Sample records for health care development

  1. [Primary health care in developing countries].

    PubMed

    Anker, H

    1991-06-20

    The Alma-Ata declaration and global strategy of Health for All by the year 2000 have given political and practical momentum to the delivery of primary health care in developing countries. WHO has provided leadership for this process, with support from other UN agencies and international donor organizations. Primary health care is based on the concept of a District Health System which provides comprehensive services. Community participation and intersectoral collaboration are the cornerstones of primary health care. Using Malawi, Uganda, India and Indonesia as examples, the article explores experiences of health problems and of health care delivery to underprivileged populations in African and Asian countries. PMID:1866729

  2. Future developments in health care performance management

    PubMed Central

    Crema, Maria; Verbano, Chiara

    2013-01-01

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

  3. Health Care System Reforms in Developing Countries

    PubMed Central

    Han, Wei

    2012-01-01

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

  4. Development of integrated mental health care: critical workforce competencies.

    PubMed

    Delaney, Kathleen R; Robinson, Karen M; Chafetz, Linda

    2013-01-01

    In integrated care, a person will have his or her medical and behavioral health needs addressed within one health care system. Support for integrated models has grown with the increasing awareness of how the medical comorbidities of individuals with serious mental illness contribute to their morbidity and mortality, the prevalence of mental health problems in the general population, and the mental health issues among those with chronic medical problems. The enactment of effective integrated care will demand developing clinicians who are trained to work with mental health needs at various levels of intensity, who are capable of addressing complex comorbidities, and who operate from a person-centered approach to care. In this light we argue that given their unique skill set and clinical training, Psychiatric-Mental Health Advanced Practice Nurses could play a critical role in integrated care and present policy recommendations which support the development of the Psychiatric-Mental Health Advanced Practice Nurses role in such models. PMID:23702474

  5. Education and health care in developing countries

    E-print Network

    Nguyen, Trang V

    2008-01-01

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

  6. 76 FR 44956 - Solicitation for a Cooperative Agreement; Correctional Health Care Executive Curriculum Development

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-27

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

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

    PubMed

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

    2013-03-01

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

  8. New developments in a consolidating health care industry.

    PubMed

    Taylor, D; Kleiner, B H

    1998-01-01

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

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

    PubMed

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

    2012-01-01

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

  10. Medical oncology patients’ preferences with regard to health care: development of a patient-driven questionnaire

    Microsoft Academic Search

    H. Wessels; A. de Graeff; K. Wynia; H. J. Sixma; M. de Heus; M. Schipper; G. T. G. J. Woltjer; S. C. C. M. Teunissen; E. E. Voest

    2009-01-01

    Background: To improve quality of care for cancer patients, it is important to have an insight on the patient’s view on health care and on their specific wishes, needs and preferences, without restriction and without influence of researchers and health care providers. The aim of this study was to develop a questionnaire assessing medical oncology patients’ preferences for health care

  11. Primary Health Care.

    ERIC Educational Resources Information Center

    Lauffer, Sandra, Ed.

    1979-01-01

    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…

  12. Developing a Health Care Intermediary-Delivered Intervention to Promote an Online Health Information Resource: Results from Formative Research

    Microsoft Academic Search

    Jiang Li; Jeff Quinn; Cassandra L. Rico; Amaris C. Noguera; Christie Silbajoris; Jane D. Brown; Diana McDuffee

    2010-01-01

    This study describes the development of a health care intermediary-delivered intervention to promote an existing state-based health information Web site (NC Health Info) originally designed by health science librarians. Two focus groups and six key informant interviews were conducted with 17 health care intermediaries (HCIs) to: (1) identify key trends in HCIs' use of and attitudes toward online health information;

  13. Women Veterans Health Care

    MedlinePLUS

    ... Health Care » Women Veterans Health Care Women Veterans Health Care Menu Menu Womens Health Women Veterans Health Care ... more » MyHealtheVet LGBT Awareness Role Models Women Veterans Health Care Did you know that women are the fastest ...

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

    ERIC Educational Resources Information Center

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

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

  15. Child health care demand in a developing country

    Microsoft Academic Search

    Kelly Hallman

    1999-01-01

    This study examines how quality, price, and access to curative health care influence use of modern public, modern private, and traditional providers among 3,000 children age 0-2 years in Cebu, Philippines. The analysis relies on a series of household, community, and health facility surveys conducted in 33 rural and urban communities during 1983-1986. The inclusion of data on potential health

  16. Are Incentives Everything? Payment Mechanisms for Health Care Providers in Developing Countries

    Microsoft Academic Search

    Varun Gauri

    2001-01-01

    Can provider payment mechanisms solve some of the key problems in developing countries? health care systems by ?getting the incentives right?? Perhaps.Reforms in developing countries? health care systems often focus on ?getting the incentives right.? They aim to use provider payments to optimize the use of scarce resources, transform clinical practice, and improve the quality of care. Gauri examines the

  17. Home Health Care

    MedlinePLUS

    ... Page Resize Text Printer Friendly Online Chat Home Health Care What is Home Health Care? How Do I ... More About Home Health Care? What is Home Health Care? Home health care helps seniors live independently for ...

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

    PubMed Central

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

    2014-01-01

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

  19. Health care fraud: recent developments and timeless advice.

    PubMed

    Bennett, Robert S; Medearis, David M

    2003-10-01

    Health care fraud has gained increased attention at both the state and federal levels in recent years. The $875 million criminal settlement by TAP Pharmaceutical Products, Inc, in October 2001 and subsequent indictments of physicians involved with the alleged HCA Medicare fraud conspiracy highlight the fact that physicians who are unaware of any wrongdoing may get dragged into the government's battle. The various laws and overlapping enforcement agencies can be complex and daunting to a physician who is falsely accused. This article provides a brief overview of three relevant federal health care fraud statutes: the Prescription Drug Marketing Act, the Medicaid Anti-Kickback Statute, and the False Claims Act. The article also briefly discusses the Texas Medicaid Fraud Prevention Act and the roles of various state agencies responsible for the detection and prevention of health care fraud. Finally, the article provides practical advice about the investigate process and what every prudent physician should do if under investigation. PMID:14650813

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

    PubMed Central

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

    2004-01-01

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

  1. The development and maturation of a statewide academic health care system: Clarian Health Partners/Indiana University Health.

    PubMed

    Handel, David J; Kleit, Stuart A; Handel, Daniel A

    2014-02-01

    As health care reform continues, health care organizations are evolving both structurally and operationally to position themselves to meet the challenges ahead. Academic medical centers (i.e., teaching hospitals) particularly need an effective strategy that will allow them to meet their tripartite missions of patient care, education, and research in this time of increasing competition and resource constraints. Clarian Health Partners, recently renamed Indiana University Health, is a health care entity that developed from a partnership of the Indiana University Hospitals and Methodist Hospital of Indiana. This case study explores the history behind the development of Clarian Health Partners, the model employed, and the lessons learned. It discusses the governance and management models implemented, the steps taken to integrate the two partners in the new system, and the specific challenges of physician partnerships and collaborations. As mergers and consolidations continue in an era of health care reform, the lessons learned from previous endeavors, such as that of Clarian Health Partners, may be applicable. PMID:24362393

  2. Health care in Cuba: socialized medicine in a developing country.

    PubMed

    Parsons, L C; Barter, M

    2001-01-01

    Several registered nurses representing the American Organization of Nurse Executives (AONE), the American Association of Critical Care Nurses, and a group of nurses and physicians representing Disease Case Management visited Cuba under the auspices of the People to People Ambassador Program. The purpose of the People to People Ambassador Program is to exchange ideas, foster international friendships, and advance worldwide peace and communication. The authors were a part of the AONE delegation and will share their experiences during their visit to Cuban health care facilities. PMID:12503457

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

    PubMed

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

    2012-11-01

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

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

    ERIC Educational Resources Information Center

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

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

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

    SciTech Connect

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

    1995-06-01

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

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

    PubMed

    Lee, Teresa; Schiller, Jennifer

    2015-02-01

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

  7. Developing a multivariate electronic medical record integration model for primary health care.

    PubMed

    Lau, Francis; Price, Morgan; Lesperance, Mary

    2013-01-01

    This paper describes the development of a multivariate electronic medical record (EMR) integration model for the primary health care setting. Our working hypothesis is that an integrated EMR is associated with high quality primary health care. Our assumption is that EMR integration should be viewed as a form of complex intervention with multiple interacting components that can impact the quality of care. Depending on how well the EMR is integrated in the practice setting, one can expect a corresponding change in the quality of care as measured through a set of primary health care quality indicators. To test the face validity of this model, a Delphi study is being planned where health care providers and information technology professionals involved with EMR adoption are polled for their feedback. This model has the potential to quantify and explain the factors that influence successful EMR integration to improve primary health care. PMID:23388317

  8. The information needs of health care professionals and consumers in developing countries.

    PubMed Central

    Royaltey, H H

    1988-01-01

    The health information needs of health care professionals and consumers in less-developed countries, although somewhat similar to those of their U.S. counterparts, have a number of unique differences. Health care professionals in developing countries are more diverse in their backgrounds, training, experience, and work settings. These differences, combined with cultural variables, a lack of resources and trained information professionals, contribute to the complexity of health information delivery. Consumers in developing countries, due to a lower literacy rate and a higher rate of commercial health information, face different problems when attempting to make health-related decisions. PMID:3370374

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

    PubMed

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

    2015-01-01

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

  10. A Description of the New York City Infant Day Care Study: Health, Nutrition and Physical Development.

    ERIC Educational Resources Information Center

    Gareen, Diane B.

    This report provides an account of the nature and purposes of data collected concerning the health, nutrition, and physical development of infants during the first three years of life, in order to compare the physical health of children in family or group day care and children with no previous day care experience. The data collected include the…

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

    ERIC Educational Resources Information Center

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

    2013-01-01

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

  12. Health Care Team

    MedlinePLUS

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

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

    PubMed

    Touburg, Giorgio; Veenhoven, Ruut

    2015-07-01

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

  14. Respiratory Home Health Care

    MedlinePLUS

    Respiratory Home Health Care Respiratory care at home can contribute to improved quality of life and significant cost savings. Your respiratory care ... your family and home situation to help your health care provider plan for your care after you are ...

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

    PubMed

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

    2003-01-01

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

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

    PubMed

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

    2003-01-01

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

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

    PubMed Central

    ITO, HIROTO; SETOYA, YUTARO; SUZUKI, YURIKO

    2012-01-01

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

  18. Primary oral health care.

    PubMed

    Honkala, Eino

    2014-01-01

    The aim of this review was to describe the background and evolution of primary oral health care (POHC), including the development of an oral health policy, by identifying the resources necessary for oral health services, reviewing the evidence of the effectiveness of oral health promotion and education, providing essential oral health care, and establishing evidence of the benefits of regular dental visits for effective POHC. At present, evidence for the effectiveness of oral health education and regular dental visits is very weak. Nevertheless, POHC needs to be developed as an integral part of primary health care (PHC). Therefore, a need exists to increase financial investment, resources and workforce in PHC to lower the prevalence of dental caries and periodontal disease in the Middle-East using the POHC approach. PMID:24503932

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

    E-print Network

    Grundy, John

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

  20. National Health Care Survey

    Cancer.gov

    The National Health Care Survey (NHCS) encompasses a family of health care provider surveys, including information about the facilities that supply health care, the services rendered, and the characteristics of the patients served.

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

    PubMed

    Gressel, Justin W

    2013-01-01

    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

  2. Health Care Expenditures

    Microsoft Academic Search

    Edward C. Norton; Sally C. Stearns

    Changes in the size and composition of the older population will have profound effects on future health care expenditures\\u000a in developed nations. With the baby boom cohorts joining the ranks of the elderly after 2010, the absolute amount of health\\u000a care spending on elderly will increase greatly. The increasing expenditures raise concerns about the effectiveness of such\\u000a spending and the

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed Central

    Odeyemi, Isaac AO; Nixon, John

    2013-01-01

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

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

    PubMed

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

    2013-09-01

    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

  6. Childhood Mental Health Problems In Primary Health Care In A Developing Country: Some Factors Influencing Detection By Primary Health Care Nursing Staff

    Microsoft Academic Search

    C. Rudd; J McMaster

    1996-01-01

    The detection of mental health problems in children by primary health care (PHC) nurses was investigated. The sample consisted of 133 children who attended a primary health care facility and 15 nurses. The results indicated that 49,6% of the child sample were identified by the RQC as having a mental health problem, however, the nurses only detected 1,5% of these

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

    PubMed Central

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

    2012-01-01

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

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

    PubMed

    Ariyoshi, Hiromi

    2009-02-01

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

  9. Home health care

    MedlinePLUS

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

  10. Health care informatics

    Microsoft Academic Search

    Keng Siau

    2003-01-01

    The health care industry is currently experiencing a fundamental change. Health care organizations are reorganizing their processes to reduce costs, be more competitive, and provide better and more personalized customer care. This new business strategy requires health care organizations to implement new technologies, such as Internet applications, enterprise systems, and mobile technologies in order to achieve their desired business changes.

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

    NASA Technical Reports Server (NTRS)

    Laurini, Kathy; Sawin, Charles F.

    2006-01-01

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

  12. Developing cultural competence in health care settings. National Center for Cultural Competence.

    PubMed

    2002-01-01

    Increasing cultural and linguistic competence in health care settings is important for several reasons, including: responding to current and projected demographic changes in the United States; eliminating long-standing disparities in the health status of people of diverse racial, ethnic, and cultural backgrounds; improving quality of both services provided and health outcomes; meeting legislative, regulatory, and accreditation mandates; gaining a competitive edge in the market place; and decreasing the likelihood of liability/malpractice claims. Changes in policies, structures, practices, and procedures are often needed to bring about improvements in this arena. To support the process of change, The National Center for Cultural Competence (NCCC) was funded to increase the capacity of health care and mental health systems, institutions, programs, and providers to design, implement, and evaluate service delivery systems for cultural and linguistic competence. Several checklists developed by the NCCC are presented here for use by individual practitioners, programs, and institutions in assessing aspects of cultural competence. PMID:11962178

  13. National Health Care Skill Standards.

    ERIC Educational Resources Information Center

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

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

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

    PubMed Central

    2011-01-01

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

  15. Developing Measures of Educational Change for Academic Health Care Teams Implementing the Chronic Care Model in Teaching Practices

    PubMed Central

    Stevens, David P.; Sixta, Connie S.; Provost, Lloyd; Johnson, Julie K.; Woods, Donna M.; Wagner, Edward H.

    2010-01-01

    BACKGROUND The Chronic Care Model (CCM) is a multidimensional framework designed to improve care for patients with chronic health conditions. The model strives for productive interactions between informed, activated patients and proactive practice teams, resulting in better clinical outcomes and greater satisfaction. While measures for improving care may be clear, measures of residents’ competency to provide chronic care do not exist. This report describes the process used to develop educational measures and results from CCM settings that used them to monitor curricular innovations. SUBJECTS Twenty-six academic health care teams participating in the national and California Academic Chronic Care Collaboratives. METHOD Using successive discussion groups and surveys, participants engaged in an iterative process to identify desirable and feasible educational measures for curricula that addressed educational objectives linked to the CCM. The measures were designed to facilitate residency programs’ abilities to address new accreditation requirements and tested with teams actively engaged in redesigning educational programs. ANALYSIS Field notes from each discussion and lists from work groups were synthesized using the CCM framework. Descriptive statistics were used to report survey results and measurement performance. RESULTS Work groups generated educational objectives and 17 associated measurements. Seventeen (65%) teams provided feasibility and desirability ratings for the 17 measures. Two process measures were selected for use by all teams. Teams reported variable success using the measures. Several teams reported use of additional measures, suggesting more extensive curricular change. CONCLUSION Using an iterative process in collaboration with program participants, we successfully defined a set of feasible and desirable education measures for academic health care teams using the CCM. These were used variably to measure the results of curricular changes, while simultaneously addressing requirements for residency accreditation. Electronic supplementary material The online version of this article (doi:10.1007/s11606-010-1358-1) contains supplementary material, which is available to authorized users. PMID:20737234

  16. The development of joint principles: integrating behavioral health care into the patient-centered medical home.

    PubMed

    2014-06-01

    This article describes the development of the Joint Principles of The Patient-Centered Medical Home (PCMH) by the Working Party Group on Integrated Behavioral Healthcare. The Joint Principles establish the primacy of integrated behavioral health care as a core principle of the PCMH. PMID:24955690

  17. Rich doctors and poor patients: Market failure and health care systems in developing countries

    Microsoft Academic Search

    B. N. Ghosh

    2008-01-01

    This article argues that, in developing countries, health care systems (HCS) have been facing the problem of market failure, implying that the fair rules of market principles do not apply and patients often become losers. Explaining the theoretical issues involved, the article examines various causes of market failures in HCS, including: rent-seeking activities by doctors, asymmetric information between doctors and

  18. A model of interdisciplinary adolescent health care in a developing country.

    PubMed

    Mendez Ribas, J; Girard, G; Coll, A; Yunes, R; Villegas, D

    1993-01-01

    In Argentina, an integrated program has been developed to provide health care to adolescents in a hospital setting. In order to describe the structure and operation of the program and the constitution and dynamics of the working team, data were gathered through observations and interviews. The objectives of the program are 1) to provide adolescents with health care which integrates their physical, psychological, and social needs; 2) to detect disorders in early stages; 3) to emphasize reproductive health; 4) to strengthen families; 5) to train health care professionals; 6) to extend the program; 7) to do research on the Argentine adolescent; and 8) to collaborate with professional organizations concerned with adolescents. This report relates the evolution of the program, which has its roots in a 1973 study on the effectiveness of hospital services to adolescents, and describes the building and equipment devoted to the adolescent program. The organization of the program is discussed in terms of administration, material and financial resources, and human resources. The functions of the program are detailed and, as indicated by its goals, include health care (clinical medicine, gynecology, obstetrics, and mental health), teaching (pre/post graduate workshops, annual intensive courses, and scientific meetings), research, and community outreach. Finally, each area of medical care is described, with data tabulated for the most frequent reasons for each type of clinical and gynecological consultation. Reproductive health care includes sex education, counseling, pregnancy or postabortion care, and social services to unmarried adolescent mothers. The mental health staff offers individual, family, linking, and group therapy as well as vocational guidance, parental guidance, and psychopedagogical diagnoses. The social workers on the team interact with the adolescent in question and other professionals. In conclusion, it is noted that adolescent medicine is developing as a distinct field, and there is a need for more medical centers to provide the range of services adolescents require as well as to afford training opportunities for health care professionals. The positive results of this program based on increasing demand and user satisfaction justify the work done to create the service. PMID:12319493

  19. Annual Initiative Review: Report of Health Care Delivery Initiative. California Community Colleges Economic Development Program Annual Initiative Report.

    ERIC Educational Resources Information Center

    Comins, James L.; Krozek, Charles

    This 1999-2000 report addresses the objectives and impact of California's Health Care Delivery Initiative (HCDI), which is comprised of a network of Regional Health Occupations Resource Centers (RHORCs) and their community college and health care industry partners. The HCDI identifies needed workers, develops/modifies community college curricula,…

  20. Vacation health care

    MedlinePLUS

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

  1. Growing Pains: Mental Health Care in a Developing China

    Microsoft Academic Search

    Doris F. Chang; Arthur Kleinman

    Around the world, in high- and low-income countries alike, mental illness and high-risk behaviors contribute to profound suffering and loss at the level of the individual and the state. In the case of China as in other developing countries, gains made in the areas of economics, technology, education, and overall standard of living are being offset by a rise in

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

    PubMed Central

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

    2007-01-01

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

  3. Advancing Geriatric Education: Development of an Interprofessional Program for Health Care Faculty.

    PubMed

    Ford, Channing R; Brown, Cynthia J; Sawyer, Patricia; Rothrock, Angela G; Ritchie, Christine S

    2015-01-01

    To improve the health care of older adults, a faculty development program was created to enhance geriatric knowledge. The University of Alabama at Birmingham (UAB) Geriatric Education Center leadership instituted a one-year, 36-hour curriculum focusing on older adults with complex health care needs. Content areas were chosen from the Institute of Medicine Transforming Health Care Quality report and a local needs assessment. Potential preceptors were identified and participant recruitment efforts began by contacting UAB department chairs of health care disciplines. This article describes the development of the program and its implementation over three cohorts of faculty scholars (n = 41) representing 13 disciplines, from nine institutions of higher learning. Formative and summative evaluation showed program success in terms of positive faculty reports of the program, information gained, and expressed intent by each scholar to apply learned content to teaching and/or clinical practice. This article describes the initial framework and strategies guiding the development of a thriving interprofessional geriatric education program. PMID:24884900

  4. Your Health Care Team

    MedlinePLUS

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

  5. DEVELOPMENT OF A RURAL COMMUNITY HEALTH CARE MODEL BASED ON INDIAN INDIGENOUS SYSTEM OF MEDICINE

    PubMed Central

    Hyma, B.; Ramesh, A.; Subhadra, N.L.

    1988-01-01

    Based on the principles of primary health care as outlined by WHO at the Alma Ata Conference in 1978, many voluntary organizations in India have been formulating, organizing and experimenting with the comprehensive rural community health Schemes. The goal is to indentify the felt needs at both individual and community levels and facilitate direct participation in decision making, develop suitable alternative, ecologically Sound indigenous models for socioeconomic well-being. In this context the Indian system of medicine has a useful and complementary role to play in the preventive and curative aspects of primary health care programmes. With the above objectives in mind the investigators undertook a brief survey of a “comprehensive rural health” project. The primary aim of this project is to develop a community health care model using innovative alternative methods using Indian indigenous system of medicine and participatory research techniques to improve rural health services of the surrounding under privileged villages. Many gaps exist in the assessment, however, a birds eye-view is presented here. PMID:22557645

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

    PubMed Central

    Ahgren, Bengt; Axelsson, Runo

    2011-01-01

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

  7. 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 ...

  8. Health care informatics.

    PubMed

    Siau, Keng

    2003-03-01

    The health care industry is currently experiencing a fundamental change. Health care organizations are reorganizing their processes to reduce costs, be more competitive, and provide better and more personalized customer care. This new business strategy requires health care organizations to implement new technologies, such as Internet applications, enterprise systems, and mobile technologies in order to achieve their desired business changes. This article offers a conceptual model for implementing new information systems, integrating internal data, and linking suppliers and patients. PMID:12670013

  9. Benchmarking Home Health Care Data

    Microsoft Academic Search

    Paula Howard

    1997-01-01

    Benchmarking data is a relatively new process in the home health care industry. But the results can assist an agency in the strategic planning— staffing needs and program development—for the present and future. This descriptive research project benchmarked home health care data at the national, state (ie, North Carolina), and local (ie, Triangle area: Raleigh, Durham, and Chapel Hill) level

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

    PubMed

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

    2005-03-01

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

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

    ERIC Educational Resources Information Center

    Keener, Patricia A.

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

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

    PubMed

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

    2013-01-01

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

  13. [Health care insurance for Africa].

    PubMed

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

    2007-12-01

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

  14. Private health care

    Microsoft Academic Search

    Mukund W. Uplekar

    2000-01-01

    During the last decade there has been considerable international mobilisation around shrinking the role of States in health care. The World Bank reports that, in many low and middle-income countries, private sources of finance comprise the largest share of total national health expenditures. Private sector health care is ubiquitous, reaches throughout the population, preferred by the people and is significant

  15. The development and application of a public health skills assessment tool for use in primary care organisations

    Microsoft Academic Search

    Neil. J Brocklehurst; Ann Rowe

    2003-01-01

    The public health skills assessment instrument described in this paper was developed to provide a key group of UK primary care practitioners (health visitors) with a personal development planning tool and researchers with a robust assessment tool for use in evaluations of innovative local public health programmes. Pilot testing with over 120 practitioners has provided evidence of its reliability and

  16. Health care in Brazil.

    PubMed Central

    Haines, A

    1993-01-01

    Brazil has great geopolitical importance because of its size, environmental resources, and potential economic power. The organisation of its health care system reflects the schisms within Brazilian society. High technology private care is available to the rich and inadequate public care to the poor. Limited financial resources have been overconcentrated on health care in the hospital sector and health professionals are generally inappropriately trained to meet the needs of the community. However, recent changes in the organisation of health care are taking power away from federal government to state and local authorities. This should help the process of reform, but many vested interests remain to be overcome. A link programme between Britain and Brazil focusing on primary care has resulted in exchange of ideas and staff between the two countries. If primary care in Brazil can be improved it could help to narrow the health divide between rich and poor. Images p503-a p504-a p505-a PMID:8448465

  17. Development and implementation of a nationwide health care quality indicator system in Taiwan

    Microsoft Academic Search

    WEN-TA CHIU; CHE-MING YANG; HUI-WEN LIN; TU-BIN CHU

    2007-01-01

    Abstract Quality issues.Quality is an increasingly importantissue to the health care sector. The Taiwanese government,also recognizes the need to implement a nationwide health care quality indicator system to strengthen quality surveillance. Choice of solution. In 1999, the Department of Health funded a 2-year project led by the Taiwan Healthcare Executive

  18. Leadership in Health Care Systems: Health Care Organization Management

    E-print Network

    Goldman, Steven A.

    , Influence and Leadership in Complex Organizations (5 credits) Epidemiology and Population Health ManagementLeadership in Health Care Systems: Health Care Organization Management and Leadership Track: ­ Health Care Organization, Management and Leadership ­ Clinical Research Coordinator ­ Clinical Nurse

  19. US health care crisis.

    PubMed

    Ciri?, Ivan

    2013-01-01

    The United States health care is presently challenged by a significant economic crisis. The purpose of this report is to introduce the readers of Medicinski Pregled to the root causes of this crisis and to explain the steps undertaken to reform health care in order to solve the crisis. It is hoped that the information contained in this report will be of value, if only in small measure, to the shaping of health care in Serbia. PMID:24245454

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

    PubMed Central

    Pakenham-Walsh, Neil; Bukachi, Frederick

    2009-01-01

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

  1. A call to action for evidence-based military women's health care: developing a women's health research agenda that addresses sex and gender in health and illness.

    PubMed

    Trego, Lori; Wilson, Candy; Steele, Nancy

    2010-10-01

    Women in the Army, Navy, Air Force, and Marines are serving in complex occupational specialties that sustain national policy and ensure combat effectiveness of our forces. Their roles have evolved from supportive roles during early conflicts to active roles in combat support and counterinsurgency operations today. Although women have received military health care over the past three decades, sex- and gender-specific care has been limited to reproductive needs and has rarely addressed military-specific health risks and outcomes. The complexity of military jobs and increased deployments to combat operations has led to increased occupational and health risks for women. As differences have been noted between men and women's deployment-related health outcomes, it is incumbent on the Military Health Care System (MHS) to create an evidence base that addresses sex and gender differences in the health of its service members. A working group of military women's health advanced practice nurses (APN) and research experts proposes to address this gap in knowledge and practices through sex- and gender-specific research. A sex-and gender-based research agenda for military women's health will be a valuable instrument to those who are dedicated to the health of this population, including members of the Army, Navy, and Air Force military nursing community. Using the knowledge that the research agenda generates, military health care providers can develop clinical practice guidelines, influence policy, and participate in program development to improve the health of servicewomen. Shaping a sex- and gender-specific military women's health research agenda will create the foundation for future evidence-based care. PMID:20798161

  2. [About the legal regulation of health care].

    PubMed

    Yefremov, D V

    2012-01-01

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

  3. Monitoring health care.

    PubMed

    Herrmann, W L; Moore, J S

    1975-10-15

    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

  4. Rethinking primary health care ethics: ethics in contemporary primary health care in the United Kingdom

    Microsoft Academic Search

    Robyn Martin

    2004-01-01

    Ethics have long been recognized as underpinning primary health care. While dis- crete understandings of ethics have developed to support many areas of health care and research, there has been little attempt to formulate an ethics framework which is focused on primary health care. Developments both within and external to primary health care practice make it timely to address primary

  5. Has implementation of integrated mental health services in primary care programs positively impacted health outcomes among the mentally ill in developing countries?

    Microsoft Academic Search

    Amelia Ubesie

    2010-01-01

    Objective. The World Health Organization (WHO) estimates that nearly 450 million people suffer from a mental disorder in the world. Developing countries do not have the health system structure in place to support the demand of mental health services. This study will conduct a review of mental health integration in primary care research that is carried out in low-income countries

  6. Indian Health Service: Find Health Care

    MedlinePLUS

    ... and Human Services Indian Health Service The Federal Health Program for American Indians and Alaska Natives Feedback ... Home Find Health Care Share This Page: Find Health Care IMPORTANT If you are having a health ...

