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1

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.

Crema, Maria; Verbano, Chiara

2013-01-01

2

Future developments in health care performance management.  

PubMed

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 Update: Development of New National Child Care Health Standards.  

ERIC Educational Resources Information Center

Discusses the absence of national standards which are uniformly applicable to health, safety, sanitation, and nutrition aspects of child care programs. Explains the responsive collaborative project of the American Academy of Pediatrics and American Public Health Association to develop national reference standards for out-of-home child care

Aronson, Susan S.

1988-01-01

4

[Health care reform as a development of the health care system].  

PubMed

The German health care system is undergoing a serious crisis. Current health care policies have been failing badly. The parties involved in the provision of health care are willing and able to conduct health reform. All healthcare workers expect to be included in the decision-making processes. They anticipate that their expertise and skills will be appreciated and employed to make improvements. Wise and thoughtful health policy decisions would focus on measures to support innovative practices within the existing system and strengthen current change processes. It is proposed that the reform be based on sustainable procedures. Change Management within the health care system should be guided by the principles of the Learning Organisation and the varied experience with sophisticated industrial management practices. Successful health systems development opens up new opportunities for social and economic growth. PMID:17902407

Huber, Ellis

2007-01-01

5

Design of health care technologies for the developing world.  

PubMed

Approximately 20 years ago, the international community embarked on a project to bring health care to everyone by the year 2000 featuring, among other things, technologies that were known to be effective and economical. It was largely a failure. In fact, health care deteriorated in many of the target nations. Problems such as public mistrust, lack of spare parts, lack of required consumables, lack of reliable power and water, lack of public infrastructure such as roads, lack of technical expertise, and other problems plague health care technology in the developing world. Biomedical engineers are just beginning to quantify and address the barriers to technology unique to the developing world. This article reviews the barriers, both real and perceived, to the introduction of health care technology with a main focus on health care technology in hospitals. PMID:17430083

Malkin, Robert A

2007-01-01

6

Maternal Health, Primary Health Care (PHC) and The Millennium Development Goals (MDGs) in Developing Economies  

Microsoft Academic Search

Reform in the area of maternal health in developing economies is necessary if the targets of the Millennium Development Goals (MDGs) are to be achieved. Primary Health Care (PHC) is an option in achieving goal five of the MDG, being closer to the people. In a research carried out in 2002, deficiencies in access to health services were identified as

Josephine Nkiru-edna Alumanah

7

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

EPA Science Inventory

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

8

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

ERIC Educational Resources Information Center

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

Griesemer, Bernard A.; Hough, David L.

1993-01-01

9

Developing targets for public health initiatives to improve palliative care  

PubMed Central

Background Palliative Care is an approach that improves quality of life for patients and their families facing the problems associated with incurable life-threatening illness. In many countries, due to the rapidly ageing population, increasingly more people are suffering from serious chronic disease towards the end of life, making further development in palliative care a major public health challenge. The aim of this study was to develop the first targets for public health initiatives to improve palliative care in Germany. Methods Based on the findings from pilot studies (qualitative interviews and surveys with different stakeholders in the health care system), we conducted a modified Delphi study with two rounds of questionnaires with experts in public health and palliative care. In the first round, the experts commented on the findings from the pilot studies. The answers were evaluated descriptively and with qualitative content analysis, resulting in the formulation of 25 targets. These were presented to the experts in the second Delphi round to assess each of them separately with regard to its importance and current implementation (7-point answer scales) and in relation to the other targets (defining the five most important of the 25 targets). Results Six most relevant targets for public health initiatives to improve palliative care in Germany were worked out: Supporting palliative care as a basic attitude for the care of people in the last phase of life; coordinating healthcare for people in the last phase of life; establishing cooperation among health professions and disciplines; establishing education in palliative care for all professional groups with contact to people in the last phase of life; reviewing the evidence of palliative care measures; offering support to family members who are caring for someone in the last phase of life. Conclusions To systematically develop palliative care, it makes sense to define fields of action with individual targets. For Germany, it can be recommended to give priority to the targets that were highlighted as the most relevant in this study. The next step will be to develop, implement and evaluate tangible measures to achieve these targets.

2010-01-01

10

Recent developments in health care law: culture and controversy.  

PubMed

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

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

2013-03-01

11

Developing Electronic Cooperation Tools: A Case From Norwegian Health Care  

PubMed Central

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

Mydske, Per Kristen

2013-01-01

12

Lessons learned in developing community mental health care in Africa  

PubMed Central

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

HANLON, CHARLOTTE; WONDIMAGEGN, DAWIT; ALEM, ATALAY

2010-01-01

13

New developments in a consolidating health care industry.  

PubMed

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

Taylor, D; Kleiner, B H

1998-01-01

14

[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

15

Knowledge and attitudes of primary health care personnel concerning mental health problems in developing countries.  

PubMed Central

A semi-structured interview for assessing the knowledge and attitude of health workers concerning mental health problems was applied in seven developing country areas within the context of a World Health Organization coordinated collaborative study. The results indicate a lack of basic mental health training associated with a failure to recognize mental health problems, restricted knowledge concerning psychotropic drug therapy, and an inability to visualize practical forms of mental health care which could be introduced at primary care level. The results were used to design appropriate training programs, and the observations will be repeated to assess the effectiveness of training.

Ignacio, L L; de Arango, M V; Baltazar, J; Busnello, E D; Climent, C E; Elhakim, A; Farb, M; Gueye, M; Harding, T W; Ibrahim, H H; Murthy, R S; Wig, N N

1983-01-01

16

Health care data recording system for developing countries.  

PubMed

Developed countries have an established pattern for recording clinical data. The unit medical record allows statistics to be extrapolated, as well as disease patterns, births, and causes of deaths. In technologically advanced countries, medical records serve the health needs of clinic and hospital patients. However, it is now becoming clear that the emphasis on hospitalization in patient care is no longer appropriate; the emphasis must be switched from curative services to preventive and basic curative services at the primary health care level. A similar alteration will be necessary in the recordkeeping system. As progress towards literacy occurs, the aim will be to expand and improve the recording of basic data. In the next highest level, the district health center, records can be very simple. Increasing sophistication can be instituted at the higher levels of district hospital and central referral hospital. Obviously there must be adequate medical records to directly support clinical care. This paper goes on to outline the structure of such a system geared to the needs of a developing country. It is basically a model for a pilot project. The various problems which might arise before the system is implemented and can be viable include: 1) precise identification of medical records, 2) the need for standardization and definition of diagnoses, and 3) lack of coordination and/or inappropriate utilization of medical records, procedures, or personnel. Concerning procedures, there could be problems with incorrect data production, erroneous channelling of information, or improper feedback. At the lowest level of the chain would be the rural or urban health unit or the mobile health visitor with the primary health worker (PHW). Forms to be used include an attendance card, an infant weight chart, temperature chart, and referral form. The PHW must be appropriately trained in the recognition of signs and symptoms of diseases most likely to be encountered, basic drug therapy, how to record weight and temperature, and when and to whom to refer a patient. The district center is at the next level in the chain and similar schedules and training have been prepared for this and other health workers at higher levels in the health care chain. PMID:7112668

Brolly, E H

1982-07-01

17

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

ERIC Educational Resources Information Center

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

GMS Partners, Inc. Silver Spring, MD.

18

[Mental health care in Austria: history--developments--perspectives].  

PubMed

The reform of psychiatric services in Austria started during the second half of the seventies of the 20th century. During the early phase the reform focussed on dehospitalization and principles of community psychiatry. About 60% of psychiatric hospital beds were closed and the size of psychiatric hospitals was reduced. One of the psychiatric hospitals was closed and psychiatric departments were opened as part of district general hospitals. During this time the number of psychiatric hospital admissions increased markedly and a large proportion of mentally ill are treated as inpatients in non-psychiatric wards. Only about a fifth of self-employed psychiatrists working in their own office have a contract with health insurances. In Austria, the number of psychotherapists is much higher than the number of psychiatrist. A variety of different types of community services provide social and vocational rehabilitation, focussing on consultation, housing, daily structure and employment. Psychiatric services are nowadays fragmented into a number of sub-disciplines such as psychosomatics or child and adolescent psychiatry. This fragmentation and the missing coordination of psychiatric services hamper the enhancements of psychiatric care. This complicates the development of integrated services, i.e. the structured and planned cooperation of the different types of services. Since there are no binding rules for the organisation and planning in entire Austria, financing and organisation of services is fragmented. For establishing an integrated health care, coordination and cooperation between providers, sponsors of health care as well as policy makers are essential. PMID:19080994

Meise, Ullrich; Wancata, Johannes; Hinterhuber, Hartmann

2008-01-01

19

Primary Health Care.  

ERIC Educational Resources Information Center

This report contains 13 articles and book/film reviews on various topics related to the diffusion of health care information in developing countries; beginning with two articles which define primary health care, and suggest principles related to the community, communication, and the health practitioner upon which primary health care should be…

Lauffer, Sandra, Ed.

1979-01-01

20

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

ERIC Educational Resources Information Center

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

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

21

Development of the Competency Assessment Tool-Mental Health, an Instrument to Assess Core Competencies for Mental Health Care Workers  

Microsoft Academic Search

As the focus on accountability in health care increases, there has been a corresponding emphasis on establishing core competencies for health care workers. This article discusses the development of an instrument to establish core competencies for workers in inpatient mental health settings. Twenty-six competencies were identified and rated by mental health care personnel on two subscales: the importance of the

Carla Clasen; Cheryl L Meyer; Carl F Brun; Willam A Mase

2003-01-01

22

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

PubMed

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

Lock, J; Walsh, M

1999-02-01

23

Primary Care Development Guide. Volume II: Public Health Clinics and Services.  

National Technical Information Service (NTIS)

The second volume of the primary care development guide for Kitsap County, Washington is concerned with the county's public health clinics and their services. The guide includes working definitions of primary care and public health, and delineates the fun...

1975-01-01

24

Public involvement in health care: Lessons from developing countries  

Microsoft Academic Search

Experience suggests that pluralistic boards of trustees combining community representatives, civil servants and health professionals can contribute to: improve quality of care and coverage; reduce corruption, and patronage; define and apply patients' rights; monitor access to care; encourage payment modes consistent with solidarity; organise credit for indigents; penalise irrational utilisation of services; control costs; favour use of essential drugs; select

Jean-Pierre Unger; Pierre De Paepe; Patricia Ghilbert; Andrew Green

2004-01-01

25

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’.

2013-01-01

26

Health and Health Care  

Microsoft Academic Search

Health plays a central role in people’s perceptions of their quality of life, and access to good health care is a key ingredient\\u000a in an overall sense of security and well-being. This chapter examines how health and health care have evolved over the course\\u000a of Ireland’s economic boom. Media coverage highlights the negatives: increasing suicide, road deaths, binge drinking and

Richard Layte; Anne Nolan; Brian Nolan

27

Fiscal Issues for the District of Columbia Behavioral Health Managed Care Initiative Demonstration Development. Volume 1.  

National Technical Information Service (NTIS)

This is the report of a project to assist the District of Columbia in developing the budget model for the Distrct's initiatives in managed behavioral health care. The District needed better information on proposed rates for acute care services, particular...

1998-01-01

28

[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

29

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

30

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

31

Visualisation of human characteristics in vehicle and health care product development  

Microsoft Academic Search

The purpose of the research project described in this paper is to improve the efficiency of product development processes by exchanging knowledge and experiences about user centred design methods and technologies between the two branches: vehicle and health care industries. The health care industry can benefit from visualisation and simulation tools that include computer manikins, a physical representation of the

Mikael Blomé; Maria Jönsson; Daniel Lundström; CARAN AB; Dan Högberg

32

[Child health care and its development in Vrsac].  

PubMed

Documents concerning history of medicine during the Turkish reign (1552-1716) are very rare. However, there is evidence of plague epidemic in 18th century and colera epidemic in the 19th century. The first medical institutions: The German Communal Hospital, The Serbian Hospital and the Pharmacy were founded in the second half of the 18th century. In the year 1803, children were vaccinated against variola. The first Serbian book about child care--"Cadoljub" was written by Dr. Gavrilo Pekarovi? (1812-1851) during his studies of medicine in Budapest. In 1927 the city founded a dispensary for the newborn. The Polyclinic for schoolchildren was established as a part of the Health Center in 1934. After World War II, Children's Department was opened in the Health Center, later on it was turned into Mother and Child Center. At the beginning of 1955, a provisional children's ward with 18 beds was established in the former sanatorium, whereas till the end of the year it had 49 beds. In May 1965, it was moved into a new hospital building. After integration of Hospital and the Health Center into a Medical Center in 1967, a department for children was founded and it consisted of the emergency center and a hospital. Parents counseling, dispensary for children and dispensary for schoolchildren were founded in August 1971. PMID:12584900

Sljapi?, Ziva; Sljapi?-Roganovi?, Miljana

2002-01-01

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.

ITO, HIROTO; SETOYA, YUTARO; SUZUKI, YURIKO

2012-01-01

35

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

PubMed Central

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

RAZZOUK, DENISE; GREGORIO, GUILHERME; ANTUNES, RENATO; MARI, JAIR DE JESUS

2012-01-01

36

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

PubMed

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

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

2012-10-01

37

Women Veterans Health Care  

MedlinePLUS

... be a sign of dementia. Learn more » Comprehensive Primary Care No other health service in the world understands ... care anywhere. Learn more » Women and Dementia Comp. Primary Care WVCC Women Veterans Health Care Did you know ...

38

National Emergency Health Preparedness Study Including the Development and Testing of a Total Emergency Health Care System Model. Summary.  

National Technical Information Service (NTIS)

The research, conducted for the Public Health Service was directed toward the development of a total Emergency Health Care System Model that can be used to study and evaluate the nuclear postattack health posture of a single locality. This total model con...

E. L. Hill A. W. Voors R. O. Lyday J. N. Pyecha J. B. Hallan

1968-01-01

39

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.

DRAKE, ROBERT E.; LATIMER, ERIC

2012-01-01

40

Health area profiles as tools for primary care development: New York's primary care initiative.  

PubMed

It is anticipated that the ACS measures will figure significantly in the formal evaluation of the PCI, which will be carried out by an independent evaluator during the second and third years of the program. ACS measures will also form, along with other relevant data, a module for program reporting that is part of the overall program for project monitoring and review. The program should be evaluated on its ability to adhere to ACS measures; infuse primary care resources into a community; observe and measure changes in the community's patterns of use for health services; examine the community's health status, especially for hospitalization for otherwise preventable conditions; and sustain effective, adequate health care resources within the community. PMID:10122100

Tenan, P M

1992-10-01

41

Development of a quality ranking model for home health care providers.  

PubMed

This research aims to increase transparency and simplify consumer decision-making regarding the selection of a home health care provider. Currently, quality information on home health care providers is fragmented and difficult to interpret. In this study, a quality-ranking model is developed by selecting multidimensional quality indicators across multiple sources and respective weights using expert judgment. Given the weights and providers' performance on each quality indicator, a composite score is calculated that summarizes a home health care provider's overall quality level. This quality information empowers consumers to narrow their search and select the best-performing, most efficient providers. PMID:23924223

Gressel, Justin W

2013-01-01

42

Minimizing the trauma: Development of a pediatric trauma home health care program  

Microsoft Academic Search

Traumatic injuries in children account for a large percentage of physician and emergency de partment visits, as well as inpatient hospital admissions. Changes in the health care environ ment, as well as the special needs of children and families, are the incentives for the develop ment of a comprehensive home care program. This article describes the program components and educational

Patricia H. Green; Dorothy Bishop-Kurylo

1995-01-01

43

The development of early Chinese Communist health policy: health care in the Border Region, 1936-1949.  

PubMed

This paper examines the health care policy and program of the Chinese Communists in their earliest stages of development. An assessment of 1) political policy, 2) public health campaigns, 3) medical services, 4) public health education, and 5) medical education, indicates that the role of the health delivery scheme was primarily to mobilize mass support for the government, and to change popular health behavior, thereby improving the health of the people and lessening demand on scarce medical facilities. An analysis of the Border Region's health program from 1936 to 1949 gives us an insight into the strategy of a revolutionary government to win popular support and to effect social change. PMID:396785

Minden, K

1979-01-01

44

The WHO Collaborating Centre for Public Health Palliative Care Programs: An Innovative Approach of Palliative Care Development.  

PubMed

Abstract Background: The designation of the Catalan Institute of Oncology (Barcelona, Spain) as World Health Organization (WHO) Collaborating Centre for Public Health Palliative Care Programmes (WHOCC-ICO) in February 2008 turns the institution into the first ever center of international reference in regards to palliative care implementation from a public health perspective. The center aims to provide support to countries willing to develop palliative care programs, to identify models of success, to support WHO's policies, and to generate and spread evidence on palliative care. Objective: This article describes the WHOCC-ICO's contribution in the implementation of public health palliative care programs and services. The center's main features and future actions are emphasized. Results: At the end of the initial four-year designation period, the organization evaluates the task done to reach its objectives. Such global assessment would take forward the quality of the institution, and generate a revision of its terms of reference for the next designation period. Conclusions: Based on new evidence, the center has recently decided to expand its scope by adopting a community-wide chronic care approach which moves beyond cancer and focuses on the early identification of patients with any chronic disease in need of palliative care. Moreover, the center advocates the development of comprehensive models of care that address patients' psychosocial needs. This center's new work plan includes additional significant innovations, such as the startup of the first chair of palliative care in Spain. Such a whole new approach responds to the main challenges of current palliative care. PMID:24432817

Ela, Sara; Espinosa, Jose; Martínez-Muñoz, Marisa; Lasmarías, Cristina; Beas, Elba; Mateo-Ortega, Dolors; Novellas, Anna; Gómez-Batiste, Xavier

2014-04-01

45

Researcher development program of the primary health care research, evaluation and development strategy.  

PubMed

The Research Development Program (RDP) was initiated in 2004 under the Primary Health Care Research, Evaluation and Development (PHCRED) Strategy to increase the number and range of people with knowledge and skills in primary health care research and evaluation. RDP Fellows were invited to participate in an online survey about the effect the program had on their research knowledge, attitudes and practice. The response rate was 42% (105/248). Most were female (88%) with 66% aged between 31 and 50 years. Over two-thirds (72%) were health practitioners. Activities undertaken during the RDP ranged from literature reviews, developing a research question, preparing ethics submissions, attending and presenting at conferences and seminars, preparing papers and reports, and submitting grant applications. Despite the fact that only 52% agreed that the RDP time was adequate, 94% agreed that the RDP was a valuable experience, with 89% expressing interest in undertaking further research. These results indicate that this program has had a positive effect on the RDP Fellows in terms of their knowledge about research, their attitude to research, and the way they use research in their work. PMID:21616035

McIntyre, Ellen; Brun, Lyn; Cameron, Helen

2011-01-01

46

Establishing a harmonized haemophilia registry for countries with developing health care systems.  

PubMed

Over recent decades tremendous progress has been made in diagnosing and treating haemophilia and, in resource-rich countries, life expectancy of people with haemophilia (PWH) is now close to that of a healthy person. However, an estimated 70% of PWH are not diagnosed or are undertreated; the majority of whom live in countries with developing health care systems. In these countries, designated registries for people with haemophilia are often limited and comprehensive information on the natural history of the disease and treatment outcomes is lacking. Taken together, this means that planning efforts for future treatment and care of affected individuals is constrained in countries where it is most needed. Establishment of standardized national registries in these countries would be a step towards obtaining reliable sociodemographic and clinical data for an entire country. A series of consensus meetings with experts from widely differing countries with different health care systems took place to discuss concerns specific to countries with developing health care systems. As a result of these discussions, recommendations are made on parameters to include when establishing and harmonizing national registries. Such recommendations should enable countries with developing health care systems to establish standardized national haemophilia registries. Although not a primary objective, the recommendations should also help standardized data collation on an international level, enabling treatment and health care trends to be monitored across groups of countries and providing data for advocacy purposes. Greater standardization of data collation should have implications for optimizing resources for haemophilia care both nationally and internationally. PMID:23590670

Alzoebie, A; Belhani, M; Eshghi, P; Kupesiz, A O; Ozelo, M; Pompa, M T; Potgieter, J; Smith, M

2013-09-01

47

Development and testing of an HIV-risk screening instrument for use in health care settings  

Microsoft Academic Search

Objective: To develop and test a brief, reliable, and valid HIV-risk screening instrument for use in primary health care settings.Design: A two-phase study: (1) developing a self-administered HIV-risk screening instrument, and (2) testing it with a primary care population, including testing the effect of confidentiality on disclosure of HIV-risk behaviors.Setting: Phase 1: 3 types of sites (a blood donor center,

Barbara Gerbert; Amy Bronstone; Stephen McPhee; Steven Pantilat; Michael Allerton

1998-01-01

48

The successful development of a subacute care service associated with a large academic health system.  

PubMed

Ensuring the safe transition of patients from hospitals to skilled nursing facilities and from skilled nursing facilities back to the hospital or the community can present significant challenges. The University of Michigan Health System was able to overcome many of these challenges through the implementation of a health system associated Subacute Care Service that consists of the University of Michigan Health System geriatricians and nurse practitioners working in privately operated skilled nursing facilities in our primary market area. We describe the planning process surrounding the development of the Subacute Care Service and report on efforts to date. PMID:22748721

Joshi, Darius K; Bluhm, Rick A; Malani, Preeti N; Fetyko, Steve; Denton, Tony; Blaum, Caroline S

2012-07-01

49

Development of an educational program for the training of health care professionals concerning low back pain.  

PubMed

Common low back pain represents a major public health problem due to its direct cost to health care and to various socio economic consequences. Although low back pain may be caused by medical conditions, such as any kind of infections or cancer, the vast majority of the cases are attributed to mechanical or muscle skeletal conditions. Nurses and other health care professionals are on the top of the list for experiencing low back pain based on the duties performed in their working environment. The objective of this study involves the development of an educational program for the nursing stuff focused on the prevention of low back pain. PMID:23823381

Diomidous, Marianna; Gougoumati, Konstantina; Kolokathi, Aikaterini; Vogdopoulou, Diamanto

2013-01-01

50

Health care in Brazil  

Microsoft Academic Search

Brazil has great geopolitical importance because of its size, environmental resources, and potential economic power. The organisation of its health care system reflects the schisms within Brazilian society. High technology private care is available to the rich and inadequate public care to the poor. Limited financial resources have been overconcentrated on health care in the hospital sector and health professionals

A Haines

1993-01-01

51

[Epidemiology of mental health care].  

PubMed

Mental health care epidemiology seeks to investigate the practical situation of the health care system and services for individuals with mental disorders. In the past decades, mental health care structures in Germany were successively transformed from long-term inpatient treatment capacities to decentralized outpatient and day clinic services. Currently, the proportional relation between treatment facilities in different settings has been stabilized and the strategy of mental health care development focuses on innovative and integrative models of care provision. The aim is to integrate fragmented services by the introduction of network structures to overcome rigid sector boundaries. The need for health care services is associated with multiple factors such as population-based epidemiological data, usage behavior, and health politics. Due to scarce data and poor standards of care it is difficult to determine if current structures of mental health services cover the actual needs. Therefore, a substantial increase of mental health service research is needed. PMID:22371103

Jäger, M; Rössler, W

2012-03-01

52

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

Microsoft Academic Search

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

Neil M Pakenham-Walsh; Frederick Bukachi

2009-01-01

53

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

54

Development of a framework to identify patient pathways through a segment of the health care cycle  

Microsoft Academic Search

The US spends more money on health care than other industrialized nations. Nevertheless, the US lags behind them in life expectancies, access to care, and other health indicators. This can be attributed to the numerous issues that afflict the US health care sector - the lack of a universal health coverage, increasing medical errors, over and under-treatment of patients, lack

Abhik Bhattacharya

2009-01-01

55

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

56

National Health Care Skill Standards.  

ERIC Educational Resources Information Center

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

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

57

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

PubMed Central

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

2013-01-01

58

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

59

Teamwork in health care.  

