-print Network

policy; and 3) Health care treatment. #12;Health Care Operations Clinics, hospitals, hospital networksAppendix: Health Care Systems The provision of high-quality health care in the United States., 2008). * * First two sentences of "Envisioning the Health Care Initiative at Lehigh" The financial

Napier, Terrence

420

Young People's Experiences of Mental Health Care  

ERIC Educational Resources Information Center

Fifteen in-depth interviews were conducted to explore young people's experiences of mental health care in Australia with the aim of informing the headspace National Youth Mental Health Foundation. The interviews revealed that significant numbers of respondents had been aware of their mental health problems for several years before seeking help and…

Cohen, Anjalee; Medlow, Sharon; Kelk, Norm; Hickie, Ian; Whitwell, Bradley

2009-01-01

421

Home Health and Informal Care Utilization  

E-print Network

and Sano also are supported by the Department of Veterans Affairs, Veterans Health Administration of the Department of Veterans Affairs. Address correspondence to: Carolyn W. Zhu, PhD, Health Economist, GeriatricHome Health and Informal Care Utilization and Costs Over Time in Alzheimer's Disease Carolyn W. Zhu

422

Health Care Reform: Recommendations and Analysis.  

ERIC Educational Resources Information Center

Health care reform needs to assure coverage to all children regardless of income level or illnesses; address benefits, financing, administration, and delivery systems; provide substantial subsidies to low-income families; be equitable for all people; provide better monitoring of child health; protect and strengthen health providers who assist…

Lewit, Eugene M.; And Others

1993-01-01

423

A School System's Model for Meeting Special Health Care Needs.  

ERIC Educational Resources Information Center

Procedures developed by Gwinnett County (Georgia) Public Schools to evaluate and serve the increasing number of students with medically complex needs are outlined. A medical review panel convened to address health and safety issues and requests that the school provide unique or specialized health care procedures is described, as is the development

Jordan, Al; Weinroth, Michael D.

1996-01-01

424

Sudan: national health programme and primary health care 1977/78-1983/84  

PubMed Central

As a follow-up to the national health programming process developed in 1975 in Sudan, a primary health care programme for the whole country was formulated with assistance from WHO. In this article the methods used in the programming and formulation are described and discussed. These methods ensured an intersectoral approach on which technical, cultural, socioeconomic, financial, and political considerations were based. Areas in the field of health and rural development requiring government and community action during the period 1977/78-1983/84 are identified. Details on the strategies for population coverage of rural and nomadic communities with primary health care are given. Fundamental to these strategies is community participation in the development of primary health care within community development as a whole. The guiding principles of these strategies are their technical, political, social and financial feasibility. The social relevance of the primary health care programme for the community and the developmental sectors is emphasized. PMID:1086739

Idriss, A. A.; Lolik, P.; Khan, R. A.; Benyoussef, A.

1976-01-01

425

[A dilemma--public health care].  

PubMed

The financing of personal health care services has become the crucible to test elected governments in the 21st century. Governments are caught between slow economic growth, lower personal income for most workers, and the clamour of health care for more money. The Western world with an aging population, marginal employment and rising unemployment, does not appear to have the capacity to pay for all that science and technology can produce and the public wants. Neither private nor public financing seem to have developed the machinery to identify need, and to balance demand with national economic output. I wish to suggest, that although the countries in the industrialised world have travelled different routes we have arrived at the same place. The art and science of medicine coupled with the human quest for health may simply exceed our productive capacity. The organisation and financing of twenty-First Century science and technology is nearly dysfunctional, bound by Nineteenth Century values, traditions and custom, as we face the next century. This may be the question. PMID:9156626

Wilson, G

1997-02-01

426

Growth & Development / Parental Care  

E-print Network

yolks Small Large Brain size Small (3%) Large (4-7%) Small intestine Large (10.3-14.5%) Small (6 Parental care Essential Minimal Nourishment Parents Self-feeding Egg size Ssmall (4-10%) Large (9-21%) Egg

Butler, Christopher J.

