Science.gov

Sample records for societal health quality

  1. Societal health and urban sustainability indicators

    SciTech Connect

    Petrich, C.H.; Tonn, B.E.

    1996-08-27

    Without the social will, no city can successfully Undertake the planning and programs necessary for meaningful progress toward sustainability. Social will derives from wellsprings of vital societal health. This paper presents an approach to helping cities in APEC member economies initiate a program for developing indicators of sustainability. Representative indicators of social capital and other aspects of civic engagement, as proxies for societal health, are presented.

  2. Evaluating landscape health: Integrating societal goals and biophysical process

    USGS Publications Warehouse

    Rapport, D.J.; Gaudet, C.; Karr, J.R.; Baron, J. S.; Bohlen, C.; Jackson, W.; Jones, B.; Naiman, R.J.; Norton, B.; Pollock, M. M.

    1998-01-01

    Evaluating landscape change requires the integration of the social and natural sciences. The social sciences contribute to articulating societal values that govern landscape change, while the natural sciences contribute to understanding the biophysical processes that are influenced by human activity and result in ecological change. Building upon Aldo Leopold's criteria for landscape health, the roles of societal values and biophysical processes in shaping the landscape are explored. A framework is developed for indicators of landscape health and integrity. Indicators of integrity are useful in measuring biological condition relative to the condition in landscapes largely unaffected by human activity, while indicators of health are useful in evaluating changes in highly modified landscapes. Integrating societal goals and biophysical processes requires identification of ecological services to be sustained within a given landscape. It also requires the proper choice of temporal and spatial scales. Societal values are based upon inter-generational concerns at regional scales (e.g. soil and ground water quality). Assessing the health and integrity of the environment at the landscape scale over a period of decades best integrates societal values with underlying biophysical processes. These principles are illustrated in two contrasting case studies: (1) the South Platte River study demonstrates the role of complex biophysical processes acting at a distance; and (2) the Kissimmee River study illustrates the critical importance of social, cultural and economic concerns in the design of remedial action plans. In both studies, however, interactions between the social and the biophysical governed the landscape outcomes. The legacy of evolution and the legacy of culture requires integration for the purpose of effectively coping with environmental change.

  3. Estimating sign-dependent societal preferences for quality of life.

    PubMed

    Attema, Arthur E; Brouwer, Werner B F; l'Haridon, Olivier; Pinto, Jose Luis

    2015-09-01

    This paper is the first to apply prospect theory to societal health-related decision making. In particular, we allow for utility curvature, equity weighting, sign-dependence, and loss aversion in choices concerning quality of life of other people. We find substantial inequity aversion, both for gains and losses, which can be attributed to both diminishing marginal utility and differential weighting of better-off and worse-off. There are also clear framing effects, which violate expected utility. Moreover, we observe loss aversion, indicating that subjects give more weight to one group's loss than another group's gain of the same absolute magnitude. We also elicited some information on the effect of the age of the studied group. The amount of inequity aversion is to some extent influenced by the age of the considered patients. In particular, more inequity aversion is observed for gains of older people than gains of younger people. PMID:26263893

  4. Societal output and use of research performed by health research groups.

    PubMed

    Mostert, Sebastian P; Ellenbroek, Stéfan Ph; Meijer, Ingeborg; van Ark, Gerrit; Klasen, Eduard C

    2010-01-01

    The last decade has seen the evaluation of health research pay more and more attention to societal use and benefits of research in addition to scientific quality, both in qualitative and quantitative ways. This paper elaborates primarily on a quantitative approach to assess societal output and use of research performed by health research groups (societal quality of research). For this reason, one of the Dutch university medical centres (i.e. the Leiden University Medical Center (LUMC)) was chosen as the subject of a pilot study, because of its mission to integrate top patient care with medical, biomedical and healthcare research and education. All research departments were used as units of evaluation within this university medical centre.The method consisted of a four-step process to reach a societal quality score per department, based on its (research) outreach to relevant societal stakeholders (the general public, healthcare professionals and the private sector). For each of these three types of stakeholders, indicators within four modes of communication were defined (knowledge production, knowledge exchange, knowledge use and earning capacity). These indicators were measured by a bottom-up approach in a qualitative way (i.e. all departments of the LUMC were asked to list all activities they would consider to be of societal relevance), after which they were converted into quantitative scores. These quantitative scores could then be compared to standardised scientific quality scores that are based on scientific publications and citations of peer-reviewed articles.Based on the LUMC pilot study, only a weak correlation was found between societal and scientific quality. This suggests that societal quality needs additional activities to be performed by health research groups and is not simply the consequence of high scientific quality. Therefore we conclude that scientific and societal evaluation should be considered to be synergistic in terms of learning for the

  5. Societal Influences on Health and Life-styles

    PubMed Central

    Ulmer, David D.

    1984-01-01

    Strong sociocultural forces affect individual attitudes toward health and choice of life-style. Economic deprivation fosters negative health behaviors. Positive health habits are reinforced by discrete societal groups. The news media, particularly television, disseminate much useful health information, though the overall educational value is diminished by the content of commercial messages and programming. The automobile is a major societal influence, but neither individual drivers nor the car manufacturers give enough priority to highway safety, leaving that role to governmental regulation. American industry is becoming a positive influence in the encouragement of good health habits, and fashion is lately an important ally in personal health maintenance. PMID:6523860

  6. A Societal Outcomes Map for Health Research and Policy

    PubMed Central

    Garfinkel, Michele S.; Sarewitz, Daniel; Porter, Alan L.

    2006-01-01

    The linkages between decisions about health research and policy and actual health outcomes may be extraordinarily difficult to specify. We performed a pilot application of a “road mapping” and technology assessment technique to perinatal health to illustrate how this technique can clarify the relations between available options and improved health outcomes. We used a combination of data-mining techniques and qualitative analyses to set up the underlying structure of a societal health outcomes road map. Societal health outcomes road mapping may be a useful tool for enhancing the ability of the public health community, policymakers, and other stakeholders, such as research administrators, to understand health research and policy options. PMID:16449589

  7. Air Quality Management Using Modern Remote Sensing and Spatial Technologies and Associated Societal Costs

    PubMed Central

    Uddin, Waheed

    2006-01-01

    This paper presents a study of societal costs related to public health due to the degradation of air quality and the lack of physical activity, both affected by our built environment. The paper further shows road safety as another public health concern. Traffic fatalities are the number one cause of death in the world. Traffic accidents result in huge financial loss to the people involved and the related public health cost is a significant part of the total societal cost. Motor vehicle exhausts and industrial emissions, gasoline vapors, and chemical solvents as well as natural sources emit nitrogen oxides and volatile organic compounds, which are precursors to the formation of ground-level Ozone. High concentration values of ground-level Ozone in hot summer days produce smog and lead to respiratory problems and loss in worker’s productivity. These factors and associated economic costs to society are important in establishing public policy and decision-making for sustainable transportation and development of communities in both industrialized and developing countries. This paper presents new science models for predicting ground-level Ozone and related air quality degradation. The models include predictor variables of daily climatological data, traffic volume and mix, speed, aviation data, and emission inventory of point sources. These models have been implemented in the user friendly AQMAN computer program and used for a case study in Northern Mississippi. Life-cycle benefits from reduced societal costs can be used to implement sustainable transportation policies, enhance investment decision-making, and protect public health and the environment. PMID:16968969

  8. Research and Evaluations of the Health Aspects of Disasters, Part IV: Framework for Societal Structures: the Societal Systems.

    PubMed

    Birnbaum, Marvin L; Daily, Elaine K; O'Rourke, Ann P

    2015-12-01

    For the purposes of research and/or evaluation, a community/society is organized into 13 Societal Systems under the umbrella of an overall Coordination and Control System. This organization facilitates descriptions of a community/society or a component of a community for assessment at any designated time across the Temporal Phases of a disaster. Such assessments provide a picture of the functional status of one or more Systems that comprise a community. Since no system operates in isolation from the other systems, information of the concomitant status of several Societal Systems is crucial to gaining a complete understanding of compromised functions, as well as the effects and side effects of any intervention directed at restoring the functional state of the affected community or risk-reduction interventions of a community-at-risk. The 13 Societal Systems include: (1) Public Health; (2) Medical Care; (3) Water and Sanitation; (4) Shelter and Clothing; (5) Food and Nutrition; (6) Energy Supply; (7) Public Works and Engineering; (8) Social Structures; (9) Logistics and Transportation; (10) Security; (11) Communications; (12) Economy; and (13) Education. Many functions and sub-functions of the Systems overlap, or share some common sub-functions with other systems. For the purposes of research/evaluation, it is necessary to assign functions and sub-functions to only one of the Societal Systems. PMID:26568075

  9. Good governance and good health: The role of societal structures in the human immunodeficiency virus pandemic

    PubMed Central

    Menon-Johansson, Anatole S

    2005-01-01

    Background Only governments sensitive to the demands of their citizens appropriately respond to needs of their nation. Based on Professor Amartya Sen's analysis of the link between famine and democracy, the following null hypothesis was tested: "Human Immunodeficiency Virus (HIV) prevalence is not associated with governance". Methods Governance has been divided by a recent World Bank paper into six dimensions. These include Voice and Accountability, Political Stability and Absence of Violence, Government Effectiveness, Regulatory Quality, Rule of Law and the Control of Corruption. The 2002 adult HIV prevalence estimates were obtained from UNAIDS. Additional health and economic variables were collected from multiple sources to illustrate the development needs of countries. Results The null hypothesis was rejected for each dimension of governance for all 149 countries with UNAIDS HIV prevalence estimates. When these nations were divided into three groups, the median (range) HIV prevalence estimates remained constant at 0.7% (0.05 – 33.7%) and 0.75% (0.05% – 33.4%) for the lower and middle mean governance groups respectively despite improvements in other health and economic indices. The median HIV prevalence estimates in the higher mean governance group was 0.2% (0.05 – 38.8%). Conclusion HIV prevalence is significantly associated with poor governance. International public health programs need to address societal structures in order to create strong foundations upon which effective healthcare interventions can be implemented. PMID:15850480

  10. Societal preferences for distributive justice in the allocation of health care resources: a latent class discrete choice experiment.

    PubMed

    Skedgel, Chris; Wailoo, Allan; Akehurst, Ron

    2015-01-01

    Economic theory suggests that resources should be allocated in a way that produces the greatest outputs, on the grounds that maximizing output allows for a redistribution that could benefit everyone. In health care, this is known as QALY (quality-adjusted life-year) maximization. This justification for QALY maximization may not hold, though, as it is difficult to reallocate health. Therefore, the allocation of health care should be seen as a matter of distributive justice as well as efficiency. A discrete choice experiment was undertaken to test consistency with the principles of QALY maximization and to quantify the willingness to trade life-year gains for distributive justice. An empirical ethics process was used to identify attributes that appeared relevant and ethically justified: patient age, severity (decomposed into initial quality and life expectancy), final health state, duration of benefit, and distributional concerns. Only 3% of respondents maximized QALYs with every choice, but scenarios with larger aggregate QALY gains were chosen more often and a majority of respondents maximized QALYs in a majority of their choices. However, respondents also appeared willing to prioritize smaller gains to preferred groups over larger gains to less preferred groups. Marginal analyses found a statistically significant preference for younger patients and a wider distribution of gains, as well as an aversion to patients with the shortest life expectancy or a poor final health state. These results support the existence of an equity-efficiency tradeoff and suggest that well-being could be enhanced by giving priority to programs that best satisfy societal preferences. Societal preferences could be incorporated through the use of explicit equity weights, although more research is required before such weights can be used in priority setting. PMID:25145575

  11. Influence of societal and practice contexts on health professionals’ clinical reasoning: a scoping study protocol

    PubMed Central

    Carrier, Annie; Levasseur, Mélanie; Freeman, Andrew; Mullins, Gary; Quénec'hdu, Suzanne; Lalonde, Louise; Gagnon, Michaël; Lacasse, Francis

    2013-01-01

    Introduction In a context of constrained resources, the efficacy of interventions is a pivotal aim of healthcare systems worldwide. Efficacy of healthcare interventions is highly compromised if clinical reasoning (CR), the process that practitioners use to plan, direct, perform and reflect on client care, is not optimal. The CR process of health professionals is influenced by the institutional dimension (ie, legal, regulatory, administrative and organisational aspects) of their societal and practice contexts. Although several studies have been conducted with respect to the institutional dimension influencing health professionals’ CR, no clear integration of their results is yet available. The aim of this study is to synthesise and disseminate current knowledge on the influence of the institutional dimension of contexts on health professionals’ CR. Methods and analysis A scoping study of the scientific literature from January 1980 to March 2013 will be undertaken to summarise and disseminate research findings about the influence of the institutional dimension on CR. Numerous databases (n=18) from three relevant fields (healthcare, health law and politics and management) will be searched. Extended search strategies will include the manual search of bibliographies, health-related websites, public registries and journals of interest. Data will be collected and analysed using a thematic chart and content analysis. A systematic multidisciplinary team approach will allow optimal identification of relevant studies, as well as effective and valid content analysis and dissemination of the results. Discussion This scoping study will provide a rigorous, accurate and up-to-date synthesis of existing knowledge regarding: (1) those aspects of the institutional dimension of health professionals’ societal and practice contexts that impact their CR and (2) how these aspects influence health professionals’ CR. Through the synergy of a multidisciplinary research team from a

  12. Societal costs of air pollution-related health hazards: A review of methods and results

    PubMed Central

    Pervin, Tanjima; Gerdtham, Ulf-G; Lyttkens, Carl Hampus

    2008-01-01

    This paper aims to provide a critical and systematic review of the societal costs of air pollution-related ill health (CAP), to explore methodological issues that may be important when assessing or comparing CAP across countries and to suggest ways in which future CAP studies can be made more useful for policy analysis. The methodology includes a systematic search based on the major electronic databases and the websites of a number of major international organizations. Studies are categorized by origin – OECD countries or non-OECD countries – and by publication status. Seventeen studies are included, eight from OECD countries and nine from non-OECD countries. A number of studies based on the ExternE methodology and the USA studies conducted by the Institute of Transportation are also summarized and discussed separately. The present review shows that considerable societal costs are attributable to air pollution-related health hazards. Nevertheless, given the variations in the methodologies used to calculate the estimated costs (e.g. cost estimation methods and cost components included), and inter-country differences in demographic composition and health care systems, it is difficult to compare CAP estimates across studies and countries. To increase awareness concerning the air pollution-related burden of disease, and to build links to health policy analyses, future research efforts should be directed towards theoretically sound and comprehensive CAP estimates with use of rich data. In particular, a more explicit approach should be followed to deal with uncertainties in the estimations. Along with monetary estimates, future research should also report all physical impacts and source-specific cost estimates, and should attempt to estimate 'avoidable cost' using alternative counterfactual scenarios. PMID:18786247

  13. Lingering Problems of Currency and Scope in Daniels's Argument for a Societal Obligation to Meet Health Needs

    PubMed Central

    Sachs, Benjamin

    2010-01-01

    Norman Daniels's new book, Just Health, brings together his decades of work on the problem of justice and health. It improves on earlier writings by discussing how we can meet health needs fairly when we cannot meet them all and by attending to the implications of the socioeconomic determinants of health. In this article I return to the core idea around which the entire theory is built: that the principle of equality of opportunity grounds a societal obligation to meet health needs. I point, first, that nowhere does Daniels say just what version of that principle he accepts. I then proceed to construct a principle on his behalf, based on a faithful reading of Just Health. Once we actually nail down the principle, I argue, we will find that there are two problems: it is implausible in itself, and it fails to ground a societal obligation to meet health needs. PMID:20634271

  14. Measuring the patient health, societal and economic benefits of US pediatric therapeutics legislation.

    PubMed

    Vernon, John A; Shortenhaus, Scott H; Mayer, Mark H; Allen, Albert J; Golec, Joseph H

    2012-10-01

    Through at least the mid-1990s, children were often referred to as 'therapeutic orphans' for whom many treatments were administered without the benefit of appropriate studies to guide drug labeling for dosing and other critical therapeutic decisions. At that time, there were no incentives for manufacturers to pursue such work, nor regulatory requirements to compel these studies. Congress addressed this by including an important provision titled the Best Pharmaceuticals for Children Act (BPCA) in the 1997 Food and Drug Administration Modernization and Accountability Act. This was complemented by another key piece of legislation, the Pediatric Research Equity Act (PREA) in 2003. The former Act and its successors created an incentive for firms to study on-patent drugs in pediatric populations by extending the market exclusivity of a medicine by 6 months. The latter was a requirement that provided the US FDA with the authority to require studies of drugs in children if an adult indication also occurs in children. In the current paper, we consider the effects of both pieces of legislation in terms of the health, societal, and economic benefits they have likely imparted and will continue to provide in the future. We conclude that the gains have been substantial - both in terms of safer and more effective use of medicines in children and in terms of new research that has been incentivized by the BPCA exclusivity provision. We estimate the gross economic benefits from the latter alone to be approximately $US360 billion. PMID:22775493

  15. [Quality of health care].

    PubMed

    Medina, J L; De Melo, P C

    2000-01-01

    Quality assurance is a relatively recent concern but already plays a major role in health care management and provision. Quality involves the definition of a comprehensive programme tailored by realistic and effective objectives and norms that include the structured review of procedures (namely clinical audits) and the use of up-to-date protocols. The involvement and motivation of health professionals, together with an adequate internal and external communication strategy, play a key role in the planning and application of these programmes. The use of programmed assessment, based on a solid knowledge of current practice, should have practical implications, optimising procedures in order to improve the quality of care. This commitment towards quality in health care should go far beyond governmental policy and should have clear support from health professionals. PMID:11234496

  16. Societal Context and the Production of Immigrant Status Based Health Inequalities: A Comparative Study of the United States and Canada

    PubMed Central

    Siddiqi, Arjumand; Ornelas, India J.; Quinn, Kelly; Zuberi, Dan; Nguyen, Quynh C.

    2013-01-01

    Background We compare disparities in health status between first generation immigrants and others in the U.S. and Canada. Methods We used data from the Joint Canada-United States Survey of Health. Regression models adjusted for demographics, socioeconomic status, and health insurance (U.S.). Results In both nations, the health advantage belonged to immigrants. Fewer disparities between immigrants and those native-born were seen in Canada versus the U.S. Canadians of every immigrant/race group fared better than American native-born whites. Discussion Fewer disparities in Canada and better overall health of all Canadians suggest societal context may create differences in access to the resources, environments and experiences that shape health and health behaviors. PMID:23447028

  17. A sense of coherence and health. Salutogenesis in a societal context: Åland, a special case?

    PubMed Central

    Eriksson, Monica; Lindström, Bengt; Lilja, John

    2007-01-01

    Background Antonovsky's salutogenic concept of a sense of coherence (SOC) has proved most influential in the way that health is now perceived. Aim To (1) describe the distribution of SOC among 40–70‐year‐old Ålanders; (2) examine the distribution of depression in Åland, Finland, and its relationship with SOC; and (3) discuss the findings within a salutogenic framework in a societal context. Design A cross‐sectional study design was adopted. Antonovsky's SOC Questionnaire (13 items) and the Beck Depression Inventory (13 items) were used. In addition, in a separate questionnaire, sociodemographic information about each participant was sought, together with a question specific to this study and designed to measure self‐rated health. Setting Åland, an autonomous island province of Finland. Results The proportion of respondents reporting good health was high (64%). The overall mean (SD) SOC was 70.7 (11.7) points, whereas for farmers and fishermen it was 73.88 (8.8) and 74.33 (9.2) points, respectively. SOC was significantly and strongly related to the self‐rated health score. The higher the SOC, the better was the health of the respondents. Furthermore, the study provided clear evidence of the potential of the SOC concept as a positive mental health indicator. Conclusion The SOC seems to be a health‐promoting resource that supports the development of a positive subjective state of health. PMID:17630366

  18. Defining quality in health care.

    PubMed

    Buck, A S

    1992-05-01

    The difficulty and importance of developing and implementing a definition of quality in health care is discussed. Some current definitions are considered, and a recommended definition of quality health care is presented. PMID:1630660

  19. An Exploratory Analysis of Societal Preferences for Research-Driven Quality of Life Improvements in Canada

    ERIC Educational Resources Information Center

    Rudd, Murray A.

    2011-01-01

    Research in the humanities, arts, and social sciences (HASS) tends to have impacts that enhance quality of life (QOL) but that are not amenable to pricing in established markets. If the economic value of "non-market" research impacts is ignored when making the business case for HASS research, society will under-invest in it. My goal in this…

  20. The Importance of Purpose: Moving beyond Consent in the Societal Use of Personal Health Information

    PubMed Central

    Grande, David; Mitra, Nandita; Shah, Anand; Wan, Fei; Asch, David A.

    2015-01-01

    Background Adoption of electronic health record systems has increased the availability of patient-level electronic health information. Objective Examine public support for secondary uses of electronic health information under different consent arrangements. Design National experimental survey to examine perceptions of uses of electronic health information when varying along three dimensions: patient consent (obtained vs. not obtained), use (research vs. marketing), and framing of the findings (abstract description without results vs. specific results). Setting Nationally representative survey. Participants 3,064 African American, Hispanic, and non-Hispanic White individuals representing a response rate of 65%. Measurements Appropriateness of health information use described in vignettes on a 1-10 scale (1=not at all appropriate; 10=very appropriate). Results Mean ratings ranged from a low of 3.81 for a marketing use when consent was not obtained and specific results were presented to a high of 7.06 for a research use when consent was obtained and specific results were presented. Participants rated scenarios where consent was obtained as more appropriate compared to when consent was not obtained (+1.01; 95% CI 0.69, 1.34, P<0.001). Participants rated scenarios where the use was marketing as less appropriate compared to when the use was research (−2.03; 95% CI −2.27, −1.78, P<0.001). Unconsented research uses were seen as more appropriate than consented marketing uses (5.65 vs. 4.52; difference = 1.13; 95% CI 0.87, 1.39).. Limitations Participants rated hypothetical scenarios and results could be vulnerable to non-response bias despite the high response rate. Conclusions Although approaches to health information sharing emphasize consent, public opinion also emphasizes purpose suggesting a need to focus more attention on the social value of information use. Primary Funding Source National Human Genome Research Institute PMID:25506854

  1. Trends that will affect your future … a portrait of American societal health.

    PubMed

    Schwartz, Stephan A

    2011-01-01

    The SchwartzReport tracks emerging trends that will affect the world, particularly the United States. For EXPLORE, it focuses on matters of health in the broadest sense of that term, including medical issues, changes in the biosphere, technology, and policy considerations, all of which will shape our culture and our lives. PMID:21194667

  2. Is Smokeless Tobacco Use an Appropriate Public Health Strategy for Reducing Societal Harm from Cigarette Smoking?

    PubMed Central

    Tomar, Scott L.; Fox, Brion J.; Severson, Herbert H.

    2009-01-01

    Four arguments have been used to support smokeless tobacco (ST) for harm reduction: (1) Switching from cigarettes to ST would reduce health risks; (2) ST is effective for smoking cessation; (3) ST is an effective nicotine maintenance product; and (4) ST is not a “gateway” for cigarette smoking. There is little evidence to support the first three arguments and most evidence suggests that ST is a gateway for cigarette smoking. There are ethical challenges to promoting ST use. Based on the precautionary principle, the burden of proof is on proponents to provide evidence to support their position; such evidence is lacking. PMID:19440266

  3. STAPOL: A Simulation of the Impact of Policy, Values, and Technological and Societal Developments upon the Quality of Life.

    ERIC Educational Resources Information Center

    Little, Dennis; Feller, Richard

    The Institute for the Future has been conducting research in technological and societal forecasting, social indicators, value change, and simulation gaming. This paper describes an effort to bring together parts of that research into a simulation game ("State Policy," or STAPOL) for analysis of the impact of government policy, social values, and…

  4. RECREATIONAL WATER QUALITY AND HEALTH

    EPA Science Inventory

    The overall objective of this pilot study was to develop and evaluate methods to determine the effect of quality of recreational waters on the health of persons bathing in those waters. There is little scientific evidence upon which to base water quality standards for the safety ...

  5. Achieving Quality in Occupational Health

    NASA Technical Reports Server (NTRS)

    O'Donnell, Michele (Editor); Hoffler, G. Wyckliffe (Editor)

    1997-01-01

    The conference convened approximately 100 registered participants of invited guest speakers, NASA presenters, and a broad spectrum of the Occupational Health disciplines representing NASA Headquarters and all NASA Field Centers. Centered on the theme, "Achieving Quality in Occupational Health," conferees heard presentations from award winning occupational health program professionals within the Agency and from private industry; updates on ISO 9000 status, quality assurance, and information technologies; workshops on ergonomics and respiratory protection; an overview from the newly commissioned NASA Occupational Health Assessment Team; and a keynote speech on improving women's health. In addition, NASA occupational health specialists presented 24 poster sessions and oral deliveries on various aspects of current practice at their field centers.

  6. 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 ...

  7. Societal determination of usefulness and utilization wishes of community health services: a population-based survey in Wuhan city, China

    PubMed Central

    Zhang, Peipei; Zhao, Lianyi; Liang, Jing; Qiao, Yan; He, Quanyan; Zhang, Liuyi; Wang, Fang; Liang, Yuan

    2015-01-01

    Background As a developing country with the world’s largest population in a state of economic transition, reforms to China’s health system, including community health services (CHS), are very complex and difficult. The aim of this study is to provide evidence and policy recommendations for the sustainable development of CHS for China, which could also be applicable to other developing countries. Methods A cross-sectional survey was conducted door-to-door and face-to-face in Wuhan city, central China with a sample of 1134 individuals aged 15 and older. The independent variables were duration of residence, previous treatment experience, familiarity with health staff, self-reported family economic status and health insurance. The dependent variables were views on the usefulness of CHS and willingness to use them. Sociodemographic variables and health status were used as control variables. Multiple logistic regression analysis was used to analyse the influence of the independent variables on the dependent variables. Findings This study shows that 26.10% of participants reported that the CHSs are not useful and 37.74% reported they did not want to use their CHS. The results found ‘familiarity with health staff’ and ‘previous experience of using services’ had a negative influence on their views on usefulness of and willingness to use CHS. Conclusion The aim of CHS to see ‘minor illnesses treated in the community and serious illness treated in hospital’ is not being fully realized. The key to increasing the use of CHS may be to enhance the quality of services and health staff. A policy pathway of targeting older residents and those with higher education levels as the priority population, and using these groups to encourage the rest of the community to seek minor services at CHS, may be an effective and sustainable development mechanism. PMID:25492032

  8. Quality Assurance in School Health

    ERIC Educational Resources Information Center

    Newell, Susan; Schoenike, Sumner L.; Lisko, Elaine A.

    2003-01-01

    School nurses need to become more influential administrators, managers, and entrepreneurs. They must learn to lead and collaborate effectively in designing, implementing, and evaluating coordinated school health programs. Quality assurance is an essential ingredient in this process that requires accurate, timely, and confidential incident…

  9. Farmworker Housing Quality and Health.

    PubMed

    Arcury, Thomas A; Jacobs, Ilene J; Ruiz, Virginia

    2015-11-01

    On 11 November 2014, Farmworker Housing Quality and Health: A Transdisciplinary Conference was convened to draw together experts from the variety of disciplines who contribute to research and practice focused on farmworker housing and health in order to delineate current knowledge and propose next steps. The conference addressed three specific aims: (1) to consolidate current knowledge on characteristics and quality of housing provided for farmworkers; (2) to delineate pertinent directions and areas for farmworker housing health and safety research and policy; and (3) to facilitate the development of working groups to support the implementation of research, education, and engineering projects to improve farmworker housing. This article provides an overview of the conference. PMID:26378156

  10. Societal characteristics and health in the former communist countries of Central and Eastern Europe and the former Soviet Union: a multilevel analysis

    PubMed Central

    Bobak, Martin; Murphy, Mike; Rose, Richard; Marmot, Michael

    2007-01-01

    Objectives To examine whether, in former communist countries that have undergone profound social and economic transformation, health status is associated with income inequality and other societal characteristics, and whether this represents something more than the association of health status with individual socioeconomic circumstances. Design Multilevel analysis of cross‐sectional data. Setting 13 Countries from Central and Eastern Europe and the former Soviet Union. Participants Population samples aged 18+ years (a total of 15 331 respondents). Mean outcome measures Poor self‐rated health. Results There were marked differences among participating countries in rates of poor health (a greater than twofold difference between the countries with the highest and lowest rates of poor health), gross domestic product per capita adjusted for purchasing power parity (a greater than threefold difference), the Gini coefficient of income inequality (twofold difference), corruption index (twofold difference) and homicide rates (20‐fold difference). Ecologically, the age‐ and sex‐standardised prevalence of poor self‐rated health correlated strongly with life expectancy at age 15 (r = −0.73). In multilevel analyses, societal (country‐level) measures of income inequality were not associated with poor health. Corruption and gross domestic product per capita were associated with poor health after controlling for individuals' socioeconomic circumstances (education, household income, marital status and ownership of household items); the odds ratios were 1.15 (95% confidence interval 1.03 to 1.29) per 1 unit (on a 10‐point scale) increase in the corruption index and 0.79 (95% confidence interval 0.68 to 0.93) per $5000 increase in gross domestic product per capita. The effects of gross domestic product and corruption were virtually identical in people whose household income was below and above the median. Conclusion Societal measures of prosperity and corruption

  11. A transactional perspective on the interrelationship of the societal power structure, the mental health establishment, the individual, and the community: a commentary on Nassi.

    PubMed

    Dokecki, P R

    1978-01-01

    While agreeing in part with Nassi's (1978) radical position on the failure of community control to be meaningfully implemented by the mental health establishment, a complementary analysis is proposed as being more complete by virtue of integrating a variety of societal and individual perspectives. This analysis builds on transactional epistemology and a multi-level model of service delivery, also bringing to bear developmental and social evolutionary theory. A new service delivery role, the human development liaison specialist, is advanced as consistent with these notions. PMID:10306098

  12. Quality and quality improvement in occupational health nursing.

    PubMed

    Widtfeldt, A K

    1992-07-01

    Donabedian first defined quality as the result of assessing the structures, processes, and outcomes of health care. The emphasis on quality assurance is changing to quality improvement. The definition of quality in health care has expanded to include the expectations and opinion of patients, their representative, and society. As the cost of health care continues to rise at twice the rate of inflation, business wants to know how health care dollars are spent. Occupational health nurses, to add value to the businesses in which they work, must be a part of the trend in measuring the quality of the products and services of their health services. PMID:1616507

  13. Indoor air quality and health

    NASA Astrophysics Data System (ADS)

    Jones, A. P.

    During the last two decades there has been increasing concern within the scientific community over the effects of indoor air quality on health. Changes in building design devised to improve energy efficiency have meant that modern homes and offices are frequently more airtight than older structures. Furthermore, advances in construction technology have caused a much greater use of synthetic building materials. Whilst these improvements have led to more comfortable buildings with lower running costs, they also provide indoor environments in which contaminants are readily produced and may build up to much higher concentrations than are found outside. This article reviews our current understanding of the relationship between indoor air pollution and health. Indoor pollutants can emanate from a range of sources. The health impacts from indoor exposure to combustion products from heating, cooking, and the smoking of tobacco are examined. Also discussed are the symptoms associated with pollutants emitted from building materials. Of particular importance might be substances known as volatile organic compounds (VOCs), which arise from sources including paints, varnishes, solvents, and preservatives. Furthermore, if the structure of a building begins to deteriorate, exposure to asbestos may be an important risk factor for the chronic respiratory disease mesothelioma. The health effects of inhaled biological particles can be significant, as a large variety of biological materials are present in indoor environments. Their role in inducing illness through immune mechanisms, infectious processes, and direct toxicity is considered. Outdoor sources can be the main contributors to indoor concentrations of some contaminants. Of particular significance is Radon, the radioactive gas that arises from outside, yet only presents a serious health risk when found inside buildings. Radon and its decay products are now recognised as important indoor pollutants, and their effects are

  14. Defining quality improvement in public health.

    PubMed

    Riley, William J; Moran, John W; Corso, Liza C; Beitsch, Leslie M; Bialek, Ronald; Cofsky, Abbey

    2010-01-01

    Many industries commonly use quality improvement (QI) techniques to improve service delivery and process performance. Yet, there has been scarce application of these proven methods to public health settings and the public health field has not developed a set of shared principles or a common definition for quality improvement. This article discusses a definition of quality improvement in public health and describes a continuum of quality improvement applications for public health departments. Quality improvement is a distinct management process and set of tools and techniques that are coordinated to ensure that departments consistently meet the health needs of their communities. PMID:20009636

  15. Societal responsibility and moral hazard: How much are we willing to pay for quality-adjusted life?

    PubMed

    Stevenson, Megan A; Abbott, Daniel E

    2016-09-01

    Health care spending in the United States continues to rise with cancer care consuming a disproportionate amount of that spending. As the US population ages and cancer treatment options become more complex, cost containment strategies have become essential in oncology. Patient-centered decision-making will help to contain costs but requires a well-informed patient who is able to reconcile potential treatment choices with their beliefs and values. J. Surg. Oncol. 2016;114:269-274. © 2016 Wiley Periodicals, Inc. PMID:27074976

  16. Strategic service quality management for health care.

    PubMed

    Anderson, E A; Zwelling, L A

    1996-01-01

    Quality management has become one of the most important and most debated topics within the service sector. This is especially true for health care, as the controversy rages on how the existing American system should be restructured. Health care reform aimed at reducing costs and ensuring access to all Americans cannot be allowed to jeopardize the quality of care. As such, total quality management (TQM) has become a vital ingredient to strategic planning within the health care domain. At the heart of any such quality improvement effort is the issue of measurement. TQM cannot be effectively utilized as a competitive weapon unless quality can be accurately defined, measured, evaluated, and monitored over time. Through such analysis a hospital can elect how to expend its limited resources toward those quality improvement projects which will impact customer perceptions of service quality the most. Thus, the purpose of this report is to establish a framework by which to approach the issue of quality measurement, delineate the various components of quality that exist in health care, and explore how these elements affect one another. We propose that the issue of quality measurement in health care be approached as an integration of service quality attributes common to other service organizations and technical quality attributes unique to health care. We hope that this research will serve as a first step toward the synthesis of the various quality attributes inherent in the health care domain and encourage other researchers to address the interactions of the various quality attributes. PMID:8763215

  17. Health Professions Education: A Bridge to Quality

    ERIC Educational Resources Information Center

    Greiner, Ann C., Ed.; Knebel, Elisa, Ed.

    2003-01-01

    The Institute of Medicine study Crossing the Quality Chasm (2001) recommended that an interdisciplinary summit be held to further reform of health professions education in order to enhance quality and patient safety. Health Professions Education: A Bridge to Quality is the follow up to that summit, held in June 2002, where 150 participants across…

  18. Societal assessment overview

    NASA Technical Reports Server (NTRS)

    Bloomquist, C. E.

    1980-01-01

    The decision to proceed with SPS depends on a political determination that commitment of the economic, institutional, and social energies required for its implementation is a worthwhile investment. This determination is national (and international) in scope and is based on knowledge of the environmental and societal impacts of the SPS, its projected economics and technological risks, expressed through the influence of contending segments of society. To assist the decision makers, an assessment of societal issues associated with the SPS was undertaken as part of the Concept Development and Evaluation Program. Results of the assessment are reported. The primary societal assessment objectives are to determine if the societal ramifications of an SPS might significantly impede its development, and to establish an information base regarding these issues. Estimates regarding SPS impacts commensurate with its stage of development and the needs of the decision makers are provided.

  19. Quality and Electronic Health Records in Community Health Centers

    ERIC Educational Resources Information Center

    Lesh, Kathryn A.

    2014-01-01

    Adoption and use of health information technology, the electronic health record (EHR) in particular, has the potential to help improve the quality of care, increase patient safety, and reduce health care costs. Unfortunately, adoption and use of health information technology has been slow, especially when compared to the adoption and use of…

  20. Quality improvement in population health systems.

    PubMed

    Inkelas, Moira; McPherson, Marianne E

    2015-12-01

    Quality improvement methods have achieved large sustainable changes in health care quality and health outcomes. Transforming health care into a population health system requires methods for innovation and improvement that can work across professions and sectors. It may be possible to replicate improvement successes in healthcare settings within and across the broader systems of social, educational, and other human services that influence health outcomes in communities. Improvement methods could translate the rhetoric of collaboration, integration and alignment into practice across the fragmented health and human service sectors in the U.S. PMID:26699349

  1. Health Professions Education: A Bridge to Quality.

    ERIC Educational Resources Information Center

    Greiner, Ann C., Ed.; Knebel, Elisa, Ed.

    The 2001 Institute of Medicine (IOM) report "Crossing the Quality Chasm: A New Health System for the 21st Century" recommended that an interdisciplinary summit be held to develop next steps for reform of health professions education in order to enhance patient care quality and safety. In June 2002, the IOM convened this summit, which included 150…

  2. Organisational Learning for School Quality and Health

    ERIC Educational Resources Information Center

    Lagrosen, Yvonne; Lagrosen, Stefan

    2012-01-01

    Purpose: The purpose of this paper is to shed light upon the connections between quality management, employee health and organisational learning in a school setting. Design/methodology/approach: The study is based on a quantitative survey. Items measuring health status and values of quality management were included in a questionnaire addressed to…

  3. The Societal Importance of Embracing Counterintuitive Thought in Science: Assisted Exercise in Preterm Infants for Long-term Health Outcomes

    PubMed Central

    Olshansky, Ellen; Vaughan, Jessica; Sando, Kelsi; Rich, Julia; Lakes, Kimberley; Cooper, Daniel

    2014-01-01

    For research to lead to progressive change, scientists and society must embrace what may seem counterintuitive. While there is often resistance to changing views of what we presume to already understand, we must be open to evolving knowledge and evidence. Our research is examining the effect of a novel intervention designed to increase physical activity of premature babies in their first year of life on: (1) body composition, (2) associated biochemical and cellular mechanisms of growth and inflammation, and (3) quality of maternal care. This study is novel because it is counterintuitive to prevailing knowledge of the care and treatment of infants born prematurely. Traditionally, we swaddle infants and restrict their movement in order to minimize energy expenditure. We are proposing the opposite: to increase energy expenditure in a systematic, controlled way in order to increase muscle mass and bone density, with the ultimate goal of preventing diseases associated with lack of muscle mass or bone density. Our research actively engages the mothers in the study by learning about their perceptions and their experiences of doing the exercise with their infants because the mothers, too, are aware of the prevailing views that are counter to what they are being asked to do. The mothers have taught us, however, that they are willing to participate in this exercise study, while paradoxically also viewing their infants as “fragile” and are fearful of hurting their infants. Our thesis in this research-based paper is that science and society must work in tandem to be effective. PMID:25750683

  4. Quality indicators and quality assessment in child health

    PubMed Central

    Kavanagh, Patricia L.; Adams, William G.; Wang, C. Jason

    2009-01-01

    Quality indicators are systematically developed statements that can be used to assess the appropriateness of specific healthcare decisions, services and outcomes. In this review, we highlight the range and type of indicators that have been developed for children in the UK and US by prominent governmental agencies and private organizations. We also classify these indicators in an effort to identify areas of child health that may lack quality measurement activity. We review the current state of health information technology in both countries since these systems are vital to quality efforts. Finally, we propose several recommendations to advance the quality indicator development agenda for children. The convergence of quality measurement and indicator development, a growing scientific evidence base and integrated information systems in healthcare may lead to substantial improvements for child health in the 21st century. PMID:19307196

  5. How to ensure quality of health accounts.

    PubMed

    van Mosseveld, Cornelis; Hernández-Peña, Patricia; Arán, Daniel; Cherilova, Veneta; Mataria, Awad

    2016-05-01

    Policy makers need up-to-date and reliable information to formulate health policies and monitor their implementation. Given that financing is one of the pillars of the health system, quality of financing data is essential. Quality is a key element but difficult to measure. Increasing quality on financing data involves the use of standard procedures and methods. Current standard framework, the System of Health Accounts 2011, needs to be implemented with checks and controls on the individual as well as aggregated data. Data input on the construction of the accounts and their related metadata are subject to quality measures. In this paper we address a first proposal of the components of the quality in health accounts reporting. The paper assesses Quality Of Health Accounts at four stages: (1) Design; (2) Development; (3) Management; and (4) Reporting. It explains what is needed at each stage to ensure reliable results which are fit for informing decision-making. Quality is essential for reliability and trust among all stakeholders, who are responsible of data provision, construction of the accounts and using their results. Quality measurement in health accounts is a reality needing effort. PMID:27048758

  6. Measuring the quality of health care.

    PubMed

    Custer, W

    1995-03-01

    This Issue Brief examines some of the issues involved in defining and measuring the quality of health care and in implementing quality measures. It discusses the importance of measures of health care quality in the evolving health care delivery system, examines some of the conceptual issues involved in defining quality of care, and discusses some of the measures of health care quality and how these measures have been implemented in the health care delivery system. The major impetus for quality assurance programs is cost management: it is an attempt to allocate scarce health care resources efficiently. This requires making choices among alternatives, which may mean that maximizing quality of care for whole populations may not maximize the quality of care for individuals. Quality, in terms of any single good or service, has a number of dimensions. Health care is a complex bundle of services, and each component service within an episode of care affects the other components and the patients differently. Moreover, patients differ in numerous ways, which means that similar symptoms may require different services if care is to be effective. Measuring quality of health care services requires accounting for all of these factors. In attempting to manage health care costs, employers and other private health plans have begun to employ process measures of quality, i.e., evaluating caregivers' activities, the decisions made at each step in an episode of illness, and the appropriateness of the care provided. Process is an important component of quality measures because it focuses directly on the uncertainty in the efficacy of treatment. Given this uncertainty, the logic of medical decision making is an important determinant of quality and cost effectiveness. Examining the process of care involves assembling a panel of physicians who review medical records to determine the appropriateness of the care received. Providers have increasingly found that their medical decision making

  7. Achieving Quality Health Services for Adolescents.

    PubMed

    2016-08-01

    This update of the 2008 statement from the American Academy of Pediatrics redirects the discussion of quality health care from the theoretical to the practical within the medical home. This statement reviews the evolution of the medical home concept and challenges the provision of quality adolescent health care within the patient-centered medical home. Areas of attention for quality adolescent health care are reviewed, including developmentally appropriate care, confidentiality, location of adolescent care, providers who offer such care, the role of research in advancing care, and the transition to adult care. PMID:27432849

  8. Quality Assurance in Community Mental Health Centers.

    ERIC Educational Resources Information Center

    Racusin, Robert; Krell, Helen

    1980-01-01

    Advantages and disadvantages to various methods of assuring quality and accountability in community mental health centers are discussed. Examples are external structure review, peer monitoring, and site visitation. (LAB)

  9. Quality Circles and Health Promotion Planning.

    ERIC Educational Resources Information Center

    Galli, Nicholas; Corry, James M.

    1986-01-01

    This article explores the process of health education program planning, presents the model of quality circles, and examines the variables upon which decisions for or against specific programs are made within an institution. (MT)

  10. Health care choices: sharing the quality message.

    PubMed

    2001-01-01

    Information on health-care quality (in the form of report cards) is playing an increasingly important role in consumers' health-care decision making. In this brief we discuss how you can help your clients sort through available quality information and how you can prepare a report card using the approach developed by the Foundation for Accountability (FACCT), our guest authors this month. PMID:11859891

  11. Measuring Physical Neighborhood Quality Related to Health

    PubMed Central

    Rollings, Kimberly A.; Wells, Nancy M.; Evans, Gary W.

    2015-01-01

    Although sociodemographic factors are one aspect of understanding the effects of neighborhood environments on health, equating neighborhood quality with socioeconomic status ignores the important role of physical neighborhood attributes. Prior work on neighborhood environments and health has relied primarily on level of socioeconomic disadvantage as the indicator of neighborhood quality without attention to physical neighborhood quality. A small but increasing number of studies have assessed neighborhood physical characteristics. Findings generally indicate that there is an association between living in deprived neighborhoods and poor health outcomes, but rigorous evidence linking specific physical neighborhood attributes to particular health outcomes is lacking. This paper discusses the methodological challenges and limitations of measuring physical neighborhood environments relevant to health and concludes with proposed directions for future work. PMID:25938692

  12. Health reform and the quality assurance imperative.

    PubMed

    Webber, A

    The administration's blueprint for healthcare reform contains a number of positive features, including a national healthcare information database, quality "report cards," and state-based patient complaint offices. Missing from the plan, however, is "an active quality monitoring system that holds health plans and providers publicly accountable for improved performance," says Andrew Webber, Executive Vice President of the American Medical Peer Review Association, the national association of Peer Review Organizations (PROs). His antidote includes the creation of an independent, state-based network to coordinate quality assurance activities; a program to monitor compliance with practice guidelines; and a quality foundation to measure, manage, improve, and oversee quality. PMID:10131335

  13. Quality Improvement Efforts in Pediatric Oral Health.

    PubMed

    Ng, Man Wai

    2016-04-01

    Quality improvement (QI) and measurement are increasingly used in health care to improve patient care and outcomes. Despite current barriers in oral health measurement, there are nascent QI and measurement efforts emerging. This paper describes the role that QI and measurement can play in improving oral health care delivery in clinical practice by presenting a QI initiative that aimed to test and implement a chronic disease management approach to address early childhood caries. PMID:27265978

  14. Quality of health care, survival and health outcomes in Ghana.

    PubMed

    Lavy, V; Strauss, J; Thomas, D; de Vreyer, P

    1996-06-01

    This paper analyzes the effect of quality and accessibility of health services and other public infrastructure on the health of children in Ghana. We focus on child survival, child height and weight using data from the Ghana Living Standards Survey. The results suggest an important role for public health policy in eliminating the rural-urban disparities in health status and particularly in improving the health status of rural children and reducing their mortality rates. Increased availability of birth services and other related child programs, as well as Improved water and sanitation infrastructure would have an immediate payoff. PMID:10159445

  15. Review Of Internet Health Information Quality Initiatives

    PubMed Central

    Dzenowagis, Joan

    2001-01-01

    Background The massive growth of health information on the Internet; the global nature of the Internet; the seismic shift taking place in the relationships of various actors in this arena, and the absence of real protection from harm for citizens who use the Internet for health purposes are seen to be real problems. One response to many of these problems has been the burgeoning output of codes of conduct by numerous organizations trying to address quality of health information. Objectives Review the major self-regulatory initiatives in the English-speaking world to develop quality and ethical standards for health information on the Internet. Compare and analyze the approaches taken by the different initiatives. Clarify the issues around the development and enforcement of standards. Methods Quality initiatives selected meet one or more of the following criteria: Self-regulatory. A reasonable constituency. Diversity (eg, of philosophy, approach and process)-to achieve balance and wide representation, and to illustrate and compare different approaches. Historic value. A wider reach than a national audience, except when its reach is a significant sector of the Internet health information industry. The initiatives were compared in 3 ways: (1) Analysis and comparison of: key concepts, mechanism, or approach. Analysis of: the obligations that a provider has to meet to comply with the given initiative, the intended beneficiaries of that initiative, and the burdens imposed on different actors. These burdens are described in terms of their effect on the long-term sustainability and maintenance of the initiative by its developers. Analysis of the enforcement mechanisms. (2) Analysis and comparison by type of sponsoring organization, the reach of the initiative, and the sources of funding of the initiative or the sponsoring organization. (3) How the various initiatives fall under 1 of 3 key mechanisms and comparison of the advantages and disadvantages of these key mechanisms

  16. Quality measurement indicators for Iranian Health Centers

    PubMed Central

    Moslehi, Shandiz; Atefi Manesh, Pezhman; Sarabi Asiabar, Ali

    2015-01-01

    Background: Recently, quality is a serious concern in development of organizations. There are various indicators to assess quality and the purpose of this study was to identify the main indicators for quality measurement of Iranian health centers. Methods: This qualitative study was conducted in three stages: first, review of the literature was performed to identify different indicators for quality measurement in health centers; second, a tworound Delphi process was used with participation of 18 experts in both rounds; third, Analytical Hierarchy Process (AHP) method was applied to give weights to each indicator. Results: Twenty-seven indicators were identified from the literature review stage. The Delphi method reduced the list to 4 indicators. Developing a quality plan in the health center had the highest weight (38%) and percentage of followed complaints the lowest (12%). The consistency rate was 7.2% indicating appropriateness of the data. Conclusion: This list of indicators can be used as a template for measuring quality of health centers in Iran and possibly in other developing countries. PMID:26034730

  17. Does Competition Improve Health Care Quality?

    PubMed Central

    Scanlon, Dennis P; Swaminathan, Shailender; Lee, Woolton; Chernew, Michael

    2008-01-01

    Objective To identify the effect of competition on health maintenance organizations' (HMOs) quality measures. Study Design Longitudinal analysis of a 5-year panel of the Healthcare Effectiveness Data and Information Set (HEDIS) and Consumer Assessment of Health Plans Survey® (CAHPS) data (calendar years 1998–2002). All plans submitting data to the National Committee for Quality Assurance (NCQA) were included regardless of their decision to allow NCQA to disclose their results publicly. Data Sources NCQA, Interstudy, the Area Resource File, and the Bureau of Labor Statistics. Methods Fixed-effects models were estimated that relate HMO competition to HMO quality controlling for an unmeasured, time-invariant plan, and market traits. Results are compared with estimates from models reliant on cross-sectional variation. Principal Findings Estimates suggest that plan quality does not improve with increased levels of HMO competition (as measured by either the Herfindahl index or the number of HMOs). Similarly, increased HMO penetration is generally not associated with improved quality. Cross-sectional models tend to suggest an inverse relationship between competition and quality. Conclusions The strategies that promote competition among HMOs in the current market setting may not lead to improved HMO quality. It is possible that price competition dominates, with purchasers and consumers preferring lower premiums at the expense of improved quality, as measured by HEDIS and CAHPS. It is also possible that the fragmentation associated with competition hinders quality improvement. PMID:18793214

  18. Improving Indoor Environmental Quality for Public Health: Impediments and Policy Recommendations

    PubMed Central

    Wu, Felicia; Jacobs, David; Mitchell, Clifford; Miller, David; Karol, Meryl H.

    2007-01-01

    Background People in modern societies spend more than 90% of their time indoors. Hence, indoor environmental quality (IEQ) has a significant impact on public health. In this article we describe health risks associated with indoor environments, illuminate barriers to overcoming these risks, and provide policy recommendations to achieve healthier indoor environments. Objectives The weight of evidence suggests that indoor environmental contaminants pose significant public health risks, particularly among children and the poor, and the societal costs of illnesses related to indoor environments are considerable. Despite the evidence of harm to human health, poor indoor environments are generally difficult to regulate and not of sufficient concern to the general public. We discuss several reasons for this lack of concern about IEQ, focusing specifically on home environments. Discussion Economics plays a large role both in political inaction and individual-level indifference. Because little effort has been made to quantify the value of the societal and individual costs of poor housing quality, as well as the benefits achievable by simple interventions, policymakers lack motivation to act on IEQ. Similarly, individual homeowners lack the incentive to remediate homes, as other problems may be more pressing than home environmental quality. Conclusions Although the problem of IEQ involves multiple stakeholders and multiple levels of governance, it is possible to establish economic incentives that would set the wheels in motion for action at all levels to achieve healthy home environments. Also important are education and information dissemination on the public health risks associated with indoor environments. These recommendations are intended for all decision makers who have an influence in developing policy to improve indoor environmental quality. PMID:17589606

  19. [Quality assurance in occupational health services].

    PubMed

    Michalak, J

    1996-01-01

    The general conditions influencing the quality assurance and audit in Polish occupational health services are presented. The factors promoting or hampering the implementation of quality assurance and audits are also discussed. The major influence on the transformation of Polish occupational health services in exorted by employers who are committed to cover the costs of the obligatory prophylactic examination of their employees. This is the factor which also contributes to the improvement of quality if services. The definitions of the most important terms are reviewed to highlight their accordance with the needs of occupational health services in Poland. The examples of audit are presented and the elements of selected methods of auditing are suggested to be adopted in Poland. PMID:8760511

  20. Quality and Certification of Electronic Health Records

    PubMed Central

    Hoerbst, A.; Ammenwerth, E.

    2010-01-01

    Background Numerous projects, initiatives, and programs are dedicated to the development of Electronic Health Records (EHR) worldwide. Increasingly more of these plans have recently been brought from a scientific environment to real life applications. In this context, quality is a crucial factor with regard to the acceptance and utility of Electronic Health Records. However, the dissemination of the existing quality approaches is often rather limited. Objectives The present paper aims at the description and comparison of the current major quality certification approaches to EHRs. Methods A literature analysis was carried out in order to identify the relevant publications with regard to EHR quality certification. PubMed, ACM Digital Library, IEEExplore, CiteSeer, and Google (Scholar) were used to collect relevant sources. The documents that were obtained were analyzed using techniques of qualitative content analysis. Results The analysis discusses and compares the quality approaches of CCHIT, EuroRec, IHE, openEHR, and EN13606. These approaches differ with regard to their focus, support of service-oriented EHRs, process of (re-)certification and testing, number of systems certified and tested, supporting organizations, and regional relevance. Discussion The analyzed approaches show differences with regard to their structure and processes. System vendors can exploit these approaches in order to improve and certify their information systems. Health care organizations can use these approaches to support selection processes or to assess the quality of their own information systems. PMID:23616834

  1. The societal burden of osteoporosis.

    PubMed

    Becker, David J; Kilgore, Meredith L; Morrisey, Michael A

    2010-06-01

    Osteoporosis currently affects 10 million Americans and is responsible for more than 1.5 million fractures annually. The financial burden of osteoporosis is substantial, with annual direct medical costs estimated at 17 to 20 billion dollars. Most of these costs are related to the acute and rehabilitative care following osteoporotic fractures, particularly hip fractures. The societal burden of osteoporosis includes these direct medical costs and the monetary (eg, caregiver time) and nonmonetary costs of poor health. The aging of the US population is expected to increase the prevalence of osteoporosis and the number of osteoporotic fractures. Growth of the older adult population will pose significant challenges to Medicare and Medicaid, which bear most of the cost of osteoporosis. Efforts to address the looming financial burden must focus on reducing the prevalence of osteoporosis and the incidence of costly fragility fractures. PMID:20425518

  2. eHealth and quality in health care: implementation time.

    PubMed

    Ossebaard, Hans C; Van Gemert-Pijnen, Lisette

    2016-06-01

    The use of information and communication technologies in health and health care could improve healthcare quality in many ways. Today's evidence base demonstrates the (cost-)effectiveness of online education, self-management support and tele-monitoring in several domains of health and care. While new results gradually provide more evidence for eHealth's impact on quality issues, now is the time to come to grips with implementation issues. Documented drawbacks such as low acceptance, low adoption or low adherence need our attention today to make the most of eHealth' potential. Improvement science is beginning to deliver the tools to address these persistent behavioural and cultural issues. The ceHRes Roadmap, for instance, is a plural and pragmatic approach that includes users' needs. It is now imperative to improve our implementation strategies in order to scale up eHealth technologies. This will accelerate the much needed transformation of our healthcare systems and sustain access, affordability and quality for all in the near future. PMID:27029590

  3. Cross-cultural variation in preference for replantation or revision amputation: Societal and surgeon views.

    PubMed

    Maroukis, Brianna L; Shauver, Melissa J; Nishizuka, Takanobu; Hirata, Hitoshi; Chung, Kevin C

    2016-04-01

    Treatment decisions after an injury like finger amputation are made based on injury and patient factors. However, decisions can also be influenced by provider and patient preferences. We compared hand surgeon and societal preferences and attitudes regarding finger amputation treatment in Japan and the US. We performed a cross-sectional survey with subjects derived from large tertiary care academic institutions in the US and Japan. We secured 100% participation of American hand surgeon members of the Finger Replantation and Amputation Multicenter Study and presenting hand surgeons at the 32nd Annual meeting of the Central Japanese Society for Surgery of the Hand. Societal preferences were gathered from volunteers at the 2 universities in the US and Japan. There were no significant differences in estimations of function, sensation, or appearance after replantation; American and Japanese societal participants preferred replantation compared to surgeons, although this was more pronounced in Japan. The Japanese society displayed more negative attitudes toward finger amputees than did Japanese surgeons. American respondents anticipated more public stigmatisation of amputees than did American surgeons. Societal preference for replantation was not caused by inflated expectations of outcomes after replantation. Japanese societal preference was likely driven by negative views of finger amputees. American society noted no decrease in physical health after amputation, but did note a quality of life decrease attributed to public stigmatisation. Japanese society and surgeons had a stronger preference for replantation than American society and surgeons, possibly attributed to cultural differences. PMID:26961436

  4. QUALITY ASSURANCE GUIDELINES FOR ENVIRONMENTAL HEALTH RESEARCH

    EPA Science Inventory

    This document provides conceptual guidelines for the development, implementation and evaluation of research task quality assurance plans for the staff of the Health Effects Research Laboratory (HERL/RTP) of the U.S. Environmental Protection Agency, Research Triangle Park, North C...

  5. Towards medicines regulatory authorities' quality performance improvement: value for public health.

    PubMed

    Pejović, Gordana; Filipović, Jovan; Tasić, Ljiljana; Marinković, Valentina

    2016-01-01

    The purpose of this article is to explore the possibility of implementing total quality management (TQM) principles in national medicines regulatory authorities in Europe to achieve all public health objectives. Bearing in mind that medicines regulation is a governmental function that serves societal objectives to protect and promote public health, measuring the effective achievement of quality objectives related to public health is of utmost importance. A generic TQM model for meeting public health objectives was developed and was tested on 10 European national medicines regulatory authorities with different regulatory performances. Participating national medicines regulatory authorities recognised all TQM factors of the proposed model in implemented systems with different degrees of understanding. An analysis of responses was performed within the framework of two established criteria-the regulatory authority's category and size. The value of the paper is twofold. First, the new generic TQM model proposes to integrate four public health objectives with six TQM factors. Second, national medicines regulatory authorities were analysed as public organisations and health authorities to develop a proper tool for assessing their regulatory performance. The paper emphasises the importance of designing an adequate approach to performance measurement of quality management systems in medicines regulatory authorities that will support their public service missions. PMID:24986713

  6. Oral Health-related Quality of Life

    PubMed Central

    Sischo, L.; Broder, H.L.

    2011-01-01

    Despite its relatively recent emergence over the past few decades, oral health-related quality of life (OHRQoL) has important implications for the clinical practice of dentistry and dental research. OHRQoL is a multidimensional construct that includes a subjective evaluation of the individual’s oral health, functional well-being, emotional well-being, expectations and satisfaction with care, and sense of self. It has wide-reaching applications in survey and clinical research. OHRQoL is an integral part of general health and well-being. In fact, it is recognized by the World Health Organization (WHO) as an important segment of the Global Oral Health Program (2003). This paper identifies the what, why, and how of OHRQoL and presents an oral health theoretical model. The relevance of OHRQoL for dental practitioners and patients in community-based dental practices is presented. Implications for health policy and related oral health disparities are also discussed. A supplemental Appendix contains a Medline and ProQuest literature search regarding OHRQoL research from 1990-2010 by discipline and research design (e.g., descriptive, longitudinal, clinical trial, etc.). The search identified 300 articles with a notable surge in OHRQoL research in pediatrics and orthodontics in recent years. PMID:21422477

  7. Climate change, air quality, and human health.

    PubMed

    Kinney, Patrick L

    2008-11-01

    Weather and climate play important roles in determining patterns of air quality over multiple scales in time and space, owing to the fact that emissions, transport, dilution, chemical transformation, and eventual deposition of air pollutants all can be influenced by meteorologic variables such as temperature, humidity, wind speed and direction, and mixing height. There is growing recognition that development of optimal control strategies for key pollutants like ozone and fine particles now requires assessment of potential future climate conditions and their influence on the attainment of air quality objectives. In addition, other air contaminants of relevance to human health, including smoke from wildfires and airborne pollens and molds, may be influenced by climate change. In this study, the focus is on the ways in which health-relevant measures of air quality, including ozone, particulate matter, and aeroallergens, may be affected by climate variability and change. The small but growing literature focusing on climate impacts on air quality, how these influences may play out in future decades, and the implications for human health is reviewed. Based on the observed and anticipated impacts, adaptation strategies and research needs are discussed. PMID:18929972

  8. Oral health related quality of life

    PubMed Central

    Bennadi, Darshana; Reddy, C. V. K.