PubMed

It is becoming increasingly clear that maintaining and improving the health of the population, and doing so in a financially sustainable manner, requires the coordination of acute medical care with long-term care, and social support services, that is, team-based care. Despite a growing body of evidence on the benefits of team-based care, the health care ecosystem remains "resistant" to a broader implementation of such care models. This resistance is a function of both system-wide and organizational barriers, which result primarily from fragmentation in reimbursement for health care services, regulatory restrictions, and the siloed nature of health professional education. To promote the broader adoption of team-based care models, the health care system must transition to pay for value reimbursement, as well as break down the educational silos and move toward team-based and value-based education of health professionals. PMID:24896572

Landman, Natalie; Aannestad, Liv K; Smoldt, Robert K; Cortese, Denis A

2014-01-01

60

[Health care and regional disparities].  

PubMed

Municipalities in Germany have to advance health care structures to be resistant to demographic transitions and to the changing health care needs of the regional population in upcoming years. Therefore, it is important to note that needs vary from region to region and that care structures have to be differentiated according to this. Indeed regionality and community care have been increasingly referred to in current debate on improving care structures. But the discussed approaches remain relatively unclear and, moreover, fail to overcome care fragmentation and legal or sectoral perspectives. This paper points out the current lack of systematic knowledge about regional health disparities as well as knowledge about models of health care that are appropriate especially for disadvantaged communities and also rural regions. Moreover, knowledge of steering mechanisms that enforce the development of regional care systems are not developed yet. PMID:23474864

Hämel, K; Ewers, M; Schaeffer, D

2013-06-01

61

Innovation in health care: developments in NHS trusts.  

PubMed

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

Bower, D J

1994-01-01

62

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.

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

2007-01-01

63

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

PubMed

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

Barker, M; Klopper, H

2007-06-01

64

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.

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

2014-01-01

65

Types of health care providers  

MedlinePLUS

This article describes health care providers involved in primary care, nursing care, and specialty care. This is just ... PRIMARY CARE A primary care provider (PCP) is a person you may see first for checkups and health ...

66

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

PubMed Central

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

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

2002-01-01

67

The health care learning organization.  

PubMed

To many health care executives, emphasis on marketing strategy has become a means of survival in the threatening new environment of cost attainment, intense competition, and prospective payment. This paper develops a positive model of the health care organization based on organizational learning theory and the concept of the health care offering. It is proposed that the typical health care organization represents the prototype of the learning organization. Thus, commitment to a shared vision is proposed to be an integral part of the health care organization and its diagnosis, treatment, and delivery of the health care offering, which is based on the exchange relationship, including its communicative environment. Based on the model, strategic marketing implications are discussed. PMID:10158798

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

1996-01-01

68

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

PubMed Central

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

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

2004-01-01

69

Decentralization and primary health care: some negative implications in developing countries.  

PubMed

Decentralization is a highly popular concept, being a key element of Primary Health Care policies. There are, however, certain negative implications of decentralization that must be taken into account. These are analyzed in this article with particular reference to developing countries. The authors criticize the tendency for decentralization to be associated with state limitations, and discuss the dilemma of relating decentralization, which is the enhancement of the different, to equity, which is the promotion of equivalence. Those situations in which decentralization can strengthen political domination are described. The authors conclude by setting out a checklist of warning questions and issues to be taken into account to ensure that decentralization genuinely facilitates the Primary Health Care orientation of health policy. PMID:7928013

Collins, C; Green, A

1994-01-01

70

For Health Care Providers  

Cancer.gov

For Health Care Providers Training Categories Palliative Care Clinical Trials Translational Research Palliative Care Education in Palliative and End-of-Life Care For Oncology (EPEC™-O )Format: Web-based self-study, 3 plenary sessions and 15 content

71

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

72

European higher health care education curriculum: development of a cultural framework.  

PubMed

This article concerns the European Curriculum in Cultural Care Project (2005-2009), which aimed at developing a curriculum framework for the enhancement of cultural competence in European health care education. The project was initiated and supported by the Consortium of Institutes in Higher Education in Health and Rehabilitation, whose goal is to nurture educational development and networking among member institutions. The framework is the result of a collaborative endeavor by nine nurse educators from five different European countries. The production of the framework will be described in accordance with the following tenets: developing cultural competence is a continuing process, cultural competence is based on sensitivity toward others, and cultural competence is a process of progressive inquiry. Critique concerning the framework will be presented. PMID:22477718

Koskinen, Liisa; Kelly, Hélène Taylor; Bergknut, Eva; Lundberg, Pranee; Muir, Nita; Olt, Helen; Richardson, Eileen; Sairanen, Raija; De Vlieger, Lily

2012-07-01

73

Health care improvement and continuing interprofessional education: continuing interprofessional development to improve patient outcomes.  

PubMed

Health care improvement and continuing professional education must be better understood if we are to promote continuous service improvement through interprofessional learning in the workplace. We propose that situating interprofessional working, interprofessional learning, work-based learning, and service improvement within a framework of social learning theory creates a continuum between work-based interprofessional learning and service improvement in which each is integral to the other. This continuum provides a framework for continuing interprofessional development that enables service improvement in the workplace to serve as a vehicle through which individual professionals and teams can continually enhance patient care through working and learning together. The root of this lies in understanding that undertaking improvement and learning about improvement are co-dependent and that health care professionals must recognize their responsibility to improve as well as complete their everyday work. We believe that significant opportunities exist for health care commissioners, service providers, and educational institutions to work together to promote continuing interprofessional development in the workplace to enhance patient outcomes, and we outline some of the opportunities we believe exist. PMID:19530199

Wilcock, Peter M; Janes, Gillian; Chambers, Alison

2009-01-01

74

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

ERIC Educational Resources Information Center

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

Keener, Patricia A.

75

American Health Care Association  

MedlinePLUS

... AHCA/NCAL PAC Federal Political Directors Political Events Solutions Facility Operations Affordable Care Act Clinical Emergency Preparedness Finance Health Information Technology Integrity Medicaid Medicare Patient ...

76

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

77

Vacation health care  

MedlinePLUS

Travel health tips ... BEFORE LEAVING Planning ahead of time can make your travels smoother and help you avoid problems. Talk to your health care provider or visit a travel clinic 4 - 6 weeks before ...

78

Monitoring health care.  

PubMed

Health risk determinants in obstetrics and gynecology are readily obtainable from state birth records. This study demonstrates the manner in which these determinants may be used to assess health care delivery and monitor its progress. The over-all problem is quite complex. Some parameters are interrelated, while others are not. In addition, any specific parameter may be causally related to many different antecedents, acting singly or in combination. Hence, one must take care not to generalize about deficiencies in our health care systems and thereby propose simplistic, unworkable solutions. However, the study does clearly identify certain specific areas of risk which deserve greater attention than they have hitherto received from health care officials, physicians, and responsible citizens. We believe that the approach outlined in this paper offers a means to achieve unbiased, ongoing monitoring of health care, which may, in turn, be used in attempts to improve the delivery of health services. PMID:1166865

Herrmann, W L; Moore, J S

1975-10-15

79

EEO issues in the health-care field: a roundup of recent developments.  

PubMed

The rapidly expanding health-care field, like other service areas, has experienced its share of controversy over employment discrimination issues. Recent cases fall into two categories: claims involving traditional EEO questions and claims that reflect the unique nature of the health-care institution. A survey of cases in an array of key areas offers guidance for health-care employers in handling common problems. PMID:10278481

Hartstein, B A

1986-01-01

80

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.

Pakenham-Walsh, Neil; Bukachi, Frederick

2009-01-01

81

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

PubMed Central

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

Greene, Danielle

2012-01-01

82

Profile of an excellent nurse manager: identifying and developing health care team leaders.  

PubMed

The purpose of this research was to identify the profile of an excellent nurse manager who can lead effective health care teams. Leadership attributes and competencies that characterize an excellent nurse manager and tools to identify them are lacking in the literature but are required to efficiently and effectively address the growing shortage of registered nurses (RNs) in health care team leadership roles and the critical linkage of these roles to patient outcomes. A profile of an excellent nurse manager was developed on the basis of the responses of nurse managers across the United States who had been identified as excellent or competent by chief nurse executive assessment or/and the Nurse Manager Ability, Leadership, and Support of Nurses staff survey to the Kouzes and Posner Leadership Practices Inventory: Self Instrument. Statistically significant distinctions exist between nurse managers who are excellent and those who are competent as assessed by the Five Practices of Exemplary Leadership, which together comprise the profile of an excellent nurse manager. The Kouzes and Posner Leadership Practices Inventory: Self Instrument can be used to identify, recruit, and develop RNs in the nurse manager role as excellent leaders of effective health care teams. PMID:24896579

Kallas, Kathryn D

2014-01-01

83

Health Care System Accessibility  

PubMed Central

BACKGROUND People who are deaf use health care services differently than the general population; little research has been carried out to understand the reasons. OBJECTIVE To better understand the health care experiences of deaf people who communicate in American Sign Language. DESIGN Qualitative analyses of focus group discussions in 3 U.S. cities. PARTICIPANTS Ninety-one deaf adults who communicate primarily in American Sign Language. MEASUREMENTS We collected information about health care communication and perceptions of clinicians' attitudes. We elicited stories of both positive and negative encounters, as well as recommendations for improving health care. RESULTS Communication difficulties were ubiquitous. Fear, mistrust, and frustration were prominent in participants' descriptions of health care encounters. Positive experiences were characterized by the presence of medically experienced certified interpreters, health care practitioners with sign language skills, and practitioners who made an effort to improve communication. Many participants acknowledged limited knowledge of their legal rights and did not advocate for themselves. Some participants believed that health care practitioners should learn more about sociocultural aspects of deafness. CONCLUSIONS Deaf people report difficulties using health care services. Physicians can facilitate change to improve this. Future research should explore the perspective of clinicians when working with deaf people, ways to improve communication, and the impact of programs that teach deaf people self-advocacy skills and about their legal rights.

Steinberg, Annie G; Barnett, Steven; Meador, Helen E; Wiggins, Erin A; Zazove, Philip

2006-01-01

84

Lean health care.  

PubMed

Principles of Lean management are being adopted more widely in health care as a way of improving quality and safety while controlling costs. The authors, who are chief executive officers of rural North Carolina hospitals, explain how their organizations are using Lean principles to improve quality and safety of health care delivery. PMID:23802475

Hawthorne, Henry C; Masterson, David J

2013-01-01

85

Development, use and evaluation of drugs: the dominating technology in the health care system.  

PubMed

The article presents various perspectives of drug technology and health care policy in Denmark. Drugs dominate as the most widely used treatment technology in the health care system and the use of drugs is steadily increasing. The pharmaceutical industry's development of drugs is based on an economic estimate of developments, expenditures, marketing costs and the anticipated share of the market. Controlled clinical trials have become the main form of documentation required by the health authorities. This method is insufficient to evaluate the (side) effects of the drugs when in actual use. Drugs fit perfectly the technical perception of disease, a perception which prevails in the pharmaceutical industry, medical science and in the treatment of disease. This perception believes that a disease is due to an attack or dysfunction in the biological-mechanical conditions of the individual. Drugs offer a standard solution to health problems independent of the individuals' social life. Thus drugs become a tool which function in agreement with the disintegrated and achievement-orientated approach to disease as it is organized today. In general the statements in this article are not limited to special Danish circumstances but are valid for other countries as well [1, 2]. (Norris R. Pills, Pesticides & Profits. North River Press, 1982; Braithwaite J. Corporate Crime in the Pharmaceutical Industry. Routledge & Kegan Paul, London, 1984) The empirical data in this article derive from Denmark, however. PMID:3303354

Hansen, E H; Launsø, L

1987-01-01

86

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

ERIC Educational Resources Information Center

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

Delaney, Frances M., Comp.

87

Perspective Finally, Fixing Health Care: What's Different Now? Six new developments in the health reform debate show that Americans are ready for change  

Microsoft Academic Search

Is now the time to fix the U.S. health care system? Those who remember the failed attempts of the past would say no. We see it differently. Our optimism is rooted in new developments that didn't exist the last time Congress addressed health care. These include bipartisan support for our Healthy Americans Act; an ideological truce over the role of

Ron Wyden; Bob Bennett

88

Global health and primary care research  

Microsoft Academic Search

A strong primary health care system is essential to provide effective and efficient health care in both resource-rich and resource-poor countries. Although a direct link has not been proven, we can reasonably expect better economic status when the health of the population is improved. Research in primary care is essential to inform practice and to develop better health systems and

John W. Beasley; Barbara Starfield; Chris van Weel; Walter W. Rosser; Cynthia L. Haq

2007-01-01

89

Health-Care Hub  

ERIC Educational Resources Information Center

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

Bowman, Darcia Harris

2004-01-01

90

Reducing inequalities in access to health care: developing a toolkit through action research  

PubMed Central

??Problem: Healthcare organisations are expected both to monitor inequalities in access to health services and also to act to improve access and increase equity in service provision. Design: Locally developed action research projects with an explicit objective of reducing inequalities in access. Setting: Eight different health care services in the Yorkshire and Humber region, including community based palliative care, general practice asthma care, hospital based cardiology clinics, and termination of pregnancy services. Key measures for improvement: Changes in service provision, increasing attendance rates in targeted groups. Strategies for change: Local teams identified the population concerned and appropriate interventions using both published and grey literature. Where change to service provision was achieved, local data were collected to monitor the impact of service change. Effects of change: A number of evidence based changes to service provision were proposed and implemented with variable success. Service uptake increased in some of the targeted populations. Lessons learnt: Interventions to improve access must be sensitive to local settings and need both practical and managerial support to succeed. It is particularly difficult to improve access effectively if services are already struggling to meet current demand. Key elements for successful interventions included effective local leadership, identification of an intervention which is both evidence based and locally practicable, and identification of additional resources to support increased activity. A "toolkit" has been developed to support the identification and implementation of appropriate changes.

Goyder, E; Blank, L; Ellis, E; Furber, A; Peters, J; Sartain, K; Massey, C

2005-01-01

91

Development of a Baccalaureate External Degree Program in Health Service Administration With a Major in Long Term Care Administration.  

National Technical Information Service (NTIS)

The University of Pittsburgh (Pa.) developed an undergraduate external degree program in health services administration with a major in long-term care administration. Six steps in the developmental process were concerned with all program parameters (objec...

A. L. Kleppick I. Altman M. D. Hiller N. L. Costanzo

1979-01-01

92

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

93

Development of a patient safety culture measurement tool for ambulatory health care settings: analysis of content validity  

Microsoft Academic Search

The development of patient safety culture in health care organizations is a necessary precursor to patient safety improvement.\\u000a However, existing tools to measure patient safety culture are intended for implementation in hospitals. A new, abbreviated\\u000a patient safety culture survey was developed for use in ambulatory health care settings. This survey was tested for content\\u000a validity utilizing a panel of six

Amanda L. Schutz; Michael A. Counte; Steven Meurer

2007-01-01

94

Health care automation companies.  

PubMed

Health care automation companies: card transaction processing/EFT/EDI-capable banks; claims auditing/analysis; claims processors/clearinghouses; coding products/services; computer hardware; computer networking/LAN/WAN; consultants; data processing/outsourcing; digital dictation/transcription; document imaging/optical disk storage; executive information systems; health information networks; hospital/health care information systems; interface engines; laboratory information systems; managed care information systems; patient identification/credit cards; pharmacy information systems; POS terminals; radiology information systems; software--claims related/computer-based patient records/home health care/materials management/supply ordering/physician practice management/translation/utilization review/outcomes; telecommunications products/services; telemedicine/teleradiology; value-added networks. PMID:10153839

1995-12-01

95

Social Rights and Economics: Claims to Health Care and Education in Developing Countries. Policy Research Working Paper.  

ERIC Educational Resources Information Center

This paper analyzes contemporary rights-based and economic approaches to health care and education in developing countries. The paper assesses the foundations and uses of social rights in development; outlines an economic approach to improving health and education service provision; and highlights differences, similarities, and the hard questions…

Gauri, Varun

96

Development of an integrative practice placement model for students in health care.  

PubMed

VireTori, the interprofessional Empowerment Market, is both an easily accessible health service point for citizens and a provider of placements for students. This study describes undergraduate health care students' experiences of learning at VireTori, and explores how the integrative pedagogy model was executed during student placements. The integrative pedagogy model was developed for the educational framework of the placement. The participants of the study were 42 undergraduate students. The data were collected in 2010 through six focus-group interviews and background questionnaires, and were analysed using inductive content analysis. The results were categorised into personal, collaborative and organisational learning contexts and reported as the experiences of happy and unhappy students. Third-year students with a five-week or longer placement had more positive experiences than the fourth-year students with a one-week placement. There were great differences between the experiences of happy and unhappy students concerning professional roles, work orientations and scopes of action, and these were not entirely connected with the length of placement. Health care students can gain expertise through a practice placement in which the principles of integrative pedagogy have been adopted. Critique concerning the model and VireTori framework will be presented. PMID:23164975

Koskinen, Liisa; Äijö, Marja

2013-09-01

97

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

98

Mercury and health care.  

PubMed

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

2010-08-01

99

Developing sustainable models of rural health care: a community development approach.  

PubMed

Globally, small rural communities frequently are demographically similar to their neighbours and are consistently found to have a number of problems linked to the international phenomenon of rural decline and urban drift. For example, it is widely noted that rural populations have poor health status and aging populations. In Australia, multiple state and national policies and programs have been instigated to redress this situation. Yet few rural residents would agree that their town is the same as an apparently similar sized one nearby or across the country. This article reports a project that investigated the way government policies, health and community services, population characteristics and local peculiarities combined for residents in two small rural towns in New South Wales. Interviews and focus groups with policy makers, health and community service workers and community members identified the felt, expressed, normative and comparative needs of residents in the case-study towns. Key findings include substantial variation in service provision between towns because of historical funding allocations, workforce composition, natural disasters and distance from the nearest regional centre. Health and community services were more likely to be provided because of available funding, rather than identified community needs. While some services, such as mental illness intervention and GPs, are clearly in demand in rural areas, in these examples, more health services were not needed. Rather, flexibility in the services provided and work practices, role diversity for health and community workers and community profiling would be more effective to target services. The impact of industry, employment and recreation on health status cannot be ignored in local development. PMID:18067401

Allan, J; Ball, P; Alston, M

2007-01-01

100

Protecting the Rights of Children with Special Health Care Needs through the Development of Individualized Emergency Response Plans.  

ERIC Educational Resources Information Center

Addresses responding to a child with special health care needs with a life-threatening medical emergency, including an equipment malfunction, when it occurs in community settings. Collaborative development of portable individualized emergency response plans is discussed, and illustrative care scenarios, a sample plan, and policy recommendations…

Valluzzi, Janet L.; Brown, Sharan E.; Dailey, Barbara

1997-01-01

101

Health Care Megatrends and Health Psychology  

Microsoft Academic Search

Health psychology is a major new area of professional psychological practice that has emerged during a period of rapid changes in the health care industry. In this article, published literature is examined for historical, educational, and health care delivery system contributions. Four megatrends in medicine and health care that impinge upon health psychology are described.

Richard H. Dana; W. Theodore May

1986-01-01

102

Development and Validation of a Scale Measuring Satisfaction with Maternal and Newborn Health Care Following Childbirth  

Microsoft Academic Search

To demonstrate the validity and internal consistency of a multi-item scale measuring women’s satisfaction with health care\\u000a received in the weeks following childbirth for both themselves and their newborns. Data are from 1,154 women delivering healthy\\u000a singletons or twins recruited for a randomized trial. Satisfaction with care items were selected from prior research, including\\u000a the previously validated Primary Care Satisfaction

Fabian T. CamachoCarol; Carol S. Weisman; Roger T. AndersonMarianne; Marianne M. Hillemeier; Eric W. Schaefer; Ian M. Paul

103

Containing Health Care Costs  

PubMed Central

As the federal government shifted from its traditional roles in health to the payment for personal health care, the relationship between public and private sectors has deteriorated. Today federal and state revenue funds and trusts are the largest purchasers of services from a predominantly private health system. This financing or “gap-filling” role is essential; so too is the purchaser's concern for the costs and prices it must meet. The cost per person for personal health care in 1980 is expected to average $950, triple for the aged. Hospital costs vary considerably and inexplicably among states; California residents, for example, spend 50 percent more per year for hospital care than do state of Washington residents. The failure of each sector to understand the other is potentially damaging to the parties and to patients. First, and most important, differences can and must be moderated through definite changes in the attitudes of the protagonists.

Derzon, Robert A.

1980-01-01

104

The Development of a Community-Based Baccalaureate Curriculum Model in a Culturally Diverse Health Care Delivery Area.  

ERIC Educational Resources Information Center

The nursing school at the University of Texas at San Antonio revised the curriculum using a community-based health care model. More clinical experiences were offered in a variety of community settings and long-term relationships were developed with community health agencies. (SK)

Staats, Cheryl Ross

2003-01-01

105

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

106

Distinguishing service quality from patient satisfaction in developing health care marketing strategies.  

PubMed

The marketing function in health care is increasingly becoming strategic in nature. The quality of care provided and the level of patient satisfaction are emerging as the core of many marketing strategies in health services as a means to achieve a distinctive competency in ever-more competitive markets. Therefore, it is not surprising that few issues have generated more discussion in both practitioner and research circles. Nonetheless, according to the health services literature, service quality and patient satisfaction have confounded many, the outcome of which may be an inability of health care managers to effectively derive, implement, and control marketing strategies. This article identifies emerging literature that assists in overcoming these limitations. PMID:10134419

Taylor, S A

1994-01-01

107

Developing the effectiveness of primary care organisations in the UK National Health Service : A case study  

Microsoft Academic Search

This paper aims to explore the early experiences of a new primary care organisation in the NHS. It reports the findings of a longitudinal qualitative case study of one primary care group in its first year of operation. It concludes and makes recommendations in four key areas relevant to the development of the primary care group: the experiences of individuals

Steve Willcocks

2003-01-01

108

Health care interactional suffering in palliative care.  

PubMed

A secondary analysis of 2 qualitative studies was conducted to explore the experiences of suffering caused by interactions with health care providers in the hospital setting. Interview transcripts from 20 palliative care patients and 15 palliative care informal caregivers in University Malaya Medical Centre were thematically analyzed. The results of health care interactional suffering were associated with themes of attention, understanding, communication, competence, and limitation. These 5 themes may serve as a framework for the improvement in interaction skills of health care providers in palliative care. PMID:23689367

Beng, Tan Seng; Guan, Ng Chong; Jane, Lim Ee; Chin, Loh Ee

2014-05-01

109

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

PubMed

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

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

2010-09-01

110

Development of guidelines for design and construction of hospitals and health care facilities.  

PubMed

The Guidelines for Design and Construction of Hospitals and Health Care Facilities is the most widely referred to design document in the USA and is influential throughout the world. The Facility Guidelines Institute (FGI) was founded to provide continuity in the guidelines revision process. FGI functions as a contractual, fundraising, and coordinating entity to develop and enhance the content and format of guidelines publications and of ancillary services that encourage and improve their application and use. The Guidelines and the methodology for revising them have been, and still are, in an evolutionary process. It is the desire of the AIA/AAH and FGI to see that the process continues to change and improve with each passing cycle. PMID:14963892

Sprague, Joseph G

2003-01-01

111

A health economic model for the development and evaluation of innovations in aged care: an application to consumer-directed care--study protocol  

PubMed Central

Introduction Consumer-directed care is currently being embraced within Australia and internationally as a means of promoting autonomy and choice in the delivery of health and aged care services. Despite its wide proliferation little research has been conducted to date to assess the views and preferences of older people for consumer-directed care or to assess the costs and benefits of such an approach relative to existing models of service delivery. Methods and analysis A comprehensive health economic model will be developed and applied to the evolution, implementation and evaluation of consumer-directed care in an Australian community aged care setting. A mixed methods approach comprising qualitative interviews and a discrete choice experiment will determine the attitudes and preferences of older people and their informal carers for consumer-directed care. The results of the qualitative interviews and the discrete choice experiment will inform the introduction of a new consumer-directed care innovation in service delivery. The cost-effectiveness of consumer-directed care will be evaluated by comparing incremental changes in resource use, costs and health and quality of life outcomes relative to traditional services. The discrete choice experiment will be repeated at the end of the implementation period to determine the extent to which attitudes and preferences change as a consequence of experience of consumer-directed care. The proposed framework will have wide applicability in the future development and economic evaluation of new innovations across the health and aged care sectors. Ethics and dissemination The study is approved by Flinders University Social and Behavioural Research Ethics Committee (Project No. 6114/SBREC). Findings from the qualitative interviews, discrete choice experiments and the economic evaluation will be reported at a workshop of stakeholders to be held in 2015 and will be documented in reports and in peer reviewed journal articles.