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

    Microsoft Academic Search

    Khanindra Kumar Bhuyan; Kumar Bhuyan

    2004-01-01

    BACKGROUND: The concepts of health promotion, self-care and community participation emerged during 1970s, primarily out of concerns about the limitation of professional health system. Since then there have been rapid growth in these areas in the developed world, and there is evidence of effectiveness of such interventions. These areas are still in infancy in the developing countries. There is a

  8. Health-Care Hub

    ERIC Educational Resources Information Center

    Bowman, Darcia Harris

    2004-01-01

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

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

    PubMed

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

    2015-06-01

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

  10. Gendered experiences of health care

    Microsoft Academic Search

    PATRICIA M. PITTMAN

    Objective. To develop a method capable of bringing to light gender specific problems in the social interaction between providers and clients, and in so doing, contribute to improving quality of care for both sexes in five primary health care centers in Argentina. Design. A qualitative study using semi-structured interviews. Texts were processed in a database and analyzed using a formal

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

    PubMed

    Allan, J; Ball, P; Alston, M

    2007-01-01

    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

  12. Health Information Systems for Primary Health Care: Thinking About Participation

    E-print Network

    Sahay, Sundeep

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

  13. Establishment of primary health care in Vietnam.

    PubMed Central

    Birt, C A

    1990-01-01

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

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

    PubMed

    Walsh, J A; Warren, K S

    1979-11-01

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

  15. Clinical Drug Development Using Dynamic Biomarkers to Enable Personalized Health Care in COPD.

    PubMed

    Bihlet, Asger R; Karsdal, Morten A; Bay-Jensen, Anne-Christine; Read, Simon; Kristensen, Jacob Hull; Sand, Jannie Marie Bülow; Leeming, Diana Julie; Andersen, Jeppe Ragnar; Lange, Peter; Vestbo, Jørgen

    2015-07-01

    Despite massive investments in the development of novel treatments for heterogeneous diseases such as COPD, the resources spent have only benefited a fraction of the population treated. Personalized health care to guide selection of a suitable patient population already in the clinical development of new compounds could offer a solution. This review discusses past successes and failures in drug development and biomarker research in COPD, describes research in COPD phenotypes and the required characteristics of a suitable biomarker for identifying patients at higher risk of progression, and examines the role of extracellular matrix proteins found to be upregulated in COPD. Novel biomarkers of connective tissue remodeling that may provide added value for a personalized approach by detecting subgroups of patients with active disease suitable for pharmacologic intervention are discussed. PMID:25856563

  16. Mercury and health care

    PubMed Central

    Rustagi, Neeti; Singh, Ritesh

    2010-01-01

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

  17. Health care economics: impact on hearing loss prevention in the developing world.

    PubMed

    Alberti, P W

    1996-01-01

    Health care resources are unevenly distributed: 15% of the world's population utilise 87%. Physician numbers vary dramatically from one region to another, as does disease distribution and the age of the population. All this impacts both what can be delivered and what is appropriate to a region. Primary prevention is usually effective and much cheaper than treatment or rehabilitation. Alternative health care models are discussed. PMID:8668908

  18. Developing and comparing methods for measuring the content of care in mental health services

    Microsoft Academic Search

    B. Lloyd-EvansM; M. Slade; D. P. Osborn; R. Skinner; S. Johnson

    2011-01-01

    Background  Measurement of what happens in mental health services is needed to describe services, identify variation in care provision\\u000a and understand service outcomes. However, there is no consensus about appropriate methods or measures for content of care.\\u000a Previous research has primarily used a single information source and prioritised staff over patient perspectives on content\\u000a of care. This study aims to enhance

  19. Developing multimodal intelligent affective interfaces for tele-home health care

    Microsoft Academic Search

    Christine L. Lisetti; Fatma Nasoz; Cynthia Lerouge; Onur Ozyer; Kaye Alvarez

    2003-01-01

    Accounting for a patient's emotional state is integral in medical care. Telehealth research attests to the challenge clinicians must overcome in assessing patient emotional state when modalities are limited (Pettinari and Jessopp, 2001). The extra effort involved in addressing this challenge requires attention, skill, and time. Large caseloads may not afford tele-home health care clinicians the time and focus necessary

  20. [Development of highly specialized clinical drug trial units within health care institutions].

    PubMed

    Stanimirovi?, V; Babi?, M; Nikoli?, D; Cucak, S; Nikoli?, A

    2000-01-01

    The purpose of the most of clinical trials conducted under the auspices of pharmaceutical industries is to evaluate the safety and efficacy of drugs, and they are conducted at university health care institutions or appropriate clinical centres. Close collaboration among the investigators, potential investigators and other academic citizens is essential for an effective and efficient conduct of these studies. Clinical studies usually test a drug which is to be instituted for the first time; therefore more attention is being dedicated to its administration, with monitoring of a greater number of valid parameters in accordance with the Good Clinical Practices (GCP) and Good Laboratory Practices (GLP) standards. These are very strict standards, which have been internationally adopted and are valid worldwide. They define the documentation required, the setting method, the necessary equipment and the facilities within which the clinical trials are to be conducted, as well as human resources indispensable for carrying out the clinical trials. The objective of this paper was to determine whether our medical instructions fulfil the necessary conditions for establishing the clinical trials units. Creation of a symbiosis of this kind (between the pharmaceutical industry and the appropriate health care institutions), reflected in the clinical trials unit, should enable the drug research and development to remain within our country. PMID:11089432

  1. Health care entrepreneurship: financing innovation.

    PubMed

    Grazier, Kyle L; Metzler, Bridget

    2006-01-01

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

  2. Engineering VA Health Care

    E-print Network

    Adams, Mark

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

  3. Containing Health Care Costs

    PubMed Central

    Derzon, Robert A.

    1980-01-01

    As the federal government shifted from its traditional roles in health to the payment for personal health care, the relationship between public and private sectors has deteriorated. Today federal and state revenue funds and trusts are the largest purchasers of services from a predominantly private health system. This financing or “gap-filling” role is essential; so too is the purchaser's concern for the costs and prices it must meet. The cost per person for personal health care in 1980 is expected to average $950, triple for the aged. Hospital costs vary considerably and inexplicably among states; California residents, for example, spend 50 percent more per year for hospital care than do state of Washington residents. The failure of each sector to understand the other is potentially damaging to the parties and to patients. First, and most important, differences can and must be moderated through definite changes in the attitudes of the protagonists. PMID:6770551

  4. Development and first assessment of a questionnaire for health care utilization and costs for cardiac patients

    PubMed Central

    Schweikert, Bernd; Hahmann, Harry; Leidl, Reiner

    2008-01-01

    Background The valid and reliable measurement of health service utilization, productivity losses and consequently total disease-related costs is a prerequisite for health services research and for health economic analysis. Although administrative data sources are usually considered to be the most accurate, their use is limited as some components of utilization are not systematically captured and, especially in decentralized health care systems, no single source exists for comprehensive utilization and cost data. The aim of this study was to develop and test a questionnaire for the measurement of disease-related costs for patients after an acute cardiac event (ACE). Methods To design the questionnaire, the literature was searched for contributions to the assessment of utilization of health care resources by patient-administered questionnaires. Based on these findings, we developed a retrospective questionnaire appropriate for the measurement of disease-related costs over a period of 3 months in ACE patients. Items were generated by reviewing existing guidelines and by interviewing medical specialists and patients. In this study, the questionnaire was tested on 106 patients, aging 35–65 who were admitted for rehabilitation after ACE. It was compared with prospectively measured data; selected items were compared with administrative data from sickness funds. Results The questionnaire was accepted well (response rate = 88%), and respondents completed the questionnaire in an average time of 27 minutes. Concordance between retrospective and prospective data showed an intraclass correlation (ICC) ranging between 0.57 (cost of medical intake) and 0.9 (hospital days) with the other main items (physician visits, days off work, medication) clustering around 0.7. Comparison between self-reported and administrative data for days off work and hospitalized days were possible for n = 48. Respective ICCs ranged between 0.92 and 0.94, although differences in mean levels were observed. Conclusion The questionnaire was accepted favorably and correlated well with alternative measurement approaches. This first assessment showed promising characteristics of this questionnaire in different aspects of validity for patients with ACE. However, additional research and more extensive tests in other patient groups would be worthwhile. PMID:18803845

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

    PubMed

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

    2011-05-01

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

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

    PubMed Central

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

    2010-01-01

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

  7. Health care interactional suffering in palliative care.

    PubMed

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

    2014-05-01

    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

  8. Developments in total quality management in the United States: the Intermountain Health Care perspective.

    PubMed

    Richards, K F

    1994-06-01

    In summary our purpose has been to evaluate quality in the following terms. Best process of care--narrowing the variation of care decisions, working towards the best method. Best clinical outcome--decreased morbidity ond mortality. Best patient satisfaction--both for clinical outcome and the process of care. Best value--best value at the lowest cost. At Intermountain Health Care we believe that the best way to achieve the best quality improvement in a health care system is to involve all of the participants--patients, providers, and systems--in employing the principles of total quality management. Patient involvement--in prevention; participating in best care process through education and utilisation; in evaluating functional status before, during, and after intervention; in satisfaction; in clinical outcome and follow up with providers. Provider involvement--in planning, implementing, analysing, and educating; in defining guidelines; in reassessing and defining guidelines; in reassessing and continually modifying the care map, always striving for "best care." System involvement--in providing structure and mechanisms, support staff, and information systems and being willing to focus on quality as a part of its mission. An American philosopher, George Santayana, once said: "What we call the contagious force of an idea is really the force of the people who have embraced it." It will be up to all of us collectively to become the force behind moving quality management principles into the forefront of patient care methodology and ensuring that quality remains as the guiding principle of health care delivery in the future. PMID:10172132

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

    PubMed Central

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

    2000-01-01

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

  10. Application of the analytical hierarchy process to establish health care waste management systems that minimise infection risks in developing countries

    Microsoft Academic Search

    Alan C. Brent; David E. C. Rogers; Tsaletseng S. M. Ramabitsa-siimane; Mark B. Rohwer

    2007-01-01

    This paper focuses on the application of the analytical hierarchy process (AHP) technique in the context of sustainable development to establish and optimise health care waste management (HCWM) systems in rural areas of developing coun- tries. This is achieved by evaluating the way in which the AHP can best be combined with a life cycle management (LCM) approach, and addressing

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

    PubMed

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

    2014-01-01

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

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

    PubMed

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

    2012-01-01

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

  13. Workshop: Patient Centered (Health) Care Solutions Development of an Expert System for Distinguishhing Headaches from Migraines

    Microsoft Academic Search

    D. Kopec; G. Shagas; J. Selman; D. Reinharth; S. Tamang

    Information and communication technologies, and new governmental directives that have been implemented by academic and private health science centers, are paving the way for a new era of patient-centered care in the United States. As quality of care becomes a major focus in the 21st century, U.S. healthcare research has begun to address, and more accurately assess, the nature of

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

    Microsoft Academic Search

    Kai Leichsenring; Piazzale Stazione

    2004-01-01

    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

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

    PubMed

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

    2002-10-01

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

  16. Decentralisation of health care and its impact on health outcomes

    Microsoft Academic Search

    Dolores Jimenez; Peter C. Smith

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

  17. Brentwood Community Health Care Assessment

    PubMed Central

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

    2015-01-01

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

  18. Understanding dissatisfied users: developing a framework for comprehending criticisms of health care work.

    PubMed

    Coyle, J

    1999-09-01

    Recent government proposals have underlined the importance of ascertaining users' views of health care. Traditionally these have been obtained through satisfaction surveys. However, researchers argue that the focus of attention should now shift to exploring dissatisfaction because it highlights more clearly any problems in lay-practitioner relationships. Research has shown that dissatisfaction is a complex social construct which is underpinned by a range of values, beliefs, attitudes and experiences. The aim of this paper is to provide insights into the meaning of dissatisfaction by exploring how dissatisfied users attribute cause, responsibility and blame for their untoward experiences. Forty-one people were identified from a household survey of user views as experiencing problems with their health care. They were interviewed in depth, and a grounded theory approach was used to construct a framework inductively from their accounts. This identified a number of normative expectations through which health work was routinely criticized; these included respondents casting aspersions on the professional integrity of health care practitioners and preserving their own moral identity through demonstrating competence, knowledge, rationality, reasonableness and concern for others. Moreover, it is argued that these patterns help practitioners to understand how dissatisfied users' perceive subsequent health care encounters. PMID:10499230

  19. Phytotherapy in primary health care.

    PubMed

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

    2014-06-01

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

  20. Training For Health Care

    PubMed Central

    Schwartz, Owen

    1979-01-01

    As primary health care professionals, family physicians can be in the forefront of the emerging field of preventive health counselling. Thus far the emphasis has been on the screening and treatment of disease. Consideration of lifestyle factors like family communication, nutrition, exercise and degree of stress receive little attention. This article describes a family practice which functions as a health maintenance program. The influence of the family practice residency on the concept formation is described, and the difficulties and challenge of putting the concepts into practice are shown. PMID:21301587

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

    ERIC Educational Resources Information Center

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

    2012-01-01

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

  2. [Stress in health care workers].

    PubMed

    Friedrich, Stiefel; Guex, Patrice

    2008-02-13

    A growing body of evidence indicates that health care professionals are in need of support. Beside heavy clinical patient volume or administrative duties, stress related to the significance of contextual factors is an important source of clinician's distress. Identification of and working through such stress can be a durable source of support. This article discusses key elements of these stressors, namely, the role of emotions of the clinician, awareness of limits, confusion about empathy, the influence of development and life trajectory on professional identity and the conflicting roles of the health care provider being in need of support. PMID:18320773

  3. Total quality in health care.

    PubMed

    Brannan, K M

    1998-05-01

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

  4. Women's health and behavioral health issues in health care reform.

    PubMed

    Chin, Jean Lau; Yee, Barbara W K; Banks, Martha E

    2014-01-01

    As health care reform promises to change the landscape of health care delivery, its potential impact on women's health looms large. Whereas health and mental health systems have historically been fragmented, the Affordable Care Act (ACA) mandates integrated health care as the strategy for reform. Current systems fragment women's health not only in their primary care, mental health, obstetrical, and gynecological needs, but also in their roles as the primary caregivers for parents, spouses, and children. Changes in reimbursement, and in restructuring financing and care coordination systems through accountable care organizations and medical homes, will potentially improve women's health care. PMID:24410361

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

    PubMed

    Popil, Inna; Dillard-Thompson, Darlene

    2015-05-01

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

  6. Method to Develop Health Care Peer Groups for Quality and Financial Comparisons Across Hospitals

    PubMed Central

    Byrne, Margaret M; Daw, Christina N; Nelson, Harlan A; Urech, Tracy H; Pietz, Kenneth; Petersen, Laura A

    2009-01-01

    Objective To develop and explore the characteristics of a novel “nearest neighbor” methodology for creating peer groups for health care facilities. Data Sources Data were obtained from the Department of Veterans Affairs (VA) databases. Statistical Methods and Findings Peer groups are developed by first calculating the multidimensional Euclidean distance between each of 133 VA medical centers based on 16 facility characteristics. Each medical center then serves as the center for its own peer group, and the nearest neighbor facilities in terms of Euclidean distance comprise the peer facilities. We explore the attributes and characteristics of the nearest neighbor peer groupings. In addition, we construct standard cluster analysis-derived peer groups and compare the characteristics of groupings from the two methodologies. Conclusions The novel peer group methodology presented here results in groups where each medical center is at the center of its own peer group. Possible advantages over other peer group methodologies are that facilities are never on the “edge” of a group and group size—and thus group dispersion—is determined by the researcher. Peer groups with these characteristics may be more appealing to some researchers and administrators than standard cluster analysis and may thus strengthen organizational buy-in for financial and quality comparisons. PMID:19178585

  7. Adolescent Health Care in Brazil.

    ERIC Educational Resources Information Center

    Silber, Tomas Jose

    1984-01-01

    Presents an analysis of the health-care needs of Brazilian adolescents. The issues highlighted are adolescent morbidity and mortality, current delivery of adolescent health care, and future directions of adolescent programs in Brazil. (JAC)

  8. Priorities and allocation of health care resources in developing countries: A case-study from the Mtwara region, Tanzania

    Microsoft Academic Search

    Steffen Flessa

    2003-01-01

    Models of health economics usually maximise the sum of individual health. However, as the term health reflects very different aspects of well being, quite different objectives can be derived for the allocation of health care resources. This paper analyses the optimum allocation of health care resources in the Mtwara region, Tanzania, for five different objectives: minimisation of death cases, minimisation

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

    PubMed Central

    2014-01-01

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

  10. Child Care Health Connections, 2002.

    ERIC Educational Resources Information Center

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

    2002-01-01

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

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

    PubMed Central

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

    2007-01-01

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

  12. Integrated primary health care in Australia

    PubMed Central

    Davies, Gawaine Powell; Perkins, David; McDonald, Julie; Williams, Anna

    2009-01-01

    Introduction To fulfil its role of coordinating health care, primary health care needs to be well integrated, internally and with other health and related services. In Australia, primary health care services are divided between public and private sectors, are responsible to different levels of government and work under a variety of funding arrangements, with no overarching policy to provide a common frame of reference for their activities. Description of policy Over the past decade, coordination of service provision has been improved by changes to the funding of private medical and allied health services for chronic conditions, by the development in some states of voluntary networks of services and by local initiatives, although these have had little impact on coordination of planning. Integrated primary health care centres are being established nationally and in some states, but these are too recent for their impact to be assessed. Reforms being considered by the federal government include bringing primary health care under one level of government with a national primary health care policy, establishing regional organisations to coordinate health planning, trialling voluntary registration of patients with general practices and reforming funding systems. If adopted, these could greatly improve integration within primary health care. Discussion Careful change management and realistic expectations will be needed. Also other challenges remain, in particular the need for developing a more population and community oriented primary health care. PMID:19956377

  13. Developing a mobile learning solution for health and social care practice

    Microsoft Academic Search

    J. D. Taylor; C. A. Dearnley; J. C. Laxton; C. A. Coates; R. Campbell; I. Hall

    2010-01-01

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

  14. Integrating complementary and alternative medicine into conventional health care system in developing countries: an example of Amchi.

    PubMed

    Mishra, Shiva Raj; Neupane, Dinesh; Kallestrup, Per

    2015-01-01

    Complementary and alternative medicine has been a part of human life and practices since the beginning of time. The role of complementary and alternative medicine for the health of humans is undisputed particularly in light of its role in health promotion and well-being. This article discusses ways through which complementary and alternative medicine can be promoted and sustained as an integrated element of health care in developing countries. We specifically present the exemplary of Amchi traditional doctors of Northern Himalayas. PMID:25159527

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

    PubMed

    Braun, M

    2003-12-01

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

  16. Design, implementation, and evaluation of a community financing scheme for hospital care in developing countries: a pre-paid health plan in the Bwamanda health zone, Zaire.

    PubMed

    Moens, F

    1990-01-01

    Unless scarce resources can be mobilized and used efficiently, health for all by the year 2000 will remain a vain attempt. Innovative financing schemes exploring increased cost recovery from the users of the health system are explored throughout the world. In Bwamanda, Zaire, a community financing scheme for hospital care was developed through the application of operations research. A preference heuristic with considerable involvement of health providers and the community was used to identify the type of financing scheme and resulted in a pre-paid health plan, while a mathematical model was developed to determine the premiums to charge. The implementation of the health plant is briefly described. An evaluation of the effects of the pre-paid plan on the accessibility and equity of health care, as well as on the financial sustainability of the hospital, is presented and discussed: a steadily increasing membership of the health plan illustrates its appropriateness, while a doubling of the cost recovery of the hospital's operating costs after two years seems promising; the hospitalization rate of members of the health plan was significantly higher than for non-members. These findings suggest that a health zone may be an appropriate level for the organization of a regional pre-paid health plan. Problems of equity, full cost recovery, and replicability of the financing scheme are discussed. PMID:2367877

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

    PubMed Central

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

    2015-01-01

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

  18. Women Veterans Health Care: Frequently Asked Questions

    MedlinePLUS

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

  19. Development of an Undergraduate Course in Gender Issues in Health Care.

    ERIC Educational Resources Information Center

    Assa, Michelle; Berardo, Donna H.

    1997-01-01

    Describes the development of a multidisciplinary dental school course designed and taught by a pharmacy faculty member to create student awareness of the many issues and dimensions of women's health and to expand the understanding that women's health issues are not solely gynecological. Outlines course objectives, structure, resources, and…

  20. Development of Instructional Module Orientation to the Health Care Delivery System. Final Report.

    ERIC Educational Resources Information Center

    Junge, Catherine

    In an effort to fill a need for validated instructional materials in secondary vocational health occupations education, an experimental instructional module was developed based on behavioral objectives identified by teacher coordinators in Texas Health Occupations Cooperative Training (HOCT) programs. The module was then pilot tested with students…

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

    Microsoft Academic Search

    Lydia Kapiriri; Douglas K Martin

    2006-01-01

    BACKGROUND: Because the demand for health services outstrips the available resources, priority setting is one of the most difficult issues faced by health policy makers, particularly those in developing countries. However, there is lack of literature that describes and evaluates priority setting in these contexts. The objective of this paper is to describe priority setting in a teaching hospital in

  2. Towards an evidence based health care management.

    PubMed

    Axelsson, R

    1998-01-01

    Inspired by the development of Evidence Based Medicine, this article introduces a new approach for health care management called Evidence Based Management. This approach promises to improve the practice of health care management, at the same time as it may stimulate research on the organization and management of health care. Evidence Based Management means that health care managers should learn to search for and critically appraise evidence from management research as a basis for their practice. This will require some new managerial skills that should be included in the education and training of health care managers. It will also require a new orientation for research on health care management. There will be a demand for more applied research, and also for research with a more positivist orientation. PMID:10346052

  3. Attending unintended transformations of health care infrastructure

    PubMed Central

    Wentzer, Helle; Bygholm, Ann

    2007-01-01

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

  4. 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.

  5. Power Rx for the health care industry

    Microsoft Academic Search

    Lamarre

    1994-01-01

    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

  6. Teaching tomorrow's health care leaders.

    PubMed

    Mitchell, W

    1993-01-01

    Business school curricula have traditionally emphasized functional skills for people who will work in functional departments and general management skills for people who will organize interdepartmental work. Recently, some business schools have begun to develop programs that teach cross-functional work and team skills to functional specialists. Students educated in such programs will be well prepared to meet the new challenges that health care organizations will face. PMID:10130527

  7. A combined onomasiological and semasiological approach to the development of a comprehensive interface terminology for information storage and retrieval in primary health care.

    E-print Network

    Paris-Sud XI, Université de

    interface terminology for information storage and retrieval in primary health care. Robert Vander Stichele-CLUB, Bruxelles, October 15, 2012 Since 2011, the Meriterm (Medical End-user Reference Interface Terminology) Group has started the development of a reference terminology for Primary Health Care professionals

  8. University Health Care Health Sciences Center

    E-print Network

    Feschotte, Cedric

    and your child. University Health Care School of Medicine Division of Pediatric Nephrology & Hypertension Department of Pediatrics #12;Division of Pediatric Nephrology Patient Information Record Please fill out

  9. Managing the quality of health care.

    PubMed

    Larson, James S; Muller, Andreas

    2002-01-01

    This article reviews quality of health care initiatives beginning with the quality assessment/quality assurance movement of the 1970s. Conceptually, modern quality of care management is rooted in the intellectual work of Avedis Donabedian who defined quality of care as a combination of structure, process, and outcome. Donabedian's model is presented and some limitations are pointed out. In the late 1980s and 1990s. the health care industry adopted total quality management (TQM). More recently, the pursuit of health care quality has led to substantial performance measurement initiatives such as ORYX by the Joint Commission on Accreditation of Healthcare Organizations and MEDIS by the National Commission of Quality Assurance. The importance of CONQUEST, a freely available performance measurement database developed at the Harvard School of Public Health, is noted and discussed. The article concludes with a list of challenges facing public and private parties interests in health care quality improvement. PMID:15188996

  10. Access to health care

    PubMed Central

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

    2005-01-01

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

  11. Methods in informatics: using data derived from a systematic review of health care texts to develop a concept map for use in the neonatal intensive care setting.

    PubMed

    Panniers, Teresa L; Feuerbach, Renee Daiuta; Soeken, Karen L

    2003-01-01

    A qualitative systematic review of textbooks and clinical guidelines identified assessment criteria for initiation of nipple feeds in premature infants cared for in the neonatal intensive care unit (NICU) setting. Using a structured method for text source selection and data extraction, 43 health care texts were systematically reviewed yielding 153 separate statements related to assessing premature infants' feeding readiness. Following this procedure, a pile sort method was conducted wherein an expert neonatal nurse practitioner (NNP) grouped the statements according to similarity in meaning. Ten piles of terms emerged from this process. Each pile was "named," depicting discrete components used when assessing premature infants' readiness for nipple feeding. Using these public data and the private knowledge of the NNP informant, a concept map was constructed to illustrate a framework for decision support development and to examine the map's usefulness for structuring knowledge that will provide input to an intelligent decision support system. PMID:14643718

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

    PubMed

    Amara, Ahmed Hassan; Aljunid, Syed Mohamed

    2014-01-01

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

  13. 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

    2012-01-01

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

  14. The Economic Impact of Aurora Health Care in Wisconsin

    E-print Network

    Saldin, Dilano

    in Wisconsin A report prepared for Aurora Health Care By The University of Wisconsin-Milwaukee Center for Economic Development June 2013 Health Care by the University of Wisconsin- Milwaukee Center for Economic Development

  15. Health and Disability: Partnerships in Health Care

    ERIC Educational Resources Information Center

    Tracy, Jane; McDonald, Rachael

    2015-01-01

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

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

    PubMed

    Fotaki, Marianna

    2014-11-01

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

  17. Mental Health Care: Who's Who

    MedlinePLUS

    ... Living Listen Español Text Size Email Print Share Mental Health Care: Who's Who Article Body Psychiatrist: An M. ... degree in psychology, counseling or a related field. Mental Health Counselor: Master’s degree and several years of supervised ...

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

    PubMed

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

    2003-12-01

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

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

    PubMed Central

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

    2013-01-01

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

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

    PubMed Central

    Cueto, Marcos

    2004-01-01

    I present a historical study of the role played by the World Health Organization and UNICEF in the emergence and diffusion of the concept of primary health care during the late 1970s and early 1980s. I have analyzed these organizations’ political context, their leaders, the methodologies and technologies associated with the primary health care perspective, and the debates on the meaning of primary health care. These debates led to the development of an alternative, more restricted approach, known as selective primary health care. My study examined library and archival sources; I cite examples from Latin America. PMID:15514221

  1. Case Studies in Primary Health Care

    NSDL National Science Digital Library

    Perry, Henry

    2011-01-01

    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.

  2. Developments in Australian general practice 2000–2002: what did these contribute to a well functioning and comprehensive Primary Health Care System?

    PubMed Central

    Davies, Gawaine Powell; Hu, Wendy; McDonald, Julie; Furler, John; Harris, Elizabeth; Harris, Mark

    2006-01-01

    Background In recent years, national and state/territory governments have undertaken an increasing number of initiatives to strengthen general practice and improve its links with the rest of the primary health care sector. This paper reviews how far these initiatives were contributing to a well functioning and comprehensive primary health care system during the period 2000–2002, using a normative model of primary health care and data from a descriptive study to evaluate progress. Results There was a significant number of programs, at both state/territory and national level. Most focused on individual care, particularly for chronic disease, rather than population health approaches. There was little evidence of integration across programs: each tended to be based in and focus on a single jurisdiction, and build capacity chiefly within the services funded through that jurisdiction. As a result, the overall effect was patchy, with similar difficulties being noted across all jurisdictions and little gain in overall system capacity for effective primary health care. Conclusion Efforts to develop more effective primary health care need a more balanced approach to reform, with a better balance across the different elements of primary health care and greater integration across programs and jurisdictions. One way ahead is to form a single funding agency, as in the UK and New Zealand, and so remove the need to work across jurisdictions and manage their competing interests. A second, perhaps less politically challenging starting point, is to create an agreed framework for primary health care within which a collective vision for primary health care can be developed, based on population health needs, and the responsibilities of different sectors services can be negotiated. Either of these approaches would be assisted by a more systematic and comprehensive program of research and evaluation for primary health care. PMID:16412243

  3. Implemetation of Nutrition Screening at Ambulatory Health Care Sites

    Microsoft Academic Search

    G. Ewalt; J. Yee; D. Mueller; M. Lin; I. Friesen

    1997-01-01

    LEARNING OUTCOME: To recognize effectiveness of ambulatory health care nutrition screening and intervention with a multidisciplinary team.Challenged by the institution's mission to provide and promote community well-being across the health care continuum, the registered dietitians of the Nutrition Standards of Practice Committee led the development of nutrition screening protocols at four ambulatory health care sites. After careful planning and collaboration

  4. Contagious Ideas from Health Care

    ERIC Educational Resources Information Center

    Chaffee, Ellen

    2009-01-01

    Financial problems plague both higher education and health care, two sectors that struggle to meet public expectations for quality services at affordable rates. Both higher education and health care also have a complex bottom line, heavy reliance on relatively autonomous professionals, and clients who share personal responsibility for achieving…

  5. Perinatal health care in Japan.

    PubMed

    Nishida, H

    1997-01-01

    The maternal and infant health care system and vital statistics in Japan are reviewed. The improvement of socioeconomic conditions, higher education for women, comprehensive health care provided by the government, regionalization for high-risk pregnancy, medical advances in the care of pregnant women and neonates, the significant decline of perinatal and neonatal mortality rates in recent decades are all contributing factors in improved maternal-infant health care. On the basis of recent statistics showing that the survival rate of extremely low birth weight infants increased over 80%, the viability limit defined by Eugenic Protection Act was amended in 1991 from 24 to 22 completed weeks of gestation. PMID:9069070

  6. Ethics and health care ‘underfunding'

    PubMed Central

    Maynard, A.

    2001-01-01

    There are continual "crises" in health care systems worldwide as producer and patient groups unify and decry the "underfunding" of health care. Sometimes this cacophony is the self interest of profit seeking producers and often it is advocacy of unproven therapies. Such pressure is to be expected and needs careful management by explicit rationing criteria which determine who gets access to what health care. Science and rationality, however, are unfortunately, rarely the rules of conduct in the medical market-place. Key Words: Underfunding • rationing • efficiency • equity • accountability PMID:11479351

  7. Dignity violation in health care.

    PubMed

    Jacobson, Nora

    2009-11-01

    In this grounded theory analysis I sought to understand dignity violation in health care and to explore the context in which such violations take place. I found that dignity violation in health care occurs through processes of rudeness, indifference, condescension, dismissal, disregard, dependence, intrusion, objectification, restriction, labeling, contempt, discrimination, revulsion, deprivation, assault, and abjection. The conditions that promote these processes reside in the positions of the actors involved; in the asymmetrical relationships between the actors; in the health care setting itself, which is characterized by multiple tensions-including those between needs and resources, crisis and routine, experience and expertise, and rhetoric and reality; and in the embeddedness of health care in a broader social order of inequality. These findings suggest several interventions that might mitigate dignity violation in health care. PMID:19797155

  8. The national health care imperative.

    PubMed

    Halamandaris, V J

    1990-03-01

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

  9. Health Professionals' Knowledge of Women's Health Care.

    ERIC Educational Resources Information Center

    Beatty, Rebecca M.