    2013-01-01

    Diseases and disorders that damage the mouth and face can disturb well-being and his self-esteem. Oral health-related quality of life (OHRQOL) is a relatively new but rapidly growing notion. The concept of OHRQOL can become a tool to understand and shape not only the state of clinical practice, dental research and dental education but also that of community at large. There are different approaches to measure OHRQOL; the most popular one is multiple item questionnaires. OHRQOL should be the basis for any oral health programme development. Moreover, research at the conceptual level is needed in countries where OHRQOL has not been previously assessed, including India. PMID:24478972

  9. Inflammation, Oxidative Stress, and Antioxidants Contribute to Selected Sleep Quality and Cardiometabolic Health Relationships: A Cross-Sectional Study

    PubMed Central

    Kanagasabai, Thirumagal; Ardern, Chris I.

    2015-01-01

    Sleep is vital for cardiometabolic health, but a societal shift toward poor sleep is a prominent feature of many modern cultures. Concurrently, factors such as diet and lifestyle have also changed and may mediate the relationship between sleep quality and cardiometabolic health. Objectives were to explore (1) the interrelationship and (2) mediating effect of inflammation, oxidative stress, and antioxidants on sleep quality and cardiometabolic health. Cross-sectional data from the US National Health and Nutritional Examination Survey 2005-06 (≥20 y; N = 2,072) was used. Cardiometabolic health was defined as per the Joint Interim Statement; overall sleep quality was determined from six sleep habits and categorized as good, fair, poor, and very poor. Fair quality sleepers had optimal inflammation, oxidative stress, and antioxidant levels. Inflammation was above the current clinical reference range across all sleep quality categories, while oxidative stress was only within the clinical reference range for fair sleep quality. Selected sleep quality-cardiometabolic health relationships were mediated by inflammation, oxidative stress, and antioxidants and were moderated by sex. Our results provide initial evidence of a potential role for inflammation, oxidative stress, and antioxidants in the pathway between poor sleep quality-cardiometabolic decline. Further prospective research is needed to confirm our results. PMID:26568665

  10. [Quality management in a public health agency].

    PubMed

    Villalbí, Joan R; Ballestín, Manuela; Casas, Conrad; Subirana, Teresa

    2012-01-01

    This article describes the introduction of quality improvement actions in a public health organization. After ISO 17025 accreditation, which was legally mandated, was granted to the official control laboratory, the management decided to expand a quality policy in 2003, through a series of actions based on process analysis and proposals for improvement, further definition of standard operating procedures, exploration of users' opinions, the creation of improvement groups, and external audits or certification. The organizational response to these initiatives was diverse. External audit or certification of services seems to be the most powerful tool for change. Costing studies showed that up to 75% of the total expenditure of the agency in 2010 was spent on public health services subject to external audit or certification. PMID:22425456

  11. [Environmental quality: wellfare, confort and health].

    PubMed

    Vargas Marcos, Francisco; Gallego Pulgarín, Isabel

    2005-01-01

    Different ways of interpreting environmental conditions have led to the development of concepts such as the sick building, indoor air quality or indoor environment quality, for understanding the complexity of the pollutants in enclosed environments and the implications thereof on the health. The "Indoor Environment Quality" proposal is an advancement, operative and conceptual, surpassing amply prior ones, given that it orients the actions toward healthy environments without limiting the idea of pollution to the air alone. The aim is identifying the competence to preventing hazards related to exposure to pollutants within the confines of indoor environments and know the legislative framework useful for taking the actions. Optimum conditions within indoor environments must redound in health, well-being and comfort with regard to both working life as well as the environments in which everyday activities outside of work, extracurricular, leisure-time and entertainment activities are carried out. Today's society is demanding safe, clean, well-climatized places, for this is necessary to integrate the inhabitant's perceptions and demands and achieve an optimum balance among social standards, energy use and sustainable development. Legislation is being further expanded upon in the direction of occupational health and safety and the regulation of chemical substances. Environmental Health carries out prevention and control tasks, takes part in the enforcement of international pollution and waste reduction agreements and promotes measures for carrying out the European Environment and Health Strategy. It is considered useful the elaboration of protocols for the evaluation and administration gives the risks associated to the interior pollutants. PMID:15913058

  12. The societal impact value of risk

    SciTech Connect

    Simpson, D.E.

    1995-04-01

    A key ill-defined issue in the management and regulation of potentially hazardous conditions is that of the value to be associated with a reduction (or existence) of human health risks, such as radiation exposure or hazardous substance ingestion. Empirical observations of societal behavior patterns lead to a relationship for the quantitative value of societal risk impact which is consistent with general societal risk acceptance, is not inconsistent with ``de facto`` risk regulation, and is suitable and appropriate as a specification or guide for risk management and risk regulation. This societal risk impact expression is: Impact ($/year) = (8 {times} 10{sup 7}) NR{sub i}{sup 4/3} where Ri = individual annual mortality risk; N = number of persons in the population sharing the risk and benefits. The change in Impact which can be derived from a regulation or risk management activity is the value of annual benefit which society would expect to forego (or annual equivalent cost to incur) in consideration of the activity.

  13. Making Quality Health Websites a National Public Health Priority: Toward Quality Standards

    PubMed Central

    2016-01-01

    Background Most US adults have limited health literacy skills. They struggle to understand complex health information and services and to make informed health decisions. The Internet has quickly become one of the most popular places for people to search for information about their health, thereby making access to quality information on the Web a priority. However, there are no standardized criteria for evaluating Web-based health information. Every 10 years, the US Department of Health and Human Services' Office of Disease Prevention and Health Promotion (ODPHP) develops a set of measurable objectives for improving the health of the nation over the coming decade, known as Healthy People. There are two objectives in Healthy People 2020 related to website quality. The first is objective Health Communication and Health Information Technology (HC/HIT) 8.1: increase the proportion of health-related websites that meet 3 or more evaluation criteria for disclosing information that can be used to assess information reliability. The second is objective HC/HIT-8.2: increase the proportion of health-related websites that follow established usability principles. Objective The ODPHP conducted a nationwide assessment of the quality of Web-based health information using the Healthy People 2020 objectives. The ODPHP aimed to establish (1) a standardized approach to defining and measuring the quality of health websites; (2) benchmarks for measurement; (3) baseline data points to capture the current status of website quality; and (4) targets to drive improvement. Methods The ODPHP developed the National Quality Health Website Survey instrument to assess the quality of health-related websites. The ODPHP used this survey to review 100 top-ranked health-related websites in order to set baseline data points for these two objectives. The ODPHP then set targets to drive improvement by 2020. Results This study reviewed 100 health-related websites. For objective HC/HIT-8.1, a total of 58 out

  14. Quality of Life, Health Status, and Depression

    PubMed Central

    Pike, Nancy A.; Evangelista, Lorraine S.; Doering, Lynn V.; Eastwood, Jo-Ann; Lewis, Alan B.; Child, John S.

    2012-01-01

    Background Quality of life (QOL) in adolescents and adults who have undergone the Fontan procedure and are living with only 1 ventricle is presumed to be diminished. Objectives This study aimed to compare QOL, health status, and prevalence of depression in adolescents/adults after the Fontan procedure with healthy counterparts and to identify predictors of QOL in the Fontan group. Methods Using a comparative, cross-sectional design, 54 adolescents and adults with single ventricle congenital heart disease who have undergone the Fontan procedure were compared with 66 age-matched healthy counterparts. Quality of life, health status, depression, and social support were measured using the Satisfaction With Life Scale, Short Form Survey Version 2, Patient Health Questionnaire Depression Module, and Multidimensional Scale of Perceived Social Support. Clinical variables were abstracted from medical records. Predictors of QOL were determined using multiple linear regression. Results Adolescents and adults in the Fontan group reported lower physical health status (mean [SD] = 46.5 [9.3] vs mean [SD] = 55.9 [5.1], P < .001) and were more depressed (mean [SD] = 7.3 [5.9] vs mean [SD] = 4.5 [4.3], P < .004) than their healthy counterparts. There were no differences in QOL, mental health status, or social support between the 2 groups. Functional status (New York Heart Association class), depression, and social support accounted for 55% of the variance in QOL in the Fontan group. Conclusions Despite lower levels of physical health, the QOL of Fontan patients was comparable with that of their healthy counterparts; this finding contradicts previous proxy reports, self-reports, and assumptions that QOL is lower in patients with complex single ventricle congenital heart disease. However, because Fontan patients were more depressed than their healthy counterparts, the need for early screening and detection is warranted. PMID:21912272

  15. The Evaluation Scale: Exploring Decisions about Societal Impact in Peer Review Panels

    ERIC Educational Resources Information Center

    Derrick, Gemma E.; Samuel, Gabrielle N.

    2016-01-01

    Realising the societal gains from publicly funded health and medical research requires a model for a reflexive evaluation precedent for the societal impact of research. This research explores UK Research Excellence Framework evaluators' values and opinions and assessing societal impact, prior to the assessment taking place. Specifically, we…

  16. Quality of health care: the responsibility of health care professionals in delivering high quality services.

    PubMed

    Giangrande, A

    1998-11-01

    According to a recent definition, quality of care consists of the degree to which health services increase the likelihood of desired health outcomes and are consistent with current professional knowledge; a definition that introduces both requirements of outcomes and the appropriateness of the process used. Clearly many different figures are interested in quality assessment initiatives in the health care field and these include patients, administrators and doctors each having different perspective. Doctors obviously pay greater attention to technical quality and results, giving greater emphasis to the health of the individual patient, tending to give priority to technical excellence and interaction between patient and doctor. Although the perspective of health care professionals is widely acknowledged to be important and useful, other perspectives on quality have been emphasised in recent years. The most important of these is the recognition that care must be responsive to the preferences and values of the consumers of health care services. In complete harmony with one's own professional commitment, the attention to the perspectives of patients must give physician the chance to identify methods of measuring and verifying quality which take account of the expectations of the many groups with an interest in improving the functioning of the health system. A global approach in the health field is needed the more specialization advances. The quality of medicine lies in its capacity to integrate what science says is appropriate and to be recommended, what can be reconciled with human rights and the self determination of the patient and what can be achieved by optimising available resources. In this complex context, the doctor could take on both the role of the person who decides on the use of resources and the one of social mediator. PMID:9894749

  17. Quality Assurance for Social Service Programs: Lessons from Health Care.

    ERIC Educational Resources Information Center

    Coulton, Claudia J.

    1982-01-01

    Suggests that many aspects of quality assurance in health care can be applied to social service agencies. Reviews what has been learned about quality assurance in health care and suggests guidelines for its implementation in social services. (Author/JAC)

  18. 'Are you still on that stupid diet?': women's experiences of societal pressure and support regarding weight loss, and attitudes towards health policy intervention.

    PubMed

    Whale, Katie; Gillison, Fiona B; Smith, Paula C

    2014-12-01

    This study investigated how people's attitudes and motivations towards losing weight are influenced by societal pressures surrounding weight loss, their interaction with the obesogenic environment and individuals' attitudes and motivations towards weight. Semi-structured qualitative interviews were conducted with 10 women currently attending commercial weight-loss programmes. Participants experienced conflicting messages regarding weight norms, with the media portraying powerful social norms relating to thinness and beauty, and changes to the food environment and interactions with family and friends commonly undermining weight-loss activities and promoting increased consumption. Providing social and environmental support for the behaviours needed to produce weight loss may need to be a primary focus for obesity policy. PMID:23928985

  19. New health care law may spell opportunity for quality managers.

    PubMed

    2010-06-01

    New health care law emphasizes quality, safety, and efficiency. Pay-for-performance emphasis requires attention of quality managers. Many quality provisions will not kick in for several years. PMID:20491197

  20. The societal role of lifelong vaccination.

    PubMed

    Postma, Maarten J; Carroll, Stuart; Brandão, Alexandra

    2015-01-01

    The full economic and societal value of vaccination is complex to assess. Although direct protection is the immediate goal of vaccination programmes, it is rare that 100% uptake is attained. An important facet of vaccines value comes from the indirect (or herd) protection they provide. The evolving dynamics of our society, including the increase in the proportion of older individuals enhances the value of indirect protection in reducing disease transmission within the family setting and the society as a whole. For example, grandparents are increasingly involved in childcare, putting them at risk of disease transmission if they or the children are not vaccinated. Preventing disease in children can also reduce absenteeism for parents who otherwise would take days off work to care for their sick children, leading to a substantial societal burden. Preventing disease in working adults reduces absenteeism and presenteeism, enhancing productivity and contributing in turn to economic growth. Quality of life is essential at all ages. It is fundamental in children for their life chances, educational achievements, and healthy wellbeing. Additionally, preventing common diseases in adults and the elderly also contributes to their quality of life and helps to assure healthy ageing for growing ageing populations. These wider economic and societal values, although difficult to measure, should be taken into consideration in assessments of the economic value and cost-effectiveness of vaccination programmes. PMID:27123178

  1. The societal role of lifelong vaccination

    PubMed Central

    Postma, Maarten J.; Carroll, Stuart; Brandão, Alexandra

    2015-01-01

    The full economic and societal value of vaccination is complex to assess. Although direct protection is the immediate goal of vaccination programmes, it is rare that 100% uptake is attained. An important facet of vaccines value comes from the indirect (or herd) protection they provide. The evolving dynamics of our society, including the increase in the proportion of older individuals enhances the value of indirect protection in reducing disease transmission within the family setting and the society as a whole. For example, grandparents are increasingly involved in childcare, putting them at risk of disease transmission if they or the children are not vaccinated. Preventing disease in children can also reduce absenteeism for parents who otherwise would take days off work to care for their sick children, leading to a substantial societal burden. Preventing disease in working adults reduces absenteeism and presenteeism, enhancing productivity and contributing in turn to economic growth. Quality of life is essential at all ages. It is fundamental in children for their life chances, educational achievements, and healthy wellbeing. Additionally, preventing common diseases in adults and the elderly also contributes to their quality of life and helps to assure healthy ageing for growing ageing populations. These wider economic and societal values, although difficult to measure, should be taken into consideration in assessments of the economic value and cost-effectiveness of vaccination programmes. PMID:27123178

  2. Quality of indoor residential air and health

    PubMed Central

    Dales, Robert; Liu, Ling; Wheeler, Amanda J.; Gilbert, Nicolas L.

    2008-01-01

    About 90% of our time is spent indoors where we are exposed to chemical and biological contaminants and possibly to carcinogens. These agents may influence the risk of developing nonspecific respiratory and neurologic symptoms, allergies, asthma and lung cancer. We review the sources, health effects and control strategies for several of these agents. There are conflicting data about indoor allergens. Early exposure may increase or may decrease the risk of future sensitization. Reports of indoor moulds or dampness or both are consistently associated with increased respiratory symptoms but causality has not been established. After cigarette smoking, exposure to environmental tobacco smoke and radon are the most common causes of lung cancer. Homeowners can improve the air quality in their homes, often with relatively simple measures, which should provide health benefits. PMID:18625986

  3. The New Knowledge Environment: Quality Initiatives in Health Sciences Libraries.

    ERIC Educational Resources Information Center

    Nagle, Ellen

    1996-01-01

    Reviews changes in health sciences libraries, including the evolving role of health sciences librarians, education and training of health sciences librarians, rethinking reference services, impact on quality health care, improving the value of information, virtual libraries, National Library of Medicine initiatives, and quality initiatives. (LRW)

  4. Water Quality and Sustainable Environmental Health

    NASA Astrophysics Data System (ADS)

    Setegn, S. G.

    2014-12-01

    Lack of adequate safe water, the pollution of the aquatic environment and the mismanagement of resources are major causes of ill-health and mortality, particularly in the developing countries. In order to accommodate more growth, sustainable fresh water resource management will need to be included in future development plans. One of the major environmental issues of concern to policy-makers is the increased vulnerability of ground water quality. The main challenge for the sustainability of water resources is the control of water pollution. To understand the sustainability of the water resources, one needs to understand the impact of future land use and climate changes on the natural resources. Providing safe water and basic sanitation to meet the Millennium Development Goals will require substantial economic resources, sustainable technological solutions and courageous political will. A balanced approach to water resources exploitation for development, on the one hand, and controls for the protection of health, on the other, is required if the benefits of both are to be realized without avoidable detrimental effects manifesting themselves. Meeting the millennium development goals for water and sanitation in the next decade will require substantial economic resources, sustainable technological solutions and courageous political will. In addition to providing "improved" water and "basic" sanitation services, we must ensure that these services provide: safe drinking water, adequate quantities of water for health, hygiene, agriculture and development and sustainable sanitation approaches to protect health and the environment.

  5. 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 ...

  6. [Quality of health care, accreditation, and health technology assessment in Croatia: role of agency for quality and accreditation in health].

    PubMed

    Mittermayer, Renato; Huić, Mirjana; Mestrović, Josipa

    2010-12-01

    Avedis Donabedian defined the quality of care as the kind of care, which is expected to maximize an inclusive measure of patient welfare, after taking into account the balance of expected gains and losses associated with the process of care in all its segments. According to the World Medical Assembly, physicians and health care institutions have an ethical and professional obligation to strive for continuous quality improvement of services and patient safety with the ultimate goal to improve both individual patient outcomes as well as population health. Health technology assessment (HTA) is a multidisciplinary process that summarizes information about the medical, social, economic and ethical issues related to the use of a health technology in a systematic, transparent, unbiased, robust manner, with the aim to formulate safe and effective health policies that are patient focused and seek to achieve the highest value. The Agency for Quality and Accreditation in Health was established in 2007 as a legal, public, independent, nonprofit institution under the Act on Quality of Health Care. The Agency has three departments: Department of Quality and Education, Department of Accreditation, and Department of Development, Research, and Health Technology Assessment. According to the Act, the Agency should provide the procedure of granting, renewal and cancellation of accreditation of healthcare providers; proposing to the Minister, in cooperation with professional associations, the plan and program for healthcare quality assurance, improvement, promotion and monitoring; proposing the healthcare quality standards as well as the accreditation standards to the Minister; keeping a register of accreditations and providing a database related to accreditation, healthcare quality improvement, and education; providing education in the field of healthcare quality assurance, improvement and promotion; providing the HTA procedure and HTA database, supervising the healthcare insurance

  7. Utilizing Earth Observations for Societal Issues

    NASA Technical Reports Server (NTRS)

    Habib, Shahid

    2010-01-01

    Over the last four decades a tremendous progress has been made in the Earth science space-based remote sensing observations, technologies and algorithms. Such advancements have improved the predictability by providing lead-time and accuracy of forecast in weather, climate, natural hazards, and natural resources. It has further reduced or bounded the overall uncertainties by partially improving our understanding of planet Earth as an integrated system that is governed by non-linear and chaotic behavior. Many countries such as the US, European Community, Japan, China, Russia, India has and others have invested billions of dollars in developing and launching space-based assets in the low earth (LEO) and geostationary (GEO) orbits. However, the wealth of this scientific knowledge that has potential of extracting monumental socio-economic benefits from such large investments have been slow in reaching the public and decision makers. For instance, there are a number of areas such as water resources and availability, energy forecasting, aviation safety, agricultural competitiveness, disaster management, air quality and public health, which can directly take advantage. Nevertheless, we all live in a global economy that depends on access to the best available Earth Science information for all inhabitants of this planet. This presentation discusses a process to transition Earth science data and products for societal needs including NASA's experience in achieving such objectives. It is important to mention that there are many challenges and issues that pertain to a number of areas such as: (1) difficulties in making a speedy transition of data and information from observations and models to relevant Decision Support Systems (DSS) or tools, (2) data and models inter-operability issues, (3) limitations of spatial, spectral and temporal resolution, (4) communication limitations as dictated by the availability of image processing and data compression techniques. Additionally, the

  8. IMPACT OF FLUORIDE ON DENTAL HEALTH QUALITY

    PubMed Central

    Medjedovic, Eida; Medjedovic, Senad; Deljo, Dervis; Sukalo, Aziz

    2015-01-01

    Introduction: Fluoride is natural element that strengthens teeth and prevents their decay. Experts believe that the best way to prevent cavities is the use of fluoride from multiple sources. Studies even show that in some cases, fluoride can stop already started damage of the teeth. In children younger than 6 years fluoride is incorporated into the enamel of permanent teeth, making the teeth more resistant to the action of bacterial and acids in food. Goal: The aim of this study is to determine the effects of improving the health status of teeth after six months treatment with the use of topical fluoridation 0.5% NaF, and the level and quality of the impact of treatment with chemical 0.5% NaF on the dental health of children at age from 8 to 15 years, in relation to gender and chronological age. This study included school children aged 8 to 15 years who visited health and dental services dependent in Mostar. Results: It is obvious that after the implementation of treatment with 5% NaF by the method of topical fluoridation, health status of subjects from the experimental group significantly improved, so that at the final review 89.71% or 61 subjects of the experimental group had healthy (cured teeth), tooth with dental caries only 5.88% or 4 respondents tooth with dental caries and filling 4.41% or 3 respondents, extracted baby tooth 14.71% or 10 respondents, while for 13.24% of respondents was identified state with still unerupted teeth. Our findings are indirectly confirmed that the six-month treatment of fluoridation with 5% NaF, contributed to statistically significant improvement in overall oral health of the experimental group compared to the control group which was not treated by any dental treatment. Conclusion: It can be concluded that there is a statistically significant difference in the evaluated parameters of oral health of children in the control group compared to the studied parameters of oral health the experimental group of children at the final

  9. Agreement and disagreement on health care quality concepts among academic health professionals: the Saudi case.

    PubMed

    Mahrous, Mohamed Saad

    2014-01-01

    A systematic and rigorous implementation of quality improvement processes is likely to improve the well-being of staff members and heighten their job satisfaction. Assessing professionals' perceptions of health care quality should lead to the betterment of health care services. In Saudi Arabia, no previous studies examine how university health professionals view health care quality concepts. A cross-sectional analytical study employing a self-administered questionnaire with 43 statements assessing quality perceptions of academic health care professionals was used. Despite the agreement of health professionals on numerous quality concepts addressed in this study, there was insufficient agreement on 10 core quality concepts, 3 of which were the following: "quality focuses on customers" (50%), "quality is tangible and therefore measurable" (29.3%), and "quality is data-driven" (62%). Hence, providing health professionals with relevant training likely will generate a better understanding of quality concepts and optimize their performance. PMID:23897553

  10. Sustainable development and quality health care.

    PubMed

    1994-01-01

    On the occasion of Development Week in Canada, Dr. Remi Sogunro spoke in February, 1994, about the many achievements of quality primary health care and PLAN's strategy to achieve sustainability. In one generation, under-5 mortality has been cut by a third. Deaths from measles has been reduced from 2.5 million to 1 million a year. Skeletal deformities from polio also have been reduced from 1/2 million to less than 140,000. Despite all this, there is much more to be attained. 35,000 children under 5 die from preventable diseases every day in developing countries. The health community is working hard to address these silent emergencies. PLAN International's primary health care program targets the poor and undeserved populations where diseases are prevalent. The main focus of PLAN's programs are mothers and children who are most vulnerable to disease. Key interventions that PLAN gives priority to are childhood and maternal immunization programs, including pre- and post-natal care for mothers. Other interventions under PLAN's comprehensive primary health care program include: control of diarrheal diseases and acute respiratory infections, growth monitoring, nutrition and control of STDs and HIV/AIDS infection, water and sanitation, family planning information and educational services, and rehabilitation of the handicapped. "Go in search of people, begin with what they know, build on what they have," goes a Chinese proverb. This also summarizes PLAN's guiding principle for achieving sustainable development: the importance of investing in people. PLAN's programs in the field build partnerships and empower communities. PLAN's emphasis on institution-building and capacity-building with local institutions is an important part of organizational strategy to ensure sustained development. PMID:12179549

  11. Theory and practice for measuring health care quality

    PubMed Central

    Berwick, Donald M.; Knapp, Marian Gilbert

    1987-01-01

    As competition, cost control, and new modes of delivery emerge in health care, there is a need to reexamine both the traditional definitions of health care quality and the methods by which it is measured. Industries other than health care have much to teach regarding the methods for obtaining, analyzing, and displaying data; techniques for problem identification, problem solving, and reassessment; and ideas about organizational factors that produce a high quality product or service. The Quality-of-Care Measurement Department at the Harvard Community Health Plan has built a program that draws from a distinguished health care quality assurance tradition and incorporates techniques that have been successful in other industries. PMID:10312319

  12. Health, Health-Related Quality of Life, and Quality of Life: What is the Difference?

    PubMed

    Karimi, Milad; Brazier, John

    2016-07-01

    The terms health, health-related quality of life (HRQoL), and quality of life (QoL) are used interchangeably. Given that these are three key terms in the literature, their appropriate and clear use is important. This paper reviews the history and definitions of the terms and considers how they have been used. It is argued that the definitions of HRQoL in the literature are problematic because some definitions fail to distinguish between HRQoL and health or between HRQoL and QoL. Many so-called HRQoL questionnaires actually measure self-perceived health status and the use of the phrase QoL is unjustified. It is concluded that the concept of HRQoL as used now is confusing. A potential solution is to define HRQoL as the way health is empirically estimated to affect QoL or use the term to only signify the utility associated with a health state. PMID:26892973

  13. Evaluating health care quality: the moderating role of outcomes.

    PubMed

    Lytle, R S; Mokwa, M P

    1992-03-01

    An integrative model of health care quality is presented. "Health care quality" is defined as provider conformance to patient requirements at three benefit levels: core, intangible, and tangible. The model is operationalized and tested in a clinical setting, a large center for fertility studies with more than 5000 patients. Health care "process variables" such as physician and patient interactions were not as important in patients' evaluations of health care quality when successful outcomes occurred (pregnancy). However, when patients experienced unsuccessful outcomes (no pregnancy), health care "process variables" were important and had a significant influence on patient perceptions of health care quality. Hence, service outcomes can significantly affect the measurement and interpretation of health care quality. Implications for health care management and research are discussed. PMID:10116754

  14. Quality of data in multiethnic health surveys.

    PubMed Central

    Pasick, R. J.; Stewart, S. L.; Bird, J. A.; D'Onofrio, C. N.

    2001-01-01

    OBJECTIVE: There has been insufficient research on the influence of ethno-cultural and language differences in public health surveys. Using data from three independent studies, the authors examine methods to assess data quality and to identify causes of problematic survey questions. METHODS: Qualitative and quantitative methods were used in this exploratory study, including secondary analyses of data from three baseline surveys (conducted in English, Spanish, Cantonese, Mandarin, and Vietnamese). Collection of additional data included interviews with investigators and interviewers; observations of item development; focus groups; think-aloud interviews; a test-retest assessment survey; and a pilot test of alternatively worded questions. RESULTS: The authors identify underlying causes for the 12 most problematic variables in three multiethnic surveys and describe them in terms of ethnic differences in reliability, validity, and cognitive processes (interpretation, memory retrieval, judgment formation, and response editing), and differences with regard to cultural appropriateness and translation problems. CONCLUSIONS: Multiple complex elements affect measurement in a multiethnic survey, many of which are neither readily observed nor understood through standard tests of data quality. Multiethnic survey questions are best evaluated using a variety of quantitative and qualitative methods that reveal different types and causes of problems. PMID:11889288

  15. Indoor air quality and health in schools*

    PubMed Central

    Ferreira, Ana Maria da Conceição; Cardoso, Massano

    2014-01-01

    Objective: To determine whether indoor air quality in schools is associated with the prevalence of allergic and respiratory diseases in children. Methods: We evaluated 1,019 students at 51 elementary schools in the city of Coimbra, Portugal. We applied a questionnaire that included questions regarding the demographic, social, and behavioral characteristics of students, as well as the presence of smoking in the family. We also evaluated the indoor air quality in the schools. Results: In the indoor air of the schools evaluated, we identified mean concentrations of carbon dioxide (CO2) above the maximum reference value, especially during the fall and winter. The CO2 concentration was sometimes as high as 1,942 ppm, implying a considerable health risk for the children. The most prevalent symptoms and respiratory diseases identified in the children were sneezing, rales, wheezing, rhinitis, and asthma. Other signs and symptoms, such as poor concentration, cough, headache, and irritation of mucous membranes, were identified. Lack of concentration was associated with CO2 concentrations above the maximum recommended level in indoor air (p = 0.002). There were no other significant associations. Conclusions: Most of the schools evaluated presented with reasonable air quality and thermal comfort. However, the concentrations of various pollutants, especially CO2, suggest the need for corrective interventions, such as reducing air pollutant sources and improving ventilation. There was a statistically significant association between lack of concentration in the children and exposure to high levels of CO2. The overall low level of pollution in the city of Coimbra might explain the lack of other significant associations. PMID:25029649

  16. Air quality standards must protect public health

    SciTech Connect

    Norman Edelman

    2006-06-15

    Leading medical and public health organizations are deeply concerned about the proposed revisions to the National Ambient Air Quality Standard (NAAQS) that the US Environmental Protection Agency (EPA) announced in December 2005. Led by the American Lung Association (ALA), these groups are fighting to force EPA to finalize stricter standards for fine and coarse particles when the final decision is announced in September 2006. The ALA disagrees strongly with the proposal to exempt coarse particles from agriculture and mining sources, and to exclude communities with populations fewer than 100,000 from protection and monitoring requirements. ALA urges EPA to set the following health-based NAAQS for PM: Annual average PM2.5 standard of 12 {mu}mg/m{sup 3}; 24 hour average PM2.5 standard of 25 {mu}mg.m{sup 3} (99th percentile); 24-hour average PM10-2.5 standard of 25-30 {mu}g/m{sup 3} (99th percentile), applied equally to all areas of the country and to all types of particles. 72 refs., 2 figs., 1 tab.

  17. Understanding the relationships between air quality and human health

    SciTech Connect

    S.T. Rao

    2006-09-15

    Although there has been substantial progress in improving ambient air quality in the United States, atmospheric concentrations of ozone and fine particulate matter (PM2.5) continue to exceed the National Ambient Air Quality Standards in many locations. Consequently, a large portion of the U.S. population continues to be exposed to unhealthful levels of ozone and fine particles. This issue of EM, entitled 'Understanding the relationships between air quality and human health' presents a series of articles that focus on the relationships between air quality and human health - what we know so far and the challenges that remain. Their titles are: Understanding the effects of air pollution on human health; Assessing population exposures in studies of human health effects of PM2.5; Establishing a national environmental public health tracking network; Linking air quality and exposure models; and On alert: air quality forecasting and health advisory warnings.

  18. Attributes of Quality in Audiovisual Materials for Health Professionals.

    ERIC Educational Resources Information Center

    Suter, Emanuel; Waddell, Wendy H.

    1981-01-01

    Defines attributes of quality in content, instructional design, technical production, and packaging of audiovisual materials used in the education of health professionals. Seven references are listed. (FM)

  19. United States societal experiments via the Communications Technology Satellite

    NASA Technical Reports Server (NTRS)

    Donoughe, P. L.

    1976-01-01

    After a brief description of the Communication Technology Satellite and its U.S. coverage, the U.S. societal experiments via the CTS are discussed. These include education (college curriculum sharing, and project interchange), health care (biomedical communications, health communications, and communication support for decentralized education), and community and special experiments (satellite library information network, and transportable earth terminal).

  20. Electronic Health Records and Quality of Care

    PubMed Central

    Yanamadala, Swati; Morrison, Doug; Curtin, Catherine; McDonald, Kathryn; Hernandez-Boussard, Tina

    2016-01-01

    Abstract Electronic health records (EHRs) were implemented to improve quality of care and patient outcomes. This study assessed the relationship between EHR-adoption and patient outcomes. We performed an observational study using State Inpatient Databases linked to American Hospital Association survey, 2011. Surgical and medical patients from 6 large, diverse states were included. We performed univariate analyses and developed hierarchical regression models relating level of EHR utilization and mortality, readmission rates, and complications. We evaluated the effect of EHR adoption on outcomes in a difference-in-differences analysis, 2008 to 2011. Medical and surgical patients sought care at hospitals reporting no EHR (3.5%), partial EHR (55.2%), and full EHR systems (41.3%). In univariate analyses, patients at hospitals with full EHR had the lowest rates of inpatient mortality, readmissions, and Patient Safety Indicators followed by patients at hospitals with partial EHR and then patients at hospitals with no EHR (P < 0.05). However, these associations were not robust when accounting for other patient and hospital factors, and adoption of an EHR system was not associated with improved patient outcomes (P > 0.05). These results indicate that patients receiving medical and surgical care at hospitals with no EHR system have similar outcomes compared to patients seeking care at hospitals with a full EHR system, after controlling for important confounders. To date, we have not yet seen the promised benefits of EHR systems on patient outcomes in the inpatient setting. EHRs may play a smaller role than expected in patient outcomes and overall quality of care. PMID:27175631

  1. Creating Quality Improvement Culture in Public Health Agencies

    PubMed Central

    Mahanna, Elizabeth; Joly, Brenda; Zelek, Michael; Riley, William; Verma, Pooja; Fisher, Jessica Solomon

    2014-01-01

    Objectives. We conducted case studies of 10 agencies that participated in early quality improvement efforts. Methods. The agencies participated in a project conducted by the National Association of County and City Health Officials (2007–2008). Case study participants included health directors and quality improvement team leaders and members. We implemented multiple qualitative analysis processes, including cross-case analysis and logic modeling. We categorized agencies according to the extent to which they had developed a quality improvement culture. Results. Agencies were conducting informal quality improvement projects (n = 4), conducting formal quality improvement projects (n = 3), or creating a quality improvement culture (n = 4). Agencies conducting formal quality improvement and creating a quality improvement culture had leadership support for quality improvement, participated in national quality improvement initiatives, had a greater number of staff trained in quality improvement and quality improvement teams that met regularly with decision-making authority. Agencies conducting informal quality improvement were likely to report that accreditation is the major driver for quality improvement work. Agencies creating a quality improvement culture were more likely to have a history of evidence-based decision-making and use quality improvement to address emerging issues. Conclusions. Our findings support previous research and add the roles of national public health accreditation and emerging issues as factors in agencies’ ability to create and sustain a quality improvement culture. PMID:24228680

  2. History: Cooling and societal change

    NASA Astrophysics Data System (ADS)

    Haldon, John

    2016-03-01

    The rise and fall of civilizations over the past two millennia was set against a backdrop of climate change. High-resolution climate records evince a link between societal change and a period of cooling in the sixth and seventh centuries.

  3. Societal Development and Social Change

    ERIC Educational Resources Information Center

    Nderu-Boddington, Eulalee

    2008-01-01

    This article compares and contrasts the theories of three major writers on societal change: Chirot discusses the economic power struggles within and among core, peripheral, and semiperipheral societies, Toffler exposes a future in which major power shifts could have cataclysmic results, and Bruner emphasizes the importance of education to temper…

  4. [Chronic pain management: societal impact].

    PubMed

    Serrie, Alain

    2015-01-01

    Pain is a real issue of public health, quality and evolution of a system of health test: this is a major social problem. Pain management meets a humanistic, ethical purpose and dignity of man because of the physical and psychological implications. It induces a disability which excludes the patient of society gradually or suddenly. The physical pain and mental suffering to all ages of life make more vulnerable people weakened by disease. Rebel chronic pain are sources of disability, disabilities, disability and major alterations in the quality of life. All of these data shows the impact of pain and its intensity on the professional conditions, on professional activity and productivity, on the use of care systems (very significant increase in medical consultations, hospitalizations), as well as on the mental and physical health. These results confirmed analyses which consider that the unrelieved pain has a major economic impact on care systems and constitutes a public health problem with around two thirds of persons professionally impacted by pain. The progress of medicine has helped the healing of certain serious diseases, but also favoured acute diseases to turn to chronic diseases. The result is an increase in of lifetime sometimes without disease, but this survival may be also accompanied by disease or disability. Progress, pain and suffering, the end of life, ethics will be the core of the basic thoughts of tomorrow. PMID:27509674

  5. [Quality planning of Family Health Units using Quality Function Deployment (QFD)].

    PubMed

    Volpato, Luciana Fernandes; Meneghim, Marcelo de Castro; Pereira, Antonio Carlos; Ambrosano, Gláucia Maria Bovi

    2010-08-01

    Quality is an indispensible requirement in the health field, and its pursuit is necessary in order to meet demands by a population that is aware of its rights, as part of the essence of good work relations, and to decrease technological costs. Quality thus involves all parties to the process (users and professionals), and is no longer merely an attribute of the health service. This study aimed to verify the possibility of quality planning in the Family Health Units, using Quality Function Deployment (QFD). QFD plans quality according to user satisfaction, involving staff professionals and identifying new approaches to improve work processes. Development of the array, called the House of Quality, is this method's most important characteristics. The results show a similarity between the quality demanded by users and the quality planned by professionals. The current study showed that QFD is an efficient tool for quality planning in public health services. PMID:21229215

  6. Quality improvement and accountability in the Danish health care system.

    PubMed

    Mainz, Jan; Kristensen, Solvejg; Bartels, Paul

    2015-12-01

    Denmark has unique opportunities for quality measurement and benchmarking since Denmark has well-developed health registries and unique patient identifier that allow all registries to include patient-level data and combine data into sophisticated quality performance monitoring. Over decades, Denmark has developed and implemented national quality and patient safety initiatives in the healthcare system in terms of national clinical guidelines, performance and outcome measurement integrated in clinical databases for important diseases and clinical conditions, measurement of patient experiences, reporting of adverse events, national handling of patient complaints, national accreditation and public disclosure of all data on the quality of care. Over the years, Denmark has worked up a progressive and transparent just culture in quality management; the different actors at the different levels of the healthcare system are mutually attentive and responsive in a coordinated effort for quality of the healthcare services. At national, regional, local and hospital level, it is mandatory to participate in the quality initiatives and to use data and results for quality management, quality improvement, transparency in health care and accountability. To further develop the Danish governance model, it is important to expand the model to the primary care sector. Furthermore, a national quality health programme 2015-18 recently launched by the government supports a new development in health care focusing upon delivering high-quality health care-high quality is defined by results of value to the patients. PMID:26443814

  7. Health-weighted Composite Quality Metrics Offer Promise to Improve Health Outcomes in a Learning Health System.

    PubMed

    Braithwaite, Scott; Stine, Nicholas

    2013-01-01

    Health system leaders sometimes adopt quality metrics without robust supporting evidence of improvements in quality and/or quantity of life, which may impair rather than facilitate improved health outcomes. In brief, there is now no easy way to measure how much "health" is conferred by a health system. However, we argue that this goal is achievable. Health-weighted composite quality metrics have the potential to measure "health" by synthesizing individual evidence-based quality metrics into a summary measure, utilizing relative weightings that reflect the relative amount of health benefit conferred by each constituent quality metric. Previously, it has been challenging to create health-weighted composite quality metrics because of methodological and data limitations. However, advances in health information technology and mathematical modeling of disease progression promise to help mitigate these challenges by making patient-level data (eg, from the electronic health record and mobile health (mHealth) more accessible and more actionable for use. Accordingly, it may now be possible to use health information technology to calculate and track a health-weighted composite quality metric for each patient that reflects the health benefit conferred to that patient by the health system. These health-weighted composite quality metrics can be employed for a multitude of important aims that improve health outcomes, including quality evaluation, population health maximization, health disparity attenuation, panel management, resource allocation, and personalization of care. We describe the necessary attributes, the possible uses, and the likely limitations and challenges of health-weighted composite quality metrics using patient-level health data. PMID:25848572

  8. The Equity and Quality (EQual) Health-Care Project: A Connecticut Health Foundation initiative with Qualidigm.

    PubMed

    Van Hoof, Thomas J; Mahier, Stephen E; Barr, Judith K; Krause, Elizabeth M S; Kelvey-Albert, Michele; Curry, Maureen; Meehan, Thomas P

    2010-05-01

    In response to the growing incidence and prevalence of diabetes, quality and disparity of care concerns, and the increasing diversity of the US and Connecticut's populations, the Connecticut Health Foundation funded Qualidigm to implement the Equity and Quality (EQual) Health-Care Project. Now in its second full year, the EQualHealth-CareProject is helping eight primary-care practices in Connecticut improve the equity and quality of diabetes care through technology, education, and quality improvement. PMID:20509420

  9. Legal issues concerning electronic health information: privacy, quality, and liability.

    PubMed

    Hodge, J G; Gostin, L O; Jacobson, P D

    1999-10-20

    Personally identifiable health information about individuals and general medical information is increasingly available in electronic form in health databases and through online networks. The proliferation of electronic data within the modern health information infrastructure presents significant benefits for medical providers and patients, including enhanced patient autonomy, improved clinical treatment, advances in health research and public health surveillance, and modern security techniques. However, it also presents new legal challenges in 3 interconnected areas: privacy of identifiable health information, reliability and quality of health data, and tortbased liability. Protecting health information privacy (by giving individuals control over health data without severely restricting warranted communal uses) directly improves the quality and reliability of health data (by encouraging individual uses of health services and communal uses of data), which diminishes tort-based liabilities (by reducing instances of medical malpractice or privacy invasions through improvements in the delivery of health care services resulting in part from better quality and reliability of clinical and research data). Following an analysis of the interconnectivity of these 3 areas and discussing existing and proposed health information privacy laws, recommendations for legal reform concerning health information privacy are presented. These include (1) recognizing identifiable health information as highly sensitive, (2) providing privacy safeguards based on fair information practices, (3) empowering patients with information and rights to consent to disclosure (4) limiting disclosures of health data absent consent, (5) incorporating industry-wide security protections, (6) establishing a national data protection authority, and (7) providing a national minimal level of privacy protections. PMID:10535438

  10. INTEGRATING AIR QUALITY DATA TO INFORM HUMAN HEALTH DECISIONS

    EPA Science Inventory

    The August 1-2, 2005 EPA-NIEHS workshop is addressing the linkages between air quality and human health. My presentation will discuss the strengths and limitations of various databases for relating air quality to health impacts. Specifically, the need for fusing ground-based, s...

  11. UNDERSTANDING THE RELATIONSHIPS BETWEEN AIR QUALITY AND HUMAN HEALTH

    EPA Science Inventory

    This issue of EM presents a series of articles that focus on air quality and human health--what we know so far and the challenges that remain. The first article provides an overview of the problem at hand and approaches to properly address air quality and human health issues. Fo...

  12. [Health, social, societal and organizational political effects of the implementation of the ICF on integrated rehabilitation--a vision of the conversion and its consequences].

    PubMed

    Seger, W; Schian, H-M; Steinke, B; Heipertz, W; Schuntermann, M

    2004-06-01

    Fundamental joint principles on expert opinions according to the social law code no. IX (SGB IX) and their application to a virtual individual case history were published recently in this journal. They are based on the ICF (International Classification of Functioning, Disability and Health, WHO 2001). A visionary review of the chances and prospects for the further development of the rehabilitative system is outlined and the necessary steps for their implementation are demonstrated. PMID:15206043

  13. Obstacles to employers' pursuit of health care quality.

    PubMed

    Hargraves, J Lee; Trude, Sally

    2002-01-01

    Large employers' roles in improving health care quality are shifting away from value-based purchasing toward direct efforts to improve health care delivery within local markets. Although most large employers adopted the tools required for value-based purchasing, inadequate information on quality has frustrated employers and limited their ability to make choices based on quality. More recent quality initiatives aimed at directly improving local health delivery systems may be limited to specific markets where the largest employers can exert substantial influence. PMID:12224883

  14. The legal framework for health care quality assurance in Germany.

    PubMed

    Sauerland, Dirk

    2009-01-01

    Like most industrialized countries, Germany's health care system is facing two major challenges. The first is to find a sustainable financing system for increasing health care expenditures. The second is to ensure - and improve - the quality of care provided. This article describes the status quo in quality assurance in Germany and analyses the changes introduced into the SHI (Statutory Health Insurance) system with the Modernization Act of 2004. First, a theoretical framework for quality assurance that is consistent with the logic of the German social market economy is outlined. The analysis then describes new actors and their duties in the field of quality assurance, highlighting improvements in regulation and the regulatory instruments applied. Although the strategy for quality assurance is still dominated by regulation and corporatist bodies, the latest reform acts of 2004 and 2007 focus on more and better information about the quality of services provided - an important prerequisite for more competitive elements in the German health care system. PMID:19099618

  15. Assuring Quality Health Care in the Emergency Department

    PubMed Central

    Letvak, Susan; Rhew, Denise

    2015-01-01

    The provision of quality healthcare is an international mandate. The provision of quality healthcare for mental health patients poses unique challenges. Nowhere is this challenge greater than in the emergency department. The purpose of this manuscript is to describe evidence-based initiatives for improving the quality of care of mental health patients in the emergency department. Specifically, the use of telepsychiatry and reducing provider biases will be presented.

  16. Health and health-related quality of life among treatment-seeking overweight and obese adults: associations with internalized weight bias

    PubMed Central

    2013-01-01

    Background Weight bias is widespread and has numerous harmful consequences. The internalization of weight bias has been associated with significant psychological impairment. Other forms of discrimination, such as racial and anti-gay bias, have been shown to be associated with physical health impairment. However, research has not yet examined whether internalized weight bias is associated with physical as well as psychological impairment in health-related quality of life. Methods Participants included 120 treatment-seeking overweight and obese adults (mean body mass index = 35.09; mean age = 48.31; 68% female; 59% mixed or Asian ethnicity). Participants were administered measures of internalized weight bias and physical and mental health-related quality of life, and they were assessed for the presence of chronic medical conditions, use of prescription and non-prescription medications, and current exercise. Results Internalized weight bias was significantly correlated with health impairment in both physical (r = −.25) and mental (r = −.48) domains. In multivariate analyses controlling for body mass index, age, and other physical health indicators, internalized weight bias significantly and independently predicted impairment in both physical (β = −.31) and mental (β = −.47) health. Conclusions Internalized weight bias was associated with greater impairment in both the physical and mental domains of health-related quality of life. Internalized weight bias also contributed significantly to the variance in physical and mental health impairment over and above the contributions of BMI, age, and medical comorbidity. Consistent with the association between prejudice and physical health in other minority groups, these findings suggest a link between the effects of internalized weight-based discrimination and physical health. Research is needed on strategies to prevent weight bias and its internalization on both a societal and individual level. PMID:24764526

  17. Financial Health of Child Care Facilities Affects Quality of Care.

    ERIC Educational Resources Information Center

    Brower, Mary R.; Sull, Theresa M.

    2003-01-01

    Contends that child care facility owners, boards of directors, staff, and parents need to focus on financial management, as poor financial health compromises the quality of care for children. Specifically addresses the issues of: (1) concern for providing high quality child care; (2) the connection between quality and money; and (3) strengthening…

  18. Health Curriculum and School Quality: International Perspectives.

    ERIC Educational Resources Information Center

    Hawes, Hugh

    2003-01-01

    Looks at health education content in primary schools in Africa and India. Argues that health education is vital because it links home with school. Notes that curriculum planners have difficulty planning and delivering health education because they cannot work across the curriculum and rely on textbooks and examinations. (CAJ)

  19. Health-Related Quality of Life in HIV Disease.

    ERIC Educational Resources Information Center

    Hays, Ron D.; And Others

    1995-01-01

    The structure of health-related quality of life (HRQOL) in persons with human immunodeficiency virus (HIV) was studied in 205 symptomatic adults. Confirmatory factor analysis supported a two-factor model of HRQOL, with physical and mental health dimensions. Correlations of HRQOL with other aspects of health and support are discussed. (SLD)

  20. Quality assurance for health and environmental chemistry: 1990

    SciTech Connect

    Gautier, M.A.; Gladney, E.S.; Koski, N.L.; Jones, E.A.; O'Malley, B.T.

    1991-10-01

    This report documents the continuing quality assurance efforts of the Health and Environmental Chemistry Group (HSE-9) at the Los Alamos National Laboratory. The philosophy, methodology, computing resources, and laboratory information management system used by the quality assurance program to encompass the diversity of analytical chemistry practiced in the group are described. Included in the report are all quality assurance reference materials used, along with their certified or consensus concentrations, and all analytical chemistry quality assurance measurements made by HSE-9 during 1990.

  1. Quality of care and racial health disparities: a strategic overview.

    PubMed

    Chassin, Mark R; Anderson, Rebecca M

    2008-01-01

    Substantial racial and ethnic disparities in health and health care exist in the United States. The Department of Health Policy at the Mount Sinai School of Medicine has developed a strategy for reducing those disparities that builds upon its quality improvement experience. This article discusses the utility of applying quality improvement principles to the development of interventions to eliminate underuse of effective treatments and reduce the disparities that may arise from this quality problem. We present a conceptual model of racial disparities in health and our underuse hypothesis. Parallels between our disparities research strategy and six sigma quality improvement methods are described. Finally, the article provides an example of how we have been able to successfully implement proven-effective health improvement programs in the Harlem community even after grant funding has ended. PMID:18306237

  2. Issues in Measuring and Improving Health Care Quality

    PubMed Central

    Friedman, Maria A.

    1995-01-01

    This issue of the Health Care Financing Review focuses on issues and advances in measuring and improving the quality of care, particularly for Medicare and Medicaid beneficiaries. Discussions of quality-related topics are especially timely, given the growing and widespread interest in improving quality in the organization, financing, and delivery of health care services. This article has several purposes. The first is to provide a brief description of some of the causes underlying the growth of the health care quality movement; the second is to provide a contextual framework for discussion of some of the overarching themes that emerge in this issue. These themes include examining conceptual issues, developing quality measures for specific sites and populations, and creating or adapting data sets for quality-measurement purposes. PMID:10151882

  3. Is health care ready for Six Sigma quality?

    PubMed

    Chassin, M R

    1998-01-01

    Serious, widespread problems exist in the quality of U.S. health care: too many patients are exposed to the risks of unnecessary services; opportunities to use effective care are missed; and preventable errors lead to injuries. Advanced practitioners of industrial quality management, like Motorola and General Electric, have committed themselves to reducing the frequency of defects in their business processes to fewer than 3.4 per million, a strategy known as Six Sigma Quality. In health care, quality problems frequently occur at rates of 20 to 50 percent, or 200,000 to 500,000 per million. In order to approach Six Sigma levels of quality, the health care sector must address the underlying causes of error and make important changes: adopting new educational models; devising strategies to increase consumer awareness; and encouraging public and private investment in quality improvement. PMID:9879303

  4. The Unique Impact of Abolition of Jim Crow Laws on Reducing Inequities in Infant Death Rates and Implications for Choice of Comparison Groups in Analyzing Societal Determinants of Health

    PubMed Central

    Chen, Jarvis T.; Coull, Brent; Waterman, Pamela D.; Beckfield, Jason

    2013-01-01

    Objectives. We explored associations between the abolition of Jim Crow laws (i.e., state laws legalizing racial discrimination overturned by the 1964 US Civil Rights Act) and birth cohort trends in infant death rates. Methods. We analyzed 1959 to 2006 US Black and White infant death rates within and across sets of states (polities) with and without Jim Crow laws. Results. Between 1965 and 1969, a unique convergence of Black infant death rates occurred across polities; in 1960 to 1964, the Black infant death rate was 1.19 times higher (95% confidence interval [CI] = 1.18, 1.20) in the Jim Crow polity than in the non–Jim Crow polity, whereas in 1970 to 1974 the rate ratio shrank to and remained at approximately 1 (with the 95% CI including 1) until 2000, when it rose to 1.10 (95% CI = 1.08, 1.12). No such convergence occurred for Black–White differences in infant death rates or for White infants. Conclusions. Our results suggest that abolition of Jim Crow laws affected US Black infant death rates and that valid analysis of societal determinants of health requires appropriate comparison groups. PMID:24134378

  5. Health quality initiative promoted by large employers.

    PubMed

    Fine, Allan

    2004-01-01

    The goal of Care Focused Purchasing is to create a scorecard of providers and physicians enabling health care consumers to make better decisions. The employer group is united around the belief that current health plan designs and cost-sharing strategies are short-sighted. They are looking for additional companies to join this organization. PMID:15702565

  6. Statistical Estimation of Dose-response Functions of Respiratory Diseases and Societal Costs of Haze-related Air Pollution in Brunei Darussalam

    NASA Astrophysics Data System (ADS)

    Anaman, K. A.; Ibrahim, N.

    - The effects on human health resulting from the January to April 1998 haze-related air pollution episode in Brunei Darussalam were analysed for five groups of diseases of the respiratory system. The analysis concentrated on the statistical estimation of dose-response functions which related the number of cases of respiratory diseases to the level of quality of ambient environment as measured by the pollutants standards index (PSI) and other environmental variables. The total number of cases of the five groups of diseases was shown to be significantly related to PSI and temperature. Societal costs were also estimated. The results showed that societal costs were significantly related to PSI, temperature and relative humidity. Societal costs increased with higher PSI and relative humidity but decreased with increasing temperature.

  7. A model of continuous quality improvement for health service organisations.

    PubMed

    Thornber, M

    1992-01-01

    Continuous Quality Improvement (or Total Quality Management) is an approach to management originally used in manufacturing and now being applied in the health services. This article describes a model of Continuous Quality Improvement which has been used in NSW public and private hospitals. The model consists of Ten Key Elements. The first driving force of this model is 'defining quality in terms of customer expectations' of quality. The second driving force emphasises that 'quality improvement is a leadership issue'. Leaders are required to: coordinate staff participation in work process analysis; train staff in the customer service orientation; lead effective meetings and negotiate with both internal and external service partners. Increased staff motivation, quality improvement and reduction in running costs are seen to be the benefits of CQI for health service organisations. PMID:10117452

  8. Remote Sensing, Air Quality, and Public Health

    NASA Technical Reports Server (NTRS)

    Quattrochi, Dale A.; Rickman, Douglas; Mohammad, Al-Hamdan; Crosson, William; Estes, Maurice, Jr.; Limaye, Ashutosh; Qualters, Judith

    2008-01-01

    HELIX-Atlanta was developed to support current and future state and local EPHT programs to implement data linking demonstratio'n projects which could be part of the EPHT Network. HELIX-Atlanta is a pilot linking project in Atlanta for CDC to learn about the challenges the states will encounter. NASA/MSFC and the CDC are partners in linking environmental and health data to enhance public health surveillance. The use of NASA technology creates value - added geospatial products from existing environmental data sources to facilitate public health linkages. Proving the feasibility of the approach is the main objective

  9. Quality of Life, Health Status, and Health Service Utilization Related to a New Measure of Health Literacy FLIGHT/VIDAS

    PubMed Central

    Ownby, Raymond L; Acevedo, Amarilis; Jacobs, Robin J.; Caballero, Joshua; Waldrop-Valverde, Drenna

    2014-01-01

    Objective Researchers have identified significant limitations in some currently-used measures of health literacy. The purpose of this paper is to present data on the relation of health-related quality of life, health status, and health service utilization to performance on a new measure of health literacy in a nonpatient population. Methods The new measure was administered to 475 English- and Spanish-speaking community-dwelling volunteers along with existing measures of health literacy and assessments of health-related quality of life, health status, and healthcare service utilization. Relations among measures were assessed via correlations and health status and utilization was tested across levels of health literacy using ANCOVA models. Results The new health literacy measure is significantly related to existing measures of health literacy as well as to participants’ health-related quality of life. Persons with lower levels of health literacy reported more health conditions, more frequent physical symptoms, and greater healthcare service utilization. Conclusion The new measure of health literacy is valid and shows relations to measures of conceptually-related constructs such as quality of life and health behaviors. Practice Implications: FLIGHT/VIDAS may be useful to researchers and clinicians interested in a computer administered and scored measure of health literacy. PMID:24856447

  10. Electrical stimulation: a societal perspective.

    PubMed

    Gater, D R; McDowell, S M; Abbas, J J

    2000-01-01

    Societal perspective on functional electrical stimulation is colored by media influence, popular thought, and political climate as much as by the science that supports it. The purpose of this article is to examine how these influences facilitate or inhibit the application of electrical stimulation in today's world and to describe the challenges facing the use of electrical stimulation in the future. Emphasis will be placed on perceived need, cost, and available resources and how these factors must be addressed to utilize functional electrical stimulation successfully in society. PMID:11067581

  11. Societal responses to the Anthropocene.

    PubMed

    Tickell, Crispin

    2011-03-13

    This article discusses the societal responses to the Anthropocene. First we need to confront the effects of our own population proliferation in all its aspects; next to look again at economics and replace consumerism as a goal; then to work out new ways of generating energy; to manage and adapt to what is in effect climate destabilization; to give higher priority to conservation of the natural world; and last to create the necessary institutional means of coping with global problems in a world in which society is more integrated than ever before. PMID:21282154

  12. Health, Quality of Care and Quality of Life: A Case of Frail Older Adults

    ERIC Educational Resources Information Center

    Hsieh, Chang-Ming

    2009-01-01

    This study explores the relationship between health, quality of care of geriatric case management and quality of life for the purpose of furthering the understanding of the relationship between quality of life and geriatric case management. Using survey data from a group of frail older adults, this study assesses the relative merit of two…

  13. ASSESSING BIOACCUMULATION FOR DERIVING NATIONAL HUMAN HEALTH WATER QUALITY CRITERIA

    EPA Science Inventory

    The United States Environmental Protection Agency is revising its methodology for deriving national ambient water quality criteria (AWQC) to protect human health. A component of this guidance involves assessing the potential for chemical bioaccumulation in commonly consumed fish ...

  14. Improving Health Promotion Using Quality Improvement Techniques in Australian Indigenous Primary Health Care.

    PubMed

    Percival, Nikki; O'Donoghue, Lynette; Lin, Vivian; Tsey, Komla; Bailie, Ross Stewart

    2016-01-01

    Although some areas of clinical health care are becoming adept at implementing continuous quality improvement (CQI) projects, there has been limited experimentation of CQI in health promotion. In this study, we examined the impact of a CQI intervention on health promotion in four Australian Indigenous primary health care centers. Our study objectives were to (a) describe the scope and quality of health promotion activities, (b) describe the status of health center system support for health promotion activities, and (c) introduce a CQI intervention and examine the impact on health promotion activities and health centers systems over 2 years. Baseline assessments showed suboptimal health center systems support for health promotion and significant evidence-practice gaps. After two annual CQI cycles, there were improvements in staff understanding of health promotion and systems for planning and documenting health promotion activities had been introduced. Actions to improve best practice health promotion, such as community engagement and intersectoral partnerships, were inhibited by the way health center systems were organized, predominately to support clinical and curative services. These findings suggest that CQI can improve the delivery of evidence-based health promotion by engaging front line health practitioners in decision-making processes about the design/redesign of health center systems to support the delivery of best practice health promotion. However, further and sustained improvements in health promotion will require broader engagement of management, senior staff, and members of the local community to address organizational and policy level barriers. PMID:27066470

  15. Improving Health Promotion Using Quality Improvement Techniques in Australian Indigenous Primary Health Care

    PubMed Central

    Percival, Nikki; O’Donoghue, Lynette; Lin, Vivian; Tsey, Komla; Bailie, Ross Stewart

    2016-01-01

    Although some areas of clinical health care are becoming adept at implementing continuous quality improvement (CQI) projects, there has been limited experimentation of CQI in health promotion. In this study, we examined the impact of a CQI intervention on health promotion in four Australian Indigenous primary health care centers. Our study objectives were to (a) describe the scope and quality of health promotion activities, (b) describe the status of health center system support for health promotion activities, and (c) introduce a CQI intervention and examine the impact on health promotion activities and health centers systems over 2 years. Baseline assessments showed suboptimal health center systems support for health promotion and significant evidence-practice gaps. After two annual CQI cycles, there were improvements in staff understanding of health promotion and systems for planning and documenting health promotion activities had been introduced. Actions to improve best practice health promotion, such as community engagement and intersectoral partnerships, were inhibited by the way health center systems were organized, predominately to support clinical and curative services. These findings suggest that CQI can improve the delivery of evidence-based health promotion by engaging front line health practitioners in decision-making processes about the design/redesign of health center systems to support the delivery of best practice health promotion. However, further and sustained improvements in health promotion will require broader engagement of management, senior staff, and members of the local community to address organizational and policy level barriers. PMID:27066470

  16. Applications and societal benefits of plastics.

    PubMed

    Andrady, Anthony L; Neal, Mike A

    2009-07-27

    This article explains the history, from 1600 BC to 2008, of materials that are today termed 'plastics'. It includes production volumes and current consumption patterns of five main commodity plastics: polypropylene, polyethylene, polyvinyl chloride, polystyrene and polyethylene terephthalate. The use of additives to modify the properties of these plastics and any associated safety, in use, issues for the resulting polymeric materials are described. A comparison is made with the thermal and barrier properties of other materials to demonstrate the versatility of plastics. Societal benefits for health, safety, energy saving and material conservation are described, and the particular advantages of plastics in society are outlined. Concerns relating to littering and trends in recycling of plastics are also described. Finally, we give predictions for some of the potential applications of plastic over the next 20 years. PMID:19528050

  17. Applications and societal benefits of plastics

    PubMed Central

    Andrady, Anthony L.; Neal, Mike A.