Ratcliffe, Julie; Lancsar, Emily; Luszcz, Mary; Crotty, Maria; Gray, Len; Paterson, Jan; Cameron, Ian D

2014-01-01

112

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.

2014-01-01

113

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

114

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

PubMed Central

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

2014-01-01

115

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

PubMed

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

Whitaker, Glenn V; Walton, Victor A

2007-01-01

116

Brentwood community health care assessment.  

PubMed

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

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

2014-01-01

117

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

PubMed

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

Göpffarth, Dirk; Henke, Klaus-Dirk

2013-03-01

118

Competition and integration in Swedish health care.  

PubMed

Despite of an insignificant track record of quasi-market models in Sweden, new models of this kind have recently been introduced in health care; commonly referred to as "choice of care". This time citizens act as purchasers; choosing the primary care centre or family physician they want to be treated by, which, in turn, generates a capitation payment to the chosen unit. Policy makers believe that such systems will be self-remedial, that is, as a result of competition the strong providers survive while unprofitable ones will be eliminated. Because of negative consequences of the fragmented health care delivery, policy makers at the same time also promote different forms of integrated health care arrangements. One example is "local health care", which could be described as an upgraded community-oriented primary care, supported by adaptable hospital services, fitting the needs of a local population. This article reviews if it is possible to combine this kind of integrated care system with a competition driven model of governance, or if they are incompatible. The findings indicate that some choice of care schemes could hamper the development of integration in local health care. However, geographical monopolies like local health care, enclosed in a non-competitive context, lack the stimulus of competition that possibly improves performance. Thus, it could be argued that if choice of care and local health care should be combined, patients ought to choose between integrated health care arrangements and not among individual health professionals. PMID:20153910

Ahgren, Bengt

2010-07-01

119

Developing an effective mission statement for a health care organization: a step towards an evidence-based practice  

Microsoft Academic Search

Background Despite the omnipresence of mission statements, studies indicate that creating an effective mission statement is extremely difficult. Purposes Given the increasing pressure on health care administrators to develop an effective mission statement, this article sought to devise a state of the art of empirical mission statement research in order to develop a set of empirical based recommendations on how

S. DESMIDT; A. PRINZIE; A. HEENE

2009-01-01

120

Health Care Improvement and Continuing Interprofessional Education: Continuing Interprofessional Development to Improve Patient Outcomes  

ERIC Educational Resources Information Center

Health care improvement and continuing professional education must be better understood if we are to promote continuous service improvement through interprofessional learning in the workplace. We propose that situating interprofessional working, interprofessional learning, work-based learning, and service improvement within a framework of social…

Wilcock, Peter M.; Janes, Gillian; Chambers, Alison

2009-01-01

121

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

122

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

123

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

124

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

125

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

126

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

127

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.

128

Health care clinics in Cambodia.  

PubMed

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

Wollschlaeger, K

1995-04-01

129

Assessment of Two ‘Low-Tech’ Genetic Health Care Procedures Performed by Prenatal Care Providers in Washington State: Implications for Future Policy Development Activities  

Microsoft Academic Search

Equity in health care demands that patients be treated fairly, impartially and with justice. Health care professionals and others have long been aware of the concept of equity, and the many inequities that exist in our health care cystem. As part of our analysis of postpartum data collected between 1993 and 1996 by the Washington Pregnancy Risk Assessment Monitoring System

Robert M. Fineman; Thomas M. Bell

1999-01-01

130

Demonstration Project to Design, Develop and Teach a Model Health Care Career Program for the Neighborhood Youth Corps.  

National Technical Information Service (NTIS)

The report covers a seventeen month demonstration project to design, develop and teach a health care career-oriented program for 60 enrollees of the Neighborhood Youth Corps in Cambridge, Massachusetts. The report concludes on whether the concept of a lon...

C. D. Orth, 3rd F. Jacobs

1973-01-01

131

Write It Right: Recommendations for Developing User Instruction Manuals for Medical Devices Used in Home Health Care (Training Manual).  

National Technical Information Service (NTIS)

With home health care patients and their care givers using an increasing number of medical devices of varying complexity, the Center for Devices and Radiological Health, Food and Drug Administration (FDA), has concerns about the safe and effective use of ...

C. L. Backinger P. A. Kingsley

1993-01-01

132

‘A Practical Approach to Gender-Based Violence: A Programme Guide for Health Care Providers and Managers’ developed by the UN Population Fund  

Microsoft Academic Search

Gender-based violence (GBV) is a worldwide problem that can have serious physical and psychological consequences. Women need to be assessed for GBV and a logical place to do so would be where women go for health care, reproductive health facilities. The United Nations Population Fund (UNFPA) has developed ‘A Practical Approach to Gender-Based Violence: A Program Guide for Health Care

L Stevens

2002-01-01

133

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.

2014-01-01

134

Psychology's Role in Health Care.  

ERIC Educational Resources Information Center

This information packet contains eight two- to three-page publications from the American Psychological Association series "Psychological Services for the 21st Century, Psychology's Role in Health Care: Studying Human Behavior; Promoting Health; Saving Health Care Dollars; Providing Mental Health Services." The focus of the series is the connection…

American Psychological Association, Washington, DC.

135

Understanding and measuring AIDS-related stigma in health care settings: A developing country perspective  

Microsoft Academic Search

AIDS-related stigma and discrimination remain pervasive problems in health care institutions worldwide. This paper reports on stigma-related baseline findings from a study in New Delhi, India to evaluate the impact of a stigma-reduction intervention in three large hospitals. Data were collected via in-depth interviews with hospital staff and HIV-infected patients, surveys with hospital workers (884 doctors, nurses and ward staff)

Vaishali Sharma Mahendra; Laelia Gilborn; Shalini Bharat; Rupa Jakharia Mudoi; Indrani Gupta; Bitra George; Luke Samson; Celine Costello Daly; Julie Pulerwitz

2007-01-01

136

Lasers and optics in health care  

Microsoft Academic Search

Lasers and optics have affected health care in a myriad of ways. This paper surveys their impact on three aspects of health care: (1) surgery and medicine, (2) biology, and (3) biotechnology. In surgery, fiber optics have enabled the development of endoscopes, which allow access to most sites within the body. Endoscopes have, in turn, led to the development of

THOMAS F. DEUTSCH

1997-01-01

137

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

ERIC Educational Resources Information Center

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

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

2007-01-01

138

[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

139

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

PubMed

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 barriers to health care access. Innovative nursing strategies to enhance access and improve the health of migrant children are explored. These include the use of lay community outreach workers, the creation of alternative health care delivery models, and the development of information tracking systems. PMID:9592438

Gwyther, M E; Jenkins, M

1998-01-01

140

Development of Intelligent Home HealthCare Box Connecting Medical Equipments and Its Service Platform  

Microsoft Academic Search

In this paper, an intelligent computer-aided nursing (ICAN) service system is proposed. In this system, an embedded system connecting biomedical instruments to collect home patient biomedical signals is developed and deployed. The developed embedded system, also called as IHHCB, has functions of collecting and analyzing biomedical signal and Web service. IHHCB cooperating with remote care centers plays an important role

Chun-Hung Wang; Mong-Fong Horng; Jeng-Wei Lee; Yu-Chan Liu; Ren-Shang Tsai; Wei-Tong Wang; Lan Chang; Yaw-Huang Kuo; Pau-Choo Chung; Kuo-Feng Ssu

2007-01-01

141

Legislating health care coverage for the unemployed.  

PubMed

Because the unemployed and their families are often likely to develop stress-related health problems, ensuring them access to health care is a public health issue. Congressional efforts thus far to legislate health coverage for the unemployed have proposed a system that recognizes people's basic need for coverage but has several limitations. PMID:4029798

Palley, H A; Feldman, G; Gallner, I; Tysor, M

1985-01-01

142

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.

143

Primary care in Cuba: A public health approach  

Microsoft Academic Search

Cuba's primary health care model is presented. Unlike ambulatory care services, which are but one component of primary care, Cuba's model is a comprehensive public health approach that meets the World Health Organization's definition of primary care. The history of the development of Cuba's model is presented, including an update on the innovative neighborhood\\/home clinics. Achievements in health outcomes as

Karen A. Swanson; Janice M. Swanson; Ayesha E. Gill; Chris Walter

1995-01-01

144

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.

Beacham, Barbara L.; Deatrick, Janet A.

2013-01-01

145

Power Rx for the health care industry  

Microsoft Academic Search

While electricity has had a huge impact on the health care community through the development of highly sophisticated diagnostic tools and procedures, more mundane electro-technologies offer substantial opportunities as well. From innovative lighting techniques to energy management systems to new technologies for medical waste disposal, advanced electricity-based technologies can enhance health care services and help cut costs when facilities know

Lamarre

1994-01-01

146

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

147

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.

2013-01-01

148

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

149

The Athena Breast Health Network: developing a rapid learning system in breast cancer prevention, screening, treatment, and care.  

PubMed

The term breast cancer covers many different conditions, whose clinical course ranges from indolent to aggressive. However, current practice in breast cancer prevention and care, and in breast cancer epidemiology, does not take into account the heterogeneity of the disease. A comprehensive understanding of the etiology and progression of different breast cancer subtypes would enable a more patient-centered approach to breast health care: assessing an individual's risk of getting specific subtypes of the disease, providing risk-based screening and prevention recommendations, and, for those diagnosed with the disease, tailored treatment options based on risk and timing of progression and mortality. The Athena Breast Health Network is an initiative of the five University of California medical and cancer centers to prototype this approach and to enable the development of a rapid learning system-connecting risk and outcome information from a heterogeneous patient population in real time and using new knowledge from research to continuously improve the quality of care. The Network is based on integrating clinical and research processes to create a comprehensive approach to accelerating patient-centered breast health care. Since its inception in 2009, the Network has developed a multi-site, transdisciplinary collaboration that enables the learning system. The five-campus collaboration has implemented a shared informatics platform, standardized electronic patient intake questionnaires, and common biospecimen protocols, as well as new clinical programs and multi-center research projects. The Athena Breast Health Network can serve as a model of a rapid learning system that integrates epidemiologic, behavioral, and clinical research with clinical care improvements. PMID:23887672

Elson, Sarah L; Hiatt, Robert A; Anton-Culver, Hoda; Howell, Lydia P; Naeim, Arash; Parker, Barbara A; Van't Veer, Laura J; Hogarth, Michael; Pierce, John P; Duwors, Robert J; Hajopoulos, Kathy; Esserman, Laura J

2013-07-01

150

Women Veterans Health Care: Frequently Asked Questions  

MedlinePLUS

... A full continuum of health care, including comprehensive primary care (care for acute and chronic illness and gender- ... local VA health care facility to arrange a primary care appointment. return to top How do I get ...

151

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.

2012-01-01

152

Unlearning in health care  

PubMed Central

Learning in health care is essential if healthcare organisations are to tackle a challenging quality of care agenda. Yet while we know a reasonable amount about the nature of learning, how learning occurs, the forms it can take, and the routines that encourage it to happen within organisations, we know very little about the nature and processes of unlearning. We review the literature addressing issues pivotal to unlearning (what it is, why it is important, and why it is often neglected), and go further to explore the conditions under which unlearning is likely to be encouraged. There is a difference between routine unlearning (and subsequent re-learning) and deep unlearning—unlearning that requires a substantive break with previous modes of understanding, doing, and being. We argue that routine unlearning merely requires the establishment of new habits, whereas deep unlearning is a sudden, potentially painful, confrontation of the inadequacy in our substantive view of the world and our capacity to cope with that world competently.

Rushmer, R; Davies, H

2004-01-01

153

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

PubMed Central

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

2013-01-01

154

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

ERIC Educational Resources Information Center

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

Klemovage, Shirley

155

Development by a Large Integrated Health Care System of an Objective Methodology for Evaluation of Medical Oncology Service Sites  

PubMed Central

Purpose: Aurora Health Care (AHC) is the largest health care system in Wisconsin, with 14 acute care hospitals. In early 2010, a group of 18 medical oncologists became affiliated with AHC. This affiliation added 13 medical oncology infusion clinics to our existing 12 sites. In the era of health care reform and declining reimbursement, we need an objective method and criteria to evaluate our 25 outpatient medical oncology sites. We developed financial, clinical, and strategic tools for the evaluation and management of our cancer subservice lines and outpatient sites. The key to our success has been the direct involvement of stakeholders with a vested interest in the services in the selection of the criteria and evaluation process. Methods: We developed our objective metrics for evaluation based on strategic, financial, operational, and patient experience criteria. Strategic criteria included: population trends, full-time equivalent (FTE) medical oncologists/primary care physicians, FTE radiation oncologists, FTE oncologic surgeons, new annual cases of patients with cancer, and market share trends. Financial criteria per site included: physician work relative value units, staff FTE by type, staff salaries, and profit and loss. Operational criteria included: facility by type (clinic v hospital based), hours of operation, and facility detail (eg, No. of chairs, No. of procedure and examination rooms, square footage). Patient experience criteria included: nursing model primary/nurse navigators, multidisciplinary support at site, Press Ganey (South Bend, IN; health care performance improvement company) results, and employee engagement score. Results: The outcome of our data analysis has resulted in the development of recommendations for AHC senior leadership and geographic market leadership to consider the consolidation of four sites (phase one, four sites; phase two, two sites) and priority strategic sites to address capacity issues that limit growth. The recommendations if implemented would result in significant cost savings, currently being quantified as a result of consolidation and improved efficiency. A reinvestment of these cost savings would be required to address facility expansion and program enhancement to maximize patient-centered expert care consistently across all of our remaining sites of service.

Bjegovich-Weidman, Marija; Kahabka, Jill; Bock, Amy; Frick, Jacob; Kowalski, Helga; Mirro, Joseph

2012-01-01

156

Developing Treatment Plan Support in Outpatient Health Care Delivery with Decision Trees Technique  

Microsoft Academic Search

\\u000a This paper presents treatment plan support (TPS) development with the aim to support treatment decision making for physicians\\u000a during outpatient-care giving to patients. Evidence-based clinical data from system database was used. The TPS predictive\\u000a modeling was generated using decision trees technique, which incorporated predictor variables: patient’s age, gender, racial,\\u000a marital status, occupation, visit complaint, clinical diagnosis and final diagnosed diseases;

Shahriyah Nyak Saad Ali; Ahmad Mahir Razali; Azuraliza Abu Bakar; Nur Riza Suradi

2010-01-01

157

Primary care development zones.  

PubMed Central

Most commentators on the Tomlinson report have agreed with its emphasis on improving primary and community care. The three elements of such a strategy are a remedial programme to bring primary care up to national standards, a programme to provide such services to people with non-standard needs such as mobile Londoners, ethnic minorities, and homeless people, and the development of an expanded model of primary care. No one model will be appropriate across all of London. The process should start with an audit of existing resources and services within each community, together with an analysis of needs. From this would develop a local programme with specific plans for investment in premises, staffing, training, and management. New contractual mechanisms may be needed to attract practitioners, improve their premises, secure out of hours services, and provide medical cover for community beds. There should also be incentives for closer working between primary and secondary services. No developments on the scale needed for London have been carried out in primary care within the lifetime of the NHS--but their success will be critical to the calibre of health services for Londoners into the next century. Images p324-a

Beardshaw, V; Gordon, P; Plamping, D

1993-01-01

158

Modeling Health Care Policy Alternatives  

PubMed Central

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

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

2010-01-01

159

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

PubMed

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

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

2014-03-01

160

Assistive Communication Robot for Preoperative Health Care  

Microsoft Academic Search

\\u000a Health care costs and ageing population are two factors which are of major concern to western governments in the 21st century.\\u000a Existing work in affective health care is primary focused on developing avatars in the tele-health space. This paper reports\\u000a on the modeling of emotions (anxiety level) of patients in pre-operative stage using communication robots to assist nurses\\u000a in providing

Rajiv Khosla; Mei-Tai Chu; Kerstin Denecke; K. G. Yamada; T. Yamaguchi

2010-01-01

161

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

PubMed

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

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

2003-12-01

162

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

2013-01-01

163

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.

Cueto, Marcos

2004-01-01

164

Government Spending on Health Care  

Microsoft Academic Search

The economic constraints of the last decade have led western industrialized nations to consider, if not actually adopt, more stringent controls over costly social policies such as health care. Using recent, nationally representative data from the United States, Great Britain, West Germany, Italy, and Australia, this paper provides an international comparison of attitudes towards government spending on health care. Attitudes

Bernadette C. Hayes; Audrey VandenHeuvel

1996-01-01

165

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

166

Congress enacts health care reform.  

PubMed

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

2010-03-01

167

Case Studies in Primary Health Care  

NSDL National Science Digital Library

How does one learn about primary health care? Some might attend public health schools while others will find different ways to explore this fascinating field on their own. One particularly nice resource on the subject is this course from the Johns Hopkins School of Public Health. Offered as part of the Open Course Ware initiative, the course was first developed in the fall of 2011 and was co-taught by Henry Taylor and Henry Perry. It was designed to introduce students to "the origins, concepts, and development of community-based primary health care through case studies from both developing and developed countries." The materials here include the syllabus, lecture materials, readings, and assignments. Within the Lecture Materials section visitors can watch or listen to conversions on the roots of community-based primary health care and women's empowerment via public health. Additionally, visitors can look over the course assignments or check out some of the discussion questions.

Perry, Henry; Taylor, Henry

2011-01-01

168

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

169

Trends in Health Care Systems Delivery.  

ERIC Educational Resources Information Center

The trend now driving American health care is that the payors are refusing to pay the true economic costs. Health care technology and the public's demand for it, the growth of managed care (Health Maintenance Organizations), and the need to increase the effectiveness of health care are affecting health care delivery. (MLW)

Hughes, Edward F. X.

1989-01-01

170

Selective primary health care: the counter revolution.  

PubMed

Primary health care in the WHO sense was triggered indirectly by the failure of the Malaria Eradication Programme. The response to this failure was an ideological change which considered that health services were not purely a way of delivering health care interventions to people but were something important to individuals and groups in their own right. Key changes of this idea called primary health care were linked to qualities such as power, ownership, equity and dignity. Such an ideological change involves the evolution of new forms to reflect the changes in content and some of these structures still require development. The advocates of highly selected and specific health interventions plus the managerial processes to implement them have ignored, or put on one side, the ideas which are at the core of what could be described as the primary health care revolution. They are in this sense counter revolutionaries. PMID:3388069

Newell, K W

1988-01-01

171

Health care's service fanatics.  

PubMed

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

Merlino, James I; Raman, Ananth

2013-05-01

172

Integrating Public Health and Personal Care in a Reformed US Health Care System  

PubMed Central

Compared with other developed countries, the United States has an inefficient and expensive health care system with poor outcomes and many citizens who are denied access. Inefficiency is increased by the lack of an integrated system that could promote an optimal mix of personal medical care and population health measures. We advocate a health trust system to provide core medical benefits to every American, while improving efficiency and reducing redundancy. The major innovation of this plan would be to incorporate existing private health insurance plans in a national system that rebalances health care spending between personal and population health services and directs spending to investments with the greatest long-run returns.

Chernichovsky, Dov

2010-01-01

173

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

Microsoft Academic Search

BACKGROUND: 'Caring for Country' is defined as Indigenous participation in interrelated activities with the objective of promoting ecological and human health. Ecological services on Indigenous-owned lands are belatedly attracting some institutional investment. However, the health outcomes associated with Indigenous participation in 'caring for country' activities have never been investigated. The aims of this study were to pilot and validate a

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

2008-01-01

174

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

175

[Quality of maternal and child health care in different models of Primary Health Care].  

PubMed

This study evaluated the quality of the maternal and child health care in two different models of Primary Health Care. Interviews were carried out by trained personnel with 1200 families randomly selected. Processes of assistance for maternal and child health care were evaluated by Family Health Strategy Teams and traditional health centers. In the evaluation of child health care, the precocity of the first consultation, the regular assessment of growth and development, the recommendations for accident prevention and prophylactic use of iron supplementation and vitamin A had been statistically associated with the model of the health care. Regarding prenatal health care the results showed statistically significant differences between the two models for breastfeeding counseling, nutritional recommendations and cervical preventive screening using Papanicolaou smear. For women health care out of pregnancy period, the results revealed that counseling for breasts auto-examination, preventive screening using Papanicolaou smear in last year and participation in family planning programs were associated with health Primary Health Care model. All the pointed differences had shown better performance of the Family Health Strategy Teams. PMID:21049154

Caldeira, Antônio Prates; Oliveira, Rafael Morroni de; Rodrigues, Oreston Alves

2010-10-01

176

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

177

Healthy Aging: Paying for Health Care  

MedlinePLUS

... This information in Spanish ( en español ) Paying for health care More information on paying for health care Better ... Coping without insurance More information on paying for health care Explore other publications and websites Age Page: Choosing ...

178

Health Care: Constitutional Rights and Legislative Powers.  

National Technical Information Service (NTIS)

The health care reform debate raises many complex issues including those of coverage, accessibility, cost, accountability, and quality of health care. Underlying these policy considerations are issues regarding the status of health care as a constitutiona...

K. S. Swendiman

2012-01-01

179

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.

Slater, R G

1989-01-01

180

Efficiency of families managing home health care  

Microsoft Academic Search

Over the last decade, cost-containment pressures, health care reform debates, movement to case-managed health care, and reductions\\u000a in health care benefits have required most families to be responsible for selecting specific health care services that keep\\u000a costs to a minimum. As Eddy [17-20] discussed in a series of articles on making decisions in health care, the consensus among\\u000a health care

Carol E. Smith; Susan V. M. Kleinbeck; Karen Fernengel; Linda S. Mayer

1997-01-01

181

Unfair inequalities in health and health care.  

PubMed

Inequalities in health and health care are caused by different factors. Measuring "unfair" inequalities implies that a distinction is introduced between causal variables leading to ethically legitimate inequalities and causal variables leading to ethically illegitimate inequalities. An example of the former could be life-style choices, an example of the latter is social background. We show how to derive measures of unfair inequalities in health and in health care delivery from a structural model of health care and health production: "direct unfairness", linked to the variations in medical expenditures and health in the hypothetical distribution in which all legitimate sources of variation are kept constant; "fairness gap", linked to the differences between the actual distribution and the hypothetical distribution in which all illegitimate sources of variation have been removed. These two approaches are related to the theory of fair allocation. In general they lead to different results. We propose to analyse the resulting distributions with the traditional apparatus of Lorenz curves and inequality measures. We compare our proposal to the more common approach using concentration curves and analyse the relationship with the methods of direct and indirect standardization. We discuss how inequalities in health care can be integrated in an overall evaluation of social inequality. PMID:18829124

Fleurbaey, Marc; Schokkaert, Erik

2009-01-01

182

Improvement in coverage of primary health care in a developing country through use of food incentives.  

PubMed

To improve attendance at mobile clinics for children food incentives were offered to attenders in a rural municipality in northern Nicaragua. Clinic attendance in villages where food incentives were offered was higher than that in control villages (96.5% vs 63.3% of child population, p less than 0.005). When food was later offered in control villages, attendance rose by 60.2% to full attendance (p less than 0.001). Some of the large amounts of non-emergency food aid available could be offered as incentives to increase the use of basic health services in developing countries. PMID:2872440

Loevinsohn, B P; Loevinsohn, M E

1986-06-01

183

[Primary care in maternal-child health].  