    2000-01-01

    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…

  10. Health care and equity in India

    PubMed Central

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

    2011-01-01

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

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

    PubMed

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

    2013-01-01

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

  12. Advancing personalized health care through health information technology: an update from the American Health Information Community's Personalized Health Care Workgroup.

    PubMed

    Glaser, John; Henley, Douglas E; Downing, Gregory; Brinner, Kristin M

    2008-01-01

    The Personalized Health Care Workgroup of the American Health Information Community was formed to determine what is needed to promote standard reporting and incorporation of medical genetic/genomic tests and family health history data in electronic health records. The Workgroup has examined and clarified a range of issues related to this information, including interoperability standards and requirements for confidentiality, privacy, and security, in the course of developing recommendations to facilitate its capture, storage, transmission, and use in clinical decision support. The Workgroup is one of several appointed by the American Health Information Community to study high-priority issues related to the implementation of interoperable electronic health records in the United States. It is also a component of the U.S. Department of Health and Human Services' Personalized Health Care Initiative, which is designed to create a foundation upon which information technology that supports personalized, predictive, and pre-emptive health care can be built. PMID:18436899

  13. PRESIDENT'S INFORMATION TECHNOLOGY ADVISORY COMMITTEE Panel on Transforming Health Care

    E-print Network

    Horvitz, Eric

    #12;PRESIDENT'S INFORMATION TECHNOLOGY ADVISORY COMMITTEE Panel on Transforming Health Care February 2001 Transforming Health Care Through Information Technology REPORT TO THE PRESIDENT #12;c/o National Coordination Office for Information Technology Research & Development 4201 Wilson Boulevard

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

    MedlinePLUS

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

  15. The Health of Female Child Care Providers: Implications for Quality of Care

    Microsoft Academic Search

    Dee Baldwin; Sherry Gaines; Judith Lupo Wold; Armenia Williams; Janie Leary

    2007-01-01

    The purpose of this investigation was to determine the health behaviors and perceived health status of child care providers. Health behaviors and health status were also examined in relation to caring for children and the providers’ perceptions of quality child care. A researcher-developed questionnaire, adapted from Williams, Mason, and Wold (2001), was mailed to a random sample of 1,000 child

  16. Health Care Robotics: A Progress Report

    NASA Technical Reports Server (NTRS)

    Fiorini, Paolo; Ali, Khaled; Seraji, Homayoun

    1997-01-01

    This paper describes the approach followed in the design of a service robot for health care applications. Under the auspices of the NASA Technology Transfer program, a partnership was established between JPL and RWI, a manufacturer of mobile robots, to design and evaluate a mobile robot for health care assistance to the elderly and the handicapped. The main emphasis of the first phase of the project is on the development on a multi-modal operator interface and its evaluation by health care professionals and users. This paper describes the architecture of the system, the evaluation method used, and some preliminary results of the user evaluation.

  17. Discrimination in Minority Health Care.

    PubMed

    Ellen; Gurvey; Irwin

    1997-10-01

    Racial/ethnic minority adolescents are reported to have lower general health status, including higher prevalence of many infectious diseases, than white, non-Hispanic youth. Factors such as lower socioeconomic position, neighborhoods they live in, different cultural views on health, and different role of the family in health care providing are all thought to contribute to this situation. This chapter comprehensively reviews the existing data on the health status of minority adolescents, social, demographic, educational and cultural determinants of racial/ethnic minority populations and how they might interfere with health care delivery to the adolescents, and discusses the need for initiatives to improve the existing conditions. PMID:10360019

  18. Reflections on curative health care in Nicaragua.

    PubMed Central

    Slater, R G

    1989-01-01

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

  19. Comparing Health Care Quality: A National Directory

    MedlinePLUS

    Comparing Health Care Quality: A National Directory Print Email Measuring and publicly reporting on the care doctors and hospitals provide ... RSS Our mission: to improve the health and health care of all Americans. About RWJF Annual Messages Financials ...

  20. Managing Home Health Care (For Parents)

    MedlinePLUS

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

  1. Health Care for Gulf War Veterans

    MedlinePLUS

    ... Enter ZIP code here Enter ZIP code here Health Care for Gulf War Veterans VA offers a variety ... Related Illness and Injury Study Center. Eligibility for health care Veterans first must enroll in VA's health care ...

  2. Navigating Health Care with Your Family Doctor

    MedlinePLUS

    Navigating Health Care with Your Family Doctor Navigating Health Care With Your Family Doctor To be a smart patient, it’s ... tech services. Ultimately you, the patient, benefit. Fixing Health Care: What Women Want A recent nationwide poll found ...

  3. Hope for health and health care.

    PubMed

    Stempsey, William E

    2015-02-01

    Virtually all activities of health care are motivated at some level by hope. Patients hope for a cure; for relief from pain; for a return home. Physicians hope to prevent illness in their patients; to make the correct diagnosis when illness presents itself; that their prescribed treatments will be effective. Researchers hope to learn more about the causes of illness; to discover new and more effective treatments; to understand how treatments work. Ultimately, all who work in health care hope to offer their patients hope. In this paper, I offer a brief analysis of hope, considering the definitions of Hobbes, Locke, Hume and Thomas Aquinas. I then differentiate shallow and deep hope and show how hope in health care can remain shallow. Next, I explore what a philosophy of deep hope in health care might look like, drawing important points from Ernst Bloch and Gabriel Marcel. Finally, I suggest some implications of this philosophy of hope for patients, physicians, and researchers. PMID:24846726

  4. Clinical practice guidelines. The Agency for Health Care Policy and Research fosters the development of evidence-based guidelines.

    PubMed

    McCormick, K A; Fleming, B

    1992-12-01

    As medical technology increases rapidly and becomes more complex, clinical practice guidelines can help healthcare providers assess current practices and integrate technological advances. Through the Agency for Health Care Policy and Research (AHCPR), the federal government has begun to facilitate the development of clinical practice guidelines. Expert or contract panels, authorized by the AHCPR, develop guidelines on specific clinical conditions. The AHCPR guideline methodology is designed to produce evidence-based guidelines that are valid, clinically applicable, and clinically flexible. Each panel spends a year or more developing the guideline, beginning with an extensive literature search and review. The panel prepares evidence tables, statistically analyzes aggregate data (where appropriate), conducts harm and benefit analyses, and prepares health policy analyses (or cost-impact studies). During this process, the panel holds an open forum to solicit comments on the guideline topic. After this public discussion, the panel prepares a final draft of the guideline. Several hundred individuals review the guideline. Some policymakers believe clinical practice guidelines can lead to better healthcare outcomes. Guidelines can provide information in a useful format for clinicians to use at the bedside or the point of decision making in patient care. Guidelines also provide information that can be used in continuing education and professional education programs. PMID:10122521

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

    PubMed Central

    Hansen, Elisabeth Holm; Hunskaar, Steinar

    2008-01-01

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

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

    Microsoft Academic Search

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

    1988-01-01

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

  7. Panel: Trends in Health Care Information Systems

    PubMed Central

    Grams, Stanley; Dvorak, Robert M.; Pryor, T. Allan; Childs, Bill W.

    1984-01-01

    The panel presents significant trends in demographic and economic forces that are driving healthcare delivery systems, how health care providers are responding to these driving forces, and how information systems are being developed using new technology to help health care providers and consumers. An aging population and rapidly increasing government and business health care expenditures are forcing hospitals and other health care providers to consolidate, compete, become more efficient, and diversify and market their services. Emerging computer technology will facilitate the development of information systems that utilize integrated data bases, communication networks, appropriate input/output devices, and cost effective computing power to provide the financial, management, and medical information required by these evolving provider systems.

  8. Epidemic of health care reforms.

    PubMed

    Stambolovic, Vuk

    2003-03-01

    An epidemic of health care reforms is spreading through the world. The basic reason behind the epidemic is the concept of these reforms. Namely, at the time in which Modernity (the main context of mechanicism) has worn out its potentials, they are based on the principles of mechanistic paradigm. Epidemic could fade away if health care reformers would abandon their role of engeneers and turn to catalist role. In that role they could work on reforms which would rely on priciples of evolution. The first result of this reform orientation would be creation of the germ of pluralistic health care systems. PMID:12678319

  9. [Governing innovations in health care].

    PubMed

    Grilli, Roberto

    2006-11-01

    Goal of this paper is to address the problem of governing innovations in health care, underscoring how this issue, by its very nature, implies not only the need for better methodological approaches and instruments for technology assessment, but also, and more importantly, a profound reshaping of roles and responsibilities within the context of health care organisations. From this perspectives, the issue of innovation in health care overlaps the concept of clinical governance, indeed representing the best rationale for the need of the latter and the better exemplification of its meanings. PMID:17252714

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

    PubMed

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

    1998-01-01

    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

  11. Corporate moral responsibility in health care.

    PubMed

    Wilmot, S

    2000-01-01

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

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

    PubMed

    Kern, Josipa; Strnad, Marija

    2005-01-01

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

  13. Helping You Choose Quality Behavioral Health Care

    MedlinePLUS

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

  14. Health care benchmarking 2003.

    PubMed

    Hoppszallern, Suzanna

    2003-02-01

    The latest benchmarking data reveal both old trends and some surprises. Once again, hospitals in high managed care markets outperformed those in low managed care markets in profitability measures, such as total margin and return on equity. However, hospitals in areas with low managed care penetration had a lower percentage of bad-debt expense and significantly fewer days in accounts receivable and more days cash on hand. PMID:12633068

  15. Primary health care for whom? Village perspectives from Nepal

    Microsoft Academic Search

    Linda Stone

    1986-01-01

    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

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

    PubMed

    Facchini, Rose E

    2013-05-01

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

  17. [Redesigning Swiss ambulatory health care system].

    PubMed

    Bays, J-M; Ninane, F; Morin, D; Héritier, F; Cassis, I; Cornuz, J

    2012-11-28

    Primary care medicine is first in line to meet the necessary changes in our health care system. Innovations in this field pursue three types of objectives: accessibility, quality and continuity of care. The Department of ambulatory care and community medicine of the University of Lausanne (Policlinique médicale universitaire) is committed to this path, emphasizing interprofessional collaboration. The doctor, nurse and medical assistant coordinate their activities to contribute efficiently to meet the needs of patients today and tomorrow. This paper also addresses how our department, as a public and academic institution, might play a major role as a health care network actor. A master degree dissertation in health management has started to identify the critical success factors and the strategic core competencies needed to achieve this development. PMID:23240239

  18. Model Child Care Health Policies.

    ERIC Educational Resources Information Center

    Aronson, Susan; Smith, Herberta

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

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

    PubMed

    Anyinam, C A

    1989-01-01

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

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

    E-print Network

    Hutson, Malo

    2006-01-01

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

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

    PubMed Central

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

    2012-01-01

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

  2. Preparing Health Care Workers for the Year 2000.

    ERIC Educational Resources Information Center

    Philadelphia Hospital and Health Care-District 1199C, PA.

    Technological changes affecting the health care industry spurred the development and implementation of a curriculum to upgrade the skills of Philadelphia health care workers in written communication, mathematics, computer literacy, oral and listening communication, and issues surrounding their union employment in the health care field. The…

  3. Integrated Crew Health Care System for Space Flight

    NASA Technical Reports Server (NTRS)

    Davis, Jeffrey R.

    2007-01-01

    Dr. Davis' presentation includes a brief overview of space flight and the lessons learned for health care in microgravity. He will describe the development of policy for health care for international crews. He will conclude his remarks with a discussion of an integrated health care system.

  4. Health care technology in The Netherlands.

    PubMed

    Bos, M

    1994-01-01

    The Dutch health care system has been described as a 'patchwork quilt'. It is a complicated system that has evolved from a constant adding and changing of institutions, regulations and responsibilities. Every citizen of the Netherlands has an entitlement to health care. The government authorities in the Netherlands have focused on creating favourable conditions in which the already existing private sector could expand or improve services. Although health care is provided largely through private institutions and practitioners, the system is considered to have a high degree of regulation. Until the 1980s, the Dutch health care authorities had no clearly defined philosophy of controlling the development and use of health care technology. Since the mid-1980s, however, a number of initiatives have been taken, policy instruments for controlling technology have been used in a more coordinated manner, and health care technology assessment had developed rapidly. The immediate future will see increasingly explicit use of the benefit package to control introduction of new technologies, as well as a growing influence of technology assessment itself. PMID:10139491

  5. Empowering primary care workers to improve health services: results from Mozambique's leadership and management development program

    Microsoft Academic Search

    Cary Perry

    2008-01-01

    This article is the third article in the Human Resources for Health journal's feature on the theme of leadership and management in public health. The series of six articles has been contributed by Management Sciences for Health (MSH) and will be published article-by-article over the next few weeks. The third article presents a successful application in Mozambique of a leadership

  6. Health Care Provider Initiative Strategic Plan

    ERIC Educational Resources Information Center

    National Environmental Education & Training Foundation, 2012

    2012-01-01

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

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

    SciTech Connect

    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

    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.

  8. Help Yourself to Health Care.

    ERIC Educational Resources Information Center

    Snyder, Sarah

    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…

  9. Health care's 100 most wired.

    PubMed

    Solovy, A; Serb, C

    1999-02-01

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

  10. Improving China's Health Care System

    Microsoft Academic Search

    Richard Herd; Yu-Wei Hu; Vincent Koen

    2010-01-01

    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

  11. Latino Adults’ Access to Mental Health Care

    PubMed Central

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

    2008-01-01

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

  12. Health Care in Modern Cuba

    PubMed Central

    Campos-Outcalt, Douglas; Janoff, Edward

    1980-01-01

    An extensively organized, centrally controlled system, aimed at equalizing and improving the distribution and quality of medical services according to population and geography, characterizes the modern Cuban health care complex. Facilities of increasing sophistication are located in urban areas while an expanding series of ambulatory, multipotential polyclinics attempts to provide most health services in both urban and rural settings. Maternal and child care, immunization programs and other forms of preventive medicine represent major priorities for expenditures. Occupational health is increasingly understood as a valuable resource, and medical professionals on all levels are being trained in significant numbers for Cuba and its allies. ImagesFigure 1.Figure 2.Figure 3. PMID:7376666

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

    PubMed

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

    2013-07-01

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

  14. Health care seeking for Childhood Diarrhea in Developing Countries: Evidence from Seven Sites in Africa and Asia

    PubMed Central

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

    2013-01-01

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

  15. Health Care Resource Guide

    E-print Network

    Collins, Gary S.

    of Spokane County Provided as a service by the Spokane Medical Clinics Committee and the Area Health of Contents 3 How to UseThis Directory 4 Christ Clinic 5-6 Community Health Association of Spokane (CHAS) 7 DaybreakYouth Services 8 EasternWashington University Dental Hygiene Clinic 9 Hospice of Spokane 10 House

  16. Applying business management models in health care.

    PubMed

    Trisolini, Michael G

    2002-01-01

    Most health care management training programmes and textbooks focus on only one or two models or conceptual frameworks, but the increasing complexity of health care organizations and their environments worldwide means that a broader perspective is needed. This paper reviews five management models developed for business organizations and analyses issues related to their application in health care. Three older, more 'traditional' models are first presented. These include the functional areas model, the tasks model and the roles model. Each is shown to provide a valuable perspective, but to have limitations if used in isolation. Two newer, more 'innovative' models are next discussed. These include total quality management (TQM) and reengineering. They have shown potential for enabling dramatic improvements in quality and cost, but have also been found to be more difficult to implement. A series of 'lessons learned' are presented to illustrate key success factors for applying them in health care organizations. In sum, each of the five models is shown to provide a useful perspective for health care management. Health care managers should gain experience and training with a broader set of business management models. PMID:12476639

  17. Just caring: health reform and health care rationing.

    PubMed

    Fleck, L M

    1994-10-01

    Health reform must include health care rationing, both for reasons of fairness and efficiency. Few politicians are willing to accept this claim, including the Clinton Administration. Brown and others have argued that enormous waste and inefficiency must be wrung out of our health care system before morally problematic cost constraining options, such as rationing, can be justifiably adopted. However, I argue that most of the policies and practices that would diminish waste and inefficiency include implicit (and therefore morally problematic) rationing. Critics of rationing see as its most morally and psychologically troubling feature that an identified individual is denied potentially beneficial care. That psychic anguish may not be eliminable, and perhaps ought not be eliminated. But if rationing protocols are fairly adopted through a process of free and informed rational democratic deliberation to which all have access, the moral objections are largely overcome. Such a process is possible only if implicit rationing is recognized and rejected. PMID:7814999

  18. Global systems of health care and trauma.

    PubMed

    Lee, Dennis S; Mir, Hassan R

    2014-10-01

    Health care policy continues to occupy the center of national debate in the United States. Exploration of international health care and trauma systems allows for better comprehension of our own policies. Four basic models of health care exist across the globe: Bismarck, Beveridge, National Health Insurance, and Out-of-Pocket. Expectantly, disparities in trauma care necessarily follow inequities in overall health care and infrastructure. In this article, we aim to review several countries' health care models and their respective trauma systems. Critical analysis of international solutions to deficiencies in overall health and trauma care may serve as a guide for issues in the United States. PMID:25229684

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

    PubMed

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

    2008-01-01

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

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

    PubMed

    Hunter, D J

    1996-09-01

    Health care reform has become a global phenomenon. Countries are experiencing similar problems with their health care systems and are reaching for similar solutions. Management is seen as crucial in many countries as the principal means of securing supply-side reforms. Many of these centre on establishing a new relationship between professionals, notably the medical profession, and the state. The aim has been to exercise greater influence over how professionals practice and use resources. The application of new public management principles based on industrial sector practices and concepts of management has created tensions within professional groups who feel themselves, and their craft, to be under attack. But the new managerialism has to be seen within a context of rapid social and economic change. It is not possible to predict what the impact of such change is likely to be on health services in the future or on those who provide them. The paper offers an overview of health care reforms and assesses how it is shaping, or re-shaping, the roles and tasks of health care personnel. One conclusion is the mismatch between the management style favoured by policy-makers and reformers and the necessary flexibility required in skill mix and organization of work. High-trust relations lie at the heart of professional forms of organisation whereas the new managerialism appears to be based on the expectation of low-trust relations. The paper concludes with a brief look at the implications of all these developments for training and education and finds that there is still a long way to go before there is any real prospect of providing and equipping health care personnel with the requisite skills to enable them to meet the complex challenges that are a common characteristic of health care systems. PMID:8870145

  1. The Chinese health care system: Lessons for other nations

    Microsoft Academic Search

    William C. L. Hsiao

    1995-01-01

    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

  2. A defense of visible health care rationing.

    PubMed

    Montandon, M

    2001-01-01

    Health care rationing, when defined as resource allocation that makes use of a power relationship, is inescapable in every health care system. Central to this paper is the question: Is visible (publicized and centralized) health care rationing a requirement of justice or an affront to public morality? Inasmuch as health care is a public good, it is argued that health care resources should be visibly rationed in order to satisfy prevailing notions of procedural justice. PMID:12166466

  3. Spring 2014 CAN WE FIX HEALTH CARE?

    E-print Network

    Carter, John

    in health care policy. You will analyze health-related issues in the news, create and interpret graphicalSpring 2014 CAN WE FIX HEALTH CARE? HEALTH ECONOMICS & POLICY 1 Dr. Katie Fitzpatrick UCOR1630://seattleu.instructure.com/login) Course Description This course examines the U.S. health care sector from a microeconomic perspective. You

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

    ERIC Educational Resources Information Center

    Lewis, John; Dempsey, Joanne R.

    1984-01-01

    An article on American health care which focuses on health care costs and benefits is combined with a lesson plan on health care issues to enable students to consider both issues of cost effectiveness and morality in decisions about the allocation of health care. The article covers the history of interest in health care, the reasons for the…

  5. Defining high quality health care.

    PubMed

    Cooperberg, Matthew R; Birkmeyer, John D; Litwin, Mark S

    2009-01-01

    Most health care quality improvement efforts target measures of health care structures, processes, and/or outcomes. Structural measures examine relatively fixed aspects of health care delivery such as physical plant and human resources. Process measures, the focus of the largest proportion of quality improvement efforts, assess specific transactions in clinical-patient encounters, such as use of appropriate surgical antibiotic prophylaxis, which are expected to improve outcomes. Outcome measures, which comprise quality of life endpoints as well as morbidity and mortality, are of greatest interest to clinicians and patients, but entail the greatest complexity, as the majority of variance in outcomes is attributable to patient and environmental factors that may not be readily modifiable. Selecting among structure, process, and outcome measures for quality improvement efforts generally will be dictated by the specific clinical situation for which improvement is desired. One aspect of health care quality that has received a great deal of attention in recent years is the relationship between surgical volume and health outcomes. Volume, an inherent characteristic of a health care facility or provider, is generally considered a structural measure of quality. Many studies have demonstrated a positive association between volume and outcomes, and policymakers in the private and public sectors have begun to consider volume in certification and reimbursement decisions. The volume-outcome association is not without controversy, however. Most studies in the field are limited by the nature of the administrative data on which they are based, and some studies have found that variation in quality within volume quantiles exceeds differences between quantiles. Moreover, regionalization driven by a focus on volume may exert adverse effects on access to care. The movement for health care quality improvement faces substantial methodological, clinical, financial, and political challenges. Despite these challenges, it is a movement that is gaining momentum, and the emphasis on quality in health care delivery is likely only to increase in the future. It is crucial, therefore, that physicians assume increasing leadership roles in efforts to define, measure, report, and improve quality of care. PMID:19573771

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

    E-print Network

    Andry, François

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

  7. 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 ...

  8. Parkland Health Care Campus 

    E-print Network

    Jones, W., Sr.

    2011-01-01

    ? provider. ?Primary teaching hospital for UT Southwestern Medical School. ?Major regional resource in the event of a disaster. ?level III neonatal intensive care beds. ?A Level I trauma service. ?A regional burn unit. ?A network of community... Staff Trauma Tower ESL-KT-11-11-19 CATEE 2011, Dallas, Texas, Nov. 7 ? 9, 2011 Design Vision Statement The New Parkland Hospital Campus will be a safe, welcoming, patient-centered, healing environment that serves as a sustainable resource...

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

    PubMed Central

    2014-01-01

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

  10. Promoting environmentally responsible health care.

    PubMed

    Gaudry, Jacqueline; Skiehar, Kimberly

    2007-01-01

    Dioxins, polyvinyl chloride and di(2-ethylhexyl) phthalate are the three main toxins interfering with the goal to maintain a healthy environment, according to the international organization Health Care Without Harm (2004). Exposure to these chemicals has been linked to cancer, as well as reproductive, cardiac, hepatic and developmental disorders (Tickner, Schettler, Guidotti, McCally, and Rossi, 2001). Health-care clients are potentially exposed to these toxins every day: polyvinyl chloride equipment, such as i.v. bags and tubing, is widely used in hospitals, and medical incineration practices emit dioxins into the air (Chlorine Chemistry Council, 2006). Nurses are uniquely positioned to play an active role in environmentally responsible health care through education, advocacy and the implementation of measures to reduce medical wastage and exposure to these chemical toxins (Canadian Nurses Association, 2005). PMID:17269580

  11. Male adolescent sexual and reproductive health care.

    PubMed

    Marcell, Arik V; Wibbelsman, Charles; Seigel, Warren M

    2011-12-01

    Male adolescents' sexual and reproductive health needs often go unmet in the primary care setting. This report discusses specific issues related to male adolescents' sexual and reproductive health care in the context of primary care, including pubertal and sexual development, sexual behavior, consequences of sexual behavior, and methods of preventing sexually transmitted infections (including HIV) and pregnancy. Pediatricians are encouraged to address male adolescent sexual and reproductive health on a regular basis, including taking a sexual history, performing an appropriate examination, providing patient-centered and age-appropriate anticipatory guidance, and delivering appropriate vaccinations. Pediatricians should provide these services to male adolescent patients in a confidential and culturally appropriate manner, promote healthy sexual relationships and responsibility, and involve parents in age-appropriate discussions about sexual health with their sons. PMID:22123881

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

    PubMed

    Benjamins, Maureen R; Whitman, Steven

    2014-06-01

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

  13. Health Care Procedure Considerations and Individualized Health Care Plans

    ERIC Educational Resources Information Center

    Heller, Kathryn Wolff; Avant, Mary Jane Thompson

    2011-01-01

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

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

    PubMed Central

    Bax, M; Hart, H; Jenkins, S

    1983-01-01

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

  15. Discussion of patient-centered care in health care organizations.

    PubMed

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

    2012-01-01

    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

  16. Mature care in professional relationships and health care prioritizations.

    PubMed

    Nordhaug, Marita; Nortvedt, Per

    2011-03-01

    This article addresses some ambiguities and normative problems with the concept of mature care in professional relationships and in health care priorities. Mature care has recently been introduced in the literature on care ethics as an alternative to prevailing altruistic conceptions of care. The essence of mature care is an emphasis on reciprocity, where the mature agent has the ability to balance the concerns of self with those of others and act from a principle of not causing harm. Our basic claim is that the prevailing concept of mature care does not capture the real nature of professional relationships and role obligations in health care. As the focus of attention in professional care is and must be the patient's particular medical and care needs, such care must principally be altruistic. Furthermore, we argue that mature care cannot adequately address moral conflict in health care without accepting some more principle-based approaches and a richer notion of partiality. PMID:21372234

  17. Children with Special Health Care Needs

    MedlinePLUS

    Children With Special Health Care Needs Parents whose children have special health care needs already have a lot to cope with. Care of children ... new " Emergency Information Form for Children With Special Health Care Needs. " The form contains important medical information, such ...

  18. Health disparities among health care workers.

    PubMed

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

    2010-01-01

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

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

    PubMed

    Timmreck, T C

    2001-09-01

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

  20. How to develop a program to increase influenza vaccine uptake among workers in health care settings?

    Microsoft Academic Search

    Ingrid Looijmans-van den Akker; Marlies E Hulscher; Theo JM Verheij; Josien Riphagen-Dalhuisen; Johan JM van Delden; Eelko Hak

    2011-01-01

    Background  Apart from direct protection and reduced productivity loss during epidemics, the main reason to immunize healthcare workers\\u000a (HCWs) against influenza is to provide indirect protection of frail patients through reduced transmission in healthcare settings.\\u000a Because the vaccine uptake among HCWs remains far below the health objectives, systematic programs are needed to take full\\u000a advantage of such vaccination. In an earlier

  1. Space technology in remote health care

    NASA Technical Reports Server (NTRS)

    Pool, Sam L.

    1991-01-01

    Crews and passengers on future long-duration Earth orbital and interplanetary missions must be provided quality health services - to combat illnesses and accidental injuries, and for routine preventive care. People on Earth-orbital missions can be returned relatively easily to Earth, but those on interplanetary missions cannot. Accordingly, crews on long-duration missions will likely include at least one specially trained person, perhaps a physician's assistant, hospital corpsman, nurse, or physician who will be responsible for providing onboard health services. Specifically, we must determine the most effective way to administer health care to a remotely located population. NASA with the cooperation of the Department of Health, Education, and Welfare is pursuing a program for providing health services to remote locations on Earth as a necessary step to developing and verifying this capability on a spacecraft. The STARPAHC program is described.

  2. The ethical self-fashioning of physicians and health care systems in culturally appropriate health care.

    PubMed

    Shaw, Susan J; Armin, Julie

    2011-06-01

    Diverse advocacy groups have pushed for the recognition of cultural differences in health care as a means to redress inequalities in the U.S., elaborating a form of biocitizenship that draws on evidence of racial and ethnic health disparities to make claims on both the state and health care providers. These efforts led to federal regulations developed by the U.S. Office of Minority Health requiring health care organizations to provide Culturally and Linguistically Appropriate Services. Based on ethnographic research at workshops and conferences, in-depth interviews with cultural competence trainers, and an analysis of postings to a moderated listserv with 2,000 members, we explore cultural competence trainings as a new type of social technology in which health care providers and institutions are urged to engage in ethical self-fashioning to eliminate prejudice and embody the values of cultural relativism. Health care providers are called on to re-orient their practice (such as habits of gaze, touch, and decision-making) and to act on their own subjectivities to develop an orientation toward Others that is "culturally competent." We explore the diverse methods that cultural competence trainings use to foster a health care provider's ability to be self-reflexive, including face-to-face workshops and classes and self-guided on-line modules. We argue that the hybrid formation of culturally appropriate health care is becoming detached from its social justice origins as it becomes rationalized by and more firmly embedded in the operations of the health care marketplace. PMID:21553151

  3. Health Care Visits to Check More Than Just Health?

    MedlinePLUS

    ... Spotlights Media Resources Interviews & Selected Staff Profiles Multimedia Health Care Visits to Check More Than Just Health? Skip ... media links Share this: Page Content Study Shows Health Care Providers Can Help with School Readiness During Primary ...