    2009-01-01

    This article explains the history, from 1600 BC to 2008, of materials that are today termed ‘plastics’. It includes production volumes and current consumption patterns of five main commodity plastics: polypropylene, polyethylene, polyvinyl chloride, polystyrene and polyethylene terephthalate. The use of additives to modify the properties of these plastics and any associated safety, in use, issues for the resulting polymeric materials are described. A comparison is made with the thermal and barrier properties of other materials to demonstrate the versatility of plastics. Societal benefits for health, safety, energy saving and material conservation are described, and the particular advantages of plastics in society are outlined. Concerns relating to littering and trends in recycling of plastics are also described. Finally, we give predictions for some of the potential applications of plastic over the next 20 years. PMID:19528050

  18. Construction of an environmental quality index for public health research

    EPA Science Inventory

    A more comprehensive estimate of environmental quality would improve our understanding of the relationship between environmental conditions and human health. An environmental quality index (EQI) for all counties in the U.S. was developed. The EQI was developed in four parts: doma...

  19. Toward a Socioecological Conception of Health.

    ERIC Educational Resources Information Center

    Lawson, Hal A.

    1992-01-01

    Many academic fields claim jurisdiction over health research and practice. The paper examines dominant conceptions of health as a personal quality or state of being, noting the market-oriented, competitive relationship among fields. It presents a socioecological conception of health which emphasizes individuals but also includes societal and…

  20. The Quality Assurance Project: introducing quality improvement to primary health care in less developed countries.

    PubMed

    Nicholas, D D; Heiby, J R; Hatzell, T A

    1991-01-01

    Persistently excessive morbidity and mortality rates in less developed countries (LDCs) served by primary health care systems suggest that the quality of services is inadequate. The PRICOR project, sponsored by the United States Agency for International Development, has designed and implemented methods for quality assessment and problem solving in LDC health systems. After developing comprehensive lists of essential activities and tasks, similar to practice parameters, for seven child survival interventions, PRICOR supported comprehensive quality assessment studies in twelve LDC countries. The studies, yielding over 6000 observations of health worker-client encounters, indicated highly prevalent, serious program deficiencies in areas including diagnosis, treatment, patient education and supervision. To facilitate corrective action, PRICOR assisted managers in conducting operations research to resolve priority problems revealed by the assessments. The recently initiated Quality Assurance Project is building on PRICOR techniques in designing and implementing sustainable continuous quality improvement programs for LDC health systems. PMID:1782383

  1. Report Central: quality reporting tool in an electronic health record.

    PubMed

    Jung, Eunice; Li, Qi; Mangalampalli, Anil; Greim, Julie; Eskin, Michael S; Housman, Dan; Isikoff, Jeremy; Abend, Aaron H; Middleton, Blackford; Einbinder, Jonathan S

    2006-01-01

    Quality reporting tools, integrated with ambulatory electronic health records, can help clinicians and administrators understand performance, manage populations, and improve quality. Report Central is a secure web report delivery tool built on Crystal Reports XItrade mark and ASP.NET technologies. Pilot evaluation of Report Central indicates that clinicians prefer a quality reporting tool that is integrated with our home-grown EHR to support clinical workflow. PMID:17238590

  2. Report Central: Quality Reporting Tool in an Electronic Health Record

    PubMed Central

    Jung, Eunice; Li, Qi; Mangalampalli, Anil; Greim, Julie; Eskin, Michael S.; Housman, Dan; Isikoff, Jeremy; Abend, Aaron H.; Middleton, Blackford; Einbinder, Jonathan S.

    2006-01-01

    Quality reporting tools, integrated with ambulatory electronic health records, can help clinicians and administrators understand performance, manage populations, and improve quality. Report Central is a secure web report delivery tool built on Crystal Reports XI™ and ASP.NET technologies. Pilot evaluation of Report Central indicates that clinicians prefer a quality reporting tool that is integrated with our home-grown EHR to support clinical workflow. PMID:17238590

  3. Health Conditions and Perceived Quality of Life in Retirement.

    ERIC Educational Resources Information Center

    Dorfman, Lorraine T.

    1995-01-01

    Investigates the effects of specific health conditions on perceived quality of life for retirees (n=451). Pulmonary disease was a predictor of dissatisfaction for both sexes. Pulmonary disease and heart attack were the strongest predictors of dissatisfaction with health for men, followed closely by stroke. Arthritis was the strongest predictor of…

  4. The Health-Related Quality of Life of Custodial Grandparents

    ERIC Educational Resources Information Center

    Neely-Barnes, Susan L.; Graff, J. Carolyn; Washington, Gregory

    2010-01-01

    Health-related quality of life (HRQOL) was explored in a sample of 119 custodial grandparents. A latent profile analysis identified three groups of grandparents along a continuum of good to poor HRQOL, with most custodial grandparents reporting Short Form-12 Health Survey (version 2) scores significantly below U.S. population means. Grandparent…

  5. The Quality of Work and Youth Mental Health.

    ERIC Educational Resources Information Center

    Mortimer, Jeylan T.; Harley, Carolyn; Staff, Jeremy

    2002-01-01

    Data from the Youth Development Study on adolescents who worked in high school were used to examine mental health, work stress, and work/school interactions. The quality of high school work experiences had significant consequences for mental states during high school, but had little effect on long-term mental health. (Contains 70 references.) (SK)

  6. Racial and Ethnic Disparities in the Quality of Health Care.

    PubMed

    Fiscella, Kevin; Sanders, Mechelle R

    2016-01-01

    The annual National Healthcare Quality and Disparities Reports document widespread and persistent racial and ethnic disparities. These disparities result from complex interactions between patient factors related to social disadvantage, clinicians, and organizational and health care system factors. Separate and unequal systems of health care between states, between health care systems, and between clinicians constrain the resources that are available to meet the needs of disadvantaged groups, contribute to unequal outcomes, and reinforce implicit bias. Recent data suggest slow progress in many areas but have documented a few notable successes in eliminating these disparities. To eliminate these disparities, continued progress will require a collective national will to ensure health care equity through expanded health insurance coverage, support for primary care, and public accountability based on progress toward defined, time-limited objectives using evidence-based, sufficiently resourced, multilevel quality improvement strategies that engage patients, clinicians, health care organizations, and communities. PMID:26789384

  7. Impact of Influenza on Health-Related Quality of Life among Confirmed (H1N1)2009 Patients

    PubMed Central

    Hollmann, Malen; Garin, Olatz; Galante, Mariana; Ferrer, Montserrat; Dominguez, Angela; Alonso, Jordi

    2013-01-01

    Background We aimed to assess the changes in health-related quality of life (HRQL) in patients with confirmed diagnosis of influenza (H1N1)2009, and to estimate the individual and societal loss of quality-adjusted life years (QALYs) caused by the pandemic. Methods and Results Longitudinal study of patients recruited at major hospitals and primary care centers in Spain. Patients reported their HRQL (EQ-5D) during their influenza episode and seven days prior to it. A subsample was monitored to evaluate HRQL after recovery. HRQL loss was estimated as the difference between EQ-5D prior to the influenza episode and during it. Individual QALY loss (disutility multiplied by the duration of the influenza episode in days) for confirmed cases was calculated and used to estimate the societal loss in Spain (with the official estimations). A total of 432 inpatients and 563 outpatients were included, of whom 145 and 184, respectively, were followed up. Baseline mean HRQL loss was 0.58 (95% CI, 0.53–0.63) for inpatients and 0.43 (95% CI, 0.40–0.46) for outpatients. The majority of the 145 inpatients and 184 outpatients who were followed up regained initial HRQL levels, presenting a mean difference of 0.01 between the EQ-5D score prior to and after the influenza episode. Individual QALY losses for inpatients (0.031, 95% CI, 0.025–0.037) were higher than for outpatients (0.009, 95% CI, 0.007–0.011), while societal QALY losses were reversed: 94 years for inpatients and 6,778 years for outpatients. For fatal cases (an official number of 318), we estimated a QALY loss of 11,981. Conclusions The influenza (H1N1)2009 pandemic had a significant but temporary impact on the HRQL of the majority of confirmed in- and outpatients. The societal impact of the influenza pandemic in Spain was estimated to be higher than other acute conditions. These results provide useful data for future cost-utility analyses. PMID:23555979

  8. Environmental Quality Index and Childhood Mental Health

    EPA Science Inventory

    Childhood mental disorders affect between 13%-20% of children in the United States (US) annually and impact the child, family, and community. Literature suggests associations exist between environmental and children’s mental health such as air pollution with autism and ADHD...

  9. Accessing Quality Online Health Information: What Is the Solution?

    PubMed

    Boyer, Célia

    2016-01-01

    The majority of the adult population in both Europe and North America have access to the internet. Over 70% state that they have used the internet to look for health information and the majority started their search at a search engine. Given that search engines list sites according to popularity and not quality, it is imperative that users have a means of discerning trustworthy and honest information from non-reliable health information. The HONcode, a set of eight quality guidelines, ensures access to standardized trustworthy health information which can be used as a tool to guide consumers. PMID:27332317

  10. Enhancing the quality of case studies in health services research.

    PubMed Central

    Yin, R K

    1999-01-01

    OBJECTIVE: To provide guidance on improving the quality of case studies in health services research. DATA SOURCES: Secondary data, drawing from previous case study research. RESEARCH DESIGN: Guidance is provided to two audiences: potential case study investigators (eight items) and reviewers of case study proposals (four additional items). PRINCIPAL FINDINGS: The guidance demonstrates that many operational steps can be undertaken to improve the quality of case studies. These steps have been a hallmark of high-quality case studies in related fields but have not necessarily been practiced in health services research. CONCLUSIONS: Given higher-quality case studies, the case study method can become a valuable tool for health services research. Images Figure 3 PMID:10591280

  11. Quality and safety in health care, part V: introduction to crossing the quality chasm.

    PubMed

    Harolds, Jay A

    2015-12-01

    The Institute of Medicine report Crossing the Quality Chasm: A New Health System for the 21st Century focused on quality issues generally in health care, not only on mistakes. It made numerous recommendations for improving health care, including 6 aims and 10 rules to guide policy makers. This was intended to help redesign health care. However, the authors of the report did not attempt to provide all the answers because they realized that innovation was important and that they could not foresee all the sociopolitical forces and technological and research breakthroughs in the future. PMID:26402122

  12. Increasing access to quality health care for the poor: Community perceptions on quality care in Uganda

    PubMed Central

    Kiguli, Julie; Ekirapa-Kiracho, Elizabeth; Okui, Olico; Mutebi, Aloysius; MacGregor, Hayley; Pariyo, George William

    2009-01-01

    This paper examines the community’s perspectives and perceptions on quality of health care delivery in two Uganda districts. The paper addresses community concerns on service quality. It focuses on the poor because they are a vulnerable group and often bear a huge burden of disease. Community views were solicited and obtained using eight focus group discussions, six in-depth and 12 key informant interviews. User perceptions and definitions of the quality of health services depended on a number of variables related to technical competence, accessibility to services, interpersonal relations and presence of adequate drugs, supplies, staff, and facility amenities. Results indicate that service delivery to the poor in the general population is perceived to be of low quality. The factors that were mentioned as affecting the quality of services delivered were inadequate trained health workers, shortage of essential drugs, poor attitude of the health workers, and long distances to health facilities. This paper argues that there should be an improvement in the quality of health services with particular attention being paid to the poor. Despite wide focus on improvement of the existing infrastructure and donor funding, there is still low satisfaction with health services and poor perceived accessibility. PMID:19936148

  13. Health-Related Quality of Life and Health-Promoting Behaviors in Black Men

    ERIC Educational Resources Information Center

    Calvert, Wilma J.; Isaac,, E. Paulette; Johnson, Sharon

    2012-01-01

    This study examined the health-related quality of life and health-promoting behaviors in a convenience sample of low-income black men. Almost three-fourths reported their overall health as good or better. However, the mean number of recent (that is, past 30 days) mentally unhealthy days was 13.12, and more than half reported frequent (greater than…

  14. New Observational Technologies Scientific and Societal Impacts

    NASA Astrophysics Data System (ADS)

    Fabry, F.; Zawadzki, I.

    INTRODUCTION REMOTE SENSING OF THE ATMOSPHERE REMOTE SENSORS AND THEIR SCIENTIFIC IMPACTS Air Temperature and Moisture Clouds and Precipitation Wind Others Related Scientific Considerations SOCIETAL IMPACTS CONCLUSIONS REFERENCES

  15. Societal Benefits of Ocean Altimetry Data

    NASA Technical Reports Server (NTRS)

    Srinivasen, Margaret; Leben, Robert

    2004-01-01

    The NASA/CNES Jason satellite, follow-on to the highly successful TOPEX/Poseidon mission, continues to provide oceanographers and marine operators across the globe with a continuous twelve-year, high quality stream of sea surface height data. The mission is expected to extend through 2007, when the NASA/NOAA/CNES follow-on mission, OSTM, will be launched with the wide-swath ocean altimeter on board. This unprecedented resource of valuable ocean data is being used to map sea surface height, geostrophic velocity, significant wave height, and wind speed over the global oceans. Altimeter data products are currently used by hundreds of researchers and operational users to monitor ocean circulation and improve our understanding of the role of the oceans in climate and weather. Ocean altimeter data has many societal benefits and has proven invaluable in many practical applications including; a) Ocean forecasting systems; b) Climate research and forecasting; c) Ship routing; d) Fisheries management; e) Marine mammal habitat monitoring; f) Hurricane forecasting and tracking; g) Debris tracking; and h) Precision marine operations such as cable-laying and oil production. The data has been cited in nearly 2,000 research and popular articles since the launch of TOPEX/Poseidon in 1992, and almost 200 scientific users receive the global coverage altimeter data on a monthly basis. In addition to the scientific and operational uses of the data, the educational community has seized the unique concepts highlighted by these altimeter missions as a resource for teaching ocean science to students from grade school through college. This presentation will highlight societal benefits of ocean altimetry data in the areas of climate studies, marine operations, marine research, and non-ocean investigations.

  16. Quality of sleep and health-related quality of life in renal transplant recipients

    PubMed Central

    Liu, Hong-Xia; Lin, Jun; Lin, Xiao-Hong; Wallace, Linda; Teng, Sha; Zhang, Shu-Ping; Hao, Yu-Fang

    2015-01-01

    Aims and objectives: The purpose of this study was to examine the sleep quality and health-related quality of life (HRQOL) in patients after renal transplantation and to explore the relationship between the quality of sleep and the HRQOL. Background: Sleep disorders are still an important clinical problem after renal transplantation. Previous studies mainly focused on patients’ sleep quality before kidney transplant. More studies are needed to document sleep quality after renal transplantation. Design: A cross-sectional design was used in this study. Methods: A convenience sample of renal transplant recipients was recruited at an outpatient transplant clinic of a general hospital in Beijing, China. The Pittsburgh Sleep Quality Index (PSQI) was used to measure quality of sleep. The Medical Outcomes Study 36-item Short Form (MOS SF-36) was used to measure health-related quality of life. Results: The average PSQI score of the 204 renal transplant recipients was 5.81±3.52, significantly lower than the norm. Fifty (24.5%) recipients were classified as having poor sleep quality (global PSQI > 7). The mean scores of renal transplant recipients for SF-36 Mental Component Summary (MCS) and Physical Component Summary (PCS) were 47.57±6.71 and 48.26±9.66 respectively. Compared with residents in Sichuan province, recipients’ scores for SF-36 dimensions were statistically lower except the dimension of mental health. SF-36 scores of poor sleepers (PSQI > 7) were significantly lower than the good sleepers (PSQI ≤ 7) in both the MCS and PCS. Significant differences exist between the groups in physical function, bodily pain, vitality, and mental health dimensions. Conclusions: Sleep quality and HRQOL of patients after renal transplantation were lower than the norm. Poor sleep is associated with lower HRQOL. Relevance to clinical practice: Health professionals need to pay attention to sleep quality and HRQOL in renal transplant recipients and take appropriate measures to

  17. Air Quality Index (AQI) -- A Guide to Air Quality and Your Health

    MedlinePlus

    ... the AQI value, the greater the level of air pollution and the greater the health concern. For example, ... to 50. Air quality is considered satisfactory, and air pollution poses little or no risk. "Moderate" AQI is ...

  18. Quality and Safety in Health Care, Part II: Three Early Reports on Quality.

    PubMed

    Harolds, Jay A

    2015-09-01

    The 1990 Institute of Medicine report Medicare: A Strategy for Quality Assurance offered a definition of quality in health care and recommendations on how to achieve it. The forces for change would include different activities by the federal government, informed consumers, professionalism, and private initiatives. Eight years later, the National Roundtable report Statement on Quality of Care indicated that there were major problems of underuse, overuse, and misuse of health care services. In the same year, the President's Advisory Commission report Quality First: Better Health Care for All Americans discussed major problems with health care and proposed many initiatives to correct them, and also recommended a Bill of Rights and Responsibilities for the patients. PMID:26244402

  19. Informatics Resources to Support Health Care Quality Improvement in the Veterans Health Administration

    PubMed Central

    Hynes, Denise M.; Perrin, Ruth A.; Rappaport, Steven; Stevens, Joanne M.; Demakis, John G.

    2004-01-01

    Information systems are increasingly important for measuring and improving health care quality. A number of integrated health care delivery systems use advanced information systems and integrated decision support to carry out quality assurance activities, but none as large as the Veterans Health Administration (VHA). The VHA's Quality Enhancement Research Initiative (QUERI) is a large-scale, multidisciplinary quality improvement initiative designed to ensure excellence in all areas where VHA provides health care services, including inpatient, outpatient, and long-term care settings. In this paper, we describe the role of information systems in the VHA QUERI process, highlight the major information systems critical to this quality improvement process, and discuss issues associated with the use of these systems. PMID:15187063

  20. Measuring health related quality of life in juvenile rheumatoid arthritis

    PubMed Central

    Carle, Adam C.; Dewitt, E. Morgan; Seid, M.

    2011-01-01

    Pediatric researchers and clinicians increasingly recognize the importance of measuring the impact of childhood disease across many aspects of a child’s life. In this review, we describe four measures of health related quality of life (HRQOL) designed specifically for children with Juvenile Idiopathic Arthritis (JIA). HRQOL generally refers to how an individual feels about aspects of their life in relation to their health. The World Health Organization originally described HRQOL as minimally including: physical, mental, and social health dimensions.1 Subsequent HRQOL definitions, while varied, have incorporated the notion that individuals have an important and distinct viewpoint regarding their disease and the quality of their life.2 They have also often emphasized HRQOL’s subjective nature.2 These features present unique challenges when measuring HRQOL in children. Cognizant of these issues, we review the development and psychometric properties of the Pediatric Quality of Life Inventory (PedsQL) Rheumatology Module 3.0, the Juvenile Arthritis Quality of Life Questionnaire (JAQQ), the Paediatric Rheumatology Quality of Life Scale (PRQL), and the Childhood Arthritis Health Profile (CAHP). PMID:22588764

  1. Service Quality Assessment Scale (SQAS): An Instrument for Evaluating Service Quality of Health-Fitness Clubs

    ERIC Educational Resources Information Center

    Lam, Eddie T. C.; Zhang, James J.; Jensen, Barbara E.

    2005-01-01

    This study was designed to develop the Service Quality Assessment Scale to evaluate the service quality of health-fitness clubs. Through a review of literature, field observations, interviews, modified application of the Delphi technique, and a pilot study, a preliminary scale with 46 items was formulated. The preliminary scale was administered to…

  2. Informal payments and the quality of health care: Mechanisms revealed by Tanzanian health workers.

    PubMed

    Mæstad, Ottar; Mwisongo, Aziza

    2011-02-01

    Informal payments for health services are common in many transitional and developing countries. The aim of this paper is to investigate the nature of informal payments in the health sector of Tanzania and to identify mechanisms through which informal payments may affect the quality of health care. Our focus is on the effect of informal payments on health worker behaviours, in particular the interpersonal dynamics among health workers at their workplaces. We organised eight focus groups with 58 health workers representing different cadres and levels of care in one rural and one urban district in Tanzania. We found that health workers at all levels receive informal payments in a number of different contexts. Health workers sometimes share the payments received, but only partially, and more rarely within the cadre than across cadres. Our findings indicate that health workers are involved in 'rent-seeking' activities, such as creating artificial shortages and deliberately lowering the quality of service, in order to extract extra payments from patients or to bargain for a higher share of the payments received by their colleagues. The discussions revealed that many health workers think that the distribution of informal payments is grossly unfair. The findings suggest that informal payments can impact negatively on the quality of health care through rent-seeking behaviours and through frustrations created by the unfair allocation of payments. Interestingly, the presence of corruption may also induce non-corrupt workers to reduce the quality of care. Positive impacts can occur because informal payments may induce health workers to increase their efforts, and maybe more so if there is competition among health workers about receiving the payments. Moreover, informal payments add to health workers' incomes and might thus contribute to retention of health workers within the health sector. PMID:20709420

  3. Initiation of quality improvement activities in mental health services.

    PubMed

    Tobin, M; Chen, L

    1999-06-01

    In the public sector mental health service setting, accountability for quality has often been considered the responsibility of the individual clinician. This presents a particular challenge for introducing an organization-wide quality improvement culture in this setting. The introduction of a systemic view of quality may encounter resistance from individual clinicians reluctant to accept that some clinical autonomy must be subsumed within more standardized patterns of intervention and evaluation. Services must firstly tackle the issue of clinicians' readiness to embrace such a culture, which requires strong direction from the executive level. The area of recently diagnosed psychosis was selected in one public sector mental health service as a starting point for initiating the quality improvement culture. The eventual outcome for the organization has been a positive commitment to improvement, but the journey was long and hard. This paper describes the beginning of this ultimately rewarding journey. PMID:10408753

  4. Assessing Quality across Health Care Subsystems in Mexico

    PubMed Central

    Puig, Andrea; Pagán, José A.; Wong, Rebeca

    2012-01-01

    Recent healthcare reform efforts in Mexico have focused on the need to improve the efficiency and equity of a fragmented healthcare system. In light of these reform initiatives, there is a need to assess whether healthcare subsystems are effective at providing high-quality healthcare to all Mexicans. Nationally representative household survey data from the 2006 Encuesta Nacional de Salud y Nutrición (National Health and Nutrition Survey) were used to assess perceived healthcare quality across different subsystems. Using a sample of 7234 survey respondents, we found evidence of substantial heterogeneity in healthcare quality assessments across healthcare subsystems favoring private providers over social security institutions. These differences across subsystems remained even after adjusting for socioeconomic, demographic, and health factors. Our analysis suggests that improvements in efficiency and equity can be achieved by assessing the factors that contribute to heterogeneity in quality across subsystems. PMID:19305224

  5. Cultural diversity, economic development and societal instability

    USGS Publications Warehouse

    Nettle, D.; Grace, J.B.; Choisy, M.; Cornell, H.V.; Guegan, J.-F.; Hochberg, M.E.

    2007-01-01

    Background. Social scientists have suggested that cultural diversity in a nation leads to societal instability. However, societal instability may be affected not only by within-nation on ?? diversity, but also diversity between a nation and its neighbours or ?? diversity. It is also necessary to distinguish different domains of diversity, namely linguistic, ethnic and religious, and to distinguish between the direct effects of diversity on societal instability, and effects that are mediated by economic conditions. Methodology/Principal Findings. We assembled a large cross-national dataset with information on ?? and ?? cultural diversity, economic conditions, and indices of societal instability. Structural equation modeling was used to evaluate the direct and indirect effects of cultural diversity on economics and societal stability. Results show that different type and domains of diversity have interacting effects. As previously documented, linguistic ?? diversity has a negative effect on economic performance, and we show that it is largely through this economic mechanism that it affects societal instability. For ?? diversity, the higher the linguistic diversity among nations in a region, the less stable the nation. But, religious ?? diversity has the opposite effect, reducing instability, particularly in the presence of high linguistic diversity. Conclusions. Within-nation linguistic diversity is associated with reduced economic performance, which, in turn, increases societal instability. Nations which differ linguistically from their neighbors are also less stable. However, religious diversity between, neighboring nations has the opposite effect, decreasing societal instability.

  6. Merging Air Quality and Public Health Decision Support Systems

    NASA Astrophysics Data System (ADS)

    Hudspeth, W. B.; Bales, C. L.

    2003-12-01

    The New Mexico Air Quality Mapper (NMAQM) is a Web-based, open source GIS prototype application that Earth Data Analysis Center is developing under a NASA Cooperative Agreement. NMAQM enhances and extends existing data and imagery delivery systems with an existing Public Health system called the Rapid Syndrome Validation Project (RSVP). RSVP is a decision support system operating in several medical and public health arenas. It is evolving to ingest remote sensing data as input to provide early warning of human health threats, especially those related to anthropogenic atmospheric pollutants and airborne pathogens. The NMAQM project applies measurements of these atmospheric pollutants, derived from both remotely sensed data as well as from in-situ air quality networks, to both forecasting and retrospective analyses that influence human respiratory health. NMAQM provides a user-friendly interface for visualizing and interpreting environmentally-linked epidemiological phenomena. The results, and the systems made to provide the information, will be applicable not only to decision-makers in the public health realm, but also to air quality organizations, demographers, community planners, and other professionals in information technology, and social and engineering sciences. As an accessible and interactive mapping and analysis application, it allows environment and health personnel to study historic data for hypothesis generation and trend analysis, and then, potentially, to predict air quality conditions from daily data acquisitions. Additional spin off benefits to such users include the identification of gaps in the distribution of in-situ monitoring stations, the dissemination of air quality data to the public, and the discrimination of local vs. more regional sources of air pollutants that may bear on decisions relating to public health and public policy.

  7. Quality and cost-effective management of mental health care.

    PubMed

    Burton, W N; Hoy, D A; Bonin, R L; Gladstone, L

    1989-04-01

    Corporations have reduced their mental health care benefits by limits on coverage for such services. We report on a comprehensive mental health care program, including prevention and early intervention, hospital utilization review, and consulting psychiatrist, which has improved the quality and has significantly reduced inpatient insurance psychiatric hospitalization costs. Mental health service coverage was actually enhanced. Inpatient psychiatric hospitalization costs 12 months before and after the implementation of a concurrent psychiatric hospital utilization review program were reviewed for a major corporation. Total hospital days and average length of stay decreased by 43% whereas total inpatient psychiatric hospital charges decreased by $309,518. Total inpatient days decreased by 1045. Quality and cost-effective comprehensive psychiatric health care services can be offered by major corporations providing that such benefits are carefully designed and managed. PMID:2715844

  8. The management of health care service quality. A physician perspective

    PubMed Central

    Bobocea, L; Gheorghe, IR; Spiridon, St; Gheorghe, CM; Purcarea, VL

    2016-01-01

    Applying marketing in health care services is presently an essential element for every manager or policy maker. In order to be successful, a health care organization has to identify an accurate measurement scale for defining service quality due to competitive pressure and cost values. The most widely employed scale in the services sector is SERVQUAL scale. In spite of being successfully adopted in fields such as brokerage and banking, experts concluded that the SERVQUAL scale should be modified depending on the specific context. Moreover, the SERVQUAL scale focused on the consumer’s perspective regarding service quality. While service quality was measured with the help of SERVQUAL scale, other experts identified a structure-process-outcome design, which, they thought, would be more suitable for health care services. This approach highlights a different perspective on investigating the service quality, namely, the physician’s perspective. Further, we believe that the Seven Prong Model for Improving Service Quality has been adopted in order to effectively measure the health care service in a Romanian context from a physician’s perspective. PMID:27453745

  9. The management of health care service quality. A physician perspective.

    PubMed

    Bobocea, L; Gheorghe, I R; Spiridon, St; Gheorghe, C M; Purcarea, V L

    2016-01-01

    Applying marketing in health care services is presently an essential element for every manager or policy maker. In order to be successful, a health care organization has to identify an accurate measurement scale for defining service quality due to competitive pressure and cost values. The most widely employed scale in the services sector is SERVQUAL scale. In spite of being successfully adopted in fields such as brokerage and banking, experts concluded that the SERVQUAL scale should be modified depending on the specific context. Moreover, the SERVQUAL scale focused on the consumer's perspective regarding service quality. While service quality was measured with the help of SERVQUAL scale, other experts identified a structure-process-outcome design, which, they thought, would be more suitable for health care services. This approach highlights a different perspective on investigating the service quality, namely, the physician's perspective. Further, we believe that the Seven Prong Model for Improving Service Quality has been adopted in order to effectively measure the health care service in a Romanian context from a physician's perspective. PMID:27453745

  10. Introducing quality management into primary health care services in Uganda.

    PubMed Central

    Omaswa, F.; Burnham, G.; Baingana, G.; Mwebesa, H.; Morrow, R.

    1997-01-01

    In 1994, a national quality assurance programme was established in Uganda to strengthen district-level management of primary health care services. Within 18 months both objective and subjective improvements in the quality of services had been observed. In the examples documented here, there was a major reduction in maternal mortality among pregnant women referred to Jinja District Hospital, a reduction in waiting times and increased patient satisfaction at Masaka District Hospital, and a marked reduction in reported cases of measles in Arua District. Beyond these quantitative improvements, increased morale of district health team members, improved satisfaction among patients, and greater involvement of local government in the decisions of district health committees have been observed. At the central level, the increased coordination of activities has led to new guidelines for financial management and the procurement of supplies. District quality management workshops followed up by regular support visits from the Ministry of Health headquarters have led to a greater understanding by central staff of the issues faced at the district level. The quality assurance programme has also fostered improved coordination among national disease-control programmes. Difficulties encountered at the central level have included delays in carrying out district support visits and the failure to provide appropriate support. At the district level, some health teams tackled problems over which they had little control or which were overly complex; others lacked the management capacity for problem solving. PMID:9185368

  11. High-quality Health Information Provision for Stroke Patients

    PubMed Central

    Du, Hong-Sheng; Ma, Jing-Jian; Li, Mu

    2016-01-01

    Objective: High-quality information provision can allow stroke patients to effectively participate in healthcare decision-making, better manage the stroke, and make a good recovery. In this study, we reviewed information needs of stroke patients, methods for providing information to patients, and considerations needed by the information providers. Data Sources: The literature concerning or including information provision for patients with stroke in English was collected from PubMed published from 1990 to 2015. Study Selection: We included all the relevant articles on information provision for stroke patients in English, with no limitation of study design. Results: Stroke is a major public health concern worldwide. High-quality and effective health information provision plays an essential role in helping patients to actively take part in decision-making and healthcare, and empowering them to effectively self-manage their long-standing chronic conditions. Different methods for providing information to patients have their relative merits and suitability, and as a result, the effective strategies taken by health professionals may include providing high-quality information, meeting patients’ individual needs, using suitable methods in providing information, and maintaining active involvement of patients. Conclusions: It is suggested that to enable stroke patients to access high-quality health information, greater efforts need to be made to ensure patients to receive accurate and current evidence-based information which meets their individual needs. Health professionals should use suitable information delivery methods, and actively involve stroke patients in information provision. PMID:27569241

  12. Improving the quality of health care: what's taking so long?

    PubMed

    Chassin, Mark R

    2013-10-01

    Nearly fourteen years ago the Institute of Medicine's report, To Err Is Human: Building a Safer Health System, triggered a national movement to improve patient safety. Despite the substantial and concentrated efforts that followed, quality and safety problems in health care continue to routinely result in harm to patients. Desired progress will not be achieved unless substantial changes are made to the way in which quality improvement is conducted. Alongside important efforts to eliminate preventable complications of care, there must also be an effort to seriously address the widespread overuse of health services. That overuse, which places patients at risk of harm and wastes resources at the same time, has been almost entirely left out of recent quality improvement endeavors. Newer and much more effective strategies and tools are needed to address the complex quality challenges confronting health care. Tools such as Lean, Six Sigma, and change management are proving highly effective in tackling problems as difficult as hand-off communication failures and patient falls. Finally, the organizational culture of most American hospitals and other health care organizations must change. To create a culture of safety, leaders must eliminate intimidating behaviors that suppress the reporting of errors and unsafe conditions. Leaders must also hold everyone accountable for adherence to safe practices. PMID:24101066

  13. Mainstreaming quality and safety: a reformulation of quality and safety education for health professions students

    PubMed Central

    Ironside, Pamela M; Ogrinc, Gregory S

    2011-01-01

    The urgent need to expand the ability of health professionals to improve the quality and safety of patient care in the USA has been well documented. Yet the current methods of teaching quality and safety to health professionals are inadequate for the task. To the extent that quality and safety are addressed at all, they are taught using pedagogies with a narrow focus on content transmission, didactic sessions that are spatially and temporally distant from clinical work, and quality and safety projects segregated from the provision of actual patient care. In this article an argument for a transformative reorientation in quality and safety education for health professions is made. This transformation will require new pedagogies in which a) quality improvement is an integral part of all clinical encounters, b) health professions students and their clinical teachers become co-learners working together to improve patient outcomes and systems of care, c) improvement work is envisioned as the interdependent collaboration of a set of professionals with different backgrounds and perspectives skilfully optimising their work processes for the benefit of patients, and d) assessment in health professions education focuses on not just individual performance but also how the care team's patients fared and how the systems of care were improved. PMID:21450779

  14. Oral health, nutrition, and oral health-related quality of life among Korean older adults.

    PubMed

    Jung, Young-Mi; Shin, Dong-Soo

    2008-10-01

    Oral health affects older adults and their quality of life. Oral care is reported to have a low priority in nursing care of older adults, and repeated assessments to detect oral health problems are seldom performed. The purpose of this study was to investigate the relationships among level of oral health, nutrition, and oral health-related quality of life (OHRQL) and to identify predictors of OHRQL in Korean older adults. The design was a descriptive, correlational study. The level of oral pain contributed most significantly to OHRQL, followed by nutrition and number of teeth. These three predictor variables explained 46.4% of the variance in OHRQL. Older adults could benefit from oral health care, such as routine screening for oral health and nutritional status. Nurses are at the forefront in providing such services, and it is recommended they integrate oral health care into their routine nursing care plans. PMID:18942537

  15. Quality and consumer decision making in the market for health insurance and health care services.

    PubMed

    Kolstad, Jonathan T; Chernew, Michael E

    2009-02-01

    This article reviews the literature relating quality to consumer choice of health plan or health care provider. Evidence suggests that consumers tend to choose better performing health plans and providers and are responsive to initiatives that provide quality information. The response to quality and quality information differs significantly among consumers and across population subgroups. As such the effect of quality information on choice is apparent in only a relatively small, though perhaps consequential, number of consumers. Despite the wealth of findings on the topic to date, the authors suggest directions for future work, including better assessment of the dynamic issues related to information release, as well as a better understanding of how the response to information varies across different groups of patients. PMID:19029288

  16. Basic issues related to quantity and quality of health care, and quality assurance in Indonesia.

    PubMed

    Jacobalis, S

    1989-01-01

    Issues and problems related to the needs for quantity and quality in health care have been presented. The need for quantity has been quite successfully addressed in the last 20 years. Better quality of health care is very much in the minds of policy makers, providers and the informed public. Quality assessment and assurance as a programmed and on-going process in individual hospitals is systematically promoted and developed. An accreditation system for hospitals is planned for the future. This paper has not been able to contribute anything of value to the current practice of quality assurance. The industrialized world has passed the stages Indonesia is now going through. To some Australian colleagues, this presentation perhaps has revealed that one of their closest neighbours is struggling hard to improve the quality of life of its people, despite the tremendous problems and constraints with which it is confronted. Australia has always provided a helping hand in this struggle. PMID:2486044

  17. Marital quality and health: A meta-analytic review

    PubMed Central

    Robles, Theodore F.; Slatcher, Richard B.; Trombello, Joseph M.; McGinn, Meghan M.

    2013-01-01

    This meta-analysis reviewed 126 published empirical articles over the past 50 years describing associations between marital relationship quality and physical health in over 72,000 individuals. Health outcomes included clinical endpoints (objective assessments of function, disease severity, and mortality; subjective health assessments) and surrogate endpoints (biological markers that substitute for clinical endpoints, such as blood pressure). Biological mediators included cardiovascular reactivity and hypothalamic-pituitary-adrenal axis activity. Greater marital quality was related to better health, with mean effect sizes from r = .07 to .21, including lower risk of mortality, r = .11, and lower cardiovascular reactivity during marital conflict, r = −.13, but not daily cortisol slopes or cortisol reactivity during conflict. The small effect sizes were similar in magnitude to previously found associations between health behaviors (e.g., diet) and health outcomes. Effect sizes for a small subset of clinical outcomes were susceptible to publication bias. In some studies, effect sizes remained significant after accounting for confounds such as age and socioeconomic status. Studies with a higher proportion of women in the sample demonstrated larger effect sizes, but we found little evidence for gender differences in studies that explicitly tested gender moderation, with the exception of surrogate endpoint studies. Our conclusions are limited by small numbers of studies for specific health outcomes, unexplained heterogeneity, and designs that limit causal inferences. These findings highlight the need to explicitly test affective, health behavior, and biological mechanisms in future research, and focus on moderating factors that may alter the relationship between marital quality and health. PMID:23527470

  18. Is there a relationship between alcohol quality and health?

    PubMed

    Lachenmeier, Dirk W; Rehm, Jürgen

    2013-01-01

    A clear definition of 'alcohol quality' is currently not available and the use of the term varies considerably depending on the scientific field and the individual author. Intrinsic factors of 'alcohol quality' may be taste and flavour or the absence of certain toxic contaminants. Extrinsic factors may include price, brand image, labelling or perceived authenticity, which are typically unrelated to public health outcomes. This article shows that using the term 'alcohol quality' with varying definitions and underlying concepts may lead to misunderstandings, if not to clear misinformation (sometimes also intentionally by industry) when 'lower quality' is interpreted as 'more toxic' especially in the case of substitution of commercial beverages to unrecorded alcohol. We suggest the use of clearly defined terms instead, such as 'taste quality' or 'brand price', whenever possible. PMID:22986011

  19. Promoting Children's Health-Related Quality of Life.

    PubMed

    Sisk, Cara

    2016-01-01

    Pediatric health care practitioners have the ability to impact a child's HRQoL. Children's HRQoL is well documented in the literature as an important matter for children receiving health care, with research to support its significance in their lives. Children and adolescents have much to teach practitioners, and listening to their perspectives of health care experiences has a direct effect on the clinician's ability to improve their HRQoL. Pediatric practitioners focused on providing high-quality patient care must incorporate the goal to positively influence children's HRQoL. PMID:27254979

  20. eEurope 2002: Quality Criteria for Health related Websites

    PubMed Central

    2002-01-01

    Background A number of organisations have begun to provide specific tools for searching, rating, and grading this information, while others have set up codes of conduct by which site providers can attest to their high quality services. The aim of such tools is to assist individuals to sift through the mountains of information available so as to be better able to discern valid and reliable messages from those which are misleading or inaccurate. Objective Recognising that European citizens are avid consumers of health related information on the internet and recognising that they are already using the types of rating system described above, the European Council at Feira on June 19-20 2000 supported an initiative within eEurope 2002 to develop a core set of Quality Criteria for Health Related Websites. The specific aim was to draw up a commonly agreed set of simple quality criteria on which Member States, as well as public and private bodies, may draw in the development of quality initiatives for health related websites. These criteria should be applied in addition to relevant Community law. Methods A meeting was held during 2001 which drew together key players from Government departments, International Organisations, non-governmental organisations and industry, to explore current practices and experiments in this field. Some sixty invited participants from all the Member States, Norway, Switzerland, and the United States of America took part in the meeting of June 7-8, 2001: they included delegates from industrial, medical, and patient interest groups, delegates from Member States' governments, and key invited speakers from the field of health information ethics. These individuals, and many others, also took part in the web-based consultation which was open from august to November 2001. Results The broad headings for quality criteria identified include Transparency and Honesty, Authority, Privacy and data protection, Updating of information, Accountability

  1. College Student Mental Health and Quality of Workplace Relationships

    ERIC Educational Resources Information Center

    Vaughn, Allison A.; Drake, Richard R.; Haydock, Sarah

    2016-01-01

    Objective: The goal of this study was to examine the effect of quality of workplace relationships on the mental health of employed undergraduates, with work-related variables as a potential mechanism. Participants: Participants were 170 employed students (76% female, average age = 19.9) recruited in March 2011. Most worked part-time and had been…

  2. Overview of the quality assurance movement in health care.

    PubMed

    de Jonge, Vincent; Sint Nicolaas, Jerome; van Leerdam, Monique E; Kuipers, Ernst J

    2011-06-01

    This chapter aims to describe the origin and current status of quality assurance (QA) in health care and to provide a background of similar developments in other industries, which have provided a major impetus for QA initiatives in health care. The interest in quality and safety in the health care sector has rapidly risen over the past decade. Without important lessons learnt from other industries, the interest and obtained improvements would have been far less fast. Knowledge on basic principles and challenges faced by other industries like the airline, car, and nuclear energy industry, that drove quality improvement projects, is of major relevance to understand the evolutions taking place in health care. To fully appreciate the QA movement, and design or implement quality improvement projects, its basic principles need to be understood. This chapter aims to give insights in basic principles underlying QA, and to discuss historical lessons that have been learnt from other industries. Furthermore, it discusses how to implement and assure a sustainable QA program. PMID:21764002

  3. Health Effects of Air Quality Regulations in Delhi, India.

    PubMed

    Foster, Andrew; Kumar, Naresh

    2011-03-01

    This, the first systematic study, quantifies the health effects of air quality regulations in Delhi, which adopted radical measures to improve air quality, including, for example, the conversion of all commercial vehicles to compressed natural gas (CNG), and the closure of polluting industries in residential areas from 2000 to 2002. Air pollution data, collected at 113 sites (spread across Delhi and its neighboring areas) from July-December 2003, were used to compute exposure at the place of residence of 3,989 subjects. A socio-economic and respiratory health survey was administered in 1,576 households. This survey collected time-use, residence histories, demographic information, and direct measurements of lung function with subjects. The optimal interpolation methods were used to link air pollution and respiratory health data at the place of their residence. Resident histories, in combination with secondary data, were used to impute cumulative exposure prior to the air-quality interventions, and the effects of recent air quality measures on lung function were then evaluated. Three important findings emerge from the analysis. First, the interventions were associated with a significant improvement in respiratory health. Second, the effect of these interventions varied significantly by gender and income. Third, consistent with a causal interpretation of these results, effects were the strongest among those individuals who spend a disproportionate share of their time out-of-doors. PMID:21461142

  4. QUALITY ASSURANCE GUIDELINES FOR ENVIRONMENTAL HEALTH EFFECTS RESEARCH

    EPA Science Inventory

    This document is a statement of the quality assurance (QA) policy of the Health Effects Research Laboratory, U.S. Environmental Protection Agency, Research Triangle Park, North Carolina (HERL-RTP). It describes the HERL-RTP QA organization and the QA responsibilities of both mana...

  5. Health Effects of Air Quality Regulations in Delhi, India

    PubMed Central

    Foster, Andrew; Kumar, Naresh

    2011-01-01

    This, the first systematic study, quantifies the health effects of air quality regulations in Delhi, which adopted radical measures to improve air quality, including, for example, the conversion of all commercial vehicles to compressed natural gas (CNG), and the closure of polluting industries in residential areas from 2000 to 2002. Air pollution data, collected at 113 sites (spread across Delhi and its neighboring areas) from July-December 2003, were used to compute exposure at the place of residence of 3,989 subjects. A socio-economic and respiratory health survey was administered in 1,576 households. This survey collected time-use, residence histories, demographic information, and direct measurements of lung function with subjects. The optimal interpolation methods were used to link air pollution and respiratory health data at the place of their residence. Resident histories, in combination with secondary data, were used to impute cumulative exposure prior to the air-quality interventions, and the effects of recent air quality measures on lung function were then evaluated. Three important findings emerge from the analysis. First, the interventions were associated with a significant improvement in respiratory health. Second, the effect of these interventions varied significantly by gender and income. Third, consistent with a causal interpretation of these results, effects were the strongest among those individuals who spend a disproportionate share of their time out-of-doors. PMID:21461142

  6. Hostility, Relationship Quality, and Health among African American Couples

    ERIC Educational Resources Information Center

    Guyll, Max; Cutrona, Carolyn; Burzette, Rebecca; Russell, Daniel

    2010-01-01

    Objective: This study investigated the association between hostility and health and whether it is moderated by the quality of an individual's primary romantic relationship. Method: Longitudinal data were provided by 184 African Americans, including 166 women. Participants averaged 38 years old and were married or in long-term marriagelike…

  7. Health effects of air quality regulations in Delhi, India

    NASA Astrophysics Data System (ADS)

    Foster, Andrew; Kumar, Naresh

    2011-03-01

    This, the first systematic study, quantifies the health effects of air quality regulations in Delhi, which adopted radical measures to improve air quality, including, for example, the conversion of all commercial vehicles to compressed natural gas (CNG), and the closure of polluting industries in residential areas from 2000 to 2002. Air pollution data, collected at 113 sites (spread across Delhi and its neighboring areas) from July-December 2003, were used to compute exposure at the place of residence of 3989 subjects. A socio-economic and respiratory health survey was administered in 1576 households. This survey collected time-use, residence histories, demographic information, and direct measurements of lung function with subjects. The optimal interpolation methods were used to link air pollution and respiratory health data at the place of their residence. Resident histories, in combination with secondary data, were used to impute cumulative exposure prior to the air-quality interventions, and the effects of recent air quality measures on lung function were then evaluated. Three important findings emerge from the analysis. First, the interventions were associated with a significant improvement in respiratory health. Second, the effect of these interventions varied significantly by gender and income. Third, consistent with a causal interpretation of these results, effects were the strongest among those individuals who spend a disproportionate share of their time out-of-doors.

  8. Impact of Medicaid Reimbursement on Mental Health Quality Indicators

    PubMed Central

    Bellows, Nicole M; Halpin, Helen A

    2008-01-01

    Objective To examine the relationship between the use of the Minimum Data Set (MDS) for determining Medicaid reimbursement to nursing facilities and the MDS Quality Indicators examining nursing facility residents' mental health. Data Sources The 2004 National MDS facility Quality Indicator reports served as the dependent variables. Explanatory variables were based on the 2004 Online Survey Certification and Reporting system (OSCAR) and an examination of existing reports, a review of the State Medicaid Plans, and State Medicaid personnel. Study Design Multilevel regression models were used to account for the hierarchical structure of the data. Data Collection MDS and OSCAR data were linked by facility identifiers and subsequently linked with state-level variables. Principal Findings The use of the MDS for determining Medicaid reimbursement was associated with higher (poorer) quality indicator values for all four mental health quality indicators examined. This effect was not found in four comparison quality indicators. Conclusions The findings indicate that documentation of mental health symptoms may be influenced by economic incentives. Policy makers should be cautioned from using these measures as the basis for decision making, such as with pay-for-performance initiatives. PMID:18370968

  9. Challenges in Data Quality Assurance in Pervasive Health Monitoring Systems

    NASA Astrophysics Data System (ADS)

    Sriram, Janani; Shin, Minho; Kotz, David; Rajan, Anand; Sastry, Manoj; Yarvis, Mark

    Wearable, portable, and implantable medical sensors have ushered in a new paradigm for healthcare in which patients can take greater responsibility and caregivers can make well-informed, timely decisions. Health-monitoring systems built on such sensors have huge potential benefit to the quality of healthcare and quality of life for many people, such as patients with chronic medical conditions (such as blood-sugar sensors for diabetics), people seeking to change unhealthy behavior (such as losing weight or quitting smoking), or athletes wishing to monitor their condition and performance. To be effective, however, these systems must provide assurances about the quality of the sensor data. The sensors must be applied to the patient by a human, and the sensor data may be transported across multiple networks and devices before it is presented to the medical team. While no system can guarantee data quality, we anticipate that it will help for the system to annotate data with some measure of confidence. In this paper, we take a deeper look at potential health-monitoring usage scenarios and highlight research challenges required to ensure and assess quality of sensor data in health-monitoring systems.

  10. Quality and Safety in Health Care, Part VI: More on Crossing the Quality Chasm.

    PubMed

    Harolds, Jay A

    2016-01-01

    One of the most important aspects of the Institute of Medicine (IOM) Crossing the Quality Chasm. A New Health System for the 21st Century report (Chasm report) was that 6 major aims for US health care were set forth. In addition, the report indicated that health care in the United States care should be redesigned in accordance with 10 enumerated rules. There were other recommendations as well, to try to bridge the huge gap between the health care many people in the United States receive and what they should receive. PMID:26447385

  11. Water, water quality and health (Chapter 3 in Book entitled: Environmental Tracking for Public Health Surveillance).

    EPA Science Inventory

    This chapter identifies the role environmental tracking plays in identifying public health water hazard and water quality issues. It outlines public health issues to be examined and provides an integrated overview of water and diseases by combining knowledge of the hydrological ...

  12. Adult Day Health Center Participation and Health-Related Quality of Life

    ERIC Educational Resources Information Center

    Schmitt, Eva M.; Sands, Laura P.; Weiss, Sara; Dowling, Glenna; Covinsky, Kenneth

    2010-01-01

    Purpose: The purpose of this study was to assess the association between Adult Day Health Center (ADHC) participation and health-related quality of life. Design and Methods: Case-controlled prospective study utilizing the Medical Outcomes Survey Form 36 (SF-36) to compare newly enrolled participants from 16 ADHC programs with comparable…

  13. Identifying Key Hospital Service Quality Factors in Online Health Communities

    PubMed Central

    Jung, Yuchul; Hur, Cinyoung; Jung, Dain

    2015-01-01

    Background The volume of health-related user-created content, especially hospital-related questions and answers in online health communities, has rapidly increased. Patients and caregivers participate in online community activities to share their experiences, exchange information, and ask about recommended or discredited hospitals. However, there is little research on how to identify hospital service quality automatically from the online communities. In the past, in-depth analysis of hospitals has used random sampling surveys. However, such surveys are becoming impractical owing to the rapidly increasing volume of online data and the diverse analysis requirements of related stakeholders. Objective As a solution for utilizing large-scale health-related information, we propose a novel approach to identify hospital service quality factors and overtime trends automatically from online health communities, especially hospital-related questions and answers. Methods We defined social media–based key quality factors for hospitals. In addition, we developed text mining techniques to detect such factors that frequently occur in online health communities. After detecting these factors that represent qualitative aspects of hospitals, we applied a sentiment analysis to recognize the types of recommendations in messages posted within online health communities. Korea’s two biggest online portals were used to test the effectiveness of detection of social media–based key quality factors for hospitals. Results To evaluate the proposed text mining techniques, we performed manual evaluations on the extraction and classification results, such as hospital name, service quality factors, and recommendation types using a random sample of messages (ie, 5.44% (9450/173,748) of the total messages). Service quality factor detection and hospital name extraction achieved average F1 scores of 91% and 78%, respectively. In terms of recommendation classification, performance (ie, precision) is

  14. Measuring the quality of care: reforming the health care system.

    PubMed

    Longo, D R; Daugird, A J

    1994-01-01

    Elements of meaningful health care reform must include the ability of patients, providers, and payers to select services offering quality care at an affordable price. To achieve this goal, an appropriate definition of quality needs to be articulated and adopted; data capturing the definition needs to be collected; and appropriate measures need to be selected to analyze that data. Results need to be publically available to assist in making informed choices. The health professions need to fulfill their social contract. And, government needs to ensure that public safety and accountability are maintained and preserved. While the goals and strategies of the different players in the health care arena may be different, there is one thing in common--the needs of citizens must be met through the provision of available, accessible, quality, equitable, and cost-effective health care. These values need to be incorporated into a reform plan. Currently, our ability to comprehensively, consistently, and uniformly perform these tasks is severely limited. While many diverse factors, such as the limitation of financial support and the lack of uniform information systems, contribute to this situation, we believe it is possible through the implementation of a series of recommendations to achieve these goals. This paper outlines the current situation, reviews insights derived from the literature and past and current experiences. Recommendations are made that apply equally to health reform efforts at the state and/or federal levels. PMID:7950482

  15. Quality at the centre of universal health coverage.

    PubMed

    Sobel, Howard L; Huntington, Dale; Temmerman, Marleen

    2016-05-01

    The last decade of the MDG era witnessed substantial focus on reaching the bottom economic quintiles in low and middle income countries. However, the inordinate focus on reducing financial risk burden and increasing coverage without sufficient focus on expanding quality of services may account for slow progress of the MDGs in many countries. Human Resources for Health underlie quality and service delivery improvements, yet remains under-addressed in many national strategies to achieve Universal Health Coverage. Without adequate investments in improving and expanding health professional education, making and sustaining gains will be unlikely. The transition from the Millennium Development Goals (MDG) to the Sustainable Development Goals (SDG), with exciting new financing initiatives such as the Global Financing Facility brings the potential to enact substantial gains in the quality of services delivered and upgrading human health resources. This focus should ensure effective methodologies to improve health worker competencies and change practice are employed and ineffective and harmful ones eliminated (including undue influence of commercial interests). PMID:26420642

  16. Public Reporting of Quality Information on Medicaid Health Plans

    PubMed Central

    Felt-Lisk, Suzanne; Barrett, Allison; Nyman, Rebecca

    2007-01-01

    Transparency through public reporting of quality data is key to achieving the Institute of Medicine's (IOM) vision for 21st century health care. This article reviews the status of States' voluntary public reporting of Medicaid managed care (MMC) quality data, and analyzes these data. Twenty-one States, including 17 of the 20 largest managed care States, have made plan-level data publicly available online, although the data are sometimes thin, with few measures reported, hard-to-access, and old. We conclude that CMS could better leverage the power of public reporting for quality improvement (QI) by increasing the visibility of health plan employer data and information set (HEDIS®) data that States already collect. PMID:17645152

  17. Space Station Environmental Health System water quality monitoring

    NASA Technical Reports Server (NTRS)

    Vincze, Johanna E.; Sauer, Richard L.

    1990-01-01

    One of the unique aspects of the Space Station is that it will be a totally encapsulated environment and the air and water supplies will be reclaimed for reuse. The Environmental Health System, a subsystem of CHeCS (Crew Health Care System), must monitor the air and water on board the Space Station Freedom to verify that the quality is adequate for crew safety. Specifically, the Water Quality Subsystem will analyze the potable and hygiene water supplies regularly for organic, inorganic, particulate, and microbial contamination. The equipment selected to perform these analyses will be commercially available instruments which will be converted for use on board the Space Station Freedom. Therefore, the commercial hardware will be analyzed to identify the gravity dependent functions and modified to eliminate them. The selection, analysis, and conversion of the off-the-shelf equipment for monitoring the Space Station reclaimed water creates a challenging project for the Water Quality engineers and scientists.

  18. Quality assurance in the health care system in The Netherlands.

    PubMed

    Reerink, E

    1987-03-01

    Thirteen years of activities in the field of quality assurance in the health care field in The Netherlands bring to life the many ups and some downs in this intriguing endeavour. Back in 1974, quality assurance was in the minds of few individuals and in the hands of nobody. This has changed dramatically: not only are there now functioning programmes carried out by knowledgeable and dedicated health care providers, there is legislation that suits the convenience of quality assurance, and a firm delineation of responsibilities. At the same time there is flexibility which enables the various actors to interpret their roles according to their capabilities and tastes. The various contributions in this issue are part of this national development. PMID:3566639

  19. Adapting and using quality management methods to improve health promotion.

    PubMed

    Becker, Craig M; Glascoff, Mary A; Felts, William Michael; Kent, Christopher

    2015-01-01

    Although the western world is the most technologically advanced civilization to date, it is also the most addicted, obese, medicated, and in-debt adult population in history. Experts had predicted that the 21st century would be a time of better health and prosperity. Although wealth has increased, our quest to quell health problems using a pathogenic approach without understanding the interconnectedness of everyone and everything has damaged personal and planetary health. While current efforts help identify and eliminate causes of problems, they do not facilitate the creation of health and well-being as would be done with a salutogenic approach. Sociologist Aaron Antonovsky coined the term salutogenesis in 1979. It is derived from salus, which is Latin for health, and genesis, meaning to give birth. Salutogenesis, the study of the origins and creation of health, provides a method to identify an interconnected way to enhance well-being. Salutogenesis provides a framework for a method of practice to improve health promotion efforts. This article illustrates how quality management methods can be used to guide health promotion efforts focused on improving health beyond the absence of disease. PMID:25777291

  20. Impacts of Climate Policy on Regional Air Quality, Health, and Air Quality Regulatory Procedures

    NASA Astrophysics Data System (ADS)

    Thompson, T. M.; Selin, N. E.

    2011-12-01

    Both the changing climate, and the policy implemented to address climate change can impact regional air quality. We evaluate the impacts of potential selected climate policies on modeled regional air quality with respect to national pollution standards, human health and the sensitivity of health uncertainty ranges. To assess changes in air quality due to climate policy, we couple output from a regional computable general equilibrium economic model (the US Regional Energy Policy [USREP] model), with a regional air quality model (the Comprehensive Air Quality Model with Extensions [CAMx]). USREP uses economic variables to determine how potential future U.S. climate policy would change emissions of regional pollutants (CO, VOC, NOx, SO2, NH3, black carbon, and organic carbon) from ten emissions-heavy sectors of the economy (electricity, coal, gas, crude oil, refined oil, energy intensive industry, other industry, service, agriculture, and transportation [light duty and heavy duty]). Changes in emissions are then modeled using CAMx to determine the impact on air quality in several cities in the Northeast US. We first calculate the impact of climate policy by using regulatory procedures used to show attainment with National Ambient Air Quality Standards (NAAQS) for ozone and particulate matter. Building on previous work, we compare those results with the calculated results and uncertainties associated with human health impacts due to climate policy. This work addresses a potential disconnect between NAAQS regulatory procedures and the cost/benefit analysis required for and by the Clean Air Act.

  1. Agents for change: nonphysician medical providers and health care quality.

    PubMed

    Boucher, Nathan A; Mcmillen, Marvin A; Gould, James S

    2015-01-01

    Quality medical care is a clinical and public health imperative, but defining quality and achieving improved, measureable outcomes are extremely complex challenges. Adherence to best practice invariably improves outcomes. Nonphysician medical providers (NPMPs), such as physician assistants and advanced practice nurses (eg, nurse practitioners, advanced practice registered nurses, certified registered nurse anesthetists, and certified nurse midwives), may be the first caregivers to encounter the patient and can act as agents for change for an organization's quality-improvement mandate. NPMPs are well positioned to both initiate and ensure optimal adherence to best practices and care processes from the moment of initial contact because they have robust clinical training and are integral to trainee/staff education and the timely delivery of care. The health care quality aspects that the practicing NPMP can affect are objective, appreciative, and perceptive. As bedside practitioners and participants in the administrative and team process, NPMPs can fine-tune care delivery, avoiding the problem areas defined by the Institute of Medicine: misuse, overuse, and underuse of care. This commentary explores how NPMPs can affect quality by 1) supporting best practices through the promotion of guidelines and protocols, and 2) playing active, if not leadership, roles in patient engagement and organizational quality-improvement efforts. PMID:25663213

  2. Developing a risk-based air quality health index

    NASA Astrophysics Data System (ADS)

    Wong, Tze Wai; Tam, Wilson Wai San; Yu, Ignatius Tak Sun; Lau, Alexis Kai Hon; Pang, Sik Wing; Wong, Andromeda H. S.

    2013-09-01

    We developed a risk-based, multi-pollutant air quality health index (AQHI) reporting system in Hong Kong, based on the Canadian approach. We performed time series studies to obtain the relative risks of hospital admissions for respiratory and cardiovascular diseases associated with four air pollutants: sulphur dioxide, nitrogen dioxide, ozone, and particulate matter with an aerodynamic diameter less than 10 μm (PM10). We then calculated the sum of excess risks of the hospital admissions associated with these air pollutants. The cut-off points of the summed excess risk, for the issuance of different health warnings, were based on the concentrations of these pollutants recommended as short-term Air Quality Guidelines by the World Health Organization. The excess risks were adjusted downwards for young children and the elderly. Health risk was grouped into five categories and sub-divided into eleven bands, with equal increments in excess risk from band 1 up to band 10 (the 11th band is 'band 10+'). We developed health warning messages for the general public, including at-risk groups: young children, the elderly, and people with pre-existing cardiac or respiratory diseases. The new system addressed two major shortcomings of the current standard-based system; namely, the time lag between a sudden rise in air pollutant concentrations and the issue of a health warning, and the reliance on one dominant pollutant to calculate the index. Hence, the AQHI represents an improvement over Hong Kong's existing air pollution index.