PubMed

The theoretical and methodological elements of primary health care (PHC) include a philosophy of work and an epistemological focus toward the processes of health and illness, as well as a practical medical anthropological knowledge of the culture-specific aspects of disease. The work methodology of PHC requires care of the individual as a bio-psycho-socio-affective being integrated into a particular environment; none of the aspects of being should be neglected or given priority. Care should also be integrated in the sense of providing preventive health care as well as curative and rehabilitative services, in all phases from training of health personnel to record keeping. The primary health care team is multidisciplinary in constitution and interdisciplinary in function. PHC assumes that health care will be accessible to users and that continuity of care will be provided. The need for community participation in all phases of health care has been reiterated in several international health declarations. A well-functioning PHC system will require new types of pre- and postgraduate health education in a changing social and professional system and continuing education under adequate supervision for health workers. Research capability for identifying community health problems, a rigorous evaluation system, and epidemiologic surveillance are also needed. All of these elements are applicable to the field of maternal and child health as well as to PHC. The most appropriate place to intervene in order to correct existing imbalances in access to health care for mothers and children is in the PHC system. Examples of areas that should be stressed include vaccinations, nutrition, psychomotor development, early diagnosis and treatment for handicapped children, prevention of childhood accidents, school health and absenteeism, all aspects of health education, adoption and alternatives to abandonment of children, alcoholism and addiction, adolescent pregnancy and family planning, dental health, and mental problems. Trained primary care pediatricians working within the community as part of the PHC system will be required to confront and solve complex health problems. The training needed does not signify a new speciality or subspeciality, but rather a training methodology and a new type of professional practice. PMID:3752740

Pedreira Massa, J L

1986-07-01

184

[Centralized purchasing of essential drugs, a priority for the health care systems of developing countries].  

PubMed

Health sector reform is a key priority of many governments throughout the world. Drug supply systems are a major element of public health policy design in Africa, where 90% of drugs are imported. The WHO Essential Drugs Program and the UNICEF sponsored Bamako Initiative have, since the late 1980s, promoted the rational use of essential drugs and attempted to ensure a sustainable drug supply through the implementation of cost recovery schemes and quality assurance mechanisms in public health services. A new market for drugs is emerging within this framework and there is growing competition for its control. Government medical stores are all too often bankrupt and the private sector is expensive, catering mainly for the middle to upper classes of urban areas. An intermediate alternative. Essential Drugs Purchasing Offices (EDPOs), has been proposed to balance social objectives and economic constraints. Some of the experimental strategies have given promising results. However, their implementation raises a number of questions: What is the role of the EDPO? Should it promote public health issues in general or focus purely on drug availability? What is the most appropriate legal status? Public or private? For profit or not? How should the investment capital be structured? In drugs or in funds? With ample provision or a tight budget? How should drug purchases be managed? Where should drugs be purchased? How much? How often? According to which procedures? How should the distribution of drugs be organized? Supplying everyone? Pushing supplies or pulling purchasers in? The answers to these questions, analysis of the reasons for success and failure and the dissemination of the information gathered should identify priorities for action and future research and define a framework for expansion. These are the objectives of the "Concerted Action for the Development of EDPO in Sub-Saharan African Countries" which is supported by the European Union (DG XII). PMID:9690323

Blaise, P; Dujardin, B; de Béthune, X; Vandenbergh, D

1998-01-01

185

VHA enrollees' health care coverage and use of care.  

PubMed

The authors examined health care coverage for Veterans' Health Administration (VHA) enrollees and how their reliance on VHA care varies by coverage, using the largest and most detailed survey of veterans using VHA services ever conducted. The results showed that a majority of veterans who use VHA services have alternative health care coverage and that most of them use both VHA and non-VHA health care. The findings have important implications for quality of care and coordination of care. PMID:12800686

Shen, Yujing; Hendricks, Ann; Zhang, Shuo; Kazis, Lewis E

2003-06-01

186

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

187

Model Child Care Health Policies.  

ERIC Educational Resources Information Center

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

Aronson, Susan; Smith, Herberta

188

Pharmacy in the health care center: a model for health care delivery.  

PubMed

Health care consumers use a plethora of services which are accessible on an ambulatory basis. These include the services of pharmacists, optometrists, nurses, dentists, audiologists, orthotics, and so forth. Since many of these services are provided in physically and financially separate facilities and often are not located in close proximity to one another, consumers may spend a large amount of time traveling between locations. Economic inefficiencies due to the size and dispersion of separate and independent facilities may produce an increase in the cost of ambulatory health care services. Thus, the concept of a health care center, an ambulatory health care analog to the multispecialty shopping center, is proposed as a potential alternative and improvement in the delivery of these services. Space, location, personnel, and initial capital requirements for a model health care center are projected based on existing data for the establishment of each separate auxiliary health care facility. Projections are made to determine the appropriate and necessary site for the health care center's trade area. Potential revenues are calculated by examining some pharmacy operations which are beginning to pioneer these areas and utilizing revenue figures for the various individual services. The results indicate that the pharmacy, as a frequently visited health care facility, may be an excellent choice around which to develop the health care center concept in metropolitan areas. PMID:10256904

Stark, D C; Wertheimer, A I

1982-01-01

189

Trust and the development of health care as a social institution  

Microsoft Academic Search

Health systems are inherently relational and so many of the most critical challenges for health systems are relationship and behaviour problems. Yet the disciplinary perspectives that underlie traditional health policy analysis offer only limited and partial insights into human behaviour and relationships. The health sector, therefore, has much to learn from the wider literature on behaviour and the factors that

Lucy Gilson

2003-01-01

190

Telemedicine Health Care Delivery System.  

National Technical Information Service (NTIS)

The Interactive Telemedicine Systems (ITS) system was specifically developed to address the ever widening gap between our medical care expertise and our medical care delivery system. The frustrating reality is that as our knowledge of how to diagnose and ...

J. H. Sanders

1991-01-01

191

Integrating Oral Health Care into Primary Health Care System  

PubMed Central

Introduction. Systematic evaluation is an integral part of the organization and delivery of community oral health care programmes, ensuring the effectiveness of these community-based interventions. This study aimed to assess the knowledge and practice of primary health care (PHC) personnel regarding their duties toward oral health. Methods and Material. A cross-sectional study was carried out among three groups of PHC personnel in the city of Kerman (Iran). Volunteer personnel completed a piloted questionnaire which included demographic data, some question regarding their knowledge about oral health, their duties and also their practice regarding public oral health. All data were analyzed using chi-square and Pearson correlation test. Results. One hundred and fifty-seven out of 225 eligible personnel participated in the study. Sixty percent were auxiliary health workers (Behvarz). All personnel had a good level of knowledge regarding oral health. Despite significant differences among the knowledge of the personnel toward oral health, there was no significant difference between their knowledge related to their duties regarding oral health. The auxiliary health worker group had a higher rate (45.6%) for better public oral health practice. Conclusion. The study showed the personnel have good knowledge of their duties regarding oral health. However, their practice is not in line with their knowledge and needs more attention.

Hajizamani, Abolghasem; Malek Mohammadi, Tayebeh; Hajmohammadi, Ebadollah; Shafiee, Shahin

2012-01-01

192

Developing Quality Indicaton for Cancer End-of-Life Care: Proceedings From a National Symposium. Effective Health Care Program Research Reports, Number 20.  

National Technical Information Service (NTIS)

Quality indicators applicable to cancer end-of-life care exist, but have not been widely implemented. To advance this field, we worked with the Agency for Health Care Research and Quality and the National Cancer Institute to organize a national symposium ...

C. F. Snyder H. Seow J. S. Kutner L. R. Shugarman R. A. Mularski

2010-01-01

193

Day care health risks  

MedlinePLUS

... hepatitis A virus. It is spread by poor hand washing after going to the bathroom or changing a ... and then preparing food. In addition to good hand washing, day care staff and children should get the ...

194

Development and implementation of a participative intervention to improve the psychosocial work environment and mental health in an acute care hospital  

Microsoft Academic Search

Objectives: To describe the development and implementation phases of a participative intervention aimed at reducing four theory grounded and empirically supported adverse psychosocial work factors (high psychological demands, low decision latitude, low social support, and low reward), and their mental health effects.Methods: The intervention was realised among 500 care providers in an acute care hospital. A prior risk evaluation was

R Bourbonnais; C Brisson; A Vinet; M Ve?zina; A Lower

2006-01-01

195

Financial burden of health care expenditures: Turkey.  

PubMed

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

Sulku, S Nur; Bernard, D Minbay

2012-01-01

196

Health care accommodation in Scotland.  

PubMed

The Medical and Nursing Advisers of the Scottish Health Service, Common Services Agency, Building Division, advise upon the planning of health care accommodation. The overall spread of beds by function is given in a review of existing health care buildings in the year 1981. The numbers of hospital beds and of various groups of staff in the hospital and community services are calculated per 100,000 population so that any unusual disparity can be ascertained. One of the parameters for health building planning is fiscal control and so the cost per hospital in-patient week is tabulated for eight groups of specialities. The appropriate responsibilities of the Regional Councils in Scotland in 1979 are considered along with the responsibilities of Health Boards because part of each Social Work Department's work is the provision of accommodation and social care for those in need as opposed to the National Health Service responsibility for the health care of those in hospital and in the community. An overall view of residential accommodation for those requiring medical treatment or social care is presented in tabular form. The views expressed are not necessarily those of the Common Services Agency. PMID:7146882

Maclachlan, J

1982-10-01

197

45 CFR 162.414 - Implementation specifications: Health care clearinghouses.  

Code of Federal Regulations, 2013 CFR

...Implementation specifications: Health care clearinghouses. 162.414 ...Standard Unique Health Identifier for Health Care Providers § 162.414 Implementation specifications: Health care clearinghouses. A health...

2013-10-01

198

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

PubMed

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

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

2011-01-01

199

Should we ration health care?  

PubMed

The paper begins by drawing a distinction between "allocation"--the distribution of resources between different categories, and "rationing"--the distribution of scarce resources within a single category. I argue that the current allocation of funds to health care makes some form of rationing unavoidable. The paper next considers proposals by Daniel Callahan and Norman Daniels supporting age rationing publicly-financed life-extending medical care. I provide reasons for doubting that either argument succeeds. The final section of the paper sets forth an alternative approach which holds that if people have any rights to health care, then they have a right to a decent minimum. PMID:10296994

Jecker, N S

1989-01-01

200

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

201

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

202

Improving China's Health Care System  

Microsoft Academic Search

Overall, health outcomes in China have improved tremendously over the past three decades, especially thanks to the reduction in some traditional infectious diseases. However, death rates from chronic diseases have been on the rise, not least owing to changes in life styles and deteriorating environmental conditions. Supply of health care is overwhelmingly provided publicly and hospitals have been absorbing a

Richard Herd; Yu-Wei Hu; Vincent Koen

2010-01-01

203

Health care's 100 most wired.  

PubMed

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

Solovy, A; Serb, C

1999-02-01

204

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

205

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

206

A political paradigm for the health care administrator.  

PubMed

It is crucial that health care administrators develop political clout if they wish to influence health care regulation. Health care professionals must learn to represent provider and patient interests effectively in order to have impact on regulation-making bodies. PMID:7429821

Heatwole, K B; Breindel, C L

1980-01-01

207

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

208

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

209

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

ERIC Educational Resources Information Center

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

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

2007-01-01

210

Veteran's Health Care Issues.  

National Technical Information Service (NTIS)

The Department of Veterans Affairs (VA) provides services and benefits to veterans who meet certain eligibility criteria. VA carries out its programs nationwide through three administrations and the Board of Veterans Appeals (BVA). The Veterans Health Adm...

S. V. Panangala

2007-01-01

211

Health Care Financing Review, 1987 Annual Supplement.  

National Technical Information Service (NTIS)

Quality of care research is the subject of the entire issue of the Health Care Financing Review. Aspects discussed in detail are: Quality of health care measurement: a research priority; Monitoring adverse outcomes of surgery using administrative data; Me...

1987-01-01

212

Who's on Your Health Care Team?  

MedlinePLUS

... easy access to the care you need. Your Health Care Team Work with your doctors to create the ... expect from your primary diabetes doctor. Visiting Your Health Care Team Stay up-to-date on our latest ...

213

Managed Behavioral Health Care Premises, Accountable Systems of Care, and Ambha's Perms  

Microsoft Academic Search

This article discusses the concepts and approaches underlying managed behavioral health care and the need to assess quality of care. The author describes the Performance Measures for Managed Behavioral Healthcare Programs (PERMS) developed by the American Managed Behavioral Healthcare Association (AMBHA), which is offered as a first step toward enhanced quality of care assessment in managed behavioral health care.

E. Clarke Ross

1997-01-01

214

Universal health care: the changing international discourse.  

PubMed

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

Bisht, Ramila

2013-01-01

215

Development and application of an electronic health record information extraction tool to assess quality of pain management in primary care.  

PubMed

Chronic pain is one of the most common presenting problems in primary care. Standards and guidelines have been developed for managing chronic pain, but it is unclear whether primary care providers routinely engage in guideline-concordant care. The purpose of this study is to develop a tool for extracting information about the quality of pain care in the primary care setting. Quality indicators were developed through review of the literature, input from an interdisciplinary panel of pain experts, and pilot testing. A comprehensive coding manual was developed, and inter-rater reliability was established. The final tool consists of 12 dichotomously scored indicators assessing quality and documentation of pain care in three domains: assessment, treatment, and reassessment. Presence of indicators varied widely. The tool is reliable and can be utilized to gather valuable information about pain management in the primary care setting. PMID:24904702

Dorflinger, Lindsey M; Gilliam, Wesley P; Lee, Allison W; Kerns, Robert D

2014-06-01

216

Rural health care support mechanism. Final rule.  

PubMed

In this document, the Federal Communications Commission reforms its universal service support program for health care, transitioning its existing Internet Access and Rural Health Care Pilot programs into a new, efficient Healthcare Connect Fund. This Fund will expand health care provider access to broadband, especially in rural areas, and encourage the creation of state and regional broadband health care networks. Access to broadband for medical providers saves lives while lowering health care costs and improving patient experiences. PMID:23476995

2013-03-01

217

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

218

Personalized health care: from theory to practice.  

PubMed

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

Snyderman, Ralph

2012-08-01

219

Health care and the elderly.  

PubMed

America's health care crisis is hitting our elderly and threatens to cripple Medicare, the elderly's financial support system. Medicare was designed to ensure that every elderly American would be protected against the destruction of life savings as a result of illness. Elderly Americans would be able to enjoy their golden years without the financial burden of medical bills. Today, this vision is almost extinct. Medicare has been placed on the endangered species list. Market predictions indicate that Medicare's Hospital insurance Trust Fund will be depleted by 1988 if current trends continue. The elderly presently must pay on the average about 14% of their health care bill. In addition, Medicare pays little for long-term care; and about 45% of long-term care is paid for out-of-pocket by the elderly and their families. Alternative approaches are desperately needed of Medicare if our elderly are to survive. PMID:10311941

Eisdorfer, C

1985-01-01

220

Five Steps to Safer Health Care  

MedlinePLUS

... Health Systems Hospital Resources Long-Term Care Resources Primary Care Resources System Design Resources Prevention & Chronic Care Announcements Evidence-Based Decisionmaking Improving Primary Care Practice Resources Quality & Patient Safety Comprehensive Unit-based ...

221

Managed care and children with special health care needs  

Microsoft Academic Search

Providing care to children with special health care needs within a managed care environment presents special challenges for providers and parents alike. The goal of managed care is to contain costs by encouraging or requiring members to obtain services through a designated network. In managed care programs, children and families may experience limited access to specialized care and services, along

Jeanne M. Rhoades Smucker

2001-01-01

222

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 ...

223

Health care coalitions: continuity and change.  

PubMed

The purpose of this study has been to investigate how coalitions have changed during 1983-1986, to describe the current characteristics of coalitions, and to speculate about their future roles and likely evolution. Several insights emerge from the empirical findings of this study. First, the number of operational health care coalitions has greatly expanded over the last several years to the point where almost every state and metropolitan area of the country has at least one. Second, the service area of most coalitions is generally county-wide, although there has been significant growth in the number of coalitions that serve states. Third, coalitions are expanding their membership composition and including not only business members but also hospitals, physicians, insurance companies, and labor organizations. Fourth, coalitions are becoming more financially secure; most have annual cash budgets, and most rely on dues. Fifth, coalitions are increasingly hiring and using paid professional staff. Last, coalitions are expanding their agendas beyond investigating direct health care costs to examine some of the underlying issues (such as hospital and medical professional liability issues, the financing of uncompensated care, and ethical issues) and are developing programs to address them. For the near future, the extension of recent trends suggests how coalitions will look and function. Further down the road, health care coalitions may evolve into health care public/private policy forums or associations of health benefits managers and/or associations for managed care purchasers. In conclusion, the trends we documented and the projections of the future of coalitions appear to be in keeping with the summary perspective of John T. Dunlop (1987) who indicates: Coalitions provide a continuing forum in which parties become more interested and informed about health care costs, utilization and the problems and operations of the other participants. The discourse encourages a more extensive and informed development and sharing of data. Coalitions reflect and need to recognize the inevitable internal conflicts and interests of the constituent organizations. While some coalitions tend to flounder on internal conflicts and capacity to generate effective leadership; many are fruitfully addressing the hard issues of health care in a community, such as managed care, capitation payments, excess beds and capital requirements, and access to health care by the uninsured. As coalitions mature, beyond discourse and data, they are likely to concentrate on a few of the distinctive problems of their communities and the interaction within the health care environment to address these problems. PMID:10304443

Mullner, R M; Young, G W; Andersen, R M

1988-01-01

224

Development of the palliative care needs assessment tool (PC-NAT) for use by multi-disciplinary health professionals.  

PubMed

Needs assessment strategies can facilitate prioritisation of resources. To develop a needs assessment tool for use with advanced cancer patients and caregivers, to prompt early intervation. A convenience sample of 103 health professionals viewed three videotaped consultations involving a simulated patient, his/her caregiver and a health professional, completed the Palliative Care Needs Assessment Tool (PC-NAT) and provided feedback on clarity, content and acceptability of the PC-NAT. Face and content validity, acceptability and feasibility of the PC-NAT were confirmed. Kappa scores indicated adequate inter-rater reliability for the majority of domains; the patient spirituality domain and the caregiver physical and family and relationship domains had low reliability. The PC-NAT can be used by health professionals with a range of clinical expertise to identify individuals' needs, thereby enabling early intervention. Further psychometric testing and an evaluation to assess the impact of the systematic use of the PC-NAT on quality of life, unmet needs and service utilisation of patients and caregivers are underway. PMID:18952754

Waller, A; Girgis, A; Currow, D; Lecathelinais, C

2008-12-01

225

The Chinese health care system: Lessons for other nations  

Microsoft Academic Search

This paper examines China's health care from a system perspective and draws some lessons for less developed nations. A decade ago, Chinese macro-health policy shifted its health care financing and delivery toward a free market system. It encouraged all levels of health facilities to rely on user fees to support their operations. However, China continued its administered prices and hospitals

William C. L. Hsiao

1995-01-01

226

Home health-care bibliography.  

PubMed

A home health-care bibliography is presented. The bibliography includes a selection of references to descriptive reports, research papers, editorials, letters, and commentaries on home health-care (HHC) services. This bibliography represents important literature from the past 12 years on program planning, marketing, trends, and reimbursement for HHC services as well as specific types of home therapy. The bibliography can be helpful to pharmacy administrators and clinicians who are interested in designing HHC programs or becoming involved in the provision of home therapy. PMID:3085486

Harris, W L; Mellott, P J

1986-03-01

227

Changing health-care systems.  

PubMed

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

Holthof, B

1995-01-01

228

Fitch ratings. Health care special report.  

PubMed

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

2003-01-01

229

Virtual health care center in Georgia.  

PubMed

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

Schrader, Thomas; Kldiashvili, Ekaterina

2008-01-01

230

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

PubMed Central

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

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

2008-01-01

231

Open innovation in health care: Analysis of an open health platform  

Microsoft Academic Search

Today, integration of the public in research and development in health care is seen as essential for the advancement of innovation. This is a paradigmatic shift away from the traditional assumption that solely health care professionals are able to devise, develop, and disseminate novel concepts and solutions in health care. The present study builds on research in the field of

Angelika C. Bullinger; Matthias Rass; Sabrina Adamczyk; Kathrin M. Moeslein; Stefan Sohn

2012-01-01

232

Public trust in Dutch health care  

Microsoft Academic Search

This article describes the development of a valid and reliable instrument to measure different dimensions of public trust in health care in the Netherlands. This instrument is needed because the concept was not well developed, or operationalized in earlier research. The new instrument will be used in a research project to monitor trust and to predict behaviour of people such

G. F. M. Straten; R. D. Friele; P. P. Groenewegen

2002-01-01

233

Discussion of patient-centered care in health care organizations.  

PubMed

The tradition of inherent knowledge and power of health care providers stands in stark contrast to the principles of self-determination and patient participation in patient-centered care. At the organizational level, patient-centered care is a merging of patient education, self-care, and evidence-based models of practice and consists of 4 broad domains of intervention including communication, partnerships, health promotion, and physical care. As a result of the unexamined discourse of knowledge and power in health care, the possibilities of patient-centered care have not been fully achieved. In this article, we used a critical social theory lens to examine the discursive influence of power upon the integration of patient-centered care into health care organizations. We begin with an overview of patient-centered care, followed by a discussion of the various ways that it has been introduced into health care organizations. We proceed by deconstructing the inherent power and knowledge of health care providers and shed light on how these long-standing traditions have impeded the integration of patient-centered care. We conclude with a discussion of viable solutions that can be used to implement patient-centered care into health care organizations. This article presents a perspective through which the integration of patient-centered care into health organizations can be examined. PMID:22722519

Fredericks, Suzanne; Lapum, Jennifer; Schwind, Jasna; Beanlands, Heather; Romaniuk, Daria; McCay, Elizabeth

2012-01-01

234

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.

2014-01-01

235

Quality development based on informatics in health care: steps in the Danish national strategy illustrated by four cases.  

PubMed

The first step for quality development is identification of the quality problem. This should be followed by a set up of criteria and standards and relevant data should be collected to perform quality assessment. The quality-level is evaluated and in cases with non-satisfying results, the problem(s) should be identified and the process repeated [1]. Identification of the best results for continuous quality improvement and professional self-assessment is part of the process [1]. Decentralization of the whole quality development process is an aim. The Ministry of Health is politically responsible for the process and the National Board of Health is responsible for the implementation of the process at the national level. To support continuous quality development, three bills were passed in the government in 1992: 1) Free choice of hospital for the patients; 2) Appropriate local and regional distribution of specialized functions, to ensure optimal treatment of rare and complicated diseases; 3) Coordinated planning and organization of the health services. The strategy for quality development illustrated by four cases. Four projects were identified to illustrate steps in the national strategy for quality development. PROBLEM IDENTIFICATION. ESTEEM [2,3]: Using knowledge-based systems for interpretation of EMG (electromyography) in different laboratories disclosed great variations in clinical usability. The variations could be explained by different examination techniques, test planning protocols, and diagnostic criteria. It was concluded that the use of a EMG-knowledge based system disclosed great problems for standardization of procedures dependent on EMG measurements. QUALITY ASSESSMENT. Hip fracture quality project [unpublished data]: The assumption for the study was that early and active rehabilitation after hip fracture would promote the ability of the patients to cope with activities of daily living (ADL) and prevent development of complications. About 85% of the patients were expected to be able to go home on the 12th day, but this was the case for only 56% of the patients. It was concluded that the pre-set standard was not achieved and that the post-operative care was carried out in an ineffective way. QUALITY IMPROVEMENT. Laboratory quality project [4]: Quality control assessment procedures have been implemented for years in hospital laboratories. The aim of the study was to evaluate the size of analytical bias between two local hospital laboratories using the same reference intervals. The results showed that only a few of the routine analyses meet the goals for acceptance of general reference intervals in a geographical area. The problems were reflected in the quality assessment results but, nevertheless, no action seems to have been taken to minimize the bias. It is concluded that interpretation of quality control data is a great problem. QUALITY MONITORING AND EVALUATION. National databases for health care quality [5]: Principles for development, implementation, and use of national databases has been worked out by The National Board of Health. Clinical departments will get a tool to monitor and improve the daily working routines. National databases for clinical monitoring exist for vascular surgery, laparoscopic surgery, treatment of breast cancer, and surgery for hip fractures. PMID:8591518

Frølich, A; Bernstein, K; Vingtoft, S; Andersen, Y; De Neergaard, L; Schøiler, G

1995-01-01

236

Ethics of rural health care  

Microsoft Academic Search

One quarter of the US population live in areas designated as rural. Delivery of rural health care can be difficult with unique challenges including limited access to specialists such as oncologists. The Rural Cancer Outreach Program is an alliance between an academic medical center and five rural hospitals. Due to the presence of this program, the appropriate use of narcotics

Laurie J. Lyckholm; Mary Helen Hackney; Thomas J. Smith

2001-01-01

237

Hedging opportunities in health care.  