  4. Transitioning health care marketing into the twenty-first century.

    PubMed

    Rynne, T J

    1999-01-01

    With this issue, Marketing Health Services unveils an interview with an expert in health care marketing. As seen through the eyes of an industry leader, this regular feature identifies the cutting-edge developments, innovative approaches, and new ideas expected to significantly contribute to marketing in health care. In the first interview, Terrence J. Rynne, who, through his marketing consulting firm has served more than 600 hospitals nationwide, discusses the biggest trends in health care marketing and the top marketing approaches. PMID:10557749

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

    E-print Network

    Mascardi, Viviana

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

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

    ERIC Educational Resources Information Center

    Perez-Escamilla, Rafael

    2010-01-01

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

  7. Measles in health-care settings.

    PubMed

    Maltezou, Helena C; Wicker, Sabine

    2013-07-01

    Despite the availability of an effective and safe vaccine for almost half a century, measles is re-emerging in several developed countries because of the insufficient vaccination coverage among specific subpopulations, the emerging anti-vaccination movement, and the increasing movement of humans across borders. In this context, health-care settings play a critical role in the transmission of infection and generation of numerous cases. Health-care-associated outbreaks may be associated with severe morbidity and mortality among specific groups of patients, disruption of health-care services, and considerable costs. Misdiagnosis or delayed diagnosis of a measles case and inadequate implementation of infection control measures are common in almost all events of nosocomial spread. Measles vaccination of health-care workers is an effective means of prevention of nosocomial measles outbreaks. Eliminating measles by 2010 has not been accomplished. Stronger recommendations and higher vaccination coverage against measles in health-care workers could contribute to eliminate measles in the general population. PMID:23352075

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

    PubMed Central

    2014-01-01

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

  9. Integrating Primary Oral Health Care into Primary Care.

    ERIC Educational Resources Information Center

    Isman, Robert E.

    1993-01-01

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

  10. Conditional shared confidentiality in mental health care.

    PubMed

    Liégeois, Axel; Eneman, Marc

    2015-05-01

    Because of the development towards community care, care providers not only exchange information in a team, but increasingly also in networks. This is a challenge to confidentiality. The ethical question is how care providers can keep information about the care receiver confidential, whilst at the same time exchanging information about that care receiver in a team or network? Can shared confidentiality be extended from a team to a network? To clarify this question, the article refers to the advice of an expert ethics committee in mental health care. The advice regards exchange of information in a network as a further step in enhancing collaboration among care providers. Therefore, the good and evident practice of shared confidentiality in a team can be extended to a network if the same conditions are met. First, the care providers participate in a clearly defined and identifiable team or network. Secondly, they have a shared care responsibility. Thirdly, they have a duty of confidentiality. Fourth, they dialogue with the care receiver and obtain his or her consent. Finally, they apply the filter of relevance. Hence, conditional shared confidentiality is an ethical justification for the exchange of information in a team or network. PMID:25209901

  11. Solid health care waste management status at health care centers in the West Bank – Palestinian Territory

    Microsoft Academic Search

    Issam A. Al-Khatib; Chikashi Sato

    2009-01-01

    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 4720.7m3

  12. Neurology and the new health care policies

    Microsoft Academic Search

    G. Rosati

    1996-01-01

    The Author discusses some aspects of the Health Care systems in developed countries, and analyzes the reasons for the failure of recent reform programs to provide good quality service at a reasonable price. While not condemning business-style management completely, the Author points out how, in the neurological field too, under the control of physicians, biomedical research and innovation with inter-departmental

  13. Counseling and Mental Health Care in Palestine

    ERIC Educational Resources Information Center

    Shawahin, Lamise; Ciftci, Ayse

    2012-01-01

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

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

    ERIC Educational Resources Information Center

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

    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…

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

    Microsoft Academic Search

    Don E Detmer

    2003-01-01

    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

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

    PubMed Central

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

    2000-01-01

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

  17. Primary health care: making Alma-Ata a reality.

    PubMed

    Walley, John; Lawn, Joy E; Tinker, Anne; de Francisco, Andres; Chopra, Mickey; Rudan, Igor; Bhutta, Zulfiqar A; Black, Robert E

    2008-09-13

    The principles agreed at Alma-Ata 30 years ago apply just as much now as they did then. "Health for all" by the year 2000 was not achieved, and the Millennium Development Goals (MDGs) for 2015 will not be met in most low-income countries without substantial acceleration of primary health care. Factors have included insufficient political prioritisation of health, structural adjustment policies, poor governance, population growth, inadequate health systems, and scarce research and assessment on primary health care. We propose the following priorities for revitalising primary health care. Health-service infrastructure, including human resources and essential drugs, needs strengthening, and user fees should be removed for primary health-care services to improve use. A continuum of care for maternal, newborn, and child health services, including family planning, is needed. Evidence-based, integrated packages of community and primary curative and preventive care should be adapted to country contexts, assessed, and scaled up. Community participation and community health workers linked to strengthened primary-care facilities and first-referral services are needed. Furthermore, intersectoral action linking health and development is necessary, including that for better water, sanitation, nutrition, food security, and HIV control. Chronic diseases, mental health, and child development should be addressed. Progress should be measured and accountability assured. We prioritise research questions and suggest actions and measures for stakeholders both locally and globally, which are required to revitalise primary health care. PMID:18790322

  18. [President Obama's health care reform: lessons to and from the Israeli health care system].

    PubMed

    Balicer, Ran D; Shadmi, Efrat

    2011-08-01

    In March 2010 the United States enacted the most significant health care reform in several decades. The Patient Protection and Affordable Care Act, amongst other provisions, addresses two of the main current shortcomings of the U.S. health system: the large portion of the population that are uninsured and the high percentage of hsealth expenditures (mostly private] which amounts to about 16% of the GDP. Changes to the current structure and financing of the U.S. health system will have implications for other health systems, for science (e.g., through enhanced federal funding for comparative effectiveness research), and for technological advance (e.g., through accelerated development and use of electronic health records). There are several lessons from the reform, and the factors leading to its implementation, for the Israeli health system. Firstly, the basic principles of the Israeli health system are a source of pride, and undermining its main values can have deleterious effects. Overreliance on private, out-of-pocket, spending and lack of support for public practice of medicine (in community and hospital settings) will weaken the public sector, strengthen the private sector, and could result in a tiered lower quality and less accessible public system with greater widening of gaps in health and health care utilization. This paper reviews the main provisions of the U.S. health care reform and the potential implications for the IsraeLi health system. PMID:21939111

  19. Prospective health care: the second transformation of medicine

    PubMed Central

    Snyderman, Ralph; Langheier, Jason

    2006-01-01

    Emerging scientific technologies provide rich sources of predictive biomarkers, which could transform health care. Identification of causal biomarkers will enable the development of tools to quantify risk and anticipate disease. Accurate health risk analysis is rapidly becoming feasible, so health care can become rational, preventive and personalized. PMID:16522218

  20. The changing role of health care IC card systems

    Microsoft Academic Search

    Arwa Alkhateeb; Takashi Takahashi; Salah Mandil; Yasuyoshi Sekita

    1999-01-01

    Health care researchers and professionals have had increasing interest in the development of Internet-based solutions in health care, casting doubt on the future of IC card systems. However, IC cards used in conjunction with Internet-based health information systems may be more viable than either system alone. We conducted a worldwide survey to explore the possibilities of such a combined system.

  1. Case Studies in Primary Health Care

    NSDL National Science Digital Library

    Perry, Henry

    2011-01-01

    The Johns Hopkins University's Bloomberg School of Public Health has participated in the OpenCourseWare program for a number of years, and this course is one of their most recent offerings. Created by Henry Taylor and Henry Perry, these course materials introduce "students to the origins, concepts, and development of community-based primary health care through case studies from both developing and developed countries." On this course site, visitors can read through the syllabus, examine the course schedule, and look over the lecture materials. In the lecture materials area, visitors will find lecture slides and their corresponding audio files. Some of the topics covered here include the roots of community-based primary health care and women's empowerment in Afghanistan. Finally, visitors can check out some of the course readings, which are offered in the pdf format.

  2. Cross-infection prevention, basic hygiene practices and education within nursing and health care in Latvia: a Swedish–Latvian practice development project

    Microsoft Academic Search

    Valentina Grinevika

    2003-01-01

    The primary aim of this practice development project was to explore the level of knowledge of nursing and medical staff at the Infection Clinic at Liepaja regarding the spread of infectious diseases. Arrangements were also made for some of the Latvian health care staff to visit the Infection Clinic in Gothenburg to increase their knowledge about basic hygiene and to

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

    PubMed

    Bender, Bruce G

    2014-04-01

    Many Americans are failing to engage in both the behaviors that prevent and those that effectively manage chronic health conditions, including pulmonary disorders, cardiovascular conditions, diabetes, and cancer. Expectations that health care providers are responsible for changing patients' health behaviors often do not stand up against the realities of clinical care that include large patient loads, limited time, increasing co-pays, and restricted access. Organizations and systems that might share a stake in changing health behavior include employers, insurance payers, health care delivery systems, and public sector programs. However, although the costs of unhealthy behaviors are evident, financial resources to address the problem are not readily available. For most health care organizations, the return on investment for developing behavior change programs appears highest when addressing treatment adherence and disease self-management, and lowest when promoting healthy lifestyles. Organizational strategies to improve adherence are identified in 4 categories: patient access, provider training and support, incentives, and information technology. Strategies in all 4 categories are currently under investigation in ongoing studies and have the potential to improve self-management of many chronic health conditions. PMID:24152056

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

    PubMed Central

    2011-01-01

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

  5. How to develop strategies to serve the aging health care consumer.

    PubMed

    Louden, T L

    1983-07-01

    This article provides a framework for trustees to evaluate the impacts of an aging population and analyze opportunities for their hospitals to serve the needs of the elderly market. It focuses on identifying and analyzing the many aging-related market opportunities available to hospitals, and it describes a process for developing diversification strategies in aging-related products/services. PMID:10261368

  6. Developing and Using Interdisciplinary Case Studies in Teaching Geriatrics to Practicing Health Care Professionals.

    ERIC Educational Resources Information Center

    Owens, Norma J.; Padula, Cynthia A.; Hume, Anne L.

    2002-01-01

    Interdisciplinary clinical case studies in geriatrics were developed using active and problem-based learning approaches that simulate clinical environments. Feedback from their use in continuing education indicated that facilitators need interdisciplinary group skills, well-written discussion questions enhanced learning, and the presence of all…

  7. Health Care Reform for Low-Income Countries in the Twenty-First Century

    Microsoft Academic Search

    Michael M. O. Seipel

    2004-01-01

    The health care systems in many low-income countries are unable to meet the challenges of health care expectations. These systems are unable to finance health services, provide quality care, and sustain on-going health developments. This paper identifies the issues that are vital to successful health care reform in low-income countries.

  8. Job satisfaction in health-care organizations

    PubMed Central

    Bhatnagar, Kavita; Srivastava, Kalpana

    2012-01-01

    Job satisfaction among health-care professionals acquires significance for the purpose of maximization of human resource potential. This article is aimed at emphasizing importance of studying various aspects of job satisfaction in health-care organizations. PMID:23766585

  9. CDC Vital Signs: Making Health Care Safer

    MedlinePLUS

    ... 62 MB] Read the MMWR Science Clips Making Health Care Safer Stop Infections from Lethal CRE Germs Now ... to otherwise healthy people outside of medical facilities. Health Care Providers can Know if patients in your facility ...

  10. How Do Health Care Providers Diagnose Hypoparathyroidism?

    MedlinePLUS

    ... Information Clinical Trials Resources and Publications How do health care providers diagnose hypoparathyroidism? Skip sharing on social media links Share this: Page Content A health care provider will order a blood test to determine ...

  11. FastStats: Home Health Care

    MedlinePLUS

    ... Submit What's this? Submit Button NCHS Home Home Health Care Recommend on Facebook Tweet Share Compartir Data are ... Data Alzheimer’s disease Characteristics and Use of Home Health Care by Men and Women Aged 65 and Over [ ...

  12. How Do Health Care Providers Diagnose Vulvodynia?

    MedlinePLUS

    ... Information Clinical Trials Resources and Publications How do health care providers diagnose vulvodynia? Skip sharing on social media ... been ruled out. To diagnose vulvodynia, 1 a health care provider may recommend that a woman have blood ...

  13. How Do Health Care Providers Diagnose Pheochromocytoma?

    MedlinePLUS

    ... Information Clinical Trials Resources and Publications How do health care providers diagnose pheochromocytoma? Skip sharing on social media links Share this: Page Content A health care provider uses blood and urine tests that measure ...

  14. Transitions: From Pediatric to Adult Health Care

    MedlinePLUS

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

  15. Accreditation Association for Ambulatory Health Care

    MedlinePLUS

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

  16. How Do Health Care Providers Diagnose Endometriosis?

    MedlinePLUS

    ... Information Clinical Trials Resources and Publications How do health care providers diagnose endometriosis? Skip sharing on social media ... under a microscope, to confirm the diagnosis. 1 Health care providers may also use imaging methods to produce ...

  17. Organizational economics and health care markets.

    PubMed Central

    Robinson, J C

    2001-01-01

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

  18. Pharmacy and the health-care environment.

    PubMed

    Oddis, J A

    1986-06-01

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

  19. Risks and benefits of private health care: exploring physicians' views on private health care in Ho Chi Minh City, Vietnam

    Microsoft Academic Search

    Knut Lönnroth; Le Minh Thuong; Pham Duy Linh; Vinod Diwan

    1998-01-01

    As in a number of other low- and middle-income countries, the health sector in Vietnam is transforming with a rapid shift from fully state run and financed health care towards more private financing and delivery of health care. This development has been particularly noticeable in the largest city in the country, Ho Chi Minh City, where a majority of physicians

  20. Ethics and geographical equity in health care

    PubMed Central

    Rice, N.; Smith, P.

    2001-01-01

    Important variations in access to health care and health outcomes are associated with geography, giving rise to profound ethical concerns. This paper discusses the consequences of such concerns for the allocation of health care finance to geographical regions. Specifically, it examines the ethical drivers underlying capitation systems, which have become the principal method of allocating health care finance to regions in most countries. Although most capitation systems are based on empirical models of health care expenditure, there is much debate about which needs factors to include in (or exclude from) such models. This concern with legitimate and illegitimate drivers of health care expenditure reflects the ethical concerns underlying the geographical distribution of health care finance. Key Words: Health economics • resource allocation • ethics of regional health care finance • capitation systems PMID:11479357

  1. Beware the Managed Health-Care Companies.

    ERIC Educational Resources Information Center

    Ashbaugh, John; Smith, Gary

    1996-01-01

    This article discusses implications of the movement toward managed health care models for long-term health care services for people with disabilities, especially people with developmental disabilities. It notes possible advantages of managed care but raises issues concerning consumer choice, management and financial capacity of managed care

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

    PubMed

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

    2008-03-01

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

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

    ERIC Educational Resources Information Center

    McManus, Marilyn C., Ed.

    1996-01-01

    This theme issue of a bulletin on family support and children's mental health focuses on managed care and the impact on children who are in need of mental health services. Articles include: "Private Sector Managed Care and Children's Mental Health" (Ira S. Lourie and others); "Just What Is Managed Care?" (Chris Koyanagi); "Managed Behavioral…

  4. Planning Campus Health Care Services 2.

    ERIC Educational Resources Information Center

    Douglas, Bruce L.

    1975-01-01

    In a context of forecasts of major changes for America's entire health care system, colleges and universities are exploring the implications of new trends in campus health care delivery. On January 30-31, 1975, the Society for College and University Planning sponsored a workshop on "Campus Health Care Services" in Chicago to discuss such issues as…

  5. ARTEMIS: a collaborative framework for health care.

    PubMed

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

    1993-01-01

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

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

    E-print Network

    Doran, Simon J.

    Faculty of Health and Medical Sciences School of Health & Social Care Application of Leadership%) Faculty of Health and Medical Sciences School of Health and Social Care T: +44 (0) 1483 684505 F: +44 (0 service leadership and innovation, and suggest ways in which their own personal style can develop

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

    E-print Network

    Doran, Simon J.

    Faculty of Health and Medical Sciences School of Health & Social Care Supporting Education their working environment. Faculty of Health and Medical Sciences School of Health and Social Care T: +44 (0 and assessment strategies Personal and professional development Reflection and reflexivity Factors that effect

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

    E-print Network

    Harman, Neal.A.

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

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

    ERIC Educational Resources Information Center

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

    1997-01-01

    A study of 120 British adults with intellectual disability found they had higher risk factors of developing coronary heart disease and stroke than the general population. There was a greater incidence of obesity and considerably lower physical activity levels than the general population. Several also had abnormal cholesterol readings. (CR)

  10. PS2-8: Development and Implementation of Clinical Decision Support Tools in Epic to Standardize Dementia Diagnosis and Care at Essentia Health

    PubMed Central

    Waring, Stephen; Sharland, Michael; Bianco, Joseph; Boyce, Mark; Quinlan, Sharon

    2014-01-01

    Background/Aims The current estimated prevalence of Alzheimer’s disease and related dementias in the US is over 5 million and projected to increase to over 15 million by 2050. The already overwhelming personal and economic burden this represents for patients, families, and health care providers is only expected to increase as well. Essentia Health recognizes the urgent need to standardize dementia diagnosis and management system-wide to enhance earlier detection of cognitive issues that will lead to better management of dementia and comorbid conditions to reduce the burden of this devastating disease and improve quality of life for patients and their caregivers. Methods The Division of Primary Care at Essentia Health is developing a standardized approach to dementia diagnosis and care to be implemented system-wide. An advisory workgroup consisting of physicians and NPs from primary care (family practice, internal medicine), specialty care (elder care, neurology, neuropsychology), and community partners (Alzheimer’s Association, Arrowhead Area Agency on Aging, Family Memory Care Consultants) continues to meet monthly to plan integration and implementation. We have initiated a pilot study in two of our primary care clinics to implement and evaluate this approach and to inform further development. Results Two separate smartsets have been created–the EH Memory Screen/MiniCog Smartset (MCOG Set) and the Memory Screen/MOCA SmartSet (MOCA Set). The first is intended to guide cognitive screening at the annual wellness visit (AWV) and the other to serve as a guide for a follow-up examination if indicated from the MOCA Set. Conclusions We plan to present both quantitative and qualitative information based on our experience through the first few months of implementation. This will include a thorough evaluation of the work plan as well as lessons learned to inform further implementation at EH and other systems.

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

    E-print Network

    Chater 4 Roles of Child Health-Care Providers 4 Roles of Child Health-Care Providers in Childhood Lead Poisoning Prevention Roles of Child Health-Care Providers 1. Use and disseminate information from 7 #12;Chater 4 Roles of Child Health-Care Providers In addition to routine screening and follow

  12. e-Health in pediatric palliative care.

    PubMed

    Knapp, Caprice

    2010-02-01

    e-Health has the potential to improve pediatric palliative care. e-Health initiatives use the Internet or health information technology to improve quality of care and have the potential to decrease costs by reducing medical errors, reducing duplication of services, improving access to diagnostic and laboratory results, and improving communication between providers and patients, and so on. The majority of e-health initiatives are for adults and only a limited amount of evidence exists in the literature on e-health interventions in palliative care that are focused on pediatrics. To explore what role e-health could play in pediatric palliative care programs, this article aims to describe the Internet use in general in the United States and in palliative care, describe the use of health information technology in general in the United States and in palliative care, and suggest areas in pediatric palliative care that might benefit from e-health interventions. PMID:20124252

  13. Integrating the 3Ds--social determinants, health disparities, and health-care workforce diversity.

    PubMed

    LaVeist, Thomas A; Pierre, Geraldine

    2014-01-01

    The established relationships among social determinants of health (SDH), health disparities, and race/ethnicity highlight the need for health-care professionals to adequately address SDH in their encounters with patients. The ethnic demographic transition slated to occur during the next several decades in the United States will have numerous effects on the health-care sector, particularly as it pertains to the need for a more diverse and culturally aware workforce. In recent years, a substantial body of literature has developed, exploring the extent to which diversity in the health-care workforce may be used as a tool to eliminate racial/ethnic disparities in health and health care in the U.S. We explore existing literature on this topic, propose a conceptual framework, and identify next steps in health-care policy for reducing and eliminating health disparities by addressing SDH and diversification of the health-care workforce. PMID:24385659

  14. Contribution of Primary Care to Health Systems and Health

    PubMed Central

    Starfield, Barbara; Shi, Leiyu; Macinko, James

    2005-01-01

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

  15. Health care reform: possibilities & opportunities for primary care.

    PubMed

    Wexler, Randy; Hefner, Jennifer; Welker, Mary Jo; McAlearney, Ann Scheck

    2014-06-01

    Amid the swirl of change in today's US health care system, there are opportunities for new care delivery models to slow rising costs and improve outcomes in family medicine. This review summarizes the possibilities. PMID:25061618

  16. Toward the Development of a Lupus Interactive Navigator to Facilitate Patients and Their Health Care Providers in the Management of Lupus: Results of Web-Based Surveys

    PubMed Central

    Neville, Carolyn; DaCosta, Deborah; Rochon, Murray; Eng, Davy

    2014-01-01

    Background Systemic lupus erythematosus is an inflammatory autoimmune disease associated with high morbidity and unacceptable mortality. Information and management tools are needed to help persons with lupus cope with their illness and facilitate health care providers in the delivery of care. Objective The objective of the study was to assess the needs and find solutions to support persons with lupus and their health care providers. Methods Web-based surveys were distributed across Canada to persons with lupus and their relatives (n=3119), rheumatologists (n=517), and arthritis health professionals (AHPs) (n=226) by Lupus Canada, the Canadian Rheumatology Association, and the Arthritis Health Professions Association, respectively. Results The survey sample comprised 665 (21.3%) persons with lupus, 98 (19.0%) rheumatologists, and 74 (32.7%) AHPs. Among the participants with lupus, 92.4% were female, the average age was 46.8 (SD 12.7) years, 79.2% were Caucasian, and 58.8% were employed. All Canadian provinces and territories were represented. The majority (43.3%) of respondents were from Ontario. Mean disease duration was 10.2 (SD 9.5) years, and 41.9% rated their global assessment as fair or poor. There was high agreement between lupus participants and health care providers regarding disease-specific information topics. All groups rated topics related to lupus, fatigue, medications, and stress as most important. Ratings differed among lupus participants and their health care providers regarding perceived helpfulness of some of the patient tools, such as the option to view test results. Needs differed for persons with lupus based on age, sex, depression, stress, and disease activity. Differences in health care provider needs were based on amount of experience in treating lupus. Conclusions Information and support tools needed for persons with lupus and their health care providers were identified. These results will help guide us in the development of a Web-based Lupus Interactive Navigator as an intervention tool to help persons with lupus self-manage their disease and to facilitate heath care providers in clinical management. PMID:25533760

  17. A telemedicine health care delivery system

    NASA Technical Reports Server (NTRS)

    Sanders, Jay H.

    1991-01-01

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

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

    PubMed Central

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

    2012-01-01

    Background The quality of health care depends on the competence and motivation of the health workers that provide it. In the West, several tools exist to measure worker motivation, and some have been applied to the health sector. However, none have been validated for use in sub-Saharan Africa. The complexity of such tools has also led to concerns about their application at primary care level. Objective To develop a common instrument to monitor any changes in maternal and neonatal health (MNH) care provider motivation resulting from the introduction of pilot interventions in rural, primary level facilities in Ghana, Burkina Faso, and Tanzania. Design Initially, a conceptual framework was developed. Based upon this, a literature review and preliminary qualitative research, an English-language instrument was developed and validated in an iterative process with experts from the three countries involved. The instrument was then piloted in Ghana. Reliability testing and exploratory factor analysis were used to produce a final, parsimonious version. Results and discussion This paper describes the actual process of developing the instrument. Consequently, the concepts and items that did not perform well psychometrically at pre-test are first presented and discussed. The final version of the instrument, which comprises 42 items for self-assessment and eight for peer-assessment, is then shown. This is followed by a presentation and discussion of the findings from first use of the instrument with MNH providers from 12 rural, primary level facilities in each of the three countries. Conclusions It is possible to undertake work of this nature at primary health care level, particularly if the instruments are kept as straightforward as possible and well introduced. However, their development requires very lengthy preparatory periods. The effort needed to adapt such instruments for use in different countries within the region of sub-Saharan Africa should not be underestimated. PMID:23043816

  19. Neurosurgical practice and health care reform: moving toward quality-based health care delivery.

    PubMed

    Groman, Rachel F; Rubin, Koryn Y

    2013-01-01

    In an effort to rein in spending and improve patient outcomes, the US government and the private sector have adopted a number of policies over the last decade that hold health care professionals increasingly accountable for the cost and quality of the care they provide. A major driver of these efforts is the Patient Protection and Affordable Care Act of 2010 (ACA or Pub.L. 111-148), which aims to change the US health care system from one that rewards quantity to one that rewards better value through the use of performance measurement. However, for this strategy to succeed in raising the bar on quality and efficiency, it will require the development of more standardized and accurate methods of data collection and further streamlined federal regulations that encourage enhanced patient-centered care instead of creating additional burdens that interfere with the physician-patient relationship. PMID:23278262

  20. Continuing education needs of health care professionals.

    PubMed Central

    Manning, P R

    1990-01-01

    Formal continuing education for health professionals continues to grow around the base of courses, conferences, and general reading. These formats serve the indispensable function of keeping health professionals abreast of the state of medicine. Since most formal continuing education activities are planned for groups, they cannot address the specific information needed in the care of individual patients. Furthermore, the knowledge gained is memory-based, and it is misguided to believe that facts learned in lectures will be remembered accurately enough for patient-care applications. A recent study has demonstrated that physicians often want additional knowledge when they are caring for patients and that access to knowledge is often difficult and time consuming. Advances in computer and telecommunications technology may ultimately permit immediate short answers to specific questions that arise during medical practice. It is time to expand the activities of the National Library of Medicine and the libraries within the Regional Medical Library (RML) network that provide valuable information for health professionals by developing methods to answer specific questions on the spot while health professionals are caring for patients. PMID:2183903

  1. 45 CFR 162.1401 - Health care claim status transaction.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 2010-10-01 false Health care claim status transaction. 162.1401 Section 162.1401...ADMINISTRATIVE REQUIREMENTS Health Care Claim Status § 162.1401 Health care claim status transaction. The health care claim...

  2. Health Care Reform and Alzheimer's Disease

    MedlinePLUS

    ... onset Alzheimer's Quality of care Medical research Consumer health insurance website The Department of Health and Human Services ... www.cuidadodesalud.gov/ ) — to help individuals find what health insurance options are available in their communities. About Healthcare. ...

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

    ERIC Educational Resources Information Center

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

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

  4. Health informatics for low-cost and high-quality health care

    Microsoft Academic Search

    Carmen C. Y. Poon; Wenbo Gu; Y. T. Zhang

    2010-01-01

    P-Health, a future health model that can be described as a 6-P's paradigm, aims to provide low cost and high quality health care via redesigning care practice and networking information systems at different levels. To realise p-Health, a multi-level health information system has to be developed for the processing, storage, transmission, acquisition and retrieval (P-STAR) of health information that spans

  5. Primary Health Care in Canada: Systems in Motion

    PubMed Central

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

    2011-01-01

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

  6. Health care financing for the elderly in Japan.

    PubMed

    Kobayashi, Y; Reich, M R

    1993-08-01

    This paper examines the financing of elderly health care in Japan for medical institutions, nursing homes, and at home. The analysis demonstrates that the conventional figures for elderly health expenditures in Japan systematically underestimate the real costs by excluding the costs of uninsured services, nursing homes, and home health care. The paper estimates these costs and shows that they add about 10% to the conventional figure for elderly health care costs in Japan. This inquiry also shows how government policy for health care financing shaped distinctive Japanese patterns of elderly care provision. The financing system provided a hidden subsidy--through national health insurance coverage of long-term hospitalization--that encouraged high institutionalization rates of elderly in medical facilities. Public financing for long-term elderly hospitalization, however, has not been matched by government attention to quality of care, resulting in serious quality problems and reflecting a social trade-off between cost and quality. Also, until recently the financing system rarely reimbursed home health care, thereby creating strong disincentives to the development of formal home health care services. This analysis has important implications for reforms now being considered by the Japanese government in the financing and provision of health care for the elderly, especially the limitations of relying on reimbursement price policy. The reforms could have unintended negative consequences for equity, efficiency, and quality of care. PMID:8356483

  7. Achieving better health care outcomes for children in foster care.

    PubMed

    Mekonnen, Robin; Noonan, Kathleen; Rubin, David

    2009-04-01

    This article reviews the challenges health care systems face as they attempt to improve health care outcomes for children in foster care. It discusses several of the promising health care strategies occurring outside the perimeter of child welfare and identifies some of the key impasses in working alongside efforts in child welfare reform. The authors posit that the greatest impasse in establishing a reasonable quality of health care for these children is placement instability, in which children move frequently among multiple homes and in and out of the child welfare system. The authors propose potential strategies in which efforts to improve placement stability can serve as a vehicle for multidisciplinary reform across the health care system. PMID:19358924

  8. Transformation of China's rural health care financing.

    PubMed

    Liu, Y; Hsiao, W C; Li, Q; Liu, X; Ren, M

    1995-10-01

    In the late 1970s China launched its agricultural reforms which initiated a decade of continued economic growth and significant transformation of the Chinese society. The agricultural reforms altered the peasants' incentives, weakened community organization and lessened the central government's control over local communities. These changes largely caused the collapse of the widely acclaimed rural cooperative medical system in China. Consequently China experienced a decreased supply of rural health workers, increased burden of illnesses, disintegration of the three tier medical system, reduced primary health care, and an increased demand for hospital medical services. More than ten years have elapsed since China changed its agricultural economic system and China is still struggling to find an equitable, efficient and sustainable way of financing and organizing its rural health services. The Chinese experiences provided several important lessons for other nations: there is a need to understand the limits of the market forces and to redefine the role of the government in rural health care under a market economy; community participation in and control of local health financing schemes is essential in developing a sustainable rural health system; the rural health system needs to be dynamic, rather than static, to keep pace with changing demand and needs of the population. PMID:8578331

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

    ERIC Educational Resources Information Center

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

    2005-01-01

    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…

  10. Equity in health care utilization in Chile.

    PubMed

    Núñez, Alicia; Chi, Chunhuei

    2013-01-01

    One of the most extensive Chilean health care reforms occurred in July 2005, when the Regime of Explicit Health Guarantees (AUGE) became effective. This reform guarantees coverage for a specific set of health conditions. Thus, the purpose of this study is to provide timely evidence for policy makers to understand the current distribution and equity of health care utilization in Chile.The authors analyzed secondary data from the National Socioeconomic Survey (CASEN) for the years 1992-2009 and the 2006 Satisfaction and Out-of-Pocket Payment Survey to assess equity in health care utilization using two different approaches. First, we used a two-part model to estimate factors associated with the utilization of health care. Second, we decomposed income-related inequalities in medical care use into contributions of need and non-need factors and estimated a horizontal inequity index.Findings of this empirical study include evidence of inequities in the Chilean health care system that are beneficial to the better-off. We also identified some key factors, including education and health care payment, which affect the utilization of health care services. Results of this study could help researchers and policy makers identify targets for improving equity in health care utilization and strengthening availability of health care services accordingly. PMID:23937894

  11. [Self-care--the contribution of nursing sciences to health care].