  3. Quality of Life and Health-Related Quality of Life of Adolescents with Cerebral Palsy

    ERIC Educational Resources Information Center

    Rosenbaum, Peter L.; Livingston, Michael H.; Palisano, Robert J.; Galuppi, Barbara E.; Russell, Dianne J.

    2007-01-01

    This study assessed quality of life (QOL) and health-related quality of life (HRQOL) of 203 adolescents with cerebral palsy (111 males, 92 females; mean age 16y [SD 1y 9mo]). Participants were classified using the Gross Motor Function Classification System (GMFCS), as Level I (n=60), Level II (n=33), Level III (n=28), Level IV (n=50), or Level V…

  4. Quality and Safety in Health Care, Part VII: Lower Costs and Higher Quality.

    PubMed

    Harolds, Jay A

    2016-02-01

    The Institute of Medicine report entitled The Health Care Imperative: Lowering Costs and Improving Outcomes discussed numerous ways to decrease costs in the health care system without decreasing quality. The use of evidence-based medicine, eliminating wasteful spending such as needlessly high administrative costs, having more preventive services, having a better reimbursement system that emphasized quality, developing a less fragmented and more efficient medical delivery system, having more transparency for patients on the outcomes of different providers, having greater health care literacy for patients, and eliminating fraud were some of the recommendations. The total savings from eliminating unnecessary health care costs was estimated to be over 3 quarters of a trillion dollars each year. PMID:26545019

  5. 42 CFR 480.141 - Disclosure of QIO interpretations on the quality of health care.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS ACQUISITION, PROTECTION, AND DISCLOSURE OF QUALITY IMPROVEMENT ORGANIZATION REVIEW INFORMATION Utilization and Quality Control Quality Improvement Organizations (QIOs) Disclosure of Confidential Information § 480.141 Disclosure...

  6. [Continuous nursing education to improve the quality of health care].

    PubMed

    Fumić, Nera; Marinović, Marin; Brajan, Dolores

    2014-10-01

    Health care and today's medical and technical achievements and approved standards of treatment provide comprehensive quality, safety and traceability of medical procedures respecting the principles of health protection. Continuous education improves the quality of nursing health care and increases the effectiveness of patient care, consequently maintaining and enhancing patient safety. Patient health problems impose the need of appropriate, planned and timely nursing care and treatment. In providing quality nursing care, attention is focused on the patient and his/her needs in order to maintain and increase their safety, satisfaction, independence and recovery or peaceful death, so the health and nursing practices must be systematized, planned and based on knowledge and experience. Health and nursing care of patients at risk of developing acute and chronic wounds or already suffering from some form of this imply preventive measures that are provided through patient education, motivation, monitoring, early recognition of risk factors and causes, and reducing or removing them through the prescribed necessary medical treatment which is safe depending on the patient health status. Except for preventive measures, nursing care of patients who already suffer from some form of acute or chronic wounds is focused on the care and treatment of damaged tissue by providing appropriate and timely diagnosis, timely and proper evaluation of the wound and patient general status, knowledge and understanding of the wide range of local, oral and parenteral therapy and treatment, aiming to increase patient safety by preventing progression of the patient general condition and local wound status and reducing the possibility of developing infection or other complications of the underlying disease. In the overall patient management, through nursing process, medical interventions are implemented and aimed to maintain and optimize health status, prevent complications of existing diseases and

  7. Oral health related quality of life in diabetic patients.

    PubMed

    Sadeghi, Rokhsareh; Taleghani, Ferial; Farhadi, Sareh

    2014-01-01

    Background and aims. Diabetic patients display an increased risk of oral disorders, and oral health related quality of life (OHRQL) might affect their management and treatment modalities. The aim of the present study was to determine OHRQL and associated parameters in patients with diabetes. Materials and methods. In this study two hundred patients were recruited from the diabetes clinic in Mustafa Khomeini Hospital in Tehran, Iran. OHRQL was assessed using Oral Health Impact Profile Questionnaire (OHIP-20). Also, another questionnaire was designed which contained questions regarding participants' knowledge about oral complications of diabetes and oral health behavior. OHRQL was categorized as low and good. Data were analyzed using logistic regression at P = 0.05. Results. Of the diabetic patients assessed, 77.5% were in good and 22.5% were in low categories of OHRQL. This quality was significantly associated with age (OR = 4.03, 95% CI = 1.63-11.29), knowledge about diabetes oral complications (OR = 18.17 95% CI = 4.42-158.6), educational level (OR = 26.31 95% CI = 4.2-1080.3), referred for dental visit by physician (OR = 3.16 95% CI = 1.48-6.69), frequency of brushing (OR = 10.29 95% CI = 3.96-31.2) and length of time diagnosed with diabetes (OR = 6.21 95% CI = 2.86-13.63). Conclusion. Oral health related quality of life was not negatively affected by diabetes mellitus in the assessed sample. PMID:25587385

  8. Partnering health disparities research with quality improvement science in pediatrics.

    PubMed

    Lion, K Casey; Raphael, Jean L

    2015-02-01

    Disparities in pediatric health care quality are well described in the literature, yet practical approaches to decreasing them remain elusive. Quality improvement (QI) approaches are appealing for addressing disparities because they offer a set of strategies by which to target modifiable aspects of care delivery and a method for tailoring or changing an intervention over time based on data monitoring. However, few examples in the literature exist of QI interventions successfully decreasing disparities, particularly in pediatrics, due to well-described challenges in developing, implementing, and studying QI with vulnerable populations or in underresourced settings. In addition, QI interventions aimed at improving quality overall may not improve disparities, and in some cases, may worsen them if there is greater uptake or effectiveness of the intervention among the population with better outcomes at baseline. In this article, the authors review some of the challenges faced by researchers and frontline clinicians seeking to use QI to address health disparities and propose an agenda for moving the field forward. Specifically, they propose that those designing and implementing disparities-focused QI interventions reconsider comparator groups, use more rigorous evaluation methods, carefully consider the evidence for particular interventions and the context in which they were developed, directly engage the social determinants of health, and leverage community resources to build collaborative networks and engage community members. Ultimately, new partnerships between communities, providers serving vulnerable populations, and QI researchers will be required for QI interventions to achieve their potential related to health care disparity reduction. PMID:25560436

  9. Social networks, stress and health-related quality of life.

    PubMed

    Achat, H; Kawachi, I; Levine, S; Berkey, C; Coakley, E; Colditz, G

    1998-12-01

    Although evidence suggests that social networks reduce the risk of mortality and are negatively associated with severe mental disability, little is known about their relationship to everyday functioning and health-related quality of life (HRQoL). In addition, the importance of social networks in the presence of chronic stress remains unclear. We examined the association between social networks and aspects of mental functioning (mental health, vitality and role-emotional functioning) and the relationship between social networks and mental functioning in the presence of stressors. Multiple linear and logistic regression models were used to examine data in 47,912 middle-aged and older healthy women. The Medical Outcomes Study Shortform Health Survey measured dimensions of quality of life. We observed strong associations between levels of social networks and multivariate-adjusted quality of life scores, particularly in potentially high stress situations. Compared to the most socially integrated, women who were socially isolated had reductions in mental health and vitality scores of 6.5 and 7.4 points, respectively and a 60% increased risk of limitation in role-emotional functioning. Social networks are positively associated with mental functioning in women. This association is strongest for women reporting high levels of home and work stressors. PMID:10097622

  10. Exploring Social Quality and Community Health Outcomes: An Ecological Model.

    PubMed

    Jung, Minsoo

    2015-01-01

    Quality of life is widely used as a measure of individual well-being in developed countries. Social quality (SQ), however, describes how favorable the socioenvironmental components are that impact the life chance of an individual. Despite the associations between SQ, including institutional capacity and citizen capacity, and other community indicators, the impact of SQ on community health status has not been fully examined. This study investigated the interrelationships among institutional capacity, citizen capacity, and their associations with community-level health indicators such as mortality and suicide among 230 local governments in South Korea. Under the principles of conceptual suitability, clarity, reliability, consistency, changeability, and comparability, a total of 81 SQ indicators were collected, and 19 indicators of the 81 indicators were selected. The 19 indicators were transformed by the imputation of missing values, standardization, and geographic information system transformation. It was found that the health outcome of local government was superior as social welfare, political participation, and education were higher. According to the result of the regression analysis based on the regional type, social welfare had the most influence on the health level of local government in both metropolises and small-/medium-sized cities. In addition, education and political participation had a positive effect on the health indicator of local metropolis government. However, SQ indicators did not have any meaningful influence at the county level. Therefore, small- and medium-sized cities need to promote the collective health of the local government through improving social welfare, and metropolises need to consider the complex relationship among other indicators while increasing the level of social welfare and education. Meanwhile, counties need to develop health indicators that reflect aged population characteristics and social environment of rural areas

  11. 77 FR 42738 - Request for Information on Quality Measurement Enabled by Health IT

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-20

    ... Enabled by Health IT AGENCY: Agency for Healthcare Research and Quality (AHRQ), Health and Human Services... information technology (IT) system developers, including vendors; payers, quality measure developers, end... regarding quality measurement enabled by health IT. Quality measurement--the assessment of the...

  12. Promoting happiness: the malleability of individual and societal subjective wellbeing.

    PubMed

    Tay, Louis; Kuykendall, Lauren

    2013-01-01

    Is it possible to enhance the subjective wellbeing of individuals and societies? If so, what are the mental health interventions and economic mechanisms by which subjective wellbeing could be enhanced? We address these questions in our review of the literature on subjective wellbeing. Research now shows that although subjective wellbeing is heritable and stable, it can change substantially over time. Long-term changes can be affected by positive or negative life events; subjective wellbeing interventions have also proved to be effective for boosting wellbeing for as long as six months. At the societal level, economic factors matter for the subjective wellbeing of citizens. Economic wealth is shown to be a predictor of societal wellbeing across countries and over time. Also, high unemployment severely lowers the wellbeing of individuals and has spillover effects on other societal members, such as the employed. Given the weight of evidence, we are optimistic that subjective wellbeing can be enhanced. For practitioners, policy makers, and economists interested in the wellbeing of individuals, we propose that these findings have implications for mental health practice and economic policies. Future research and methodological issues are discussed. PMID:23551025

  13. Health Information on Internet: Quality, Importance, and Popularity of Persian Health Websites

    PubMed Central

    Samadbeik, Mahnaz; Ahmadi, Maryam; Mohammadi, Ali; Mohseni Saravi, Beniamin

    2014-01-01

    Background: The Internet has provided great opportunities for disseminating both accurate and inaccurate health information. Therefore, the quality of information is considered as a widespread concern affecting the human life. Despite the increasingly substantial growth in the number of users, Persian health websites and the proportion of internet-using patients, little is known about the quality of Persian medical and health websites. Objectives: The current study aimed to first assess the quality, popularity and importance of websites providing Persian health-related information, and second to evaluate the correlation of the popularity and importance ranking with quality score on the Internet. Materials and Methods: The sample websites were identified by entering the health-related keywords into four most popular search engines of Iranian users based on the Alexa ranking at the time of study. Each selected website was assessed using three qualified tools including the Bomba and Land Index, Google PageRank and the Alexa ranking. Results: The evaluated sites characteristics (ownership structure, database, scope and objective) really did not have an effect on the Alexa traffic global rank, Alexa traffic rank in Iran, Google PageRank and Bomba total score. Most websites (78.9 percent, n = 56) were in the moderate category (8 ≤ x ≤ 11.99) based on their quality levels. There was no statistically significant association between Google PageRank with Bomba index variables and Alexa traffic global rank (P > 0.05). Conclusions: The Persian health websites had better Bomba quality scores in availability and usability guidelines as compared to other guidelines. The Google PageRank did not properly reflect the real quality of evaluated websites and Internet users seeking online health information should not merely rely on it for any kind of prejudgment regarding Persian health websites. However, they can use Iran Alexa rank as a primary filtering tool of these websites

  14. The business case for health-care quality improvement.

    PubMed

    Swensen, Stephen J; Dilling, James A; Mc Carty, Patrick M; Bolton, Jeffrey W; Harper, Charles M

    2013-03-01

    The business case for health-care quality improvement is presented. We contend that investment in process improvement is aligned with patients' interests, the organization's reputation, and the engagement of their workforce. Four groups benefit directly from quality improvement: patients, providers, insurers, and employers. There is ample opportunity, even in today's predominantly pay-for-volume (that is, evolving toward value-based purchasing) insurance system, for providers to deliver care that is in the best interest of the patient while improving their financial performance. PMID:23429226

  15. Quality-based financial incentives in health care: can we improve quality by paying for it?

    PubMed

    Conrad, Douglas A; Perry, Lisa

    2009-01-01

    This article asks whether financial incentives can improve the quality of health care. A conceptual framework drawn from microeconomics, agency theory, behavioral economics, and cognitive psychology motivates a set of propositions about incentive effects on clinical quality. These propositions are evaluated through a synthesis of extant peer-reviewed empirical evidence. Comprehensive financial incentives--balancing rewards and penalties; blending structure, process, and outcome measures; emphasizing continuous, absolute performance standards; tailoring the size of incremental rewards to increasing marginal costs of quality improvement; and assuring certainty, frequency, and sustainability of incentive payoffs--offer the prospect of significantly enhancing quality beyond the modest impacts of prevailing pay-for-performance (P4P) programs. Such organizational innovations as the primary care medical home and accountable health care organizations are expected to catalyze more powerful quality incentive models: risk- and quality-adjusted capitation, episode of care payments, and enhanced fee-for-service payments for quality dimensions (e.g., prevention) most amenable to piece-rate delivery. PMID:19296779

  16. Quality of care in reproductive health programmes: education for quality improvement.

    PubMed

    Kwast, B E

    1998-09-01

    The provision of high quality maternity care will make the difference between life and death or lifelong maiming for millions of pregnant women. Barriers preventing access to affordable, appropriate, acceptable and effective services, and lack of facilities providing high quality obstetric care result in about 1600 maternal deaths every day. Education in its broadest sense is required at all levels and sectors of society to enhance policy formulation that will strengthen programme commitment, improve services with a culturally sensitive approach and ensure appropriate delegation of responsibility to health staff at peripheral levels. This paper is the second in series of three which addresses quality of care. The first (Kwast 1998) contains an overview of concepts, assessments, barriers and improvements of quality of care. The third article will describe selected aspects of monitoring and evaluation of quality of care. PMID:9856019

  17. Total quality management as a health care corporate strategy.

    PubMed

    Johnson, J A; Omachonu, V K

    1995-01-01

    Total quality management (TQM) must become a part of corporate strategy if it is to become a way of life in health care. TQM should be understood in the context of a cultural transformation. The greatest challenge for top management is to create an organization in which every employee, department and function is linked inextricably to the organization's mission and vision. One of the key benefits of TQM is the use of teams to work on and achieve organizational objectives. Health care managers must understand motivation in order to carry the workforce with them to attain those objectives. PMID:10165402

  18. Health Related Quality of Life and Influencing Factors among Welders

    PubMed Central

    Qin, Jingxiang; Liu, Wuzhong; Zhu, Jun; Weng, Wei; Xu, Jiaming; Ai, Zisheng

    2014-01-01

    Background Occupational exposure to welding fumes is a serious occupational health problem all over the world. Welders are exposed to many occupational hazards; these hazards might cause some occupational diseases. The aim of the study was to assess the health related quality of life (HRQL) of electric welders in Shanghai China and explore influencing factors to HRQL of welders. Methods 301 male welders (without pneumoconiosis) and 305 non-dust male workers in Shanghai were enrolled in this study. Short Form-36 (SF-36) health survey questionnaires were applied in this cross-sectional study. Socio-demographic, working and health factors were also collected. Multiple stepwise regress analysis was used to identify significant factors related to the eight dimension scores. Results Six dimensions including role-physical (RP), bodily pain (BP), general health (GH), validity (VT), social function (SF), and mental health (MH) were significantly worse in welders compared to non-dust workers. Multiple stepwise regress analysis results show that native place, monthly income, quantity of children, drinking, sleep time, welding type, use of personal protective equipment (PPE), great events in life, and some symptoms including dizziness, discomfort of cervical vertebra, low back pain, cough and insomnia may be influencing factors for HRQL of welders. Among these factors, only sleep time and the use of PPE were salutary. Conclusions Some dimensions of HRQL of these welders have been affected. Enterprises which employ welders should take measures to protect the health of these people and improve their HRQL. PMID:25048102

  19. Health-related quality of life assessment in clinical practice.

    PubMed

    Meers, C; Singer, M A

    1996-01-01

    Assessment of biochemical responses to therapy is routine in the management of patients with end stage renal disease (ESRD). Assessment of health-related quality of life (HRQOL), however, is less common. Previous research indicates that HRQOL is a meaningful indicator that should be integrated into clinical practice. HRQOL is longitudinally evaluated in in-centre hemodialysis patients using the RAND 36-item Health Survey 1.0. Caregivers incorporate scores from this instrument into their assessment of patient functioning and well-being. HRQOL scores can be utilized to evaluate responses to changes in therapy, and to direct clinical decision-making, adding an important dimension to holistic, quality care for ESRD patients. PMID:8900807

  20. Health, Quality of Life and Population Density: A Preliminary Study on "Contextualized" Quality of Life

    ERIC Educational Resources Information Center

    Fassio, Omar; Rollero, Chiara; De Piccoli, Norma

    2013-01-01

    Quality of life concerns individual (physical and psychological health), interpersonal (social relationships) and contextual (environment) aspects, which are both subjective and objective. In considering contextual characteristics, empirical findings have demonstrated that people's relation to their living environment is a key issue for their…

  1. State health agencies and quality improvement in perinatal care.

    PubMed

    Johnson, K A; Little, G A

    1999-01-01

    The origin of the federal-state partnership in Maternal and Child Health (MCH) can be traced from the Children's Bureau grants of 1912, through the Sheppard-Towner Act, to the creation of Title V and other programs of today that mandate planning, accountability, and systems development. In the past decade with the transformation of the health care system and the emergence of managed care, there has been a resurgence of interest in public, professional, and governmental interest in quality measurement and accountability. Regional perinatal systems have been implemented in all states with varying levels of involvement by state health agencies and the public sector. This historical framework discusses two primary themes: the decades of evolution in the federal-state partnership, and the emergence in the last three decades of perinatal regional system policy, and suggests that the structure of the federal-state partnership has encouraged state variation. A survey of state MCH programs was undertaken to clarify their operational and perceived role in promoting quality improvement in perinatal care. Data and information from the survey, along with five illustrative state case studies, demonstrate great variation in how individual state agencies function. State efforts in quality improvement, a process to make things better, have four arenas of activity: policy development and implementation, definition and measurement of quality, data collection and analysis, and communication to affect change. Few state health agencies (through their MCH programs and perinatal staff) are taking action in all four arenas. This analysis concludes that there are improvements MCH programs could implement without significant expansion in their authority or resources and points out that there is an opportunity for states to be more proactive as they have the legal authority and responsibility for assuring MCH outcomes. PMID:9917467

  2. [Physician-independent quality control of health services].

    PubMed

    Hess, Rainer

    2007-01-01

    Currently a physician-independent control of health services can only be managed by means of liability case law. Usually, claims are settled years after the service has been provided, based, though, on medical guidelines that have been established by the medical profession itself at the time of the provision of services. An essential factor in medical quality assurance (QA) is the involvement of the relevant physicians, which should be combined with external controls. Regarding quality in medicine, personal qualification will have to be distinguished from institutional quality and quality of healthcare, which should be ensured by internal and external QA. There is increasing pressure to publish QA results in an institution-related manner. However, the publication of results may lead to the unequal treatment of hospitals, as external QA includes only a limited number of indications (possible misjudgement of overall quality), and refers to different patient populations (no comparable treatment results). However, the publication of such outcome data will prevail in the long-term. The future vision of an external QA system comprises: 1. electronically based patient files and, derived thereof, pseudonymised data sets for QA; 2. IQWiG's participation in the definition of evidence-based indicators for quality assessment as well as the application of these indicators; 3. the full publication of results on an Internet platform. PMID:17711259

  3. When Weather Matters: Science and Service to Meet Critical Societal Needs

    NASA Technical Reports Server (NTRS)

    2010-01-01

    The goal of weather prediction is to provide information people and organizations can use to reduce weather-related losses and enhance societal benefits, including protection of life and property, public health and safety, and support of economic prosperity and quality of life. In economic terms, the benefit of the investment in public weather forecasts and warnings is substantial: the estimated annualized benefit is about $31.5 billion, compared to the $5.1 billion cost of generating the information. Between 1980 and 2009, 96 weather disasters in the United States each caused at least $1 billion in damages, with total losses exceeding $700 billion. Between 1999 and 2008, there were an average of 629 direct weather fatalities per year. The annual impacts of adverse weather on the national highway system and roads are staggering: 1.5 million weather-related crashes with 7,400 deaths, more than 700,000 injuries, and $42 billion in economic losses.

  4. Universal Health Insurance in India: Ensuring Equity, Efficiency, and Quality

    PubMed Central

    Prinja, Shankar; Kaur, Manmeet; Kumar, Rajesh

    2012-01-01

    Indian health system is characterized by a vast public health infrastructure which lies underutilized, and a largely unregulated private market which caters to greater need for curative treatment. High out-of-pocket (OOP) health expenditures poses barrier to access for healthcare. Among those who get hospitalized, nearly 25% are pushed below poverty line by catastrophic impact of OOP healthcare expenditure. Moreover, healthcare costs are spiraling due to epidemiologic, demographic, and social transition. Hence, the need for risk pooling is imperative. The present article applies economic theories to various possibilities for providing risk pooling mechanism with the objective of ensuring equity, efficiency, and quality care. Asymmetry of information leads to failure of actuarially administered private health insurance (PHI). Large proportion of informal sector labor in India's workforce prevents major upscaling of social health insurance (SHI). Community health insurance schemes are difficult to replicate on a large scale. We strongly recommend institutionalization of tax-funded Universal Health Insurance Scheme (UHIS), with complementary role of PHI. The contextual factors for development of UHIS are favorable. SHI schemes should be merged with UHIS. Benefit package of this scheme should include preventive and in-patient curative care to begin with, and gradually include out-patient care. State-specific priorities should be incorporated in benefit package. Application of such an insurance system besides being essential to the goals of an effective health system provides opportunity to regulate private market, negotiate costs, and plan health services efficiently. Purchaser-provider split provides an opportunity to strengthen public sector by allowing providers to compete. PMID:23112438

  5. Universal health insurance in India: ensuring equity, efficiency, and quality.

    PubMed

    Prinja, Shankar; Kaur, Manmeet; Kumar, Rajesh

    2012-07-01

    Indian health system is characterized by a vast public health infrastructure which lies underutilized, and a largely unregulated private market which caters to greater need for curative treatment. High out-of-pocket (OOP) health expenditures poses barrier to access for healthcare. Among those who get hospitalized, nearly 25% are pushed below poverty line by catastrophic impact of OOP healthcare expenditure. Moreover, healthcare costs are spiraling due to epidemiologic, demographic, and social transition. Hence, the need for risk pooling is imperative. The present article applies economic theories to various possibilities for providing risk pooling mechanism with the objective of ensuring equity, efficiency, and quality care. Asymmetry of information leads to failure of actuarially administered private health insurance (PHI). Large proportion of informal sector labor in India's workforce prevents major upscaling of social health insurance (SHI). Community health insurance schemes are difficult to replicate on a large scale. We strongly recommend institutionalization of tax-funded Universal Health Insurance Scheme (UHIS), with complementary role of PHI. The contextual factors for development of UHIS are favorable. SHI schemes should be merged with UHIS. Benefit package of this scheme should include preventive and in-patient curative care to begin with, and gradually include out-patient care. State-specific priorities should be incorporated in benefit package. Application of such an insurance system besides being essential to the goals of an effective health system provides opportunity to regulate private market, negotiate costs, and plan health services efficiently. Purchaser-provider split provides an opportunity to strengthen public sector by allowing providers to compete. PMID:23112438

  6. Improving Quality of Emergency Care Through Integration of Mental Health.

    PubMed

    Okafor, Martha; Wrenn, Glenda; Ede, Victor; Wilson, Nana; Custer, William; Risby, Emile; Claeys, Michael; Shelp, Frank E; Atallah, Hany; Mattox, Gail; Satcher, David

    2016-04-01

    The goal of this study was to better integrate emergency medical and psychiatric care at a large urban public hospital, identify impact on quality improvement metrics, and reduce healthcare cost. A psychiatric fast track service was implemented as a quality improvement initiative. Data on disposition from the emergency department from January 2011 to May 2012 for patients impacted by the pilot were analyzed. 4329 patients from January 2011 to August 2011 (pre-intervention) were compared with 4867 patients from September 2011 to May 2012 (intervention). There was a trend of decline on overall quality metrics of time to triage and time from disposition to discharge. The trend analysis of the psychiatric length of stay and use of restraints showed significant reductions. Integrated emergency care models are evidence-based approach to ensuring that patients with mental health needs receive proper and efficient treatment. Results suggest that this may also improve overall emergency department's throughput. PMID:26711094

  7. [Health care research to improve the quality of health care provision for older people].

    PubMed

    Kuhlmey, A

    2011-08-01

    This article addresses the contribution that health care research can make to facilitating appropriate health care provision for older adults. First, the major risks in this age group are described. These include multiple illnesses, the increasing need for nursing care with age, but also the growing numbers of older adults with psychological disorders, primarily dementia. The second section of the article presents a critical assessment of the current health care situation in light of the risks identified. On this basis, the third section specifies the areas of health care research that can contribute to improving the quality of the health care provision for this population. The article is based on a presentation made by the author at the 2010 Berlin Talks on Social Medicine: "The New Old--Health Care Research for a Changed Society." PMID:21800238

  8. Health benefits of improving air quality in Taiyuan, China.

    PubMed

    Tang, Deliang; Wang, Cuicui; Nie, Jiesheng; Chen, Renjie; Niu, Qiao; Kan, Haidong; Chen, Bingheng; Perera, Frederica

    2014-12-01

    Since 2000, the government in Shanxi province has mounted several initiatives and mandated factory shutdowns with the goal of reducing coal burning emissions and the environmental impacts of industrialization. We estimated the health benefits associated with air quality improvement from 2001 to 2010 in Taiyuan, Shanxi Province, using disability-adjusted life years (DALYs) and monetized the health benefits using value of statistical life (VOSL). Data were collected on annual average concentrations of particulate matter less than 10 μm in aerodynamic diameter (PM10) and relevant health outcomes in Taiyuan from 2001 to 2010. Selected exposure-response functions were used to calculate the cases of death or disease attributable to PM10 annually over a 10-year period. These were summed to calculate the DALYs lost and their monetary value associated with PM10 each year between 2001 and 2010. Air quality improvement from 2001 to 2010 was estimated to have prevented 2810 premature deaths, 951 new cases of chronic bronchitis, 141,457 cases of outpatient visits, 969 cases of emergency-room visits and 31,810 cases of hospital admissions. The DALYs (VOSL) decreased by 56.92% (52.68%) from 52,937 (7274 million Yuan) in 2001 to 22,807 (3442 million Yuan) in 2010. Premature deaths accounted for almost 95% of the total DALYs. Our analysis demonstrates that air pollution abatement during the last decade in Taiyuan has generated substantial health benefits. PMID:25168129

  9. Two-Year Impact of the Alternative Quality Contract on Pediatric Health Care Quality and Spending

    PubMed Central

    Song, Zirui; Chernew, Michael E.; Landon, Bruce E.; McNeil, Barbara J.; Safran, Dana G.; Schuster, Mark A.

    2014-01-01

    OBJECTIVE: To examine the 2-year effect of Blue Cross Blue Shield of Massachusetts’ global budget arrangement, the Alternative Quality Contract (AQC), on pediatric quality and spending for children with special health care needs (CSHCN) and non-CSHCN. METHODS: Using a difference-in-differences approach, we compared quality and spending trends for 126 975 unique 0- to 21-year-olds receiving care from AQC groups with 415 331 propensity-matched patients receiving care from non-AQC groups; 23% of enrollees were CSHCN. We compared quality and spending pre (2006–2008) and post (2009–2010) AQC implementation, adjusting analyses for age, gender, health risk score, and secular trends. Pediatric outcome measures included 4 preventive and 2 acute care measures tied to pay-for-performance (P4P), 3 asthma and 2 attention-deficit/hyperactivity disorder quality measures not tied to P4P, and average total annual medical spending. RESULTS: During the first 2 years of the AQC, pediatric care quality tied to P4P increased by +1.8% for CSHCN (P < .001) and +1.2% for non-CSHCN (P < .001) for AQC versus non-AQC groups; quality measures not tied to P4P showed no significant changes. Average total annual medical spending was ∼5 times greater for CSHCN than non-CSHCN; there was no significant impact of the AQC on spending trends for children. CONCLUSIONS: During the first 2 years of the contract, the AQC had a small but significant positive effect on pediatric preventive care quality tied to P4P; this effect was greater for CSHCN than non-CSHCN. However, it did not significantly influence (positively or negatively) CSHCN measures not tied to P4P or affect per capita spending for either group. PMID:24366988

  10. [Evaluation auditing of the quality of health care in accreditation of health facilities].

    PubMed

    Paim, Chennyfer da Rosa Paino; Zucchi, Paola

    2011-01-01

    This article shows how many health insurance companies operating in the Greater São Paulo have been performing auditing of the quality of their health care services, professionals, and which criteria are being employed to do so. Because of the legislation decreeing that health insurance companies have legal co-responsibility for the health care services and National Health Agency control the health services National Health Agency, auditing evaluations have been implemented since then. The survey was based on electronic forms e-mailed to all health insurance companies operating in the Greater São Paulo. The sample consisted of 125 health insurance companies; 29 confirmed that had monitoring and evaluation processes; 26 performed auditing of their services regularly; from those, 20 used some type of form or protocol for technical visits; all evaluation physical and administrative structure and 22 included functional structure. Regarding the professionals audited 21 were nurses, 13 administrative assistants; 04 managers and 02 doctors. Regarding criteria for accreditation the following were highlighted: region analysis (96%), localization (88.88%) and cost (36%). We conclude that this type of auditing evaluation is rather innovative and is being gradually implemented by the health insurance companies, but is not a systematic process. PMID:21503464

  11. Health-Related Quality of Life and Quality of Sexual Life in Obese Subjects

    PubMed Central

    Di Lazzaro, Luca; Pinto, Alessandro; Migliaccio, Silvia; Lenzi, Andrea; Donini, Lorenzo M.

    2014-01-01

    The increased prevalence of obesity represents, currently, one of the major public health issues, due to its consequences on physical and psychological health status as well as on the psychosocial functioning. As defined by the World Health Organization, sexual health is “a state of physical, emotional, mental, and social well-being in relation to sexuality.” The aim of the present study was to explore the relationship between sexual life in obese subjects and quality of life, psychological status, and disability. Methods. 95 obese subjects were recruited from June 2012 to February 2013 and underwent physical examination and measures for the assessment of quality of life, sexual life, psychological status, and disability. Results. In obese subjects sexual life was related to gender, age, psychological status, disability, and quality of life. Conclusion. As obesity is a multifactorial disease, and is accompanied by multiple comorbidities, it is difficult to identify a single causative factor responsible for the impairment of sexual life in obese subjects; thus, a thorough, multidimensional evaluation including sexual function assessment should be performed in obese people. PMID:24707290

  12. Applying total quality management concepts to public health organizations.

    PubMed Central

    Kaluzny, A D; McLaughlin, C P; Simpson, K

    1992-01-01

    Total quality management (TQM) is a participative, systematic approach to planning and implementing a continuous organizational improvement process. Its approach is focused on satisfying customers' expectations, identifying problems, building commitment, and promoting open decision-making among workers. TQM applies analytical tools, such as flow and statistical charts and check sheets, to gather data about activities within an organization. TQM uses process techniques, such as nominal groups, brainstorming, and consensus forming to facilitate communication and decision making. TQM applications in the public sector and particularly in public health agencies have been limited. The process of integrating TQM into public health agencies complements and enhances the Model Standards Program and assessment methodologies, such as the Assessment Protocol for Excellence in Public Health (APEX-PH), which are mechanisms for establishing strategic directions for public health. The authors examine the potential for using TQM as a method to achieve and exceed standards quickly and efficiently. They discuss the relationship of performance standards and assessment methodologies with TQM and provide guidelines for achieving the full potential of TQM in public health organizations. The guidelines include redefining the role of management, defining a common corporate culture, refining the role of citizen oversight functions, and setting realistic estimates of the time needed to complete a task or project. PMID:1594734

  13. Health-Related Quality of Life Following Blind Rehabilitation

    PubMed Central

    Kuyk, Thomas; Liu, Lei; Elliott, Jeffry L.; Grubbs, Hartley E.; Owsley, Cynthia; McGwin, Gerald; Griffin, Russell L.; Fuhr, Patti S.

    2009-01-01

    Purpose The purpose of this study was to investigate the effect of residential blind rehabilitation on patients’ vision targeted health-related quality of life (HRQOL) and general physical and mental function. Methods The National Eye Institute 25-item Visual Function Questionnaire (NEI VFQ) plus appendix questions, the 12 item Short-Form Health Survey (SF-12), Hope Scale and Coopersmith self-esteem inventory were administered to 206 legally blind veterans prior to their entering a residential (in-patient) blind rehabilitation program and again to 185 and 176 of the original cohort at two and six months after completion of the rehabilitation program, respectively. Data on visual acuity, visual field extent, contrast sensitivity and scanning ability were also collected. The duration of the in-patient rehabilitation programs ranged from 11–109 days. Questionnaire scores were compared pre-rehabilitation and post-rehabilitation. Results Following rehabilitation there was a significant improvement in nine of eleven NEI VFQ subscales and in a composite score at both 2- and 6-month post-rehab intervals. Mental health (SF-12) and self esteem also improved significantly although physical health ratings declined over the course of the study (approximately 10 months). Conclusions Residential blind rehabilitation appears to improve patients’ self-reported vision-targeted HRQOL, self-esteem, and mental health aspects of generic HRQOL. PMID:18392688

  14. Mitochondrial Protein Quality Control: The Mechanisms Guarding Mitochondrial Health

    PubMed Central

    Bohovych, Iryna; Chan, Sherine S.L.

    2015-01-01

    Abstract Significance: Mitochondria are complex dynamic organelles pivotal for cellular physiology and human health. Failure to maintain mitochondrial health leads to numerous maladies that include late-onset neurodegenerative diseases and cardiovascular disorders. Furthermore, a decline in mitochondrial health is prevalent with aging. A set of evolutionary conserved mechanisms known as mitochondrial quality control (MQC) is involved in recognition and correction of the mitochondrial proteome. Recent Advances: Here, we review current knowledge and latest developments in MQC. We particularly focus on the proteolytic aspect of MQC and its impact on health and aging. Critical Issues: While our knowledge about MQC is steadily growing, critical gaps remain in the mechanistic understanding of how MQC modules sense damage and preserve mitochondrial welfare, particularly in higher organisms. Future Directions: Delineating how coordinated action of the MQC modules orchestrates physiological responses on both organellar and cellular levels will further elucidate the current picture of MQC's role and function in health, cellular stress, and degenerative diseases. Antioxid. Redox Signal. 22, 977–994. PMID:25546710

  15. Technical Limitations of Electronic Health Records in Community Health Centers: Implications on Ambulatory Care Quality

    ERIC Educational Resources Information Center

    West, Christopher E.

    2010-01-01

    Research objectives: This dissertation examines the state of development of each of the eight core electronic health record (EHR) functionalities as described by the IOM and describes how the current state of these functionalities limit quality improvement efforts in ambulatory care settings. There is a great deal of literature describing both the…

  16. Analysis of Critical Earth Observation Priorities for Societal Benefit

    NASA Astrophysics Data System (ADS)

    Zell, E. R.; Huff, A. K.; Carpenter, A. T.; Friedl, L.

    2011-12-01

    moisture content, burn scars, and meteorological parameters. Impacts to public health and livelihoods due to food insecurity, algal blooms, and air pollution can be addressed through NRT monitoring of specific events utilizing land cover, atmospheric composition, water quality, and meteorological observations. More broadly, the assessment of water availability for drinking and agriculture and the development of floods and storms rely on continuous feeds of NRT meteorological and atmospheric composition observations. Overall, this multi-disciplinary study of user needs for NRT data and products can inform the design and operation of NRT data systems. Follow-on work for this study will also be presented, focusing on the availability of current and future satellite measurements (including NRT) of the 30 most critical Earth observation priorities, as well as a detailed analysis of users' needs for precipitation data. The results of this study summarize the priorities for critical Earth observations utilized globally for societal benefit.

  17. Cultural orientation: an emerging dimension of quality in women's health services.

    PubMed

    Stone, C E

    2000-01-01

    There are many efforts underway to document the differences in health status and health services access of women in distinct cultural segments in the U.S. Along with the measurable aspects of health status and utilization, each cultural segment carries its unique perspective on what constitutes "quality" in women's health services. These definitions of quality may reflect access, interactions, process, and outcomes. Health care providers that aspire to provide quality women's health care need to identify the distinct cultural segments in their own communities; document the gaps in women's health services; and develop programs that are specific to clinical needs and quality criteria of these populations. PMID:11183584

  18. USQA Health Profile Database as a tool for health plan quality improvement.

    PubMed

    Hanchak, N A; Murray, J F; Hirsch, A; McDermott, P D; Schlackman, N

    1996-01-01

    Managed care organizations are in a unique position to evaluate and improve the quality of care delivered to their defined memberships. Traditionally, health services delivery has been claims-focused. We describe a potentially richer, patient-centered approach, whereby patients with certain chronic diseases are first identified and then used as the unit of analysis. U.S. Quality Algorithms (USQA), a subsidiary of U.S. Healthcare (USHC) based in Blue Bell, Pennsylvania, has developed selection criteria for 36 different chronic diseases and a new database, the USQA Health Profile Database (HPD), to identify and archive patients with those diseases. Examples of how this approach and database can be used as a quality tool are demonstrated. PMID:10157263

  19. Mental Health and Health-Related Quality of Life in Multiple Sclerosis Caregivers in Mexico

    PubMed Central

    Stern, Marilyn; Arelis, Adriana Aguayo; Islas, Miguel Angel Macias; Barajas, Brenda Viridiana Rábago

    2016-01-01

    Background: Multiple sclerosis (MS) rates are increasing in Latin America, and caregiving for an individual with MS is associated with poorer mental and physical health outcomes. No existing research has examined the relation between mental health and health-related quality of life (HRQOL) in MS caregivers in Latin America. Methods: The present study examined the association between mental health (Patient Health Questionnaire-9, Satisfaction with Life Scale, Rosenberg Self-esteem Scale, State-Trait Anxiety Inventory) and HRQOL (36-item Short Form Health Status Survey) in 81 Mexican MS caregivers. Results: A canonical correlation analysis uncovered a large, significant overall association between mental health and HRQOL, with 52.7% of the variance shared between the two sets of constructs. When individual canonical loadings were examined in this analysis, the most substantial pattern that emerged was between depression and general health. Four regressions controlling for demographic variables found that HRQOL uniquely accounted for 19.0% of the variance in caregiver anxiety, 32.5% in depression, 13.5% in satisfaction with life, and 14.3% in self-esteem. Conclusions: These findings demonstrated a strong association between HRQOL and mental health, which points to directions for future studies on interventions for MS caregivers, particularly in Mexican and other Latino populations. PMID:26917994

  20. Clinicians’ perspectives of health related quality of life (HRQoL) implications of amblyopia: a qualitative study

    PubMed Central

    2011-01-01

    Aims or Purpose The health related quality of life (HRQoL) implications of amblyopia and/or its treatment have been reported. However the clinician’s perspective has not previously been explored. The purpose of this study was to explore the HRQoL implications of amblyopia and/or its treatment from a clinicians’ perspective. Methods Three focus group sessions were conducted with practising orthoptists. Thematic content analysis was undertaken, to identify HRQoL themes associated with amblyopia and/or its treatment. Results Nine HRQoL themes associated with amblyopia and/or its treatment were identified. These included adult quality of life issues; hospital appointments; appearance; glasses-wear; patching treatment; atropine treatment; limited activities; relationships within the family; and treatment compliance. Conclusions The HRQoL implications of amblyopia and/or its treatment was similar to those identified in the literature. Participants acknowledged a change in societal attitudes towards glasses and patching; with glasses becoming more socially acceptable. Further research is needed to explore the exact impact of amblyopia and/or its treatment from both the child and the parental perspective. PMID:22022338

  1. Functional health outcomes as a measure of health care quality for Medicare beneficiaries.

    PubMed Central

    Bierman, A S; Lawrence, W F; Haffer, S C; Clancy, C M

    2001-01-01

    OBJECTIVE: the Medicare Health Outcomes Survey (HOS), a new quality measure in the Health Plan Employer Data and Information Set, is designed to assess physical and mental functional health outcomes of Medicare beneficiaries enrolled in Medicare+Choice organizations. We discuss the rationale for the HOS measure together with methodologic challenges in its use and interpretation, using descriptive data from the baseline Medicare HOS to illustrate some of these challenges. DATA SOURCES/STUDY DESIGN: The 1999 Cohort 2 Medicare HOS baseline data were used for a cross-sectional descriptive analysis. A random sample of 1,000 beneficiaries from each health plan with a Medicare+Choice contract was surveyed (N = 156,842; 282 organizations included in these analyses) . PRINCIPAL FINDINGS: The HOS measure is designed to assess a previously unmeasured dimension of quality. Plan-level variation was seen across all baseline measures of sociodemographic characteristics and illness burden. At the individual level socioeconomic position as measured by educational attainment was strongly associated with functional status. The least educated beneficiaries had the highest burden of illness on all measures examined, and there was a consistent and significant gradient in health and functional status across all levels of education. In analyses stratified by race and ethnicity, socioeconomic gradients in f un ct ion persist ed. CONCLUSIONS Despite limitations, by focusing at t en t ion on the need to improve functional health out comes among elderly Medicare beneficiaries enrolled in Medicare+Choice, the HOS can serve as an important new tool to support efforts to improve health care quality. The HOS provides valuable information at the federal, state, and health plan levels that can be used to identify, prioritize, and evaluate quality improvement interventions and monitor progress for the program overall as well as for vulnerable subgroups. To interpret the HOS as a quality measure

  2. Health-Related Quality of Life in patients with Parkinson's disease--A systematic review based on the ICF model.

    PubMed

    van Uem, Janet M T; Marinus, Johan; Canning, Colleen; van Lummel, Rob; Dodel, Richard; Liepelt-Scarfone, Inga; Berg, Daniela; Morris, Meg E; Maetzler, Walter

    2016-02-01

    We analyzed features associated with a reduction in Health-Related Quality of Life (HRQoL) in people with idiopathic Parkinson's disease (PD). As a new approach, features were embedded in the WHO framework for measuring health and disability, the ICF model. From 609 articles screened, 114 articles were included. Features aligned with the ICF's body functions and structures domain (BFS) were investigated more often than personal features, activities of daily living, environmental factors, and participation in societal roles (95, 42, 35, 29 and 14 times, respectively). The strongest associations were found for the relationships between HRQoL and "psychosocial functioning" from the participation domain and HRQoL, and "mobility limitations" from the activities domain. For the BFS, non-motor symptoms were more closely associated with reduced HRQoL than motor symptoms. In conclusion, this systematic review (i) provides entirely new insights in the association of HRQoL with PD features, (ii) shows an imbalance between most extensively investigated and most relevant features for HRQoL, and (iii) demonstrates the usefulness of the ICF model for such an approach. PMID:26645499

  3. Quality and Safety in Health Care, Part I: Five Pioneers in Quality.

    PubMed

    Harolds, Jay

    2015-08-01

    Five pioneers had a huge impact on the quality movement in health care in the United States. Ernest Codman contributed in many ways, including his focus on outcome analysis. Avidis Donabedian is known for his focus on the 3 domains of structure, process, and outcome in health care. Walter Shewhart is known especially for the control chart and early work on what W. Edwards Deming made into the PDSA cycle. Deming is also known for other contributions, including his 14 points of management, correcting system problems rather than blaming the workers, and his System of Profound Knowledge. Juran is known for the Pareto principle and his emphasis on customer satisfaction and addressing the human, not just statistical side, of quality improvement. PMID:26147460

  4. 42 CFR 480.141 - Disclosure of QIO interpretations on the quality of health care.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS ACQUISITION, PROTECTION, AND DISCLOSURE OF QUALITY IMPROVEMENT ORGANIZATION REVIEW INFORMATION Utilization and Quality Control... 42 Public Health 4 2010-10-01 2010-10-01 false Disclosure of QIO interpretations on the quality...

  5. [A quality evaluation tableau for health institutions: an educational tool].

    PubMed

    Moll, Marie Christine; Decavel, Frédérique; Merlet, Christine

    2009-09-01

    For a few years, health institutions have had to comply with the certification and the need to establish the new governance. Thanks to the accreditation version 2 (obtained in 2005), the elaboration of the hospital project (adopted in October, 2006) and the organization in poles since 2006, the quality oriented management became a priority axis at the University Hospital of Angers. The strategic adaptation to quality requirements leads to develop the hospital management, more especially at the level of the clinical, medico technical and administrative poles. The elements of the hospital project including the part about the quality, risk and evaluation aim at being adapted by every pole according to the level of its project. This adaptation which is imposed to each pole manager requires a practical and educational accompaniment allowing at the same time to realize a diagnosis of the progress of the quality approach, a measure of the impact of the global impregnation within the institution and a comparison between pole. A eight axis dashboard with criteria and a user guide were developed from certification ISO 9001, the EFQM manual and the certification manual version 2 of the Healthcare High Authorities. The criteria are transcribed in an EXCEL grid ready to use. Succeeding in estimating your own quality system means that you demonstrate the maturity of the quality approach. The results of this evaluation confirmed those of the certification. The dashboard is a management structuring tool at the service of the multidisciplinary team. Two considerations emerge from these results: First of all, for the hospital top management, the axes to be improved emerge as a priority to determine and target the next annual action plans. The results also allow to support the auto evaluation for the certification version 2010 planned in January of the same year. It is a pragmatic tool which allows auto evaluation and comparison to estimate the pole performances. It is a strategic

  6. How to evaluate the quality of health related websites.

    PubMed

    Gattoni, Filippo; Sicola, Chiara

    2005-03-01

    To establish reliable quality criteria for medical websites is of foremost importance in relation to the increasing number of Internet users, both health professionals and lay people, searching for medical information in the mass of these sites. Quality in general refers to a set of features that distinguish one person or thing from others of the same type. The quality of a website is usually related to its content and usability. The first criteria we considered are contents and readability, which must be targeted to the intended type of user. Other important criteria include: transparency, consistency, honesty, references to sources, accountability, respect of privacy, currency of content material, responsibility, and accessibility. Technical criteria are the use of consolidated and standard technologies, soft colours, short page download time. Good medical websites should also follow the suggestions of organizations such as the World Health Organization, the Food and Drug Administration, the European Communities. Another organization, Health On Net Foundation, has issued some guidelines for medical websites, summarized in eight points, fundamental to assign real scientific value to a site. We believe, in agreement with the literature, that it is unnecessary to apply strict rules to medical website developers. We want to stress the importance of guidelines and recommendations to be modified with the development of web technology and the cultural evolution of patient and physicians. In the near future the presence on the Internet of websites certified by national or international medical web authorities will lead users to trust and give their preference to such sites, leading to the self-regulation of website developers and users. PMID:15775897

  7. Indoor air quality. [Health hazards due to energy conservation measures

    SciTech Connect

    Hollowell, C.D.

    1981-06-01

    Rising energy prices, among other factors, have generated an incentive to reduce ventilation rates and thereby reduce the cost of heating and cooling buildings. Reduced ventilation in buildings may significantly increase exposure to indoor air pollution and perhaps have adverse effects on occupant health and comfort. Preliminary findings suggest that reduced ventilation may adversely affect indoor air quality unless appropriate control strategies are undertaken. The strategies used to control indoor air pollution depend on the specific pollutant or class of pollutants encountered, and differ somewhat depending on whether the application is to an existing building or a new building under design and construction. Whenever possible, the first course of action is prevention or reduction of pollutant emissions at the source. In most buildings, control measures involve a combination of prevention, removal, and suppression. Common sources of indoor air pollution in buildings, the specific pollutants emitted by each source, the potential health effects, and possible control techniques are discussed.

  8. Quality and Value in an Evolving Health Care Landscape.

    PubMed

    Kamal, Robin N

    2016-07-01

    Demonstrating and improving value of care continues to be increasingly important in hand surgery. To prepare for emerging models that transition payment from volume to value, hand surgeons will benefit from a clear understanding of quality, cost, and value. National organizations and both public and private payers increasingly advocate for patient-reported outcome measures for pay for reporting and pay for performance initiatives. These are intended to incentivize providers and health systems to improve patient-centered care while minimizing costs. Appreciating the limitations to using patient-reported outcomes in hand surgery can ensure hand surgery is appropriately assessed in novel payment models. PMID:27374791

  9. Managing health care variability to achieve quality care.

    PubMed

    Simmons, J C

    2001-05-01

    While much has been written about variation and health care, one area that has received little attention is variation within hospitals related to the operations management--which can lead to wasted money and human resources. Two Boston researchers who have been studying this area say that addressing these variations--and using techniques found in other major industries across the country--could give hospitals a new tool in addressing patient safety issues, nursing shortages, cost containment, and overall better quality of care. PMID:11400326

  10. Quality Implementation in Health Physics Unit, Cosenza Hospital. Accreditation Program as Quality Improvement instrument.

    PubMed

    Loizzo, M; Siciliano, R

    2016-01-01

    Achieving high levels of quality in healthcare, which could be measurable, is increasingly important at present and is dictated by the radical changes of the welfare system imposed today by the well known economic constraints. However, even in the ongoing legislation, the practices concerning the verification and review of the quality of health care has had a major impact in the galaxy of Health. On the one hand, the citizen is developing an awareness of the possibilities of choice (Empowerment) between a plurality of providers of healthcare services, on the other hand providers themselves are obliged, within the logic of a global market, to retrain their offers to respond satisfactorily to the needs of citizens. The purpose of this study was to demonstrate how the adoption of Operational Procedures, following the granting of a certificate of accreditation to the Unit of Medical Physics, has changed the approach to the work on the part of health workers, in the direction of a dynamic quality improvement. PMID:27479767

  11. Perceptions of Local Health Care Quality in 7 Rural Communities with Telemedicine

    ERIC Educational Resources Information Center

    Nesbitt, Thomas S.; Marcin, James P.; Daschbach, Martha M.; Cole, Stacey L.

    2005-01-01

    Rural health services are difficult to maintain because of low patient volumes, limited numbers of providers, and unfavorable economies of scale. Rural patients may perceive poor quality in local health care, directly impacting the sustainability of local health care services. This study examines perceptions of local health care quality in 7…

  12. Water quality associated public health risk in Bo, Sierra Leone.

    PubMed

    Jimmy, David H; Sundufu, Abu J; Malanoski, Anthony P; Jacobsen, Kathryn H; Ansumana, Rashid; Leski, Tomasz A; Bangura, Umaru; Bockarie, Alfred S; Tejan, Edries; Lin, Baochuan; Stenger, David A

    2013-01-01

    Human health depends on reliable access to safe drinking water, but in many developing countries only a limited number of wells and boreholes are available. Many of these water resources are contaminated with biological or chemical pollutants. The goal of this study was to examine water access and quality in urban Bo, Sierra Leone. A health census and community mapping project in one neighborhood in Bo identified the 36 water sources used by the community. A water sample was taken from each water source and tested for a variety of microbiological and physicochemical substances. Only 38.9% of the water sources met World Health Organization (WHO) microbial safety requirements based on fecal coliform levels. Physiochemical analysis indicated that the majority (91.7%) of the water sources met the requirements set by the WHO. In combination, 25% of these water resources met safe drinking water criteria. No variables associated with wells were statistically significant predictors of contamination. This study indicated that fecal contamination is the greatest health risk associated with drinking water. There is a need to raise hygiene awareness and implement inexpensive methods to reduce fecal contamination and improve drinking water safety in Bo, Sierra Leone. PMID:22350346

  13. [Determinants of health and health policy. Part 3. From intervention of quality of life].

    PubMed

    Zácek, A

    2000-03-29

    Effectiveness of outputs of a qualified intervention can be valued by several positive criteria corresponding to the "quality of life" conception, which is based on the feeling of the health and contentment. The finding that great differences in the income among different social groups in conditions of the liberal market society correlate with several health and social problems brought about to the hypothesis that the decrease of the differences in the income, accompanied by strengthening of various forms of the social cohesion, civic solidarity, legitimate equality, and ethical justice may substantially improve the health status of the population. The hypothesis has been verified in many epidemiological studies and found to be valid enough for the health policy and far-seeing economy. Analytics of the World Bank recommend to governments primary invest into the health of socially week groups in order to decrease their poverty and to keep social conciliation. World Health Organization (WHO) sets in its new program for Europe called "21 Goals for the 21st Century" that differences in the health status among the European states should diminish till 2020 by one third and within the countries by one quarter at least. Both goals should be achieved by a substantial improvement of the health status of the ill-adapted social groups and by significant improvement of those socioeconomical conditions which may have adverse effects namely on the differences in incomes, education and opportunities for employment. PMID:10916199

  14. Making the case to improve quality and reduce costs in pediatric health care.

    PubMed

    Sachdeva, Ramesh C; Jain, Shabnam

    2009-08-01

    This article makes a case for the urgent need to improve health care quality and reduce costs. It provides an overview of the importance of the quality movement and the definition of quality, including the concept of clinical and operational quality. Some national drivers for quality improvement as well as drivers of escalating health care costs are discussed, along with the urgency of reducing health care costs. The link between quality and cost is reviewed using the concept of value in health care, which combines quality and cost in the same equation. The article ends with a discussion of future directions of the quality movement, including emerging concepts, such as risk-adjustment, shared responsibility for quality, measuring quality at the individual provider level, and evolving legal implications of the quality movement, as well as the concept of a shared savings model. PMID:19660624

  15. Dental health and oral health-related quality of life in children with congenital bleeding disorders.

    PubMed

    Salem, K; Eshghi, P

    2013-01-01

    The purpose of this study was to investigate the dental and some other aspects of oral health status of young patients with congenital bleeding disorders (CBD) and the impact of these on their quality of life (OHR-QoL) compared with controls. DMFS-dmfs (Decayed, Missed, Filled Tooth surfaces in permanent and primary teeth) scores, Simplified oral hygiene index, occurance of hypoplasia of first permanent molars, Temporomandibular joint dysfunction and occlusion of 46 CBD patients at the age range of 2-15 years and 46 of other children as control were compared, and the impact of their oral health situation on quality of life was also investigated. Data were analysed by chi-square, t-test and Pearson correlation. Patients were significantly more caries-free with less decayed teeth in primary-permanent dentition (P = 0.03, t = -2.17).The mean scores of OHR-QoL of CBD patients and controls were not significantly different. Oral Bleeding was the significant variable in relation to 'oral health-related quality of life' in CBD groups (Pearson correlation, r = -0.56, P = 0.000). OHR-QoL in the control group was related to dmfs score (r = -0.392, P = 0.011) and male gender (r = -0.329, P = 0.026). Congenital bleeding disorder CBD patients were found to have a better dental health situation in primary dentition compared with controls; however, their 'oral health-related quality of life' was similar. Oral bleeding was the only significant factor related to OHR-QoL in CBD. It shows an overall importance of development of comprehensive care centres for CBD as the main cause of this achievement. PMID:22970656

  16. Societal Factors in the Teaching of Chemistry.

    ERIC Educational Resources Information Center

    Cheek, William Edward

    The purpose of this study was to show that societal problems such as energy and pollution should be included as a central and underlying theme in a college chemistry course. A questionnaire was administered to 156 college students in science and technology to determine whether the students felt that they would be more highly motivated in chemistry…

  17. Atomoxetine's Effect on Societal Costs in Sweden

    ERIC Educational Resources Information Center

    Myren, Karl-Johan; Thernlund, Gunilla; Nylen, Asa; Schacht, Alexander; Svanborg, Par

    2010-01-01

    Objective: To compare societal costs between patients treated with atomoxetine and placebo in Sweden. Method: Ninety-nine pediatric ADHD patients were randomized to a 10-week double-blind treatment with atomoxetine (n = 49) or placebo (n = 50). All parents received four sessions of psycho-education. Parents filled out a resource utilization…

  18. Geospatial decision support systems for societal decision making

    USGS Publications Warehouse

    Bernknopf, R.L.

    2005-01-01

    While science provides reliable information to describe and understand the earth and its natural processes, it can contribute more. There are many important societal issues in which scientific information can play a critical role. Science can add greatly to policy and management decisions to minimize loss of life and property from natural and man-made disasters, to manage water, biological, energy, and mineral resources, and in general, to enhance and protect our quality of life. However, the link between science and decision-making is often complicated and imperfect. Technical language and methods surround scientific research and the dissemination of its results. Scientific investigations often are conducted under different conditions, with different spatial boundaries, and in different timeframes than those needed to support specific policy and societal decisions. Uncertainty is not uniformly reported in scientific investigations. If society does not know that data exist, what the data mean, where to use the data, or how to include uncertainty when a decision has to be made, then science gets left out -or misused- in a decision making process. This paper is about using Geospatial Decision Support Systems (GDSS) for quantitative policy analysis. Integrated natural -social science methods and tools in a Geographic Information System that respond to decision-making needs can be used to close the gap between science and society. The GDSS has been developed so that nonscientists can pose "what if" scenarios to evaluate hypothetical outcomes of policy and management choices. In this approach decision makers can evaluate the financial and geographic distribution of potential policy options and their societal implications. Actions, based on scientific information, can be taken to mitigate hazards, protect our air and water quality, preserve the planet's biodiversity, promote balanced land use planning, and judiciously exploit natural resources. Applications using the

  19. Health-related quality of life for chronically ill children.

    PubMed

    Cantrell, Mary Ann; Kelly, Michelle M

    2015-01-01

    Approximately 43% of children in the United States (32 million) are currently living with at least 1 of 20 common chronic childhood illnesses. The most common chronic childhood illnesses are asthma, cystic fibrosis, diabetes, obesity, malnutrition, developmental disabilities, cerebral palsy, consequences of low birthweight, and mental illness. For all chronically ill pediatric populations, the outcome of health-related quality of life (HRQOL) is particularly important because many of these children have not and will not be cured, and will continue to manage their chronic illness into adulthood. Advances in biomedical science and technology continue to improve efficacy of treatments and care for chronically ill children, adolescents, and their families, which highlight the importance measurement of HRQOL as a treatment and health status outcome. The construct of HRQOL is subjective, multidimensional, dynamic, and unique to each individual. It includes aspects of physical, psychological, social function, and goal attainment. Outcomes of HRQOL now include the financial implications for these children and their families, as well as financial and organizational consequences for healthcare planning and delivery of services.This article reviews the importance of HRQOL as a health outcome for chronically ill children. A historical overview and synthesis of the conceptualization and measurement of HRQOL for the chronically ill pediatric population is provided. Current research investigations that have measured health outcomes using individual scales tailored to children's specific symptoms health outcomes, such as PROMIS®-Patient Reported Outcomes Measurement Information System-are reviewed. The clinical applications of HRQOL outcomes research include facilitation of patient-healthcare provider communication, improved patient satisfaction, identification of hidden morbidities, a positive impact on clinical decision making, and improvement of patient outcomes over time

  20. Health-Related Quality of Life and Appropriateness of Cholecystectomy

    PubMed Central

    Quintana, José Ma; Cabriada, Jose; Aróstegui, Inmaculada; Oribe, Victor; Perdigo, Luis; Varona, Mercedes; Bilbao, Amaia

    2005-01-01

    Ojbective: To evaluate the relationship among appropriateness of the use of cholecystectomy and outcomes. Summary Background Data: The use of cholecystectomy varies widely across regions and countries. Explicit appropriateness criteria may help identify suitable candidates for this commonly performed procedure. This study evaluates the relationship among appropriateness of the use of cholecystectomy and outcomes. Methods: Prospective observational study in 6 public hospitals in Spain of all consecutive patients on waiting lists to undergo cholecystectomy for nonmalignant disease. Explicit appropriateness criteria for the use of cholecystectomy were developed by a panel of experts using the RAND appropriateness methodology and applied to recruited patients. Patients were asked to complete 2 questionnaires that measure health-related quality of life—the Short Form 36 (SF-36) and the Gastrointestinal Quality of Life Index (GIQLI)—before the intervention and 3 months after it. Results: Patients judged as being appropriate candidates for cholecystectomy, using the panel's explicit appropriateness criteria, had greater improvements in the bodily pain, vitality, and social function domains of the SF-36 than those judged to be inappropriate candidates. They also demonstrated improvements in the GIQLI's physical impairment domain. Interventions judged as inappropriate were performed primarily among patients without symptoms of cholelithiasis. Those asymptomatic had a lower improvement in the bodily pain, social functioning, and physical summary scale of the SF-36 and in the symptomatology, physical impairment, and total score domains of the GIQLI. Conclusions: These results suggest a direct relationship between the application of explicit appropriateness criteria and better outcomes, as measured by health-related quality of life. They also indicate that patients without symptoms are not good candidates for cholecystectomy. PMID:15621998

  1. [Health-related quality of life in Parkinson's disease].