PubMed

Medical care futures contracts offer new hedging opportunities to increase protection against unexpected price changes. Commodity futures contracts can be designed explicitly to hedge volatile group health insurance premiums and capitated hospital and physician prices. This article describes one way to design and use these hedging instruments. PMID:10103960

Hayes, J A

1990-03-01

238

Simulation in Health Care Education  

Microsoft Academic Search

During the past 15 years there has been widespread adoption of sim- ulation in health care education as a method to train and assess learners. Multiple fac- tors have contributed to this movement, including reduced patient availability, limited faculty teaching time, technological advances in diagnosis and treatment that require a new skills set, greater attention to patient safety with the

S. Barry Issenberg; Ross J. Scalese

2008-01-01

239

Interactive Computerized Health Care Education  

Microsoft Academic Search

Acknowledgments: This work has been supported by grants from the National Science Foundation (IRI-9523646 and IRI-9701617) and by a gift from the University of Wisconsin Medical School, Department of Medicine 2 2 Abstract The Patient Education and Activation System (PEAS) project aims to prepare people to take a more active role in their health care decisions. In this paper, we

Susan W. McRoy; Alfredo Liu-Perez; Syed S. Ali

240

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

PubMed

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

Oakman, Jodi; Macdonald, Wendy; Wells, Yvonne

2014-11-01

241

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

242

Consumer-directed health care: understanding its value in health care reform.  

PubMed

The purpose of this article is to describe the importance of consumer-directed health care as the essential strategy needed to lower health care costs and support its widespread adoption for making significant strides in health care reform. The pros and cons of health care consumerism are discussed. The intent is to show that the viability of the US health care system depends on the application of appropriate consumer-directed health care strategies. PMID:20145464

Guo, Kristina L

2010-01-01

243

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

ERIC Educational Resources Information Center

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

Lucia, David

2010-01-01

244

Building the national health information infrastructure for personal health, health care services, public health, and research  

Microsoft Academic Search

BACKGROUND: Improving health in our nation requires strengthening four major domains of the health care system: personal health management, health care delivery, public health, and health-related research. Many avoidable shortcomings in the health sector that result in poor quality are due to inaccessible data, information, and knowledge. A national health information infrastructure (NHII) offers the connectivity and knowledge management essential

Don E Detmer

2003-01-01

245

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

246

Costs and coverage. Pressures toward health care reform.  

PubMed

Signs of discontent with the health care system are growing. Calls for health care reform are largely motivated by the continued increase in health care costs and the large number of people without adequate health insurance. For the past 20 years, health care spending has risen at rates higher than the gross national product. As many as 35 million people are without health insurance. As proposals for health care reform are developed, it is useful to understand the roots of the cost problem. Causes of spiraling health care costs include "market failure" in the health care market, expansion in technology, excessive administrative costs, unnecessary care and defensive medicine, increased patient complexity, excess capacity within the health care system, and low productivity. Attempts to control costs, by the federal government for the Medicare program and then by the private sector, have to date been mostly unsuccessful. New proposals for health care reform are proliferating, and important changes in the health care system are likely. PMID:1441510

Lee, P R; Soffel, D; Luft, H S

1992-11-01

247

Project #138. Coronary Care Education of Health Care Team. Final Report.  

ERIC Educational Resources Information Center

The goal of this project was to develop, establish, and implement a system for the educational development of health care team members of the St. Joseph region in emergency and coronary care. Programs, curricula, and evaluation methodology were devised for four levels of critical care personnel: R.N.s emphasizing emergency and coronary care;…

Saint Joseph Hospital, MO.

248

A labor relations research agenda for health care settings  

Microsoft Academic Search

Inadequate attention has been given to labor-management relations in health care organizations. Bacause of the labor-intensive nature of health care and the great dependence on human resources, health services researchers should place greater emphasis on labor-management issues. This article develops a framework and suggests methodologies for examining labor relations in health care organizations. Specifically, six cirtical issues are suggested for

Gregory E. Huszezo; Bruce J. Fried

1988-01-01

249

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

250

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

251

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

252

Power Rx for the health care industry  

SciTech Connect

While electricity has had a huge impact on the health care community through the development of highly sophisticated diagnostic tools and procedures, more mundane electro-technologies offer substantial opportunities as well. From innovative lighting techniques to energy management systems to new technologies for medical waste disposal, advanced electricity-based technologies can enhance health care services and help cut costs when facilities know where and how to apply them. Recognizing that few hospitals and clinics have the in-house expertise to fully exploit such opportunities, EPRI has launched an initiative to help utilities deliver the Institute's research results to this crucial customer segment. The resulting partnerships promise to be of mutual benefit to the utility and health care industries as they both move through a period of substantial change. 6 figs.

Lamarre, L.

1994-06-01

253

Transforming a health care information management system.  

PubMed

The article presents results from a survey of 98 top executives at Baylor Health Care System (BHCS), a large, multifunction health care organization in Dallas, Texas. The survey assessed the executives' perceptions of current BHCS quality practices using the first survey developed for the health care industry based on the Malcolm Baldrige National Quality Award (MBNQA) criteria. Findings regarding the quality of BHCS internal and external data and information include the need for a $50 million information system transformation to achieve seven critical success factors for all business units and improved internal and external data and information for the business process redesign and quality transformation. Results highlight the need for further research investigating the information and analysis MBNQA criteria. PMID:10174724

Prybutok, V R; Spink, A

1997-11-01

254

[Evolution of primary health care in Spain].  

PubMed

Coinciding with the celebration of the 35th anniversary of the journal of nursing, invented in 1977, conducted a systematic review of all issues published (371) to identify items (222) and news (94) related to primary care health. Events are arranged temporarily and refer to accompanying the evolution of primary care model. The Analysis Shows the evolution of primary care, since its inception in 1978, has been reflected in the type of articles and the content of news published, be an excellent indicator of its development and contribution for the nurses. PMID:23390875

Martínez Riera, José Ramón

2012-12-01

255

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

256

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

PubMed

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

Archambault, Patrick Michel

2011-01-01

257

Minor depression: risk profiles, functional disability, health care use and risk of developing major depression  

Microsoft Academic Search

Background: minor depression has been found to affect quality of life, result in a increased service utilization, and lead to an increased risk of developing a major depression. In this study we examine risk profiles, functional disability, service utilization and the risk of developing major depression in minor depression. Methods: a random sample of the Dutch population (n=7076) was interviewed

Pim Cuijpers; Ron de Graaf; Saskia van Dorsselaer

2004-01-01

258

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

259

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

260

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

PubMed Central

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

2014-01-01

261

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

262

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.

263

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.

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

264

Job satisfaction in health-care organizations  

PubMed Central

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

Bhatnagar, Kavita; Srivastava, Kalpana

2012-01-01

265

The Cultural Geography of Health Care Delivery.  

ERIC Educational Resources Information Center

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

Gesler, Wilbert M.

1987-01-01

266

Study of the Impact of Managed Care on the Formation and Development of Regional Mental Health Services for Darnall Army Community Hospital, Great Plains Regional Medical Command, Tricare Region VI.  

National Technical Information Service (NTIS)

The purpose of this research is to determine the effectiveness of managed care on the formation and development of regional mental health services. This retrospective review will include the impact managed care principals have on the quality, access, and ...

L. G. Gross

1996-01-01

267

Practical Applications of Confidentiality Rules to Health Care Transition Instruction  

ERIC Educational Resources Information Center

The increase in the number of students with disabilities and special health care needs and their need for health care transition (HCT) creates opportunity for education and health services professionals to work together. In response to this opportunity, the authors developed an HCT teaching module for 6th to 12th graders. A concern that surfaced…

Repetto, Jeanne B.; Gibson, Robert W.; Lubbers, Joyce H.; Gritz, Sheila; Reiss, John

2008-01-01

268

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

269

Seminar Program for Professional and Supervisory Health Care Personnel: Development and Evaluation.  

National Technical Information Service (NTIS)

The report covers the development, administration, and evaluation of a management seminar program for the U. S. Navy Medical Department. The program was one phase of broader scope project designed to analyze and evaluate the long-range educational and tra...

R. F. Cook C. P. Hahn D. L. Sheppard

1971-01-01

270

A Microcenter: Developing and Managing Distributed Processing in a Health Care Institution.  

ERIC Educational Resources Information Center

Describes development and utilization of microcomputer center at Nyack Hospital which decentralized information processing and implemented small-scale automation. Highlights include microcenter's role in: (1) training hospital staff in using database management; (2) providing advice, software/hardware evaluations, and purchasing assistance; and…

Heenan, Daniel J.

1985-01-01

271

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

Microsoft Academic Search

Of the 175 million people (2.9% of the world's population) living outside their country of birth in 2000, 65 million were economically active. The rise in the number of people migrating is significant for many developing countries because they are losing their better-educated nationals to richer countries. Medical practitioners and nurses represent a small proportion of the highly skilled workers

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

2004-01-01

272

Promoting Health Care to Infants and Toddlers in Child Day Care.  

National Technical Information Service (NTIS)

Project goals were to examine the total health care of children under the age of 3 years in group settings and to develop a model program that would enhance the quality of health care for infants and toddlers in day care settings. At 12 selected sites, th...

J. Goclowski

1989-01-01

273

Point-of-care systems, informatics, and health care delivery.  

PubMed

Evolving information technology has had profound effects on business operations and the marketplace. The health care services industry, particularly hospitals, clinics, and medical offices, has historically lagged behind other industries in the implementation of comprehensive, integrated, computerized data management tools. Health care reformers are looking to the promises of the information technology "revolution" as a means of improving systemic efficiency and health care quality. This study discusses the impact of informatics, or information technology, on the delivery of health care services. We present the evolution of informatics and the predicted future benefits of integrated computerized patient records and point-of-care systems. PMID:10162811

Montoya, I D; Carlson, J W

1996-12-01

274

Feasibility of National Surveillance of Health-Care-Associated Infections in Home-Care Settings  

PubMed Central

This article examines the rationale and strategies for surveillance of health-care-associated infections in home-care settings, the challenges of nonhospital-based surveillance, and the feasibility of developing a national surveillance system.

Manangan, Lilia P.; Pearson, Michele L.; Tokars, Jerome I.; Miller, Elaine

2002-01-01

275

The Emerging Imperative for Health Care  

Microsoft Academic Search

There are widespread and growing concerns about the variable and too often inadequate quality of health care in the United States. As a result, health care quality is being questioned and subjected to scrutiny as never before. Awareness of the quality deficits, combined with rising health care expenditures and changing attitudes of payers and consumers, has given rise to a

Kenneth W. Kizer

276

Special Health Care Procedures in the Schools.  

ERIC Educational Resources Information Center

A study of 147 school districts in Georgia examined the extent to which special health care procedures are performed in a school setting, the involvement of teachers performing special health care procedures, training and supervision issues, and the availability of written procedures. Results found teachers performed health care procedures more…

Heller, Kathryn Wolff; And Others

1997-01-01

277

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

278

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

279

Satisfaction with Health Care among Latinas  

PubMed Central

Despite growing interest in disparities in access to health care, relatively little is known about different facets of care among Latinas, their satisfaction with the care they receive, and the predictors of satisfaction. This study examined whether various health care access and context factors, the quality of the patient-physician interaction, and medical mistrust predict satisfaction with health care among Latina immigrants in New York City. Structured interviews were conducted with 220 Latinas predominantly from the Dominican Republic and aged 40 years or over. Of the access to health care variables examined, greater waiting time predicted dissatisfaction with health care. Greater quality of the patient-physician interaction predicted less dissatisfaction. The effect of the patient-physician interaction on dissatisfaction was mediated, in part, by waiting time. The results illustrate the important role of specific health care factors in satisfaction with care.

Abraido-Lanza, Ana F.; Cespedes, Amarilis; Daya, Shaira; Florez, Karen R.; White, Kellee

2013-01-01

280

[Costs of maternal-infant care in an institutionalized health care system].  

PubMed

Partial and total maternal and child health care costs were estimated. The study was developed in a Primary Care Health Clinic (PCHC) and a General Hospital (GH) of a social security health care system. Maternal and child health care services, type of activity and frequency utilization during 1995, were defined; cost examination was done separately for the PCHC and the GH. Estimation of fixed cost included departmentalization, determination of inputs, costs, basic services disbursements, and weighing. These data were related to depreciation, labor period and productivity. Estimation of variable costs required the participation of field experts; costs corresponded to those registered in billing records. The fixed cost plus the variable cost determined the unit cost, which multiplied by the of frequency of utilization generated the prenatal care, labor and delivery care, and postnatal care cost. The sum of these three equaled the maternal and child health care cost. The prenatal care cost was $1,205.33, the labor and delivery care cost was $3,313.98, and the postnatal care was $559.91. The total cost of the maternal and child health care corresponded to $5,079.22. Cost information is valuable for the health care personnel for health care planning activities. PMID:9528219

Villarreal Ríos, E; Salinas Martínez, A M; Guzmán Padilla, J E; Garza Elizondo, M E; Tovar Castillo, N H; García Cornejo, M L

1998-01-01

281

Empowering women and health care.  

PubMed

Women health workers have made great contributions to the health of their community for many years. In India, women physicians have established some hospitals, e.g., Christian Medical Colleges in Ludhiana and Vellore. Some such hospitals operate in remote areas to serve the poor and the suffering. Women health workers of Jamkhed, Deen Bandhu of Pachod, have proved that village women can improve the health status of their community, particularly that of women and children, if they receive encouragement to learn health care skills In India, community health care lies mainly with women (e.g., nursing personnel and in rural areas). Yet, despite their competence and experience, few become physicians, health project directors, and administrators because the society continues to be patriarchal and discriminates against females. Women need to become empowered to ensure equal opportunities for training and promotion and equal wages for equal work. In Bangladesh, use of bicycles to visit houses allows women paramedical workers from Gonasasthya Kendra, Sawar, freedom and imparts confidence. People must identify customs, practices, laws, attitudes, religious misrepresentations, and policies that discriminate against women and then oppose them. They should set these changes in motion at home, in villages, and from district to national, and even global levels. In India, society blames the mother for having a girl, but the man donates the chromosome determining sex. In Gandhigram, a woman physician and her peers have effected an apparent change in attitude toward the birth of a girl. Now the people confer equal happiness to her birth as they do to a boy's birth. Yet, female infanticides still occur in some villages of Salem District of Tamil Nadu. Sex determination tests often lead to abortion of female fetuses. Once a woman marries she has no right to her maternal home and often suffers from domestic violence. Many people resist legislation to grant women more rights, e.g., property rights. Various media promote women's empowerment. PMID:12286352

Shiva, M

1993-02-01

282

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

283

Public Perceptions Of Private Health Care In Socialist China China's burgeoning private health care sector holds both promises and perils  

Microsoft Academic Search

We present the findings of a United Nations Development Programme-World Health Organization study commissioned by China's Ministry of Health on use of public and private ambulatory care services in three Chinese provinces. We found much unmet medi- cal need (16 percent), attributed mainly to the perceived high cost of care. Seventy-one per- cent had no health insurance (90 percent in

Meng-Kin Lim; Hui Yang; Tuohong Zhang; Wen Feng; Zijun Zhou

284

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.

Starfield, Barbara; Shi, Leiyu; Macinko, James

2005-01-01

285

Financing Primary Health Care: Experiences in Pharmaceutical Cost Recovery.  

National Technical Information Service (NTIS)

Substantial country and donor efforts in recent years have been directed toward the development and implementation of child survival, primary health care, and maternal health services. Concern is now being focussed on how to best ensure the sustainability...

R. B. Blakney J. I. Litvack J. D. Quick

1989-01-01

286

Health in Day Care: A Manual for Health Professionals.  

ERIC Educational Resources Information Center

Addressed especially to community pediatricians, but also useful to other health workers, this manual discusses aspects of day care that require a physician's attention. Chapter I historically traces the positive effect of a nurturing environment upon the development of the infant and child, covering the period from the early 1900s to the present.…

Deitch, Selma R., Ed.

287

The demand for private health care under national health insurance  

Microsoft Academic Search

This study explores the demand for private health care and supplemental health insurance in Israel, where universal national health insurance provides all inhabitants with a standard package of medical care. Our theoretical model and empirical study follow research previously conducted in four other countries. It was found that the self-employed in Israel demand more private health services and supplemental health

Y. Machnes

2006-01-01

288

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

289

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.

290

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

291

[The role of nursing in primary health care].  

PubMed

The Role of Nursing in Primary Health Care. In this brief review the existing health trends are described and the risk factors related to lifestyles, the environment and the socioeconomic development are mentioned. Strategies and actions contributing to development of effective nursing leadership are emphasized and the nurses' leading role in preparing the changes for primary health care and the achievement "Health for All by the year 2000" are stressed. PMID:2378667

Plati, Ch

1990-01-01

292

['European primary care': a visionary report of the Dutch Health Council on primary health care in the European Union].  

PubMed

Although the agenda of the European Union (EU) does not directly provide for it, it seems reasonable to assume that due to the process of European social and economic integration there will be mounting pressure on the presently widely differing systems for primary care to move towards a more uniform orientation. In 2004, during its rotating presidency of the EU, the Dutch government asked its Health Council for advice on the current level of knowledge with regard to the organisation and significance of primary care. The Council formulated a set of key recommendations for the future development of primary care in Europe. The Council defines primary care as: generalist care, consisting of general medical, paramedical and pharmaceutical care, nursing and supportive care and non-specialised mental and social health care together with preventive and health educational activities linked to these forms of care. This care is for all health problems, is aimed at ambulatory patients, and is delivered close to the patients' homes. It is easily accessible to all, and provides emergency care when necessary. The main differences in the provision of primary care between countries in Europe concern the presence or absence of registration with a general practitioner and the gate-keeper role of primary care. International comparative research has identified the presence of precisely these features as predictors of better health outcomes in terms of morbidity and mortality. They therefore form a prominent role in the key recommendations, which state, among other things, that a patient should choose a primary-care team in the context of an integrated care circuit, thereby giving up his or her freedom to select care givers outside that circuit, in the interest of quality continuity and the efficiency of care. Other key recommendations are: close cooperation between primary-care teams, preventive services and public health and occupational health, a transparent provision on information between all providers of care, and the creation of a European Center for primary-care development. PMID:15932132

Thomas, S

2005-05-14

293

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

294

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

295

A telemedicine health care delivery system  

NASA Technical Reports Server (NTRS)

The Interactive Telemedicine Systems (ITS) system was specifically developed to address the ever widening gap between our medical care expertise and our medical care delivery system. The frustrating reality is that as our knowledge of how to diagnose and treat medical conditions has continued to advance, the system to deliver that care has remained in an embryonic stage. This has resulted in millions of people being denied their most basic health care needs. Telemedicine utilizes an interactive video system integrated with biomedical telemetry that allows a physician at a base station specialty medical complex or teaching hospital to examine and treat a patient at multiple satellite locations, such as rural hospitals, ambulatory health centers, correctional institutions, facilities caring for the elderly, community hospital emergency departments, or international health facilities. Based on the interactive nature of the system design, the consulting physician at the base station can do a complete history and physical examination, as if the patient at the satellite site was sitting in the physician's office. This system is described.

Sanders, Jay H.

1991-01-01

296

On reducing information asymmetry in U.S. health care.  

PubMed

Information asymmetry is a significant issue facing the U.S. health care system. In this article, we investigate some methods of reducing this asymmetry. We trace the information asymmetry using the "wicked problem" of the health care distribution system. An information asymmetry reduction method requiring joint responsibilities among health care stakeholders is developed. It is argued that information asymmetry is a contributor to enormous health care inflation. Hence, any reduction in such asymmetry will reduce health care costs. Concepts from both signaling and corrective justice theories are integrated in this article to help reduce the information asymmetry that exists in the U.S. health care system. Getting health care costs in line with other "advanced" nations, is the long-term solution to the wicked problem that currently exists in the U.S. health care system. There is an immediate need for a centralized health care database with adequate provisions for individual privacy. Both processes as well as an outcome-based control system are essential for reducing information asymmetries in the U.S. health care system. PMID:24308415

Mascarenhas, Oswald A J; Kesavan, Ram; Bernacchi, Michael D

2013-01-01

297

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

Microsoft Academic Search

Health care is one of the most prominent areas for the application of wireless technologies. New services and applications are today under research and development targeting different areas of health care, from high risk and chronic patients’ remote monitoring to mobility tools for the medical personnel. In this direction the MobiHealth project developed and trailed a system and a service

Katarzyna Wac; Richard Bults; Dimitri Konstantas; Halteren van Aart; Val Jones; Ing Widya; Rainer Herzog

2004-01-01

298

Adult care transitioning for adolescents with special health care needs: a pivotal role for family centered care.  

PubMed

To examine the relationship between having a usual source of care, family centered care, and transition counseling for adolescents with special health care needs. Data are from 18,198 parents/guardians, of youth aged 12-17 years, who participated in the 2005-2006 National Survey of Children With Special Health Care Needs. Linear and logistic regression models were used to define relationships between parent report of identification of a usual place and provider of medical care for their child and counseling on four transition issues: transfer to adult providers, review of future health needs, maintaining health insurance in adulthood, and youth taking responsibility for care. The direct mediating effect of family centered care was evaluated. Youth having a usual source of care (vs. not) were more likely to receive counseling on future health needs (47.4 vs. 33.6%, P < 0.001) and taking responsibility for their own care (79.3 vs. 64.4%, P < 0.001). Having a high level of family centered care (vs. low) was also associated with high rates of discussing future health needs (56.3 vs. 39.6%, P < 0.001) and encouragement to take responsibility for care (91.2 vs. 70.3%, P < 0.001). Family centered care mediated 39.1% of the effect of a usual source of care on discussion of future health needs and 94.9% of the effect of a usual source of care on encouragement to take responsibility for care. Study findings support the development of health care delivery models focusing on family centered care to the same degree as other health care access issues. PMID:20012347

Duke, Naomi N; Scal, Peter B

2011-01-01

299

Paid Sick Days and Health Care Use  

PubMed Central

Background In identifying factors of health care use, past research has focused on individual-level characteristics or on the health care system itself. This study investigates whether access to paid sick days, an amenable environmental factor outside the health care system, is associated with primary and emergency care use. Methods A nationally representative sample of 14,302 U.S. working adults extracted from the 2007 National Health Interview Survey data was used. Multiple logistic regressions were performed, controlling for demographic variables, health conditions and status, and access to health care. Results Workers with lower socioeconomic status, poorer health status, or without health insurance or regular places for care were more likely to lack paid sick leave than higher-status workers. For all U.S. working adults, access to paid sick days benefits was significantly associated with increased use of outpatient care but not with reduced use of ER. For U.S. working adults with health insurance coverage, access to paid sick days benefits was significantly associated with increased use of outpatient care and reduced use of emergency care. Conclusions A public policy mandating paid sick days may help facilitate timely access to primary care, reduce avoidable emergency care use, and reduce health disparities among workers.

Cook, Won Kim

2011-01-01

300

Physicians’ utilization of health care  

Microsoft Academic Search

OBJECTIVE: To describe how physicians attend to their own health care needs.\\u000a \\u000a \\u000a SETTING: Rhode Island.\\u000a \\u000a \\u000a \\u000a \\u000a PARTICIPANTS: A random sample of Blue Cross\\/Blue Shield providers. The 306 respondents (67% of 458) primarily (92%) had MD or DO degrees.\\u000a The nonphysician providers were chiropractors, dentists, optometrists, and podiatrists.\\u000a \\u000a \\u000a \\u000a \\u000a DESIGN: A mailed survey provided data describing the respondents’ medical conditions and utilization of

Tom J. Wachtel; Victoria L. Wilcox; Anne W. Moulton; Dominick Tammaro; Michael D. Stein

1995-01-01

301

Teaching primary health care: a comprehensive approach.  