    PubMed

    Bekel, Gerd; Panfil, Eva-Maria; Scupin, Olaf

    2005-01-01

    The future development of the German health care system needs to recognize patient views of medical treatment in order to foster their health care responsibility. In nursing sciences, practice and clinical research are based on the concepts of self-help and self-care. The principle of Self-Care Deficit Nursing Theory (S-CDNT), developed by the American nursing scientist D.E. Orem, defines self-care as a trainable and deliberate practice. The theory describes, among other factors, general and situation-specific needs of self-care and dependence care, forms of self-care com petence, and self-care deficit. Clinical studies have focused on self-care activities and deficits of particular patient groups, testing the effectiveness of care interventions. In view of the changes in the German health system (e.g., diagnosis-related groups, reduction of hospitalization periods), the S-CDNT is relevant not only for the treatment of individual patients, but also for the management of care provision. The fostering of self-care and dependence-care competence is an important tool to increase the autonomy of affected patients and their families, as well as to reduce the costs of health care. PMID:16433264

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

    Microsoft Academic Search

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

    2008-01-01

    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

  13. Psychometric assessment of the Health Care Alliance Questionnaire with women in prenatal care.

    PubMed

    Roosevelt, Lee K; Holland, Kathryn J; Hiser, Jan; Seng, Julia S

    2015-07-01

    The current study assessed the reliability and validity of the Health Care Alliance Questionnaire, which was developed using a Delphi process and embedded in an ongoing perinatal outcomes study. The Health Care Alliance Questionnaire exhibited content and face validity and high reliability. Results indicated concurrent validity in relation to satisfaction with practitioner and discriminant validity in relation to interpersonal sensitivity and posttraumatic stress disorder. The Health Care Alliance Questionnaire demonstrated predictive validity in relation to perceptions of practitioner's care during labor and postpartum depression. Overall, results suggest that alliance may be an important factor in maternity care processes and outcomes. Further psychometric work is warranted. PMID:24155197

  14. Financial Models for Integrated Behavioral Health Care

    Microsoft Academic Search

    Blake Chaffee

    Integrated behavioral health care or “integrated care” is a distinct service delivery model aimed at early identification and appropriate intervention with that portion of medical\\/surgical patients presenting with behavioral health issues. The clinical rationale for integrated care and the potential for medical cost offset savings have been clearly substantiated in available research (Cummings, 2007; O’Donohue, Ferguson & Cummings, 2002), but

  15. Rural Health Care in New York State: A Preliminary Report.

    ERIC Educational Resources Information Center

    New York State Legislative Commission on Rural Resources, Albany.

    Supporting the premise that rural communities require functioning health care systems for their physiological, emotional, and economic well-being, the First Statewide Legislative Symposium on Rural Development defined problems and established goals for rural health care in New York. Despite increases in New York's overall physician supply during…

  16. Towards pervasive computing in health care – A literature review

    Microsoft Academic Search

    Carsten Orwat; Andreas Graefe; Timm Faulwasser

    2008-01-01

    BACKGROUND: The evolving concepts of pervasive computing, ubiquitous computing and ambient intelligence are increasingly influencing health care and medicine. Summarizing published research, this literature review provides an overview of recent developments and implementations of pervasive computing systems in health care. It also highlights some of the experiences reported in deployment processes. METHODS: There is no clear definition of pervasive computing

  17. Obesity in Children Is Associated With Increased Health Care Use

    Microsoft Academic Search

    Elie Hering; Irena Pritsker; Ludmila Gonchar; Giora Pillar

    2009-01-01

    Background: The prevalence of obesity in children has steadily risen during recent years in developed countries. There is increasing data associating this rise in obesity with a rise in morbidity. In adults, data show clear association between obesity and health care use. This study examined the effects of obesity on health care use in children of several age groups. Methods:

  18. Public health and palliative care: principles into practice?

    Microsoft Academic Search

    Steve Conway

    2008-01-01

    Public health approaches to palliative care have a valuable contribution to make in understanding and developing community capacity related to death, dying, loss and care, acknowledging that carers of the dying and bereaved are an important group who have their own significant needs in end-of-life care. Drawing upon a sociological framework, this article suggests that an even greater contribution is

  19. Health Status Determinants: Lifestyle, Environment, Health Care Resources and Efficiency

    Microsoft Academic Search

    Isabelle Joumard; Christophe André; Chantal Nicq; Olivier Chatal

    2008-01-01

    This paper aims to shed light on the contribution of health care and other determinants to the health status of the population and to provide evidence on whether or not health care resources are producing similar value for money across OECD countries. First, it discusses the pros and cons of various indicators of the health status, concluding that mortality and

  20. Health Services and Health Care Providers

    MedlinePLUS

    College Health: Health Services and Common Health Problems Posted under Health Guides . Updated 12 March 2015. +Related Content What are student health services? The student health services (sometimes called ...

  1. Development of a multi-dimensional health assessment questionnaire (MDHAQ) for the infrastructure of standard clinical care.

    PubMed

    Pincus, T; Yazici, Y; Bergman, M

    2005-01-01

    The HAQ has become the pre-eminent patient questionnaire used in rheumatology. It is easily completed by patients, but not easily reviewed and scored in standard clinical care and has some minor psychometric limitations, as do all questionnaires. Modifications of the HAQ been made to facilitate use in standard care, particularly to include 8-10 activities of daily living, along with scores for pain and global status and other information on one side of one page for rapid review by the clinician. A patient questionnaire for standard care should be limited to 2 sides of 1 page, in a format amenable to "eyeball" review by the clinician in 5 seconds or less. It can be scored formally in 15-20 seconds or less, and is useful in patients with all rheumatic diseases. The current version of a multi-dimensional HAQ (MDHAQ) includes scoring templates on the questionnaire to allow formal scoring in less than 15 seconds by a rheumatologist or an assistant, for possible entry onto a paper and/or computerized flow sheet. Various versions of the MDHAQ may also include a "constant" region of physical function, pain and patient global status, and "variable" regions of fatigue, morning stiffness, psychological distress, change in status, a review of systems, a rheumatoid arthritis disease activity self-report joint count (RADAI), review of recent health events, and review of medications. The MDHAQ can be used in the infrastructure of rheumatology care to include quantitative data in standard care of all patients with all rheumatic diseases. PMID:16273781

  2. Individual Health Accounts: An Alternative Health Care Financing Approach

    PubMed Central

    Stano, Miron

    1981-01-01

    After examining the major determinants of inefficiency in health care markets and several recent proposals to correct these problems, this paper introduces a market-oriented alternative which could be highly efficient while meeting all the established goals of a national health plan. To achieve these objectives, traditional forms of insurance would be replaced by a system with the following characteristics: (1) Instead of buying insurance, individuals and their employers would be required to contribute into individual health accounts from which each family would pay for medical care; (2) Once accumulations attain a designated level, any excess accumulations are distributed to the individual; and (3) A national health fund is established to support those without regular accumulations or those whose accounts have been depleted. This paper develops these principles to show how everyone would have access to care as well as the financial security normally associated with comprehensive insurance. But, by inducing many patients to behave as if they were paying for the full cost of care through reductions in potential earnings from their accounts, the paper explains how significant savings in total spending could also be achieved. PMID:10309471

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

    PubMed

    Sherrill, Windsor W; Keels-Williams, Frankie

    2005-01-01

    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

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

    ERIC Educational Resources Information Center

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

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

  5. The health care response to pandemic influenza.

    PubMed

    Barnitz, Laura; Berkwits, Michael

    2006-07-18

    The threat of an H5N1 influenza virus (avian flu) pandemic is substantial. The success of the current U.S. influenza pandemic response plan depends on effective coordination among state and local public health authorities and individual health care providers. This article is a summary of a public policy paper developed by the American College of Physicians to address issues in the U.S. Department of Health and Human Services Pandemic Influenza Plan that involve physicians. The College's positions call for the following: 1) development of local public health task forces that include physicians representing all specialties and practice settings; 2) physician access to 2-way communication with public health authorities and to information technology tools for diagnosis and syndrome surveillance; 3) clear identification and authorization of agencies to process licensing and registration of volunteer physicians; 4) clear guidelines for overriding standard procedures for confidentiality and consent in the interest of the public's health; 5) clear and fair infection control measures that do not create barriers to care; 6) analysis of and solutions to current problems with seasonal influenza vaccination programs as a way of developing a maximally efficient pandemic flu vaccine program; 7) federal funding to provide pandemic flu vaccine for the entire U.S. population and antiviral drugs for 25% of the population; and 8) planning for health care in alternative, nonhospital settings to prevent a surge in demand for hospital care that exceeds supply. *This paper is an abridged version of a full-text position paper (available at http://www.acponline.org/college/pressroom/as06/pandemic_policy.pdf) written by Laura Barnitz, BJ, MA, and updated and adapted for publication in Annals of Internal Medicine by Michael Berkwits, MD, MSCE. The original position paper was developed for the Health and Public Policy Committee of the American College of Physicians: Jeffrey P. Harris, MD (Chair); David L. Bronson, MD (Vice Chair); CPT Julie Ake, MD; Patricia P. Barry, MD; Molly Cooke, MD; Herbert S. Diamond, MD; Joel S. Levine, MD; Mark E. Mayer, MD; Thomas McGinn, MD; Robert M. McLean, MD; Ashley E. Starkweather; and Frederick E. Turton, MD. It was approved by the Board of Regents on 3 April 2006. PMID:16801625

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

    Microsoft Academic Search

    Hilmiye Aksu; Mert Kucuk; Banu Karaoz

    2010-01-01

    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

  7. Prioritizing health-care funding.

    PubMed

    O'Donnell, J L; Smyth, D; Frampton, C

    2005-07-01

    In the face of limited resources, on what basis should we prioritize health-care funding? The most influential consideration should be the knowledge that an intervention does something beneficial for the person who receives it. Rather than using imposed knowledge or knowledge obtained by grace, modern medicine uses knowledge obtained by rational thought. Traditionally, two philosophical schools of rational thought support medical interventions: empiricism and rationalism. Empiricist knowledge underpins the treatment of risk, while rationalist knowledge underpins the treatment of disease. To introduce reasoned order into the rationing process we must understand the limitations inherent in the application of these two forms of knowledge. Why are screening programmes for breast and uterine cervical cancer supported while severe restrictions are placed on treatments for chronic arthritis? Can the benefits of cholesterol-lowering drugs be measured? Empiricism has achieved an unchallenged ascendancy in modern health-care delivery. Is this ascendancy justified? There is a need for reference criteria to compare the benefits of competing interventions across disciplines. As a starting point for debate we propose that interventions should be given a priority based on how closely they fulfil five criteria: knowledge of disease pathophysiology, measurability of short-term and long-term benefits, incidence of serious adverse effects and affordability. It is only by using and refining such funding criteria that better public understanding of the rationing process will be achieved and political interference minimized. PMID:15958111

  8. East Carolina University Health Care Components

    E-print Network

    ;Page 1 of 5 NOTICE OF PRIVACY PRACTICES EAST CAROLINA UNIVERSITY HEALTH CARE COMPONENTS ECU PHYSICIANS Physicians (ECUP) and the other Health Care Components at East Carolina University (collectively referred services, or by calling in a prescription. Electronic Health Information Exchange Program. ECUP, and any

  9. Fundamental Mechanisms of Managed Behavioral Health Care

    Microsoft Academic Search

    Gary Mihalik; Michael Scherer

    1998-01-01

    Making sense of managed behavioral health care organizations (MBHOs) is difficult as they rapidly evolve in response to payer, member, legislative, and market demands. This article describes the basic mechanisms involved in managed behavioral health care's evolution, including the nature of carve-out organizations, carved-in services, the array of payment mechanisms between payer and MBHO, and between MBHO and mental health

  10. Who leaves managed behavioral health care?

    Microsoft Academic Search

    Carole Roan Gresenz; Roland Sturm

    1999-01-01

    The growth of managed care and the possibility of biased enrollment and disenrollment rates have raised concerns about cost shifting. This article analyzes the duration of continuous enrollment in a managed behavioral health organization among members with and without behavioral health care utilization and among members with different mental health conditions. Eleven large employers with more than 250,000 members who

  11. Healing, Medical Care, and Health Service Organizations

    Microsoft Academic Search

    William E. Lafferty

    2004-01-01

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

  12. Predictors of Adolescent Health Care Utilization

    ERIC Educational Resources Information Center

    Vingilis, Evelyn; Wade, Terrance; Seeley, Jane

    2007-01-01

    This study, using Andersen's health care utilization model, examined how predisposing characteristics, enabling resources, need, personal health practices, and psychological factors influence health care utilization using a nationally representative, longitudinal sample of Canadian adolescents. Second, this study examined whether this process…

  13. Native-American elders. Health care status.

    PubMed

    Rousseau, P

    1995-02-01

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

  14. Mental Health Consultation in Child Care and

    E-print Network

    McQuade, D. Tyler

    Mental Health Consultation in Child Care and Early Childhood Settings Opportunities to Expand Department of Children & Families Children's Mental Health Program June 30, 2006 Florida State University-922-1300 · www.cpeip.fsu.edu #12;Mental Health Consultation in Child Care and Early Childhood Settings

  15. Health Care Utilization by Canadian Women

    Microsoft Academic Search

    Arminée Kazanjian; Denise Morettin; Robert Cho; F Ahmad; DE Stewart; JI Camerson; I Hyman; F Beland; A Lemay; M Boucher; CE Bird; PP Rieker; R Blais; A Maiga; A Aboubacar; AD Brown; AI Magistretti; H Cooper; CE De Grasse; AM O'Connor; J Boulet; N Edwards; H Bryant; K Breithaupt; S Dunlop; PC Coyte; W McIsaac; CJ Erdwins; LC Buffardi; WJ Casper; AS O' Brien; J Foster; CJ Fries; KS Menzies; R Fuhrer; SA Stansfeld; J Chemali; MJ Shipley; LA Gaudette; CA Altmayer; KM Nobrega; J Lee; CMT Gijsbers Van Wijk; KP Van Vliet; AM Kolk; RH Glazier; EM Badley; JE Gilbert; L Rothman; V Goel; K Iron; JI Williams; CA Green; CR Pope; N Hall; TP Hofer; SJ Katz; LG Houle; AW Salmoni; RW Pong; S Laflamme; GA Viverais-Dresler; IMA Joung; JBW Van der Meer; JP Mackenbach; WG Manning; JK Zemencuk; I Savoie; JA Kopec; PC Austin; CJ Maxwell; CM Bancej; J Snider; J McCusker; S Cardin; F Bellavance; E Belzile; E Healey; B Connolly; P McDonough; V Walters; SL Mercer; N Mittmann; K Trakas; N Risebrough; BA Liu; I Mittra; M Baum; H Thornton; J Houghton; AM Morton; C Loos; CA Mustard; S Derksen; D Tataryn; P Kaufert; A Kozyrskyj; T Mayer; L Potvin; J Camirand; J Randhawa; R Riley; AE Rhodes; PN Goering; C Sanmartin; C Houle; S Tremblay; J Berthelot; SB Sheps; RJ Reid; ML Barer; H Krueger; KM McGrail; B Green; O Szafran; N Bell; K Taggart; F Tudiver; E Fuller-Thomson; P Tully; C Mohl; H Tuokko; P MacCourt; Y Heath; I Waldron; CC Weiss; ME Hughes; PP Wang; R Weir; G Browne; E Tunks; A Gafni; J Roberts; J Wiles; MW Rosenberg; K Wilkins

    1997-01-01

    HEALTH ISSUES: While women are reported to be more frequent users of health services in Canada, differences in women's and men's health care utilization have not been fully explored. To provide an overview on women's healthcare utilization, we selected two key issues that are important for public policy purposes: access to care and patterns of utilization. These issues are examined

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

    Microsoft Academic Search

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

    1998-01-01

    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,

  17. Health care law versus constitutional law.

    PubMed

    Hall, Mark A

    2013-04-01

    National Federation of Independent Business v. Sebelius, the Supreme Court's ruling on the Patient Protection and Affordable Care Act, is a landmark decision - both for constitutional law and for health care law and policy. Others will study its implications for constitutional limits on a range of federal powers beyond health care. This article considers to what extent the decision is also about health care law, properly conceived. Under one view, health care law is the subdiscipline that inquires how courts and government actors take account of the special features of medicine that make legal or policy issues especially problematic - rather than regarding health care delivery and finance more generically, like most any other economic or social enterprise. Viewed this way, the opinions from the Court's conservative justices are mainly about general constitutional law principles. In contrast, Justice Ruth Bader Ginsburg's dissenting opinion for the four more liberal justices is just as much about health care law as it is about constitutional law. Her opinion gives detailed attention to the unique features of health care finance and delivery in order to inform her analysis of constitutional precedents and principles. Thus, the Court's multiple opinions give a vivid depiction of the compelling contrasts between communal versus individualistic conceptions of caring for those in need, and between health care and health insurance as ordinary commodities versus ones that merit special economic, social, and legal status. PMID:23262771

  18. Internet and Your Health 1 UC Irvine Health Care Facilitator

    E-print Network

    Burke, Peter

    information on a number of health topics, including the latest government health news, how to choose qualityInternet and Your Health 1 UC Irvine Health Care Facilitator Internet and Your Health There are currently thousands of health related sites on the World Wide Web. There is detailed information on hundreds

  19. Health Care Experiment at Many Farms

    ERIC Educational Resources Information Center

    McDermott, Walsh; And Others

    1972-01-01

    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)

  20. Health care: economic impact of caring for geriatric patients.

    PubMed

    Rich, Preston B; Adams, Sasha D

    2015-02-01

    National health care expenditures constitute a continuously expanding component of the US economy. Health care resources are distributed unequally among the population, and geriatric patients are disproportionately represented. Characterizing this group of individuals that accounts for the largest percentage of US health spending may facilitate the introduction of targeted interventions in key high-impact areas. Changing demographics, an increasing incidence of chronic disease and progressive disability, rapid technological advances, and systemic market failures in the health care sector combine to drive cost. A multidisciplinary approach will become increasingly necessary to balance the delicate relationship between our constrained supply and increasing demand. PMID:25459539

  1. [Communication between health care professionals and patients].

    PubMed

    Ohara, Yoshiko

    2010-06-01

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

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

    PubMed

    Kerr, J K; Jelinek, R

    1990-01-01

    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

  3. Home health care and burn care: an educational and economical program.

    PubMed

    Dattolo, J; Trout, S; Connolly, M L

    1996-01-01

    Changes in health care reimbursement have challenged providers of health care to work smarter instead of harder, with more efficient and effective use of resources. Patients with burn injuries remain hospitalized for dressing changes that could be completed in the home environment by health care professionals. An early discharge for a select group of patients from a resource-intensive hospital stay to a quality, cost-effective home care program was achieved. An educational program was developed to provide home care nurses the necessary knowledge and skill to care for the patient with burn injuries at home. This program combines didactic classroom lectures with a clinical orientation for home care registered nurses. The outcome for patients is a well-integrated continuity of care with a decreased length of hospital stay. PMID:8675510

  4. Commentary: Informatics in biomedicine and health care.

    PubMed

    Greenes, Robert A; Shortliffe, Edward H

    2009-07-01

    During the last two decades, biomedical informatics (BMI) has become a critical component in biomedical research and health care delivery, as evidenced by two recent phenomena. One, as discussed in the article by Bernstam and colleagues in this issue, has been the introduction of Clinical and Translational Science Awards. Perhaps even more important has been the recent, arguably long overdue, emphasis on deployment of health information technology (IT) nationally. BMI utilizes IT and computer science as tools and methods for improving data acquisition, data management, data analysis, and knowledge generation, but it is driven by a focus on applications based in deep understanding of the science and practice, problems, interactions, culture, and milieu of biomedicine and health. Building from Bernstam and colleagues' distinction between BMI and other IT disciplines, the authors discuss the evolving role of BMI professionals as individuals uniquely positioned to work within the human and organizational context and culture in which the IT is being applied. The focus is not on the IT but on the combination--the interactions of IT systems, human beings, and organizations aimed at achieving a particular purpose. There has never been a time when the need for individuals well trained in BMI--those who understand the complexities of the human, social, and organizational milieu of biomedicine and health--has been more critical than it is now, as the nation seeks to develop a national infrastructure for biomedicine and health care, and as these fields seek to broadly deploy IT wisely and appropriately. PMID:19550167

  5. In health care reform, who cares for the community?

    PubMed

    Sigmond, R; Seay, J D

    1994-01-01

    Health care reform has again focused the issues of ownership and mission of organizations in the health care field. Some believe that universal entitlement will eventually make both charitable patient care and the nonprofit form of organization obsolete. Others believe that special treatment of nonprofit organizations does not depend on charity at all; rather that the nonprofit form has social value in and of itself. The authors reflect a different point of view. They suggest that with reform, community benefit as the modern expression of a charitable mission will become ever more important in achieving the nation's health care goals. They believe that nonprofit organizations will continue to be entitled to special treatment only if their missions and programs extend beyond care of patients and entitled populations to focus also on care of communities. Any health organization's investment in disciplined community initiatives encompasses all the people in targeted communities, including those served by competing organizations. Without tax exemption, an organization committed to community care initiatives will be at a competitive disadvantage under the proposed community rated capitation payment system. Rather than abandoning the community benefit standard for tax exemption, health care reform calls for more systematic management of community care initiatives by nonprofit organizations and also of tax-exemption eligibility by the IRS. PMID:10135183

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

    PubMed Central

    Liu, Yuanli

    2004-01-01

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

  7. Willingness to participate in accountable care organizations: health care managers' perspective.

    PubMed

    Wan, Thomas T H; Demachkie Masri, Maysoun; Ortiz, Judith; Lin, Blossom Y J

    2014-01-01

    This study examines how health care managers responded to the accountable care organization (ACO). The effect of perceived benefits and barriers of the commitment to develop a strategic plan for ACOs and willingness to participate in ACOs is analyzed, using organizational social capital, health information technology uses, health systems integration and size of the health networks, geographic factors, and knowledge about ACOs as predictors. Propensity score matching and analysis are used to adjust the state and regional variations. When the number of perceived benefits is greater than the number of perceived barriers, health care managers are more likely to reveal a stronger commitment to develop a strategic plan for ACO adoption. Health care managers who perceived their organizations as lacking leadership support or commitment, financial incentives, and legal and regulatory support to ACO adoption were less willing to participate in ACOs in the future. Future research should gather more diverse views from a larger sample size of health professionals regarding ACO participation. The perspective of health care managers should be seriously considered in the adoption of an innovative health care delivery system. The transparency on policy formulation should consider multiple views of health care managers. PMID:24463593

  8. Spirulina in health care management.

    PubMed

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

    2008-10-01

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

  9. e-Health in Pediatric Palliative Care

    Microsoft Academic Search

    Caprice Knapp

    2010-01-01

    e-Health has the potential to improve pediatric palliative care. e-Health initiatives use the Internet or health information technology to improve quality of care and have the potential to decrease costs by reducing medical errors, reducing duplication of services, improving access to diagnostic and laboratory results, and improving communication between providers and patients, and so on. The majority of e-health initiatives

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

    Microsoft Academic Search

    Lisa C. Lindley; Barbara A. Mark

    2010-01-01

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

  11. Vulnerability of point-of-care test reagents and instruments to environmental stresses: implications for health professionals and developers.

    PubMed

    Louie, Richard F; Ferguson, William J; Curtis, Corbin M; Vy, John H; Kost, Gerald J

    2014-03-01

    Strategic integration of point-of-care (POC) diagnostic tools during crisis response can accelerate triage and improve management of victims. Timely differential diagnosis is essential wherever care is provided to rule out or rule in disease, expedite life-saving treatment, and improve utilization of limited resources. POC testing needs to be accurate in any environment in which it is used. Devices are exposed to potentially adverse storage and operating conditions, such as high/low temperature and humidity during emergencies and field rescues. Therefore, characterizing environmental conditions allows technology developers, operators, and responders to understand the broad operational requirements of test reagents, instruments, and equipment in order to improve the quality and delivery of care in complex emergencies, disasters, and austere environmental settings. This review aims to describe the effects of environmental stress on POC testing performance and its impact on decision-making, to describe how to study the effects, and to summarize ways to mitigate the effects of environmental stresses through good laboratory practice, development of robust reagents, and novel thermal packaging solutions. PMID:24114917

  12. Complementary and alternative health care in Israel.

    PubMed

    Shuval, Judith T; Averbuch, Emma

    2012-01-01

    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

  13. Factors Associated with Health Care Access for Mississippi Children with Special Health Care Needs

    Microsoft Academic Search

    Debra J. Kane; Marianne E. Zotti; Deborah Rosenberg

    2005-01-01

    Objectives: This purpose of the study was to examine the factors associated with access to routine care and to specialty care for Mississippi children with special health care needs (CSHCN). Methods: We analyzed data for Mississippi CSHCN from the 2001 National Survey of Children with Special Health Care Needs. Using a modified version of Andersen and Aday’s Behavioral Model of

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

    E-print Network

    Oxford, University of

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

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

    PubMed

    Al-Khatib, Issam A; Sato, Chikashi

    2009-08-01

    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(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. PMID:19398317

  16. A Conceptual Model for Health Care Information Systems

    PubMed Central

    Nadell, Avrom P.; Ronis, Norman

    1978-01-01

    The health care delivery system both needs and generates information in the course of providing service to its beneficiaries. The heightened interest of groups peripheral to the patient-provider relationship has resulted in ever increasing requests for information and serve to focus attention on the need for uniform data. This paper describes initial efforts to identify and define a core grouping of health-care-related information which is expected to be of maximum use both to members of the health care team and external oversight agencies. To explore the concept of maximum utility, a model of the health care information system was postulated, and functional information categories identified. Application of other criteria resulted in identification of discrete items of information. Definitions and codes, where appropriate, are being developed. The potential usefulness of the concepts to the health care community at large are also discussed.