427

[External and internal financing in health care].  

PubMed

The objective of this contribution is to characterize the functional and institutional features of the German health-care system. This takes place after a short introduction and examination of the ongoing debate on health care in Germany. External funding describes the form of revenue generation. Regarding external funding of the German health care system, one of the favored alternatives in the current debate is the possibility of introducing per capita payments. After a short introduction to the capitation option, focus is on the so-called health fund that is currently debated on and being made ready for implementation in Germany, actually a mixed system of capitation and contributions based on income. On the other hand, internal funding is the method of how different health-care services are purchased or reimbursed. This becomes a rather hot topic in light of new trends for integrated and networked care to patients and different types of budgeting. Another dominating question in the German health-care system is the liberalization of the contractual law, with its "joint and uniform" regulations that have to be loosened for competition gains. After a discussion of the consequences of diagnosis-related groups (DRGs) in Germany, the article is concluded by a note on the political rationality of the current health-care reform for increased competition within the Statutory Health Insurance and its players as exemplified by the health fund. To sum up, it has to be said that the complexity and specific features of how the German system is financed seem to require ongoing reform considerations even after realization of the currently debated health-care reform law which, unfortunately, is dominated by political rationalities rather than objective thoughts. PMID:17497087

Henke, Klaus-Dirk

2007-05-15

428

Improving Incentives in Health Care Spending  

Microsoft Academic Search

Although U.S. economic growth is likely to continue to\\u000a be robust, the growth of private and public spending on\\u000a health care presents long-run public policy challenges.\\u000a To meet these challenges health care resources must be\\u000a used more efficiently. Currently, there are few incentives\\u000a to put health care dollars to the highest value use. This\\u000a is true in both public and

Katherine Baicker

2006-01-01

429

When do health care decisions discriminate against persons with disabilities?  

PubMed

Recent interpretations of laws prohibiting discrimination against persons with disabilities indicate that these laws will play a greater role in health care decision making than previously anticipated. This article employs lessons from other areas of antidiscrimination law to examine these developments and to provide a framework for making health care decisions that are consistent with these new legal interpretations. This article addresses decisions in individual cases, treatment policies adopted by health care providers, and coverage programs of third-party payers, both public and private. PMID:9459133

Mehlman, M J; Durchslag, M R; Neuhauser, D

1997-12-01

430

Health care coalitions: from joint purchasing to local health reform.  

PubMed

For several decades, business and health coalitions have played an important role in representing the interests of business in the health care arena. During the 1990s, these coalitions focused their efforts on supporting purchasing activities related to health insurance benefits and direct health care. Based on a national survey conducted in 2006, and prior similar surveys, we find that business and health coalitions have invested in pooling regional health care data, promoting public reporting of quality and cost information, and coordinating pay-for-performance initiatives. In addition, many business and health coalitions are broadening their membership to include other stakeholders and to support community health reform efforts with far-reaching benefits. Through this work, coalitions increasingly are recognizing and embracing their role as catalysts for local market reform. PMID:18767380

Camillus, Joseph A; Rosenthal, Meredith B

2008-01-01

431

The link between health care spending and health outcomes for the new English Primary Care Trusts  

Microsoft Academic Search

English programme budgeting data have yielded major new insights into the link between health care spending and health outcomes. This paper updates two recent studies that have used programme budgeting data for 295 Primary Care Trusts (PCTs) in England to examine the link between spending and outcomes for several programmes of care. We use the same economic model employed in

Stephen Martin; Nigel Rice; Peter C Smith

2008-01-01

432

Analysis of Assembly Bill 213: Health Care Coverage for Lymphedema  

E-print Network

Division of Health Care Finance and Policy, July 26). Thishealth care services plans licensed by Knox-Keene 1 and to health insurance policieshealth care services plans licensed by Knox-Keene 5 and to