PubMed

The MEDEX Primary Health Care Series, an integrated training system for everyone in primary care (PHC), was published in 1983. It is now used in over 70 countries and has demonstrated its value in the developing world. The Series lays considerable emphasis on the crucial link between the performance of health workers and the management support with which they are provided. It was the result of 10 years of development and field testing. The Series is so widely employed because its development involved health centers and health workers associated in PHC programs in Guyana, Lesotho, Micronesia, Pakistan, and Thailand. It also addresses everyday problems and provides pragmatic solutions which PHC programs can apply. Attention is given to the development of skills in health workers, using a competency-based methodology, in contrast to the concentration on knowledge acquition found in more conventional training programs. Training activities are detailed for as little as 15 minutes at a time in courses lasting 6-15 months. Dialogic methods are used for the more peripheral workers who may not be literate. Management is given systematic, practical treatment. The Series advocates disease prevention and health promotion and helps to train health workers to diagnose an treat the most common clinical problems. It can be used to strengthen existing programs or to start new ones. It has a consistent formant, facilitating local adaption. Any part of the Series can be copied or reproduced for noncommercial purposes without persmission from the publisher. The Series is based on the realistic and pragmatic organization of health care delivery systems found in most countries and places great importance on the use of health center presonnel to orientate and link resources at the center to needs at the periphery. Nurses, the health center person at the middle level of the PHC, often fulfills the role of trainer and supervisor of the community health worker. The diagnostic, curative and community health skills in the Series are consistent with the expanding role of nursing in PHC. The Series is published in English but also available in a mini-edition in Spanish with increasing interest in a French translation. Various sections have been translated into 21 other languages. A newsletter and a network of series users (MEDINET) has been established. PMID:3252832

Smith, R A; Mehra, S; Devereaux, M O; Rich, J

1988-01-01

302

[Elderly care in the supplementary health system].  

PubMed

The purpose of this study was to identify and analyze the assistance provided to the elderly by the supplementary health care system. Information was collected from interviews with managers of chronic diseases management programs and/or of specific programs in this area. Information was organized in cases and analyzed. Eleven companies operating private health plans in the cities of Rio de Janeiro and Sao Paulo were investigated. A general care model for the elderly was defined for the analysis. This model consists in a proposal for a care and assistance system hierarchically organized according to the deterioration of the functional capacity of the elderly (levels of dependence). None of the six companies that had health plans for the elderly already implemented provided full assistance to all enrolled seniors. There are major differences in the stage of development of their programs. Four companies had already implemented plans and two companies had plans in development. Even with the teams of managers and professionals working on some level within the advocated model, none of these companies followed any logic of integrated care and monitoring in all stages of the ageing process in accordance with the degree of dependence of the associate. PMID:18813610

Veras, Renato Peixoto; Caldas, Célia Pereira; Araújo, Denizar Viana; Mendes, Rosana Kuschniere Walter

2008-01-01

303

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

304

Consumer-directed health care: implications for health care organizations and managers.  

PubMed

This article uses a pyramid model to illustrate the key components of consumer-directed health care. Consumer-directed health care is considered the essential strategy needed to lower health care costs and is valuable for making significant strides in health care reform. Consumer-directed health care presents new challenges and opportunities for all health care stakeholders and their managers. The viability of the health system depends on the success of managers to respond rapidly and with precision to changes in the system; thus, new and modified roles of managers are necessary to successfully sustain consumerism efforts to control costs while maintaining access and quality. PMID:20436329

Guo, Kristina L

2010-01-01

305

The challenges of developing an instrument to assess health provider motivation at primary care level in rural Burkina Faso, Ghana and Tanzania  

PubMed Central

Background The quality of health care depends on the competence and motivation of the health workers that provide it. In the West, several tools exist to measure worker motivation, and some have been applied to the health sector. However, none have been validated for use in sub-Saharan Africa. The complexity of such tools has also led to concerns about their application at primary care level. Objective To develop a common instrument to monitor any changes in maternal and neonatal health (MNH) care provider motivation resulting from the introduction of pilot interventions in rural, primary level facilities in Ghana, Burkina Faso, and Tanzania. Design Initially, a conceptual framework was developed. Based upon this, a literature review and preliminary qualitative research, an English-language instrument was developed and validated in an iterative process with experts from the three countries involved. The instrument was then piloted in Ghana. Reliability testing and exploratory factor analysis were used to produce a final, parsimonious version. Results and discussion This paper describes the actual process of developing the instrument. Consequently, the concepts and items that did not perform well psychometrically at pre-test are first presented and discussed. The final version of the instrument, which comprises 42 items for self-assessment and eight for peer-assessment, is then shown. This is followed by a presentation and discussion of the findings from first use of the instrument with MNH providers from 12 rural, primary level facilities in each of the three countries. Conclusions It is possible to undertake work of this nature at primary health care level, particularly if the instruments are kept as straightforward as possible and well introduced. However, their development requires very lengthy preparatory periods. The effort needed to adapt such instruments for use in different countries within the region of sub-Saharan Africa should not be underestimated.

Prytherch, Helen; Leshabari, Melkidezek T.; Wiskow, Christiane; Aninanya, Gifty A.; Kakoko, Deodatus C.V.; Kagone, Moubassira; Burghardt, Juliane; Kynast-Wolf, Gisela; Marx, Michael; Sauerborn, Rainer

2012-01-01

306

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.

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

2011-01-01

307

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.

2011-01-01

308

Patient care information systems and health care work: a sociotechnical approach  

Microsoft Academic Search

Those who face the difficulties of developing useful patient care information systems (PCISs) often stress the importance of ‘organizational issues’. Building upon recent sociological insights in the construction and use of information technologies for (health care) work, this paper underscores the importance of these insights for the development and evaluation of these systems. A sociotechnical approach to PCISs in health

Marc Berg

1999-01-01

309

Review of the Naval Health Research Center's development of medical information systems for far-forward echelons of care, 1983 to 1997.  

PubMed

Medical treatment information must be gathered quickly and accurately to ensure continuity of care at far-forward echelons. The manual documentation methods in use during the Vietnam War revealed the need for considerable improvements in medical information documentation, patient tracking, and effective transfer of data throughout each of the first three echelons of care. The U.S. military determined that automation would result in the greatest enhancement of documentation techniques. The Naval Health Research Center (NHRC) has been an integral part of the development of medical information systems for the Navy's far-forward echelons of care. The prototypes designed by NHRC for echelons I and II can successfully raise the standard of treatment while simultaneously reducing the number of individuals needed for administrative duties and increasing the number of medical staff available for patient care. An overview of NHRC's work in medical information systems from 1983 to 1997 is presented. PMID:11469041

Tropeano, A M; Pugh, W M

2001-07-01

310

Dual Loyalty in Prison Health Care  

PubMed Central

Despite the dissemination of principles of medical ethics in prisons, formulated and advocated by numerous international organizations, health care professionals in prisons all over the world continue to infringe these principles because of perceived or real dual loyalty to patients and prison authorities. Health care professionals and nonmedical prison staff need greater awareness of and training in medical ethics and prisoner human rights. All parties should accept integration of prison health services with public health services. Health care workers in prison should act exclusively as caregivers, and medical tasks required by the prosecution, court, or security system should be carried out by medical professionals not involved in the care of prisoners.

Stover, Heino; Wolff, Hans

2012-01-01

311

[Reducing fragmentation in the care of frail older people: the successful development and implementation of the Health and Welfare Information Portal].  

PubMed

Our fragmented health care systems are insufficiently equipped to provide frail older people with high quality of care. Therefore, we developed the Health and Welfare Information Portal (ZWIP), an e-health intervention which aims (1) to facilitate self-management by frail older people and informal caregivers and (2) to improve collaboration among professionals. The ZWIP is a personal conference table, accessible through a secure internet connection, for multidisciplinary communication and information exchange for frail older people, their informal caregivers and professionals. After development, the ZWIP was implemented in seven general practices, and this process was evaluated by means of a mixed-methods study. Eventually, 290 frail older people and 169 professionals participated in the ZWIP. Most professionals were positive about its implementation. Facilitators for the implementation were the experienced need for improvement of interprofessional collaboration and the user-friendliness of the ZWIP. Barriers were the low computer-literacy of frail older people, start-up problems, preferring personal contact, and limited use of the ZWIP by other professionals. In sum, this article describes the successful development and implementation of the ZWIP, an e-health intervention which can reduce fragmentation in the care of frail older people. PMID:23494689

Robben, S H M; Heinen, M M; Makai, P; Olde Rikkert, M G M; Perry, M; Schers, H J; Melis, R J F

2013-04-01

312

Tuberculosis among health care workers.  

PubMed

To assess the annual risk for latent tuberculosis infection (LTBI) among health care workers (HCWs), the incidence rate ratio for tuberculosis (TB) among HCWs worldwide, and the population-attributable fraction of TB to exposure of HCWs in their work settings, we reviewed the literature. Stratified pooled estimates for the LTBI rate for countries with low (<50 cases/100,000 population), intermediate (50-100/100,000 population), and high (>100/100,000 population) TB incidence were 3.8% (95% confidence interval [CI] 3.0%-4.6%), 6.9% (95% CI 3.4%-10.3%), and 8.4% (95% CI 2.7%-14.0%), respectively. For TB, estimated incident rate ratios were 2.4 (95% CI 1.2-3.6), 2.4 (95% CI 1.0-3.8), and 3.7 (95% CI 2.9-4.5), respectively. Median estimated population-attributable fraction for TB was as high as 0.4%. HCWs are at higher than average risk for TB. Sound TB infection control measures should be implemented in all health care facilities with patients suspected of having infectious TB. PMID:21392441

Baussano, Iacopo; Nunn, Paul; Williams, Brian; Pivetta, Emanuele; Bugiani, Massimiliano; Scano, Fabio

2011-03-01

313

Health changes in Sri Lanka: benefits of primary health care and public health.  

PubMed

The Democratic Socialist Republic of Sri Lanka is an island in the Indian Ocean that has achieved a unique status in the world with health indicators that are comparable with those of developed countries. This is illustrated, among others, by the reduction in both child and maternal mortality in the country. This achievement is the result of a range of long-term interventions, including providing education and health care free of charge, training of health care workers, developing public health infrastructure in rural areas, and adopting steps to improve sanitation, nutrition, and immunization coverage. PMID:22815304

Karunathilake, Indika Mahesh

2012-07-01

314

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

315

Knowledge and Attitudes of Health Care Providers Working in Primary Health Care Units Concerning Emergency Contraception  

Microsoft Academic Search

Aims: The aim of the current study was to explore the extent of knowledge health care providers working in primary health care units in Aydin, Turkey, had about emergency contraception (EC), to determine whether they provide EC counseling, and to understand the barriers and misconceptions in this context. Methods: A total of 120 health care professionals working in primary health

Hilmiye Aksu; Mert Kucuk; Banu Karaoz

2010-01-01

316

Rx for Rising Health Care Premiums.  

ERIC Educational Resources Information Center

Strategies for containing the cost of providing health insurance for college employees include cost sharing with employees, cost reduction through options such and managed care, incentives for use of health maintenance organizations, offering health care alternatives, and entering into multiple-employer purchasing groups. (MSE)

Younger, Sandra Millers

1990-01-01

317

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

318

Keynote Address: The Health Care Environment.  

ERIC Educational Resources Information Center

An address to dental school deans looks at anticipated changes in the health care system, the public sector's changing role in health care, and draws implications for dentistry. It is suggested that academic health centers, and especially dental schools, will be particularly affected by these trends. (MSE)

Wilensky, Gail

1996-01-01

319

Selecting Performance Indicators for Prison Health Care  

Microsoft Academic Search

Improving prison health care requires a robust measurement dashboard that addresses multiple domains of care. We sought to identify tested indicators of clinical quality and access that prison health managers could use to ascertain gaps in performance and guide quality improvement. We used the RAND\\/UCLA modified Delphi method to select the best indicators for correctional health. An expert panel rated

Steven M. Asch; Cheryl L. Damberg; Liisa Hiatt; Stephanie S. Teleki; Rebecca Shaw; Terry E. Hill; Rhondee Benjamin-Johnson; David P. Eisenman; Sonali P. Kulkarni; Emily Wang; Brie Williams; Ambeshie Yesus; Corita R. Grudzen

2011-01-01

320

Refugee health: a new model for delivering primary health care.  

PubMed

Providing health care to newly arrived refugees within the primary health care system has proved challenging. The primary health care sector needs enhanced capacity to provide quality health care for this population. The Primary Care Amplification Model has demonstrated its capacity to deliver effective health care to patients with chronic disease such as diabetes. This paper describes the adaption ofthe model to enhance the delivery ofhealth care to the refugee community. A 'beacon' practice with an expanded clinical capacity to deliver health care for refugees has been established. Partnerships link this practice with existing local general practices and community services. Governance involves collaboration between clinical leadership and relevant government and non-government organisations including local refugee communities. Integration with tertiary and community health sectors is facilitated and continuing education of health care providers is an important focus. Early incorporation of research in this model ensures effective feedback to inform providers of current health needs. Although implementation is currently in its formative phase, the Primary Care Amplification Model offers a flexible, yet robust framework to facilitate the delivery of quality health care to refugee patients. PMID:21133306

Kay, Margaret; Jackson, Claire; Nicholson, Caroline

2010-01-01

321

Integration of Medical and Psychological Treatment within the Primary Health Care Setting  

Microsoft Academic Search

Integrated care entails the provision of behavioral health services within the primary care setting and emphasizes a collaborative approach between mental health professionals and primary care providers (Kenkel, Deleon, Orabona Mantell, Steep, 2005). Research was collected to highlight the history, development, and implementation of integrated care within primary care facilities. The authors performed a comprehensive literature review of collaborative care

Cristine E. Hine; Heather B. Howell; Kimberly A. Yonkers

2008-01-01

322

Psychology Can Be Indispensable to Health Care Reform and the Patient-Centered Medical Home  

Microsoft Academic Search

The Patient Protection and Affordable Care Act (PPACA) was passed into legislation in March 2010, making health care reform a reality. Perhaps the most well-developed model of primary care that aligns with the PPACA's agenda is the patient-centered medical home (PCMH). Integrated care, as defined by collaborative care between mental health and primary care providers and systems, will undoubtedly play

Christine N. Runyan

2011-01-01

323

Appropriate Perspectives for Health Care Decisions  

Microsoft Academic Search

NICE uses cost-effectiveness analysis to compare the health benefits expected to be gained by using a technology with the health that is likely to be forgone due to additional costs falling on the health care budget and displacing other activities that improve health. This approach to informing decisions will be appropriate if the social objective is to improve health, the

Karl Claxton; Simon Walker; Steven Palmer; Mark Sculpher

2010-01-01

324

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

325

Health Care Experiment at Many Farms  

ERIC Educational Resources Information Center

Describes an experimental program of health care for a Navajo community, and discusses the use of personal physician care where a para-medical referral system may have been more technologically efficient. (AL)

McDermott, Walsh; And Others

1972-01-01

326

Social Antecedents of Learned Helplessness in the Health Care Setting.  

ERIC Educational Resources Information Center

Examines social factors that lead to the development of learned helplessness in elderly persons in the health care setting, including stereotyping elderly by health care professionals, effects of unequal interpersonal exchange, and behaviors associated with sick and healer roles. Discusses programatic and educational prophylaxis and solutions to…

Solomon, Kenneth

1982-01-01

327

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

328

Mapping competencies for the multiskilled health care professional: an allied health curriculum reform project.  

PubMed

Health care organizations increasingly face the pressures of meeting the needs of patients while responding to the financial pressures of cost containment and quality optimization. One strategy that health care providers use to adapt to the changing environment is multiskilling. Multi-skilled health care technicians are trained to perform multiple tasks so that they can be deployed more efficiently within health care organizations. Multiskilling can provide numerous benefits to providers, organizations, and patients, but appropriate training for such individuals is critical. The Multiskilled Competencies Development Project was initiated to identify professional standards for entry-level multi-skilled health care technicians. The project was designed to meet the training needs of multiskilled workers through improved allied health curricula. The results of the DACUM (Developing a Curriculum) competency profile for multiskilled health care technicians are presented. PMID:16529180

Sherrill, Windsor W; Keels-Williams, Frankie

2005-01-01

329

Sustainable medicines and global health care.  

PubMed

The global population has now exceeded 7 billion, and forests and other resources around the world are being irreversibly depleted for energy, food, shelter, material goods, and drugs to accommodate population needs. For most of the world's population, plants, based on many well-established systems of medicine, in either crude or extract form, represent the foundation of primary health care for the foreseeable future. Contemporary harvesting methods for medicinal plants are severely depleting these critical indigenous resources. However, maintaining and enhancing the availability of quality medicinal agents on a sustainable basis is an unappreciated public health care concept. To accomplish these goals for future health care, and restore the health of the Earth, a profound paradigm shift is necessary: ALL medicinal agents should be regarded as a sustainable commodity, irrespective of their source. Several approaches to enhancing the availability of safe and efficacious plant-based medicinal agents will be presented including integrated strategies to manifest the four pillars (information, botany, chemistry, and biology) for medicinal plant quality control. These integrated initiatives involve information systems, DNA barcoding, metabolomics, biotechnology, nanotechnology, in-field analysis of medicinal plants, and the application of new detection techniques for the development of medicinal plants with enhanced levels of safe and reproducible biological agents. PMID:21308611

Cordell, Geoffrey A

2011-07-01

330

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

331

Future delivery of health care: Cybercare  

Microsoft Academic Search

Health-care system reforms can change the structure of the current U.S. health-care system, from centralized large hospitals to a distributed, networked healthcare system. In our model, medical care is delivered locally in neighborhoods and individual homes, using computer technologies like telemedicine, to link patients and primary care providers to tertiary medical providers. This decentralization could reduce costs enough to provide

C. EVERETT KOOP; ROBYN MOSHER; LUIS KUN; JIM GEILING; ELIOT GRIGG; SARAH LONG; RONALD C. MERRELL; RICHARD SATAVA; JOSEPH M. ROSEN

2008-01-01

332

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

333

A Study on a Home Health Care Support Information System for Health Evaluation  

Microsoft Academic Search

The need for home health care has been increasing in Japan and the application of various techniques such as medical informatics are desired to support home health care services. Therefore, we developed an information system for health evaluation of the elderly including patients at home by applying a multifunctional telephone set and an IC memory card, by which complaints, symptoms,

H. Inada; H. Horio; K. Nakazawa; Y. Sekita; T. Yamanaka; E. Harasawa; H. Hosaka; K. Ishikawa

1998-01-01

334

Impact of technology in health care and health administration: hospitals and alternative care delivery systems.  

PubMed

Applications as outlined above and many more that have not yet even been identified--but that will be invented and developed--will have an enormous impact on the health care industry. Clearly, capital requirements to purchase this technology will go up and thus exert further pressure for the reduction of personnel. Computers and robots will replace a significant percentage of health care personnel; overall health care costs as a percent of gross national product will nevertheless probably continue to rise in spite of improvements in productivity. Added costs will be offset in part by the use of technology in areas that will impact efficiency. Because of these accelerating uses of sophisticated technology, future administrators will have a greater appreciation for what technology can offer. Practical uses of robotics, expert systems, and artificial intelligence will require administrators to be technologically proficient. PMID:10103712

Kerr, J K; Jelinek, R

1990-01-01

335

Public Policy and Primary Health Care: Issues and Recommendations Report of the Health Advisory Council Primary Care Task Force.  

National Technical Information Service (NTIS)

Primary health care was the focus of a 1980 task force which examined the provision of accessible, affordable, and high-quality care to all New York residents. The task force studied methods for planning, developing, financing, and regulating primary care...

1981-01-01

336

Spirulina in health care management.  

PubMed

Spirulina is a photosynthetic, filamentous, spiral-shaped and multicellular edible microbe. It is the nature's richest and most complete source of nutrition. Spirulina has a unique blend of nutrients that no single source can offer. The alga contains a wide spectrum of prophylactic and therapeutic nutrients that include B-complex vitamins, minerals, proteins, gamma-linolenic acid and the super anti-oxidants such as beta-carotene, vitamin E, trace elements and a number of unexplored bioactive compounds. Because of its apparent ability to stimulate whole human physiology, Spirulina exhibits therapeutic functions such as antioxidant, anti-bacterial, antiviral, anticancer, anti-inflammatory, anti-allergic and anti-diabetic and plethora of beneficial functions. Spirulina consumption appears to promote the growth of intestinal micro flora as well. The review discusses the potential of Spirulina in health care management. PMID:18855693

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

2008-10-01

337

Health psychology in primary care: recent research and future directions.  

PubMed

Over the last decade, research about health psychology in primary care has reiterated its contributions to mental and physical health promotion, and its role in addressing gaps in mental health service delivery. Recent meta-analyses have generated mixed results about the effectiveness and cost-effectiveness of health psychology interventions. There have been few studies of health psychology interventions in real-world treatment settings. Several key challenges exist: determining the degree of penetration of health psychology into primary care settings; clarifying the specific roles of health psychologists in integrated care; resolving reimbursement issues; and adapting to the increased prescription of psychotropic medications. Identifying and exploring these issues can help health psychologists and primary care providers to develop the most effective ways of applying psychological principles in primary care settings. In a changing health care landscape, health psychologists must continue to articulate the theories and techniques of health psychology and integrated care, to put their beliefs into practice, and to measure the outcomes of their work. PMID:22114536

Thielke, Stephen; Thompson, Alexander; Stuart, Richard

2011-01-01

338

Health psychology in primary care: recent research and future directions  

PubMed Central

Over the last decade, research about health psychology in primary care has reiterated its contributions to mental and physical health promotion, and its role in addressing gaps in mental health service delivery. Recent meta-analyses have generated mixed results about the effectiveness and cost-effectiveness of health psychology interventions. There have been few studies of health psychology interventions in real-world treatment settings. Several key challenges exist: determining the degree of penetration of health psychology into primary care settings; clarifying the specific roles of health psychologists in integrated care; resolving reimbursement issues; and adapting to the increased prescription of psychotropic medications. Identifying and exploring these issues can help health psychologists and primary care providers to develop the most effective ways of applying psychological principles in primary care settings. In a changing health care landscape, health psychologists must continue to articulate the theories and techniques of health psychology and integrated care, to put their beliefs into practice, and to measure the outcomes of their work.

Thielke, Stephen; Thompson, Alexander; Stuart, Richard

2011-01-01

339

Identification of Energy Issues in Health Care.  

National Technical Information Service (NTIS)

This report delineates significant issues that should be considered in order to achieve energy conservation in health care facilities. Comprehensive, factual, and practical solutions must be found for two reasons. First, escalating costs in both health ca...

R. Plunkett

1978-01-01

340

Coming Together To Cut Health Care Costs.  

ERIC Educational Resources Information Center

Describes how, through a shared plan, the Health Insurance Initiative of the Independent Colleges and Universities in Florida (ICUF) is saving participating institutions millions in costs associated with providing employee health care. (EV)

Heron, W. David; Donatelli, Ben

2003-01-01

341

Managed care and a process of integration in health care sector: A case study from Poland  

Microsoft Academic Search

The aim of the paper is to explore a causal nexus between contract type (financing rules and scale of responsibilities) and tendency towards integration between Polish health care providers. For more than 40 years Polish health care sector structures were fully integrated. The law introduced in 1991 initiated development of a system of contracts between public payer and the independent

Katarzyna Kowalska

2007-01-01

342

Trends in Health Care Cost Growth And The Role of the Affordable Care Act.  

National Technical Information Service (NTIS)

The Affordable Care Act (ACA) was passed against a backdrop of decades of rapid growth in health care spending in the United States. While much of this historical increase reflects the development of new treatments that have greatly improved health and we...

2013-01-01

343

Consumer-driven health care marketing.  