    PubMed

    Cano-de la Cuerda, Roberto; Vela-Desojo, Lydia; Miangolarra-Page, Juan C; Macías-Macías, Yolanda; Muñoz-Hellin, Elena

    2010-01-01

    Parkinson's disease is a disabling and progressive neurological condition characterized by multiple motor and non motor symptoms that contribute to deterioration in quality of life. The diversity of symptoms associated with the disease and its management affect the patients on their physical, social and mental quality of life. The aim of this study was to identify key dimensions of health related quality of life (HRQOL) in a population affected with Parkinson's disease with a degree of mild-moderate impairment. Thirty six patients with Parkinson were recruited. The Hoehn and Yarh scale, the Unified Parkinson's Disease Rate Scale, the scale of activities of daily life and Schwab & England Get Up & Go Test were applied. HRQOL was assessed with the EuroQol-5D and the specific questionnaire Parkinson's Disease Questionnaire-39 items. The dimensions of the PDQ-39, except the PDQ-39 Pain domain and the EuroQol-5D correlated significantly with the severity of the disease. HRQOL was correlated with the functional status of patients. Only the PDQ-39 pain domain correlated with the risk of falls. Our results suggest that the HRQOL of patients with PD, in a state of mild-moderate impairment, is strongly influenced by disease severity and functional status. PMID:21163736

  2. Client satisfaction and quality of health care in rural Bangladesh.

    PubMed Central

    Mendoza Aldana, J.; Piechulek, H.; al-Sabir, A.

    2001-01-01

    OBJECTIVE: To assess user expectations and degree of client satisfaction and quality of health care provided in rural Bangladesh. METHODS: A total of 1913 persons chosen by systematic random sampling were successfully interviewed immediately after having received care in government health facilities. FINDINGS: The most powerful predictor for client satisfaction with the government services was provider behaviour, especially respect and politeness. For patients this aspect was much more important than the technical competence of the provider. Furthermore, a reduction in waiting time (on average to 30 min) was more important to clients than a prolongation of the quite short (from a medical standpoint) consultation time (on average 2 min, 22 sec), with 75% of clients being satisfied. Waiting time, which was about double at outreach services than that at fixed services, was the only element with which users of outreach services were dissatisfied. CONCLUSIONS: This study underscores that client satisfaction is determined by the cultural background of the people. It shows the dilemma that, though optimally care should be capable of meeting both medical and psychosocial needs, in reality care that meets all medical needs may fail to meet the client's emotional or social needs. Conversely, care that meets psychosocial needs may leave the clients medically at risk. It seems important that developing countries promoting client-oriented health services should carry out more in-depth research on the determinants of client satisfaction in the respective culture. PMID:11436472

  3. The ethics of using quality improvement methods in health care.

    PubMed

    Lynn, Joanne; Baily, Mary Ann; Bottrell, Melissa; Jennings, Bruce; Levine, Robert J; Davidoff, Frank; Casarett, David; Corrigan, Janet; Fox, Ellen; Wynia, Matthew K; Agich, George J; O'Kane, Margaret; Speroff, Theodore; Schyve, Paul; Batalden, Paul; Tunis, Sean; Berlinger, Nancy; Cronenwett, Linda; Fitzmaurice, J Michael; Dubler, Nancy Neveloff; James, Brent

    2007-05-01

    Quality improvement (QI) activities can improve health care but must be conducted ethically. The Hastings Center convened leaders and scholars to address ethical requirements for QI and their relationship to regulations protecting human subjects of research. The group defined QI as systematic, data-guided activities designed to bring about immediate improvements in health care delivery in particular settings and concluded that QI is an intrinsic part of normal health care operations. Both clinicians and patients have an ethical responsibility to participate in QI, provided that it complies with specified ethical requirements. Most QI activities are not human subjects research and should not undergo review by an institutional review board; rather, appropriately calibrated supervision of QI activities should be part of professional supervision of clinical practice. The group formulated a framework that would use key characteristics of a project and its context to categorize it as QI, human subjects research, or both, with the potential of a customized institutional review board process for the overlap category. The group recommended a period of innovation and evaluation to refine the framework for ethical conduct of QI and to integrate that framework into clinical practice. PMID:17438310

  4. Marital quality and health: Implications for marriage in the 21st century

    PubMed Central

    Robles, Theodore F.

    2014-01-01

    Being in a happy marriage is related to better psychological and physical health. This paper describes current approaches to conceptualizing and measuring marital quality and physical health, and results from a recent meta-analysis examining associations between marital quality and physical health outcomes. To illustrate the practical significance of these findings, this paper also illustrates how the magnitude of the marital quality – physical health association is similar in size to associations between health behaviors (diet, physical activity) and health outcomes, and briefly reviews the state of the science regarding plausible biobehavioral pathways that explain how marital functioning influences health. After describing the current state of research on factors that might modify the association between marital quality and health, particularly individual differences and gender, the paper concludes with implications of the past 50 years of research on marital quality and health for marriage in the 21st century. PMID:25544806

  5. Optimism and diet quality in the Women's Health Initiative.

    PubMed

    Hingle, Melanie D; Wertheim, Betsy C; Tindle, Hilary A; Tinker, Lesley; Seguin, Rebecca A; Rosal, Milagros C; Thomson, Cynthia A

    2014-07-01

    Diet quality has not been well studied in relation to positive psychological traits. Our purpose was to investigate the relationship between optimism and diet quality in postmenopausal women enrolled in the Women's Health Initiative observational study (OS) and clinical trials (CTs), and to determine whether optimism was associated with diet change after a 1-year dietary intervention. Diet quality was scored with the Alternate Healthy Eating Index (AHEI) and optimism assessed with the Life Orientation Test-Revised. Baseline characteristics were compared across AHEI quintiles or optimism tertiles using regression models with each variable of interest as a function of quintiles or tertiles (OS, n=87,630; CT, n=65,360). Association between optimism and baseline AHEI and change in AHEI over 1 year were tested using multivariate linear regression (CT, n=13,645). Potential interaction between optimism and trial arm and demographic/lifestyle factors on AHEI change was tested using likelihood ratio test (CT intervention, n=13,645; CT control, n=20,242). Women reporting high AHEI were non-Hispanic white, educated, physically active, past or never smokers, hormone therapy users, had lower body mass index and waist circumference, and were less likely to have chronic conditions. In the CT intervention, higher optimism was associated with higher AHEI at baseline and with greater change over 1 year (P=0.001). Effect modification by intervention status was observed (P=0.014), whereas control participants with highest optimism achieved threefold greater AHEI increase compared with those with the lowest optimism. These data support a relationship between optimism and dietary quality score in postmenopausal women at baseline and over 1 year. PMID:24556429

  6. mHealth Quality: A Process to Seal the Qualified Mobile Health Apps.

    PubMed

    Yasini, Mobin; Beranger, Jérôme; Desmarais, Pierre; Perez, Lucas; Marchand, Guillaume

    2016-01-01

    A large number of mobile health applications (apps) are currently available with a variety of functionalities. The user ratings in the app stores seem not to be reliable to determine the quality of the apps. The traditional methods of evaluation are not suitable for fast paced nature of mobile technology. In this study, we propose a collaborative multidimensional scale to assess the quality of mHealth apps. During our process, the app quality is assessed in various aspects including medical reliability, legal consistency, ethical consistency, usability aspects, personal data privacy and IT security. A hypothetico-deductive approach was used in various working groups to define the audit criteria based on the various use cases that an app could provide. These criteria were then implemented into a web based self-administered questionnaires and the generation of automatic reports were considered. This method is on the one hand specific to each app because it allows to assess each health app according to its offered functionalities. On the other hand, this method is automatic, transferable to all apps and adapted to the dynamic nature of mobile technology. PMID:27577372

  7. Subjective food intake ability related to oral health-related quality of life and psychological health.

    PubMed

    Choi, S-H; Kim, J-S; Cha, J-Y; Lee, K-J; Yu, H-S; Hwang, C-J

    2016-09-01

    Reduced food intake ability can restrict an individual's choice of foods and might have a significant impact on the individual's quality of life and mental health. The aim of this study was to evaluate the correlations between self-reported masticatory ability and oral health-related quality of life (OHRQOL) and psychological health. The study included 72 (26 men, 46 women) adults with a mean age of 26·4 ± 8·6 years. Each participant completed the key subjective food intake ability (KFIA) test for five key foods, the Korean version of the Oral Health Impact Profile-14 (OHIP-14K) and three questionnaires for measuring anxiety, depression and self-esteem. The participants were distributed into two groups by sex (a mean age of 23·9 ± 5·2 for men and 27·9 ± 9·8 for women) and by the median KFIA score. There were no significant differences in any of the variables according to sex. Thirty-two participants (12 men, 20 women) in the lower KFIA group had a higher total OHIP-14K (P < 0·001) and depression level (P < 0·05) than the 40 participants (14 men, 26 women) in the higher KFIA group. As the KFIA decreased, OHRQOL worsened (P < 0·001) and depression increased (P < 0·05). Participants with lower KFIA scores were more than 4·3 times as likely as to have a poor OHRQOL than the reference group (odds ratio, 4·348; 95% confidence interval, 1·554-12·170, P < 0·01). Lower subjective food intake ability is associated with a poor oral health-related quality of life and higher depression level. PMID:27224265

  8. 42 CFR 422.2430 - Activities that improve health care quality.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ..., evidence-based medicine, and health information technology under the plan or coverage. (iv) To promote... 42 Public Health 3 2014-10-01 2014-10-01 false Activities that improve health care quality. 422.2430 Section 422.2430 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH...

  9. 42 CFR 423.2430 - Activities that improve health care quality.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ..., evidence-based medicine, and health information technology under the plan or coverage. (iv) To promote... 42 Public Health 3 2013-10-01 2013-10-01 false Activities that improve health care quality. 423.2430 Section 423.2430 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH...

  10. 42 CFR 423.2430 - Activities that improve health care quality.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ..., evidence-based medicine, and health information technology under the plan or coverage. (iv) To promote... 42 Public Health 3 2014-10-01 2014-10-01 false Activities that improve health care quality. 423.2430 Section 423.2430 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH...

  11. 42 CFR 422.2430 - Activities that improve health care quality.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ..., evidence-based medicine, and health information technology under the plan or coverage. (iv) To promote... 42 Public Health 3 2013-10-01 2013-10-01 false Activities that improve health care quality. 422.2430 Section 422.2430 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH...

  12. Health information technology and health system redesign--the Quality Chasm revisited.

    PubMed

    Tuckson, Reed V; Vojta, Deneen; Slavitt, Andrew M

    2010-12-01

    UnitedHealth Group constructed the Diabetes Prevention and Control Alliance (DPCA) in a manner consistent with the recommendations for health system redesign outlined in the Institute of Medicine's Crossing the Quality Chasm. This evidence-based, multidisciplinary education and intervention program is enabled by a state-of-the-art health information technology (HIT) infrastructure. DPCA coordinates and connects a variety of interventions through HIT, including community-based services offered by YMCAs and local pharmacists. Our initial experience in operating DPCA gives us confidence that large-scale prevention and disease control management programs make economic sense, are worthy of front-end investment, and can achieve cost-effective results. Others who want to use our model will benefit from policymakers' efforts to prioritize future versions of transaction and coding standards that meet the needs of preventive healthcare as much as they do acute and chronic care. PMID:21314221

  13. Towards Evidence-Based, Quality-Controlled Health Promotion: The Dutch Recognition System for Health Promotion Interventions

    ERIC Educational Resources Information Center

    Brug, Johannes; van Dale, Djoeke; Lanting, Loes; Kremers, Stef; Veenhof, Cindy; Leurs, Mariken; van Yperen, Tom; Kok, Gerjo

    2010-01-01

    Registration or recognition systems for best-practice health promotion interventions may contribute to better quality assurance and control in health promotion practice. In the Netherlands, such a system has been developed and is being implemented aiming to provide policy makers and professionals with more information on the quality and…

  14. Social and economic costs and health-related quality of life in stroke survivors in the Canary Islands, Spain

    PubMed Central

    2012-01-01

    Background Cost-of-illness analysis is the main method of providing an overall vision of the economic impact of a disease. Such studies have been used to set priorities for healthcare policies and inform resource allocation. The aim of this study was to determine the economic burden and health-related quality of life (HRQOL) in the first, second and third years after surviving a stroke in the Canary Islands, Spain. Methods Cross-sectional, retrospective study of 448 patients with stroke based on ICD 9 discharge codes, who received outpatient care at five hospitals. The study was approved by the Research Ethics Committee of Nuestra Señora de la Candelaria University Hospital. Data on demographic characteristics, health resource utilization, informal care, labor productivity losses and HRQOL were collected from the hospital admissions databases and questionnaires completed by stroke patients or their caregivers. Labor productivity losses were calculated from physical units and converted into monetary units with a human capital-based method. HRQOL was measured with the EuroQol EQ-5D questionnaire. Healthcare costs, productivity losses and informal care costs were analyzed with log-normal, probit and ordered probit multivariate models. Results The average cost for each stroke survivor was €17 618 in the first, €14 453 in the second and €12 924 in the third year after the stroke; the reference year for unit prices was 2004. The largest expenditures in the first year were informal care and hospitalizations; in the second and third years the main costs were for informal care, productivity losses and medication. Mean EQ-5D index scores for stroke survivors were 0.50 for the first, 0.47 for the second and 0.46 for the third year, and mean EQ-5D visual analog scale scores were 56, 52 and 55, respectively. Conclusions The main strengths of this study lie in our bottom-up-approach to costing, and in the evaluation of stroke survivors from a broad perspective (societal

  15. Determinants of Health and the Quality of Life in the Bella Coola Valley

    ERIC Educational Resources Information Center

    Michalos, Alex C.; Thommasen, Harvey V.; Read, Rua; Anderson, Nancy; Zumbo, Bruno D.

    2005-01-01

    The aim of this investigation is to obtain some baseline self-reported data of the health status and overall quality of life of all residents of the Bella Coola Valley of British Columbia aged 17 years or older, and to measure the impact of a set of designated health determinants on their health and quality of life. In the period from August to…

  16. 77 FR 70786 - Request for Information Regarding Health Care Quality for Exchanges

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-27

    ... HUMAN SERVICES Centers for Medicare & Medicaid Services Request for Information Regarding Health Care... Improvement in Health Care (National Quality Strategy) to create national aims and priorities that would guide local, state, and national efforts to improve the quality of health care in the United States....

  17. Improving the quality of workers' compensation health care delivery: the Washington State Occupational Health Services Project.

    PubMed

    Wickizer, T M; Franklin, G; Plaeger-Brockway, R; Mootz, R D

    2001-01-01

    This article has summarized research and policy activities undertaken in Washington State over the past several years to identify the key problems that result in poor quality and excessive disability among injured workers, and the types of system and delivery changes that could best address these problems in order to improve the quality of occupational health care provided through the workers' compensation system. Our investigations have consistently pointed to the lack of coordination and integration of occupational health services as having major adverse effects on quality and health outcomes for workers' compensation. The Managed Care Pilot Project, a delivery system intervention, focused on making changes in how care is organized and delivered to injured workers. That project demonstrated robust improvements in disability reduction; however, worker satisfaction suffered. Our current quality improvement initiative, developed through the Occupational Health Services Project, synthesizes what was learned from the MCP and other pilot studies to make delivery system improvements. This initiative seeks to develop provider incentives and clinical management processes that will improve outcomes and reduce the burden of disability on injured workers. Fundamental to this approach are simultaneously preserving workers' right to choose their own physician and maintaining flexibility in the provision of individualized care based on clinical need and progress. The OHS project then will be a "real world" test to determine if aligning provider incentives and giving physicians the tools they need to optimize occupational health delivery can demonstrate sustainable reduction in disability and improvements in patient and employer satisfaction. Critical to the success of this initiative will be our ability to: (1) enhance the occupational health care management skills and expertise of physicians who treat injured workers by establishing community-based Centers of Occupational

  18. Association between overuse of mobile phones on quality of sleep and general health among occupational health and safety students.

    PubMed

    Eyvazlou, Meysam; Zarei, Esmaeil; Rahimi, Azin; Abazari, Malek

    2016-01-01

    Concerns about health problems due to the increasing use of mobile phones are growing. Excessive use of mobile phones can affect the quality of sleep as one of the important issues in the health literature and general health of people. Therefore, this study investigated the relationship between the excessive use of mobile phones and general health and quality of sleep on 450 Occupational Health and Safety (OH&S) students in five universities of medical sciences in the North East of Iran in 2014. To achieve this objective, special questionnaires that included Cell Phone Overuse Scale, Pittsburgh's Sleep Quality Index (PSQI) and General Health Questionnaire (GHQ) were used, respectively. In addition to descriptive statistical methods, independent t-test, Pearson correlation, analysis of variance (ANOVA) and multiple regression tests were performed. The results revealed that half of the students had a poor level of sleep quality and most of them were considered unhealthy. The Pearson correlation co-efficient indicated a significant association between the excessive use of mobile phones and the total score of general health and the quality of sleep. In addition, the results of the multiple regression showed that the excessive use of mobile phones has a significant relationship between each of the four subscales of general health and the quality of sleep. Furthermore, the results of the multivariate regression indicated that the quality of sleep has a simultaneous effect on each of the four scales of the general health. Overall, a simultaneous study of the effects of the mobile phones on the quality of sleep and the general health could be considered as a trigger to employ some intervention programs to improve their general health status, quality of sleep and consequently educational performance. PMID:26942630

  19. Systematic review of health-related quality of life models

    PubMed Central

    2012-01-01

    Background A systematic literature review was conducted to (a) identify the most frequently used health-related quality of life (HRQOL) models and (b) critique those models. Methods Online search engines were queried using pre-determined inclusion and exclusion criteria. We reviewed titles, abstracts, and then full-text articles for their relevance to this review. Then the most commonly used models were identified, reviewed in tables, and critiqued using published criteria. Results Of 1,602 titles identified, 100 articles from 21 countries met the inclusion criteria. The most frequently used HRQOL models were: Wilson and Cleary (16%), Ferrans and colleagues (4%), or World Health Organization (WHO) (5%). Ferrans and colleagues’ model was a revision of Wilson and Cleary’s model and appeared to have the greatest potential to guide future HRQOL research and practice. Conclusions Recommendations are for researchers to use one of the three common HRQOL models unless there are compelling and clearly delineated reasons for creating new models. Disease-specific models can be derived from one of the three commonly used HRQOL models. We recommend Ferrans and colleagues’ model because they added individual and environmental characteristics to the popular Wilson and Cleary model to better explain HRQOL. Using a common HRQOL model across studies will promote a coherent body of evidence that will more quickly advance the science in the area of HRQOL. PMID:23158687

  20. Construction of an environmental quality index for public health research

    PubMed Central

    2014-01-01

    Background A more comprehensive estimate of environmental quality would improve our understanding of the relationship between environmental conditions and human health. An environmental quality index (EQI) for all counties in the U.S. was developed. Methods The EQI was developed in four parts: domain identification; data source acquisition; variable construction; and data reduction. Five environmental domains (air, water, land, built and sociodemographic) were recognized. Within each domain, data sources were identified; each was temporally (years 2000–2005) and geographically (county) restricted. Variables were constructed for each domain and assessed for missingness, collinearity, and normality. Domain-specific data reduction was accomplished using principal components analysis (PCA), resulting in domain-specific indices. Domain-specific indices were then combined into an overall EQI using PCA. In each PCA procedure, the first principal component was retained. Both domain-specific indices and overall EQI were stratified by four rural–urban continuum codes (RUCC). Higher values for each index were set to correspond to areas with poorer environmental quality. Results Concentrations of included variables differed across rural–urban strata, as did within-domain variable loadings, and domain index loadings for the EQI. In general, higher values of the air and sociodemographic indices were found in the more metropolitan areas and the most thinly populated areas have the lowest values of each of the domain indices. The less-urbanized counties (RUCC 3) demonstrated the greatest heterogeneity and range of EQI scores (−4.76, 3.57) while the thinly populated strata (RUCC 4) contained counties with the most positive scores (EQI score ranges from −5.86, 2.52). Conclusion The EQI holds promise for improving our characterization of the overall environment for public health. The EQI describes the non-residential ambient county-level conditions to which residents are

  1. Cost-Effectiveness of Treatments for Relapsing Remitting Multiple Sclerosis: A French Societal Perspective

    PubMed Central

    Chevalier, Julie; Chamoux, Catherine; Hammès, Florence; Chicoye, Annie

    2016-01-01

    Objectives The paper aimed to estimate the incremental cost-effectiveness ratio (ICER) at the public published price for delayed-release dimethyl fumarate versus relevant Multiple Sclerosis disease-modifying therapies available in France in June 2015. Methods The economic model was adapted to the French setting in accordance with the Haute Autorité de Santé guidelines using a model previously developed for NICE. A cohort of Relapsing Remitting Multiple Sclerosis patients was simulated over a 30-year time horizon. Twenty one health states were taken into account: Kurtzke Expanded Disability Status Scale (EDSS) 0–9 for Relapsing Remitting Multiple Sclerosis patients, EDSS 0–9 for Secondary Progressive Multiple Sclerosis patients, and death. Estimates of relative treatment efficacy were determined using a mixed-treatment comparison. Probabilities of events were derived from the dimethyl fumarate pivotal clinical trials and the London Ontario Dataset. Costs and utilities were extracted from the published literature from both the payer and societal perspectives. Univariate and probabilistic sensitivity analyses were performed to assess the robustness of the model results. Results From both perspectives, dimethyl fumarate and interferon beta-1a (IFN beta-1a) 44mcg were the two optimal treatments, as the other treatments (IFN beta-1a 30mcg, IFN beta-1b 250mcg, teriflunomide, glatiramer acetate, fingolimod) were dominated on the efficiency frontier. From the societal perspective, dimethyl fumarate versus IFN beta-1a 44mcg incurred an incremental cost of €3,684 and an incremental quality-adjusted life year (QALY) of 0.281, corresponding to an ICER of €13,110/QALY. Conclusions Despite no reference threshold for France, dimethyl fumarate can be considered as a cost-effective option as it is on the efficiency frontier. PMID:26987055

  2. Health-Related Quality of Life in Children with High-Functioning Autism

    ERIC Educational Resources Information Center

    Potvin, Marie-Christine; Snider, Laurie; Prelock, Patricia A.; Wood-Dauphinee, Sharon; Kehayia, Eva

    2015-01-01

    The health-related quality of life of school-aged children with high-functioning autism is poorly understood. The objectives of this study were to compare the health-related quality of life of children with high-functioning autism to that of typically developing peers and to compare child-self and parent-proxy reports of health-related quality of…

  3. End-user perspectives on e-commerce and health care web site quality.

    PubMed

    Le Rouge, Cynthia; De Leo, Gianluca

    2008-01-01

    We explore and compare the importance of various quality dimensions for health care and e-commerce web sites. The results show that the importance of various quality attributes for all except four of ten quality dimensions studied differ between health care and e-commerce web sites. These results can help health care managers to improve and/or to guide the design of their web sites. PMID:18998907

  4. Assessing societal impacts when planning restoration of large alluvial rivers: a case study of the Sacramento River project, California.

    PubMed

    Golet, Gregory H; Roberts, Michael D; Larsen, Eric W; Luster, Ryan A; Unger, Ron; Werner, Gregg; White, Gregory G

    2006-06-01

    Studies have shown that ecological restoration projects are more likely to gain public support if they simultaneously increase important human services that natural resources provide to people. River restoration projects have the potential to influence many of the societal functions (e.g., flood control, water quality) that rivers provide, yet most projects fail to consider this in a comprehensive manner. Most river restoration projects also fail to take into account opportunities for revitalization of large-scale river processes, focusing instead on opportunities presented at individual parcels. In an effort to avoid these pitfalls while planning restoration of the Sacramento River, we conducted a set of coordinated studies to evaluate societal impacts of alternative restoration actions over a large geographic area. Our studies were designed to identify restoration actions that offer benefits to both society and the ecosystem and to meet the information needs of agency planning teams focusing on the area. We worked with local partners and public stakeholders to design and implement studies that assessed the effects of alternative restoration actions on flooding and erosion patterns, socioeconomics, cultural resources, and public access and recreation. We found that by explicitly and scientifically melding societal and ecosystem perspectives, it was possible to identify restoration actions that simultaneously improve both ecosystem health and the services (e.g., flood protection and recreation) that the Sacramento River and its floodplain provide to people. Further, we found that by directly engaging with local stakeholders to formulate, implement, and interpret the studies, we were able to develop a high level of trust that ultimately translated into widespread support for the project. PMID:16523370

  5. Health Reporting in Print Media in Lebanon: Evidence, Quality and Role in Informing Policymaking

    PubMed Central

    El-Jardali, Fadi; Bou Karroum, Lama; Bawab, Lamya; Kdouh, Ola; El-Sayed, Farah; Rachidi, Hala; Makki, Malak

    2015-01-01

    Background Media plays a vital role in shaping public policies and opinions through disseminating health-related information. This study aims at exploring the role of media in informing health policies in Lebanon, identifying the factors influencing health reporting and investigating the role of evidence in health journalism and the quality of health reporting. It also identifies strategies to enhance the use of evidence in health journalism and improve the quality of health reporting. Methods Media analysis was conducted to assess the way media reports on health-related issues and the quality of reporting using a quality assessment tool. Semi-structured interviews were also conducted with 27 journalists, researchers and policymakers to explore their perception on the role of media in health policymaking and the factors influencing health reporting. In addition, a validation workshop was conducted. Results Out of 1,279 health-related news articles identified, 318 articles used certain type of evidence to report health issues 39.8% of which relied on experts’ opinions as their source of evidence while only 5.9% referenced peer-reviewed research studies. The quality of health reporting was judged to be low based on a quality assessment tool consisting of a set of ten criteria. Journalists raised concerns about issues impeding them from referring to evidence. Journalists also reported difficulties with the investigative health journalism. Policymakers and researchers viewed media as an important tool for evidence-informed health policies, however, serious concerns were voiced in terms of the current practice and capacities. Conclusion Our study provides a structured reflection on the role of media and the factors that influence health reporting including context-specific strategies that would enhance the quality and promote the use of evidence in health reporting. In the light of the political changes in many Middle Eastern countries, findings from this study can

  6. 77 FR 3841 - Proposed Information Collection (Survey of Veteran Enrollees (Quality and Efficiency of VA Health...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-25

    ... Care)) Activities Under OMB Review AGENCY: Veterans Health Administration, Department of Veterans... VA Health Care), VA Form 10-21088. OMB Control Number: 2900-0725. Type of Review: Extension of a... promote quality and efficient delivery of health care through the use of health information...

  7. Assessment of the quality of measures of child oral health-related quality of life

    PubMed Central

    2014-01-01

    Background Several measures of oral health-related quality of life have been developed for children. The most frequently used are the Child Perceptions Questionnaire (CPQ), the Child Oral Impacts on Daily Performances (C-OIDP) and the Child Oral Health Impact Profile (COHIP). The aim of this study was to assess the methodological quality of the development and testing of these three measures. Methods A systematic search strategy was used to identify eligible studies published up to December 2012, using both MEDLINE and Web of Science. Titles and abstracts were read independently by two investigators and full papers retrieved where the inclusion criteria were met. Data were extracted by two teams of two investigators using a piloted protocol. The data were used to describe the development of the measures and their use against existing criteria. The methodological quality and measurement properties of the measures were assessed using standards proposed by the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) group. Results The search strategy yielded 653 papers, of which 417 were duplicates. Following analysis of the abstracts, 119 papers met the inclusion criteria. The majority of papers reported cross-sectional studies (n = 117) with three of longitudinal design. Fifteen studies which had used the original version of the measures in their original language were included in the COSMIN analysis. The most frequently used measure was the CPQ. Reliability and construct validity appear to be adequate for all three measures. Children were not fully involved in item generation which may compromise their content validity. Internal consistency was measured using classic test theory with no evidence of modern psychometric techniques being used to test unidimensionality of the measures included in the COSMIN analysis. Conclusion The three measures evaluated appear to be able to discriminate between groups. CPQ has been most widely

  8. Making the Case for Universal School-Based Mental Health Screening

    ERIC Educational Resources Information Center

    Humphrey, Neil; Wigelsworth, Michael

    2016-01-01

    Mental health difficulties affect 1 in 10 children and adolescents, and up to half of adult cases begin during the school years. The individual and societal impacts of such difficulties are huge, and include poorer quality of life, lost economic productivity, destabilisation of communities, and high rates of health, education and social care…

  9. Do employers know the quality of health care benefits they provide? Use of HEDIS depression scores for health plans.

    PubMed

    Robst, John; Rost, Kathryn; Marshall, Donna

    2013-11-01

    OBJECTIVE Dissemination of health quality measures is a necessary ingredient of efforts to harness market-based forces, such as value-based purchasing by employers, to improve health care quality. This study examined reporting of Healthcare Effectiveness Data and Information Set (HEDIS) measures for depression to firms interested in improving depression care. METHODS During surveys conducted between 2009 and 2011, a sample of 325 employers that were interested in improving depression treatment were asked whether their primary health plan reports HEDIS scores for depression to the National Committee for Quality Assurance (NCQA) and if so, whether they knew the scores. Data about HEDIS reporting by the health plans were collected from the NCQA. RESULTS HEDIS depression scores were reported by the primary health plans of 154 (47%) employers, but only 7% of employers knew their plan's HEDIS scores. Because larger employers were more likely to report knowing the scores, 53% of all employees worked for employers who reported knowing the scores. A number of structural, health benefit, and need characteristics predicted knowledge of HEDIS depression scores by employers. CONCLUSIONS The study demonstrated that motivated employers did not know their depression HEDIS scores even when their plan publicly reported them. Measures of health care quality are not reaching the buyers of insurance products; however, larger employers were more likely to know the HEDIS scores for their health plan, suggesting that value-based purchasing may have some ability to affect health care quality. PMID:23945985

  10. Sensory Impairment and Health-Related Quality of Life

    PubMed Central

    KWON, Hye-Jin; KIM, Ji-su; KIM, Yoon-jung; KWON, Su-jin; YU, Jin-Na

    2015-01-01

    Background: Sensory impairment is a common condition that exerts negative effects on health-related quality of life (HRQoL) in the elderly. This study aimed to determine the relationship between sensory impairment and HRQoL and identify sensory-specific differences in the HRQoL of elderly. Methods: This study used data from the Korean National Health and Nutrition Examination Survey V (2010–2012), analyzing 5,260 subjects over 60 years of age who completed ophthalmic and otologic examinations. Vision and hearing impairment were measured and classified. HRQoL was determined according to the European QoL five dimension test (EQ-5D). Multivariate logistic regression analysis and analysis of covariance were performed to identify relationships between sensory impairment and HRQoL dimensions as well as differences in HRQoL scores. Results: In the final adjusted multivariate model, there was a statistically higher proportion of those with dual sensory impairment who reported problems with mobility (adjusted odds ratio [aOR] 2.30, 95% confidence interval [CI] 1.45–5.03), usual activities (aOR 2.32, 95% CI 1.16–4.64), and pain/discomfort among EQ-5D subcategories (aOR 1.79, 95% CI 1.07–2.97). In the EQ-5D dimensions, the means and standard deviations of vision impairment (0.86 [0.01]) and dual sensory impairment (0.84 [0.02]) appeared meaningfully lower than those for no sensory impairment (0.88 [0.00]) or hearing impairment (0.88 [0.01]); P = .02). Conclusion: Sensory impairment reduces HRQoL in the elderly. Improvement of HRQoL in the elderly thus requires regular screening and appropriate management of sensory impairment. PMID:26258089

  11. Housing quality, housing instability, and maternal mental health.

    PubMed

    Suglia, Shakira Franco; Duarte, Cristiane S; Sandel, Megan T

    2011-12-01

    Poor housing conditions and residential instability have been associated with distress among women; however, this association could be the result of other social factors related to housing, such as intimate partner violence (IPV) and economic hardship. We examined associations of housing conditions and instability with maternal depression and generalized anxiety disorder (GAD) while accounting for IPV and economic hardship in the Fragile Families and Child Wellbeing Study (N = 2,104). In the third study wave, interviewers rated indoor housing quality, including housing deterioration (e.g., peeling paint and holes in floor) and housing disarray (e.g., dark, crowded, and noisy). Mothers reported whether they had moved more than twice in the past two years, an indicator of housing instability. A screening for depression and GAD was obtained from questions derived from the Composite International Diagnostic Interview-Short Form in the second and third study waves. IPV and economic hardship were assessed through questionnaire. In this sample, 16% of women were classified as having probable depression and 5% as having probable GAD. In adjusted analyses, mothers experiencing housing disarray (odds ratio [OR], 1.3 [95% confidence interval (CI), 1.0, 1.7]) and instability (OR, 1.4 [95% CI, 1.2, 2.3]) were more likely to screen positive for depression. In addition, those experiencing housing instability were more likely to screen positive for GAD (OR 1.9 [95% CI, 1.2, 3.0]) even after adjusting for other social factors. No associations were noted between housing deterioration and maternal mental health. Similar associations were noted when incident cases of probable depression and GAD were examined. Housing instability and disarray, but not deterioration, are associated with screening positive for depression and generalized anxiety among women regardless of other social stressors present in their lives. Housing could potentially present a point of intervention to prevent

  12. The effects of congestions tax on air quality and health

    NASA Astrophysics Data System (ADS)

    Johansson, Christer; Burman, Lars; Forsberg, Bertil

    -berg since reductions are expected in both respiratory and cardiovascular morbidity. This study demonstrates the importance of not only assessing the effects on air quality limit values, but also to make quantitative estimates of health impacts, in order to justify actions to reduce air pollution.

  13. Quality of Mental Health Care for Nursing Home Residents: A Literature Review

    PubMed Central

    Grabowski, David C.; Aschbrenner, Kelly A.; Rome, Vincent F.; Bartels, Stephen J.

    2010-01-01

    Because of the high proportion of nursing home residents with a mental illness other than dementia, the quality of mental health care in nursing homes is a major clinical and policy issue. The authors apply Donabedian's framework for assessing quality of care based on the triad of structure, process, and outcome-based measures in reviewing the literature on the quality of mental health care in nursing homes. Quality measures used within the literature include mental health consultations and hospitalizations, inappropriate use of medications, and mental health survey deficiencies. Factors related to the resident's welfare (nurse staffing), provider norms (locality), and financial factors (payer mix) were associated with the quality of mental health care. Although future research is necessary, the extant literature suggests that persons with mental illness are frequently admitted to nursing homes and their care is often of poor quality and related to a series of resident and facility factors. PMID:20223943

  14. Body mass index, poor diet quality and health related quality of life are associated with mortality in rural older adults

    Technology Transfer Automated Retrieval System (TEKTRAN)

    In an aging population, potentially modifiable factors impacting mortality such as diet quality, body mass index (BMI), and health-related quality of life (HRQOL) are of interest. Surviving members of the Geisinger Rural Aging Study (GRAS) (n = 5,993; aged =74 years) were contacted in the fall of 20...

  15. Emergent Societal Effects of Crimino-Social Forces in an Animat Agent Model

    NASA Astrophysics Data System (ADS)

    Scogings, Chris J.; Hawick, Ken A.

    Societal behaviour can be studied at a causal level by perturbing a stable multi-agent model with new microscopic behaviours and observing the statistical response over an ensemble of simulated model systems. We report on the effects of introducing criminal and law-enforcing behaviours into a large scale animat agent model and describe the complex spatial agent patterns and population changes that result. Our well-established predator-prey substrate model provides a background framework against which these new microscopic behaviours can be trialled and investigated. We describe some quantitative results and some surprising conclusions concerning the overall societal health when individually anti-social behaviour is introduced.

  16. [Burnout of general practitioners in Belgium: societal consequences and paths to solutions].

    PubMed

    Kacenelenbogen, N; Offermans, A M; Roland, M

    2011-09-01

    The definition of burn-out the most often cited and proposed by Maslach and Jackson, clarifies the three cardinal symptoms affecting doctors, namely, emotional exhaustion, with depersonalization of their patients and reduction of the feeling of personal accomplishment. The causes of this phenomenon are relatively well-known: individual psychological factors, stressful factors intrinsic to the medical practice and finally extrinsic factors related to the professional environment and its organization. The purpose of this review is to estimate the prevalence of burnout within the population of Belgian family physicians and to understand both individual and societal consequences. About the method. This is a literature review using databases Medline, Cochrane Library, and the American Psychological Association from 2000 to 2011 with the keywords: primary health care, family practice, burnout, emotional exhaustion, psychological stressors, distress, fatigue, depersonalization, substance and alcohol abuse, depression, well-being, quality of life, job satisfaction, professional efficiency, patient care, physician-patient relations, medical errors, quality of health care, pharmaceutical/health expenditure/statistics-numerical data, obstacles to prevention, health system assessment, medical demography. Selecting of the most relevant articles through the reading of abstracts and then full text reading of 49 selected articles. In conclusion, the exact prevalence of burn-out amongst Belgian general practitioners is not known. From some works, it is estimated that about half of them would be achieved at least in terms of emotional exhaustion. The symptoms related to burn-out are potentially serious: ea depression, alcohol and tobacco abuse and cardiovascular complications. There are also arguments demonstrating the fact that this disorder amongst general practitioners influences negatively the quality of care, their cost, but also medical demography of primary care with as a

  17. Societal Impacts of Solar Electromagnetic Radiation

    NASA Astrophysics Data System (ADS)

    Lean, J. L.

    2000-05-01

    Changes in solar electromagnetic radiation, which occur continuously and at all wavelengths of the spectrum, can have significant societal impacts on a wide range of time scales. Detection of climate change and ozone depletion requires reliable specification of solar-induced processes that mask or exacerbate anthropogenic effects. Living with, and mitigating, climate change and ozone depletion has significant economic, habitat and political impacts of international extent. As an example, taxes to restrict carbon emission may cause undue economic stress if the role of greenhouse gases in global warming is incorrectly diagnosed. Ignoring solar-induced ozone changes in the next century may lead to incorrect assessment of the success of the Montreal Protocol in protecting the ozone layer by limiting the use of ozone-destroying chlorofluorocarbons. Societal infrastructure depends in many ways on space-based technological assets. Communications and navigation for commerce, industry, science and defense rely on satellite signals transmitted through, and reflected by, electrons in the ionosphere. Electron densities change in response to solar flares, and by orders of magnitude in response to EUV and X-ray flux variations during the Sun's 11-year activity cycle. Spacecraft and space debris experience enhanced drag on their orbits when changing EUV radiation causes upper atmosphere densities to increase. Especially affected are spacecraft and debris in lower altitude orbits, such as Iridium-type communication satellites, and the International Space Station (ISS). Proper specification of solar-induced fluctuations in the neutral upper atmosphere can, for example, aid in tracking the ISS and surrounding space debris, reducing the chance of ISS damage from collisions, and maximizing its operations. Aspects of solar electromagnetic radiation variability will be briefly illustrated on a range of time scales, with specific identification of the societal impacts of different

  18. Health-Related Quality of Life in Morphea

    PubMed Central

    Klimas, N.K.; Shedd, A.D.; Bernstein, I.H.; Jacobe, H.

    2014-01-01

    Background Little is known about the health-related quality of life (HRQOL) of patients with morphea, and previous studies have yielded conflicting results. Objectives To determine the impact of morphea on HRQOL and clinical and demographic correlates of HRQOL in adults. Methods Cross sectional survey (n=73) of Morphea in Adults and Children (MAC) cohort. Results Morphea impairs HRQOL in adults. Patients were most impaired by emotional well-being and concerns that the disease will progress to their internal organs. Patients with morphea had worse skin-specific HRQOL than those with non-melanoma skin cancer, vitiligo, and alopecia (lowest P <.0001). Study subjects had significantly worse global HRQOL scores than the general U.S. population for all subscales (all P ≤.004) with the exception of bodily pain. Comorbidity (r =.35-.51, P ≤ .0029 -.0001) and symptoms of pruritus (r =.38 -.64, P ≤.001-.0001) and pain (r =.46-.74, P <.0001) were associated with impairment in multiple domains of skin-specific and global HRQOL. Physician-based measures of disease severity correlated with patient-reported HRQOL. Conclusion Patients with morphea have negative impact on HRQOL particularly if symptoms (pruritus and pain) or concerns regarding internal manifestations are present. Providers should be aware of this when evaluating and treating patients. PMID:25483169

  19. Quality Improvement Education for Health Professionals: A Systematic Review.

    PubMed

    Starr, Stephanie R; Kautz, Jordan M; Sorita, Atsushi; Thompson, Kristine M; Reed, Darcy A; Porter, Barbara L; Mapes, David L; Roberts, Catherine C; Kuo, Daniel; Bora, Pavithra R; Elraiyah, Tarig A; Murad, Mohammad H; Ting, Henry H

    2016-05-01

    Effective quality improvement (QI) education should improve patient care, but many curriculum studies do not include clinical measures. The research team evaluated the prevalence of QI curricula with clinical measures and their association with several curricular features. MEDLINE, Embase, CINAHL, and ERIC were searched through December 31, 2013. Study selection and data extraction were completed by pairs of reviewers. Of 99 included studies, 11% were randomized, and 53% evaluated clinically relevant measures; 85% were from the United States. The team found that 49% targeted 2 or more health professions, 80% required a QI project, and 65% included coaching. Studies involving interprofessional learners (odds ratio [OR] = 6.55; 95% confidence interval [CI] = 2.71-15.82), QI projects (OR = 13.60; 95% CI = 2.92-63.29), or coaching (OR = 4.38; 95% CI = 1.79-10.74) were more likely to report clinical measures. A little more than half of the published QI curricula studies included clinical measures; they were more likely to include interprofessional learners, QI projects, and coaching. PMID:25583877

  20. Quality of Health Management Information System for Maternal & Child Health Care in Haryana State, India

    PubMed Central

    Sharma, Atul; Rana, Saroj Kumar; Prinja, Shankar; Kumar, Rajesh

    2016-01-01

    Background Despite increasing importance being laid on use of routine data for decision making in India, it has frequently been reported to be riddled with problems. Evidence suggests lack of quality in the health management information system (HMIS), however there is no robust analysis to assess the extent of its inaccuracy. We aim to bridge this gap in evidence by assessing the extent of completeness and quality of HMIS in Haryana state of India. Methods Data on utilization of key maternal and child health (MCH) services were collected using a cross-sectional household survey from 4807 women in 209 Sub-Centre (SC) areas across all 21 districts of Haryana state. Information for same services was also recorded from HMIS records maintained by auxiliary nurse midwives (ANMs) at SCs to check under- or over-recording (Level 1 discordance). Data on utilisation of MCH services from SC ANM records, for a subset of the total women covered in the household survey, were also collected and compared with monthly reports submitted by ANMs to assess over-reporting while report preparation (Level 2 discordance) to paint the complete picture for quality and completeness of routine HMIS. Results Completeness of ANM records for various MCH services ranged from 73% for DPT1 vaccination dates to 94.6% for dates of delivery. Average completeness level for information recorded in HMIS was 88.5%. Extent of Level 1 discordance for iron-folic acid (IFA) supplementation, 3 or more ante-natal care (ANC) visits and 2 Tetanus toxoid (TT) injections was 41%, 16% and 2% respectively. In 48.2% cases, respondents from community as well as HMIS records reported at least one post-natal care (PNC) home visit by ANM. Extent of Level 2 discordance ranged from 1.6% to 6%. These figures were highest for number of women who completed IFA supplementation, contraceptive intra-uterine device insertion and provision of 2nd TT injection during ANC. Conclusions HMIS records for MCH services at sub-centre level

  1. Disparities in Health Care Quality Indicators among US Children with Special Health Care Needs According to Household Language Use

    PubMed Central

    Yu, Stella; Lin, Sue; Strickland, Bonnie

    2015-01-01

    Background: Lower health care utilization and less favorable health outcomes have been demonstrated in children from Non-English Primary Language households (NEPL) in previous studies. This study examines prevalence of health care quality indicators among US children with special health care needs (CSHCN) and their association with household language use. Methods: We used data from the 2009-2010 National Survey of Children with Special Health Care Needs, restricted to an analytic sample of 40,242 children. Logistic regression models were used to examine the effects of primary household language on the attainment of the 6 health care quality indicators for CSHCN. Results: Compared to CSHCN from English primary language households (EPL), CSHCN from NEPL households had 31% higher odds of not feeling like partners in health care decision-making. They had 67% higher odds of lacking care through a medical home and 42% higher odds of reporting inadequate health insurance. NEPL children had 32% higher odds of not receiving early and continuous screening for special health care needs. NEPL youths had 69% higher odds of not receiving services for transition to adulthood. Minority race/ethnicity, lower income and families other than two biological parents all conferred additional risks to not attaining quality indicators. Publicly insured or uninsured CSHCN were also at higher risk. Conclusions and Global Health Implications: Our study provides compelling evidence that significant disparities exist for CSHCN by primary household language status across all health care quality indicators. Establishment of effective surveillance systems and targeting of outreach programs in both developed and developing countries may lead to improved understanding of health care needs and quality of services and reduction of health disparities for this underserved population.

  2. Application of quality measurement and performance standards to public health systems: Washington State's approach.

    PubMed

    Mauer, Barbara J; Mason, Marlene; Brown, Bruce

    2004-01-01

    To date, there have been few points of intersection between the quality work done in the general health system and performance review in the public health system. This article describes Washington State's set of performance standards for public health, the accreditation-type evaluation process, and some of the results of the recent performance evaluation against the Washington State Standards. Taking action on the evaluation results could enhance the capacity of public health to join general health systems in Washington State to address several of the priority areas described in Transforming Health Care Quality, the 2003 Institute of Medicine Report. PMID:15235380

  3. The how and why of societal publications for citizen science projects and scientists

    NASA Astrophysics Data System (ADS)

    van Vliet, Arnold J. H.; Bron, Wichertje A.; Mulder, Sara

    2014-05-01

    In the scientific community, the importance of communication to society is often underestimated. Scientists and scientific organisations often lack the skills to organise such communication effectively. The Dutch citizen science phenology network Nature's Calendar has been successful in communicating to the general public via numerous newspaper articles, television appearances, presentations, websites and social media. We refer to these publications as societal publications. Due to active communication to mass media, we frequently reach millions of people. This communication helped us to involve thousands of volunteers in recording the timing of phenological events like the start of flowering, leaf unfolding and bird migration, but also several health-related events like hay fever symptoms and tick bites. In this paper, we analyse and present our experiences with the Nature's Calendar project regarding societal publications. Based on this analysis, we explain the importance of societal publications for citizen science projects and scientists in general, and we show how scientists can increase the newsworthiness of scientific information and what factors and activities can increase the chances of media paying attention to this news. We show that societal publications help phenological networks by facilitating the recruitment, retention and instruction of observers. Furthermore, they stimulate the generation of new ideas and partners that lead to an increase in knowledge, awareness and behavioural change of the general public or specific stakeholders. They make projects, and scientists involved, better known to the public and increase their credibility and authority. Societal publications can catalyse the production of new publications, thereby enforcing the previous mentioned points.

  4. A curriculum for training quality scholars to improve the health and health care of veterans and the community at large.

    PubMed

    Splaine, Mark E; Aron, David C; Dittus, Robert S; Kiefe, Catarina I; Landefeld, C Seth; Rosenthal, Gary E; Weeks, William B; Batalden, Paul B

    2002-01-01

    In 1998, the Veterans Health Administration invested in the creation of the Veterans Administration National Quality Scholars Fellowship Program (VAQS) to train physicians in new ways to improve the quality of health care. We describe the curriculum for this program and the lessons learned from our experience to date. The VAQS Fellowship program has developed a core improvement curriculum to train postresidency physicians in the scholarship, research, and teaching of the improvement of health care. The curriculum covers seven domains of knowledge related to improvement: health care as a process; variation and measurement; customer/beneficiary knowledge; leading, following, and making changes in health care; collaboration; social context and accountability; and developing new, locally useful knowledge. We combine specific knowledge about the improvement of health care with the use of adult learning strategies, interactive video, and development of learner competencies. Our program provides insights for medical education to better prepare physicians to participate in and lead the improvement of health care. PMID:12512460

  5. Health Information: Does Quality Count for the Consumer? How Consumers Evaluate the Quality of Health Information Materials across a Variety of Media

    ERIC Educational Resources Information Center

    Marshall, Lyndsay A.; Williams, Dorothy

    2006-01-01

    An aspect of the information literacy of health information consumers is explored, in particular whether and how they evaluate the quality of health information on the Internet and in printed formats. A total of 32 members of patient support groups in North-East Scotland were recruited to take part in information review groups (a variation of…

  6. Health promoting schools and children’s oral health related quality of life

    PubMed Central

    2013-01-01

    Background The study objective was to compare children’s oral health related quality of life (OHRQoL) in schools with 6 years of implementation of a health promoting school model in Malaysia, i.e. the Doktor Muda Programme (DMP) and in schools without the DMP. Methods This report was part of a larger study to evaluate the DMP impact on schoolchildren’s oral health knowledge, attitudes, behaviour, caries progression and OHRQoL. It was conducted in Negri Sembilan state. The sample comprised 3455, Year 6 (11–12 year old) children; 1282 from DMP (intervention) and 2173 from non-DMP (control) schools. The Malay Child-OIDP index was used to evaluate children’s levels of oral impacts on 8 daily performances after 6 years of DMP implementation (2006–2011). Prevalence, score, impact intensity, causes and extent of impacts were compared. Chi-square and Mann–Whitney tests were used in the data analysis. Results Overall response rate was 95.1%. Prevalence of overall impacts was 57.8% and 60.8% (mean total impact score was 7.10 and 7.77) in the intervention and control group, respectively. The three most frequently affected performances in both groups were eating, cleaning teeth and emotional stability. Significantly less DMP children had oral impact on cleaning teeth (p = 0.034). The majority of children with impacts in both groups reported ‘very little’ to ‘moderate’ levels of impact intensity. Significantly more DMP children reported having ‘very little’ and ‘little’ levels of impact intensity on cleaning teeth (p = 0.037) and emotional stability (p = 0.020), respectively. Significantly less DMP children reported having ‘very severe’ level of impact intensity on speaking (p = 0.038). The most prevalent cause of impacts in both groups was toothache. Significantly less DMP children reported bleeding gums (p = 0.016) and presence of plaque/calculus as causes of impacts (p = 0.032). About 75% of children with impacts in both groups reported having

  7. Quality of reproductive health services at commune health stations in Viet Nam: implications for national reproductive health care strategy.

    PubMed

    Ngo, Anh D; Hill, Peter S

    2011-05-01

    This paper presents a qualitative study conducted in 2009 of provider and patient perceptions of primary level reproductive health services provided by commune health stations (CHSs), and the implications for Viet Nam's 2011-2020 National Strategy for Reproductive Health Care. In the three provinces of Thai Nguyen, Thua Thien Hue, and Vinh Long, we interviewed the heads of CHSs, held focus group discussions with midwives and women patients, and observed facilities. Half the 30 CHSs visited were in poor physical condition; the rest were newly renovated. However, the model of service delivery was largely unchanged from ten years before. Many appeared to fall short in meeting patient expectations in terms of modern medical equipment and technology, range of drug supplies, and levels of staff expertise. As a result, many women were turning to private doctors and public hospitals, at least in urban areas, or seeking medication from pharmacies. To make CHS clinics sustainable, promotion of access to reproductive health services should be undertaken concurrently with quality improvement. A responsive payment scheme must also be developed to generate revenues. Efforts should be made to reduce the unnecessary use of more costly services from private clinics and higher level public facilities. PMID:21555086

  8. [Quality improvement of health care services in Croatian emergency medicine].

    PubMed

    Predavec, Sanja; Sogorić, Selma; Jurković, Drazen

    2010-12-01

    Emergency medical services (EMS) in the Republic of Croatia are currently organized as part of the existing health care system and delivered in the form of pre-hospital and hospital EMS. The pre-hospital EMS are delivered by standalone EMS Centers, EMS units set up in community health centers, and by general practitioners working in shifts and on call in remote and scarcely populated areas. In hospitals, each ward usually has its own emergency reception area, and only in a couple of cases there is an integrated emergency admission unit for the entire hospital. The current EMS structure does not meet the basic requirements that would make an EMS system optimal, i.e. equal quality, equal access, effectiveness and appropriate equipment. The EMS Restructuring Project is part of the Croatian health care system reform and is addressed by the National Health Development Strategy 2006-2011. As part of restructuring efforts, the Croatian National Institute of Emergency Medicine, 21 County Institutes of Emergency Medicine and county-level call centers are going to be set up. In addition, the project will introduce the following: integrated emergency admission areas at hospitals; telemedicine as part of emergency medicine; emergency medicine specialty for physicians and additional specialized training for nurses/technicians; separation of emergency and non-emergency transport; standards for vehicles and equipment and guidelines/protocols/algorithms for care. The Croatian National Institute of Emergency Medicine is an umbrella EMS organization. It shapes the EMS in Croatia and proposes, plans, monitors and analyzes EMS actions in Croatia. In addition, it submits a proposal of the Emergency Medicine Network to the minister, sets standards for EMS transport, and coordinates, guides and supervises the work of County Institutes of Emergency Medicine. County Institutes organize and deliver pre-hospital EMS in their counties. Integrated hospital emergency admission units represent a

  9. A Nursing Interaction Approach to Consumer Internet Training on Quality Health Care

    ERIC Educational Resources Information Center

    Lesley, Marsha L.; Oermann, Marilyn H.; Vander Wal, Jillon S.

    2004-01-01

    This study examined the effectiveness of using the Internet to teach consumers about quality health care, compared consumer definitions of quality health care prior to and following completion of the Internet experience, and compared ratings of learning, satisfaction and value of the Internet instruction between consumers who completed the…

  10. Implementing the patient circle. Call on patients to help improve perceptions of health care quality.

    PubMed

    Ostasiewski, P; Fugate, D L

    1994-01-01

    Adapting the quality-circle concept to a health care setting helped one hospital solve a problem and boosted its image among patients. The "patient circle" technique is one step health care providers can take toward delivering "total customer value," a quality perception that can mean the difference between surviving and thriving in the future. PMID:10154633

  11. Child Health-Related Quality of Life and Parental Social Capital in Greece: An Exploratory Study

    ERIC Educational Resources Information Center

    El-Dardiry, Giulia; Dimitrakaki, Christine; Tzavara, Chara; Ravens-Sieberer, Ulrike; Tountas, Yannis

    2012-01-01

    In this paper, we examined dimensions of child health-related quality of life in Greece in relation to parental assessments of neighbourhood social capital and social support networks. For the analysis, two main measures were used: (1) child self-reported health-related quality of life in ten dimensions, as measured by the KIDSCREEN questionnaire;…

  12. Rural-Urban Analyses of Health-Related Quality of Life among People with Multiple Sclerosis

    ERIC Educational Resources Information Center

    Buchanan, Robert J.; Zhu, Li; Schiffer, Randolph; Radin, Dagmar; James, Wesley

    2008-01-01

    Context: Health-related quality of life (HRQOL) is a multi-dimensional construct including aspects of life quality or function that are affected by physical health and symptoms, psychosocial factors, and psychiatric conditions. HRQOL gives a broader measure of the burden of disease than physical impairment or disability levels. Purpose: To…

  13. Health and Quality of Life of Aboriginal Residential School Survivors, Bella Coola Valley, 2001

    ERIC Educational Resources Information Center

    Barton, Sylvia S.; Thommasen, Harvey V.; Tallio, Bill; Zhang, William; Michalos, Alex C.

    2005-01-01

    The purpose of this study was to make comparisons between Aboriginal residential school survivors' perceptions of health status and overall quality of life, and Aboriginal non-residential school attendees, as well as between non-Aboriginals. Data were obtained from thirty-three questions derived from the 2001 Determinants of Health and Quality of…

  14. Quality Improvement Initiative in School-Based Health Centers across New Mexico

    ERIC Educational Resources Information Center

    Booker, John M.; Schluter, Janette A.; Carrillo, Kris; McGrath, Jane

    2011-01-01

    Background: Quality improvement principles have been applied extensively to health care organizations, but implementation of quality improvement methods in school-based health centers (SBHCs) remains in a developmental stage with demonstration projects under way in individual states and nationally. Rural areas, such as New Mexico, benefit from the…

  15. QUALITY OF LIFE, FAMILY BEHAVIOR, AND HEALTH OUTCOMES IN CHILDREN WITH TYPE 2 DIABETES

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Quality of life of youth and disease-specific family behavior have both been shown to be important in the study of health outcomes across a broad range of chronic physical conditions of childhood. Very few studies have addressed quality of life, the family’s role in diabetes management, and health o...

  16. Perceptions of Neighborhood Problems and Health-Related Quality of Life

    ERIC Educational Resources Information Center

    Hill, Erin M.; Shepherd, Daniel; Welch, David; Dirks, Kim N.; McBride, David

    2012-01-01

    This article examines the association between perceptions of neighborhood problems and health-related quality of life (HRQOL) in a sample of New Zealand residents (n = 692). A modified version of the Neighborhood Problems Scale (originally developed by Steptoe and Feldman, 2001) and the World Health Organization Quality of Life (WHOQOL-BREF) were…

  17. Health-Related Quality of Life among Abused Women One Year after Leaving a Violent Partner

    ERIC Educational Resources Information Center

    Alsaker, Kjersti; Moen, Bente E.; Kristoffersen, Kjell

    2008-01-01

    This is the first follow up study measuring quality of life among abused women who have left their abusive partner. The women (n = 22) answered a questionnaire while staying at women's shelter and one year later. The aim was to examine long-term effects of intimate partner violence against women on health-related quality of life. Health-related…

  18. Quality Health Care for People with Developmental Disabilities: A Guide for Parents and Other Caregivers.

    ERIC Educational Resources Information Center

    Pfaffinger, Kathleen M.; Nelson, Richard P.

    Starting with the premise that all people have a right to quality health care, this guide emphasizes that assisting people with developmental disabilities to obtain health care and maintain healthy life styles will enhance the quality of their lives at home and in the community. The guide consists of four sections. A section on obtaining care…

  19. Heat stress and societal impacts in the 21st century

    NASA Astrophysics Data System (ADS)

    Coffel, E.; Horton, R. M.; de Sherbinin, A. M.

    2015-12-01

    Heat is the number-one weather related killer in the US and around the world. As a result of rising temperatures and steady or slightly rising levels of specific humidity, heat stress is projected to become increasingly severe. Here we show that heat stress as measured by two common indices -- the heat index and the wet-bulb temperature -- is projected to rapidly and dramatically increase, and that by mid-century crippling summertime conditions are possible across some of the most densely populated regions of the planet. Many of these regions are places where cooling infrastructure is scarce, adaptive capacity is low, and populations are rapidly rising. We find that by the end of the 21st century, the habitability of some regions of the planet may be questionable due to heat stress alone, and in many other regions severe impacts to human health, infrastructure, agriculture, and economic performance will create significant societal stress and necessitate rapid adaptation.

  20. Societal reintegration following cadaveric orthotopic liver transplantation

    PubMed Central

    Kelly, Ryan; Hurton, Scott; Ayloo, Subhashini; Cwinn, Mathew; De Coutere-Bosse, Sarah

    2016-01-01

    Background Studies on patients’ societal reintegration following orthotopic liver transplantation (OLT) are scarce. Methods Between September 2006 and January 2008, all adults who were alive after 3 years post OLT were included in this prospective cohort study. Validated questionnaires were administered to all candidates with the primary aim of investigating the rate of their social re-integration following OLT and potential barriers they might have encountered. Results Among 157 eligible patients 110 (70%) participated. Mean participants’ age was 57 years (SD 11.4) and 43% were females. Prior to OLT, 75% of patients were married and 6% were divorced. Following OLT there was no significant difference in marital status. Employment rate fell from 72% to 30% post-OLT. Patients who had been employed in either low-skill or advanced-skill jobs were less likely to return to work. After OLT, personal income fell an average of 4,363 Canadian dollars (CAN$) (SD 20,733) (P=0.03) but the majority of recipients (80%) reported high levels of satisfaction for their role in society. Conclusions Although patients’ satisfaction post-OLT is high, employment status is likely to be negatively affected for individuals who are not self-employed. Strategies to assist recipients in returning to their pre-OLT jobs should be developed to improve patients’ economical status and societal ability to recoup resources committed for OLT. PMID:27275465

  1. Genetic Diversity and Societally Important Disparities

    PubMed Central

    Rosenberg, Noah A.; Kang, Jonathan T. L.

