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Sample records for health care university

  1. The liberty principle and universal health care.

    PubMed

    Sachs, Benjamin

    2008-06-01

    A universal entitlement to health care can be grounded in the liberty principle. A detailed examination of Rawls's discussion of health care in Justice as Fairness shows that Rawls himself recognized that illness is a threat to the basic liberties, yet failed to recognize the implications of this fact for health resource allocation. The problem is that one cannot know how to allocate health care dollars until one knows which basic liberties one seeks to protect, and yet one cannot know which basic liberties to protect until one knows how health care dollars will be allocated. The solution is to design the list of basic liberties and the health care system in tandem so as to fit each other, such that every citizen is guaranteed a set of basic liberties and access to the health services needed to secure them.

  2. Universal health care: the changing international discourse.

    PubMed

    Bisht, Ramila

    2013-01-01

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

  3. Universal health care: the changing international discourse.

    PubMed

    Bisht, Ramila

    2013-01-01

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

  4. Universal health care in India: Panacea for whom?

    PubMed

    Qadeer, Imrana

    2013-01-01

    This paper examines the current notion of universal health care (UHC) in key legal and policy documents and argues that the recommendations for UHC in these entail further abdication of the State's responsibility in health care with the emphasis shifting from public provisioning of services to merely ensuring universal access to services. Acts of commission (recommendations for public private partnership [PPPs], definition and provision of an essential health package to vulnerable populations to ensure universal access to care) and omission (silence maintained on tertiary care) will eventually strengthen the private and corporate sector at the cost of the public health care services and access to care for the marginalized. Thus, the current UHC strategy uses equity as a tool for promoting the private sector in medical care rather than health for all.

  5. Universal health care in India: Panacea for whom?

    PubMed

    Qadeer, Imrana

    2013-01-01

    This paper examines the current notion of universal health care (UHC) in key legal and policy documents and argues that the recommendations for UHC in these entail further abdication of the State's responsibility in health care with the emphasis shifting from public provisioning of services to merely ensuring universal access to services. Acts of commission (recommendations for public private partnership [PPPs], definition and provision of an essential health package to vulnerable populations to ensure universal access to care) and omission (silence maintained on tertiary care) will eventually strengthen the private and corporate sector at the cost of the public health care services and access to care for the marginalized. Thus, the current UHC strategy uses equity as a tool for promoting the private sector in medical care rather than health for all. PMID:24351383

  6. The meanings of universal health care in Latin America.

    PubMed

    Clark, Mary A

    2015-02-01

    In Latin America, competing definitions of universal health care are found. Variants include traditional universalism, basic universalism, and minimal or residual universalism. These definitions are informed by European traditions, a renewed emphasis on equity among Latin American social policy experts, and World Bank strategy. This essay explores these definitions as well as areas of overlap and points of difference between and among them using examples from several Latin American countries. The most important difference concerns the preventive and curative services not covered by the benefits packages of minimal universal programs, a gap expected to grow increasingly costly for patients.

  7. A conservative case for universal access to health care.

    PubMed

    Menzel, Paul; Light, Donald W

    2006-01-01

    Universal access to health care has historically faced strident opposition from political conservatives in the United States, although it has long been accepted by most conservatives in the rest of the industrialized world. Now, in a global economy where American business is crippled by the rising cost of market-based health care, the time may be ripe for change. The key to fostering a new mindset among American conservatives is to show why universal access fulfills many of the basic values that all conservatives hold.

  8. Bonhoeffer and universal health care as a human right.

    PubMed

    Clarke Chapman, G

    2013-12-01

    Bonhoeffer gave a theocentric basis for human rights, as God is the ground of ethics. In our earthly world, the "ultimate" must be prepared by what is "penultimate." That includes humanity's natural life and bodily wholeness, leading to human duties crafted by human reason. Nowadays, biblical texts should not be used as partisan weapons attacking government provision of health care, since all Scripture (even the Law) is seen as a Christ-centered focus on human redemption. Thus, Bonhoeffer implies a right to universal health care, but leaves entirely open which practical structures may best provide it.