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

    PubMed Central

    2014-01-01

    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. PMID:24405849

  18. Brief Description: Establishing a community health care collaborative grant program. Sponsors: Senate Committee on Health & Long-Term Care (originally sponsored by Senators Keiser, Brandland, Franklin, Murray, Brown, Ranker, Fraser, Parlette and Kohl-Welles). Senate Committee on Health & Long-Term Care House Committee on Health Care & Wellness House Committee on Ways & Means

    Microsoft Academic Search

    Background: The Community Health Care Collaborative (CHCC) Grant Program was established by the Legislature in 2006 to enhance and support the efforts of collaborative community-based organizations in developing health care delivery models that could be duplicated throughout the state. The program was created because the Legislature found that community-based health care organizations had been able to increase access to care

  19. Justice in Health Care Decision-Making: Patients’ Appraisals of Health Care Providers and Health Plan Representatives

    PubMed Central

    Fondacaro, Mark; Frogner, Bianca; Moos, Rudolf

    2010-01-01

    This study describes the development of two versions of a Health Care Justice Inventory (HCJI). One version focuses on patients’ interactions with their providers (HCJI-P) and the other focuses on patients’ interactions with the representatives of their health plans (HCJI-HP). Each version of the HCJI assesses patients’ appraisals of their interactions (with either their Provider or representatives of their Health Plan) along three common dimensions of procedural justice: Trust, Impartiality, and Participation. Both the Provider and Health Plan scales assess indices that are relatively independent of patients’ demographic characteristics. In addition, patients’ appraisals of their interactions with their provider were only moderately related to their appraisals of their interactions with representatives of their health plan, indicating that the Provider and Health Plan scales tap distinct aspects of patients’ overall experience with the health care system. Overall, procedural justice dimensions were significantly related to patient satisfaction in both the Provider and the Health Plan contexts. As predicted, procedural justice factors were more strongly tied to patient satisfaction in the Provider than in the Health Plan context, and health care decisions based on distributive justice principles of Need (rather than Equity or Equality) were most closely tied to patient satisfaction in both contexts. PMID:16021741

  20. Information Technology for Health Care in Mozambique

    E-print Network

    Monteiro, Eric

    /AIDS. The country's 435 physicians and 1200 health facilities are hard-pressed to serve the population of about 20.hisp.org) aiming at improving health information management within the primary health care sector. The aim of HISP is, by furthering more effective health information management, to encourage more decentralized

  1. Insights From Health Care in Germany

    PubMed Central

    Altenstetter, Christa

    2003-01-01

    German Statutory Health Insurance (national health insurance) has remained relatively intact over the past century, even in the face of governmental change and recent reforms. The overall story of German national health insurance is one of political compromise and successful implementation of communitarian values. Several key lessons from the German experience can be applied to the American health care system. PMID:12511381

  2. Application of lean thinking to health care: issues and observations

    PubMed Central

    Joosten, Tom; Bongers, Inge; Janssen, Richard

    2009-01-01

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

  3. Digital health care: cementing centralisation?

    PubMed

    Keen, Justin

    2014-09-01

    This article reviews large-scale digital developments in the National Health Service in England in recent years and argues that there is a mismatch between digital and organisational thinking and practice. The arguments are based on new institutional thinking, where the digital infrastructure is taken to be an institution, which has been shaped over a long period, and which in turn shapes the behaviour of health professionals, managers and others. Many digital services are still being designed in line with a bureaucratic data processing model. Yet health services are increasingly based on a network model, where health professionals and service managers require information systems that allow them to manage risks proactively and to coordinate multiple services on behalf of patients. This article further argues that the data processing model is being reinforced by Open Data policies and by related developments in the acquisition of genomic and telehealth data, suggesting that the mismatch will persist. There is, therefore, an ongoing tension between frontline and central objectives for digital services. It may be that the tension can only be resolved when--or if--there is trust between the interested parties. PMID:25183607

  4. Does it matter who organises your health care?

    PubMed Central

    Dawda, Paresh; McRae, Ian S; Yen, Laurann; Islam, Md Mofizul; Bagheri, Nasser; Jowsey, Tanisha; Banfield, Michelle; Parkinson, Anne

    2015-01-01

    Background As the prevalence of long-term and multimorbid conditions is increasing, patients increasingly require consultations with multiple health care professionals and coordination of their care needs. Methods This study is based on a 2011 survey of older Australians which draws on sub-populations of people with diabetes aged 50 years or over, people with chronic obstructive pulmonary disease, and members of Nationals Seniors Australia. We develop a composite coordination measure and examine differences in the measure with different care coordination indicators using both descriptive and regression methods. Three categories of respondent-perceived care organisers are used: health care professionals; “no one”; and patients, their partner, relative or friend. Results Of the 2,540 survey respondents (an overall response rate of 24%), 1,865 provided information on who organised their health care, and composite coordination measures were calculated for 1,614. Multivariate analysis showed the composite score was highest where a health care professional coordinated care, followed by care organised by self or a carer, and then the group reporting no organiser. Conclusion In moving towards care coordination there are opportunities to improve the care coordination process itself, and the key enablers to improving care coordination appear to be the availability and communication of clinical information and the role of the clinical team. PMID:26150760

  5. Beyond magic bullets: true innovation in health care.

    PubMed

    Narayan, Vaibhav A; Mohwinckel, Marco; Pisano, Gary; Yang, Michael; Manji, Husseini K

    2013-02-01

    The time has come to move beyond product-focused 'magic bullet' therapeutic development strategies towards models that can also incorporate devices, tools and services to provide integrated health-care solutions. PMID:23370233

  6. Health Care Provider Physical Activity Prescription Intervention

    ERIC Educational Resources Information Center

    Josyula, Lakshmi; Lyle, Roseann

    2013-01-01

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

  7. A Guide to Adolescent Health Care EPSDT.

    ERIC Educational Resources Information Center

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

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

  8. Child Health and Access to Medical Care

    ERIC Educational Resources Information Center

    Leininger, Lindsey; Levy, Helen

    2015-01-01

    It might seem strange to ask whether increasing access to medical care can improve children's health. Yet Lindsey Leininger and Helen Levy begin by pointing out that access to care plays a smaller role than we might think, and that many other factors, such as those discussed elsewhere in this issue, strongly influence children's health.…

  9. Viewing health care as a war theater.

    PubMed

    Kessler, D M

    1988-03-01

    Strategies for success in the health-care marketplace are similar to those used on the battlefield. The following article applies the teachings of Niccolo Machiavelli, Karl von Clausewitz, Napolean Bonaparte and other classic military strategists to power management, marketing and competition in health-care organizational management. PMID:10302345

  10. Award Recipient Sharp HealthCare

    E-print Network

    --some 785,000 people--each year. A not-for-profit organization, Sharp has an annual net revenue of greater enables Sharp to offer a full spectrum of health care services, from emergency, hospice, and mental health services to multi- organ transplants and hyperbaric treatment. Continuous Improvement Yields Quality Care

  11. Trust Between Family and Health Care Provider

    Microsoft Academic Search

    Debra J. Lynn-sMcHale; Janet A. Deatrick

    2000-01-01

    This concept analysis includes the definition, characteristics, boundaries, preconditions, and outcomes of the concept of trust between the family and health care provider. Based on the results of this concept analysis, trust between the family and health care provider is defined as a process, consisting of varying levels, that evolves over time and is based on mutual intention, reciprocity, and

  12. On Changing Indian Eligibility for Health Care.

    ERIC Educational Resources Information Center

    Bashushur, Rashid; And Others

    1987-01-01

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

  13. Health Care Industry. Workforce & Workplace Literacy Series.

    ERIC Educational Resources Information Center

    BCEL Brief, 1991

    1991-01-01

    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;…

  14. Race and Health Care in America.

    ERIC Educational Resources Information Center

    Airhihenbuwa, Collins O.

    1985-01-01

    Discusses the disparity in health care delivery for whites and blacks as a result of racial prejudice. Presents statistics showing that: (1) black workers are more likely to be exposed to job hazards; and (2) black children make greater use of health care when racial barriers are reduced. (KH)

  15. Changing trends in health care tourism.

    PubMed

    Karuppan, Corinne M; Karuppan, Muthu

    2010-01-01

    Despite much coverage in the popular press, only anecdotal evidence is available on medical tourists. At first sight, they seemed confined to small and narrowly defined consumer segments: individuals seeking bargains in cosmetic surgery or uninsured and financially distressed individuals in desperate need of medical care. The study reported in this article is the first empirical investigation of the medical tourism consumer market. It provides the demographic profile, motivations, and value perceptions of health care consumers who traveled abroad specifically to receive medical care. The findings suggest a much broader market of educated and savvy health care consumers than previously thought. In the backdrop of the health care reform, the article concludes with implications for health care providers. PMID:21045588

  16. Home Health Care: What It Is and What to Expect

    MedlinePLUS

    ... are here: Plan of care Share What’s home health care & what should I expect? What's home health care? Home health care is a wide range of ... listed. What should I expect from my home health care? Doctor’s orders are needed to start care. Once ...

  17. Monitoring of health care personnel employee and occupational health immunization program practices in the United States.

    PubMed

    Carrico, Ruth M; Sorrells, Nikka; Westhusing, Kelly; Wiemken, Timothy

    2014-01-01

    Recent studies have identified concerns with various elements of health care personnel immunization programs, including the handling and management of the vaccine. The purpose of this study was to assess monitoring processes that support evaluation of the care of vaccines in health care settings. An 11-question survey instrument was developed for use in scripted telephone surveys. State health departments in all 50 states in the United States and the District of Columbia were the target audience for the surveys. Data from a total of 47 states were obtained and analyzed. No states reported an existing monitoring process for evaluation of health care personnel immunization programs in their states. Our assessment indicates that vaccine evaluation processes for health care facilities are rare to nonexistent in the United States. Identifying existing practice gaps and resultant opportunities for improvements may be an important safety initiative that protects patients and health care personnel. PMID:24176603

  18. Afghanistan's national strategy for improving quality in health care

    PubMed Central

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

    2013-01-01

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

  19. The promise of Lean in health care.

    PubMed

    Toussaint, John S; Berry, Leonard L

    2013-01-01

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

  20. Developments in Australian general practice 2000-2002: what did these contribute to a well functioning and comprehensive Primary Health Care System?

    Microsoft Academic Search

    Gawaine Powell Davies; Julie Mcdonald; John Furler; Elizabeth Harris; Mark Harris

    2009-01-01

    Background: In recent years, national and state\\/territory governments have undertaken an increasing number of initiatives to strengthen general practice and improve its links with the rest of the primary health care sector. This paper reviews how far these initiatives were contributing to a well functioning and comprehensive primary health care system during the period 2000-2002, using a normative model of

  1. Developments in Australian general practice 2000–2002: what did these contribute to a well functioning and comprehensive Primary Health Care System?

    Microsoft Academic Search

    Gawaine Davies; Wendy Hu; Julie McDonald; John Furler; Elizabeth Harris; Mark Harris

    2006-01-01

    BACKGROUND: In recent years, national and state\\/territory governments have undertaken an increasing number of initiatives to strengthen general practice and improve its links with the rest of the primary health care sector. This paper reviews how far these initiatives were contributing to a well functioning and comprehensive primary health care system during the period 2000–2002, using a normative model of

  2. A computer-assisted health care cost management system.

    PubMed

    Burton, W N; Hoy, D A; Stephens, M

    1991-03-01

    To our knowledge, First Chicago has developed and implemented the first operational integrated health data computer system that includes the traditional occupational medicine data base together with medical claims and health risk appraisal data. OMNIS has combined medical claims, personnel, disability, employee assistance program, wellness program participation, administrative functions, laboratory, periodic health evaluation data, and health risk appraisal data in a single system. OMNIS provides data that are being used to more accurately predict health care and disability costs and design intervention strategies. Clearly, the integrated health data computer system provides information to manage increasingly complex issues of health care quality and cost. For companies concerned about the quality as well as the cost of health care, an integrated health data computer system (OMNIS) may be a valuable tool to objectively assess quality of care. For example, a company could evaluate how effectively various providers (eg, health maintenance organizations, preferred provider organizations, indemnity plan) control medical conditions such as hypertension. Integrated health data management systems have the potential to assist in the selection of the highest quality and most cost-effective health care plans. PMID:2030422

  3. Correctional health care: implications for public health policy.

    PubMed Central

    Adams, Diane L.; Leath, Brenda A.

    2002-01-01

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

  4. Health care employee perceptions of patient-centered care.

    PubMed

    Balbale, Salva Najib; Turcios, Stephanie; LaVela, Sherri L

    2015-03-01

    Given the importance of health care employees in the delivery of patient-centered care, understanding their unique perspectives is essential for quality improvement. The purpose of this study was to use photovoice to evaluate perceptions and experiences around patient-centered care among U.S. Veterans Affairs (VA) health care employees. We asked participants to take photographs of salient features in their environment related to patient-centered care. We used the photographs to facilitate dialogue during follow-up interviews. Twelve VA health care employees across two VA sites participated in the project. Although most participants felt satisfied with their work environment and experiences at the VA, they identified several areas for improvement. These included a need for more employee health and wellness initiatives and a need for enhanced opportunities for training and professional growth. Application of photovoice enabled us to learn about employees' unique perspectives around patient-centered care while engaging them in an evaluation of care delivery. PMID:25274626

  5. 41TREE CARE INDUSTRY -DECEMBER 2001 Plant Health Care

    E-print Network

    41TREE CARE INDUSTRY - DECEMBER 2001 Plant Health Care Why Do Trees Vary in Suitability to Insects relationships among tree food quality to in- sects and pathogens, the environment and tree growth rates. The articles are based on a paper presented at "Trees 2000: Challenges for the future," a conference or

  6. Comparisons among national health care systems in the European marketplace.

    PubMed

    Normand, C

    1993-01-01

    Most European countries have adopted either a Bismarckian system of compulsory health care insurance or a national health care system funded by taxation. For both systems, a basic level of health care is free at the point of use for all citizens. Health care has been undergoing reforms in most European countries. In the western nations, the autonomy of providers of services has increased, elements of competition and cost control have been introduced, and incentives to provide more cost-effective care have been initiated. Most central and eastern European countries have begun to return to the social insurance model for funding services. The ownership of some hospitals in these countries has been transferred to the private sector or to not-for-profit organizations. The European countries vary widely in their standards of facilities and professional staffing, and these generally reflect the prosperity of the country. During the 1980s, western countries implemented measures to limit the growth of health care expenditure, resulting in some reduction in the proportion of the gross domestic product spent on health care. Cost controls may not be as effective in the 1990s, as a result of demographic changes. More modern health care systems will likely develop in some of the central and eastern European countries, although this change will probably be slow. PMID:10123843

  7. A Guide to Health Education in Ambulatory Care Settings.

    ERIC Educational Resources Information Center

    Health Services Administration (DHEW/PHS), Rockville, MD. Bureau of Community Health Services.

    This report outlines ways in which health education strategies can be developed within an ambulatory care center and how they can be implemented to optimize their effectiveness and efficiency. Section 1 describes a program planning model for use in the development of health education programs. Sections 2 through 5 trace the consumer through four…

  8. Public health in Primary Care Trusts: a resource needs assessment

    Microsoft Academic Search

    Richard F Heller; Richard Edwards; Lesley Patterson; Moneim Elhassan

    2003-01-01

    Background. This study was commissioned by the UK Health Development Agency to provide a snapshot of how, at the outset of the 2002 NHS reorganisation, Primary Care Trust (PCT) staff and Professional Executive Committee (PEC) members perceived their public health roles and functions, the opportunities and barriers to delivering those roles and functions and the development needs in order to

  9. An intelligent assistant for patient health care

    Microsoft Academic Search

    Silvia Miksch; Kenneth Cheng; Barbara Hayes-Roth

    1997-01-01

    The Patient Advocate is designed to be an intelligent assistant for patient-centered health care. Residing on a home computer or special-purpose device and operating within an extended health-care information network, the Patient Advocate will extend medical expertise into the outpatient setting. It will have remote access to the patient's medical record, an understanding of the patient's health status and history,

  10. Postfracture interventions disseminated through health care and drug insurers: attempting to integrate fragmented health care delivery

    Microsoft Academic Search

    D. H. Solomon

    2011-01-01

    Osteoporosis care after a fracture is often suboptimal. Suboptimal treatment seems to be most common in fragmented health\\u000a care systems. We examined the literature to assess possible causes for suboptimal postfracture osteoporosis care within fragmented\\u000a health care systems. The review of the literature did not attempt to meta-analyze prior studies. We found several possible\\u000a methods for improving postfracture osteoporosis care

  11. Achieving Population Health in Accountable Care Organizations

    PubMed Central

    Walker, Deborah Klein

    2013-01-01

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

  12. Unrounding the corners of collaborative family health care.

    PubMed

    Blount, Alexander

    2015-06-01

    C. J. Peek has done us two lasting services with this beautiful summary. He has reminded us of Don Bloch's contributions to the beginning of collaborative family health care, and he has catalogued the elements of Don's vision for the field. Don's vision was for "collaborative family health care." Although we have made a great deal of progress developing collaborative health care that he would endorse, the full vision including the family as a basic unit of care and of understanding in health care is still ahead of us. The requirement of the inclusion of the family in the formulation of the patient-centered medical home may provide the impetus for a full realization of the "unrounded corners" version of Don's vision. (PsycINFO Database Record PMID:26053573

  13. Four policies to reduce HIV transmission through unsterile health care.

    PubMed

    Gisselquist, David; Friedman, Eric; Potterat, John J; Minkin, Stephen F; Brody, Stuart

    2003-11-01

    Residents of many developing countries face risks for themselves and their families to contract HIV and other bloodborne pathogens during unsterile health care. Helping people to understand and reduce these risks enlists their assistance to control the HIV/AIDS epidemic. To reduce HIV transmission through health care, we recommend four policies that international, foreign, and local public and private organizations can adopt and begin to implement even with little or no additional funds: (1) Educate the public about risks to contract HIV through unsterile health care. (2) Promote transparent practices for injections and other procedures that allow patients to see and know that care is safe (e.g., taking a new auto-disable syringe out of a sealed package and taking injecta from a single-dose vial). (3) Promote safe health care practices equally for clients and staff. (4) Establish a zero-tolerance policy for iatrogenic HIV infections, with publicly reported monitoring and investigations. PMID:14624731

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

    PubMed

    Giraldo Osorio, Alexandra; Vélez Álvarez, Consuelo

    2013-01-01

    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

  15. Growth & Development / Parental Care

    E-print Network

    Butler, Christopher J.

    Parental care Essential Minimal Nourishment Parents Self-feeding Egg size Ssmall (4-10%) Large (9-21%) Egg from insects) and calcium (from eggs or bones) Bird Protein (%) Lipid (%) Carbohydrates (%) Pigeon 23

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

    ERIC Educational Resources Information Center

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

    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

  17. Continuity in health care: lessons from supply chain management.

    PubMed

    Meijboom, Bert R; Bakx, Saskia J W G C; Westert, Gert P

    2010-01-01

    In health care, multidisciplinary collaboration is both indispensable and complicated. We discuss organizational problems that occur in situations where multiple health care providers are required to cooperate for patients with complex needs. Four problem categories, labelled as communication, patient safety, waiting times and integration are distinguished. Then we develop a supply chain perspective on these problems in the sense of discussing remedies according to supply chain management (SCM) literature. This perspective implies a business focus on inter-organizational conditions and requirements necessary for delivering health care and cure across organizational borders. We conclude by presenting some strategic and policy recommendations. PMID:21069770

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

    PubMed

    Fortuit, P

    2005-09-01

    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

  19. Health care practices in ancient Greece: The Hippocratic ideal.

    PubMed

    Kleisiaris, Christos F; Sfakianakis, Chrisanthos; Papathanasiou, Ioanna V

    2014-01-01

    Asclepius and Hippocrates focused medical practice on the natural approach and treatment of diseases, highlighting the importance of understanding the patient's health, independence of mind, and the need for harmony between the individual, social and natural environment, as reflected in the Hippocratic Oath. The aim of this study was to present the philosophy of care provision in ancient Greece and to highlight the influence of the Hippocratic ideal in modern health care practices. A literature review was carried out using browser methods in international databases. According to the literature, "healthy mind in a healthy body" was the main component of the Hippocratic philosophy. Three main categories were observed in the Hippocratic provision of care: health promotion, interventions on trauma care, and mental care and art therapy interventions. Health promotion included physical activity as an essential part of physical and mental health, and emphasized the importance of nutrition to improve performance in the Olympic Games. Interventions on trauma care included surgical practices developed by Hippocrates, mainly due to the frequent wars in ancient Greece. Mental care and art therapy interventions were in accordance with the first classification of mental disorders, which was proposed by Hippocrates. In this category music and drama were used as management tools in the treatment of illness and in the improvement of human behavior. The role of Asclepieion of Kos was highlighted which clearly indicates a holistic health care model in care provision. Finally, all practices regarded detailed recordings and evaluation of information within the guidelines. The Hippocratic philosophy on health care provision focused on the holistic health care model, applying standards and ethical rules that are still valid today. PMID:25512827

  20. The effect of social health insurance on prenatal care: the case of Ghana.

    PubMed

    Abrokwah, Stephen O; Moser, Christine M; Norton, Edward C

    2014-12-01

    Many developing countries have introduced social health insurance programs to help address two of the United Nations' millennium development goals-reducing infant mortality and improving maternal health outcomes. By making modern health care more accessible and affordable, policymakers hope that more women will seek prenatal care and thereby improve health outcomes. This paper studies how Ghana's social health insurance program affects prenatal care use and out-of-pocket expenditures, using the two-part model to model prenatal care expenditures. We test whether Ghana's social health insurance improved prenatal care use, reduced out-of-pocket expenditures, and increased the number of prenatal care visits. District-level differences in the timing of implementation provide exogenous variation in access to health insurance, and therefore strong identification. Those with access to social health insurance have a higher probability of receiving care, a higher number of prenatal care visits, and lower out-of-pocket expenditures conditional on spending on care. PMID:25143181

  1. Young People's Experiences of Mental Health Care

    ERIC Educational Resources Information Center

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

    2009-01-01

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

  2. Home Health and Informal Care Utilization

    E-print Network

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

  3. 75 FR 48235 - Rural Health Care Universal Service Support Mechanism

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-09

    ...47 CFR Part 54 Rural Health Care Universal Service Support Mechanism...02-60; FCC 10-125] Rural Health Care Universal Service Support Mechanism...improve the quality and delivery of health care, and addresses each of the...

  4. 77 FR 42185 - Rural Health Care Support Mechanism

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-18

    ...02-60; FCC 12-74] Rural Health Care Support Mechanism AGENCY: Federal...responsible basis for specific Rural Health Care Pilot Program participants that...connectivity and the resulting health care benefits that patients...

  5. 78 FR 13935 - Rural Health Care Support Mechanism

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-01

    ...47 CFR Part 54 Rural Health Care Support Mechanism; Final Rule...02-60; FCC 12-150] Rural Health Care Support Mechanism AGENCY: Federal...universal service support program for health care, transitioning its existing...

  6. 75 FR 79323 - Health Care for Homeless Veterans Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-20

    ...38 CFR Part 63 RIN 2900-AN73 Health Care for Homeless Veterans Program AGENCY...community-based treatment facilities in the Health Care for Homeless Veterans (HCHV...response to ``RIN 2900-AN73, Health Care for Homeless Veterans...

  7. 76 FR 57637 - TRICARE; Continued Health Care Benefit Program Expansion

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-16

    ...0720-AB30 TRICARE; Continued Health Care Benefit Program Expansion AGENCY...eligible to purchase Continued Health Care Benefit Program (CHCBP) coverage...program that provides continued health care coverage for eligible...

  8. 76 FR 37307 - Rural Health Care Support Mechanism

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-27

    ...02-60; FCC 11-101] Rural Health Care Support Mechanism AGENCY: Federal...discounted services under the rural health care program. Grandfathered providers...but play a key role in delivering health care services to surrounding...

  9. Disparities in Health Care Quality among Minority Women

    MedlinePLUS

    ... 3-EF Go to Online Store Disparities in Health Care Quality Among Minority Women Selected Findings From the ... race and ethnicity are combined. Return to Contents Health Care Delivery and Systems Information about health care delivery ...

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

    PubMed Central

    Gutteling, Jolie J; de Man, Robert A; Busschbach, Jan JV; Darlington, Anne-Sophie E

    2008-01-01

    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 Of health care services Through the patients' Eyes. QUOTE methodology aims to standardise the measurement of satisfaction as the discrepancy between patients' needs, and the extent to which these needs are being met. Methods As part of the QUOTE methodology routine, 11 Patients with chronic liver disease from the Erasmus MC (Rotterdam, the Netherlands) participated in focus-group meetings on patient satisfaction with the provided service at the outpatient hepatology clinic. Twenty-eight other patients were invited to rank the items generated during the focus-group meetings according to importance. With this information, the QUOTE-Liver was constructed. Face validity, construct validity, content validity, and reliability of the newly developed questionnaire were assessed in a test sample of 152 patients with chronic liver disease. Results Two liver-disease specific, and the 18 items ranked as most important were included in the QUOTE-Liver. Face validity and content validity were acceptable: neither patients (n = 152) nor psychologists (n = 3) or a hepatologist suggested any extra items to be included. Construct validity was good: the overall score correlated significantly with the Visual Analogue Scale (VAS) measuring overall satisfaction (r = 0.69, p < 0.01). The reliability of the QUOTE-Liver was excellent (? = 0.90). Conclusion The QUOTE-Liver is an easy to complete instrument based on standardized state-of-the-art satisfaction measurement methodology. Preliminary evidence for its validity and reliability was demonstrated. The QUOTE-liver covers those aspects of satisfaction that CLD patients consider to be important when visiting the outpatient department of hepatology. Even though further substantiating of the favourable psychometric findings is desirable, it seems to be a useful instrument that can be used to identify those aspects of care that need improvement in order to optimise the provision of health care for patients with chronic liver disease. PMID:18570638

  11. Why Health Care Is Going Green.

    PubMed

    Sadler, Blair L

    2015-07-01

    Ten years ago, when I was president and chief executive officer of Rady Children's Hospital in San Diego, if you had asked me about our commitment to environmental sustainability or about the hospital's carbon footprint, I would have given you a blank look. The issues were simply not on my radar screen. And that was true of most health care leaders. The good news? Environmental sustainability is becoming a health care priority, and exciting progress is occurring. In Greening Health Care: How Hospitals Can Heal the Planet, Kathy Gerwig eloquently relates how one leading large health care system, Kaiser Permanente, achieved remarkable results in responding to the environmental health challenge over the past several years. PMID:26152389

  12. Management of HealthCare Associated Pneumonia (HCAP)

    Microsoft Academic Search

    Alessia Rosato; Claudio Santini

    IntroductionThe traditional classification of Pneumonia as either community acquired (CAP) or hospital acquired (HAP) reflects deep differences in the etiology, pathogenesis, approach and prognosis between the two entities. Health-Care Associated Pneumonia (HCAP) develops in a heterogeneous group of patients receiving invasive medical care or surgical procedures in an outpatient setting. For epidemiology and outcomes, HCAP closely resembles HAP and possibly

  13. Providing Perinatal Mental Health Services in Pediatric Primary Care

    ERIC Educational Resources Information Center

    Talmi, Ayelet; Stafford, Brian; Buchholz, Melissa

    2009-01-01

    After birth, newborns and their caregivers are seen routinely and frequently in pediatric primary care settings. The close succession of visits in the first few months of life puts pediatric primary care professionals in a unique position to enhance infant mental health by developing strong relationships with caregivers, supporting babies and…

  14. Inpatient care to community care: improving clinical handover in the private mental health setting

    Microsoft Academic Search

    Susan K Wood; Allison K Campbell; Judith D Marden; Lavinia Schmidtman; George H Blundell; Noella J Sheerin; Patricia M Davidson

    2009-01-01

    Objectives: To develop and test a standardised clinical handover discharge strategy for improving information transfer between private mental health hospitals and community practitioners. Design, setting and participants: A quality improvement intervention using collaborative, iterative methods to develop a standardised discharge and outcome assessment strategy. 150 patient participants were consecutively recruited from two private mental health care hospitals in New South

  15. Ecology of health care in Canada

    PubMed Central

    Stewart, Moira; Ryan, Bridget

    2015-01-01

    Abstract Objective To provide a population-based, Canada-wide picture of health care needs and health care use, and present it in a highly accessible manner, allowing provincial comparisons and comparisons with other international jurisdictions. Design A comparison of the rates of health care use among jurisdictions, using Canadian-population survey data and health administrative data. Setting Provincial jurisdictions across Canada. Main outcome measures Canadian and provincial rates of ill health (presence of chronic conditions) and health care use (contacts with family physicians, contacts with other specialist physicians, contacts with nurses, and hospitalizations) as monthly rates per 1000 population standardized by age and sex. Results The monthly rate per 1000 population of having at least 1 chronic condition ranged from 524 in Quebec to 638 in Nova Scotia; contacts with family physicians ranged from 158 in Quebec to 295 in British Columbia; contacts with other physician specialists ranged from 53 in Saskatchewan to 79 in Ontario; and contacts with nurses ranged from 23 in British Columbia to 41 in Quebec. Hospital stays ranged from 8 to 11 per 1000 people, and rates were similar among the provinces. Conclusion Recognizing the differences among jurisdictions is critical to informing health care policy across the country. Differences persisted when rates were standardized for different age and sex compositions in the provinces. This article provides a straightforward methodology using publicly available data that can be employed in each province to examine, in the future, the evolution over time of health care use by provincial jurisdictions. PMID:25971762

  16. Maintaining confidentiality: health care's ongoing dilemma.

    PubMed

    Dowd, S B; Dowd, L P

    1996-09-01

    Confidentiality of patient information is an ethical obligation of health care professionals. The exercise of confidentiality is not a simple process; it is dynamic rather than static and must be upgraded with changes in technology. This article discusses some of the common issues that arise in maintaining confidentiality in the health care environment, including spoken and written breaches of confidentiality, use of the computer, confidentiality as an ethical rather than legal obligation, and the use of programs in health care institutions to maintain confidentiality. PMID:10159637

  17. Evolution of Child Mental Health Services in Primary Care

    PubMed Central

    Kelleher, Kelly J.; Stevens, Jack

    2009-01-01

    Objective While the importance of mental health assessment and treatment in primary care is increasingly recognized, the research that underlies current practices largely stems from a considerable body of non-mental health primary care studies. Our purpose was to describe trends in research over the past two decades and suggest further key items for the research agenda. Methods We reviewed the literature broadly on health services research in pediatrics, especially studies of changes in primary care practice, and examined recent articles in primary care mental health services. Results The evolution of primary care mental health services for children has been slow, but the focus of research has changed with the development of clinical improvements. Proposals to deliver more effective services have evolved over the past forty years in a series of approaches that paralleled initiatives in the broader fields of medicine and pediatrics. Current trends in electronic technology, practice consolidation and coordination, and personalized medicine are likely to increase the pace of change in mental health services for primary care. Conclusion The evolution of pediatric mental health services in primary care suggests a continuing expansion from a focus initially on provider behavior and quality to a growing attention to patient and systems' behavior over time and within communities. PMID:19329085

  18. Massachusetts health care reform: is it working?

    PubMed

    McAdoo, Joshua; Irving, Julian; Deslich, Stacie; Coustasse, Alberto

    2013-01-01

    Before 2006, Massachusetts had more than 500 000 residents who lacked health insurance. Governor Mitt Romney enacted landmark legislation requiring all residents to obtain health insurance. Also, the legislation established a health insurance exchange for the purpose of broadening the choices of insurance plans made available to individuals in the state. The purpose of this research was to assess the Massachusetts health care reform in terms of access, cost, and sustainability. The methodology used was a literature review from 2006 to 2013; a total of 43 references were used. Health reform resulted in additional overall state spending of $2.42 billion on Medicaid for Massachusetts. Since the 2006 reform, 401 000 additional residents have obtained insurance. The number of Massachusetts residents who had access to health care increased substantially after the health care reform was enacted, to 98.1% of residents. The Massachusetts health care reform has not saved money for the state; its funding has been covered by Federal spending. However, reform has been sustained over time because of the high percentage of state residents who have supported the state mandate to obtain health care coverage. PMID:24168866

  19. Linking primary health care and self-care through case management.

    PubMed

    Holzemer, W L

    1992-01-01

    Primary health care (PHC) strategies have heightened health care providers' awareness of the need to understand their communities and provided knowledge on how to mobilize communities for health. Orem, a nurse theorist, has developed a similar philosophical position on mobilizing individuals for self-care, which complements PHC theory at the community level. This article links the philosophies and strategies of PHC with self-are and proposes a delivery model of case management, drawing on examples from the HIV/AIDS pandemic and the aging population to illustrate the type of coordinating activities required of case managers in the 21st century. PMID:1639590

  20. Understanding and Measuring Health Care Insecurity

    PubMed Central

    Tomsik, Philip E.; Smith, Samantha; Mason, Mary Jane; Zyzanski, Stephen J.; Stange, Kurt C.; Werner, James J.; Flocke, Susan A.