    2015-01-01

    The magnitude of genetic diversity within human populations varies in a way that reflects the sequence of migrations by which people spread throughout the world. Beyond its use in human evolutionary genetics, worldwide variation in genetic diversity sometimes can interact with social processes to produce differences among populations in their relationship to modern societal problems. We review the consequences of genetic diversity differences in the settings of familial identification in forensic genetic testing, match probabilities in bone marrow transplantation, and representation in genome-wide association studies of disease. In each of these three cases, the contribution of genetic diversity to social differences follows from population-genetic principles. For a fourth setting that is not similarly grounded, we reanalyze with expanded genetic data a report that genetic diversity differences influence global patterns of human economic development, finding no support for the claim. The four examples describe a limit to the importance of genetic diversity for explaining societal differences while illustrating a distinction that certain biologically based scenarios do require consideration of genetic diversity for solving problems to which populations have been differentially predisposed by the unique history of human migrations. PMID:26354973

  2. Health-related quality of life in migrant preschool children

    PubMed Central

    2013-01-01

    Background Minority groups have a lower health-related quality of life (HRQOL), but there is little information if this finding also applies to children. In this study, we compared HRQOL between young children with and without migrant parents. Methods Two cross-sectional studies of culturally diverse preschool populations in Switzerland: Ballabeina (40 preschools, 258 girls and 232 boys aged 4 to 6 years) and Youp’là Bouge (58 child care centers, 453 girls and 522 boys aged 2 to 4 years). Most children were born in Switzerland (Ballabeina: 92.3%; Youp’là Bouge: 93.7%). Number of migrant parents was considered as the main exposure. HRQOL was measured using the 23-item Pediatric Quality of Life Inventory. Results Children of migrant parents had a significantly lower HRQOL total score (mean ± SD, Ballabeina: 84.2 ± 9.1; 82.7 ± 9.6 and 81.7 ± 11.7 for children with none, one or two migrant parents, respectively; Youp’là Bouge: 83.8 ± 8.6; 82.9 ± 9.5; 80.7 ± 11.7, all p < 0.05). Similar results were found in Ballabeina and Youp’là Bouge for social, school and physical functioning (all p < 0.05), but not for emotional functioning. The differences in HRQOL measures were partly mediated by children’s place of birth, parental education, paternal occupational level, children’s BMI, screen time and physical activity in one study (Ballabeina), but not in the other (Youp’là Bouge). Conclusion In preschoolers, children of migrant parents have lower HRQOL than children of non-migrant parents. These differences are only partly mediated by other sociocultural characteristics or lifestyle behavior. These families may need assistance to prevent further inequalities. PMID:23617686

  3. Characterizing the Quality Workforce in Private U.S. Child and Family Behavioral Health Agencies.

    PubMed

    McMillen, J Curtis; Raffol, Matthew

    2016-09-01

    Behavioral health agencies have been encouraged to monitor performance and improve service quality. This paper characterizes the workforce charged with these tasks through a national survey of 238 behavioral health quality professionals. A latent class analysis suggests only 30 % of these workers report skills in both basic research and quality-specific skills. Respondents wanted to learn a variety of research and data analytic skills. The results call into question the quality of data collected in behavioral health agencies and the conclusions agencies are drawing from their data. Professional school and continuing education programs are needed to prepare this workforce. PMID:26108643

  4. Methodological quality of systematic reviews and clinical trials on women's health published in a Brazilian evidence-based health journal

    PubMed Central

    Macedo, Cristiane Rufino; Riera, Rachel; Torloni, Maria Regina

    2013-01-01

    OBJECTIVES: To assess the quality of systematic reviews and clinical trials on women's health recently published in a Brazilian evidence-based health journal. METHOD: All systematic reviews and clinical trials on women's health published in the last five years in the Brazilian Journal of Evidence-based Health were retrieved. Two independent reviewers critically assessed the methodological quality of reviews and trials using AMSTAR and the Cochrane Risk of Bias Table, respectively. RESULTS: Systematic reviews and clinical trials accounted for less than 10% of the 61 original studies on women's health published in the São Paulo Medical Journal over the last five years. All five reviews were considered to be of moderate quality; the worst domains were publication bias and the appropriate use of study quality in formulating conclusions. All three clinical trials were judged to have a high risk of bias. The participant blinding, personnel and outcome assessors and allocation concealment domains had the worst scores. CONCLUSIONS: Most of the systematic reviews and clinical trials on women's health recently published in a Brazilian evidence-based journal are of low to moderate quality. The quality of these types of studies needs improvement. PMID:23778332

  5. SURVEY OF INDOOR AIR QUALITY HEALTH CRITERIA AND STANDARDS

    EPA Science Inventory

    The report is a survey of the state-of-the-art of the scientific studies on indoor air quality criteria and standards. The principal subject is the indoor nonworkplace environment. Indoor air quality standards are classified into three types: (1) maximum allowable air quality sta...

  6. Health-Related Quality of Life of Former Lead Workers in Brazil

    PubMed Central

    Teixeira, Martha Carvalho Pereira; Carvalho, Fernando Martins; Lins, Liliane

    2015-01-01

    Little is known about the health-related quality of life of former lead workers. Using the Short-Form 36 Questionnaire (SF-36), a cross-section design study evaluated the health-related quality of life of 186 former workers of a lead smelter that operated in Santo Amaro da Purificação, Brazil, from 1960 to 1993, when it closed down. The smelter had very poor occupational and environmental hygiene standards. The health-related quality of life of former lead workers was low, compared to population-based and other nosological groups from Brazil. Former lead workers who indicated metal poisoning, difficulty getting another job and who could not get another job after dismissal by the smelter presented poorer health-related quality of life. Former lead workers with poor health-related quality of life form part of the huge occupational liability left by the Santo Amaro lead smelter. PMID:26540067

  7. School quality and the education-health relationship: evidence from blacks in segregated schools.

    PubMed

    Frisvold, David; Golberstein, Ezra

    2011-12-01

    In this paper, we estimate the effect of school quality on the relationship between schooling and health outcomes using the substantial improvements in the quality of schools attended by black students in the segregated southern states during the mid-1900s as a source of identifying variation. Using data from the National Health Interview Survey, our results suggest that improvements in school quality, measured as the pupil-teacher ratio, average teachers' wage, and length of the school year, amplify the beneficial effects of education on several measures of health in later life, including self-rated health, smoking, obesity, and mortality. PMID:21893357

  8. Mental Health, Quality of Life, and Health Functioning in Women Veterans: Differential Outcomes Associated with Military and Civilian Sexual Assault

    ERIC Educational Resources Information Center

    Suris, Alina; Lind, Lisa; Kashner, T. Michael; Borman, Patricia D.

    2007-01-01

    The present study examined psychiatric, physical, and quality-of-life functioning in a sample of 270 women veterans receiving outpatient treatment at a Veterans Affairs medical center. Participants were interviewed regarding their civilian (CSA) and military sexual assault (MSA) histories, and data regarding quality of life and health outcomes…

  9. Accountability and quality in managed care: implications for health care practitioners.

    PubMed

    Dobalian, A; Rivers, P A

    1998-01-01

    The development of managed care plans is the most dramatic change in the USA's health care system in recent decades. Despite the widespread growth, society is increasingly concerned with the quality of managed care programs. This article addresses the regulatory pressures that are being placed on managed care organisations and examines what health care practitioners can do to minimize the impact of increased regulation. We look at the major factors that are likely to bring about changes in the health care sector, and predict how these changes will affect the quality of health care that is being delivered in the near future. Addresses how quality can become and remain the primary factor in the delivery of health care services. Finally, concludes that greater involvement by the federal government is necessary to protect consumers' rights, and ensure better quality health care from managed care programs. PMID:10185327

  10. Quality of maternal healthcare in India: Has the National Rural Health Mission made a difference?

    PubMed Central

    Nair, Harish; Panda, Rajmohan

    2011-01-01

    Despite a five decade old Family Welfare programme, India still continues to contribute almost a quarter of the global estimates of maternal morbidity and mortality. Quality aspects in maternal health care have long been ignored in the Indian public health system. It is only with the launch of the National Rural Health Mission (NRHM) that quality of care has been accorded due recognition at the policy and planning levels of the national health programmes. Using review of available data sources and published literature, this paper aims to examine the scenario of quality of care in maternal health over the last decade and the impact of NRHM initiatives on the same. While NRHM has made efforts to address lacunae associated with quality of maternal care in the public health system, there is much scope for improvement. PMID:23198105

  11. Public health interactions with the public: can quality be assured? "This call may be monitored for quality assurance purposes".

    PubMed

    Berkelman, Ruth

    2004-01-01

    I describe what happened when a citizen called her state health department "after-hours" to report possible contamination of food at a commercial establishment. The call, inadequately handled by the health department, illustrates the need to assure quality of the public health responses to calls on a 24 hour, 7-day week basis. I examine possible reasons for the poor response. Health departments should consider training for those assigned to handle phone calls from the public, such as that provided to poison control center personnel. In addition, a quality assurance program should routinely assess the adequacy of public health responses. As medical care is available on an emergency basis, 24 hours a day, 7 days a week, emergency services for prevention of illness in the population should be available to the public at all times with the response provided by appropriately trained individuals. PMID:15134134

  12. Health-related quality of life in early breast cancer.

    PubMed

    Groenvold, Mogens

    2010-09-01

    The treatment of primary breast cancer usually consists of surgery often followed by adjuvant therapy (radiotherapy, chemotherapy, hormonal treatment, etc.) to reduce the risk of recurrence. The cancer diagnosis and the treatments may have significant impact on the patients' quality of life. This thesis deals with scientific aspects and clinical results of a study aimed at assessing the impact of breast cancer (and its treatment) on the patients' quality of life. Studies such as this assessing the problems and symptoms experienced by the patients are often referred to as health-related quality of life (HRQL) research. HRQL research deals with subjective experiences and raises challenging, scientific questions. Therefore, much attention was directed towards methodological issues in this clinically motivated project. The study was a prospective, longitudinal, questionnaire-based investigation of women with newly diagnosed breast cancer registered in the Danish Breast Cancer Co-operative Group's DBCG 89 Program. The patients were sub-divided into low-risk and high-risk patients. High-risk patients were offered randomisation in one of three randomised adjuvant therapy trials involving chemotherapy, ovarian ablation, and endocrine therapy. After a literature study and interviews with breast cancer patients, a questionnaire was composed that included two widely used standard questionnaires (EORTC QLQ-C30 and Hospital Anxiety and Depression (HAD) Scale) and a DBCG 89 Questionnaire developed for this study. A total of 1,898 eligible patients were invited by post to participate in the study involving six assessments over a 2-year period, and 1,713 patients (90%) completed the first questionnaire. Furthermore, a questionnaire was sent to 872 women selected at random from the general population; 608 (70%) responded. The multi-item scales of the two standard questionnaires were analysed for so-called differential item functioning (DIF) in order to investigate whether the

  13. Measuring quality of life in mental health: Are we asking the right questions?

    PubMed Central

    Connell, Janice; O'Cathain, Alicia; Brazier, John

    2014-01-01

    Measuring quality-adjusted-life years using generic preference-based quality of life measures is common practice when evaluating health interventions. However, there are concerns that measures in common use, such as the EQ-5D and SF-6D, focus overly on physical health and therefore may not be appropriate for measuring quality of life for people with mental health problems. The aim of this research was to identify the domains of quality of life that are important to people with mental health problems in order to assess the content validity of these generic measures. Qualitative semi-structured interviews were conducted with 19 people, recruited from UK mental health services, with a broad range of mental health problems at varying levels of severity. This complemented a previous systematic review and thematic synthesis of qualitative studies on the same topic. Seven domains important to quality of life for people with mental health problems were identified: well-being and ill-being; relationships and a sense of belonging; activity; self-perception; autonomy, hope and hopelessness; and physical health. These were consistent with the systematic review, with the addition of physical health as a domain, and revealed a differing emphasis on the positive and negative aspects of quality of life according to the severity of the mental health problems. We conclude that the content of existing generic preference-based measures of health do not cover this domain space well. Additionally, because people may experience substantial improvements in their quality of life without registering on the positive end of a quality of life scale, it is important that the full spectrum of negative through to positive aspects of each domain are included in any quality of life measure. PMID:25194472

  14. Measuring quality of life in mental health: are we asking the right questions?

    PubMed

    Connell, Janice; O'Cathain, Alicia; Brazier, John

    2014-11-01

    Measuring quality-adjusted-life years using generic preference-based quality of life measures is common practice when evaluating health interventions. However, there are concerns that measures in common use, such as the EQ-5D and SF-6D, focus overly on physical health and therefore may not be appropriate for measuring quality of life for people with mental health problems. The aim of this research was to identify the domains of quality of life that are important to people with mental health problems in order to assess the content validity of these generic measures. Qualitative semi-structured interviews were conducted with 19 people, recruited from UK mental health services, with a broad range of mental health problems at varying levels of severity. This complemented a previous systematic review and thematic synthesis of qualitative studies on the same topic. Seven domains important to quality of life for people with mental health problems were identified: well-being and ill-being; relationships and a sense of belonging; activity; self-perception; autonomy, hope and hopelessness; and physical health. These were consistent with the systematic review, with the addition of physical health as a domain, and revealed a differing emphasis on the positive and negative aspects of quality of life according to the severity of the mental health problems. We conclude that the content of existing generic preference-based measures of health do not cover this domain space well. Additionally, because people may experience substantial improvements in their quality of life without registering on the positive end of a quality of life scale, it is important that the full spectrum of negative through to positive aspects of each domain are included in any quality of life measure. PMID:25194472

  15. Quality target negotiation in health care: evidence from the English NHS.

    PubMed

    Fichera, Eleonora; Gravelle, Hugh; Pezzino, Mario; Sutton, Matt

    2016-09-01

    We examine how public sector third-party purchasers and hospitals negotiate quality targets when a fixed proportion of hospital revenue is required to be linked to quality. We develop a bargaining model linking the number of quality targets to purchaser and hospital characteristics. Using data extracted from 153 contracts for acute hospital services in England in 2010/2011, we find that the number of quality targets is associated with the purchaser's population health and its budget, the hospital type, whether the purchaser delegated negotiation to an agency, and the quality targets imposed by the supervising regional health authority. PMID:26362867

  16. Systems for Quality Assurance in Mental Health Services: A Strategy for Improvement.

    ERIC Educational Resources Information Center

    Jessee, William F.; Morgan-Williams, Gale

    1987-01-01

    Discusses need for systems-based approach to quality assurance in mental health services, which can provide useful information to administrators and practitioners as they work to maintain or improve quality of care provided to patients. Introduces generic model for monitoring and evaluating quality of care and discusses potential barriers to its…

  17. The Relative Contribution of Health Status and Quality of Life Domains in Subjective Health in Old Age

    ERIC Educational Resources Information Center

    Prieto-Flores, Maria-Eugenia; Moreno-Jimenez, Antonio; Fernandez-Mayoralas, Gloria; Rojo-Perez, Fermina; Forjaz, Maria Joao

    2012-01-01

    To analyze the influence of different health status dimensions and quality of life (QoL) domains on older adults' subjective health, and to assess the role that residential satisfaction plays in these relationships. A QoL survey was conducted on a representative sample of the community-dwelling older adult population in Madrid province (Spain).…

  18. Assessing Health-Related Quality of Life in Northern Plains American Indians: Prominence of Physical Activity as a Health Behavior

    ERIC Educational Resources Information Center

    Poltavski, Dmitri; Holm, Jeffrey; Vogeltanz-Holm, Nancy; McDonald, Leander

    2010-01-01

    Associations of behavioral health risks and healthy behaviors with self-reported health-related quality of life measures were investigated in a Northern Plains American Indian sample. Participants were surveyed in person using the Behavioral Risk Factor Surveillance Survey. The results showed that regular physical activity was significantly…

  19. Primary health-care nurses and Internet health information-seeking: Access, barriers and quality checks.

    PubMed

    Gilmour, Jean; Strong, Alison; Chan, Helen; Hanna, Sue; Huntington, Annette

    2016-02-01

    Online information is a critical resource for evidence-based practice and patient education. This study aimed to establish New Zealand nurses' access and evaluation of online health information in the primary care context using a postal questionnaire survey; there were 630 respondents from a random sample of 931 nurses. The majority of respondents were satisfied with work access to online information (84.5%, n = 501) and searched for online information at least several times a week (57.5%, n = 343). The major barrier to online information seeking was insufficient time, but 68 respondents had no work online information access. The level of nursing qualification was significantly correlated with computer confidence and information quality checking. A range of information evaluation approaches was used. Most nurses in study accessed and evaluated Internet information in contrast to the findings of earlier studies, but there were barriers preventing universal integration into practice. PMID:25355072

  20. Quality Measures For Mental Health And Substance Use: Gaps, Opportunities, And Challenges.

    PubMed

    Pincus, Harold Alan; Scholle, Sarah Hudson; Spaeth-Rublee, Brigitta; Hepner, Kimberly A; Brown, Jonathan

    2016-06-01

    Following up on its Crossing the Quality Chasm report, in 2006 the Institute of Medicine issued a report that included sweeping recommendations to improve the quality of behavioral health care in the United States. To date, few of those recommendations have been implemented, and there is little evidence that behavioral health care quality has improved significantly over the past ten years. However, the advent of health care reform, parity of insurance coverage, and growing recognition of the impact of behavioral health disorders on population health and health care costs have created new demands and opportunities for expanded and innovative strategies to assess the quality of care for this patient population. We provide an overview of the current state of quality measurement in behavioral health, identify key priorities for measure development, and describe the most important challenges. We recommend a coordinated plan that would boost investment in developing, evaluating, and implementing behavioral health quality measures; conduct research to develop the evidence necessary to support a more robust set of measures; overcome barriers to the improvement and linking of data sources; and expand efforts to build the capacity of the clinical workforce, in partnership with consumers, to improve quality. PMID:27269015

  1. 45 CFR 158.150 - Activities that improve health care quality.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 45 Public Welfare 1 2014-10-01 2014-10-01 false Activities that improve health care quality. 158.150 Section 158.150 Public Welfare Department of Health and Human Services REQUIREMENTS RELATING TO HEALTH CARE ACCESS ISSUER USE OF PREMIUM REVENUE: REPORTING AND REBATE REQUIREMENTS Disclosure...

  2. 45 CFR 158.150 - Activities that improve health care quality.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 45 Public Welfare 1 2012-10-01 2012-10-01 false Activities that improve health care quality. 158.150 Section 158.150 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS ISSUER USE OF PREMIUM REVENUE: REPORTING AND REBATE REQUIREMENTS Disclosure...

  3. 45 CFR 158.150 - Activities that improve health care quality.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 45 Public Welfare 1 2013-10-01 2013-10-01 false Activities that improve health care quality. 158.150 Section 158.150 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS ISSUER USE OF PREMIUM REVENUE: REPORTING AND REBATE REQUIREMENTS Disclosure...

  4. 45 CFR 158.150 - Activities that improve health care quality.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 45 Public Welfare 1 2011-10-01 2011-10-01 false Activities that improve health care quality. 158.150 Section 158.150 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS ISSUER USE OF PREMIUM REVENUE: REPORTING AND REBATE REQUIREMENTS Disclosure...

  5. Techniques for Developing Health Quality of Life Scales for Point of Service Use

    ERIC Educational Resources Information Center

    Lee, Young-Sun; Douglas, Jeffrey; Chewning, Betty

    2007-01-01

    Clinical and health policy research frequently involves health status measurement using generic or disease specific instruments. These instruments are generally developed to arrive at several scales, each measuring a distinct domain of health quality of life (HQOL). Clinical settings are starting to explore how to integrate patient perspectives of…

  6. English Language Proficiency and Health-Related Quality of Life among Chinese and Korean Immigrant Elders

    ERIC Educational Resources Information Center

    Mui, Ada C.; Kang, Suk-Young; Kang, Dooyeon; Domanski, Margaret Dietz

    2007-01-01

    This study examined the association between English language proficiency and health outcomes in a regional probability sample (n = 205) of elderly Chinese and Korean immigrants. Data support that these two Asian ethnic subgroups differ in English proficiency and health-related quality of life. Chinese and Korean elders had poorer health than the…

  7. The Influence Factors and Mechanism of Societal Risk Perception

    NASA Astrophysics Data System (ADS)

    Zheng, Rui; Shi, Kan; Li, Shu

    Risk perception is one of important subjects in management psychology and cognitive psychology. It is of great value in the theory and practice to investigate the societal hazards that the public cares a lot especially in Socio-economic transition period. A survey including 30 hazards and 6 risk attributes was designed and distributed to about 2, 485 residents of 8 districts, Beijing. The major findings are listed as following: Firstly, a scale of societal risk perception was designed and 2 factors were identified (Dread Risk & Unknown Risk). Secondly, structural equation model was used to analyze the influence factors and mechanism of societal risk perception. Risk preference, government support and social justice could influence societal risk perception directly. Government support fully moderated the relationship between government trust and societal risk perception. Societal risk perception influenced life satisfaction, public policy preferences and social development belief.

  8. Patients' perceptions of service quality dimensions: an empirical examination of health care in New Zealand.

    PubMed

    Clemes, M D; Ozanne, L K; Laurensen, W L

    2001-01-01

    The 1984 liberalization of the New Zealand economy has resulted in a health care sector that has become very competitive (Zwier and Clarke, 1999). The private sector is now able to supply health care services and, as a result, a greater value is being placed on patient satisfaction (Zwier and Clarke, 1999). However, despite the increasing focus on customer satisfaction, research into health care patients' perceptions of the dimensions of service quality is scarce. This can be problematic, as quality of care is an essential issue in the strategic marketing of health care services (Turner and Pol, 1995). This study takes a step towards addressing this deficiency by identifying patients' perceptions of the dimensions of service quality in health care. The findings of this study are based on the empirical analysis of a sample of 389 respondents interviewed by telephone. The findings indicate that the service quality dimensions identified in this health care specific study differ in number and dimensional structure from the widely adopted service quality dimensions first identified by Parasuraman, Berry and Zeithaml (1988): reliability, responsiveness, assurance, empathy and tangibles. The service quality dimensions identified in this study were: reliability, tangibles, assurance, empathy, food, access, outcome, admission, discharge and responsiveness. In addition, health care patients perceive the service quality dimensions relating to the core product in health care delivery (for example, outcome and reliability) as more important than the service quality dimensions relating to the peripheral product in health care delivery (for example, food, access and tangibles). Finally, the results of this study suggest that patients with different geographic, demographic, and behavioristic characteristics have different needs and wants during health care delivery and therefore perceive different service quality dimensions as important. PMID:11727291

  9. Creating a Patient-Centered Health Care Delivery System: A Systematic Review of Health Care Quality From the Patient Perspective.

    PubMed

    Mohammed, Khaled; Nolan, Margaret B; Rajjo, Tamim; Shah, Nilay D; Prokop, Larry J; Varkey, Prathibha; Murad, Mohammad H

    2016-01-01

    Patient experience is one of key domains of value-based purchasing that can serve as a measure of quality and be used to improve the delivery of health services. The aims of this study are to explore patient perceptions of quality of health care and to understand how perceptions may differ by settings and condition. A systematic review of multiple databases was conducted for studies targeting patient perceptions of quality of care. Two reviewers screened and extracted data independently. Data synthesis was performed following a meta-narrative approach. A total of 36 studies were included that identified 10 quality dimensions perceived by patients: communication, access, shared decision making, provider knowledge and skills, physical environment, patient education, electronic medical record, pain control, discharge process, and preventive services. These dimensions can be used in planning and evaluating health care delivery. Future research should evaluate the effect of interventions targeting patient experience on patient outcomes. PMID:25082873

  10. The Impact of eHealth on the Quality and Safety of Health Care: A Systematic Overview

    PubMed Central

    Black, Ashly D.; Car, Josip; Pagliari, Claudia; Anandan, Chantelle; Cresswell, Kathrin; Bokun, Tomislav; McKinstry, Brian; Procter, Rob; Majeed, Azeem; Sheikh, Aziz

    2011-01-01

    Background There is considerable international interest in exploiting the potential of digital solutions to enhance the quality and safety of health care. Implementations of transformative eHealth technologies are underway globally, often at very considerable cost. In order to assess the impact of eHealth solutions on the quality and safety of health care, and to inform policy decisions on eHealth deployments, we undertook a systematic review of systematic reviews assessing the effectiveness and consequences of various eHealth technologies on the quality and safety of care. Methods and Findings We developed novel search strategies, conceptual maps of health care quality, safety, and eHealth interventions, and then systematically identified, scrutinised, and synthesised the systematic review literature. Major biomedical databases were searched to identify systematic reviews published between 1997 and 2010. Related theoretical, methodological, and technical material was also reviewed. We identified 53 systematic reviews that focused on assessing the impact of eHealth interventions on the quality and/or safety of health care and 55 supplementary systematic reviews providing relevant supportive information. This systematic review literature was found to be generally of substandard quality with regards to methodology, reporting, and utility. We thematically categorised eHealth technologies into three main areas: (1) storing, managing, and transmission of data; (2) clinical decision support; and (3) facilitating care from a distance. We found that despite support from policymakers, there was relatively little empirical evidence to substantiate many of the claims made in relation to these technologies. Whether the success of those relatively few solutions identified to improve quality and safety would continue if these were deployed beyond the contexts in which they were originally developed, has yet to be established. Importantly, best practice guidelines in effective

  11. Reflections on societal change, adjustments, and responses.

    PubMed

    Friedlander, D; Okun, B

    2009-04-01

    Building on Davis (1963) and subsequent work, we propose a conceptual framework that provides a guide for the organization of empirical demographic research. Our approach is based on the notion that changes in nuptiality, fertility, and migration are not objectives in and of themselves, but means for reducing welfare gaps - defined as the gaps between actual welfare and that which could be attained with altered demographic and/or other behavior. We clarify theoretical issues concerning three levels of analysis. At the highest level, societal change leads to welfare gaps for families and/or individuals. In turn, behavioral adjustments are made to reduce these gaps. Finally, demographic responses at the community level result when large numbers of families and/or individuals adjust behavior in a particular manner. We consider and exemplify relationships among demographic and other responses in historical, agricultural contexts. PMID:19618558

  12. Extreme space weather studies: Addressing societal needs

    NASA Astrophysics Data System (ADS)

    Ngwira, C. M.

    2014-12-01

    Extreme space weather events can adversely impact the operations of critical modern-day technological infrastructure such as high-voltage electric power transmission grids. Understanding of coupled magnetosphere-ionosphere dynamics under extreme solar wind driving conditions is still a major challenge mainly because of a lack of data during such time intervals. This presentation will highlight some of the past and on-going investigations on extreme space weather events, and how these investigations are used to address societal needs. Particularly, I will describe how first principles physics-based 3-D global MHD models are playing a major role in advancing our knowledge on extreme geomagnetically induced currents. These MHD models represent a very important component of attempts to understand the response of the magnetosphere-ionosphere system to varying solar wind conditions.

  13. The population value of quality indicator reporting: a framework for prioritizing health care performance measures.

    PubMed

    Meltzer, David O; Chung, Jeanette W

    2014-01-01

    The Agency for Healthcare Research and Quality (AHRQ) National Healthcare Quality and Disparities Reports contain more than 250 quality indicators, such as whether a patient with a suspected heart attack received an aspirin. The Department of Health and Human Services National Quality Measures Clearinghouse identifies more than 2,100 such indicators. Because resources for making quality improvements are limited, there is a need to prioritize among these indicators. We propose an approach to assess how reporting specific quality indicators would change care to improve the length and quality of life of the US population. Using thirteen AHRQ quality indicators with readily available data on the benefits of indicator reporting, we found that seven of them account for 93 percent of total benefits, while the remaining six account for only 7 percent of total benefits. Use of a framework such as this could focus resources on indicators having the greatest expected impact on population health. PMID:24395945

  14. Space-based societal applications—Relevance in developing countries

    NASA Astrophysics Data System (ADS)

    Bhaskaranarayana, A.; Varadarajan, C.; Hegde, V. S.

    2009-11-01

    Space technology has the vast potential for addressing a variety of societal problems of the developing countries, particularly in the areas of communication, education and health sectors, land and water resources management, disaster management and weather forecasting. Both remote sensing and communication technologies can be used to achieve this goal. With its primary emphasis on application of space technology, on an end-to-end basis, towards national development, the Indian Space Programme has distinguished itself as one of the most cost-effective and development-oriented space programmes in the world. Developing nations are faced with the enormous task of carrying development-oriented education to the masses at the lower strata of their societies. One important feature of these populations is their large number and the spread over vast and remote areas of these nations, making the reaching out to them a difficult task. Satellite communication (Satcom) technology offers the unique capability of simultaneously reaching out to very large numbers, spread over vast areas, including the remote corners of the country. It is a strong tool to support development education. India has been amongst the first few nations to explore and put to use the Satcom technology for education and development-oriented services to the rural masses. Most of the developing countries have inadequate infrastructure to provide proper medical care to the rural population. Availability of specialist doctors in rural areas is a major bottleneck. Use of Satcom and information technology to connect rural clinics to urban hospitals through telemedicine systems is one of the solutions; and India has embarked upon an effective satellite-based telemedicine programme. Space technology is also useful in disaster warning and management related applications. Use of satellite systems and beacons for locating the distressed units on land, sea or air is well known to us. Indian Space Research Organisation

  15. Girls, science and epistemology: A societal approach

    NASA Astrophysics Data System (ADS)

    Arner Welsh, Jennifer M.

    This study examines the ways in which girls' personal epistemologies are applied and modulated in relationship with scientific disciplinary epistemology in the context of their early science learning. The research takes a societal approach, assuming that both girls' reasoning and scientific disciplinary epistemology are socially constituted, emphasizing the role of gendered discourses, realities and experiences in the construction of girls' subjectivities and disciplinary epistemology. Initially, three research scientists were interviewed to provide a naturalized understanding of scientific disciplinary epistemology. Subsequently, over the course of spring semester, seven ninth-grade girls from a small middle-class town participated in a series of in-depth interviews about their reasoning in scientific contexts. The focus of the interview analysis is two-fold. Possible points of connection and contention are examined between the ways in which girls deploy their personal epistemologies and scientific disciplinary epistemology. Individual profiles of each girl are also developed, describing patterns and tensions in her reasoning. This study reveals the intersection between personal and disciplinary epistemology as a productive area for research, and further, shows that examining societal context and personal epistemologies provides new insight into the issues facing girls learning science. Results suggest that there are both significant disjuncts and points of connection between these girls' personal epistemologies and scientific disciplinary epistemology. In particular, the personal understandings of knowledge as perspectival and the role of experience as providing frameworks for thinking which were shown by the girls in this study could be meaningfully used in conjunction with contemporary trends in philosophy of science to enhance understanding of science and scientific disciplinary epistemology.

  16. Critical Zone Science and Global Societal Challenges

    NASA Astrophysics Data System (ADS)

    Goldhaber, M. B.; Banwart, S. A.

    2014-12-01

    Earth's Critical Zone (CZ) is the thin outer veneer of our planet from the top of the tree canopy to the bottom of our drinking water aquifers that supports almost all human activity. Despite its fundamental importance to terrestrial life, understanding of the operation of the coupled geologic, hydrologic, topographic, and biotic CZ processes across time and space is far from complete. These interactions are complex and they establish a mechanistic 'chain of impact' that transmits the effects of environmental change throughout the CZ. Characterization of these processes is made more urgent by the fact that globally, the CZ is experiencing ever-increasing pressure from growth in human population and wealth. Within the next four decades, demand for food and fuel is expected to double along with a more than 50% increase in demand for clean water. Understanding, predicting and managing intensification of land use and associated economic services, while mitigating and adapting to rapid climate change, is now one of the most pressing societal challenges of the 21st century. In this talk we summarize the profound global societal impacts to the Earth's near surface arising from exponential human population growth, increasing affluence, and technological advance, to provide context for discussions on constructing an array of CZ observatories to both characterize fundamental critical zone processes and forecast the effects of planetary change. We will suggest goals and options relevant to planning for a future international array of CZ observatories and a research agenda that matches the urgency of the projected resource demands and environmental pressures of the coming four decades.

  17. Cognitive Function, Mental Health, and Health-related Quality of Life after Lung Transplantation

    PubMed Central

    Cohen, David G.; Christie, Jason D.; Anderson, Brian J.; Diamond, Joshua M.; Judy, Ryan P.; Shah, Rupal J.; Cantu, Edward; Bellamy, Scarlett L.; Blumenthal, Nancy P.; Demissie, Ejigayehu; Hopkins, Ramona O.

    2014-01-01

    Rationale: Cognitive and psychiatric impairments are threats to functional independence, general health, and quality of life. Evidence regarding these outcomes after lung transplantation is limited. Objectives: Determine the frequency of cognitive and psychiatric impairment after lung transplantation and identify potential factors associated with cognitive impairment after lung transplantation. Methods: In a retrospective cohort study, we assessed cognitive function, mental health, and health-related quality of life using a validated battery of standardized tests in 42 subjects post-transplantation. The battery assessed cognition, depression, anxiety, resilience, and post-traumatic stress disorder (PTSD). Cognitive function was assessed using the Montreal Cognitive Assessment, a validated screening test with a range of 0 to 30. We hypothesized that cognitive function post-transplantation would be associated with type of transplant, cardiopulmonary bypass, primary graft dysfunction, allograft ischemic time, and physical therapy post-transplantation. We used multivariable linear regression to examine the relationship between candidate risk factors and cognitive function post-transplantation. Measurements and Main Results: Mild cognitive impairment (score, 18–25) was observed in 67% of post-transplant subjects (95% confidence interval [CI]: 50–80%) and moderate cognitive impairment (score, 10–17) was observed in 5% (95% CI, 1–16%) of post-transplant subjects. Symptoms of moderate to severe anxiety and depression were observed in 21 and 3% of post-transplant subjects, respectively. No transplant recipients reported symptoms of PTSD. Higher resilience correlated with less psychological distress in the domains of depression (P < 0.001) and PTSD (P = 0.02). Prolonged graft ischemic time was independently associated with worse cognitive performance after lung transplantation (P = 0.001). The functional gain in 6-minute-walk distance achieved at the end of post

  18. Assuring the quality of health care for older persons. An expert panel's priorities.

    PubMed

    Fink, A; Siu, A L; Brook, R H; Park, R E; Solomon, D H

    1987-10-01

    To select topics for quality assurance activities focusing on older patients, we convened a 14-member panel of physicians and experts in quality assurance. In two rounds of ratings, panelists rated 42 medical conditions (eg, pneumonia) in terms of their effects on patient outcomes, the availability of beneficial interventions, and the health benefits from improving current quality. They rated 27 health services (eg, adult day-care) on similar dimensions. The feasibility of doing quality assurance work on each condition and service also was rated. Using the ratings, the conditions selected for quality assurance work were congestive heart failure, hypertension, pneumonia, breast cancer, adverse effects of drugs, incontinence, and depression. Health care services selected were hospital discharge planning, acute inpatient care for the frail elderly, long-term-care facilities (intermediate-care facilities and skilled nursing facilities), home health care services, and case management. PMID:3656600

  19. The Quality of Family Relationships and Maternal Health Care Use in India

    PubMed Central

    Allendorf, Keera

    2016-01-01

    Marital quality is well established as a determinant of health in Western contexts, yet the importance of relationship quality to health in non-Western contexts is largely limited to a focus on domestic violence. Using the Women's Reproductive Histories Survey, this paper examines whether women with higher quality family relationships are more likely to use maternal health care in Madhya Pradesh, India. Results show that among nuclear families, women with better marital relationships are more likely to use antenatal care and deliver in a health facility. Among joint families, women who have better relationships with their in-laws are more likely to use antenatal care. The results further suggest that women's agency mediates some, but not all, of the effect of relationship quality on maternal health care use. PMID:21465727

  20. Health benefits from improved outdoor air quality and intervention in China.

    PubMed

    Li, Shanshan; Williams, Gail; Guo, Yuming

    2016-07-01

    China is at its most critical stage of outdoor air quality management. In order to prevent further deterioration of air quality and to protect human health, the Chinese government has made a series of attempts to reduce ambient air pollution. Unlike previous literature reviews on the widespread hazards of air pollution on health, this review article firstly summarized the existing evidence of human health benefits from intermittently improved outdoor air quality and intervention in China. Contents of this paper provide concrete and direct clue that improvement in outdoor air quality generates various health benefits in China, and confirm from a new perspective that it is worthwhile for China to shift its development strategy from economic growth to environmental economic sustainability. Greater emphasis on sustainable environment design, consistently strict regulatory enforcement, and specific monitoring actions should be regarded in China to decrease the health risks and to avoid long-term environmental threats. PMID:27061471

  1. Deciphering the imperative: translating public health quality improvement into organizational performance management gains.

    PubMed

    Beitsch, Leslie M; Yeager, Valerie A; Moran, John

    2015-03-18

    With the launching of the national public health accreditation program under the auspices of the Public Health Accreditation Board (PHAB), health department momentum around quality improvement adoption has accelerated. Domain 9 of the PHAB standards (one of 12 domains) focuses on evaluation and improvement of performance and is acting as a strong driver for quality improvement and performance management implementation within health departments. Widespread adoption of quality improvement activities in public health trails that in other US sectors. Several performance management models have received broad acceptance, including models among government and nonprofits. A model specifically for public health has been developed and is presented herein. All models in current use reinforce customer focus; streamlined, value-added processes; and strategic alignment. All are structured to steer quality improvement efforts toward organizational priorities, ensuring that quality improvement complements performance management. High-performing health departments harness the synergy of quality improvement and performance management, providing powerful tools to achieve public health strategic imperatives. PMID:25494050

  2. Blackberry fruit quality components, composition, and potential health benefits.

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Blackberries have long been a popular small fruit. Their chemical composition data was assembled for this invited book chapter. Briefly, primary and secondary metabolites important to blackberry fruit quality were summarized. Metabolites are involved in many critical aspects of fruit quality includi...

  3. Sensitivity of health risk estimates to air quality adjustment procedure

    SciTech Connect

    Whitfield, R.G.

    1997-06-30

    This letter is a summary of risk results associated with exposure estimates using two-parameter Weibull and quadratic air quality adjustment procedures (AQAPs). New exposure estimates were developed for children and child-occurrences, six urban areas, and five alternative air quality scenarios. In all cases, the Weibull and quadratic results are compared to previous results, which are based on a proportional AQAP.

  4. Health and productivity benefits of improved indoor air quality

    SciTech Connect

    Dorgan, C.B.; Dorgan, C.E.; Kanarek, M.S.; Willman, A.J.

    1998-10-01

    This paper is a summary of two studies completed for a national contractor`s association on the health costs and productivity benefits of improved IAQ. The original study documented the general health costs and productivity benefits of improved IAQ. The second study expanded the scope to include medical cost reductions for specific illnesses from improved IAQ. General information on the objectives, assumptions, definitions, and results of the studies are presented, followed by detailed information on research methodology, building inventory and wellness categories, health and medical effects of poor IAQ, health cost benefits, productivity benefits, recommended improvements, and conclusions and future improvements.

  5. Advancing children's health care and outcomes through the pediatric quality measures program.

    PubMed

    Mistry, Kamila B; Chesley, Francis; LLanos, Karen; Dougherty, Denise

    2014-01-01

    In 2009 Congress passed the Children's Health Insurance Program Reauthorization Act (CHIPRA), which presented an unprecedented opportunity to measure and improve health care quality and outcomes for children. The Agency for Healthcare Research and Quality, in partnership with the Centers for Medicare & Medicaid Services, has worked to fulfill a number of quality measurement provisions under CHIPRA, including establishing the Pediatric Quality Measures Program (PQMP). The PQMP was charged with establishing a publicly available portfolio of new and enhanced evidence-based pediatric quality measures for use by Medicaid/Children's Health Insurance Program and other public and private programs and to also provide opportunities to improve and strengthen the Child Core Set of quality measures. This article focuses on the PQMP and provides an overview of the program's goals and related activities, lessons learned, and future opportunities. PMID:25169453

  6. Association between health worker motivation and healthcare quality efforts in Ghana

    PubMed Central

    2013-01-01

    Background Ghana is one of the sub-Saharan African countries making significant progress towards universal access to quality healthcare. However, it remains a challenge to attain the 2015 targets for the health related Millennium Development Goals (MDGs) partly due to health sector human resource challenges including low staff motivation. Purpose This paper addresses indicators of health worker motivation and assesses associations with quality care and patient safety in Ghana. The aim is to identify interventions at the health worker level that contribute to quality improvement in healthcare facilities. Methods The study is a baseline survey of health workers (n = 324) in 64 primary healthcare facilities in two regions in Ghana. Data collection involved quality care assessment using the SafeCare Essentials tool, the National Health Insurance Authority (NHIA) accreditation data and structured staff interviews on workplace motivating factors. The Spearman correlation test was conducted to test the hypothesis that the level of health worker motivation is associated with level of effort by primary healthcare facilities to improve quality care and patient safety. Results The quality care situation in health facilities was generally low, as determined by the SafeCare Essentials tool and NHIA data. The majority of facilities assessed did not have documented evidence of processes for continuous quality improvement and patient safety. Overall, staff motivation appeared low although workers in private facilities perceived better working conditions than workers in public facilities (P <0.05). Significant positive associations were found between staff satisfaction levels with working conditions and the clinic’s effort towards quality improvement and patient safety (P <0.05). Conclusion As part of efforts towards attainment of the health related MDGs in Ghana, more comprehensive staff motivation interventions should be integrated into quality improvement strategies especially

  7. Innovations to Enhance the Quality of Health Professions Education at the University of Zimbabwe College of Health Sciences -NECTAR Program

    PubMed Central

    Ndhlovu, Chiratidzo E; Nathoo, Kusum; Borok, Margaret; Chidzonga, Midion; Aagaard, Eva M.; Connors, Susan C.; Barry, Michele; Campbell, Thomas; Hakim, James

    2014-01-01

    The University of Zimbabwe College of Health Sciences (UZCHS) is Zimbabwe's premier health professions training institution. However, several concerns were raised during the past decade over the quality of health education at UZCHS. The number of faculty and students declined markedly until 2010, when there was a medical student intake of 147 while the faculty comprised only 122 (39%) of a possible 314 positions. The economic and political crises that the country experienced from 1999 to 2009 compounded the difficulties faced by the institution by limiting the availability of resources. The Medical Education Partnership Initiative (MEPI) funding opportunity has given UZCHS the stimulus to embark on reforms to improve the quality of health education it offers. UZCHS, in partnership with the University of Colorado School of Medicine (UCSOM), the University of Colorado Denver Evaluation Center (UCDEC), and Stanford University designed the Novel Education Clinical Trainees and Researchers (NECTAR) program to implement a series of health education innovations to meet this challenge. Between 2010 and 2013, innovations that have positively affected the quality of health professions education at UZCHS include the launch of comprehensive faculty development programs and mentored clinical and research programs for postgraduate students. A competency-based curriculum reform process has been initiated; a health professions department has been established; and the Research Support Center has been strengthened, providing critical resources to institutionalize health education and research implementation at the college. A core group of faculty trained in medical education has been assembled, helping to ensure the sustainability of these NECTAR activities. PMID:25072588

  8. Health systems, quality of health care, and translational cancer research: the role of the Istituto Superiore Sanità - Rome.

    PubMed

    Ricciardi, Walter

    2015-01-01

    Faced with the challenge of ensuring high-quality and cost-effective health systems in the context of persistent financial crisis, a global strategy for cancer prevention and treatment represents a priority for public health bodies and governments. The key goals for the initiative are to define standards of cancer prevention and care while leveraging the continuous progress of biomedical research in the interest of public health. In Italy, the establishment of a network of Comprehensive Cancer Centres (CCC) named the Alliance Against Cancer (ACC) is an important initiative taken by the Ministry of Health to foster common strategies for enhancing the quality of oncology research and care at the national level. The Istituto Superiore di Sanità (ISS) has played an important role in supporting ACC activities through a special national program called ISS for ACC, launched by the Italian Ministry of Health in 2006. A similar role has been pursued in subsequent initiatives, including ISS support for a project aimed at providing international accreditation of the CCC of the ACC, funded by the Italian Ministry of Health. The results of this initiative, reported in the current issue of Tumori, are especially significant since specific indicators of quality for research and cancer care have been successfully defined for all the participating institutes. As the leading technical and scientific body of the Italian National Health Service, the ISS will continue to play a proactive role in supporting national networks and strategic national and international initiatives aimed at promoting public health. PMID:27096278

  9. Evidence for action on improving the maternal and newborn health workforce: The basis for quality care.

    PubMed

    Campbell, Jim; Sochas, Laura; Cometto, Giorgio; Matthews, Zoë

    2016-01-01

    Ambitious new goals to end preventable maternal and newborn deaths will not only require increased coverage but also improved quality of care. Unfortunately, current levels of quality in the delivery of maternal and newborn care are low in high-burden countries, for reasons that are intimately linked with inadequate planning and management of the maternal and newborn health workforce. The Global Strategy on Human Resources for Health is a key opportunity to strengthen global and country-level accountability frameworks for the health workforce and its capacity to deliver quality care. In order to succeed, maternal and newborn health specialists must embrace this strategy and its linkages with the new Global Strategy for Women's, Children's, and Adolescents' Health; action is needed across high- and low-income countries; and any accountability framework must be underpinned by ambitious, measurable indicators and strengthened data collection on human resources for health. PMID:26725857

  10. Association between HIV programs and quality of maternal health inputs and processes in Kenya.

    PubMed

    Kruk, Margaret E; Jakubowski, Aleksandra; Rabkin, Miriam; Kimanga, Davies O; Kundu, Francis; Lim, Travis; Lumumba, Vane; Oluoch, Tom; Robinson, Katherine A; El-Sadr, Wafaa

    2015-04-01

    We assessed whether quality of maternal and newborn health services is influenced by presence of HIV programs at Kenyan health facilities using data from a national facility survey. Facilities that provided services to prevent mother-to-child HIV transmission had better prenatal and postnatal care inputs, such as infrastructure and supplies, and those providing antiretroviral therapy had better quality of prenatal and postnatal care processes. HIV-related programs may have benefits for quality of care for related services in the health system. PMID:25689188

  11. Association Between HIV Programs and Quality of Maternal Health Inputs and Processes in Kenya

    PubMed Central

    Kruk, Margaret E.; Jakubowski, Aleksandra; Rabkin, Miriam; Kimanga, Davies O.; Kundu, Francis; Lim, Travis; Lumumba, Vane; Oluoch, Tom; Robinson, Katherine A.; El-Sadr, Wafaa

    2016-01-01

    We assessed whether quality of maternal and newborn health services is influenced by presence of HIV programs at Kenyan health facilities using data from a national facility survey. Facilities that provided services to prevent mother-to-child HIV transmission had better prenatal and postnatal care inputs, such as infrastructure and supplies, and those providing antiretroviral therapy had better quality of prenatal and postnatal care processes. HIV-related programs may have benefits for quality of care for related services in the health system. PMID:25689188

  12. The opportunity and strategy for quality and health-system improvement now and in the future.

    PubMed

    Sherar, Michael; Maley, Oonagh

    2015-01-01

    Since 2004, Cancer Care Ontario (CCO) has played a leadership role in linking funding to quality of care, and in using evidence and administrative and clinical data to drive performance and quality improvement. This article describes how CCO has used its cancer and renal health system strategies to establish an environment of continuous health system improvement. The article also describes how CCO's Corporate Strategy is driving organizational improvement: evolving CCO's capacity and capability to drive quality and value across healthcare settings, and its ability to advance broader health system transformation in support of cancer and renal patients. PMID:25562136

  13. RELATING AIR QUALITY AND ENVIRONMENTAL PUBLIC HEALTH TRACKING DATA

    EPA Science Inventory

    Initiated in February 2004, the Public Health Air Surveillance Evaluation (PHASE) Project is a multi-disciplinary collaboration between the Centers for Disease Control and Prevention (CDC), the U.S Environmental Protection Agency (EPA), and three Environmental Public Health Track...

  14. The effect of school quality on black-white health differences: evidence from segregated southern schools.

    PubMed

    Frisvold, David; Golberstein, Ezra

    2013-12-01

    This study assesses the effect of black-white differences in school quality on black-white differences in health in later life resulting from the racial convergence in school quality for cohorts born between 1910 and 1950 in southern states with segregated schools. Using data from the 1984-2007 National Health Interview Surveys linked to race-specific data on school quality, we find that reductions in the black-white gap in school quality led to modest reductions in the black-white gap in disability. PMID:23839102

  15. The Effect of School Quality on Black-White Health Differences: Evidence From Segregated Southern Schools

    PubMed Central

    Frisvold, David; Golberstein, Ezra

    2013-01-01

    This study assesses the effect of black-white differences in school quality on black-white differences in health in later life resulting from the racial convergence in school quality for cohorts born between 1910 and 1950 in southern states with segregated schools. Using data from the 1984 through 2007 National Health Interview Surveys linked to race-specific data on school quality, we find that reductions in the black-white gap in school quality led to modest reductions in the black-white gap in disability. PMID:23839102

  16. Software Quality Evaluation Models Applicable in Health Information and Communications Technologies. A Review of the Literature.

    PubMed

    Villamor Ordozgoiti, Alberto; Delgado Hito, Pilar; Guix Comellas, Eva María; Fernandez Sanchez, Carlos Manuel; Garcia Hernandez, Milagros; Lluch Canut, Teresa

    2016-01-01

    Information and Communications Technologies in healthcare has increased the need to consider quality criteria through standardised processes. The aim of this study was to analyse the software quality evaluation models applicable to healthcare from the perspective of ICT-purchasers. Through a systematic literature review with the keywords software, product, quality, evaluation and health, we selected and analysed 20 original research papers published from 2005-2016 in health science and technology databases. The results showed four main topics: non-ISO models, software quality evaluation models based on ISO/IEC standards, studies analysing software quality evaluation models, and studies analysing ISO standards for software quality evaluation. The models provide cost-efficiency criteria for specific software, and improve use outcomes. The ISO/IEC25000 standard is shown as the most suitable for evaluating the quality of ICTs for healthcare use from the perspective of institutional acquisition. PMID:27350495

  17. A novel framework for assessing metadata quality in epidemiological and public health research settings

    PubMed Central

    McMahon, Christiana; Denaxas, Spiros

    2016-01-01

    Metadata are critical in epidemiological and public health research. However, a lack of biomedical metadata quality frameworks and limited awareness of the implications of poor quality metadata renders data analyses problematic. In this study, we created and evaluated a novel framework to assess metadata quality of epidemiological and public health research datasets. We performed a literature review and surveyed stakeholders to enhance our understanding of biomedical metadata quality assessment. The review identified 11 studies and nine quality dimensions; none of which were specifically aimed at biomedical metadata. 96 individuals completed the survey; of those who submitted data, most only assessed metadata quality sometimes, and eight did not at all. Our framework has four sections: a) general information; b) tools and technologies; c) usability; and d) management and curation. We evaluated the framework using three test cases and sought expert feedback. The framework can assess biomedical metadata quality systematically and robustly. PMID:27570670

  18. Using quality improvement methods to improve public health emergency preparedness: PREPARE for Pandemic Influenza.

    PubMed

    Lotstein, Debra; Seid, Michael; Ricci, Karen; Leuschner, Kristin; Margolis, Peter; Lurie, Nicole

    2008-01-01

    Many public health departments seek to improve their capability to respond to large-scale events such as an influenza pandemic. Quality improvement (QI), a structured approach to improving performance, has not been widely applied in public health. We developed and tested a pilot QI collaborative to explore whether QI could help public health departments improve their pandemic preparedness. We demonstrated that this is a promising model for improving public health preparedness and may be useful for improving public health performance overall. Further efforts are needed, however, to encourage the robust implementation of QI in public health. PMID:18628274

  19. Blending Key Ingredients to Assure Quality in Home Health Care.

    ERIC Educational Resources Information Center

    Griffith, Deloris G.

    1986-01-01

    Careful staff selection, training, and review are among the methods the author recommends to home care agencies striving to provide top-notch services. Discusses measuring the quality of care employees are providing, accreditation, and the benefits of accreditation. (CT)

  20. A Review of Data Quality Assessment Methods for Public Health Information Systems

    PubMed Central

    Chen, Hong; Hailey, David; Wang, Ning; Yu, Ping

    2014-01-01

    High quality data and effective data quality assessment are required for accurately evaluating the impact of public health interventions and measuring public health outcomes. Data, data use, and data collection process, as the three dimensions of data quality, all need to be assessed for overall data quality assessment. We reviewed current data quality assessment methods. The relevant study was identified in major databases and well-known institutional websites. We found the dimension of data was most frequently assessed. Completeness, accuracy, and timeliness were the three most-used attributes among a total of 49 attributes of data quality. The major quantitative assessment methods were descriptive surveys and data audits, whereas the common qualitative assessment methods were interview and documentation review. The limitations of the reviewed studies included inattentiveness to data use and data collection process, inconsistency in the definition of attributes of data quality, failure to address data users’ concerns and a lack of systematic procedures in data quality assessment. This review study is limited by the coverage of the databases and the breadth of public health information systems. Further research could develop consistent data quality definitions and attributes. More research efforts should be given to assess the quality of data use and the quality of data collection process. PMID:24830450

  1. Assessing and improving data quality from community health workers: a successful intervention in Neno, Malawi

    PubMed Central

    Admon, A. J.; Bazile, J.; Makungwa, H.; Chingoli, M. A.; Hirschhorn, L. R.; Peckarsky, M.; Rigodon, J.; Herce, M.; Chingoli, F.; Malani, P. N.

    2013-01-01

    Setting: A community health worker (CHW) program was established in Neno District, Malawi, in 2007 by Partners In Health in support of Ministry of Health activities. Routinely generated CHW data provide critical information for program monitoring and evaluation. Informal assessments of the CHW reports indicated poor quality, limiting the usefulness of the data. Objectives: 1) To establish the quality of aggregated measures contained in CHW reports; 2) to develop interventions to address poor data quality; and 3) to evaluate changes in data quality following the intervention. Design: We developed a lot quality assurance sampling-based data quality assessment tool to identify sites with high or low reporting quality. Following the first assessment, we identified challenges and best practices and followed the interventions with two subsequent assessments. Results: At baseline, four of five areas were classified as low data quality. After 8 months, all five areas had achieved high data quality, and the reports generated from our electronic database became consistent and plausible. Conclusion: Program changes included improving the usability of the reporting forms, shifting aggregation responsibility to designated assistants and providing aggregation support tools. Local quality assessments and targeted interventions resulted in immediate improvements in data quality. PMID:25767750

  2. A Tentative Study on the Evaluation of Community Health Service Quality*

    NASA Astrophysics Data System (ADS)

    Ma, Zhi-qiang; Zhu, Yong-yue

    Community health service is the key point of health reform in China. Based on pertinent studies, this paper constructed an indicator system for the community health service quality evaluation from such five perspectives as visible image, reliability, responsiveness, assurance and sympathy, according to service quality evaluation scale designed by Parasuraman, Zeithaml and Berry. A multilevel fuzzy synthetical evaluation model was constructed to evaluate community health service by fuzzy mathematics theory. The applicability and maneuverability of the evaluation indicator system and evaluation model were verified by empirical analysis.

  3. Europe supports UK government in putting quality at the heart of health care.

    PubMed

    Jackson, S

    1998-01-01

    The new government drive for quality to be at the heart of health care is discussed, following which an insight into the membership and remit of the new European Health-Care Working Group is given. The article also provides a brief description of the European Foundation for Quality Management model and the benefits associated with applying self-assessment as a tool for attaining business excellence. Finally, the first stages of the work proposed by the European Health-Care Working Group is highlighted along with the potential effect on health care within the UK. PMID:10346303

  4. Associations between urban greenspace and health-related quality of life in children.

    PubMed

    McCracken, Deborah S; Allen, Deonie A; Gow, Alan J

    2016-06-01

    With research to suggest that urban greenspace use can affect the health and wellbeing of adults, it is important to investigate this association in children. Compared with factors such as physical activity, research considering greenspace and its association with the health and wellbeing of children from urban areas is relatively rare. This study examined the health-related quality of life of 276 children residing in the city of Edinburgh in relation to quantity and use of greenspace. As much of the existing research has employed parental reports of children's health, the current study assessed health-related quality of life via self-report, measured using the Kid-KINDL questionnaire (Ravens-Sieberer & Bullinger, 1998). Spatial analysis of greenspace quantity and typology was undertaken using mapping software, ArcGIS (Esri, 2011). In regression analysis, higher greenspace use and having fewer siblings were significantly associated with better health-related quality of life. Further analysis revealed that these variables were also associated with the 'friends' sub-scale score of the Kid-KINDL. Higher greenspace use was positively associated with 'self-esteem' sub-scale scores. However, the quantity of residential greenspace was not associated with the health-related quality of life of children. This study suggests that increased use of greenspace in urban areas might have a small but positive impact on child health-related quality of life, though future longitudinal and intervention studies are required to confirm these causal assumptions. PMID:27419017

  5. Switching health insurers: the role of price, quality and consumer information search.

    PubMed

    Boonen, Lieke H H M; Laske-Aldershof, Trea; Schut, Frederik T

    2016-04-01

    We examine the impact of price, service quality and information search on people's propensity to switch health insurers in the competitive Dutch health insurance market. Using panel data from annual household surveys and data on health insurers' premiums and quality ratings over the period 2006-2012, we estimate a random effects logit model of people's switching decisions. We find that switching propensities depend on health plan price and quality, and on people's age, health, education and having supplementary or group insurance. Young people (18-35 years) are more sensitive to price, whereas older people are more sensitive to quality. Searching for health plan information has a much stronger impact on peoples' sensitivity to price than to service quality. In addition, searching for health plan information has a stronger impact on the switching propensity of higher than lower educated people, suggesting that higher educated people make better use of available health plan information. Finally, having supplementary insurance significantly reduces older people's switching propensity. PMID:25820635

  6. Socio-demographic differentials of adult health indicators in Matlab, Bangladesh: self-rated health, health state, quality of life and disability level

    PubMed Central

    Razzaque, Abdur; Nahar, Lutfun; Akter Khanam, Masuma; Kim Streatfield, Peter

    2010-01-01

    Background Mortality has been declining in Bangladesh since the mid- twentieth century, while fertility has been declining since the late 1970s, and the country is now passing through the third stage of demographic transition. This type of demographic transition has produced a huge youthful population with a growing number of older people. For assessing health among older people, this study examines self-rated health, health state, quality of life and disability level in persons aged 50 and over. Data and methods This is a collaborative study between the World Health Organization Study on global AGEing and adult health and the International Network for the Demographic Evaluation of Populations and Their Health in developing countries which collected data from eight countries. Two sources of data from the Matlab study area were used: health indicator data collected as a part of the study, together with the ongoing Health and Demographic Surveillance System (HDSS) data. For the survey, a total of 4,000 randomly selected people aged 50 and over (HDSS database) were interviewed. The four health indicators derived from these data are self-rated health (five categories), health state (eight domains), quality of life (eight items) and disability level (12 items). Self-rated health was coded as dummy while scores were calculated for the rest of the three health indicators using WHO-tested instruments. Results After controlling for all the variables in the regression model, all four indicators of health (self-rated health, health state, quality of life and disability level) documented that health was better for males than females, and health deteriorates with increasing age. Those people who were in current partnerships had generally better health than those who were single, and better health was associated with higher levels of education and asset score. Conclusions To improve the health of the population it is important to know health conditions in advance rather than

  7. Convenient meat and meat products. Societal and technological issues.

    PubMed

    Leroy, Frédéric; Degreef, Filip

    2015-11-01

    In past and contemporary foodscapes, meat and meat products have not only been following convenience trends, they have been at the heart of them. Historically, the first substantial demands for meat convenience must have been for the outsourcing of hunting or domestication, as well as slaughtering activities. In its turn, this prompted concerns for shelf-life stabilisation and the development of preservation strategies, such as meat fermentation. Demands for ease of preparation and consumption can be traced back to Antiquity but have gained in importance over the centuries, especially with the emergence of novel socio-cultural expectations and (perceived) time scarcity. Amongst other trends, this has led to the creation of ready meals and meat snacks and the expansion of urban fast food cultures. Additionally, contemporary requirements focus on the reduction of mental investments, via the "convenient" concealment of slaughtering, the optimisation of nutritional qualities, and the instant incorporation of more intangible matters, such as variety, hedonistic qualities, reassurance, and identity. An overview is given of the technological issues related to the creation of meat convenience, in its broadest sense, along with their societal implications. PMID:25656303

  8. Health-Related Quality of Life of Rural Clients Seeking Telepsychology Services

    PubMed Central

    Tarlow, Kevin R.; McCord, Carly E.; Elliott, Timothy R.; Brossart, Daniel F.