PubMed

In this article, a health care marketing executive takes an opposing view: That the consumer will not only continue to exercise choice but also, at annual renewal time, veto power. In part, that is because the consumers are feeling the rising cost of health care much more directly than in the past, through ever-higher premiums, deductibles and copayments. As they assumed more of the burden of medical care delivery, consumers are becoming more knowledgeable about and discriminating toward the health care system and provider plans they are offered. They understand--as does their employer--that no longer are all health care plans alike or at parity with each other. The consumer is also demanding greater access to freedom of provider choice, quality of health care coverage. PMID:10164646

Upton, R L

1997-01-01

344

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

345

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

346

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

347

Transferring patients to tertiary health care: the role of family and Primary Health Care Teams  

PubMed Central

Purpose One of the main problems of health systems is to ensure access and proper coordination between different health services. This problem is particularly felt when a patient is transferred from one level to another, especially for long-term care. Therefore, it is essential to develop new organizational models, which should meet user’s need. The primary Health Care (PHC) within the current Portuguese Primary Health Care Reform (PPHCR) could develop an important role, due to intrinsic innovative aspects associated with new governance model based on the development of a small family health multi-professional unit (USF) with functional and technical autonomy, integrated within a network with other functional units and the establishment of Health Center Clusters, producing meaningful healthcare delivered value. Theory Grounded on the health services utilization model of Dutton (1986) and on multidisciplinary assessment and decision-making model of Beckingham and Baumann (1990) for ageing families. Research question In the PPHCR context, how families experience the decision-making process of transferring an elderly relative with dementia? Research method An exploratory case study, with two embedded units of analysis (Ying 2003): families of the elderly with dementia and primary health care teams, Data were collected through semi-structured interviews and focus group. The data analysis was achieved through thematic content analysis (Bardin 2008) and descriptive statistical analysis with the support of computer program SPSS. See Figure 1 for the conceptual research model. Results Families who had shared their decision-making process with health care teams, recognize their fundamental role as mediator between the families and the complexity of the health and social system. The families, who had been followed up by the Primary Health Care Teams (PHCT), were more satisfied with their decision. However, there still exist some difficulties to address in order to benefit from a more integrated care: The communication between the different functional health units and health and social professionals is sometimes inadequate, with gaps, causing delays in response time, especially in crisis situations; Misunderstood and overlap competencies among team members; Different interpretations of referrals practices and clinical criteria to transferring patients. Restrict use of new technologies. Conclusions The PPHCR has been an opportunity to create innovation in healthcare delivering value, which is recognized through the families who had been accompanied by the Primary Health Care Teams. However, there still exist some problems, mainly associated to team-work, communication and the use of new technologies. To achieve an innovation culture of excellence it is fundamental the development by PHCT of integration competences and the capacity to introduce project-based approaches that would foster collaboration initiatives. Discussion What are the key integration competences that PHCT must domain?How can we measured the degree of health care delivery integration?

Joaquim, Filipa; Lapao, Luis

2012-01-01

348

45 CFR 162.406 - Standard unique health identifier for health care providers.  

Code of Federal Regulations, 2010 CFR

...unique health identifier for health care providers. 162.406 Section 162...Unique Health Identifier for Health Care Providers § 162.406 Standard unique health identifier for health care providers. (a) Standard....

2010-10-01

349

45 CFR 162.406 - Standard unique health identifier for health care providers.  

Code of Federal Regulations, 2010 CFR

...Standard unique health identifier for health care providers. 162.406 Section...Standard Unique Health Identifier for Health Care Providers § 162.406 Standard unique health identifier for health care providers. (a)...

2009-10-01

350

45 CFR 162.406 - Standard unique health identifier for health care providers.  

Code of Federal Regulations, 2013 CFR

...Standard unique health identifier for health care providers. 162.406 Section...Standard Unique Health Identifier for Health Care Providers § 162.406 Standard unique health identifier for health care providers. (a)...

2013-10-01

351

Female farmworkers' health during pregnancy: health care providers' perspectives.  

PubMed

Pregnant farmworkers and their fetuses are at increased risk of negative health outcomes due to environmental and occupational factors at their workplaces. Health care providers who serve farm communities can positively affect workers' health through the informed care they deliver. Yet, interviews with rural health care providers reveal limited knowledge about agricultural work or occupational and environmental health risks during pregnancy. Professional associations, government organizations, academic institutions, and practice settings must renew their efforts to ensure that environmental and occupational health education, especially as it relates to women and their children, is incorporated into academic and practice environments. PMID:23799657

Kelley, Maureen A; Flocks, Joan D; Economos, Jeannie; McCauley, Linda A

2013-07-01

352

Models of cancer survivorship health care: moving forward.  

PubMed

The population of cancer survivors in the United States and worldwide is rapidly increasing. Many survivors will develop health conditions as a direct or indirect consequence of their cancer therapy. Thus, models to deliver high-quality care for cancer survivors are evolving. We provide examples of three different models of survivorship care from a cancer center, a community setting, and a country-wide health care system, followed by a description of the ASCO Cancer Survivorship Compendium, a tool to help providers understand the various models of survivorship care available and integrate survivorship care into their practices in a way that fits their unique needs. PMID:24857078

Oeffinger, Kevin C; Argenbright, Keith E; Levitt, Gill A; McCabe, Mary S; Anderson, Paula R; Berry, Emily; Maher, Jane; Merrill, Janette; Wollins, Dana S

2014-01-01

353

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

Microsoft Academic Search

The coverage, cost, and quality problems of the U.S. health care system are evident. Sustainable health care reform must go beyond financing expanded access to care to substantially changing the organization and delivery of care. The FRESH-Thinking Project (www.fresh-thinking.org) held a series of workshops during which physicians, health policy experts, health insurance executives, business leaders, hospital administrators, economists, and others

K. Arrow; A. Auerbach; J. Bertko; L. P. Casalino; F. J. Crosson; A. Enthoven; E. Falcone; R. C. Feldman; V. R. Fuchs; A. M. Garber; M. R. Gold; D. A. Goldman; G. K. Hadfield; M. A. Hall; R. I. Horwitz; M. Hooven; P. D. Jacobson; T. S. Jost; L. J. Kotlikoff; J. Levin; S. Levine; R. Levy; K. Linscott; H. S. Luft; R. Mashal; D. McFadden; D. Mechanic; D. Meltzer; J. P. Newhouse; R. G. Noll; J. B. Pietzsch; P. Pizzo; R. D. Reischauer; S. Rosenbaum; W. Sage; L. D. Schaeffer; E. Sheen; B. N. Silber; J. Skinner; S. M. Shortell; S. O. Thier; S. Tunis; L. Wulsin Jr; P. Yock; G. B. Nun; S. Bryan; O. Luxenburg; Ven van de W. P. M. M; J. Cooper

2009-01-01

354

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.

Ellison-Loschmann, Lis; Pearce, Neil

2006-01-01

355

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.

Liu, Yuanli

2004-01-01

356

45 CFR 162.410 - Implementation specifications: Health care providers.  

Code of Federal Regulations, 2013 CFR

...Implementation specifications: Health care providers. 162.410 Section...Standard Unique Health Identifier for Health Care Providers § 162.410 Implementation specifications: Health care providers. (a) A covered...

2013-10-01

357

45 CFR 162.410 - Implementation specifications: Health care providers.  

Code of Federal Regulations, 2010 CFR

...Implementation specifications: Health care providers. 162.410 Section...Standard Unique Health Identifier for Health Care Providers § 162.410 Implementation specifications: Health care providers. (a) A covered...

2009-10-01

358

45 CFR 162.410 - Implementation specifications: Health care providers.  

Code of Federal Regulations, 2010 CFR

...Implementation specifications: Health care providers. 162.410 Section...Standard Unique Health Identifier for Health Care Providers § 162.410 Implementation specifications: Health care providers. (a) A covered...

2010-10-01

359

Health Training Needs of Child Care Professionals.  

ERIC Educational Resources Information Center

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

Caulfield, Rick; Kataoka-Yahiro, Merle

2001-01-01

360

Inquiries into health care: learning or lynching?  

Microsoft Academic Search

There is a spectrum of reasons for inquiries into health care: learning, catharsis, reassurance, and accountability. The tension is immediately obvious. Is the primary purpose learning or lynching? We need to learn from major health inquiries. New Zealand needs a culture of inquiry that encourages health professionals to discuss their concerns. We need mechanisms that enable health professionals to share,

Ron Paterson

361

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.

2012-01-01

362

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.

Kepros, John P; Opreanu, Razvan C

2009-01-01

363

Complementary and alternative health care in Israel.  

PubMed

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

Shuval, Judith T; Averbuch, Emma

2012-01-01

364

Managed behavioral health care premises, accountable systems of care, and AMBHA'S perms. American Managed Behavioral Healthcare Association.  

PubMed

This article discusses the concepts and approaches underlying managed behavioral health care and the need to assess quality of care. The author describes the Performance Measures for Managed Behavioral Healthcare Programs (PERMS) developed by the American Managed Behavioral Healthcare Association (AMBHA), which is offered as a first step toward enhanced quality of care assessment in managed behavioral health care. PMID:10183283

Ross, E C

1997-06-01

365

A Method for the Design and Development of Medical or Health Care Information Websites to Optimize Search Engine Results Page Rankings on Google  

PubMed Central

Background The Internet is a widely used source of information for patients searching for medical/health care information. While many studies have assessed existing medical/health care information on the Internet, relatively few have examined methods for design and delivery of such websites, particularly those aimed at the general public. Objective This study describes a method of evaluating material for new medical/health care websites, or for assessing those already in existence, which is correlated with higher rankings on Google's Search Engine Results Pages (SERPs). Methods A website quality assessment (WQA) tool was developed using criteria related to the quality of the information to be contained in the website in addition to an assessment of the readability of the text. This was retrospectively applied to assess existing websites that provide information about generic medicines. The reproducibility of the WQA tool and its predictive validity were assessed in this study. Results The WQA tool demonstrated very high reproducibility (intraclass correlation coefficient=0.95) between 2 independent users. A moderate to strong correlation was found between WQA scores and rankings on Google SERPs. Analogous correlations were seen between rankings and readability of websites as determined by Flesch Reading Ease and Flesch-Kincaid Grade Level scores. Conclusions The use of the WQA tool developed in this study is recommended as part of the design phase of a medical or health care information provision website, along with assessment of readability of the material to be used. This may ensure that the website performs better on Google searches. The tool can also be used retrospectively to make improvements to existing websites, thus, potentially enabling better Google search result positions without incurring the costs associated with Search Engine Optimization (SEO) professionals or paid promotion.

Cummins, Niamh Maria; Hannigan, Ailish; Shannon, Bill; Dunne, Colum; Cullen, Walter

2013-01-01

366

Guidelines for the care of the child with special health care needs.  

PubMed

CSHCN present a challenge to the primary care provider. These children are medically complex, require services and supports well beyond those that typically developing children require, and command a considerable proportion of the pediatric health care budget. How clinics are organized can have a considerable impact on the delivery of care to this heterogeneous group of complicated children. In this article, the authors articulate the philosophic underpinnings of one clinic-the SCC-located in an academic tertiary care center. Establishing a multidisciplinary medical home with a noncategoric approach to health care is one way of serving patients who have special health care needs. The more common medical problems encountered in the SCC are identified, along with strategies to address them. The ethics of caring for CSHCN are complex and controversial and have only been touched on in the context of providing a medical home. It is clear that CSHCN are going to increase in numbers as technology and medical care change. Thus, it is incumbent on child health care providers to develop resources to meet the needs of this complicated population. There needs to be a change in the way CSHCN and their families are addressed, accepting them as individuals worthy of the same care, concern, and respect that typically developing children receive. The establishment of a medical home with a noncategoric approach to care may be one step in achieving comprehensive care for this population of underserved children. PMID:17089866

Goldson, Edward; Louch, Glenda; Washington, Kimberly; Scheu, Holly

2006-01-01

367

Study protocol for the development of a European measure of best practice for people with long term mental health problems in institutional care (DEMoBinc)  

PubMed Central

Background This study aims to build a measure for assessing and reviewing the living conditions, care and human rights of people with longer term mental health problems in psychiatric and social care institutions. Protection of their human rights is imperative since impaired mental capacity secondary to mental illness can make them vulnerable to abuse and exploitation from others. They also constitute a major resource pressure for mental health services, social services, informal carers and society as a whole. Methods/Design This study uses an iterative methodology to develop a toolkit to assess internationally agreed domains of care that are considered most important for recovery. These domains are identified by collating results from: i) a systematic review of the literature on institutional care for this service user group; ii) a review of the relevant care standards in each participating country; iii) Delphi exercises in partner countries with mental health professionals, service users, carers and advocates. Common domains and cross-cutting themes are agreed by the principal researchers and an international expert panel. Items are developed to assess these domains and incorporated into the toolkit which is designed to be administered through a face to face interview with the institution's manager. The toolkit is refined in response to inter-rater reliability testing, feedback from interviewers and interviewees regarding its utility, and feedback from key stakeholders in each country about its ability to deliver information that can be used within each country's established systems for quality assessment and review. Cross-validation of the toolkit ratings against service users' quality of life, autonomy and markers of recovery tests whether it can deliver a proxy-measure of the service users' experiences of care and the institution's promotion of their human rights and recovery. The ability of the toolkit to assess the "value for money" delivered by institutions is investigated by comparing toolkit ratings and service costs. Discussion The study will deliver the first international tool for the assessment of the quality of institutional care for people with longer term mental health problems that is accurate, reliable, informative, useful and easy to use.

Killaspy, Helen; King, Michael; Wright, Christine; White, Sarah; McCrone, Paul; Kallert, Thomas; Cervilla, Jorge; Raboch, Jiri; Onchev, Georgi; Mezzina, Roberto; Wiersma, Durk; Kiejna, Andrzej; Ploumpidis, Dimitris; Caldas de Almeida, Jose Miguel

2009-01-01

368

Medicaid Managed Care Model of Primary Care and Health Care Management for Individuals with Developmental Disabilities  

ERIC Educational Resources Information Center

Lack of sufficient accessible community-based health care services for individuals with developmental disabilities has led to disparities in health outcomes and an overreliance on expensive models of care delivered in hospitals and other safety net or state-subsidized providers. A functioning community-based primary health care model, with an…

Kastner, Theodore A.; Walsh, Kevin K.

2006-01-01

369

Public Perceptions Of Private Health Care In Socialist China  

Microsoft Academic Search

ABSTRACT: We present the findings of a United Nations Development,Programme–World Health Organization study commissioned,by China’s Ministry of Health on use of public and private ambulatory,care services in three Chinese provinces. We found much,unmet,medi- cal need (16 percent), attributed mainly to the perceived high cost of care. Seventy-one per- cent had no health insurance,(90 percent in rural and 51 percent in

Meng-kin Lim; Hui Yang; Tuohong Zhang; Wen Feng; Zijun Zhou

2004-01-01

370

The Dutch health care performance report: seven years of health care performance assessment in the Netherlands  

PubMed Central

In 2006, the first edition of a monitoring tool for the performance of the Dutch health care system was released: the Dutch Health Care Performance Report (DHCPR). The Netherlands was among the first countries in the world developing such a comprehensive tool for reporting performance on quality, access, and affordability of health care. The tool contains 125 performance indicators; the choice for specific indicators resulted from a dialogue between researchers and policy makers. In the ‘policy cycle’, the DHCPR can rationally be placed between evaluation (accountability) and agenda-setting (for strategic decision making). In this paper, we reflect on important lessons learned after seven years of health care system performance assessment. These lessons entail the importance of a good conceptual framework for health system performance assessment, the importance of repeated measurement, the strength of combining multiple perspectives (e.g., patient, professional, objective, subjective) on the same issue, the importance of a central role for the patients’ perspective in performance assessment, how to deal with the absence of data in relevant domains, the value of international benchmarking and the continuous exchange between researchers and policy makers.

2014-01-01

371

Computer Programming Languages for Health Care  

PubMed Central

This paper advocates the use of standard high level programming languages for medical computing. It recommends that U.S. Government agencies having health care missions implement coordinated policies that encourage the use of existing standard languages and the development of new ones, thereby enabling them and the medical computing community at large to share state-of-the-art application programs. Examples are based on a model that characterizes language and language translator influence upon the specification, development, test, evaluation, and transfer of application programs.

O'Neill, Joseph T.

1979-01-01

372

Library Services and Health Care Administration.  

ERIC Educational Resources Information Center

Discusses progress made in meeting the information needs of health care administrators and the role of the library in providing information for administrative decision making. Highlights include health care economics; a shifting power structure; quality improvement initiatives; standards; communicating the role and value of library services; and…

Buchanan, Holly Shipp

1993-01-01

373

Military Family and the Health Care System.  

National Technical Information Service (NTIS)

This chapter reviews the scientific literature on the role of the family in health promotion, self/family care, social support, health care utilization, and recovery. Although it is clear that military families have a direct impact on the demand for healt...

D. S. Nice

1993-01-01

374

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

375

Safe Practices for Better Health Care.  

National Technical Information Service (NTIS)

Modern health care is highly complex, high risk, and error prone. Not surprisingly, health care errors and consequent adverse events are a leading cause of death and injury, even though well-documented methods to prevent the occurrence of many of these er...

K. W. Kizer L. N. Blum

2005-01-01

376

Medical Devices Used in Home Health Care.  

National Technical Information Service (NTIS)

The report was written by the CDRH Ad Hoc Home Health Care Committee in order to begin to address specific concerns associated with medical devices used in home health care. The report includes summaries of the following eight device-related issues: accre...

C. L. Backinger E. J. McCarthy

1992-01-01

377

Health Care Industry. Workforce & Workplace Literacy Series.  

ERIC Educational Resources Information Center

This brief gives an overview of the topic of workplace literacy in the health care industry and lists program contacts. The following 35 organizations operate basic skills upgrading programs for health care workers: American Hospital Association; Chinese American Civic Association; Massachusetts Department of Employment and Training; BostonWorks;…

BCEL Brief, 1991

1991-01-01

378

The Pharmaceutical Industry and Health Care Reform  

Microsoft Academic Search

While the goals of President Clinton's health care reform plan—to expand access to health care by the underserved and reduce the unacceptably high cost of care—are important, his proposed mechanisms for doing so include provisions that are counterproductive. Blacklisting certain drugs from the Medicare program, imposing red tape on physicians who participate in Medicare, and establishing a Medicare rebate tax

1994-01-01

379

The Pharmaceutical Industry and Health Care Reform  

Microsoft Academic Search

:While the goals of President Clinton's health care reform plan—to expand access to health care by the underserved and reduce the unacceptably high cost of care—are important, his proposed mechanisms for doing so include provisions that are counterproductive. Blacklisting certain drugs from the Medicare program, imposing red tape on physicians who participate in Medicare, and establishing a Medicare rebate tax

William L. Lucas

1994-01-01

380

Catastrophic payments for health care in Asia  

Microsoft Academic Search

Out-of-pocket (OOP) payments are the principal means of financing health care throughout much of Asia. We estimate the magnitude and distribution of OOP payments for health care in fourteen countries and territories accounting for 81% of the Asian population. We focus on payments that are catastrophic, in the sense of severely disrupting household living standards, and approximate such payments by

Eddy van Doorslaer; Owen ODonnell; Ravindra P. Rannan-Eliya; Aparnaa Somanathan; Shiva Raj Adhikari; Charu C. Garg; Deni Harbianto; Alejandro N. Herrin; Mohammed Nazmul Huq; Shamsia Ibragimova; Anup Karan; Tae-Jin Lee; Gabriel M. Leung; Jui-Fen Rachel Lu; Chiu Wan Ng; Badri Raj Pande; Rachel Racelis; Sihai Tao; Keith Tin; Kanjana Tisayaticom; Laksono Trisnantoro; Chitpranee Vasavid; Yuxin Zhao

2007-01-01

381

Integrated health care systems: emerging models.  

PubMed

Health care institutions and professionals are transforming the organizational structure of the nation's delivery system. Buyers and payers of health care are seeking more effective and efficient services for their dollars. Several new model organizational structures seek to put the providers who are aligning themselves with one another into a better position to deal with today's marketplace. PMID:8945275

Riley, D W

1994-01-01

382

Biomedical equipment systems for rural health care  

Microsoft Academic Search

Biomedical equipment technology can be of significant help in bringing health care to large rural populations. Of the possible technology alternatives, providing an equipment package to the health worker to take to the domestic site is most appropriate. Equipment choice must give priority to preventive care especially for the mother and the child. Besides the general equipment design features of

Sujoy K. Guha

1992-01-01

383

A Comprehensive Primary Health Care Delivery Model.  

ERIC Educational Resources Information Center

This primary health care model is based on four assumptions: emphasis on collective, not individual, needs; coordination of preventive/episodic care with secondary/tertiary care; comprehensive, holistic approach; and partnership and equality among professional disciplines and community members. Stakeholders involved are medical, nursing, and…

Pullen, Carol; And Others

1994-01-01

384

Feasibility of National Surveillance of Health-Care-Associated Infections in Home-Care Settings  

Microsoft Academic Search

This article examines the rationale and strategies for surveillance of health-care-associated infections in home- care settings, the challenges of nonhospital-based surveillance, and the feasibility of developing a national sur- veillance system. ver the past 2 decades, the delivery of health care in the United States has shifted increasingly from hospitals to patients' homes (1-3). Nearly eight million people in the

Lilia P. Manangan; Michele L. Pearson; Jerome I. Tokars; Elaine Miller; William R. Jarvis

2002-01-01

385

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.

Joosten, Tom; Bongers, Inge; Janssen, Richard

2009-01-01

386

Pertussis Vaccination for Health Care Workers  

PubMed Central

Pertussis, an acute respiratory infection caused by Bordetella pertussis, classically manifests as a protracted cough illness. The incidence of pertussis in the United States has been increasing in recent years. Immunity wanes after childhood vaccination, leaving adolescents and adults susceptible to infection. The transmission of pertussis in health care settings has important medical and economic consequences. Acellular pertussis booster vaccines are now available for use and have been recommended for all adolescents and adults. These vaccines are safe, immunogenic, and effective. Health care workers are a priority group for vaccination because of their increased risk of acquiring infection and the potential to transmit pertussis to high-risk patients. Health care worker vaccination programs are likely to be cost-effective, but further research is needed to determine the acceptability of pertussis vaccines among health care workers, the duration of immunity after booster doses, and the impact of vaccination on the management of pertussis exposures in health care settings.

Sandora, Thomas J.; Gidengil, Courtney A.; Lee, Grace M.

2008-01-01

387

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.

Wheatley, Benjamin

2013-01-01

388

The Future of U.S. Health Care and Its Effect on Health Care Education.  

ERIC Educational Resources Information Center

Traces trends in health care, including growth of managed care, increased consumer choice, and changes in administration and funding of academic health centers, and examines the challenges they create for teaching, research, and practice. The Oregon Health Plan and its effect on Oregon Health Sciences University are used for illustration. (MSE)

Hildick, Sue; Kohler, Peter O.

1998-01-01

389

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

390

Remote health-care monitoring using Personal Care Connect  

Microsoft Academic Search

Caring for patients with chronic illnesses is costly—nearly $1.27 trillion today and predicted to grow much larger. To address this trend, we have designed and built a platform, called Personal Care Connect (PCC), to facilitate the remote monitoring of patients. By providing caregivers with timely access to a patient's health status, they can provide patients with appropriate preventive interventions, helping

Marion Blount; Virinder M. Batra; Andrew N. Capella; Maria Ebling; William F. Jerome; Sherri M. Martin; Michael Nidd; Michael R. Niemi; Steven P. Wright

2007-01-01

391

Health care technology and quality of care.  

PubMed

The increasing costs and complexity of technologic advances in diagnosis and treatment have been accompanied by other important issues. They are often moral or ethical in nature; they include the public's desire and determination to have access to these "high-tech" advances; and the quality and equity with which those advances are apportioned and applied must be addressed. Seven criteria that can be applied to technology assessment are identified as is a process for that assessment. Together, these procedures can provide valuable information and assistance to those who make decisions about health benefits coverage--both in the public and the private sectors. PMID:2980910

Schaffarzick, R W

1987-08-01

392

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

393

Simplified Health Care Program in Rural Guatemala: The Patulul Project.  

National Technical Information Service (NTIS)

In 1976-77, the Institute of Nutrition of Central America and Panama (INCAP) adapted a previously developed simplified health care program for implementation in communities surrounding the town of Patulul, Guatemala. This report describes the Patulul expe...