    2015-01-01

    Purpose To define the concept of “health care insecurity,” validate a new self-report measure, and examine the impact of beginning care at a free clinic on uninsured patients’ health care insecurity. Methods Consecutive new patients presenting at a free clinic completed 15 items assessing domains of health care insecurity (HCI) at their first visit and again four to eight weeks later. Psychometrics and change of the HCI measure were examined. Results The HCI measure was found to have high internal consistency (?=0.94). Evidence of concurrent validity was indicated by negative correlation with VR-12 health-related quality of life physical and mental health components and positive correlation with the Perceived Stress Scale. Predictive validity was shown among the 83% of participants completing follow-up: HCI decreased after beginning care at a free clinic (p<.001). Conclusion Reliably assessing patient experience of health care insecurity is feasible and has potential to inform efforts to improve quality and access to care among underserved populations. PMID:25418245

  1. Challenges to Native American health care.

    PubMed

    Noren, J; Kindig, D; Sprenger, A

    1998-01-01

    Native American health care programs face complex and unprecedented challenges resulting from the increased assumption of clinical operations by tribal authorities, shortfalls in Federal funding, modifications in state and Federal health and welfare programs, and intensifying involvement with managed care organizations. These challenges are further complicated by service populations that are increasing at a faster rate than the growth in funding. The authors conducted onsite surveys of 39 Native American health programs in 10 states in order to assess the organizational and management problems they faced. The trend toward transfer of health programs from the Indian Health Service to tribal operation seems likely to continue and accelerate. The survey results indicate that in order for programs to be effective in the long run, they will need to be guided by skilled managers able to adapt to these powerful changes in the health care environment. PMID:9885525

  2. Challenges to Native American health care.

    PubMed Central

    Noren, J; Kindig, D; Sprenger, A

    1998-01-01

    Native American health care programs face complex and unprecedented challenges resulting from the increased assumption of clinical operations by tribal authorities, shortfalls in Federal funding, modifications in state and Federal health and welfare programs, and intensifying involvement with managed care organizations. These challenges are further complicated by service populations that are increasing at a faster rate than the growth in funding. The authors conducted onsite surveys of 39 Native American health programs in 10 states in order to assess the organizational and management problems they faced. The trend toward transfer of health programs from the Indian Health Service to tribal operation seems likely to continue and accelerate. The survey results indicate that in order for programs to be effective in the long run, they will need to be guided by skilled managers able to adapt to these powerful changes in the health care environment. Images p[23]-a p27-a p28-a p30-a PMID:9885525

  3. The Affordable Care Act, health care reform, prescription drug formularies and utilization management tools.

    PubMed

    Ung, Brian L; Mullins, C Daniel

    2015-01-01

    The U.S. Patient Protection and Affordable Care Act (hence, Affordable Care Act, or ACA) was signed into law on March 23, 2010. Goals of the ACA include decreasing the number of uninsured people, controlling cost and spending on health care, increasing the quality of care provided, and increasing insurance coverage benefits. This manuscript focuses on how the ACA affects pharmacy benefit managers and consumers when they have prescriptions dispensed. PBMs use formularies and utilization control tools to steer drug usage toward cost-effective and efficacious agents. A logic model was developed to explain the effects of the new legislation. The model draws from peer-reviewed and gray literature commentary about current and future U.S. healthcare reform. Outcomes were identified as desired and undesired effects, and expected unintended consequences. The ACA extends health insurance benefits to almost 32 million people and provides financial assistance to those up to 400% of the poverty level. Increased access to care leads to a similar increase in overall health care demand and usage. This short-term increase is projected to decrease downstream spending on disease treatment and stunt the continued growth of health care costs, but may unintentionally exacerbate the current primary care physician shortage. The ACA eliminates limitations on insurance and increases the scope of benefits. Online health care insurance exchanges give patients a central location with multiple insurance options. Problems with prescription drug affordability and control utilization tools used by PBMs were not addressed by the ACA. Improving communication within the U.S. healthcare system either by innovative health care delivery models or increased usage of health information technology will help alleviate problems of health care spending and affordability. PMID:25217142

  4. Organizational innovations and health care decentralization: a perspective from Spain.

    PubMed

    López-Casasanovas, Guillem

    2007-04-01

    Recent policy developments in public health care systems lead to a greater diversity in health care. Decentralization, either geographically or at an institutional level, is the key force, because it encourages innovation and local initiatives in health care provision. The devolution of responsibilities allows for a sort of 'deconstruction' of the status quo by changing both organizational forms and service provision. The new organizations enjoy greater freedom in the way they pay their staff, and are judged according to the results. These organizations may retain financial surpluses, develop 'spin-off' companies, and commission a range of specialized services (such as Diagnostic and Treatment Centres in UK) from providers outside the institutional setting in order to have more access to capital markets. However, this diversity may generate a feeling of a lack of commitment to a national health service and ultimately a loss of social cohesion. Through fiscal decentralization to regional authorities or planned delegation of financial agreements to providers, financial incentives are more explicit and may seem to place profit making above a commitment to better health care. An evaluation of the 'myths and realities' of the decentralization process is needed. Here, I offer an assessment of the 'pros' and 'cons' of the health care decentralization process in Spain, drawing on the experience of regional reforms from the pioneering organizational innovations implemented in Catalonia in 1981, up to the currently observed dispersion of health care spending per capita across the regions. PMID:18634666

  5. Benefits and Systems of Care for Maternal and Child Health under Health Care Reform: Workshop Highlights.

    ERIC Educational Resources Information Center

    Abel, Cynthia H., Ed.

    This report discusses the health care needs of and benefits for women, children, and adolescents in light of national health care reform proposals put forth in 1994, and is based on presentations and discussions at an invitational workshop on maternal and child health. The report asserts that since women and children are disproportionately…

  6. Bridging Organizational Divides in Health Care: An Ecological View of Health Information Exchange

    PubMed Central

    Johnson, Kevin B; Gadd, Cynthia S; Lorenzi, Nancy M

    2013-01-01

    Background The fragmented nature of health care delivery in the United States leads to fragmented health information and impedes patient care continuity and safety. Technologies to support interorganizational health information exchange (HIE) are becoming more available. Understanding how HIE technology changes health care delivery and affects people and organizations is crucial to long-term successful implementation. Objective Our study investigated the impacts of HIE technology on organizations, health care providers, and patients through a new, context-aware perspective, the Regional Health Information Ecology. Methods We conducted more than 180 hours of direct observation, informal interviews during observation, and 9 formal semi-structured interviews. Data collection focused on workflow and information flow among health care team members and patients and on health care provider use of HIE technology. Results We structured the data analysis around five primary information ecology components: system, locality, diversity, keystone species, and coevolution. Our study identified three main roles, or keystone species, involved in HIE: information consumers, information exchange facilitators, and information repositories. The HIE technology impacted patient care by allowing providers direct access to health information, reducing time to obtain health information, and increasing provider awareness of patient interactions with the health care system. Developing the infrastructure needed to support HIE technology also improved connections among information technology support groups at different health care organizations. Despite the potential of this type of technology to improve continuity of patient care, HIE technology adoption by health care providers was limited. Conclusions To successfully build a HIE network, organizations had to shift perspectives from an ownership view of health data to a continuity of care perspective. To successfully integrate external health information into clinical work practices, health care providers had to move toward understanding potential contributions of external health information. Our study provides a foundation for future context-aware development and implementation of HIE technology. Integrating concepts from the Regional Health Information Ecology into design and implementation may lead to wider diffusion and adoption of HIE technology into clinical work. PMID:25600166

  7. Health Care Facilities Resilient to Climate Change Impacts

    PubMed Central

    Paterson, Jaclyn; Berry, Peter; Ebi, Kristie; Varangu, Linda

    2014-01-01

    Climate change will increase the frequency and magnitude of extreme weather events and create risks that will impact health care facilities. Health care facilities will need to assess climate change risks and adopt adaptive management strategies to be resilient, but guidance tools are lacking. In this study, a toolkit was developed for health care facility officials to assess the resiliency of their facility to climate change impacts. A mixed methods approach was used to develop climate change resiliency indicators to inform the development of the toolkit. The toolkit consists of a checklist for officials who work in areas of emergency management, facilities management and health care services and supply chain management, a facilitator’s guide for administering the checklist, and a resource guidebook to inform adaptation. Six health care facilities representing three provinces in Canada piloted the checklist. Senior level officials with expertise in the aforementioned areas were invited to review the checklist, provide feedback during qualitative interviews and review the final toolkit at a stakeholder workshop. The toolkit helps health care facility officials identify gaps in climate change preparedness, direct allocation of adaptation resources and inform strategic planning to increase resiliency to climate change. PMID:25522050

  8. Health Care Waste Management and Environmentally Preferable Purchasing

    Microsoft Academic Search

    Jennifer M. Brusco; Mary Ogg

    2010-01-01

    The nation's health care system produces a large amount of waste, both hazardous and nonhazardous; however, there are simple steps that any health care professional can take to minimize the effects of health care waste on the environment and human health. Not only can health care professionals reduce, reuse, and recycle, but they can also make smarter, “green” purchasing decisions.

  9. Capital structure strategy in health care systems.

    PubMed

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

    2000-01-01

    The capital structures (the relative use of debt and equity to support assets) of leading health care systems are viewed as a strategic component of their financial plans. While not-for-profit hospitals as a group have maintained nearly constant levels of debt over the past decade, investor-owned hospitals and a group of leading health care systems have reduced their relative use of debt. Chief financial officers indicated that in addition to reducing debt because of less favorable reimbursement incentives, there was a focus on maintaining high bond ratings. Debt levels have not been reduced as sharply in these health care systems as they have in investor-owned hospitals, in part due to the use of debt to support investments in financial markets. Because these health care systems do not have easy access to equity, high bond ratings and solid investment earnings are central to their capital structure policies of preserving access to debt markets. PMID:10845385

  10. HealthCare Provider BLS (CPR) Certification

    E-print Network

    Alford, Simon

    HealthCare Provider BLS (CPR) Certification UIC COM, CON, COP, COD Faculty, Residents, and Students The Graham Clinical Performance Center (GCPC) is offering BLS Certification (healthcare provider CPR) on site

  11. Essays on health care delivery and financing

    E-print Network

    Chan, David C. (David Cchimin)

    2013-01-01

    This thesis contains essays on health care delivery and financing. Chapter 1 studies the effect of organizational structure on physician behavior. I investigate this by studying emergency department (ED) physicians who ...

  12. Assuring Equity Through Health and Health Care Reform Conference Registration Information (Type or Print)

    E-print Network

    Brown, Lucy L.

    Research in Clinical and Translational Science Immigrant Health Caring for Veterans Children's HealthAssuring Equity Through Health and Health Care Reform Conference Registration Information (Type of Health Reform in the Pharmaceutical Industry Sustaining Community Health Workers Comparative

  13. The English and Swedish health care reforms.

    PubMed

    Glennerster, H; Matsaganis, M

    1994-01-01

    England and Sweden have two of the most advanced systems of universal access to health care in the world. Both have begun major reforms based on similar principles. Universal access and finance from taxation are retained, but a measure of competition between providers of health care is introduced. The reforms therefore show a movement toward the kind of approach advocated by some in the United States. This article traces the origins and early results of the two countries' reform efforts. PMID:8034391

  14. Abortion and Health Care Chaplaincy in Australia

    Microsoft Academic Search

    Lindsay B. Carey; Christopher Newell

    2007-01-01

    This paper summarizes the results gained from quantitative and qualitative research involving 327 Australian health care chaplains\\u000a with regard to their involvement in abortion issues within the health care context. The findings indicate that approximately\\u000a 20% of surveyed chaplains had provided some form of pastoral intervention to patients and\\/or their families dealing with issues\\u000a of abortion and that approximately 10%

  15. Gender, social roles and health care utilization 

    E-print Network

    David, Jennifer Louise

    1992-01-01

    GENDER, SOCIAL ROLES AND HEALTH CARE UTILIZATION A Thesis by JENNIFER LOUISE DAVID Submitted to the Office of Graduate Studies of Texas A&M University in partial fulfillment of the requirements for the degree of MASTER OF SCIENCE December... 1992 Major Subject: Sociology GENDER, SOCIAL ROLES AND HEALTH CARE UTILIZATION A Thesis by JENNIFER LOUISE DAVID Approved as to style and content by: Howard B. Kaplan (Chair of Committee) m. Alex Mclntosh (Member) J oehr (Member) 0 0N...

  16. Update: Health Insurance and Utilization of Care among Rural Adolescents

    ERIC Educational Resources Information Center

    Probst, Janice C.; Moore, Charity G.; Baxley, Elizabeth G.

    2005-01-01

    Context: Adolescence is critical for the development of adult health habits. Disparities between rural and urban adolescents and between minority and white youth can have life-long consequences. Purpose: To compare health insurance coverage and ambulatory care contacts between rural minority adolescents and white and urban adolescents. Methods:…

  17. The physician's perception of health care.

    PubMed

    Lawrence, R S

    1994-01-01

    A general malaise appears to have settled on the American medical scene; most Americans continue to trust their own physicians but do not trust the medical profession or the health system as a whole, while many physicians feel harassed by the regulatory, bureaucratic, or litigious intrusions upon the patient-doctor relationship. The strains on mutual trust among physicians, their patients, and the public are being played out against a background of contradictions. The advances of biomedicine are offset by the neglect of social and behavioural aspects of medical care. Preoccupation with specialized, hospital-based treatment is accompanied by isolation of public health and preventive interests from medical education and practice. Society remains uncertain whether health care is a right or a privilege while accepting public responsibility for financing the health care of certain groups such as the indigent sick (Medicaid), the elderly (Medicare), Native Americans, or members of the armed forces and veterans. Rising expectations about better outcomes through advances in technology are accompanied by rising anxieties about cost, appropriateness of care, access, and quality. Physicians must alter their perception of health care by adopting a population-based approach to need, a commitment to restoring equity in staffing patterns and compensation between primary care and specialty care, and adoption of a social contract that provides for full access by all Americans to basic cost-effective preventive and clinical services before spending on less cost-effective services. PMID:8064752

  18. The Hospice Concept in Health Care

    Microsoft Academic Search

    Kathleen Ann Allen

    The hospice movement has been receiving a great deal of attention lately. Care of the dying has become the byline for any professional as well as non-professional writers. You are sure to find at least one article in any current journal for health professionals devoted to the care of the terminally ill. Television has presented news miniseries and specials on

  19. Model Child Care Health Policies. Fourth Edition.

    ERIC Educational Resources Information Center

    Aronson, Susan S.

    Drawn from a review of policies at over 100 child care programs nationwide, this document compiles model health policies intended for adaptation and selective use by out-of-home child care facilities. Following an introduction, the document presents model policy forms with blanks for adding individualized information for the following areas: (1)…

  20. [Professional perspective in primary health care reform: a qualitative approximation].

    PubMed

    Rodríguez, R; Márquez, S; López, M

    1995-01-01

    The objective of this study was to find out opinions and experiences of primary health centre professionals on the process of implementation and development of the New Model of Primary Health Care in the Valencian Community. Nin semi-structured group interviews with professionals were carried out, directed by two researchers who proposed the topics for discussion by means of open questions and took notes on the interventions. Some others aspects of health centres' situation were also assessed by observation. The majority of the professionals thought high prevalence disease programmes should be elaborated by the Health Administration that community participation was an important dimension but difficult to develop, that the population perceived an improvement in health care with the new model, and that relationships with Health Area Managers were good, even though they were not thought to have a real management role. The greatest differences in opinions and experiences among primary health care teams concerned the development of some dimensions of the new model, especially comprehensive care, continuous care and team work. PMID:8582795

  1. Traveller health and primary care in Ireland: a consultative forum.

    PubMed

    Van Hout, Marie Claire

    2010-05-01

    Travellers in Ireland continue to experience health disparity, cultural fragmentation and a lack of visibility in health service provision. This paper reports on a pilot study exploring factors that affect Traveller health and the experiences of primary care services from the perspectives of key Traveller health stakeholders in Ireland. The study was designed as an initial consultative forum using a single focus group (n = 13) in order to yield specific recommendations for the development of a designated primary care service framework for Travellers. A thematic analysis of the narratives identified key areas of interest--emerging issues in Traveller health, recognition of Traveller culture and ethnic identity,Traveller uptake of primary care services, the role of the primary health care Traveller (PHCT) worker, and recommendations for a primary care service framework for Travellers in Ireland. The findings highlight the importance of consulting Traveller communities in the design of a primary care service framework within each local needs analysis. The promotion of Traveller advocacy, visible access and referral pathways can therefore be achieved, with PHCT workers acting as a 'bridge' between Travellers and the designated area primary care team. PMID:20503791

  2. 77 FR 38838 - Lists of Designated Primary Medical Care, Mental Health, and Dental Health Professional Shortage...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-29

    ...designated as a result of the Health Care Safety Net Amendments of 2002...definition of such Tribes in the Indian Health Care Improvement Act of 1976, 25 U...health professional shortages. The Health Care Safety Net Amendments of 2002...

  3. 76 FR 68198 - Lists of Designated Primary Medical Care, Mental Health, and Dental Health Professional Shortage...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-03

    ...designated as a result of the Health Care Safety Net Amendments of 2002...definition of such Tribes in the Indian Health Care Improvement Act of 1976, 25 U...health professional shortages. The Health Care Safety Net Amendments of 2002...

  4. 78 FR 38718 - Lists of Designated Primary Medical Care, Mental Health, and Dental Health Professional Shortage...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-27

    ...designated as a result of the Health Care Safety Net Amendments of 2002...definition of such Tribes in the Indian Health Care Improvement Act of 1976, 25 U...health professional shortages. The Health Care Safety Net Amendments of 2002...

  5. Community health workers: a front line for primary care?

    PubMed

    Sprague, Lisa

    2012-09-17

    Among the potential changes invoked in discussions on health system transformation, a need to revitalize primary care remains paramount. One way of doing this, most agree, is to move more in the direction of team-based care. Professionals such as physician assistants and nurse practitioners may be able to ease some of the physician's clinical care load, but some populations also need help accessing services and basic health education in a familiar setting. Enter the community health worker (CHW), known by many titles and playing a variety of roles, who comes from the community he or she is serving and therefore can interact with and effectively motivate clients. This paper examines what CHWs do, how they are trained, and the outlook for their incorporation into mainstream health care, as well as the challenges for developing the profession further. PMID:23057101

  6. Controlling the US health care system with policy wedges.

    PubMed

    Pasdirtz, George W

    2007-12-01

    Two state-space models, one for the US health care system and one for the US economy, were developed and estimated for the period 1950-1999. The output from the US economy model was then used as a reference input to control the growth of the health care system model. The counterfactual history produced by simulating the controlled model shows that a reduction in investment and volume-based services would have been needed to bring the growth of the health care system in line with the US economy. Specifically, a 13% reduction in capital expenditure, a 15% reduction in drug prices and a 32% reduction in prices for physician's services would have been needed over the late twentieth century. The methodology also suggests how universal health care programs might be designed using planning and economic incentives without either over-engineering plan provisions or using centralized, command-and-control approaches. PMID:18074965

  7. Expensive cancer drugs and just health care.

    PubMed

    Ehni, Hans-Jörg

    2014-04-01

    Extremely expensive drugs which cost more than 100.000 $ per year for the treatment of one patient are increasingly common. The benefit of these drugs may either be not accessible to many patients or the overall costs could lead to a heavy burden on the health care system and public resources. This article describes the overall background of this trend and addresses the problem of expensive drugs from a perspective of just health care and just health outcomes. Therefore, basic aspects of just health care are outlined such as goods and principles relevant from a perspective of justice. This framework is applied to the allocation of expensive drugs on three levels. These reflections will demonstrate that there is no simple solution to this problem, and that the decisions cannot be taken by experts, but should be the result of an open, transparent, and fair public dialogue on health priorities. PMID:24810193

  8. Assurance of Learning Assessment Matrix -MS Health Care Management Learning Goals Learning Objectives Assessment/Assignment

    E-print Network

    Niebur, Ernst

    Assurance of Learning Assessment Matrix - MS Health Care Management Learning Goals Learning Objectives Assessment/Assignment Understand and master core concepts and methods in the health care concepts and tools in the health care management discipline to develop integrated and innovative strategies

  9. Patient Data Confidentiality Issues of the Dutch Electronic Health Care Record

    E-print Network

    Groot, Perry

    Patient Data Confidentiality Issues of the Dutch Electronic Health Care Record Perry Groot Ferry.O.Box 9010, 6500GL Nijmegen Abstract Health care is currently in a phase of transition. One of the recent developments that seems to be in- escapable is the introduction of an Electronic Health care Record

  10. Practitioner Perceptions of the A3 Method for Process Improvement in Health Care

    ERIC Educational Resources Information Center

    Visich, John K.; Wicks, Angela M.; Zalila, Faiza

    2010-01-01

    The focus of this article is to present students' perceptions of the recently developed A3 method, a structured problem-solving approach based on lean concepts and tools that have been adapted to the health care environment. The students were all employees of a large health care provider and were enrolled in a customized health care executive MBA…

  11. “Functional localities: an integrated spatial approach towards health care locality definition”

    Microsoft Academic Search

    Niamh K. Shortt; Adrian J. Moore

    2006-01-01

    This paper demonstrates a spatial approach towards the definition of localities for health care planning. Recent international decentralisation of health care provision, and more specifically devolution within the United Kingdom, emphasises the need to develop a geographical focus in the delimitation of local structures for health care planning. Geographers, but most especially those applying Geographical Information Science (GIS) techniques, have

  12. The mantra of modeling and the forgotten powers of paper: a sociotechnical view on the development of process-oriented ICT in health care

    Microsoft Academic Search

    Marc Berg; Pieter J. Toussaint

    2003-01-01

    The recognition that restructuring care processes is central to effective and efficient health care will result in the emergence of process-oriented electronic patient records (EPRs). How will these technologies come into being? Within informatics, it is often stated that to informate something, we should first model it. This paper queries whether a detailed modeling of work processes and data flows

  13. The Athletic Health Care and Training Program

    PubMed Central

    Rice, Stephen G.; Schlotfeldt, John D.; Foley, Wayne E.

    1985-01-01

    The Athletic Health Care and Training Program was developed to meet the educational, organizational and record-keeping needs of the interscholastic athletic program of the Seattle Public Schools. The program components were the education of coaches, school nurses and student trainers; development of a centralized training room; implementation of written procedures, and establishment of a record-keeping system. At the end of the three-year study period, schools involved in the program were better prepared to handle emergencies than were control schools. Schools involved in the program were found to have an injury-recognition rate comparable to that previously reported for high schools that had athletic trainers, a rate substantially higher than that in the control schools. The experimental schools were judged to have managed these injuries satisfactorily 95% of the time, compared with a satisfactory management rate of 14% for the control schools. PMID:3993012

  14. A Model for Provision of ENT Health Care Service at Primary and Secondary Hospital Level in a Developing Country

    PubMed Central

    Emerson, Lingamdenne Paul; Job, Anand; Abraham, Vinod

    2013-01-01

    ENT problems are the most common reason for a visit to a doctor in both rural and urban communities. In many developing countries, there is a lack of ENT specialists and overburdened hospital facilities. To date, there is no comprehensive study that has evaluated the spectrum of ENT disorders in a rural community. Methods. A prospective study was done for a period of three years to profile the cases presenting to the outpatient clinic in a secondary care hospital and in the camps conducted in tribal areas in Vellore District of Tamil Nadu, India. Trained community volunteers were used to identify ENT conditions and refer patients. Results. A total of 2600 patients were evaluated and treated. Otological symptoms were the most commonly reported with allergic rhinitis being the second most commonly reported. Presbycusis was the most common disability reported in the rural community. The other symptoms presented are largely related to hygiene and nutrition. Conclusion. Using trained community workers to spread the message of safe ENT practices, rehabilitation of hearing loss through provision of hearing aids, and the evaluation and surgical management by ENT specialist helped the rural community to access the service. PMID:24078919

  15. Palliative care in public health: a formal and content-related analysis of European journals

    Microsoft Academic Search

    Nils Schneider; Anke Bramesfeld; Larissa Burruano

    2007-01-01

    Public health and health care science take on an important role in the further development of palliative care. This study\\u000a examines to what degree palliative care is represented in the pertinent academic journals of public health and health care\\u000a science and what the major subjects are. We analysed the European journals that were listed in the Journal Citation Reports in

  16. Attitudes of Health Care Trainees About Genetics and Disability: Issues of Access, Health Care Communication, and Decision Making

    Microsoft Academic Search

    Kelly E. Ormond; Carol J. Gill; Patrick Semik; Kristi L. Kirschner

    2003-01-01

    Prior studies suggest that knowledge and attitudes of health care professionals influence patient communication and medical decision making. To study this dynamic in the context of genetic disability, we developed a survey on health professionals' attitudes regarding disability and genetic screening and pilot-tested it on a sample of medical students, residents, and genetic counseling students (N = 85). Despite minimal

  17. Boundaries and e-health implementation in health and social care

    PubMed Central

    2012-01-01

    Background The major problem facing health and social care systems globally today is the growing challenge of an elderly population with complex health and social care needs. A longstanding challenge to the provision of high quality, effectively coordinated care for those with complex needs has been the historical separation of health and social care. Access to timely and accurate data about patients and their treatments has the potential to deliver better care at less cost. Methods To explore the way in which structural, professional and geographical boundaries have affected e-health implementation in health and social care, through an empirical study of the implementation of an electronic version of Single Shared Assessment (SSA) in Scotland, using three retrospective, qualitative case studies in three different health board locations. Results Progress in effectively sharing electronic data had been slow and uneven. One cause was the presence of established structural boundaries, which lead to competing priorities, incompatible IT systems and infrastructure, and poor cooperation. A second cause was the presence of established professional boundaries, which affect staffs’ understanding and acceptance of data sharing and their information requirements. Geographical boundaries featured but less prominently and contrasting perspectives were found with regard to issues such as co-location of health and social care professionals. Conclusions To provide holistic care to those with complex health and social care needs, it is essential that we develop integrated approaches to care delivery. Successful integration needs practices such as good project management and governance, ensuring system interoperability, leadership, good training and support, together with clear efforts to improve working relations across professional boundaries and communication of a clear project vision. This study shows that while technological developments make integration possible, long-standing boundaries constitute substantial risks to IT implementations across the health and social care interface which those initiating major changes would do well to consider before committing to the investment. PMID:22958223

  18. Johns Hopkins Bloomberg School of Public Health: Refugee Health Care

    NSDL National Science Digital Library

    These online course materials were generated from a Johns Hopkins Bloomberg School of Public Health (JHSPH) course on Refugee Health Care. The materials were put online as part of the JHSPH OpenCourseWare program which provides "free, searchable access to JHSPH's course materials for educators, students, and self-learners around the world." The Refugee Health Care course "addresses the provision of basic health requirements for refugees and the coordination of care among agencies concerned with them." Site visitors will find a selection of downloadable lecture notes on such topics as Hemorrhagic Fever Outbreak Investigation, Control of Communicable Diseases, Health and Human Rights Principles for Refugee Health, and more. The site also offers a downloadable Reading List, and case study materials.