    2014-01-01

    Sixty million US residents live in rural areas, but health policies and interventions developed from an urban mindset often fail to address the significant barriers to health experienced by these local communities. Telepsychology, or psychological services delivered by distance via technology, is an emerging treatment modality with special implications for underserved rural areas. This study found that a sample of rural residents seeking telepsychology services (n = 94) had low health-related quality of life (HRQOL), often due to cooccurring physical and mental health diagnoses including high rates of depression. However, a brief telepsychology treatment delivered to rural clients (n = 40) was associated with an improvement in mental health-related quality of life (d = 0.70, P < .001). These results indicate that despite the complex health needs of these underserved communities, telepsychology interventions may help offset the disparities in health service access in rural areas. PMID:25505906

  9. Creating an Overall Environmental Quality Index to Examine Health Outcomes

    EPA Science Inventory

    The interaction between environmental conditions and human health transpire from complex processes. Environmental exposures tend to cluster and disamenities such as landfills or industrial plants are often located in areas with high a percentage of minority and poor residents. Wh...

  10. CHILD HEALTH CHAMPION AIR QUALITY MONITORING AND EDUCATION PROJECT

    EPA Science Inventory

    In response to two presidential directives, EPA has created the Child Health Champion (CHC) Environmental Monitoring for Public Access and Community Tracking (EMPACT) pilot program in communities where environmental data are not widely available and significant environmental heal...

  11. Americans' Views of Health Care Costs, Access, and Quality

    PubMed Central

    Blendon, Robert J; Brodie, Mollyann; Benson, John M; Altman, Drew E; Buhr, Tami

    2006-01-01

    For more than two decades, polls have shown that Americans are dissatisfied with their current health care system. However, the public's views on how to change the current system are more conflicted than often suggested by individual poll results. At the same time, Americans are both dissatisfied with the current health care system and relatively satisfied with their own health care arrangements. As a result of the conflict between these views and the public's distrust of government, there often is a wide gap between the public's support for a set of principles concerning what needs to be done about the overall problems facing the nation's health care system and their support for specific policies designed to achieve those goals. PMID:17096637

  12. Developing and Transitioning Numerical Air Quality Models to Improve Air Quality and Public Health Decision-Making in El Salvador and Costa Rica As Part of the Servir Applied Sciences Team

    NASA Astrophysics Data System (ADS)

    Thomas, A.; Huff, A. K.; Gomori, S. G.; Sadoff, N.

    2014-12-01

    In order to enhance the capacity for air quality modeling and improve air quality monitoring and management in the SERVIR Mesoamerica region, members of SERVIR's Applied Sciences Team (AST) are developing national numerical air quality models for El Salvador and Costa Rica. We are working with stakeholders from the El Salvador Ministry of the Environment and Natural Resources (MARN); National University of Costa Rica (UNA); the Costa Rica Ministry of the Environment, Energy, and Telecommunications (MINAET); and Costa Rica National Meteorological Institute (IMN), who are leaders in air quality monitoring and management in the Mesoamerica region. Focusing initially on these institutions will build sustainability in regional modeling activities by developing air quality modeling capability that can be shared with other countries in Mesoamerica. The air quality models are based on the Community Multi-scale Air Quality (CMAQ) model and incorporate meteorological inputs from the Weather Research and Forecasting (WRF) model, as well as national emissions inventories from El Salvador and Costa Rica. The models are being optimized for urban air quality, which is a priority of decision-makers in Mesoamerica. Once experimental versions of the modeling systems are complete, they will be transitioned to servers run by stakeholders in El Salvador and Costa Rica. The numerical air quality models will provide decision support for stakeholders to identify 1) high-priority areas for expanding national ambient air monitoring networks, 2) needed revisions to national air quality regulations, and 3) gaps in national emissions inventories. This project illustrates SERVIR's goal of the transition of science to support decision-making through capacity building in Mesoamerica, and it aligns with the Group on Earth Observations' health societal benefit theme. This presentation will describe technical aspects of the development of the models and outline key steps in our successful

  13. STATISTICAL MODELS FOR ESTIMATING THE HEALTH IMPACT OF AIR QUALITY REGULATIONS

    EPA Science Inventory

    Despite increasingly stringent national and local air quality regulations in the last three decades, adverse health effects associated with ambient exposure to air pollution persist. Not surprisingly, regulators, regulated industries, and the public are looking for evidence...

  14. Quality of life and people living with AIDS: relationship with sociodemographic and health aspects1

    PubMed Central

    da Costa, Tadeu Lessa; de Oliveira, Denize Cristina; Gomes, Antonio Marcos Tosoli; Formozo, Gláucia Alexandre

    2014-01-01

    OBJECTIVE: to analyze the relationship of sociodemographic and health dimensions with the quality of life of people living with the human immunodeficiency virus. METHOD: descriptive and quantitative study. The subjects were 131 seropositive people treated in a specialized center of the Norte-Fluminense municipality, Brazil. A form with sociodemographic and health data was applied, as well as the World Health Organization instrument for the assessment of the quality of life of people with the human immunodeficiency virus. RESULTS: the statistical analysis revealed a significant difference in the assessment of the various dimensions of quality of life by the subjects for gender, education, employment, personal income, medical condition, self-perception of sickness, history of hospitalizations, and bodily alterations due to the antiretroviral drugs. CONCLUSION: professional nursing and health care, as well as public policies in the area, should valorize the quality of life approach, considering the conditions related to its configuration. PMID:25296141

  15. WATER QUALITY AND OYSTER HEALTH (CRASSOSTREA VIRGINICA): AN INTEGRATED APPROACH TO DETERMINING HABITAT RESTORATION POTENTIAL

    EPA Science Inventory

    Volety, Aswani K., S. Gregory Tolley and James T. Winstead. 2001. Water Quality and Oyster Health (Crassostrea virginica): An Integrated Approach to Determining Habitat Restoration Potential (Abstract). Presented at the 5th International Conference on Shellfish Restoration, 18-21...

  16. [Evaluating quality and effectiveness in the promotion of health: approaches and methods of public health and social sciences].

    PubMed

    Deccache, A

    1997-06-01

    Health promotion and health education have often been limited to evaluation of the effectiveness of actions and programmes. However, since 1996 with the Third European Conference on Health Promotion and Education Effectiveness, many researchers have become interested in "quality assessment" and new ways of thinking have emerged. Quality assurance is a concept and activity developed in industry with the objective of increasing production efficiency. There are two distinct approaches: External Standard Inspection (ESI) and Continuous Quality Improvement (CQI). ESI involves establishing criteria of quality, evaluating them and improving whatever needs improvement. CQI views the activity or service as a process and includes the quality assessment as part of the process. This article attempts to answer the questions of whether these methods are sufficient and suitable for operationalising the concepts of evaluation, effectiveness and quality in health promotion and education, whether it is necessary to complement them with other methods, and whether the ESI approach is appropriate. The first section of the article explains that health promotion is based on various paradigms from epidemiology to psychology and anthropology. Many authors warn against the exclusive use of public health disciplines for understanding, implementing and evaluating health promotion. The author argues that in practice, health promotion: -integrates preventive actions with those aiming to maintain and improve health, a characteristic which widens the actions of health promotion from those of classic public health which include essentially an epidemiological or "risk" focus; -aims to replace vertical approaches to prevention with a global approach based on educational sciences; -involves a community approach which includes the individual in a "central position of power" as much in the definition of needs as in the evaluation of services; -includes the participation and socio-political actions

  17. Supporting consumer involvement in decision making: what constitutes quality in consumer health information?

    PubMed

    Entwistle, V A; Sheldon, T A; Sowden, A J; Watt, I S

    1996-10-01

    The promotion of consumer involvement in decisions about individual health care is now high on many health policy agendas, but the structures to support it are not all in place. While it is generally accepted that information to support consumer involvement should be of good quality, the question of what constitutes quality in such information packages is far from settled. Debate around this issue should consider the various theoretical perspectives which relate to the nature and purpose of consumer involvement in health care decision making, and the contexts in which information is used. If we are to judge the quality of information within a consequentialist framework, we need empirical research evidence about the effects of information provision. Until such evidence becomes available, we can only hypothesize about what makes for quality. In this paper we discuss some dimensions of quality which are suggested by a consequentialist perspective. PMID:9117196

  18. NASA Earth Observation Systems and Applications for Public Health and Air Quality Models and Decisions Support

    NASA Astrophysics Data System (ADS)

    Estes, S. M.; Haynes, J. A.; Omar, A. H.

    2012-12-01

    Health and Air Quality providers and researchers need environmental data to study and understand the geographic, environmental, and meteorological differences in disease. Satellite remote sensing of the environment offers a unique vantage point that can fill in the gaps of environmental, spatial, and temporal data for tracking disease. This presentation will demonstrate the need for collaborations between multi-disciplinary research groups to develop the full potential of utilizing Earth Observations in studying health. Satellite earth observations present a unique vantage point of the earth's environment from space, which offers a wealth of health applications for the imaginative investigator. The presentation is directly related to Earth Observing systems and Global Health Surveillance and will present research results of the remote sensing environmental observations of earth and health applications, which can contribute to the public health and air quality research. As part of NASA approach and methodology they have used Earth Observation Systems and Applications for Public Health and Air Quality Models to provide a method for bridging gaps of environmental, spatial, and temporal data for tracking disease. This presentation will provide an overview of projects dealing with infectious diseases, water borne diseases and air quality and how many environmental variables effect human health. This presentation will provide a venue where the results of both research and practice using satellite earth observations to study weather and it's role in public health research.

  19. NASA Earth Observation Systems and Applications for Public Health and Air Quality Models and Decisions Support

    NASA Technical Reports Server (NTRS)

    Estes, Sue; Haynes, John; Omar, Ali

    2013-01-01

    Health and Air Quality providers and researchers need environmental data to study and understand the geographic, environmental, and meteorological differences in disease. Satellite remote sensing of the environment offers a unique vantage point that can fill in the gaps of environmental, spatial, and temporal data for tracking disease. This presentation will demonstrate the need for collaborations between multi-disciplinary research groups to develop the full potential of utilizing Earth Observations in studying health. Satellite earth observations present a unique vantage point of the earth's environment from space, which offers a wealth of health applications for the imaginative investigator. The presentation is directly related to Earth Observing systems and Global Health Surveillance and will present research results of the remote sensing environmental observations of earth and health applications, which can contribute to the public health and air quality research. As part of NASA approach and methodology they have used Earth Observation Systems and Applications for Public Health and Air Quality Models to provide a method for bridging gaps of environmental, spatial, and temporal data for tracking disease. This presentation will provide an overview of projects dealing with infectious diseases, water borne diseases and air quality and how many environmental variables effect human health. This presentation will provide a venue where the results of both research and practice using satellite earth observations to study weather and it's role in public health research.

  20. NASA Earth Observation Systems and Applications for Public Health and Air Quality Models and Decisions Support

    NASA Technical Reports Server (NTRS)

    Estes, Sue; Haynes, John; Omar, Ali

    2012-01-01

    Health and Air Quality providers and researchers need environmental data to study and understand the geographic, environmental, and meteorological differences in disease. Satellite remote sensing of the environment offers a unique vantage point that can fill in the gaps of environmental, spatial, and temporal data for tracking disease. This presentation will demonstrate the need for collaborations between multi-disciplinary research groups to develop the full potential of utilizing Earth Observations in studying health. Satellite earth observations present a unique vantage point of the earth's environment from space, which offers a wealth of health applications for the imaginative investigator. The presentation is directly related to Earth Observing systems and Global Health Surveillance and will present research results of the remote sensing environmental observations of earth and health applications, which can contribute to the public health and air quality research. As part of NASA approach and methodology they have used Earth Observation Systems and Applications for Public Health and Air Quality Models to provide a method for bridging gaps of environmental, spatial, and temporal data for tracking disease. This presentation will provide an overview of projects dealing with infectious diseases, water borne diseases and air quality and how many environmental variables effect human health. This presentation will provide a venue where the results of both research and practice using satellite earth observations to study weather and it's role in public health research.

  1. Primary Care Quality among Different Health Care Structures in Tibet, China

    PubMed Central

    Yin, Aitian; Mao, Zongfu; Liu, Xiaoyun

    2015-01-01

    Objective. To compare the primary care quality among different health care structures in Tibet, China. Methods. A self-administered questionnaire survey including Primary Care Assessment Tool-Tibetan version was used to obtain data from a total of 1386 patients aged over 18 years in the sampling sites in two prefectures in Tibet. Multivariate analysis was performed to assess the association between health care structures and primary care quality while controlling for sociodemographic and health care characteristics. Results. The services provided by township health centers were more often used by a poor, less educated, and healthy population. Compared with prefecture (77.42) and county hospitals (82.01), township health centers achieved highest total score of primary care quality (86.64). Factors that were positively and significantly associated with higher total assessment scores included not receiving inpatient service in the past year, less frequent health care visits, good self-rated health status, lower education level, and marital status. Conclusions. This study showed that township health centers patients reported better primary care quality than patients visiting prefecture and county hospitals. Government health reforms should pay more attention to THC capacity building in Tibet, especially in the area of human resource development. PMID:25861619

  2. Cancer control in developing countries: using health data and health services research to measure and improve access, quality and efficiency

    PubMed Central

    2010-01-01

    Background Cancer is a rapidly increasing problem in developing countries. Access, quality and efficiency of cancer services in developing countries must be understood to advance effective cancer control programs. Health services research can provide insights into these areas. Discussion This article provides an overview of oncology health services in developing countries. We use selected examples from peer-reviewed literature in health services research and relevant publicly available documents. In spite of significant limitations in the available data, it is clear there are substantial barriers to access to cancer control in developing countries. This includes prevention, early detection, diagnosis/treatment and palliation. There are also substantial limitations in the quality of cancer control and a great need to improve economic efficiency. We describe how the application of health data may assist in optimizing (1) Structure: strengthening planning, collaboration, transparency, research development, education and capacity building. (2) Process: enabling follow-up, knowledge translation, patient safety and quality assurance. (3) Outcome: facilitating evaluation, monitoring and improvement of national cancer control efforts. There is currently limited data and capacity to use this data in developing countries for these purposes. Summary There is an urgent need to improve health services for cancer control in developing countries. Current resources and much-needed investments must be optimally managed. To achieve this, we would recommend investment in four key priorities: (1) Capacity building in oncology health services research, policy and planning relevant to developing countries. (2) Development of high-quality health data sources. (3) More oncology-related economic evaluations in developing countries. (4) Exploration of high-quality models of cancer control in developing countries. Meeting these needs will require national, regional and international

  3. 42 CFR 476.72 - Review of the quality of care of risk-basis health maintenance organizations and competitive...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT... Quality Improvement Organizations (QIOs) General Provisions § 476.72 Review of the quality of care of risk... 42 Public Health 4 2011-10-01 2011-10-01 false Review of the quality of care of risk-basis...

  4. Timely Access to Quality Health Care Among Georgia Children Ages 4 to 17 Years

    PubMed Central

    Ogbuanu, Chinelo; Goodman, David A.; Kahn, Katherine; Long, Cherie; Noggle, Brendan; Bagchi, Suparna; Barradas, Danielle; Castrucci, Brian

    2015-01-01

    We examined factors associated with children's access to quality health care, a major concern in Georgia, identified through the 2010 Title V Needs Assessment. Data from the 2007 National Survey of Children's Health were merged with the 2008 Area Resource File and Health Resources and Services Administration medically under-served area variable, and restricted to Georgia children ages 4–17 years (N = 1,397). The study outcome, access to quality health care was derived from access to care (timely utilization of preventive medical care in the previous 12 months) and quality of care (compassionate/culturally effective/family-centered care). Andersen's behavioral model of health services utilization guided independent variable selection. Analyses included Chi-square tests and multinomial logit regressions. In our study population, 32.8 % reported access to higher quality care, 24.8 % reported access to moderate quality care, 22.8 % reported access to lower quality care, and 19.6 % reported having no access. Factors positively associated with having access to higher/moderate versus lower quality care include having a usual source of care (USC) (adjusted odds ratio, AOR:3.27; 95 % confidence interval, 95 % CI 1.15–9.26), and special health care needs (AOR:2.68; 95 % CI 1.42–5.05). Lower odds of access to higher/moderate versus lower quality care were observed for non-Hispanic Black (AOR:0.31; 95 % CI 0.18–0.53) and Hispanic (AOR:0.20; 95 % CI 0.08–0.50) children compared with non-Hispanic White children and for children with all other forms of insurance coverage compared with children with continuous-adequate-private insurance. Ensuring that children have continuous, adequate insurance coverage and a USC may positively affect their access to quality health care in Georgia. PMID:23054451

  5. Studies in Ambulatory Care Quality Assessment in the Indian Health Service. Volume III: Comparison of Rural Private Practice, Health Maintenance Organizations, and the Indian Health Service.

    ERIC Educational Resources Information Center

    Nutting, Paul A.; And Others

    Utilizing a quality assessment methodology for ambulatory patient care currently under development by the Indian Health Service's (IHS) Office of Research and Development, comparisons were made between results derived from a pilot test in IHS service units, 2 metropolitan Health Maintenance Organizations (HMO), and 3 rural private practices.…

  6. Indoor air quality and sources in schools and related health effects.

    PubMed

    Annesi-Maesano, Isabella; Baiz, Nour; Banerjee, Soutrik; Rudnai, Peter; Rive, Solenne; SINPHONIE Group

    2013-01-01

    Good indoor air quality in schools is important to provide a safe, healthy, productive, and comfortable environment for students, teachers, and other school staff. However, existing studies demonstrated that various air pollutants are found in classrooms, sometimes at elevated concentrations. Data also indicated that poor air quality may impact children's health, in particular respiratory health, attendance, and academic performance. Nevertheless, it should be noted that there are other adverse health effects that are less documented. Few data exist for teachers and other adults that work in schools. Allergic individuals seem to be at a higher risk for adverse respiratory health consequences. Air quality improvement represents an important measure for prevention of adverse health consequences in children and adults in schools. PMID:24298914

  7. Reducing societal vulnerability to drought: A methodology

    SciTech Connect

    Wilhite, D.A.

    1995-12-31

    Given worldwide experience with drought during the past several decades and the magnitude of associated impacts, it is apparent that vulnerability to extended periods of water shortage is escalating. Developing a national or provincial drought policy and preparedness plan is a complicated but essential first step toward reducing societal vulnerability. Until recently, nations had devoted little effort to drought preparedness, preferring instead the reactive or crisis management approach. Presently, an increasing number of nations are pursuing a more proactive approach that emphasizes the principles of risk management and sustainable development. Because of the multitude of impacts associated with drought and the numerous governmental agencies that have responsibility for some aspect of monitoring, assessment, mitigation, and planning, developing a policy and plan must be an integrated process within and between levels of government. This paper outlines a generic process that can be adopted by governments that desire to develop a more comprehensive and long-term approach to drought management and planning. Countries and states or provincial authorities that have adopted this approach is presented as case studies. This process is timely, given the declaration of the 1990s as the International Decade for Natural Disaster Reduction and the recent International Convention to Combat Desertification and Drought (June, 1994), an offshoot of deliberations at the United Nations Conference on Environment and Development.

  8. Satellite Power System (SPS) societal assessment

    SciTech Connect

    Not Available

    1980-12-01

    Construction and operation of a 60-unit (300 GW) domestic SPS over the period 2000 to 2030 would stress many segments of US society. A significant commitment of resources (land, energy, materials) would be required, and a substantial proportion of them would have to be committed prior to the production of any SPS electricity. Estimated resource demands, however, seem to be within US capabilities. Modifications will be required of institutions called upon to deal with SPS. These include financial, managerial and regulatory entities and, most particularly, the utility industry. Again, the required changes, while certainly profound, seem to be well within the realm of possibility. Enhanced cooperation in international affairs will be necessary to accommodate development and operation of the SPS. To remove its potential as a military threat and to reduce its vulnerability, either the SPS itself must become an international enterprise, or it must be subject to unrestricted international inspection. How either of these objectives could, in fact, be achieved, or which is preferable, remains unclear. Forty-four concerns about the SPS were identified via a public outreach experiment involving 9000 individuals from three special interest organizations. The concerns focused on environmental impacts (particularly the effects of microwave radiation) and the centralizing tendency of the SPS on society. The interim results of the public outreach experiment influenced the scope and direction of the CDEP; the final results will be instrumental in defining further societal assessment efforts.

  9. Computer ethics education: Impact from societal norms

    SciTech Connect

    White, G.B.

    1994-12-31

    Discussions have occurred on the best way to implement the horizontal and vertical integration of education on the social, ethical and professional issues relating to computer science. These discussions have not only included debates on the subject matter and what manner to approach it (i.e. integrated among all computer science courses taught, as a separate required course, or a combination of both), but have also involved debates over who is best qualified to address the subject. What has seldom been addressed, however, is how societal impressions of what is ethical have impacted both those who develop software and those who use it. In light of the experience of such institutions as the U.S. Air Force Academy which recently instituted a program called the Center for Character Development (due to a perceived erosion of the core values of its recruits), should academia and industry expect more from computer scientists than from the population as a whole? It is the integration of ethics courses in the computer science curriculum in light of a general erosion of ethical values in society as a whole that is addressed in this paper.

  10. Economics and societal impacts of tornadoes

    NASA Astrophysics Data System (ADS)

    Bluestein, Howard B.

    2011-08-01

    During the spring of 2011, there were a record number of unusually strong and devastating tornadoes in the United States, which killed more than 500 people, the most in the country since 1953. Tornadoes are responsible for more than $1 billion annually (adjusted to 2007 U.S. dollars) in property damage and for disrupting thousands of lives and businesses. The most notable tornado this past spring devastated Joplin, Mo.; tornadoes also struck such diverse locations as Springfield, Mass.; Tuscaloosa, Ala.; Raleigh, N. C.; communities near Oklahoma City, Okla.; Minneapolis, Minn.; central and east Texas; Philadelphia, Pa.; and St. Louis, Mo. It is therefore timely to assess the economic and societal impacts of tornadoes. In this book the authors use various statistical techniques to evaluate the cost of tornadoes to society. They begin by reviewing the methodologies of formulating a tornado climatology across diverse regions according to tornado intensity, deaths, injuries, and property damage, and they then provide a history of the U.S. National Weather Service's (NWS) public warning efforts, describe tornado shelters and how the public responds to warnings, and suggest ways to reduce tornado risk.

  11. Factors Associated With Health-Related Quality of Life in Children With Duchenne Muscular Dystrophy.

    PubMed

    Wei, Yi; Speechley, Kathy Nixon; Zou, Guangyong; Campbell, Craig

    2016-06-01

    This study investigated clinical and family characteristics associated with health-related quality of life in children with Duchenne muscular dystrophy. Families of 176 boys with Duchenne muscular dystrophy were identified and mailed questionnaires via the Canadian Neuromuscular Disease Registry. Multiple linear regressions analyses were used to examine the relationship between clinical and family characteristics and child-self and parent-proxy reported health-related quality of life. Greater fatigue and use of wheelchairs were consistently associated with worse health-related quality of life independent of other factors. Higher household income and parent having a postsecondary degree were associated with better health-related quality of life in some of the measures. A greater clinical focus on and efforts to reduce fatigue could lead to improvement of health-related quality of life in the Duchenne muscular dystrophy population. This study also sets the ground for longitudinal studies where changes in health-related quality of life can be monitored over time. PMID:26863997

  12. Availability and quality of mobile health app privacy policies.

    PubMed

    Sunyaev, Ali; Dehling, Tobias; Taylor, Patrick L; Mandl, Kenneth D

    2015-04-01

    Mobile health (mHealth) customers shopping for applications (apps) should be aware of app privacy practices so they can make informed decisions about purchase and use. We sought to assess the availability, scope, and transparency of mHealth app privacy policies on iOS and Android. Over 35,000 mHealth apps are available for iOS and Android. Of the 600 most commonly used apps, only 183 (30.5%) had privacy policies. Average policy length was 1755 (SD 1301) words with a reading grade level of 16 (SD 2.9). Two thirds (66.1%) of privacy policies did not specifically address the app itself. Our findings show that currently mHealth developers often fail to provide app privacy policies. The privacy policies that are available do not make information privacy practices transparent to users, require college-level literacy, and are often not focused on the app itself. Further research is warranted to address why privacy policies are often absent, opaque, or irrelevant, and to find a remedy. PMID:25147247

  13. "A Latino Advantage in Oral Health-Related Quality of Life is Modified by Nativity Status"

    PubMed Central

    2010-01-01

    Explanations for the social gradient in health status are informed by the rare exceptions. This cross-sectional observational study examined one such exception, the “Latino paradox” by investigating the presence of a Latino advantage in oral health-related quality of life and the effect of nativity status on this relationship. A nationally representative sample of adults (n = 4208) completed the National Health and Nutrition Examination Survey (NHANES) 2003–2004. The impact of oral disorders on oral health-related quality of life was evaluated using the NHANES Oral Health Impact Profile. Exposures of interest were race, ethnicity and nativity status. Covariates included sociodemographic characteristics, smoking status, self-rated health, access to dental care and number of teeth. Unconditional logistic regression models estimated odds of impaired oral health-related quality of life for racial/ethnic and nativity groups compared to the Non-Latino white population. Overall prevalence of impaired oral health-related quality of life was 15.1%. A protective effect of Latino ethnicity was modified by nativity status, such that Latino immigrants experienced substantially better outcomes than non-Latino whites. However the effect was limited to first-generation Latinos. U.S. born Latinos did not share the oral health-related quality of life advantage of their foreign-born counterparts. This advantage was not attributable to the healthy migrant phenomenon since immigrants of non-Latino origin did not differ from Non-Latino whites. The excess risk among Non-Hispanic Blacks was rendered non-significant after adjustment for socioeconomic position. A protective effect conferred by Latino nativity is unexpected given relatively disadvantaged socioeconomic position of this group, their language barrier and restrictions to needed dental care. As the Latino advantage in oral health-related quality of life is not explained by healthy immigrant selection, cultural explanations

  14. A Latino advantage in oral health-related quality of life is modified by nativity status.

    PubMed

    Sanders, Anne E

    2010-07-01

    Explanations for the social gradient in health status are informed by the rare exceptions. This cross-sectional observational study examined one such exception, the "Latino paradox" by investigating the presence of a Latino advantage in oral health-related quality of life and the effect of nativity status on this relationship. A nationally representative sample of adults (n=4208) completed the National Health and Nutrition Examination Survey (NHANES) 2003-2004. The impact of oral disorders on oral health-related quality of life was evaluated using the NHANES Oral Health Impact Profile. Exposures of interest were race, ethnicity and nativity status. Covariates included sociodemographic characteristics, smoking status, self-rated health, access to dental care and number of teeth. Unconditional logistic regression models estimated odds of impaired oral health-related quality of life for racial/ethnic and nativity groups compared to the Non-Latino white population. Overall, prevalence of impaired oral health-related quality of life was 15.1%. A protective effect of Latino ethnicity was modified by nativity status, such that Latino immigrants experienced substantially better outcomes than non-Latino whites. However, the effect was limited to first-generation Latinos. U.S. born Latinos did not share the oral health-related quality of life advantage of their foreign-born counterparts. This advantage was not attributable to the healthy migrant phenomenon since immigrants of non-Latino origin did not differ from Non-Latino whites. The excess risk among Non-Hispanic Blacks was rendered non-significant after adjustment for socioeconomic position. A protective effect conferred by Latino nativity is unexpected given relatively disadvantaged socioeconomic position of this group, their language barrier and restrictions to needed dental care. As the Latino advantage in oral health-related quality of life is not explained by healthy immigrant selection, cultural explanations seem

  15. Associations Between Cardiovascular Health and Health-Related Quality of Life, Behavioral Risk Factor Surveillance System, 2013

    PubMed Central

    Fang, Jing; Zack, Matthew; Moore, Latetia; Loustalot, Fleetwood

    2016-01-01

    Introduction The American Heart Association established 7 cardiovascular health metrics as targets for promoting healthier lives. Cardiovascular health has been hypothesized to play a role in individuals’ perception of quality of life; however, previous studies have mostly assessed the effect of cardiovascular risk factors on quality of life. Methods Data were from the 2013 Behavioral Risk Factor Surveillance System, a state-based telephone survey of adults 18 years or older (N = 347,073). All measures of cardiovascular health and health-related quality of life were self-reported. The 7 ideal cardiovascular health metrics were normal blood pressure, cholesterol, body mass index, not having diabetes, not smoking, being physically active, and having adequate fruit or vegetable intake. Cardiovascular health was categorized into meeting 0–2, 3–5, or 6–7 ideal cardiovascular health metrics. Logistic regression models examined the association between cardiovascular health, general health status, and 3 measures of unhealthy days per month, adjusting for age, sex, race/ethnicity, education, and annual income. Results Meeting 3 to 5 or 6 to 7 ideal cardiovascular health metrics was associated with a 51% and 79% lower adjusted prevalence ratio (aPR) of fair/poor health, respectively (aPR = 0.49, 95% confidence interval [CI] [0.47–0.50], aPR = 0.21, 95% CI [0.19–0.23]); a 47% and 72% lower prevalence of ≥14 physically unhealthy days (aPR = 0.53, 95% CI [0.51–0.55], aPR = 0.28, 95% CI [0.26–0.20]); a 43% and 66% lower prevalence of ≥14 mentally unhealthy days (aPR = 0.57, 95% CI [0.55–0.60], aPR = 0.34, 95% CI [0.31–0.37]); and a 50% and 74% lower prevalence of ≥14 activity limitation days (aPR = 0.50, 95% CI [0.48–0.53], aPR = 0.26, 95% CI [0.23–0.29]) in the past 30 days. Conclusion Achieving a greater number of ideal cardiovascular health metrics may be associated with less impairment in health-related quality of life. PMID:27468158

  16. How does employment quality relate to health and job satisfaction in Europe? A typological approach.

    PubMed

    Van Aerden, Karen; Puig-Barrachina, Vanessa; Bosmans, Kim; Vanroelen, Christophe

    2016-06-01

    The changing nature of employment in recent decades, due to an increased emphasis on flexibility and competitiveness in European labour markets, compels the need to assess the consequences of contemporary employment situations for workers. This article aims to study the relation between the quality of employment and the health and well-being of European workers, using data from the 2010 European Working Conditions Survey. A typology of employment arrangements, mapping out employment quality in the European labour force, is constructed by means of a Latent Class Cluster Analysis. This innovative approach shows that it is possible to condense multiple factors characterising the employment situation into five job types: Standard Employment Relationship-like (SER-like), instrumental, precarious unsustainable, precarious intensive and portfolio jobs. Binary logistic regression analyses show that, controlling for other work quality characteristics, this employment quality typology is related to self-perceived job satisfaction, general health and mental health. Precarious intensive jobs are associated with the worst and SER-like jobs with the best health and well-being situation. The findings presented in this study indicate that, among European wage workers, flexible and de-standardised employment tends to be related to lower job satisfaction, general health and mental health. The quality of employment is thus identified as an important social determinant of health (inequalities) in Europe. PMID:27135543

  17. Association between diet, social resources and oral health related quality of life in edentulous patients.

    PubMed

    Allen, P F

    2005-09-01

    To assess whether there was an association between diet, oral health related quality of life and social resources in a population of older edentulous adults, and, to assess the impact of provision of new complete replacement dentures. This study was carried out at Cork University Dental Hospital in Ireland. In this prospective clinical study, 35 edentulous adults who requested new complete dentures completed pre-treatment questionnaires which included validated oral health status, social resources and nutritional assessment questionnaires. New dentures were provided and the impact of treatment on oral health related quality of life, diet and ability to chew food was assessed. Satisfaction with dentures and oral health related quality of life improved following provision of new dentures. However, food choice remained similar to pre-treatment choice, and subjects were rated as medium risk for poor nutritional status on the Mini Nutritional Assessment (MNA) score. Oral health related quality of life and diet were not correlated. Three quarters of the sample felt they had no nutritional problems. However, approximately 70% reported that they had changed their food choices because of dental problems and that financial cost was a barrier to dental treatment. Food selection among the group studied was not ideal, and not improved by the provision of new dentures. There was no association between diet and oral health related quality of life. Further research is needed to improve our understanding of the relationship between oral health and diet. PMID:16102073

  18. Sam Ho on health system quality and population medicine. Interview by Nancy Houyoux.

    PubMed

    Ho, Sam

    2003-01-01

    As PacifiCare Health Systems' senior vice president and chief medical officer, Dr. Sam Ho is responsible for developing and implementing strategies and programs to improve the quality and cost-effectiveness of healthcare services throughout the company. Dr. Ho is responsible for all initiatives related to quality assessment and improvement, medical management, disease management, informatics, report cards, clinical product development, e-health, and healthcare liaison with public policy, government affairs, industry relations, media relations, provider network management, and sales and marketing. Since joining PacifiCare in its California MCO in October 1994, he has spearheaded companywide quality initiatives and improvement in population health outcomes, and developed the QUALITY INDEX profile of medical groups, a consumer-focused report card of provider performance. He also led efforts to achieve systemwide accreditation by the National Committee for Quality Assurance in all markets and Health Plan Employer Data and Information Set (HEDIS) score improvements. Previously he served as deputy director of health, medical director, and county health officer for the San Francisco Department of Public Health. He has held faculty appointments at the Schools of both Medicine and Nursing at the University of California, San Francisco. The Honolulu native received his BA in sociology from Northwestern University in 1972 with Phi Beta Kappa honors and his MD from Tufts University School of Medicine in 1976. Dr. Ho completed his residency in family practice at the University of California, San Francisco, and has since maintained board certification with the American Board of Family Practice. PMID:14671853

  19. Measuring health care access and quality to improve health in populations.

    PubMed

    Kottke, Thomas E; Isham, George J

    2010-07-01

    Poor health status, rapidly escalating health care costs, and seemingly little association between investments in health care and health outcomes have prompted a call for a "pay-for-performance" system to improve population health. We suggest that both health plans and clinical service providers measure and report the rates of 5 behaviors: 1) smoking, 2) physical activity, 3) excessive drinking, 4) nutrition, and 5) condom use by sexually active youth. Because preventive services can improve population health, we suggest that health plans and clinical service providers report delivery rates of preventive services. We also suggest that an independent organization report 8 county-level indicators of health care performance: 1) health care expenditures, 2) insurance coverage, 3) rates of unmet medical, dental, and prescription drug needs, 4) preventive services delivery rates, 5) childhood vaccination rates, 6) rates of preventable hospitalizations, 7) an index of affordability, and 8) disparities in access to health care associated with race and income. To support healthy behaviors, access to work site wellness and health promotion programs should be measured. To promote coordinated care, an indicator should be developed for whether a clinical service provider is a member of an accountable care organization. To encourage clinical service providers and health plans to address the social determinants of health, organizational participation in community-benefit initiatives that address the leading social determinants of health should be assessed. PMID:20550831

  20. A Qualitative Study of the Health-Related Quality of Life of Disabled Children

    ERIC Educational Resources Information Center

    Young, Bridget; Rice, Helen; Dixon-Woods, Mary; Colver, Allan F.; Parkinson, Kathryn N.

    2007-01-01

    This qualitative study investigated what disabled children thought most important in their lives and examined how well their priorities are represented in KIDSCREEN, a generic health-related quality of life (HRQoL) instrument. Participants were a subgroup of families who had previously taken part in a study of quality of life and participation in…

  1. The Importance of Good Quality Services for People with Complex Health Needs

    ERIC Educational Resources Information Center

    Campbell, Martin

    2008-01-01

    This article describes the use of a set of evidence-based quality indicators to assess performance by 15 NHS Boards across Scotland in a national review, with a particular focus on the quality of services for people with complex health needs. Evidence based best practice and evaluative data from previous inspections were used to develop Quality…

  2. The Structure and Quality of Social Network Support among Mental Health Consumers of Clubhouse Programs

    ERIC Educational Resources Information Center

    Pernice-Duca, Francesca M.

    2008-01-01

    This study explored the structure and quality of social network support among a group of adult consumers of community-based mental health programs known as "clubhouses". The structure and quality of social network support was also examined by diagnosis, specifically between consumers living with and without schizophrenia. The study involved a…

  3. Relationship between Sleep Quality and Health Risk Behaviors in Undergraduate College Students

    ERIC Educational Resources Information Center

    Vail-Smith, Karen; Felts, W. Michael; Becker, Craig

    2009-01-01

    The Sleep Quality Index (SQI) and the Centers for Disease Control's National College Health Risk Survey (NCHRS) were administered to 859 undergraduates at a large southeastern university. Results indicated that 76.6% reported occasional sleep problems and 11.8 % experienced poor sleep quality. Among the problems reported, "general morning…

  4. WATER QUALITY AND SWIMMING-ASSOCIATED HEALTH EFFECTS

    EPA Science Inventory

    Evidence from various sources around the world indicate that there is a relationship between gastroenteritis in swimmers and the quality of the bathing water as measured with bacterial indicators of fecal contamination. Current EPA guidelines recommend the use of cultural method...

  5. Health and Quality of Life in Northern Plains Indians

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Quality of life and standard of living are consistently depicted as indigent among American Indian and Alaska Native (AI/AN) populations. American Indians (AI) are among the most heterogeneous and impoverished ethnic groups in the U.S.,have the highest per capita suicide rate at 247% of the national...

  6. Campus Health and Its Implications for Quality of Life for Bridgewater State College Students.

    ERIC Educational Resources Information Center

    Bridgewater State Coll., MA.

    An exploratory study was conducted to investigate the impact of health state on academic achievement, attrition, and quality of life satisfaction in a population of students at Bridgewater State College (Massachusetts). The study also explored the impact of specific health factors such as alienation, stress, and general physical/emotional health…

  7. Examining the Relationship between Electronic Health Record Interoperability and Quality Management

    ERIC Educational Resources Information Center

    Purcell, Bernice M.

    2013-01-01

    A lack of interoperability impairs data quality among health care providers' electronic health record (EHR) systems. The problem is whether the International Organization for Standardization (ISO) 9000 principles relate to the problem of interoperability in implementation of EHR systems. The purpose of the nonexperimental quantitative…

  8. School Nurse Case Management for Children with Chronic Illness: Health, Academic, and Quality of Life Outcomes

    ERIC Educational Resources Information Center

    Engelke, Martha Keehner; Guttu, Martha; Warren, Michelle B.; Swanson, Melvin

    2008-01-01

    More children with chronic illnesses are attending school, and some of them struggle academically because of issues related to their health. School-based case management has been suggested as one strategy to improve the academic success of these children. This study tracked the academic, health, and quality of life outcomes for 114 children with…

  9. A Longitudinal Analysis of Rural and Urban Veterans' Health-Related Quality of Life

    ERIC Educational Resources Information Center

    Wallace, Amy E.; Lee, Richard; MacKenzie, Todd A.; West, Alan N.; Wright, Steven; Booth, Brenda M.; Hawthorne, Kara; Weeks, William B.

    2010-01-01

    Context: Cross-sectional studies have identified rural-urban disparities in veterans' health-related quality-of-life (HRQOL) scores. Purpose: To determine whether longitudinal analyses confirmed that these disparities in veterans' HRQOL scores persisted. Methods: We obtained data from the SF-12 portion of the veterans health administration's…

  10. Health Related Quality of Life among Insulin-Dependent Diabetics: Disease-Related and Psychosocial Correlates.

    ERIC Educational Resources Information Center

    Aalto, Anna-Mari; Uutela, Antti; Aro, Arja R.

    1997-01-01

    The associations of health and psychosocial factors with the Health Related Quality of Life Questionnaire were examined in adult type 1 diabetic patients (N=385). The most important factors from multivariate analysis were self-efficacy and diabetes-related social support, especially among those in good physical condition. Diabetes-specific factors…

  11. Health Sciences Graduate Students' Perceptions of the Quality of their Supervision: A Measurement Scale

    ERIC Educational Resources Information Center

    Bravo, Gina; Saint-Mleux, Julie; Dubois, Marie-France

    2007-01-01

    We developed and evaluated the G3S-SP, a scale measuring health sciences graduate students' perceptions of the quality of their supervision. The scale was developed from a literature review and existing questionnaires. Feedback from health sciences graduate students and supervisors led to a revised version of the scale that was mailed to 215…

  12. Marketing and Quality of Life: A Model for Improving Perinatal Health Status

    ERIC Educational Resources Information Center

    Dever, G. E. Alan; Smith, Leah T.; Stamps, Bunnie V.

    2005-01-01

    Introduction: A marketing/business model using non-traditional Quality of Life measures was developed to assess perinatal health status on a micro-geographic level. This perinatal health status needs assessment study for Georgia South Central Region was conducted for the years 1994-1999. The model may be applied to any geographic unit in the…

  13. Personal genome testing: Test characteristics to clarify the discourse on ethical, legal and societal issues

    PubMed Central

    2011-01-01

    Background As genetics technology proceeds, practices of genetic testing have become more heterogeneous: many different types of tests are finding their way to the public in different settings and for a variety of purposes. This diversification is relevant to the discourse on ethical, legal and societal issues (ELSI) surrounding genetic testing, which must evolve to encompass these differences. One important development is the rise of personal genome testing on the basis of genetic profiling: the testing of multiple genetic variants simultaneously for the prediction of common multifactorial diseases. Currently, an increasing number of companies are offering personal genome tests directly to consumers and are spurring ELSI-discussions, which stand in need of clarification. This paper presents a systematic approach to the ELSI-evaluation of personal genome testing for multifactorial diseases along the lines of its test characteristics. Discussion This paper addresses four test characteristics of personal genome testing: its being a non-targeted type of testing, its high analytical validity, low clinical validity and problematic clinical utility. These characteristics raise their own specific ELSI, for example: non-targeted genetic profiling poses serious problems for information provision and informed consent. Questions about the quantity and quality of the necessary information, as well as about moral responsibilities with regard to the provision of information are therefore becoming central themes within ELSI-discussions of personal genome testing. Further, the current low level of clinical validity of genetic profiles raises questions concerning societal risks and regulatory requirements, whereas simultaneously it causes traditional ELSI-issues of clinical genetics, such as psychological and health risks, discrimination, and stigmatization, to lose part of their relevance. Also, classic notions of clinical utility are challenged by the newer notion of 'personal

  14. Quality of psoriasis care in Germany: results of the national health care study "PsoHealth3".

    PubMed

    Langenbruch, Anna; Radtke, Marc Alexander; Jacobi, Arnd; Purwins, Sandra; Haack, Kristina; Reich, Kristian; Stroemer, Klaus; Mrowietz, Ulrich; Augustin, Matthias

    2016-08-01

    Two national surveys conducted in 2005 and 2007 indicated deficits in psoriasis care and induced the composition of the ''National Goals for Health Care in Psoriasis 2010-2015''. The aim of this work was to (1) evaluate the quality of care for patients with psoriasis in Germany, (2) compare this with prior psoriasis studies PsoHealth1 (2005) and PsoHealth2 (2007), and (3) review the implementation of national treatment goals. By means of a cross sectional study the following indicators of health care quality were collected: psoriasis severity (Psoriasis Area Severity Index (PASI) and proportion of PASI >20), quality of life (Dermatology Life Quality Index (DLQI) were corporated: proportion of DLQI >10), previous systemic treatment, inpatient treatment, and days absent from work due to psoriasis. Between January 2013 and March 2014, 1265 patients from 82 dermatological centres were included (mean age of 52 years). 9.2 % had a PASI >20 (2007: 11.6 %; 2005: 17.8 %). 21.3 % reported strong quality of life restrictions (DLQI >10) (2007: 28.2 %; 2005: 34.0 %). 59.5 % had received a systemic treatment at least once within the last 5 years (2007: 47.3 %; 2005: 32.9 %). 20.1 % were treated inpatient within the last 5 years (2007: 20.1 %; 2005: 26.9 %). The current data indicate a better health care situation for psoriasis in Germany. The implementation of the S3-Guideline and the ''National Goals for Health Care in Psoriasis 2010-2015'' could have been contributing factors. PMID:27206971

  15. Quality Assurance Activities in High School Student Mental Health Centers.

    ERIC Educational Resources Information Center

    Nabors, Laura; Tashman, Nancy; Myers, Patrick; Weist, Mark

    This study of school-based mental health programs used stakeholder focus groups to examine factors related to positive treatment outcomes, barriers to accessing services, and methods for improving service delivery to high school students with emotional/behavioral disorders. Fifty-one high school students (34 receiving treatment) at three urban…

  16. Enhancing the health-beneficial qualities of whole grain rice

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Various pre- and post-harvest approaches (i.e. pre-germination of whole grains and reduced milling degree) to enhancing the health beneficial compounds of whole grain and milled rice have been reported. A discussion of the results from our pre-harvest efforts is as follows. The majority of rice cons...

  17. Health Education and Safety for High Quality Performance.

    ERIC Educational Resources Information Center

    Bulo, Apollos

    2000-01-01

    Discusses the methodologies successfully used at the University of Michigan Plant Building Services for the maintenance of the safety and health of almost 400 management and custodial staff, and which may be extended to cover all the more than 1,500 workers throughout the university's Plant Operations Department. The establishing of departmental…

  18. Integration of Satellite, Modeled, and Ground Based Aerosol Data for use in Air Quality and Public Health Applications

    NASA Astrophysics Data System (ADS)

    Garcia, V.; Kondragunta, S.; Holland, D.; Dimmick, F.; Boothe, V.; Szykman, J.; Chu, A.; Kittaka, C.; Al-Saadi, J.; Engel-Cox, J.; Hoff, R.; Wayland, R.; Rao, S.; Remer, L.

    2006-05-01

    Advancements in remote sensing over the past decade have been recognized by governments around the world and led to the development of the international Global Earth Observation System of Systems 10-Year Implementation Plan. The plan for the U.S. contribution to GEOSS has been put forth in The Strategic Plan for the U.S. Integrated Earth Observation System (IEOS) developed under IWGEO-CENR. The approach for the development of the U.S. IEOS is to focus on specific societal benefits that can be achieved by integrating the nation's Earth observation capabilities. One such challenge is our ability to understand the impact of poor air quality on human health and well being. Historically, the air monitoring networks put in place for the Nations air quality programs provided the only aerosol air quality data on an ongoing and systematic basis at national levels. However, scientific advances in the remote sensing of aerosols from space have improved dramatically. The MODIS sensor and GOES Imager aboard NASA and NOAA satellites, respectively, provide synoptic-scale measurements of aerosol optical depth (AOD) which have been demonstrated to correlate with high levels of PM10 and PM2.5 at the surface. The MODIS sensor has been shown to be capable of a 1 km x 1 km (at nadir) AOD product, while the GOES Imager can provide AOD at 4 km x 4 km every 30 minutes. Within the next several years NOAA and EPA will begin to issue PM2.5 air quality forecasts over the entire domain of the eastern United States, eventually extending to national coverage. These forecasts will provide continuous estimated values of PM2.5 on a daily basis. A multi-agency collaborative project among government and academia is underway to improve the spatial prediction of fine particulate matter through the integration of multi-sensor and multi-platform aerosol observations (MODIS and GOES), numerical model output, and air monitoring data. By giving more weight to monitoring data in monitored areas and relying

  19. Choosing quality of care measures based on the expected impact of improved care on health.

    PubMed Central

    Siu, A L; McGlynn, E A; Morgenstern, H; Beers, M H; Carlisle, D M; Keeler, E B; Beloff, J; Curtin, K; Leaning, J; Perry, B C

    1992-01-01

    Consumers, payers, and policymakers are demanding to know more about the quality of the services they are purchasing or might purchase. The information provided, however, is often driven by data availability rather than by epidemiologic and clinical considerations. In this article, we present an approach for selecting topics for measuring technical quality of care, based on the expected impact on health of improved quality. This approach employs data or estimates on disease burden, efficacy of available treatments, and the current quality of care being provided. We use this model to select measures that could be used to measure the quality of care in health plans, but the proposed framework could also be used to select quality of care measures for other purposes or in other contexts (for example, to select measures for hospitals). Given the limited resources available for quality assessment and the policy consequences of better information on provider quality, priorities for assessment efforts should focus on those areas where better quality translates into improved health. PMID:1464537

  20. Comparative analysis of quality assurance in health care delivery and higher medical education

    PubMed Central

    Busari, Jamiu O

    2012-01-01

    Quality assurance (QA) in higher medical education involves the development, sustenance, improvement, and evaluation of the standard of training of medical professionals. In health care delivery, QA focuses on guaranteeing and maintaining a high standard of the service provided in different health care systems. When the service delivered by the care provider is in accordance with what the recipients of health care expect, then quality in health care is considered to be present. There are several factors in higher medical education and health care that are responsible for the emergence of QA. These include externally imposed obligations requiring demonstration of public accountability and responsibility from educational institutions, as well as the need for activity-specific information by policy makers as an aid for important decision-making within educational institutions. In health care delivery on the other hand, the emergence of QA is linked to the need for containing rising health care costs in the face of limited resources and to guaranteeing high quality patient care in a changing health care environment where the power relationship between doctors and patients is shifting towards patients. Although medical education can be regarded as a distinct entity in the health care industry, it still remains an inherent part of the health care delivery system. As a result, different strategies aimed at guaranteeing and assuring high standards of health care and education in many countries tend to overlap. This paper reflects on whether quality assurance in health care delivery and medical education should be seen as separate entities. PMID:23762010

  1. Developing quality indicators for family support services in community team-based mental health care.

    PubMed

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

    2014-01-01

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

  2. Impact of Climate Change on Air Quality and Public Health in Urban Areas.

    PubMed

    Hassan, Noor Artika; Hashim, Zailina; Hashim, Jamal Hisham

    2016-03-01

    This review discusses how climate undergo changes and the effect of climate change on air quality as well as public health. It also covers the inter relationship between climate and air quality. The air quality discussed here are in relation to the 5 criteria pollutants; ozone (O3), carbon dioxide (CO2), nitrogen dioxide (NO2), sulfur dioxide (SO2), and particulate matter (PM). Urban air pollution is the main concern due to higher anthropogenic activities in urban areas. The implications on health are also discussed. Mitigating measures are presented with the final conclusion. PMID:26141092

  3. Trends in Higher Education: Implications for Health, Physical Education, and Leisure Studies.

    ERIC Educational Resources Information Center

    Edginton, Christopher R.; And Others

    1994-01-01

    Discusses some of the changes currently facing higher education and how those changes might affect the areas of health, physical education, and leisure studies (HPELS). The article suggests that, as technology improves, HPELS must be quick in responding to emerging societal needs with thoughtful programs of high quality. (SM)

  4. Human Initiated Cascading Failures in Societal Infrastructures

    PubMed Central

    Barrett, Chris; Channakeshava, Karthik; Huang, Fei; Kim, Junwhan; Marathe, Achla; Marathe, Madhav V.; Pei, Guanhong; Saha, Sudip; Subbiah, Balaaji S. P.; Vullikanti, Anil Kumar S.

    2012-01-01

    In this paper, we conduct a systematic study of human-initiated cascading failures in three critical inter-dependent societal infrastructures due to behavioral adaptations in response to a crisis. We focus on three closely coupled socio-technical networks here: (i) cellular and mesh networks, (ii) transportation networks and (iii) mobile call networks. In crises, changes in individual behaviors lead to altered travel, activity and calling patterns, which influence the transport network and the loads on wireless networks. The interaction between these systems and their co-evolution poses significant technical challenges for representing and reasoning about these systems. In contrast to system dynamics models for studying these interacting infrastructures, we develop interaction-based models in which individuals and infrastructure elements are represented in detail and are placed in a common geographic coordinate system. Using the detailed representation, we study the impact of a chemical plume that has been released in a densely populated urban region. Authorities order evacuation of the affected area, and this leads to individual behavioral adaptation wherein individuals drop their scheduled activities and drive to home or pre-specified evacuation shelters as appropriate. They also revise their calling behavior to communicate and coordinate among family members. These two behavioral adaptations cause flash-congestion in the urban transport network and the wireless network. The problem is exacerbated with a few, already occurring, road closures. We analyze how extended periods of unanticipated road congestion can result in failure of infrastructures, starting with the servicing base stations in the congested area. A sensitivity analysis on the compliance rate of evacuees shows non-intuitive effect on the spatial distribution of people and on the loading of the base stations. For example, an evacuation compliance rate of 70% results in higher number of overloaded

  5. Human initiated cascading failures in societal infrastructures.

    PubMed

    Barrett, Chris; Channakeshava, Karthik; Huang, Fei; Kim, Junwhan; Marathe, Achla; Marathe, Madhav V; Pei, Guanhong; Saha, Sudip; Subbiah, Balaaji S P; Vullikanti, Anil Kumar S

    2012-01-01

    In this paper, we conduct a systematic study of human-initiated cascading failures in three critical inter-dependent societal infrastructures due to behavioral adaptations in response to a crisis. We focus on three closely coupled socio-technical networks here: (i) cellular and mesh networks, (ii) transportation networks and (iii) mobile call networks. In crises, changes in individual behaviors lead to altered travel, activity and calling patterns, which influence the transport network and the loads on wireless networks. The interaction between these systems and their co-evolution poses significant technical challenges for representing and reasoning about these systems. In contrast to system dynamics models for studying these interacting infrastructures, we develop interaction-based models in which individuals and infrastructure elements are represented in detail and are placed in a common geographic coordinate system. Using the detailed representation, we study the impact of a chemical plume that has been released in a densely populated urban region. Authorities order evacuation of the affected area, and this leads to individual behavioral adaptation wherein individuals drop their scheduled activities and drive to home or pre-specified evacuation shelters as appropriate. They also revise their calling behavior to communicate and coordinate among family members. These two behavioral adaptations cause flash-congestion in the urban transport network and the wireless network. The problem is exacerbated with a few, already occurring, road closures. We analyze how extended periods of unanticipated road congestion can result in failure of infrastructures, starting with the servicing base stations in the congested area. A sensitivity analysis on the compliance rate of evacuees shows non-intuitive effect on the spatial distribution of people and on the loading of the base stations. For example, an evacuation compliance rate of 70% results in higher number of overloaded

  6. Practical approaches for health care: Indoor air quality management

    SciTech Connect

    Turk, A.R.; Poulakos, E.M.

    1996-05-01

    The management of indoor air quality (IAQ) is of interest to building occupants, managers, owners, and regulators alike. Whether by poor design, improper attention, inadequate maintenance or the intent to save energy, many buildings today have significantly degraded IAQ levels. Acceptable IAQ is defined by the American Society of Heating, Refrigerating, and Air Conditioning Engineers (ASHRAE) in Standard 62-1989 {open_quotes}Ventilation for Acceptable Indoor Air Quality{close_quotes} as {open_quotes}air in which there are no known contaminants at harmful concentrations as determined by cognizant authorities and with which a substantial majority (80 percent or more) of the people exposed do not express dissatisfaction.{close_quotes} ASHRAE`s definition not only addresses the chemical compounds that may be present in the air, but it also recognizes a need to address both physiological and psychosocial comfort. The second step is to conduct a performance review of the HVAC systems based on equipment design specifications and guidelines for acceptable IAQ. And the third step is to identify potential chemical, physical and biological sources that are known to contribute to adverse air quality. Upon completion of these three steps, you will able to identify the more significant contributors to IAQ problems and establish applications for prevention and mitigation.

  7. Lower Health-Related Quality of Life in Polytrauma Patients

    PubMed Central

    Zwingmann, Jörn; Hagelschuer, Paul; Langenmair, Elia; Bode, Gerrit; Herget, Georg; Südkamp, Norbert P.; Hammer, Thorsten

    2016-01-01

    Abstract Although trauma-associated mortality has fallen in recent decades, and medical care has continued to improve in many fields, the quality of life after experiencing polytrauma has attracted little attention in the literature. This group of patients suffer from persisting physical disabilities. Moreover, they experience long-term social, emotional, and psychological effects that limit/lower considerably their quality of life. We analyzed retrospective data on 147 polytraumatized patients by administering written questionnaires and conducting face-to-face interviews 6 ± 0.8 years after the trauma in consideration of the following validated scores: Glasgow Outcome Scale, European Quality of Life Score, Short Form-36, Trauma Outcome Profile, and Beck Depressions Inventory II. Our analysis of these results reveals that polytraumatized patients suffer from persistent pain and functional disabilities after >5 years. We also observed changes in their socioeconomic situation, as well as psychological after-effects. The rehabilitation of this particular group of patients should not only address their physical disabilities. The psychological after-effects of trauma must be acknowledged and addressed for an even longer period of time. PMID:27175646

  8. Changing health care quality paradigms: the rise of clinical guidelines and quality measures in American medicine.

    PubMed

    Nigam, Amit

    2012-12-01

    Clinical guidelines and quality measures are important new paradigms for conceptualizing and managing quality in the United States. Researchers have proposed that professional elites-including members of academic medicine-were an important cause of the shift to guidelines and measures. This paper draws on content analysis of abstracts focused on quality in major American medical journals between 1975 and 2009 to empirically assess whether and how paradigms for managing quality changed in academic medicine. The content analysis shows that guidelines- and measures-based approaches to quality increased in prominence. Individual expertise-based approaches to quality, however, remain important. Concurrent with changing paradigms in academic medicine, there was a reorientation of policy toward increased use of guidelines and measures the late 1980s and early 1990s in the United States. This policy reorientation was informed by earlier work by medical researchers proposing new approaches to quality. The policy reorientation was followed by an increase in the prominence of guidelines and measures in medical research. PMID:22920278

  9. A comparative study of total quality management of health care system in India and Iran

    PubMed Central

    2011-01-01

    Background Total quality management (TQM) has a great potential to address quality problems in a wide range of industries and improve the organizational performance. The growing need to take initiatives by hospitals in countries like India and Iran to improve the service quality and reduce wastage of resources has inspired the authors to develop a survey instrument to measure health care quality and performance in the two countries. Methods Based on the Baldrige health care criteria for performance excellence 2009-2010 and the guidelines proposed by the American Hospitals Association for hospitals in pursuit of excellence, compared health care services in three countries. The data are collected from the capital cities and their nearby places in India and Iran. Using ANOVAs, three groups in quality planning and performance have been compared. Result Results showed there is significantly difference between groups and in no case the hospitals from India and Iran are found scoring close to the benchmarks. The average scores of Indian and Iranian hospitals on different constructs of the IHCQPM model are compared with the major results achieved by the recipients of the MBNQ award. Conclusion In no case the hospitals from India and Iran are found scoring close to the benchmarks (Baldrige health care criteria for performance excellence 2009-2010 and the guidelines proposed by the American Hospitals Association for hospitals). These results suggested to health care services more attempt to achieve high quality in management and performance. PMID:22204664

  10. Methods and dimensions of electronic health record data quality assessment: enabling reuse for clinical research

    PubMed Central

    Weng, Chunhua

    2013-01-01

    Objective To review the methods and dimensions of data quality assessment in the context of electronic health record (EHR) data reuse for research. Materials and methods A review of the clinical research literature discussing data quality assessment methodology for EHR data was performed. Using an iterative process, the aspects of data quality being measured were abstracted and categorized, as well as the methods of assessment used. Results Five dimensions of data quality were identified, which are completeness, correctness, concordance, plausibility, and currency, and seven broad categories of data quality assessment methods: comparison with gold standards, data element agreement, data source agreement, distribution comparison, validity checks, log review, and element presence. Discussion Examination of the methods by which clinical researchers have investigated the quality and suitability of EHR data for research shows that there are fundamental features of data quality, which may be difficult to measure, as well as proxy dimensions. Researchers interested in the reuse of EHR data for clinical research are recommended to consider the adoption of a consistent taxonomy of EHR data quality, to remain aware of the task-dependence of data quality, to integrate work on data quality assessment from other fields, and to adopt systematic, empirically driven, statistically based methods of data quality assessment. Conclusion There is currently little consistency or potential generalizability in the methods used to assess EHR data quality. If the reuse of EHR data for clinical research is to become accepted, researchers should adopt validated, systematic methods of EHR data quality assessment. PMID:22733976

  11. Analysis of Water Conflicts across Natural and Societal Boundaries: Integration of Quantitative Modeling and Qualitative Reasoning

    NASA Astrophysics Data System (ADS)

    Gao, Y.; Balaram, P.; Islam, S.