H. L. Delgado J. M. Belizan V. E. Valverde E. M. Giron R. E. Klein

1980-01-01

394

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

395

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

PubMed Central

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.

Bednarz, Daniel; Bae, Jaeyong; Pierce, Jessica

2011-01-01

396

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

397

Development and implementation of a participative intervention to improve the psychosocial work environment and mental health in an acute care hospital  

PubMed Central

Objectives To describe the development and implementation phases of a participative intervention aimed at reducing four theory grounded and empirically supported adverse psychosocial work factors (high psychological demands, low decision latitude, low social support, and low reward), and their mental health effects. Methods The intervention was realised among 500 care providers in an acute care hospital. A prior risk evaluation was performed, using a quantitative approach, to determine the prevalence of adverse psychosocial work factors and of psychological distress in the hospital compared to an appropriate reference population. In addition, a qualitative approach included observation in the care units, interviews with key informants, and collaborative work with an intervention team (IT) including all stakeholders. Results The prior risk evaluation showed a high prevalence of adverse psychosocial factors and psychological distress among care providers compared to a representative sample of workers from the general population. Psychosocial variables at work associated with psychological distress in the prior risk evaluation were high psychological demands (prevalence ratio (PR)?=?2.27), low social support from supervisors and co?workers (PR?=?1.35), low reward (PR?=?2.92), and effort?reward imbalance (PR?=?2.65). These results showed the empirical relevance of an intervention on the four selected adverse psychosocial factors among care providers. Qualitative methods permitted the identification of 56 adverse conditions and of their solutions. Targets of intervention were related to team work and team spirit, staffing processes, work organisation, training, communication, and ergonomy. Conclusion This study adds to the scarce literature describing the development and implementation of preventive intervention aimed at reducing psychosocial factors at work and their health effects. Even if adverse conditions in the psychosocial environment and solutions identified in this study may be specific to the healthcare sector, the intervention process used (participative problem solving) appears highly exportable to other work organisations.

Bourbonnais, R; Brisson, C; Vinet, A; Vezina, M; Lower, A

2006-01-01

398

Polity and health care expenditures: the association among 159 nations.  

PubMed

This paper hypothesized that democratic nations, as characterized by Polity IV Project regime scores, spend more on health care than autocratic nations and that the association reported here is independent of other demographic, health system or economic characteristics of nations. WHO Global Observatory data on 159 nations with roughly 98% of the world's population were examined. Regime scores had significant, direct and independent associations with each of four measures of health care expenditure. For every unit increment in a nation's regime score toward a more democratic authority structure of governance, we estimated significant (p<0.05) increments in the percent of GDP expended on health care (+0.14%), percent of general government expenditures targeted to health care (+0.25%), total per capita expenditures on health (+34.4Int$) and per capita general government expenditures (+22.4Int$), while controlling for a population's age distribution, life expectancy, health care workforce and system effectiveness and gross national income. Moreover, these relationships were found to persist across socio-economic development levels. The finding that practices of health care expenditure and authority structures of government co-vary is instructive about the politics of health and the challenges of advancing global health objectives. PMID:23856538

Gregorio, Leah E; Gregorio, David I

2013-03-01

399

[Professional health cards (CPS): informatic health care system in France].  

PubMed

The Professional Health Card Public interest group (Groupement d'Intérêt Public-Carte de professionnel de Santé (GIP-CPS)) was founded in 1993 as a joint initiative by the different parties involved in health care in France: the state, the representatives of the health care professions and the compulsory and complementary health insurance organizations. The CPS system enables safe exchange and electronic sharing of medical data. Via Intranet connections and Extranet hosting of medical files, databases, the CPS system enables health care professionals who access servers to be identified with certainty. For email exhanges, the CPS systems guarantees the sender's identity and capacity. The electronic signature gives legal value to the email. The system also enables confidential email. The health card system (CPS) contributes to making the health service efficient. Shared medical files, health care networks, health warning systems or electronic requests for reimbursement of health insurance expenses all use the CPS system. More than 300,000 health care professionals use it regularly. The freedom of movement of patients throughout Europe has led to the growth of exchanges and information sharing between health professionals in the States of the Union. More and more health professionals will be leaving their own countries to work in foreign countries in the future. It is essential that their freedom of movement is accompanied by the ability to prove their rights to practice. PMID:16385785

Fortuit, P

2005-09-01

400

Contributions of Public Health to Genetics Education for Health Care Professionals  

ERIC Educational Resources Information Center

With growing knowledge about the role of genetics in health, genetics education for health care professionals has taken on increasing importance. Many efforts are under way to develop new genetics curricula. Although such efforts are primarily the responsibility of health professional schools and professional societies, the public health system is…

Burke, Wylie

2005-01-01

401

Hospital-Based Comprehensive Care Programs for Children With Special Health Care Needs  

PubMed Central

Objective To examine the effectiveness of hospital-based comprehensive care programs in improving the quality of care for children with special health care needs. Data Sources A systematic review was conducted using Ovid MEDLINE, CINAHL, EMBASE, PsycINFO, Sociological Abstracts SocioFile, and Web of Science. Study Selection Evaluations of comprehensive care programs for categorical (those with single disease) and noncategorical groups of children with special health care needs were included. Selected articles were reviewed independently by 2 raters. Data Extraction Models of care focused on comprehensive care based at least partially in a hospital setting. The main outcome measures were the proportions of studies demonstrating improvement in the Institute of Medicine’s quality-of-care domains (effectiveness of care, efficiency of care, patient or family centeredness, patient safety, timeliness of care, and equity of care). Data Synthesis Thirty-three unique programs were included, 13 (39%) of which were randomized controlled trials. Improved outcomes most commonly reported were efficiency of care (64% [49 of 76 outcomes]), effectiveness of care (60% [57 of 95 outcomes]), and patient or family centeredness (53% [10 of 19 outcomes). Outcomes less commonly evaluated were patient safety (9% [3 of 33 programs]), timeliness of care (6% [2 of 33 programs]), and equity of care (0%). Randomized controlled trials occurred more frequently in studies evaluating categorical vs noncategorical disease populations (11 of 17 [65%] vs 2 of 16 [17%], P = .008). Conclusions Although positive, the evidence supporting comprehensive hospital-based programs for children with special health care needs is restricted primarily to nonexperimental studies of children with categorical diseases and is limited by inadequate outcome measures. Additional high-quality evidence with appropriate comparative groups and broad outcomes is necessary to justify continued development and growth of programs for broad groups of children with special health care needs.

Cohen, Eyal; Jovcevska, Vesna; Kuo, Dennis Z.; Mahant, Sanjay

2014-01-01

402

How Will Comparative Effectiveness Research Affect the Quality of Health Care?  

Microsoft Academic Search

Summary The health reform legislation recently discussed by Congress would develop an infrastructure for the ongoing generation and dissemination of information on the comparative effectiveness of different health care treatments. The specifics of these proposals have not yet been fully defined, even as the concept of comparative effectiveness raises concerns for many health care stakeholders. The quality of health care

Robert Berenson

2010-01-01

403

Developing Iraq's mental health policy.  

PubMed

As Iraq faces the challenge of securing a sustainable resolution to the current violence, the burden of mental illness is likely to increase dramatically. The impact of Saddam Hussein's dictatorship, the Iran-Iraq war, U.S.-led economic sanctions, the Persian Gulf wars, and the U.S. invasion and subsequent violent insurgency have devastated Iraq's governmental and social infrastructure. Health care delivery across sectors has suffered greatly. During the reconstruction phase, the United States and coalition forces allocated resources to restructure Iraq's health care system. Many multinational organizations, governments, and policy makers had the political will as well as the financial and human resources to greatly influence Iraq's mental health program. However, the lack of an existing mental health plan stifled these efforts. Applying Kingdon's model for policy development, which includes political analysis, problem defining, and proposal drafting, the authors describe the development of Iraq's current mental health policy. PMID:17914016

Hamid, Hamada I; Everett, Anita

2007-10-01

404

Promoting coordination in Norwegian health care1  

PubMed Central

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

Rom?ren, Tor Inge; Torjesen, Dag Olaf; Landmark, Brynjar

2011-01-01

405

Geographic Disparities in Children's Mental Health Care  

Microsoft Academic Search

Objective. It is widely believed that only a minority of vulnerable children and adolescents receive any mental health services. Although health care dispar- ities associated with sociodemographic characteristics are well known, almost no information exists about another potentially important source of disparity for children: How does state of residence affect mental health service use? Methods. Observational analysis was conducted us-

Roland Sturm; Jeanne S. Ringel; Tatiana Andreyeva

2010-01-01

406

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

407

Health Care Issues of Incarcerated Women.  

ERIC Educational Resources Information Center

Presents health profile of the female offender. Discusses needs in areas of gynecology, breast assessment, and health education and services related to childbearing and parenting. Describes incarcerated health care delivery system and looks to communication and education, nursing personnel, and community resources for potential solutions to…

McGaha, Glenda S.

1987-01-01

408

[Primary health care: challenges for implementation in Latin America].  

PubMed

A development process, marked by the re-appearance of the primary health care as the core of health systems, has emerged in Latin America. Governments have made a commitment to renew this strategy as the basis of their health systems. However, these health systems are mainly faced with re-introducing equity values, and there are common challenges such as providing the health systems with trained human resources in sufficient numbers, overcoming the fragmentation/segmentation of the systems, ensuring financial sustainability, improving governance, quality of care and information systems, expanding coverage, preparing to face the consequences of an aging population, the changing epidemiological profile, and increase in the response capacity of the public health system. This article is intended to provide a comprehensive view of the progress and challenges of the inclusion of primary care health systems in Latin American countries. PMID:23490062

Giraldo Osorio, Alexandra; Vélez Álvarez, Consuelo

2013-01-01

409

Paediatricians' perspectives on global health priorities for newborn care in a developing country: a national survey from Nigeria  

PubMed Central

Background An understanding of the perception of paediatricians as key stakeholders in child healthcare delivery and the degree of congruence with current investment priorities is crucial in accelerating progress towards the attainment of global targets for child survival and overall health in developing countries. This study therefore elicited the views of paediatricians on current global priorities for newborn health in Nigeria as possible guide for policy makers. Methods Paediatric consultants and residents in the country were surveyed nationally between February and March 2011 using a questionnaire requiring the ranking of nine prominent and other neonatal conditions based separately on hospital admissions, mortality, morbidity and disability as well as based on all health indices in order of importance or disease burden. Responses were analysed with Friedman test and differences between subgroups of respondents with Mann-Whitney U test. Results Valid responses were received from 152 (65.8%) of 231 eligible physicians. Preterm birth/low birthweight ranked highest by all measures except for birth asphyxia which ranked highest for disability. Neonatal jaundice ranked next to sepsis by all measures except for disability and above tetanus except mortality. Preterm birth/low birthweight, birth asphyxia, sepsis, jaundice and meningitis ranked highest by composite measures while jaundice had comparable rating with sepsis. Birth trauma was most frequently cited under other unspecified conditions. There were no significant differences in ranking between consultants and residents except for birth asphyxia in relation to hospital admissions and morbidity as well as sepsis and tetanus in relation to mortality. Conclusions Current global priorities for neonatal survival in Nigeria largely accord with paediatricians’ views except for neonatal jaundice which is commonly subsumed under “other“ or "miscellaneous" neonatal conditions. While the importance of these priority conditions extends beyond mortality thus suggesting the need for a broader conceptualisation of newborn health to reflect the current realities, paediatricians should be actively engaged in advancing the attainment of global priorities for child survival and health in this population.

2012-01-01

410

Spina Bifida: Guidelines of Care for Children with Special Health Care Needs.  

ERIC Educational Resources Information Center

These guidelines were written to help families coordinate the health care that may be needed by a child with spina bifida. The booklet begins with general information about spina bifida. It then discusses the goals of health care, the health care team, the importance of periodic health care, and record keeping procedures. The child's health care

Minnesota State Dept. of Health, Minneapolis. Services for Children with Handicaps.

411

Health captology--application of persuasive technologies to health care.  

PubMed

Professionals in industries such as advertising and sales have used techniques of persuasion to enhance the efficacy of marketing campaigns and sales revenues. In contrast, health care has traditionally relied on the persuasive power of facts and evidence to encourage healthy behavior. The evidence suggests, however, that this current approach is failing. Health care experts and opinion leaders cite overwhelming evidence of an epidemic in diseases such as obesity and diabetes, despite numerous initiatives to educate the public how to prevent morbidity and mortality. Health captology, the application of persuasive technology to health care, attempts to leverage proven persuasive techniques to improve clinical outcomes. PMID:15853239

Chan, Albert S

2004-01-01

412

The Ottawa Charter and acute health care.  

PubMed

The Ottawa Charter is a significant document in relation to health promotion and the priorities for action needed to facilitate health for all people. The relevance of this document to an intensive care setting and the extent to which it may be translated into meaningful practice is examined in this paper. Acute care is an area lying at the extreme end of tertiary health, and at first glance it may be difficult to reconcile the significance of health promotion and the Ottawa Charter with this particular area of health care practice. On closer inspection, however, the relevance of the Charter lies in its impact on the number and type of patients seen in the Intensive Care Unit, and on the effect that the implementation of the health promotion action areas has on the client base. Even at the extreme end of tertiary care it is equally important to be aware of public health issues and to advocate, enable and mediate, where necessary, on behalf of and alongside patients, particularly as we care for them when they are most vulnerable. A commitment to both action and meaningful practice must continue to be pursued while equity in health remains a goal to be achieved. PMID:18556735

Munster, Francesca

2008-06-01

413

Statements of Antitrust Enforcement Policy in Health Care.  

National Technical Information Service (NTIS)

The antitrust guidelines for health care providers are designed to encourage agreements that promote efficiency in the health care industry and lower health care costs to consumers. The nine statements detail new antitrust enforcement policies and princip...

1996-01-01

414

20 CFR 402.65 - Health care information.  

Code of Federal Regulations, 2013 CFR

...2013-04-01 2013-04-01 false Health care information. 402.65 Section...RECORDS TO THE PUBLIC § 402.65 Health care information. We have some information about health care programs under titles XVIII...

2013-04-01

415

47 CFR 54.602 - Health care support mechanism.  

Code of Federal Regulations, 2013 CFR

...2013-10-01 2013-10-01 false Health care support mechanism. 54.602... Universal Service Support for Health Care Providers Defined Terms and Eligibility § 54.602 Health care support mechanism. (a)...

2013-10-01

416

47 CFR 54.601 - Health care provider eligibility.  

Code of Federal Regulations, 2013 CFR

...2013-10-01 2013-10-01 false Health care provider eligibility. 54.601... Universal Service Support for Health Care Providers Defined Terms and Eligibility § 54.601 Health care provider eligibility....

2013-10-01

417

45 CFR 162.1401 - Health care claim status transaction.  

Code of Federal Regulations, 2013 CFR

... 2013-10-01 2013-10-01 false Health care claim status transaction. 162.1401 ...REQUIREMENTS ADMINISTRATIVE REQUIREMENTS Health Care Claim Status § 162.1401 Health care claim status transaction. The...

2013-10-01

418

42 CFR 476.76 - Cooperation with health care facilities.  

Code of Federal Regulations, 2013 CFR

...2013-10-01 false Cooperation with health care facilities. 476.76 Section... § 476.76 Cooperation with health care facilities. Before implementation...review procedures with each involved health care...

2013-10-01

419

20 CFR 402.65 - Health care information.  

...2014-04-01 2014-04-01 false Health care information. 402.65 Section 402...RECORDS TO THE PUBLIC § 402.65 Health care information. We have some information about health care programs under titles XVIII and XIX...

2014-04-01

420

7 CFR 205.238 - Livestock health care practice standard.  

...2014-01-01 false Livestock health care practice standard. 205.238 Section...Requirements § 205.238 Livestock health care practice standard. (a) The producer...and maintain preventive livestock health care practices, including: (1)...

2014-01-01

421

Community mental health care in the future: nine proposals.  

PubMed

The aim of this article was to put community psychiatry into a longitudinal and global perspective and to try to look into the future. Specifically, we set out the following nine proposals:1. Central and regional government should measure the treated percentage of people with mental illness (coverage) and set specific targets to increase coverage over set time periods.2. Health care services need to recognize the far lower life expectancy among people with mental disorders and develop and evaluate new methods to reduce this health disparity.3. Mental health services should provide specific modules to reduce stigma and discrimination experienced by people with mental illness.4. Mental health staff should provide care that service users (and their family members) find accessible and acceptable.5. Mental health care should consist of a careful balance of hospital and community care, with most care provided at or near people's homes.6. Mental health planners, both in times of economic growth and recession, should invest in treatments known to be effective and disinvest from treatments known to be ineffective or even harmful.7. Mental health staff and service users should develop and evaluate methods to improve shared decision making.8. Health care practitioners (of western and nonwestern traditions) should take practical steps to see each other as partners in an integrated system that increases the total amount of mental health care available, while ensuring that only effective and acceptable treatments are provided.9. Mental health services should develop dedicated programs for recovery: this implies that staff understand an individual's personal recovery goals and fully support his/her achievement. PMID:24886950

Thornicroft, Graham; Tansella, Michele

2014-06-01

422

Nongrowth strategies and options in health care.  

PubMed

Changing economic and market forces in health care delivery have stimulated much management thinking about innovative, entrepreneurial forms of strategic growth. Along with this thinking comes a new imperative to rethink strategies to include nongrowth options in either services or markets. The health care manager must go beyond describing the strategies and tactics as simple reversals of the organizational pattern of growth in explaining the available nongrowth options. Examples of nine nongrowth options demonstrate their practicality and relevance to health care organizations. PMID:10302290

Breindel, C L

1988-01-01

423

Study protocol for a randomized, controlled, superiority trial comparing the clinical and cost- effectiveness of integrated online mental health assessment-referral-care in pregnancy to usual prenatal care on prenatal and postnatal mental health and infant health and development: the Integrated Maternal Psychosocial Assessment to Care Trial (IMPACT)  

PubMed Central

Background Stress, depression, and anxiety affect 15 to 25% of pregnant women. However, fewer than 20% of prenatal care providers assess and treat mental health problems and fewer than 20% of pregnant women seek mental healthcare. For those who seek treatment, the lack of health system integration and existing barriers frequently prevent treatment access. Without treatment, poor prenatal mental health can persist for years and impact future maternal, child, and family well-being. Methods/Design The purpose of this randomized controlled trial is to evaluate the effectiveness of an integrated process of online psychosocial assessment, referral, and cognitive behavior therapy (CBT) for pregnant women compared to usual prenatal care (no formal screening or specialized care). The primary outcome is self-reported prenatal depression, anxiety, and stress symptoms at 6 to 8 weeks postrandomization. Secondary outcomes are postpartum depression, anxiety, and stress symptoms; self-efficacy; mastery; self-esteem; sleep; relationship quality; coping; resilience; Apgar score; gestational age; birth weight; maternal-infant attachment; infant behavior and development; parenting stress/competence; and intervention cost-effectiveness, efficiency, feasibility, and acceptability. Pregnant women are eligible if they: 1) are <28 weeks gestation; 2) speak/read English; 3) are willing to complete email questionnaires; 4) have no, low, or moderate psychosocial risk on screening at recruitment; and 5) are eligible for CBT. A sample of 816 women will be recruited from large, urban primary care clinics and allocation is by computer-generated randomization. Women in the intervention group will complete an online psychosocial assessment, and those with mild or moderate depression, anxiety, or stress symptoms then complete six interactive cognitive behavior therapy modules. All women will complete email questionnaires at 6 to 8 weeks postrandomization and at 3, 6, and 12 months postpartum. Clinic-based providers and researchers conducting chart abstraction and analysis are blinded. Qualitative interviews with 8 to 10 healthcare providers and 15 to 30 intervention group women will provide data on feasibility and acceptability of the intervention. Results of this trial will determine the feasibility and effectiveness of an integrated approach to prenatal mental healthcare and the use of highly accessible computer-based psychosocial assessment and CBT on maternal, infant, and family-based outcomes. Trial registration ClinicalTrials.gov Identifier: NCT01901796

2014-01-01

424

Alaska Native community assessment: health care services, knowledge of health issues, and health education.  

PubMed

This project gathered information from 32 Alaska Native communities in Bristol Bay, located in southwestern Alaska, regarding use of health care services and knowledge of health care issues. It also educated residents about health care and their role in improving health status, enabling participants to feel that their involvement in planning health care services is important. In conjunction with the University of Washington Community Development Program and the Alaska Center for Rural Health, a household survey was developed. A coordinator in each community was trained, and packets of surveys and health education materials were delivered to each household or post-office box. Completed surveys were returned, confidentially, to the village clinic. An English/Yup'ik cassette tape explaining the project was also available. Results were analyzed by the University of Washington. The findings were determined to be accurate with a 95% confidence level. Of surveys delivered to households, there was a 66% return rate and an overall return rate of 45%. PMID:10093361

DeCourtney, C A

1998-01-01

425

Health and Safety Considerations: Caring for Young Children with Exceptional Health Care Needs.  

ERIC Educational Resources Information Center

This manual on health and safety considerations in caring for young children with exceptional health care needs is a product of Project EXCEPTIONAL (EXceptional Children: Education in Preschool Techniques for Inclusion, Opportunity-building, Nurturing And Learning), which has the goal of increasing the quality and quantity of inclusive child care

Presler, Betty

426

Mobile Health Care: Towards a Commercialization of Research Results  

Microsoft Academic Search

During the last fours years a consortium of universities, hospitals and commercial companies has been working together for the development of innovative systems and services for mobile health care. Two major projects were financed by the European Union allowed us to develop a complete mobile healthcare system and validate it with extensive medical trials. MobiHealth1 and HealthService241 have developed a

Dimitri Konstantas; Richard Bults; Aart Van Halteren; Katarzyna Wac; Val Jones; Ing Widya; Rainer Herzog; Barbara Streimelweger; A. Meier; M. Schumacher

2006-01-01

427

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

PubMed Central

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

2011-01-01

428

An Interdisciplinary Online Course in Health Care Informatics  

PubMed Central

Objectives To design an interdisciplinary course in health care informatics that enables students to: (1) understand how to incorporate technology into the provision of safe, effective and evidence-based health care; (2) make decisions about the value and ethical application of specific technologies; and (3) appreciate the perspectives and roles of patients and providers when using technology in care. Design An online, interdisciplinary elective course using a distributive learning model was created. Standard courseware was used to manage teaching and to facilitate student/instructor interactions. Interactive, multimedia lectures were developed using Internet communication software. Assessment Upon completion of the course, students demonstrated competency in identifying, analyzing, and applying informatics appropriately in diverse health settings. Conclusion Online education using multimedia software technology is effective in teaching students about health informatics and providing an innovative opportunity for interdisciplinary learning. In light of the growing need for efficient health care informatics training, additional study of this methodology is warranted.

Smith, Scott R.

2007-01-01

429

Use of Electronic Technologies to Promote Community and Personal Health for Individuals Unconnected to Health Care Systems  

PubMed Central

Ensuring health care services for populations outside the mainstream health care system is challenging for all providers. But developing the health care infrastructure to better serve such unconnected individuals is critical to their health care status, to third-party payers, to overall cost savings in public health, and to reducing health disparities. Our increasingly sophisticated electronic technologies offer promising ways to more effectively engage this difficult to reach group and increase its access to health care resources. This process requires developing not only newer technologies but also collaboration between community leaders and health care providers to bring unconnected individuals into formal health care systems. We present three strategies to reach vulnerable groups, outline benefits and challenges, and provide examples of successful programs.

Crilly, John F.; Volpe, Fred

2011-01-01

430

Silver in Health Care: Antimicrobial Effects and Safety in Use  

Microsoft Academic Search

Silver has a long and intriguing history as an antibiotic in human health care. It has been developed for use in water purification, wound care, bone prostheses, reconstructive orthopaedic surgery, cardiac devices, catheters and surgical appliances. Advancing biotechnology has enabled incorporation of ionizable silver into fabrics for clinical use to reduce the risk of nosocomial infections and for personal hygiene.

A. Lansdown

2006-01-01

431

Providing Perinatal Mental Health Services in Pediatric Primary Care  

ERIC Educational Resources Information Center

After birth, newborns and their caregivers are seen routinely and frequently in pediatric primary care