  9. Primary health care and public health: foundations of universal health systems.

    PubMed

    White, Franklin

    2015-01-01

    The aim of this review is to advocate for more integrated and universally accessible health systems, built on a foundation of primary health care and public health. The perspective outlined identified health systems as the frame of reference, clarified terminology and examined complementary perspectives on health. It explored the prospects for universal and integrated health systems from a global perspective, the role of healthy public policy in achieving population health and the value of the social-ecological model in guiding how best to align the components of an integrated health service. The importance of an ethical private sector in partnership with the public sector is recognized. Most health systems around the world, still heavily focused on illness, are doing relatively little to optimize health and minimize illness burdens, especially for vulnerable groups. This failure to improve the underlying conditions for health is compounded by insufficient allocation of resources to address priority needs with equity (universality, accessibility and affordability). Finally, public health and primary health care are the cornerstones of sustainable health systems, and this should be reflected in the health policies and professional education systems of all nations wishing to achieve a health system that is effective, equitable, efficient and affordable.

  10. The fundamental law that shapes the United States health care system: is universal health care realistic within the established paradigm?

    PubMed

    Gunnar, William P

    2006-01-01

    In this article, the author draws from his own experience as a doctor in describing the issues the uninsured patient population faces. Pointing out that neither the U.S. Constitution nor case law provides a positive right to health care, the author describes the parameters of federal health care funding and ultimately concludes that universal health care cannot be fully achieved in the U.S.

  11. The fundamental law that shapes the United States health care system: is universal health care realistic within the established paradigm?

    PubMed

    Gunnar, William P

    2006-01-01

    In this article, the author draws from his own experience as a doctor in describing the issues the uninsured patient population faces. Pointing out that neither the U.S. Constitution nor case law provides a positive right to health care, the author describes the parameters of federal health care funding and ultimately concludes that universal health care cannot be fully achieved in the U.S. PMID:17552136

  12. Is universal health coverage the practical expression of the right to health care?

    PubMed

    Ooms, Gorik; Latif, Laila A; Waris, Attiya; Brolan, Claire E; Hammonds, Rachel; Friedman, Eric A; Mulumba, Moses; Forman, Lisa

    2014-01-01

    The present Millennium Development Goals are set to expire in 2015 and their next iteration is now being discussed within the international community. With regards to health, the World Health Organization proposes universal health coverage as a 'single overarching health goal' for the next iteration of the Millennium Development Goals.The present Millennium Development Goals have been criticised for being 'duplicative' or even 'competing alternatives' to international human rights law. The question then arises, if universal health coverage would indeed become the single overarching health goal, replacing the present health-related Millennium Development Goals, would that be more consistent with the right to health? The World Health Organization seems to have anticipated the question, as it labels universal health coverage as "by definition, a practical expression of the concern for health equity and the right to health".Rather than waiting for the negotiations to unfold, we thought it would be useful to verify this contention, using a comparative normative analysis. We found that--to be a practical expression of the right to health--at least one element is missing in present authoritative definitions of universal health coverage: a straightforward confirmation that international assistance is essential, not optional.But universal health coverage is a 'work in progress'. A recent proposal by the United Nations Sustainable Development Solutions Network proposed universal health coverage with a set of targets, including a target for international assistance, which would turn universal health coverage into a practical expression of the right to health care. PMID:24559232

  13. Universal access to health care: a practical perspective.

    PubMed

    Battistella, R M; Kuder, J M

    1993-01-01

    Policy disconnected from economic reality is bad policy. Neither government financed health insurance nor an employer mandated health insurance approach are in the national interest. Higher national priorities compel a reallocation of resources from consumption to investment. This need not, however, cause an abandonment of efforts to deal with the problems of the uninsured and other health reforms. Successful health care reform is achievable provided it is responsive to higher priorities for economic growth. A strong economy and the production of wealth are indispensable to economic justice. Toward this end, a program of universal access is proposed whereby families and individuals are required to pay for their own health insurance up to a fixed percentage of disposable personal income before public payments kick in. Government's chief role is to establish a standard package of cost-effective benefits to be offered by all insurance carriers, the cost of which is approximately 40 percent less than conventional insurance coverage because of the elimination of reimbursement for clinically non-efficacious and cost-ineffective services. Public financing is relegated to a residual role in which subsidies are targeted on the needy. Much of the momentum for cost control is transferred to consumers and private insurers, both of whom acquire a vested interest in obtaining value for money. Uniform rules for underwriting, eligibility, and enrollment practices guard against socially harmful practices such as experience rating and exclusion of preexisting conditions. The household responsibility and equity plan described herein could free up as much as $90 billion or more for public investment in economic growth and national debt reduction while assuring access to health care regardless of ability to pay. Economic revitalization will be assisted by changes in household savings. With health care no longer a free good and government social programs concentrated on the truly needy