    2009-12-01

    Water issues and problems have bewildered humankind for a long time yet a systematic approach for understanding such issues remain elusive. This is partly because many water-related problems are framed from a contested terrain in which many actors (individuals, communities, businesses, NGOs, states, and countries) compete to protect their own and often conflicting interests. We argue that origin of many water problems may be understood as a dynamic consequence of competition, interconnections, and feedback among variables in the Natural and Societal Systems (NSSs). Within the natural system, we recognize that triple constraints on water- water quantity (Q), water quality (P), and ecosystem (E)- and their interdependencies and feedback may lead to conflicts. Such inherent and multifaceted constraints of the natural water system are exacerbated often at the societal boundaries. Within the societal system, interdependencies and feedback among values and norms (V), economy (C), and governance (G) interact in various ways to create intractable contextual differences. The observation that natural and societal systems are linked is not novel. Our argument here, however, is that rigid disciplinary boundaries between these two domains will not produce solutions to the water problems we are facing today. The knowledge needed to address water problems need to go beyond scientific assessment in which societal variables (C, G, and V) are treated as exogenous or largely ignored, and policy research that does not consider the impact of natural variables (E, P, and Q) and that coupling among them. Consequently, traditional quantitative methods alone are not appropriate to address the dynamics of water conflicts, because we cannot quantify the societal variables and the exact mathematical relationships among the variables are not fully known. On the other hand, conventional qualitative study in societal domain has mainly been in the form of individual case studies and therefore

  12. Running With the Pack: Teen Peer-Relationship Qualities as Predictors of Adult Physical Health

    PubMed Central

    Allen, Joseph P.; Uchino, Bert N.; Hafen, Christopher A.

    2015-01-01

    This study assessed qualities of adolescent peer relationships as long-term predictors of physical health quality in adulthood. In an intensive multimethod, multireporter study of a community sample of 171 individuals assessed repeatedly from the ages of 13 to 27 years, physical health quality in adulthood was robustly predicted by independent reports of early-adolescent close-friendship quality and by a pattern of acquiescence to social norms in adolescent peer relationships. Predictions remained after accounting for numerous potential confounds, including prior health problems, concurrent body mass index, anxious and depressive symptoms, personality characteristics, adolescent-era financial adversity, and adolescent-era physical attractiveness. These findings have important implications for understanding the unique intensity of peer relationships in adolescence. PMID:26290522

  13. Measuring health care quality: comparing and contrasting the medical and the marketing approaches.

    PubMed

    Bowers, Michael R; Kiefe, Catarina I

    2002-01-01

    Health care quality, a key concept for medical practice and research, is also a widely used construct in health care administration and marketing research. We explored discipline-specific differences in the definition of quality, with the intent of finding a more unified approach. We summarized definitions and basic conceptual approaches to quality in both disciplines and then compared them on several attributes: basic goals, sources of measurement, role of patient perceptions, role of health care personnel, and need for risk adjustment. We developed a conceptual model combining the 2 approaches. Both disciplines could benefit from broadening their outcome measures. Patient satisfaction deserves more attention from medical researchers, whereas marketing approaches should go beyond using patient satisfaction as the only outcome of interest. It is conceptually feasible to integrate medical and marketing approaches to quality, with important insights resulting from this integration. PMID:12153066

  14. Validating Health Information Exchange (HIE) Data For Quality Measurement Across Four Hospitals

    PubMed Central

    Garg, Nupur; Kuperman, Gil; Onyile, Arit; Lowry, Tina; Genes, Nicholas; DiMaggio, Charles; Richardson, Lynne; Husk, Gregg; Shapiro, Jason S

    2014-01-01

    Health information exchange (HIE) provides an essential enhancement to electronic health records (EHR), allowing information to follow patients across provider organizations. There is also an opportunity to improve public health surveillance, quality measurement, and research through secondary use of HIE data, but data quality presents potential barriers. Our objective was to validate the secondary use of HIE data for two emergency department (ED) quality measures: identification of frequent ED users and early (72-hour) ED returns. We compared concordance of various demographic and encounter data from an HIE for four hospitals to data provided by the hospitals from their EHRs over a two year period, and then compared measurement of our two quality measures using both HIE and EHR data. We found that, following data cleaning, there was no significant difference in the total counts for frequent ED users or early ED returns for any of the four hospitals (p<0.001). PMID:25954362

  15. The role of air quality management programs in improving public health: a brief synopsis.

    PubMed

    Vandenberg, John J

    2005-02-01

    Observations of adverse effects of air pollution on public health, illustrated by the London smog events in the 1950s, led to legislation in the United States requiring development of federal, state, and local air quality management programs. The implementation of management programs has resulted in significant reductions in air pollutant emissions from stationary and mobile sources and hence their ambient concentrations and associated health risks. Evidence of benefits from improvements in air quality can be identified from studies in which rapid changes in air quality have occurred. Health risk assessment and benefits estimates also can be predictive, resulting in mean estimates of avoided mortality in excess of many thousands of cases per year as a result of implementation of air quality management programs in the United States. PMID:15696091

  16. Running With the Pack: Teen Peer-Relationship Qualities as Predictors of Adult Physical Health.

    PubMed

    Allen, Joseph P; Uchino, Bert N; Hafen, Christopher A

    2015-10-01

    This study assessed qualities of adolescent peer relationships as long-term predictors of physical health quality in adulthood. In an intensive multimethod, multireporter study of a community sample of 171 individuals assessed repeatedly from the ages of 13 to 27 years, physical health quality in adulthood was robustly predicted by independent reports of early-adolescent close-friendship quality and by a pattern of acquiescence to social norms in adolescent peer relationships. Predictions remained after accounting for numerous potential confounds, including prior health problems, concurrent body mass index, anxious and depressive symptoms, personality characteristics, adolescent-era financial adversity, and adolescent-era physical attractiveness. These findings have important implications for understanding the unique intensity of peer relationships in adolescence. PMID:26290522

  17. Socioeconomic inequalities in the access to and quality of health care services

    PubMed Central

    Nunes, Bruno Pereira; Thumé, Elaine; Tomasi, Elaine; Duro, Suele Manjourany Silva; Facchini, Luiz Augusto

    2014-01-01

    OBJECTIVE To assess the inequalities in access, utilization, and quality of health care services according to the socioeconomic status. METHODS This population-based cross-sectional study evaluated 2,927 individuals aged ≥ 20 years living in Pelotas, RS, Southern Brazil, in 2012. The associations between socioeconomic indicators and the following outcomes were evaluated: lack of access to health services, utilization of services, waiting period (in days) for assistance, and waiting time (in hours) in lines. We used Poisson regression for the crude and adjusted analyses. RESULTS The lack of access to health services was reported by 6.5% of the individuals who sought health care. The prevalence of use of health care services in the 30 days prior to the interview was 29.3%. Of these, 26.4% waited five days or more to receive care and 32.1% waited at least an hour in lines. Approximately 50.0% of the health care services were funded through the Unified Health System. The use of health care services was similar across socioeconomic groups. The lack of access to health care services and waiting time in lines were higher among individuals of lower economic status, even after adjusting for health care needs. The waiting period to receive care was higher among those with higher socioeconomic status. CONCLUSIONS Although no differences were observed in the use of health care services across socioeconomic groups, inequalities were evident in the access to and quality of these services. PMID:26039400

  18. Association between social capital, health-related quality of life, and mental health: a structural-equation modeling approach

    PubMed Central

    Hassanzadeh, Jafar; Asadi-Lari, Mohsen; Baghbanian, Abdolvahab; Ghaem, Haleh; Kassani, Aziz; Rezaianzadeh, Abbas

    2016-01-01

    Aim To explore the association(s) between demographic factors, socioeconomic status (SES), social capital, health-related quality of life (HRQoL), and mental health among residents of Tehran, Iran. Methods The pooled data (n = 31 519) were extracted from a population-based survey Urban Health Equity Assessment and Response Tool-2 (Urban HEART-2) conducted in Tehran in 2011. Mental health, social capital, and HRQoL were assessed using the 28-item General Health Questionnaire (GHQ-28), social capital questionnaire, and Short-Form Health Survey (SF-12), respectively. The study used a multistage sampling method. Social capital, HRQoL, and SES were considered as latent variables. The association between these latent variables, demographic factors, and mental health was determined by structural-equation modeling (SEM). Results The mean age and mental health score were 44.48 ± 15.87 years and 23.33 ± 11.10 (range, 0-84), respectively. The prevalence of mental disorders was 41.76% (95% confidence interval 41.21-42.30). The SEM model showed that age was directly associated with social capital (P = 0.016) and mental health (P = 0.001). Sex was indirectly related to mental health through social capital (P = 0.018). SES, HRQoL, and social capital were associated both directly and indirectly with mental health status. Conclusion This study suggests that changes in social capital and SES can lead to positive changes in mental health status and that individual and contextual determinants influence HRQoL and mental health. PMID:26935615

  19. Precision with Ease: Refining Thesaurus Support for Quality Health Information Searching on Health"Insite"

    ERIC Educational Resources Information Center

    Smith, Jill Buckley; Deacon, Prue

    2009-01-01

    Health"Insite" is the Australian Government's Internet gateway to reliable health information online, providing access to over 15,000 information items on the websites of more than 80 approved information partners. The gateway provides a variety of searching and browsing options to assist users to find information on a wide range of health topics.…

  20. The how and why of societal publications for citizen science projects and scientists.

    PubMed

    van Vliet, Arnold J H; Bron, Wichertje A; Mulder, Sara

    2014-05-01

    In the scientific community, the importance of communication to society is often underestimated. Scientists and scientific organisations often lack the skills to organise such communication effectively. The Dutch citizen science phenology network Nature's Calendar has been successful in communicating to the general public via numerous newspaper articles, television appearances, presentations, websites and social media. We refer to these publications as societal publications. Due to active communication to mass media, we frequently reach millions of people. This communication helped us to involve thousands of volunteers in recording the timing of phenological events like the start of flowering, leaf unfolding and bird migration, but also several health-related events like hay fever symptoms and tick bites. In this paper, we analyse and present our experiences with the Nature's Calendar project regarding societal publications. Based on this analysis, we explain the importance of societal publications for citizen science projects and scientists in general, and we show how scientists can increase the news worthiness of scientific information and what factors and activities can increase the chances of media paying attention to this news. We show that societal publications help phenological networks by facilitating the recruitment, retention and instruction of observers. Furthermore, they stimulate the generation of new ideas and partners that lead to an increase in knowledge, awareness and behavioural change of the general public or specific stakeholders. They make projects, and scientists involved, better known to the public and increase their credibility and authority. Societal publications can catalyse the production of new publications, thereby enforcing the previous mentioned points. PMID:24705824

  1. Correlates of health-related quality of life in Thai patients with alcohol dependence.

    PubMed

    Saengcharnchai, Pichai; Likhitsathian, Surinporn; Yingwiwattanapong, Jatsada; Wittayanookulluk, Apisak; Uttawichai, Kanok; Boonchareon, Hathaichonnanee; Srisurapanont, Manit

    2016-01-01

    This study aimed to examine the correlates of health related quality of life in Thai patients with alcohol dependence. The amount of alcohol intake was calculated by timeline followback chart and the health related quality of life was determined by Short Form-36 Health Survey. The means of the Short Form-36 Physical Component and Mental Component Summary were 67.43 (18.74) and 64.45 (20.90), respectively. Stepwise linear regression models showed the number of heavy drinking days was significantly correlated with the Physical Component Summary and Mental Component Summary. Such moderate correlations suggest that drinking and health related quality of life measures might tap different aspects of alcohol outcomes and should be concurrently administered. PMID:26422548

  2. Edible Mushrooms: Improving Human Health and Promoting Quality Life

    PubMed Central

    Valverde, María Elena; Hernández-Pérez, Talía; Paredes-López, Octavio

    2015-01-01

    Mushrooms have been consumed since earliest history; ancient Greeks believed that mushrooms provided strength for warriors in battle, and the Romans perceived them as the “Food of the Gods.” For centuries, the Chinese culture has treasured mushrooms as a health food, an “elixir of life.” They have been part of the human culture for thousands of years and have considerable interest in the most important civilizations in history because of their sensory characteristics; they have been recognized for their attractive culinary attributes. Nowadays, mushrooms are popular valuable foods because they are low in calories, carbohydrates, fat, and sodium: also, they are cholesterol-free. Besides, mushrooms provide important nutrients, including selenium, potassium, riboflavin, niacin, vitamin D, proteins, and fiber. All together with a long history as food source, mushrooms are important for their healing capacities and properties in traditional medicine. It has reported beneficial effects for health and treatment of some diseases. Many nutraceutical properties are described in mushrooms, such as prevention or treatment of Parkinson, Alzheimer, hypertension, and high risk of stroke. They are also utilized to reduce the likelihood of cancer invasion and metastasis due to antitumoral attributes. Mushrooms act as antibacterial, immune system enhancer and cholesterol lowering agents; additionally, they are important sources of bioactive compounds. As a result of these properties, some mushroom extracts are used to promote human health and are found as dietary supplements. PMID:25685150

  3. Edible mushrooms: improving human health and promoting quality life.

    PubMed

    Valverde, María Elena; Hernández-Pérez, Talía; Paredes-López, Octavio

    2015-01-01

    Mushrooms have been consumed since earliest history; ancient Greeks believed that mushrooms provided strength for warriors in battle, and the Romans perceived them as the "Food of the Gods." For centuries, the Chinese culture has treasured mushrooms as a health food, an "elixir of life." They have been part of the human culture for thousands of years and have considerable interest in the most important civilizations in history because of their sensory characteristics; they have been recognized for their attractive culinary attributes. Nowadays, mushrooms are popular valuable foods because they are low in calories, carbohydrates, fat, and sodium: also, they are cholesterol-free. Besides, mushrooms provide important nutrients, including selenium, potassium, riboflavin, niacin, vitamin D, proteins, and fiber. All together with a long history as food source, mushrooms are important for their healing capacities and properties in traditional medicine. It has reported beneficial effects for health and treatment of some diseases. Many nutraceutical properties are described in mushrooms, such as prevention or treatment of Parkinson, Alzheimer, hypertension, and high risk of stroke. They are also utilized to reduce the likelihood of cancer invasion and metastasis due to antitumoral attributes. Mushrooms act as antibacterial, immune system enhancer and cholesterol lowering agents; additionally, they are important sources of bioactive compounds. As a result of these properties, some mushroom extracts are used to promote human health and are found as dietary supplements. PMID:25685150

  4. Quality Measures at the Interface of Behavioral Health and Primary Care.

    PubMed

    Goldman, Matthew L; Spaeth-Rublee, Brigitta; Nowels, Abraham D; Ramanuj, Parashar Pravin; Pincus, Harold Alan

    2016-04-01

    The development of quality measures has gained increasing attention as health care reimbursements transition from fee-for-service to value-based payment models. As behavioral health care moves towards integration of services with primary care, specific measures and payment incentives will be needed to successfully expand access. This study uses a keyword search to identify 730 quality indicators that are relevant to behavioral health and general medical health. Measures identified have been coded and grouped into domains based on a taxonomy developed by the authors. The analysis reveals that quality measures focusing on general medical conditions exceed those focused on behavioral health diagnoses for evidence-based treatments, patient safety, and outcomes. Furthermore, measures predominantly concentrate on care during or following hospitalizations, which represents a minority of behavioral health care and does not characterize the outpatient settings that are the focus of many models of integrated care. The authors offer recommendations for future steps to identify the quality measures that can best evaluate the evolving behavioral health care system. PMID:26898821

  5. The Quality of Health Information on Allergic Rhinitis, Rhinitis, and Sinusitis Available on the Internet

    PubMed Central

    Chang, Mun Young; Kim, Jeong-Whun

    2015-01-01

    Purpose The internet has become one of the most important media outlets used to obtain health information. Therefore, the quality of health information available on the internet is very important. We evaluated the quality of internet-derived health information on allergic rhinitis, rhinitis and sinusitis and compared these results to those of previous studies performed five years ago. Methods The terms "allergic rhinitis (AR)", "rhinitis" and "sinusitis" were searched among the four most commonly used search engines in South Korea. These websites were evaluated according to the author, the Journal of the American Medical Association (JAMA) benchmarks, the DISCERN questionnaire and the Allergic rhinitis and its Impact on Asthma (ARIA) 2008 Update. Results A total of 120 websites were obtained and analyzed. For all diseases, "Oriental physician" had the largest portion (almost half of all websites), followed by "Western physician". Based on analyses using the JAMA benchmark, "Attribution" and "Disclosure" were ignored in almost all surveyed websites. According to the scores of the DISCERN question, the majority of websites did not supply appropriate references for their health information, and information on the negative aspects of treatment such as risks and uncertainty was not provided in several websites. In an analysis based on the ARIA 2008 Update concepts, 65% of websites pertaining to health information on AR contained unreliable information. Conclusions The quality of health information on the internet was not acceptable. Thus, governmental regulation or control to improve the quality of health information is required. PMID:25729621

  6. Accreditation of public health education in India: Enhancing quality, competence and trust.

    PubMed

    Sharma, Kavya; Zodpey, Sanjay; Zahiruddin, Quazi Syed

    2013-01-01

    With an increase in the number of institutes offering public health education, there is a need for discussion on future directions and challenges. The World Health Report 2006 identified the need to improve the quality of public health education. There are various mechanisms and bodies that look after accreditation issues in several countries. The Council on Education for Public Health in the USA assists in the accreditation of schools of public health, as well as public health programmes. The Australian Network of Academic Public Health Institutions is actively engaged in discussions to improve the quality of its programme and institutions. In Europe, the European Agency for Accreditation in Public Health Education is responsible for accreditation. The South-East Asia Public Health Education Institutes Network facilitates accreditation of public health education in the region. In India, public health education varies across institutes. India needs an accreditation system to ensure that public health education is of the desired quality. Certain initiatives, such as conferences, consultation and the Calcutta Declaration, have been taken in the past two decades. However, the ideas mooted have yet to be translated into reality. The broad framework for accreditation may entail an institutional self-assessment against set standards, preparation of a database, cataloguing, and site visits by a peer team. There is a need for an apical body with all stakeholders participating in the process. Accreditation has specific benefits, but there are critical challenges as well. For example, the autonomy of the institutions needs to be protected, the accreditation bodies should exhibit professionalism and substantial financial resources are required. Before tackling specific criteria for accreditation, it is necessary to define a collective vision for schools of public health in India. PMID:25073994

  7. Global challenges for e-waste management: the societal implications.

    PubMed

    Magalini, Federico

    2016-03-01

    Over the last decades the electronics industry and ICT Industry in particular has revolutionized the world: electrical and electronic products have become ubiquitous in today's life around the planet. After use, those products are discarded, sometimes after re-use cycles in countries different from those where they were initially sold; becoming what is commonly called e-waste. Compared to other traditional waste streams, e-waste handling poses unique and complex challenges. e-Waste is usually regarded as a waste problem, which can cause environmental damage and severe human health consequences if not safely managed. e-Waste contains significant amounts of toxic and environmentally sensitive materials and is, thus, extremely hazardous to humans and the environment if not properly disposed of or recycled. On the other hand, e-waste is often seen as a potential source of income for individuals and entrepreneurs who aim to recover the valuable materials (metals in particular) contained in discarded equipment. Recently, for a growing number of people, in developing countries in particular, recycling and separation of e-waste has become their main source of income. In most cases, this is done informally, with no or hardly any health and safety standards, exposing workers and the surrounding neighborhoods to extensive health dangers as well as leading to substantial environmental pollution. Treatment processes of e-waste aim to remove the hazardous components and recover as much reusable material (e.g. metals, glass and plastics) as possible; achieving both objectives is most desired. The paper discuss societal implications of proper e-waste management and key elements to be considered in the policy design at country level. PMID:26812759

  8. Risk management: Role of societal factors in major industrial accidents

    SciTech Connect

    Hovden, J.; Rausand, M.; Sergeev, G.

    1995-12-31

    The paper discusses factors influencing the occurrence of major accidents in complex technological systems. Societal factors are identified as most significant in this context. Important types of societal factors are pin-pointed and discussed. The safety situation in the former Soviet Union and in today`s Russian is described. The calamities at Chernobyl, Three Mile Island, and partly also Bhopal are discussed, and the role of societal factors identified. A main point of view is that it is not surprising that these catastrophes happened in the then existing conditions. What is surprising is that they did not happen earlier!

  9. A cost-efficiency and health benefit approach to improve urban air quality.

    PubMed

    Miranda, A I; Ferreira, J; Silveira, C; Relvas, H; Duque, L; Roebeling, P; Lopes, M; Costa, S; Monteiro, A; Gama, C; Sá, E; Borrego, C; Teixeira, J P

    2016-11-01

    When ambient air quality standards established in the EU Directive 2008/50/EC are exceeded, Member States are obliged to develop and implement Air Quality Plans (AQP) to improve air quality and health. Notwithstanding the achievements in emission reductions and air quality improvement, additional efforts need to be undertaken to improve air quality in a sustainable way - i.e. through a cost-efficiency approach. This work was developed in the scope of the recently concluded MAPLIA project "Moving from Air Pollution to Local Integrated Assessment", and focuses on the definition and assessment of emission abatement measures and their associated costs, air quality and health impacts and benefits by means of air quality modelling tools, health impact functions and cost-efficiency analysis. The MAPLIA system was applied to the Grande Porto urban area (Portugal), addressing PM10 and NOx as the most important pollutants in the region. Four different measures to reduce PM10 and NOx emissions were defined and characterized in terms of emissions and implementation costs, and combined into 15 emission scenarios, simulated by the TAPM air quality modelling tool. Air pollutant concentration fields were then used to estimate health benefits in terms of avoided costs (external costs), using dose-response health impact functions. Results revealed that, among the 15 scenarios analysed, the scenario including all 4 measures lead to a total net benefit of 0.3M€·y(-1). The largest net benefit is obtained for the scenario considering the conversion of 50% of open fire places into heat recovery wood stoves. Although the implementation costs of this measure are high, the benefits outweigh the costs. Research outcomes confirm that the MAPLIA system is useful for policy decision support on air quality improvement strategies, and could be applied to other urban areas where AQP need to be implemented and monitored. PMID:27348699

  10. PHYSIOLOGICAL INFORMATION FOR PAVEMENT HEALTH MONITORING BASED ON SURFACE RIDE QUALITY

    NASA Astrophysics Data System (ADS)

    Tomiyama, Kazuya; Kawamura, Akira; Takahashi, Kiyoshi; Ishida, Tateki

    Pavement ride quality testing has traditionally been based on subjective questionnaire ratings. The questionnaire survey has ability to directly measure the sense of road users' ride quality. However, it is difficult to quantify the evaluation results based on the questionnaire due to its lack of objectivity. This study examines pavement health monitoring method using physiological information such as heart rate variability (HRV) for detecting mental stress of road users toward pavement ride quality. First, a results of a driving simulator experiment shows that potential mental stress caused by road roughness can be observed in high-frequency oscillations in 0.15-0.4Hz of HRV processed by continuous wavelet transform. Then, the high-frequency oscillations of HRV is summarized as an index related to the mental stress that makes objective ride quality evaluation possible. Finally, this study indicates that the index contributes to improve the accuracy of pavement health monitoring based on surface ride quality.

  11. The role of Environmental Health System air quality monitors in Space Station Contingency Operations

    NASA Technical Reports Server (NTRS)

    Limero, Thomas F.; Wilson, Steve; Perlot, Susan; James, John

    1992-01-01

    This paper describes the Space Station Freedom (SSF) Environmental Health System's air-quality monitoring strategy and instrumentation. A two-tier system has been developed, consisting of first-alert instruments that warn the crew of airborne contamination and a volatile organic analyzer that can identify volatile organic contaminants in near-real time. The strategy for air quality monitoring on SSF is designed to provide early detection so that the contamination can be confined to one module and so that crew health and safety can be protected throughout the contingency event. The use of air-quality monitors in fixed and portable modes will be presented as a means of following the progress of decontamination efforts and ensuring acceptable air quality in a module after an incident. The technology of each instrument will be reviewed briefly; the main focus of this paper, however, will be the use of air-quality monitors before, during, and after contingency incidents.

  12. [Research on quality of health care from the Mexican Social Security Institute: a bibliometric study].

    PubMed

    Navarrete-Navarro, Susana; Gómez-Delgado, Alejandro; Riebeling-Navarro, Carlos; López-García, Gloria Araceli; Nava-Zavala, Arnulfo

    2013-12-01

    OBJECTIVE. To identify studies on quality of health care in the IMSS. MATERIALS AND METHODS. A bibliometric, descriptive cross-sectional and retrospective study was conducted, from 1992 to 2011. RESULTS. We identified 881 research studies related to the issue of quality (CI95% 10.6-12.0) of 7 762 studies presented at the annual research meetings. 10 521 articles were published in this period of time and only 946 (CI95% 8.4-9.5) were linked to the issue of quality. CONCLUSIONS. The results of this study allowed us to identify the interest about research on quality. Further research is needed to establish what has been the impact on the improvement of quality in health care. PMID:24715009

  13. Mental health nurse practitioners in Australia: improving access to quality mental health care.

    PubMed

    Fisher, Jacklin E

    2005-12-01

    Under The Nurses Amendment (Nurse Practitioners) Act 1998, New South Wales became the first state in Australia to legislate for nurse practitioners. Mental health was identified as a priority 'area of practice' for nurse practitioners. Issues surrounding the implementation of the nurse practitioner role in Australia and the potential for the role to address the current crisis in mental health nursing and the mental health sector will be discussed. The potential for partnerships with other health-care providers, in particular medical practitioners, will demonstrate how successful implementation of the role can fulfil consumer demand for primary prevention counselling, improve access to mental health services and early intervention, and provide mental health services that better reflect national priorities. This examination of the Australian context will be contrasted with a review of the overseas literature on mental health nurse practitioners. PMID:16296989

  14. A Strategic Study about Quality Characteristics in e-Health Systems Based on a Systematic Literature Review

    PubMed Central

    Domínguez-Mayo, F. J.; Escalona, M. J.; Mejías, M.; Aragón, G.; García-García, J. A.; Torres, J.; Enríquez, J. G.

    2015-01-01

    e-Health Systems quality management is an expensive and hard process that entails performing several tasks such as analysis, evaluation, and quality control. Furthermore, the development of an e-Health System involves great responsibility since people's health and quality of life depend on the system and services offered. The focus of the following study is to identify the gap in Quality Characteristics for e-Health Systems, by detecting not only which are the most studied, but also which are the most used Quality Characteristics these Systems include. A strategic study is driven in this paper by a Systematic Literature Review so as to identify Quality Characteristics in e-Health. Such study makes information and communication technology organizations reflect and act strategically to manage quality in e-Health Systems efficiently and effectively. As a result, this paper proposes the bases of a Quality Model and focuses on a set of Quality Characteristics to enable e-Health Systems quality management. Thus, we can conclude that this paper contributes to implementing knowledge with regard to the mission and view of e-Health (Systems) quality management and helps understand how current researches evaluate quality in e-Health Systems. PMID:26146656

  15. Societal and ethical issues in human biomonitoring – a view from science studies

    PubMed Central

    Bauer, Susanne

    2008-01-01

    Background Human biomonitoring (HBM) has rapidly gained importance. In some epidemiological studies, the measurement and use of biomarkers of exposure, susceptibility and disease have replaced traditional environmental indicators. While in HBM, ethical issues have mostly been addressed in terms of informed consent and confidentiality, this paper maps out a larger array of societal issues from an epistemological perspective, i.e. bringing into focus the conditions of how and what is known in environmental health science. Methods In order to analyse the effects of HBM and the shift towards biomarker research in the assessment of environmental pollution in a broader societal context, selected analytical frameworks of science studies are introduced. To develop the epistemological perspective, concepts from "biomedical platform sociology" and the notion of "epistemic cultures" and "thought styles" are applied to the research infrastructures of HBM. Further, concepts of "biocitizenship" and "civic epistemologies" are drawn upon as analytical tools to discuss the visions and promises of HBM as well as related ethical problematisations. Results In human biomonitoring, two different epistemological cultures meet; these are environmental science with for instance pollution surveys and toxicological assessments on the one hand, and analytical epidemiology investigating the association between exposure and disease in probabilistic risk estimation on the other hand. The surveillance of exposure and dose via biomarkers as envisioned in HBM is shifting the site of exposure monitoring to the human body. Establishing an HBM platform faces not only the need to consider individual decision autonomy as an ethics issue, but also larger epistemological and societal questions, such as the mode of evidence demanded in science, policy and regulation. Conclusion The shift of exposure monitoring towards the biosurveillance of human populations involves fundamental changes in the ways

  16. The image of health status and quality of life in a Caribbean society

    PubMed Central

    Bourne, Paul A.; McGrowder, Donovan A.; Charles, Christopher A.D.; Francis, Cynthia G.

    2010-01-01

    Background: Health is defined as the presence or absence of illness. This conceptualization of health status is dominant in health treatment and in fashioning the health care system. However, very little research has been done on how Jamaicans view health status and quality of life (QoL). Aims: This article seeks to understand how Jamaicans conceptualize health status and QoL because definitional content has implications for their health. Material and Methods: The current study utilized two national cross-sectional probability surveys from the Centre for Leadership and Governance (CLG) which looked at QoL among other variables and the Jamaican Survey of Living Conditions (JSLC) which measured living standards including health status. The sample in both surveys was 8,120 participants. Results: The majority of the respondents in the CLG (54%) and the JSLC (82.2%) surveys reported good health status. There was a strong statistical relationship between area of residence and health status (P < 0.0001) unlike the relationship between area of residence and quality of life (P < 0.137). The respondents dichotomized health status and QoL and a significant relationship was found between both variables (P < 0.0001). The respondents’ dichotomization of health status and QoL is explained by the significant relationship between health status and self reported illness (P < 0.0001) where respondents view health status as the absence or presence of illness, excluding QoL. Conclusion: Health status means the presence or absence of illness and excludes QoL which is not in keeping with previous findings. This distinction is culturally determined. PMID:22624140

  17. Does globalization of water reduce societal resilience to drought?

    NASA Astrophysics Data System (ADS)

    D'Odorico, Paolo; Laio, Francesco; Ridolfi, Luca

    2010-07-01

    Most food production depends, directly or indirectly, on freshwater resources. In the absence of importation of food commodities, population growth is constrained by the availability of local resources—including water—as well as by cultural and health-related factors. The global trade of massive amounts of food makes societies less reliant on locally available water resources, thereby allowing some populations to exceed the limits posed by their local water budget. Thus, international trade implies a virtual transfer of water resources from areas of food production to importing regions. While it is recognized that in the short term this globalization of (virtual) water resources may prevent malnourishment, famine, and conflicts, its long-term effects on the coupled human-natural system remain poorly investigated. Here we develop a minimalist modeling framework to investigate the effect of the uncontrolled trade of food products on the resilience of human societies with respect to drought and famine. Our results suggest that in the long run the globalization of water resources reduces the societal resilience with respect to water limitations in that it leaves fewer options available to cope with exceptional droughts and crop failure.

  18. Globalization of water, water solidarity, and societal resilience

    NASA Astrophysics Data System (ADS)

    D'Odorico, P.; Laio, F.; Ridolfi, L.

    2010-12-01

    In arid and semiarid regions the availability of freshwater resources has historically limited food production and population growth. Although international trade developed early in the history of civilization, until recently the growth of human populations has been constrained for most part by the availability of local resources as well as by other cultural and health-related factors. More recently, the global trade of massive amounts of food has allowed population growth to exceed in some dryland regions the limits posed by the local water budget. Here we show how the uncontrolled trade of food products and of water virtually embedded in these commodities reduces the resilience of human societies with respect to drought and famine. Globalization of virtual water may prevent in the short term malnourishment, famine, and conflicts, but in the long run leaves fewer options available to cope with exceptional droughts and crop failures. We propose a system of water solidarity as an alternative model of global allocation and redistribution of water resources, which limits the effects of drought-induced famine while maintaining societal resilience.

  19. Mobile App Rating Scale: A New Tool for Assessing the Quality of Health Mobile Apps

    PubMed Central

    Kavanagh, David J; Zelenko, Oksana; Tjondronegoro, Dian; Mani, Madhavan

    2015-01-01

    Background The use of mobile apps for health and well being promotion has grown exponentially in recent years. Yet, there is currently no app-quality assessment tool beyond “star”-ratings. Objective The objective of this study was to develop a reliable, multidimensional measure for trialling, classifying, and rating the quality of mobile health apps. Methods A literature search was conducted to identify articles containing explicit Web or app quality rating criteria published between January 2000 and January 2013. Existing criteria for the assessment of app quality were categorized by an expert panel to develop the new Mobile App Rating Scale (MARS) subscales, items, descriptors, and anchors. There were sixty well being apps that were randomly selected using an iTunes search for MARS rating. There were ten that were used to pilot the rating procedure, and the remaining 50 provided data on interrater reliability. Results There were 372 explicit criteria for assessing Web or app quality that were extracted from 25 published papers, conference proceedings, and Internet resources. There were five broad categories of criteria that were identified including four objective quality scales: engagement, functionality, aesthetics, and information quality; and one subjective quality scale; which were refined into the 23-item MARS. The MARS demonstrated excellent internal consistency (alpha = .90) and interrater reliability intraclass correlation coefficient (ICC = .79). Conclusions The MARS is a simple, objective, and reliable tool for classifying and assessing the quality of mobile health apps. It can also be used to provide a checklist for the design and development of new high quality health apps. PMID:25760773

  20. The Acute Respiratory Infection Quality Dashboard: a performance measurement reporting tool in an electronic health record.

    PubMed

    Linder, Jeffrey A; Jung, Eunice; Housman, Dan; Eskin, Michael S; Schnipper, Jeffrey L; Middleton, Blackford; Einbinder, Jonathan S

    2007-01-01

    Quality reporting tools, integrated with electronic health records, can help clinicians understand performance, manage populations, and improve quality. The Acute Respiratory Infection Quality Dashboard (ARI QD) for LMR users is a secure web report for performance measurement of an acute condition delivered through a central data warehouse and custom-built reporting tool. Pilot evaluation of the ARI QD indicates that clinicians prefer a quality report that combines not only structured data regarding diagnosis and antibiotic prescribing rates entered into EHRs but one that also shows billing data. The ARI QD has the potential to reduce inappropriate antibiotic prescribing for ARIs. PMID:18694133

  1. Burnout and Self-Reported Quality of Care in Community Mental Health

    PubMed Central

    Salyers, Michelle P.; Fukui, Sadaaki; Rollins, Angela L.; Firmin, Ruth; Gearhart, Timothy; Noll, James P.; Williams, Stacy; Davis, C.J.

    2014-01-01

    Staff burnout is widely believed to be problematic in mental healthcare, but few studies have linked burnout directly with quality of care. The purpose of this study was to examine the relationship between burnout and a newly developed scale for quality of care in a sample of community mental health workers (N=113). The Self-Reported Quality of Care scale had three distinct factors (Client-Centered Care, General Work Conscientiousness, and Low Errors), with good internal consistency. Burnout, particularly personal accomplishment, and to a lesser extent depersonalization, were predictive of overall self-reported Quality of Care, over and above background variables. PMID:24659446

  2. Healthy lifestyles and health-related quality of life among men living with HIV infection.

    PubMed

    Uphold, Constance R; Holmes, Wanda; Reid, Kimberly; Findley, Kimberly; Parada, Jorge P

    2007-01-01

    Although healthy lifestyles are related to improved quality of life in the general population, little is known about the role of healthy lifestyles during HIV infection. The authors examined the relationships between health-promoting behaviors, risk behaviors, stress, and health-related quality of life (HRQOL) among 226 men with HIV infection who were attending three infectious disease clinics. As hypothesized, health-promoting behaviors were positively related and stress was negatively related with most of the HRQOL dimensions. Contrary to the hypothesis, tobacco use, recreational drug use, and unsafe sexual behaviors were not related to the HRQOL dimensions. Hazardous alcohol use was negatively associated with one HRQOL dimension--social functioning. The association of modifiable factors, such as health-promoting behaviors and stress, with HQROL offers opportunities for improving HIV-related health care. Relatively simple, straightforward changes in lifestyles such as eating well, remaining active, and avoiding stressful life events may result in improvements in HRQOL. PMID:17991599

  3. Empowering Graduate Students to Lead on Interdisciplinary Societal Issues

    NASA Astrophysics Data System (ADS)

    Grubert, E.

    2015-12-01

    Challenging societal problems that cannot be solved by one method or one discipline alone, like epidemic preparedness, mental health, and climate change, demand leadership and the ability to work across disciplines from those with specialized expertise. Teaching leadership at the graduate school level is a challenge that many schools are striving to meet, through mechanisms like project-based courses, leadership skill development workshops, and others. We argue that some of the most valuable but most difficult leadership skills to learn are those that require cultural norms that are fundamentally different from those traditionally encountered in graduate school. These include the ability to make informed decisions based on limited knowledge and resources, the need to make choices in the face of uncertainty, and the recognition that one ultimately bears responsibility for the outcomes. These skills are also among the most important for students planning on nonacademic careers. Acquiring such skills requires a focus on learning-by-doing and a culture of graduate student empowerment. This submission focuses on the experience of students in a student-centered, interdisciplinary, cross-campus leadership program called Emerging Leaders in Science and Society (ELISS), hosted by the American Association for the Advancement of Science (AAAS). ELISS establishes the expectation that students act as leaders, which in itself reframes leadership as an achievable goal. A major finding from two years of experience with ELISS is the critical importance of establishing cultures of trust and empowerment at the graduate level in order to foster development of transferable skills. ELISS graduate students specifically focus on interdisciplinary collaboration (the 13 2015 fellows come from 13 academic disciplines); stakeholder engagement, primarily focused on outreach to both traditional and nontraditional experts in our communities outside of academia; and solution-generating rather

  4. Impact of air quality on lung health: myth or reality?

    PubMed Central

    Marino, Elisa; Caruso, Massimo; Campagna, Davide

    2015-01-01

    The respiratory system is a primary target of the harmful effects of key air pollutants of health concern. Several air pollutants have been implicated including particulate matter (PM), ozone (O3), nitrogen dioxide (NO2) polycyclic aromatic hydrocarbons (PAHs) and volatile organic compounds (VOCs). It is well known that episodes of exposure to high concentrations of outdoor air pollutants can cause acute respiratory exacerbations. However, there is now increasing evidence suggesting that significant exposure to outdoor air pollutants may be also associated with development of lung cancer and with incident cases of chronic obstructive pulmonary disease (COPD) and respiratory allergies. Here we provide a critical appraisal of the impact of air pollution on respiratory diseases and discuss strategies for preventing excessive exposure to harmful air pollutants. However, the evidence that significant exposure to air pollutants is causing COPD, lung cancer or respiratory allergies is not conclusive and therefore regulators must be aware that execution of clean air policies may not be that cost-effective and may lead to unintended consequences. Addressing the lung health effects of air pollution must be considered work in progress. PMID:26336597

  5. Impact of air quality on lung health: myth or reality?

    PubMed

    Marino, Elisa; Caruso, Massimo; Campagna, Davide; Polosa, Riccardo

    2015-09-01

    The respiratory system is a primary target of the harmful effects of key air pollutants of health concern. Several air pollutants have been implicated including particulate matter (PM), ozone (O3), nitrogen dioxide (NO2) polycyclic aromatic hydrocarbons (PAHs) and volatile organic compounds (VOCs). It is well known that episodes of exposure to high concentrations of outdoor air pollutants can cause acute respiratory exacerbations. However, there is now increasing evidence suggesting that significant exposure to outdoor air pollutants may be also associated with development of lung cancer and with incident cases of chronic obstructive pulmonary disease (COPD) and respiratory allergies. Here we provide a critical appraisal of the impact of air pollution on respiratory diseases and discuss strategies for preventing excessive exposure to harmful air pollutants. However, the evidence that significant exposure to air pollutants is causing COPD, lung cancer or respiratory allergies is not conclusive and therefore regulators must be aware that execution of clean air policies may not be that cost-effective and may lead to unintended consequences. Addressing the lung health effects of air pollution must be considered work in progress. PMID:26336597

  6. What is important in evaluating health care quality? An international comparison of user views

    PubMed Central

    Groenewegen, Peter P; Kerssens, Jan J; Sixma, Herman J; van der Eijk, Ingrid; Boerma, Wienke GW

    2005-01-01

    Background Quality of care from the perspective of users is increasingly used in evaluating health care performance. Going beyond satisfaction studies, quality of care from the users' perspective is conceptualised in two dimensions: the importance users attach to aspects of care and their actual experience with these aspects. It is well established that health care systems differ in performance. The question in this article is whether there are also differences in what people in different health care systems view as important aspects of health care quality. The aim is to describe and explain international differences in the importance that health care users attach to different aspects of health care. Methods Data were used from different studies that all used a version of the QUOTE-questionnaire that measures user views of health care quality in two dimensions: the importance that users attach to aspects of care and their actual experience. Data from 12 European countries and 5133 individuals were used. They were analysed using multi-level analysis. Results Although most of the variations in importance people attach to aspects of health care is located at the individual level, there are also differences between countries. The ranking of aspects shows similarities. 'My GP should always take me seriously' was in nearly all countries ranked first, while an item about waiting time in the GP's office was always ranked lowest. Conclusion Differences between countries in how health care users value different aspects of care are difficult to explain. Further theorising should take into account that importance and performance ratings are positively related, that people compare their experiences with those of others, and that general and instrumental values might be related through the institutions of the health care system. PMID:15723701

  7. Heavy menstrual bleeding and health-associated quality of life in women with von Willebrand's disease

    PubMed Central

    GOVOROV, IGOR; EKELUND, LENA; CHAIRETI, ROZA; ELFVINGE, PETRA; HOLMSTRÖM, MARGARETA; BREMME, KATARINA; MINTS, MIRIAM

    2016-01-01

    Women with the inherited bleeding disorder von Willebrand's disease (VWD) face gender-specific hemostatic challenges during menstruation. Heavy menstrual bleeding (HMB) can negatively affect their overall life activities and the health-associated quality of life. The purpose of the present study was to investigate whether women with VWD experienced HMB and an impaired health-associated quality of life. The study subjects were recruited from the Coagulation Unit of Karolinska University Hospital. Information was retrieved from various self-administered forms and medical records. Of the 30 women (18–52 years) that were included in the present study, 50% suffered from HMB, although the majority received treatment for HMB. In addition, almost all the included women perceived limitations in the overall life activities due to menstruation. The health-associated quality of life for women with HMB was significantly lower (P<0.10) with regards to ‘bodily pain’ compared with Swedish women of the general population. In conclusion, women with VWD experienced reduced health-associated quality of life as a result of HMB. Therefore, preventing limitations in overall life activities and improving their health-associated quality of life thorough counseling on menstrual bleeding is important for women with VWD. PMID:27168829

  8. Quality of life of people with mental health problems: a synthesis of qualitative research

    PubMed Central

    2012-01-01

    Purpose To identify the domains of quality of life important to people with mental health problems. Method A systematic review of qualitative research undertaken with people with mental health problems using a framework synthesis. Results We identified six domains: well-being and ill-being; control, autonomy and choice; self-perception; belonging; activity; and hope and hopelessness. Firstly, symptoms or ‘ill-being’ were an intrinsic aspect of quality of life for people with severe mental health problems. Additionally, a good quality of life was characterised by the feeling of being in control (particularly of distressing symptoms), autonomy and choice; a positive self-image; a sense of belonging; engagement in meaningful and enjoyable activities; and feelings of hope and optimism. Conversely, a poor quality life, often experienced by those with severe mental health difficulties, was characterized by feelings of distress; lack of control, choice and autonomy; low self-esteem and confidence; a sense of not being part of society; diminished activity; and a sense of hopelessness and demoralization. Conclusions Generic measures fail to address the complexity of quality of life measurement and the broad range of domains important to people with mental health problems. PMID:23173689

  9. The role of quality improvement in strengthening health systems in developing countries.

    PubMed

    Leatherman, Sheila; Ferris, Timothy G; Berwick, Donald; Omaswa, Francis; Crisp, Nigel

    2010-08-01

    Quality of care was recognized as a key element for improved health outcomes and efficiency in the World Health Organization's (WHO) widely adopted framework for health system strengthening in resource-poor countries. Although modern approaches to improving quality are increasingly used globally, their adoption remains sporadic in developing countries. Healthcare leaders and improvement experts representing 15 countries met in October 2008 to catalyze the adoption of quality improvement (QI) methods to improve healthcare quality in resource-poor settings. This paper describes the evidence used to frame deliberations, the proceedings and a proposal for incorporating QI methods into plans for strengthening health systems. The conference participants presented case reports and reviewed a growing body of evidence from peer-reviewed journals demonstrating that QI methods can make significant contributions in resource poor settings. Deliberations focused on the barriers to adoption of QI methods and potential strategies for addressing those barriers. Attendees concluded that QI has the potential to optimize the use of limited resources available from governments and global initiatives targeted at achieving shared aims. Demonstrable improvements in quality may encourage greater investment in health systems in developing countries by increasing donor, population and governmental confidence that resources are being used well. PMID:20543209

  10. Ecosystem and Societal Consequences of Ocean versus Atmosphere Carbon Storage

    NASA Astrophysics Data System (ADS)

    Barry, J. P.; Adams, E. E.; Bleck, R.; Caldeira, K.; Carman, K.; Erickson, D.; Kennett, J. P.; Sarmiento, J. L.; Tsouris, C.

    2005-12-01

    high emission scenarios appears weaker, due partially to uncertainty in the trajectories of ecosystem change and societal issues. For high emission scenarios (e.g. SRES A1F1, A2; 900 ppm CO2, 4.2 oC global temperature increase by 2100), the mitigation effect of ocean sequestration is still ~ -0.4 oC, with a reduction of atmospheric CO2 near 50 ppm. However, under such high emissions, the effects of large global temperature on societal issues such as disease, hunger, and water are expected to be severe, with an unknown incremental benefit from ocean sequestration. These results indicate the importance of a careful consideration of the benefits and liabilities of ocean sequestration, in terms of ecosystem health for global ecosystems and terrestrial concerns. A cautionary approach to ocean carbon sequestration in consideration of the global consequences of anthropogenic climate change may differ from an approach considering deep-ocean ecosystems alone.

  11. State of Health and Quality of Life of Women at Advanced Age.

    PubMed

    Pinkas, Jarosław; Gujski, Mariusz; Humeniuk, Ewa; Raczkiewicz, Dorota; Bejga, Przemysław; Owoc, Alfred; Bojar, Iwona

    2016-01-01

    BACKGROUND Evaluation of the state of health, quality of life, and relationship between the level of the quality of life and health status in a group of women at advanced age (90 and more years) in Poland. MATERIAL AND METHODS The study was conducted in 2014 in an all-Polish sample of 870 women aged 90 and over. The research instruments were: the author's questionnaire, and standardized tests: Katz index of independence in Activities of Daily Living (ADL), Abbreviated Mental Test Score (AMTS), The World Health Organization Quality of Life (WHOQOL) - BREF. The results of the study were statistically analyzed using significant t test for mean and regression analysis. RESULTS The majority of women at advanced age suffered from chronic pain (76%) and such major geriatric problems as hypoacusis (81%), visual disturbances (69%) and urinary incontinence (60%), the minority - fall and fainting (39%) as well as stool incontinence (17%), severe functional and cognitive impairment (24% and 10% respectively). Women at advanced age assessed positively for overall quality of life (mean 3.3 on 1-5 scale), social relationships (3.5) and environment (3.2), but negatively - general, physical and psychological health (2.7, 2.7 and 2.8 respectively). The presence of chronic pain and major geriatric problems: urinary and stool incontinences, falls and fainting, visual disturbances and hypoacusis significantly decreases overall quality of life, general, physical and psychological health, social relationships and environment of women at advanced age. Overall quality of life, general, physical and psychological health, social relationships and environment correlate to functional and cognitive impairments of women at advanced age. CONCLUSIONS Quality of life of women at advanced age decreased if chronic pain, major geriatric problems as well as functional and cognitive impairments occur. PMID:27580565

  12. FACTORS ASSOCIATED WITH HEALTH-RELATED QUALITY OF LIFE AMONG UNIVERSITY STUDENTS IN TURKEY

    PubMed Central

    Oztasan, Nuray; Ozyrek, Pakize; Kilic, Ibrahim

    2016-01-01

    Introduction: Purpose of this descriptive study is to determine the mental health problems and quality of life levels of college students and examine the relationship between them. Methods: The sample of the study consisted of 429 students continuing their education in Health School at Afyon Kocatepe University. Data were collected by using information form, Brief Symptom Inventory (BSI), SF 36 Quality of Life Scale questionnaires. In the analysis of obtained data, descriptive statistics, t-test, ANOVA and correlation analyses were used. Findings: Mental symptoms which the students got the highest scores from the subscales of BSI were respectively, depression (1.31±0.75), hostility (1.22±0.67) and anxiety (1.00±0.65). Discomfort severity index which is the overall score of the scale was found 1.07±0.61. Relation between state of mind and quality of life was found statistically significant (F: 70.894; p<0.000). When quality of life summary scores examined, it was found out that physical health summary score (48.92±7.93) and mental health summary score (43.44±9.52) points were low. Conclusions: Consequently, according to averages of scores, it can be said that frequency of the mental symptoms of students are high but their quality of life is low. It was found that when students’ quality of life decreased, their mental symptoms increased. PMID:27482164

  13. The role of Health Impact Assessment in the setting of air quality standards: An Australian perspective

    SciTech Connect

    Spickett, Jeffery; Katscherian, Dianne; Harris, Patrick

    2013-11-15

    The approaches used for setting or reviewing air quality standards vary from country to country. The purpose of this research was to consider the potential to improve decision-making through integration of HIA into the processes to review and set air quality standards used in Australia. To assess the value of HIA in this policy process, its strengths and weaknesses were evaluated aligned with review of international processes for setting air quality standards. Air quality standard setting programmes elsewhere have either used HIA or have amalgamated and incorporated factors normally found within HIA frameworks. They clearly demonstrate the value of a formalised HIA process for setting air quality standards in Australia. The following elements should be taken into consideration when using HIA in standard setting. (a) The adequacy of a mainly technical approach in current standard setting procedures to consider social determinants of health. (b) The importance of risk assessment criteria and information within the HIA process. The assessment of risk should consider equity, the distribution of variations in air quality in different locations and the potential impacts on health. (c) The uncertainties in extrapolating evidence from one population to another or to subpopulations, especially the more vulnerable, due to differing environmental factors and population variables. (d) The significance of communication with all potential stakeholders on issues associated with the management of air quality. In Australia there is also an opportunity for HIA to be used in conjunction with the NEPM to develop local air quality standard measures. The outcomes of this research indicated that the use of HIA for air quality standard setting at the national and local levels would prove advantageous. -- Highlights: • Health Impact Assessment framework has been applied to a policy development process. • HIA process was evaluated for application in air quality standard setting.

  14. Attachment, forgiveness, and physical health quality of life in HIV + adults.

    PubMed

    Martin, Luci A; Vosvick, Mark; Riggs, Shelley A

    2012-01-01

    Research aims to help HIV + individuals improve and maintain a healthy quality of life, while managing a chronic illness. Using Lazarus and Folkman's model of stress and coping, we examined the main and interactive effects of attachment style and forgiveness on physical health quality of life of HIV + adults. Participants (n=288, 49% women) were recruited in Dallas/Fort Worth and self-identified as African-American (52%), European-American (32%), Latino(a) (12%), and other (4%), with an average age of 41.7 (SD=8.6). The average number of years participants reported being HIV + was 7.6 (SD=5.4). Participants completed medical and demographic information, measures assessing attachment anxiety and avoidance, forgiveness of self and others, and five quality of life scales (physical functioning, pain, role functioning, social functioning, and health perceptions). Significant correlations revealed that attachment anxiety was inversely related to physical health quality of life, while forgiveness of self was associated with greater quality of life. Hierarchical multiple regression analyses revealed that attachment anxiety and avoidance, forgiveness of self and others, as well as interactions between attachment style and forgiveness, were related to the physical health quality of life of HIV + adults. Interpretation of the interactions identified that for individuals who endorsed greater attachment anxiety, forgiveness of others was associated with greater pain, while forgiveness of self was associated with a greater perception of health. Research has indicated that forgiveness interventions lead to positive health outcomes for most individuals; however, in HIV + adults, whether an outcome is health promoting may be dependent on attachment style. PMID:22292903

  15. Evaluation of the Quality of Health Service Providers: The Iranian People Perspective 2014

    PubMed Central

    Asefzadeh, Saeed; Gholami, Soheyla; Rajaee, Roya; Najafi, Marziye; Alijanzadeh, Mehran

    2016-01-01

    Introduction Quality is the center of attention in all service providing organizations that are effective in promoting satisfaction of patients who are referred to medical centers. The aim of this study was to investigate the quality of health service providers in a case study of Qazvin, Iran, in 2014. Methods This descriptive study was conducted on 1,002 people who were residents of Qazvin Province (Iran) in 2014. The people were selected randomly from the population of the study area. The main variables studied were education, perceptions, expectations, and gaps in service quality. The data collection tool was the standard Servequal questionnaire. To determine the reliability of the research tool, we used Cronbach’s Alpha coefficient and the test-retest method. Statistical analyses were conducted using SPSS and the ANOVA test. Results The mean age of people included in the study was 32 ± 9.9 years, and the average waiting time to receive services was 73 ± 47 minutes. Hospitals and doctors’ offices had the highest quality gap of −1.420 ± 0.82 and −1.01 ± 0.75, respectively. The service quality gaps in medical centers, health providers of rural area, and health providers of urban area were −0.883 ± 0.67, −0.882 ± 0.83, and −0.804 ± 0.62, respectively. There was a significant relationship between peoples’ perceptions and expectations concerning the quality of health services and their educational levels. Conclusion The higher gaps in quality in hospitals and in doctors’ offices require more attention. Managers and policy makers should consider developing and implementing plans to reduce these gaps in quality and to promote better health services in these two sectors. PMID:27123214

  16. Relationships between technical efficiency and the quality and costs of health care in Italy†

    PubMed Central

    Nuti, S.; Daraio, C.; Speroni, C.; Vainieri, M.

    2011-01-01

    Objectives This paper reports the measurement of technical efficiency of Tuscan Local Health Authorities and its relationship with quality and appropriateness of care. Design First, a bias-corrected measure of technical efficiency was developed using the bootstrap technique applied to data envelopment analysis. Then, correlation analysis was used to investigate the relationships among technical efficiency, quality and appropriateness of care. Setting and Participants These analyses have been applied to the Local Health Authorities of Tuscany Region (Italy), which provide not only hospital inpatient services, but also prevention and primary care. All top managers of Tuscan Local Health Authorities were involved in selection of the inputs and outputs for calculating technical efficiency. Main Outcome Measures The main measures used in this study are volume, quality and appropriateness indicators monitored by the multidimensional performance evaluation system developed in the Tuscany Region. Results On average, Tuscan Local Health Authorities experienced 14(%) of bias-corrected inefficiency in 2007. Correlation analyses showed a significant negative correlation between per capita costs and overall performance. No correlation was found in 2007 between technical efficiency and overall performance or between technical efficiency and per capita costs. Conclusions Technical efficiency cannot be considered as an extensive measure of healthcare performance, but evidence shows that Tuscan Local Health Authorities have room for improvement in productivity levels. Indeed, correlation findings suggest that, to pursue financial sustainability, Local Health Authorities mainly have to improve their performance in terms of quality and appropriateness. PMID:21454349

  17. Hamilton study: distribution of factors confounding the relationship between air quality and respiratory health

    SciTech Connect

    Pengelly, L.D.; Kerigan, A.T.; Goldsmith, C.H.; Inman, E.M.

    1984-10-01

    Hamilton, Ontario is an industrial city with a population of 300,000 which is situated at the western end of Lake Ontario. Canada's two largest iron and steel mills are located here; the city historically has had relatively poor air quality, which has improved markedly in the last 25 years. Concern about the health effects of current air quality recently led us to carry out an epidemiological study of the effects of air pollution on the respiratory health of over 3500 school children. Respiratory health was measured by pulmonary function testing of each child, and by an assessment of each child's respiratory symptoms via a questionnaire administered to the parents. Previous studies had shown that other environmental factors (e.g. parental smoking, parental cough, socioeconomic level, housing, and gas cooking) might also affect respiratory health, and thus confound any potential relationships between health and air pollution. The questionnaire also collected information on many of these confounding factors. For the purposes of initial analysis, the city was divided into five areas in which differences in air quality were expected. In general, factors which have been associated with poor respiratory health were observed to be more prevalent in areas of poorer air quality.

  18. Association of Oral Health Indicators with Quality-of-Life Related to Oral Health among Iranian Adolescent

    PubMed Central

    Bakhtiar, Maryam; Mohammadi, Tayebeh Malek; Hajizamani, Abolghasem; Vossoughi, Mehrdad

    2014-01-01

    Background: There has been an increase in the development and use of oral health-related quality-of-life (OHRQoL) measures in the past two decades. This study aimed to assess the association between OHRQoL and clinical oral health measures, among mid-level school children in Southeast of Iran. Materials and Methods: A cross-sectional study was conducted on a random cluster sample of 11-13 year-old student population. Consented participants interviewed for OHRQoL measurements using Persian version of child-oral impacts on daily performances (OIDP). Oral examination was done by a trained dentist using WHO oral health assessment form, version 2011. Data were analyzed by SPSS software version 20 using Mann–Whitney and correlation tests. Results: A total of 400 school children participated. The overall mean of decayed missing filled teeth (DMFT) was 1.76 ± 2.4. A total of 82% of the school children presented the impact of oral problems in at least one of the eight daily performances. As DMFT increased, the OIDP score tended to increase or quality-of-life of children tended to be worse (r = 0.397, P < 0.001). Conclusions: The results showed a positive relation between some oral health status and quality-of-life score. PMID:25628474

  19. Comparison of Perceived and Technical Healthcare Quality in Primary Health Facilities: Implications for a Sustainable National Health Insurance Scheme in Ghana

    PubMed Central

    Alhassan, Robert Kaba; Duku, Stephen Opoku; Janssens, Wendy; Nketiah-Amponsah, Edward; Spieker, Nicole; van Ostenberg, Paul; Arhinful, Daniel Kojo; Pradhan, Menno; Rinke de Wit, Tobias F.

    2015-01-01

    Background Quality care in health facilities is critical for a sustainable health insurance system because of its influence on clients’ decisions to participate in health insurance and utilize health services. Exploration of the different dimensions of healthcare quality and their associations will help determine more effective quality improvement interventions and health insurance sustainability strategies, especially in resource constrained countries in Africa where universal access to good quality care remains a challenge. Purpose To examine the differences in perceptions of clients and health staff on quality healthcare and determine if these perceptions are associated with technical quality proxies in health facilities. Implications of the findings for a sustainable National Health Insurance Scheme (NHIS) in Ghana are also discussed. Methods This is a cross-sectional study in two southern regions in Ghana involving 64 primary health facilities: 1,903 households and 324 health staff. Data collection lasted from March to June, 2012. A Wilcoxon-Mann-Whitney test was performed to determine differences in client and health staff perceptions of quality healthcare. Spearman’s rank correlation test was used to ascertain associations between perceived and technical quality care proxies in health facilities, and ordered logistic regression employed to predict the determinants of client and staff-perceived quality healthcare. Results Negative association was found between technical quality and client-perceived quality care (coef. = -0.0991, p<0.0001). Significant staff-client perception differences were found in all healthcare quality proxies, suggesting some level of unbalanced commitment to quality improvement and potential information asymmetry between clients and service providers. Overall, the findings suggest that increased efforts towards technical quality care alone will not necessarily translate into better client-perceived quality care and willingness to

  20. 42 CFR 476.72 - Review of the quality of care of risk-basis health maintenance organizations and competitive...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... disclosure of peer review information; and (2) Part 1004 of Chapter V regarding a QIO's responsibilities, and... 42 Public Health 4 2010-10-01 2010-10-01 false Review of the quality of care of risk-basis health... ORGANIZATIONS UTILIZATION AND QUALITY CONTROL REVIEW Review Responsibilities of Utilization and Quality...