  19. Health Instruction Packages: Nursing Care Plans.

    ERIC Educational Resources Information Center

    Kowalski, Dorcas S.; And Others

    Text, illustrations, and exercises are provided in this set of learning modules to teach nurses and nursing students various patient care skills. The first module, "How to Write a Nursing Care Plan" by Dorcas S. Kowalski, discusses three tasks in developing patient care plans: identifying and prioritizing a patient's needs, gathering information…

  20. Optimizing cancer care through mobile health.

    PubMed

    Odeh, Bassel; Kayyali, Reem; Nabhani-Gebara, Shereen; Philip, Nada

    2015-07-01

    The survival rates for patients living with cancer are increasing, due to recent advances in detection, prevention and treatment. It has been estimated that there were 28 million cancer survivors around the world in 2012. In the UK, for patients diagnosed in 2007, it is predicted that more than half of them will survive their cancer for 5 years or more. A large majority of cancer survivors report unmet supportive care needs and distressing symptoms and adverse long-term consequences related to their cancer. Cancer management could be optimized to better meet patients demand through technology, including mobile health (m-Health). m-Health is defined as the use of mobile communications and network technologies for health care. m-Health can help both patients and health-care professionals and play an important part in managing and delivering cancer care including managing side effects, supporting drug adherence, providing cancer information, planning and follow up and detecting and diagnosing cancer. Health authorities have already published guidelines regulating m-Health to insure patient safety and improve the accountability of its applications. PMID:25649121

  1. Health and Safety in Day Care.

    ERIC Educational Resources Information Center

    Sells, Clifford J.; Paeth, Susan

    1987-01-01

    Basic health and day care policies and procedures should be implemented and closely monitored with the help of a health consultant, particularly in terms of respiratory tract, enteric, skin, invasive bacterial, and multiple system infections; Acquired Immune Deficiency Syndrome; vaccine preventable diseases; and general safety procedures.…

  2. Health care – an everlasting challenge in temporal and spatial domains

    PubMed Central

    Chen, Wenxi

    2010-01-01

    Health care is an everlasting challenge that requires effort at all levels, from national and organizational to individual domains, over a long-term period. This article reviews the historical development of health care-related issues worldwide and accentuates the necessity of health care in the current era. Through investigating the historical background in both the occidental and the oriental worlds and the latest achievements from academic and industrial endeavors, many lessons can be learnt, and as a result, an integrative strategy is proposed to meet today’s pressing needs. A government-funded project, “Challenge to 100 years of age”, which involved more than 600 residents in west Aizu village, lasted over 15 years. After reviewing its outcomes, a metrology of health based upon the three-dimensional phase space, which integrates with social well-being, mental status, and physical condition for a lifelong span, is advocated as a measure of the holistic view of health state. PMID:21197368

  3. Basics of quality improvement in health care.

    PubMed

    Varkey, Prathibha; Reller, M Katherine; Resar, Roger K

    2007-06-01

    With the rapid expansion of knowledge and technology and a health care system that performs far below acceptable levels for ensuring patient safety and needs, front-line health care professionals must understand the basics of quality improvement methodologies and terminology. The goals of this review are to provide clinicians with sufficient information to understand the fundamentals of quality improvement, provide a starting point for improvement projects, and stimulate further inquiry into the quality improvement methodologies currently being used in health care. Key quality improvement concepts and methodologies, including plan-do-study-act, six-sigma, and lean strategies, are discussed, and the differences between quality improvement and quality-of-care research are explored. PMID:17550754

  4. e Health networking to cater to Rural Health Care and Health Care for the Aged

    Microsoft Academic Search

    D. S. Venkateswarlu; K. S. Verma; K. S. R. Murthy

    2007-01-01

    This paper deals with health care problems in India and the possible solutions from the information and communication technologies (ICT) point of view. It first presents the requirements of the rural population, the aged, the chronic patients, and the accident victims, and then brings out the appropriate ICT to tailor to the needs of healthcare as an integrated solution to

  5. The changing environment for technological innovation in health care.

    PubMed

    Goodman, C S; Gelijns, A C

    1996-01-01

    A distinguishing feature of American health care is its emphasis on advanced technology. Yet today's changing health care environment is overhauling the engine of technological innovation. The rate and direction of technological innovation are affected by a complex of supply- and demandside factors, including biomedical research, education, patent law, regulation, health care payment, tort law, and more. Some distinguishing features of technological innovation in health care are now at increased risk. Regulatory requirements and rising payment hurdles are especially challenging to small technology companies. Closer management of health care delivery and payment, particularly the standardization that may derive from practice guidelines and clamping down on payment for investigational technologies, curtails opportunities for innovation. Levels and distribution of biomedical research funding in government and industry are changing. Financial constraints are limiting the traditional roles of academic health centers in fostering innovation. Despite notable steps in recent years to lower regulatory barriers and speed approvals, especially for products for life-threatening conditions, the Food and Drug Administration is under great pressure from Congress, industry, and patients to do more. Technology gatekeeping is shifting from hundreds of thousands of physicians acting on behalf of their patients to fewer, yet more powerful, managed care organizations and health care networks. Beyond its direct effects on adoption, payment, and use of technologies, the extraordinary buying leverage of these large providers is cutting technology profit margins and heightening competition among technology companies. It is contributing to unprecedented restructuring of the pharmaceutical and medical device industries, leading to unprecedented alliances with generic product companies, health care providers, utilization review companies, and other agents. These industry changes are already having considerable effects on investment patterns and the development, adoption, and use of new technologies. Until recently, new technologies that offered the prospect for health benefit, however, marginal or unproven, were paid for with little or no regard to cost. Technical wizardry alone no longer carries the day in health care. Today's health care market increasingly demands what other markets do--measurable improvements in benefits at acceptable costs--and innovators have begun to respond accordingly. Even so, certain key venues for health care innovation are at risk. PMID:11066263

  6. WHO Guidelines on Hand Hygiene in Health Care

    E-print Network

    Kim, Duck O.

    .1 Organisms present on patient skin or in the inanimate environment 7.2 Organism transfer to health-careWHO Guidelines on Hand Hygiene in Health Care First Global Patient Safety Challenge Clean Care is Safer Care WHOGuidelinesonHandHygieneinHealthCare #12;WHO Library Cataloguing-in-Publication Data WHO

  7. Benefit Limits for Behavioral Health Care in Private Health Plans

    Microsoft Academic Search

    Dominic Hodgkin; Constance M. Horgan; Deborah W. Garnick; Elizabeth L. Merrick

    2009-01-01

    Data from a nationally representative sample of private health plans reveal that special lifetime limits on behavioral health\\u000a care are rare (used by 16% of products). However, most plans have special annual limits on behavioral health utilization;\\u000a for example, 90% limit outpatient mental health and 93% limit outpatient substance abuse treatment. As a result, enrollees\\u000a in the average plan face

  8. Children with Special Health Care Needs: How Immigrant Status is Related to Health Care Access, Health Care Utilization, and Health Status

    Microsoft Academic Search

    Joyce R. Javier; Lynne C. Huffman; Fernando S. Mendoza; Paul H. Wise

    2010-01-01

    To compare health care access, utilization, and perceived health status for children with SHCN in immigrant and nonimmigrant\\u000a families. This cross-sectional study used data from the 2003 California Health Interview Survey to identify 1404 children\\u000a (ages 0–11) with a special health care need. Chi-square and logistic regression analyses were used to examine relations between\\u000a immigrant status and health access, utilization,

  9. Development and Validation of Questionnaires Exploring Health Care Professionals' Intention to Use Wiki-Based Reminders to Promote Best Practices in Trauma

    PubMed Central

    Gagnon, Susie; Gagnon, Marie-Pierre; Turcotte, Stéphane; Lapointe, Jean; Fleet, Richard; Côté, Mario; Beaupré, Pierre; Le Sage, Natalie; Émond, Marcel; Légaré, France

    2014-01-01

    Background Little is known about factors influencing professionals’ use of wikis. Objective We developed and validated two questionnaires to assess health care professionals’ intention to use wiki-based reminders for the management of trauma patients. Methods We developed questionnaires for emergency physicians (EPs) and allied health professions (AHPs) based on the Theory of Planned Behavior and adapted them to the salient beliefs of each, identified in an earlier study. Items measured demographics and direct and indirect theoretical constructs. We piloted the questionnaires with 2 focus groups (5 EPs and 5 AHPs) to identify problems of wording and length. Based on feedback, we adjusted the wording and combined certain items. A new convenience sample of 25 EPs and 26 AHPs then performed a test-retest of the questionnaires at a 2-week interval. We assessed internal consistency using Cronbach alpha coefficients and temporal stability of items with an agreement intraclass correlation coefficient (ICC). Results Five EPs and 5 AHPs (3 nurses, 1 respiratory therapist, and 1 pharmacist) formed 2 focus groups; 25 EPs and 26 AHPs (12 nurses, 7 respiratory therapists, and 7 pharmacists) completed the test and retest. The EP questionnaire test-retest scores for consistency (Cronbach alpha) and stability (ICC) were intention (test: Cronbach alpha=.94; retest: Cronbach alpha=.98; ICC=.89), attitude (.74, .72, .70), subjective norm (.79, .78, .75), perceived behavioral control (.67, .65, .66), attitudinal beliefs (.94, .86, .60), normative beliefs (.83, .87, .79), and control beliefs barriers (.58, .67, .78) and facilitators (.97, .85, .30). The AHP questionnaire scores for consistency and stability were: intention (test Cronbach alpha=.69, retest Cronbach alpha=.81, ICC=.48), attitude (.85, .87, .83), subjective norm (.47, .82, .62), perceived behavioral control (.55, .62, .60), attitudinal beliefs (.92, .91, .82), normative beliefs (.85, .90, .74), and control beliefs barriers (.58, .55, .66) and facilitators (.72, .94, –.05). To improve the psychometric properties of both questionnaires, we reformulated poorly consistent or unstable items. Conclusions Our new theory-based questionnaires to measure health care professionals’ intention to use wiki-based reminders have adequate validity and reliability for use in large surveys. In the long run, they can be used to develop a theory-based implementation intervention for a wiki promoting best practices in trauma care. PMID:25281856

  10. Rapid Business Transformations in Health Care: A Systems Approach

    ERIC Educational Resources Information Center

    Shulaiba, Refaat A.

    2011-01-01

    The top two priorities of health care business leaders are to constantly improve the quality of health care while striving to contain and reduce the high cost of health care. The Health Care industry, similar to all businesses, is motivated to deliver innovative solutions that accelerate business transformation and increase business capabilities. …

  11. Investigation of health care waste management in Binzhou District, China

    Microsoft Academic Search

    Gai Ruoyan; Xu Lingzhong; Li Huijuan; Zhou Chengchao; He Jiangjiang; Shirayama Yoshihisa; Tang Wei; Kuroiwa Chushi

    2010-01-01

    In China, national regulations and standards for health care waste management were implemented in 2003. To investigate the current status of health care waste management at different levels of health care facilities (HCF) after the implementation of these regulations, one tertiary hospital, one secondary hospital, and four primary health care centers from Binzhou District were visited and 145 medical staff

  12. Community-based mental health care in Africa: mental health workers’ views

    PubMed Central

    ALEM, ATALAY; JACOBSSON, LARS; HANLON, CHARLOTTE

    2008-01-01

    The World Health Organization (WHO) has for long proposed the development of community-based mental health services worldwide. However, the progress toward community mental health care in most African countries is still hampered by a lack of resources, with specialist psychiatric care essentially based in large, centrally located mental hospitals. It is again time to reconsider the direction of mental health care in Africa. Based on a small inquiry to a number of experienced mental health professionals in sub-Saharan Africa, we discuss what a community concept of mental health care might mean in Africa. There is a general agreement that mental health services should be integrated in primary health care. A critical issue for success of this model is perceived to be provision of appropriate supervision and continuing education for primary care workers. The importance of collaboration between modern medicine and traditional healers is stressed and the paper ends in a plea for WHO to take the initiative and develop mental health services according to the special needs and the socio-cultural conditions prevailing in sub-Saharan Africa. PMID:18458779

  13. Page 1 of 2 Affordable Care Act / Health Care Reform

    E-print Network

    Eligibility III. ACA Health Fee Information IV. Contract and Grant Accounting I. Overview · Under the Affordable Care Act (ACA), the definition of Full-time Employee includes variable hour employees who are paid an average of 130 hours/month (30 or more hours per week). · All employees meeting the ACA criteria ACA FAQs

  14. The development of measures of organizational citizenship behaviour and changes in job behaviours related to quality management in health care.

    PubMed

    Irvine, D

    1995-08-01

    A study was conducted at two tertiary care hospitals in Canada for the purpose of developing instruments to measure organizational citizenship behaviours (OCB) and changes in job behaviours that occur as a result of participation on hospital quality improvement (CQI) teams. Semi structured interviews were conducted among 52 hospital employees in order to elicit critical incidents of OCB and changes in job behaviours related to CQI. The results of the staff interviews were used to develop a measure of OCB in the hospital setting, and a measure of changes in job behaviours related to CQI. 39 employees, who were drawn from the major departments within the two hospitals on the basis of their membership on CQI teams, participated in a test of the psychometric properties of the two research instruments. Exploratory factor analysis, employing an orthogonal rotation, yielded two factors that accounted for 30% of the variation among the OCB items. The Cronbach alpha for items loading highly on the first factor was .88. The factor was labelled 'OCB directed towards individuals within the organization'. This factor was dominated by items reflecting the kinds of extra-role job behaviours employees engage in to assist patients, family members, visitors, and other employees within the organization. The Cronbach alpha for items loading highly on the second factor was 0.71. The second factor was labelled 'organizationally directed OCB', and consisted of behaviours that reflected an impersonal form of OCB in the hospital setting. Factor analysis, employing an orthogonal rotation, yielded four factors that accounted for 48% of the variation among the items measuring changes in job behaviours related to CQI. The four factors were labelled 'problem-solving', Cronbach alpha 0.82; 'customer awareness', Cronbach alpha 0.79; 'use of CQI knowledge', Cronbach alpha 0.77; and 'organizational interests', Cronbach alpha 0.79. The two OCB factors were moderately correlated, there were no significant correlations among any of the factors measuring changes in job behaviours related to CQI, and the problem-solving job behaviours factor was moderately correlated with the two OCB factors. Directions for future research are discussed. PMID:10151087

  15. Health care leader competencies and the relevance of emotional intelligence.

    PubMed

    Weiszbrod, Twila

    2015-01-01

    As health care leader competencies continue to be refined and emphasized in health care administration educational programs, the "soft skills" of emotional intelligence have often been implied, but not included explicitly. The purpose of this study was to better understand what relationship, if any, could be identified between health care leader competencies and emotional intelligence. A quantitative correlational method of study was used, utilizing self-assessments and 360-degree assessments of both constructs. There were 43 valid participants in the study, representing the various types of health care delivery systems. Correlational analysis suggested there was a positive relationship; for each unit of increase in emotional intelligence, there was a 0.6 increase in overall health care leadership competence. This study did not suggest causation, but instead suggested that including the study and development of emotional intelligence in health care administration programs could have a positive impact on the degree of leader competence in graduates. Some curricula suggestions were provided, and further study was recommended. PMID:25909402

  16. Choosing the right health care provider for pregnancy and childbirth

    MedlinePLUS

    ... have to decide about is what kind of health care provider you would like to care for you ... or a certified nurse-midwife. Each of these health care providers is described below. Each one has different ...

  17. How Do Health Care Providers Diagnose Klinefelter Syndrome?

    MedlinePLUS

    ... Information Clinical Trials Resources and Publications How do health care providers diagnose Klinefelter syndrome (KS)? Skip sharing on ... karyotype (pronounced care-EE-oh-type ) test. A health care provider will take a small blood or skin ...

  18. Psychiatric and Medical Health Care Policies in Juvenile Detention Facilities

    ERIC Educational Resources Information Center

    Pajer, Kathleen A.; Kelleher, Kelly; Gupta, Ravindra A.; Rolls, Jennifer; Gardner, William

    2007-01-01

    A study aims to examine the existing health care policies in U.S. juvenile detention centres. The results conclude that juvenile detention facilities have many shortfalls in providing care for adolescents, particularly mental health care.

  19. Use of Electronic Health Records in Residential Care Communities

    MedlinePLUS

    ... 2013 Use of Electronic Health Records in Residential Care Communities On This Page Key findings Most residential ... National Survey of Residential Care Facilities Most residential care communities did not use electronic health records in ...

  20. Incorporating health care quality into health antitrust law

    Microsoft Academic Search

    Helen Schneider

    2008-01-01

    BACKGROUND: Antitrust authorities treat price as a proxy for hospital quality since health care quality is difficult to observe. As the ability to measure quality improved, more research became necessary to investigate the relationship between hospital market power and patient outcomes. This paper examines the impact of hospital competition on the quality of care as measured by the risk-adjusted mortality

  1. [Governance of primary health-care-based health-care organization].

    PubMed

    Báscolo, Ernesto

    2010-01-01

    An analytical framework was developed for explaining the conditions for the effectiveness of different strategies promoting integrated primary health-care (PHC) service-based systems in Latin-America. Different modes of governance (clan, incentives and hierarchy) were characterised from a political economics viewpoint for representing alternative forms of regulation promoting innovation in health-service-providing organisations. The necessary conditions for guaranteeing the modes of governance's effectiveness are presented, as are their implications in terms of posts in play. The institutional construction of an integrated health system is interpreted as being a product of a social process in which different modes of governance are combined, operating with different ways of resolving normative aspects for regulating service provision (with the hierarchical mode), resource distribution (with the incentives mode) and on the social values legitimising such process (with the clan mode). PMID:20963299

  2. Improving care transitions from hospital to home: standardized orders for home health nursing with remote telemonitoring.

    PubMed

    Heeke, Sheila; Wood, Felecia; Schuck, Jennifer

    2014-01-01

    A task force at a multihospital health care system partnered with home health agencies to improve gaps during the discharge transition process. A standardized order template for home health nursing and remote telemonitoring was developed to decrease discrepancies in communication between hospital health care providers and home health nurses caring for patients with heart failure. Pilot results showed significantly improved communication with no readmissions, using the order template. PMID:23938358

  3. Playing in the mud: health psychology, the arts and creative approaches to health care.

    PubMed

    Camic, Paul M

    2008-03-01

    Health psychologists' use of the arts is an emerging area for research and practice. This article examines recent research findings and suggests strategies for incorporating the arts in health care across a wide range of clinical and community settings. Ethological theories support the evolutionary significance of the arts in human development and help form a foundation to understand the biopsychosocial processes involved in arts participation. This article builds upon this foundation and presents a wide range of arts and health interventions in the areas of health promotion and prevention, illness management, clinical assessment and improvement of the health care system. PMID:18375633

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

    PubMed Central

    Detmer, Don E

    2003-01-01

    Background Improving health in our nation requires strengthening four major domains of the health care system: personal health management, health care delivery, public health, and health-related research. Many avoidable shortcomings in the health sector that result in poor quality are due to inaccessible data, information, and knowledge. A national health information infrastructure (NHII) offers the connectivity and knowledge management essential to correct these shortcomings. Better health and a better health system are within our reach. Discussion A national health information infrastructure for the United States should address the needs of personal health management, health care delivery, public health, and research. It should also address relevant global dimensions (e.g., standards for sharing data and knowledge across national boundaries). The public and private sectors will need to collaborate to build a robust national health information infrastructure, essentially a 'paperless' health care system, for the United States. The federal government should assume leadership for assuring a national health information infrastructure as recommended by the National Committee on Vital and Health Statistics and the President's Information Technology Advisory Committee. Progress is needed in the areas of funding, incentives, standards, and continued refinement of a privacy (i.e., confidentiality and security) framework to facilitate personal identification for health purposes. Particular attention should be paid to NHII leadership and change management challenges. Summary A national health information infrastructure is a necessary step for improved health in the U.S. It will require a concerted, collaborative effort by both public and private sectors. If you cannot measure it, you cannot improve it. Lord Kelvin PMID:12525262

  5. Developing Federal Clinical Care Recommendations for Men.

    PubMed

    Marcell, Arik V; Gavin, Loretta E; Moskosky, Susan B; McKenna, Robert; Rompalo, Anne M

    2015-08-01

    U.S. men experience substantial sexual and reproductive health needs across the life span. A significant barrier for providers in serving men in family planning, primary care, and sexually transmitted disease clinics has been the lack of standards for men's sexual and reproductive health care. The goal of this synthesis paper is to describe the development of clinical recommendations for the delivery of family planning services for men that were developed and published by CDC and the U.S. Office of Population Affairs. This paper is intended to describe the process used from 2011 to 2014 to develop the recommendations for the delivery of comprehensive reproductive healthcare services to men, and the rationale underpinning them. PMID:26190843

  6. Quality of Health Care: The Views of Homeless Youth

    PubMed Central

    Ensign, Josephine

    2004-01-01

    Objective To develop homeless-youth-identified process and outcome measures of quality of health care. Data Sources/Study Setting Primary data collection with homeless youth from both street and clinic settings in Seattle, Washington, for calendar year 2002. Study Design The research was a focused ethnography, using key informant and in-depth individual interviews as well as focus groups with a purposeful sample of 47 homeless youth aged 12–23 years. Data Collection/Extraction Methods All interviews and focus groups were tape-recorded, transcribed, and preliminarily coded, with final coding cross-checked and verified with a second researcher. Principal Findings Homeless youth most often stated that cultural and interpersonal aspects of quality of care were important to them. Physical aspects of quality of care reported by the youth were health care sites separate from those for homeless adults, andsites that offered a choice of allopathic and complementary medicine. Outcomes of health care included survival of homelessness, functional and disease-state improvement, and having increased trust and connections with adults and with the wider community. Conclusions Homeless youth identified components of quality of care as well as how quality of care should be measured. Their perspectives will be included in a larger follow-up study to develop quality of care indicators for homeless youth. PMID:15230923

  7. Cloud based emergency health care information service in India.

    PubMed

    Karthikeyan, N; Sukanesh, R

    2012-12-01

    A hospital is a health care organization providing patient treatment by expert physicians, surgeons and equipments. A report from a health care accreditation group says that miscommunication between patients and health care providers is the reason for the gap in providing emergency medical care to people in need. In developing countries, illiteracy is the major key root for deaths resulting from uncertain diseases constituting a serious public health problem. Mentally affected, differently abled and unconscious patients can't communicate about their medical history to the medical practitioners. Also, Medical practitioners can't edit or view DICOM images instantly. Our aim is to provide palm vein pattern recognition based medical record retrieval system, using cloud computing for the above mentioned people. Distributed computing technology is coming in the new forms as Grid computing and Cloud computing. These new forms are assured to bring Information Technology (IT) as a service. In this paper, we have described how these new forms of distributed computing will be helpful for modern health care industries. Cloud Computing is germinating its benefit to industrial sectors especially in medical scenarios. In Cloud Computing, IT-related capabilities and resources are provided as services, via the distributed computing on-demand. This paper is concerned with sprouting software as a service (SaaS) by means of Cloud computing with an aim to bring emergency health care sector in an umbrella with physical secured patient records. In framing the emergency healthcare treatment, the crucial thing considered necessary to decide about patients is their previous health conduct records. Thus a ubiquitous access to appropriate records is essential. Palm vein pattern recognition promises a secured patient record access. Likewise our paper reveals an efficient means to view, edit or transfer the DICOM images instantly which was a challenging task for medical practitioners in the past years. We have developed two services for health care. 1. Cloud based Palm vein recognition system 2. Distributed Medical image processing tools for medical practitioners. PMID:22865161

  8. Continuing Education for the Health Professions. Developing, Managing, and Evaluating Programs for Maximum Impact on Patient Care.

    ERIC Educational Resources Information Center

    Green, Joseph S., Ed.; And Others

    Advice on making continuing education (CE) responsive to the practice needs of professionals in medicine, dentistry, nursing, pharmacy, allied health, and public health is provided in 16 chapters. Attention is directed to: establishing realistic goals, tailoring programs to specific needs, recruiting subject matter experts, evaluating programs and…

  9. Health care reform 2009-2010: a neurosurgeon's perspective.

    PubMed

    Tippett, Troy M

    2010-12-01

    Organized neurosurgery through its Washington Committee developed a number of principles against which all health care reform legislation was measured, and none of the bills were acceptable. The American Association of Neurological Surgeons/Congress of Neurological Surgeons (AANS/CNS) worked through multiple venues to modify or reject the legislation. In the author's view, the American Medical Association (AMA) supported the bills because its board of trustees was too focused on eliminating the sustainable growth rate, or SGR. Physicians failed to shape the health care debate. The leadership of many medical organizations was not prepared for the debate. Many had no experience in this arena and thus were too willing to let lobbyists dictate their position. In the future there are 3 things organized neurosurgery must do: be prepared, never give in, and stick with their principles. Organized neurosurgery must be prepared by developing leaders that have experience in the full spectrum of organized medicine. Neurosurgeons must not count on others, and because the specialty is small all must be involved. Neurosurgeons must never give in. Organized neurosurgery started 2009 with little support for its positions but by the end of the debate had convinced many other organizations, representing almost 500,000 physicians, to take their position. From an organizational point of view, neurosurgeons should now do 3 things: 1) reform or reject the AMA; 2) develop a real surgical coalition; and 3) change the current political environment. Neurosurgeons must also follow their principles. In the author's opinion the most important principles are: health care as a responsibility, medical liability reform, and the right to privately contract. In the United Kingdom and Germany, where health care is considered a right rather than a responsibility, bureaucratic entities determine whether you have the right to health care just as the Independent Payment Advisory Board, established under the new health care reform law in the US, will soon limit by rationing of health care under the guise of cutting costs. If, however, health care is a responsibility not a right, the obligation is shifted from society to the individual. It puts the patient and the doctor in charge. It is a far better mechanism to control costs and preserve quality without rationing. It becomes our obligation to have health care, and it puts us in charge of our destiny. Proven liability reform was not included in the health care legislation despite the fact that up to $200 billion per year is spent on defensive medicine. Another and possibly the most important principle ignored in the legislation is the right for a patient and his/her physician to privately contract under Medicare without penalty. PMID:21121764

  10. Oral Health Care for Persons with Disabilities

    NSDL National Science Digital Library

    Burtner, Paul

    Across the web, online courses and educational materials are becoming increasingly common, and a number of universities have helped lead the way with several well-publicized initiatives. Developed by Professor Paul Burtner of the University of Florida, this site presents an online course on oral health care for persons with disabilities that will be useful to professionals in the field who are hoping to brush up and expand their own professional and vocational knowledge base. By clicking on the "begin course" section, users can begin looking through the materials here and moving through them at their own pace. The course includes an introduction to understanding various disabilities and how these might affect the creation of effective dental treatment plans. Finally, the site also includes a nice glossary and a selection of external links to other useful sites.

  11. A study of the relationship between health care access and access barriers to behavioral health care for African Americans utilizing the managed care model

    Microsoft Academic Search

    Darrell Maxwell Nearon

    2001-01-01

    Managed care has revolutionized the healthcare industry. Prior to managed care, traditional insurance companies managed the healthcare industry. These insurance firms would monitor and authorize treatment to persons enrolled with the insurance company. Health Maintenance Organizations (HMOs) began to develop methods to provide similar service as the large insurance companies at a fraction of the cost. HMOs accomplished this by

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

    E-print Network

    Detmer, Don E

    2003-01-06

    by evidence of effectiveness. [5,6] Practice patterns differ across institutions and regions, re- sulting in varying health outcomes and costs of care. [7] Patients trying to make informed health decisions often encounter conflicting information with varying... on patientPage 5 of 12 (page number not for citation purposes) widely. Although an increasing number of institutions rely on an information infrastructure to practice evidence- and citizen access to ICT, health care professionals willing to interact...

  13. Managed Care, Technology Adoption, and Health Care: The Adoption of Neonatal Intensive Care

    Microsoft Academic Search

    Laurence C. Baker; Ciaran S. Phibbs

    2002-01-01

    Managed care may influence technology diffusion in health care. This article empirically examines the relationship between HMO market share and the diffusion of neonatal intensive care units. Higher HMO market share is associated with slower adoption of mid-level units, but not with adoption of the most advanced high-level units. Opposite the common supposition that slowing technology growth will harm patients,

  14. Measuring competition in health care markets.

    PubMed Central

    Baker, L C

    2001-01-01

    OBJECTIVE: Measuring competition is increasingly important for analysis of health care markets and policies. Measurement of competition in health care is made complex by the breadth of potential issues under study, by the lack of necessary data, and by rapid changes in health care financing and delivery. This study reviews key issues in the measurement of competition and is designed to familiarize researchers and policymakers interested in competition measurement, but not steeped in its practice, with key concepts, data sources, and ways of adapting measures to fit ongoing changes in health care markets. PRINCIPAL FINDINGS: Attention to several key issues will strengthen measurement. Important components of successful measurement are: careful identification of the products and market areas for study; selection of Herfindahl-Hirschman or other indices to fit the issues being considered; consideration of econometric problems, like endogeneity, with common measures; and attention to the ways that current marketplace changes, like growth in managed care, affect the performance of classic measures. Data needed for constructing measures are also frequently scarce, insufficient, or both. Measurement could be improved with access to better data. PMID:11327175

  15. Towards a more demand oriented health care: analyzing demand for local primary health care

    Microsoft Academic Search

    D. H. de Bakker; M. Zwaanswijk; E. M. Zantinge; P. F. M. Verhaak

    2007-01-01

    One of the goals of the current health care reform in the Netherlands is to strengthen demand orientation. Community based primary health care provision should be tuned to local demand. Information on local demand is missing, however. Research goal is to provide local decision makers (patient organizations, insurers, providers) with a tool to analyse local demand, thus creating a basis

  16. Improving motivation among health care workers in private health care organizations : A perspective of nursing personnel

    Microsoft Academic Search

    Zydziunaite Vilma; Katiliute Egle

    2007-01-01

    Purpose – The study aims to explore the experiences of nursing personnel in private health care organizations in Lithuania, in terms of their work motivation and satisfaction, promotion and quitting the job, interpersonal interaction at work and to identify areas for sustainable improvement to the health care services they provide. Design\\/methodology\\/approach – The research problem includes the following questions. What

  17. Primary health care use and health care accessibility among adolescents in the United Arab Emirates.

    PubMed

    Barakat-Haddad, C; Siddiqua, A

    2015-03-01

    This study examined primary health care use and accessibility among adolescents living in the United Arab Emirates. In a cross-sectional study, we collected health care use, sociodemographic and residential data for a sample of 6363 adolescents. Logistic regression modelling was used to examine predictors of health care use. The most-consulted health professionals were dentists or orthodontists, family doctors and eye specialists. Local adolescents were more likely to attend public clinics/hospitals than private facilities, while the opposite was true for expatriates. In the previous 12 months 22.6% of the participants had not obtained the health care they needed and 19.5% had not had a routine health check-up. Common reasons for not obtaining care were busy schedules, dislike/fear of doctors and long waiting times. Predictors of not obtaining needed care included nationality and income, while those for having a routine check-up were mother's education and car ownership. Improvements to the health care sector may increase health care accessibility among adolescents. PMID:26074217

  18. The Design of Health Care Management Program for Chinese Health Care Professionals

    ERIC Educational Resources Information Center

    Qiu, Xiao Ling

    2008-01-01

    Business education has been booming in China due to the increasing demand of business graduates since China's economic reform. Chinese health care professionals are eager for business education to improve their competencies. The purpose of the study was to investigate the determinants of a successful health care management program for Chinese…

  19. Child Care Health Connections, 2001: A Health and Safety Newsletter for California Child Care Professionals.

    ERIC Educational Resources Information Center

    Walery, Nancy, Ed.; Evinger, Sara, Ed.; Dailey, Lyn, Ed.; Zamani, Rahman, Ed.; Guralnick, Eva, Ed.

    2001-01-01

    This document is comprised of the six 2001 issues of a bimonthly newsletter providing information on young children's health and safety for California's child care professionals. Regular features include a column on infant/toddler concerns, a question-answer column regarding medical and health issues, and resources for child care providers.…

  20. Attacking Soaring Health Care Costs: How One University Controls Health Care Costs.

    ERIC Educational Resources Information Center

    Clarke, Susan S.

    1993-01-01

    Health care costs at Rensselaer Polytechnic Institute (New York) were projected to double between 1986 and 1990. The university has met cost-reduction goals through varied approaches, planned future cuts in overall costs by studying its employee population and is working toward a flexible plan for diverse health care needs. (MSE)