  14. Health care financing in Nigeria: Implications for achieving universal health coverage.

    PubMed

    Uzochukwu, B S C; Ughasoro, M D; Etiaba, E; Okwuosa, C; Envuladu, E; Onwujekwe, O E

    2015-01-01

    The way a country finances its health care system is a critical determinant for reaching universal health coverage (UHC). This is so because it determines whether the health services that are available are affordable to those that need them. In Nigeria, the health sector is financed through different sources and mechanisms. The difference in the proportionate contribution from these stated sources determine the extent to which such health sector will go in achieving successful health care financing system. Unfortunately, in Nigeria, achieving the correct blend of these sources remains a challenge. This review draws on relevant literature to provide an overview and the state of health care financing in Nigeria, including policies in place to enhance healthcare financing. We searched PubMed, Medline, The Cochrane Library, Popline, Science Direct and WHO Library Database with search terms that included, but were not restricted to health care financing Nigeria, public health financing, financing health and financing policies. Further publications were identified from references cited in relevant articles and reports. We reviewed only papers published in English. No date restrictions were placed on searches. It notes that health care in Nigeria is financed through different sources including but not limited to tax revenue, out-of-pocket payments (OOPs), donor funding, and health insurance (social and community). In the face of achieving UHC, achieving successful health care financing system continues to be a challenge in Nigeria and concludes that to achieve universal coverage using health financing as the strategy, there is a dire need to review the system of financing health and ensure that resources are used more efficiently while at the same time removing financial barriers to access by shifting focus from OOPs to other hidden resources. There is also need to give presidential assent to the national health bill and its prompt implementation when signed into law.

  15. Health care financing in Nigeria: Implications for achieving universal health coverage.

    PubMed

    Uzochukwu, B S C; Ughasoro, M D; Etiaba, E; Okwuosa, C; Envuladu, E; Onwujekwe, O E

    2015-01-01

    The way a country finances its health care system is a critical determinant for reaching universal health coverage (UHC). This is so because it determines whether the health services that are available are affordable to those that need them. In Nigeria, the health sector is financed through different sources and mechanisms. The difference in the proportionate contribution from these stated sources determine the extent to which such health sector will go in achieving successful health care financing system. Unfortunately, in Nigeria, achieving the correct blend of these sources remains a challenge. This review draws on relevant literature to provide an overview and the state of health care financing in Nigeria, including policies in place to enhance healthcare financing. We searched PubMed, Medline, The Cochrane Library, Popline, Science Direct and WHO Library Database with search terms that included, but were not restricted to health care financing Nigeria, public health financing, financing health and financing policies. Further publications were identified from references cited in relevant articles and reports. We reviewed only papers published in English. No date restrictions were placed on searches. It notes that health care in Nigeria is financed through different sources including but not limited to tax revenue, out-of-pocket payments (OOPs), donor funding, and health insurance (social and community). In the face of achieving UHC, achieving successful health care financing system continues to be a challenge in Nigeria and concludes that to achieve universal coverage using health financing as the strategy, there is a dire need to review the system of financing health and ensure that resources are used more efficiently while at the same time removing financial barriers to access by shifting focus from OOPs to other hidden resources. There is also need to give presidential assent to the national health bill and its prompt implementation when signed into law

  16. "More Universal for Some than Others": Canada's Health Care System and the Role of Adult Education

    ERIC Educational Resources Information Center

    Quigley, B. Allan; Coady, Maureen; Gregoire, Helene; Folinsbee, Sue; Kraglund-Gauthier, Wendy

    2009-01-01

    Health and health care in Canada is a story of high ideals, complex policy agreements, moments of raging public controversy, and the creation of a national health system that is the envy of many other nations. Despite its many health care achievements, evidence is mounting that good health is far from being universally accessible to all Canadians.…

  17. Is universal health coverage the practical expression of the right to health care?

    PubMed Central

    2014-01-01

    The present Millennium Development Goals are set to expire in 2015 and their next iteration is now being discussed within the international community. With regards to health, the World Health Organization proposes universal health coverage as a ‘single overarching health goal’ for the next iteration of the Millennium Development Goals. The present Millennium Development Goals have been criticised for being ‘duplicative’ or even ‘competing alternatives’ to international human rights law. The question then arises, if universal health coverage would indeed become the single overarching health goal, replacing the present health-related Millennium Development Goals, would that be more consistent with the right to health? The World Health Organization seems to have anticipated the question, as it labels universal health coverage as “by definition, a practical expression of the concern for health equity and the right to health”. Rather than waiting for the negotiations to unfold, we thought it would be useful to verify this contention, using a comparative normative analysis. We found that – to be a practical expression of the right to health – at least one element is missing in present authoritative definitions of universal health coverage: a straightforward confirmation that international assistance is essential, not optional. But universal health coverage is a ‘work in progress’. A recent proposal by the United Nations Sustainable Development Solutions Network proposed universal health coverage with a set of targets, including a target for international assistance, which would turn universal health coverage into a practical expression of the right to health care. PMID:24559232

  18. Analysis of Universal Health Coverage and Equity on Health Care in Kenya.

    PubMed

    Okech, Timothy Chrispinus; Lelegwe, Steve Ltumbesi

    2016-01-01

    Kenya has made progress towards universal health coverage as evidenced in the various policy initiatives and reforms that have been implemented in the country since independence. The purpose of this analysis was to critically review the various initiatives that the government of Kenya has over the years initiated towards the realization of Universal Health Care (UHC) and how this has impacted on health equity. The paper relied heavly on secondary sources of information although primary data data was collected. Whereas secondary data was largely collected through critical review of policy documents and commissioned studies by the Ministry of Health and development partners, primary data was collected through interviews with various stakeholders involved in UHC including policy makers, implementers, researchers and health service providers. Key findings include commitment towards UHC; minimal solidarity in health care financing; cases of dysfunctionalilty of health care system; minimal opportunities for continuous medical training; quality concerns in terms of stock-outs of drugs and other medical supplies, dilapidated health infrastructure and inadequqte number of health workers. Other findings include governance concerns at NHIF coupled with, high operational costs, low capitation, fraud at facility levels, low pay out ratio, accreditation of facilities, and narrowness of the benefit package, among others. In lieu of these, various recommendations have been suggested. Among these include promotion of solidarty in health care financing that are reliable and economical in collecting; political will to enhance commitment towards devolution of health care, engagement of various stakeholders at both county and national government in fast tracking the enactment of Health Act; investment in health infrastructure and training of human resources; revamping NHIF into a full-fledged social health insurance scheme, and enhancing capacity of NHIF human resources, enhanced

  19. Analysis of Universal Health Coverage and Equity on Health Care in Kenya.

    PubMed

    Okech, Timothy Chrispinus; Lelegwe, Steve Ltumbesi

    2016-01-01

    Kenya has made progress towards universal health coverage as evidenced in the various policy initiatives and reforms that have been implemented in the country since independence. The purpose of this analysis was to critically review the various initiatives that the government of Kenya has over the years initiated towards the realization of Universal Health Care (UHC) and how this has impacted on health equity. The paper relied heavly on secondary sources of information although primary data data was collected. Whereas secondary data was largely collected through critical review of policy documents and commissioned studies by the Ministry of Health and development partners, primary data was collected through interviews with various stakeholders involved in UHC including policy makers, implementers, researchers and health service providers. Key findings include commitment towards UHC; minimal solidarity in health care financing; cases of dysfunctionalilty of health care system; minimal opportunities for continuous medical training; quality concerns in terms of stock-outs of drugs and other medical supplies, dilapidated health infrastructure and inadequqte number of health workers. Other findings include governance concerns at NHIF coupled with, high operational costs, low capitation, fraud at facility levels, low pay out ratio, accreditation of facilities, and narrowness of the benefit package, among others. In lieu of these, various recommendations have been suggested. Among these include promotion of solidarty in health care financing that are reliable and economical in collecting; political will to enhance commitment towards devolution of health care, engagement of various stakeholders at both county and national government in fast tracking the enactment of Health Act; investment in health infrastructure and training of human resources; revamping NHIF into a full-fledged social health insurance scheme, and enhancing capacity of NHIF human resources, enhanced

  20. Analysis of Universal Health Coverage and Equity on Health Care in Kenya

    PubMed Central

    Okech, Timothy Chrispinus; Lelegwe, Steve Ltumbesi

    2016-01-01

    Kenya has made progress towards universal health coverage as evidenced in the various policy initiatives and reforms that have been implemented in the country since independence. The purpose of this analysis was to critically review the various initiatives that the government of Kenya has over the years initiated towards the realization of Universal Health Care (UHC) and how this has impacted on health equity. The paper relied heavly on secondary sources of information although primary data data was collected. Whereas secondary data was largely collected through critical review of policy documents and commissioned studies by the Ministry of Health and development partners, primary data was collected through interviews with various stakeholders involved in UHC including policy makers, implementers, researchers and health service providers. Key findings include commitment towards UHC; minimal solidarity in health care financing; cases of dysfunctionalilty of health care system; minimal opportunities for continuous medical training; quality concerns in terms of stock-outs of drugs and other medical supplies, dilapidated health infrastructure and inadequqte number of health workers. Other findings include governance concerns at NHIF coupled with, high operational costs, low capitation, fraud at facility levels, low pay out ratio, accreditation of facilities, and narrowness of the benefit package, among others. In lieu of these, various recommendations have been suggested. Among these include promotion of solidarty in health care financing that are reliable and economical in collecting; political will to enhance commitment towards devolution of health care, engagement of various stakeholders at both county and national government in fast tracking the enactment of Health Act; investment in health infrastructure and training of human resources; revamping NHIF into a full-fledged social health insurance scheme, and enhancing capacity of NHIF human resources, enhanced

  1. Challenges for regulating the private health services in India for achieving universal health care.

    PubMed

    Baru, Rama V

    2013-01-01

    Commercial interests pose a serious challenge for universalizing health-care. This is because "for-profit" health-care privileges individual responsibility and choice over principles of social solidarity. This fundamentally opposing tendency raises ethical dilemmas for designing a health service that is universal and equitable. It is an inadequate to merely state the need for regulating the private sector, the key questions relate to what must be done and how to do it. This paper identifies the challenges to regulating the private health services in India. It argues that regulation has been fragmented and largely driven by the center. Given the diversity of the private sector and health being a state subject, regulating this sector is fraught with the technical and socio-political factors.

  2. Primary Health Care and partnerships: collaboration of a community agency, health department, and university nursing program.

    PubMed

    Leonard, L G

    1998-03-01

    Health care reform proposals emphasize health care that is essential, practical, scientifically sound, coordinated, accessible, appropriately delivered, and affordable. One route to achievement of improved health outcomes within these parameters is the formation of partnerships. Partnerships adopting the philosophy and five principles of Primary Health Care (PHC) focus on health promotion and prevention of illness and disability, maximum community participation, accessibility to health and health services, interdisciplinary and intersectoral collaboration, and use of appropriate technologies such as resources and strategies. A community service agency serving a multicultural population initiated a partnership with a health department and a university undergraduate nursing program. The result was a preschool health fair and there were benefits for each partner-benefits which could not have been realized without the collaboration. The health fair partnership planning, implementation, and evaluation process was guided by a framework shaped by the philosophy and five principles of PHC. The educational process described can be applied to other learning experiences where the goal is to help students understand and apply the concepts of PHC, develop myriad nursing competencies, and form collaborative relationships with the community and health agencies. Community health care dilemmas and nursing education challenges can be successfully addressed when various disciplines and sectors form effective partnerships. PMID:9535233

  3. Health care inequities in north India: Role of public sector in universalizing health care

    PubMed Central

    Prinja, Shankar; Kanavos, Panos; Kumar, Rajesh

    2012-01-01

    Background & objectives: Income inequality is associated with poor health. Inequities exist in service utilization and financing for health care. Health care costs push high number of households into poverty in India. We undertook this study to ascertain inequities in health status, service utilization and out-of-pocket (OOP) health expenditures in two States in north India namely, Haryana and Punjab, and Union Territory of Chandigarh. Methods: Data from National Sample Survey 60th Round on Morbidity and Health Care were analyzed by mean consumption expenditure quintiles. Indicators were devised to document inequities in the dimensions of horizontal and vertical inequity; and redistribution of public subsidy. Concentration index (CI), and equity ratio in conjunction with concentration curve were computed to measure inequity. Results: Reporting of morbidity and hospitalization rate had a pro-rich distribution in all three States indicating poor utilization of health services by low income households. Nearly 57 and 60 per cent households from poorest income quintile in Haryana and Punjab, respectively faced catastrophic OOP hospitalization expenditure at 10 per cent threshold. Lower prevalence of catastrophic expenditure was recorded in higher income groups. Public sector also incurred high costs for hospitalization in selected three States. Medicines constituted 19 to 47 per cent of hospitalization expenditure and 59 to 86 per cent OPD expenditure borne OOP by households in public sector. Public sector hospitalizations had a pro-poor distribution in Haryana, Punjab and Chandigarh. Interpretation & conclusions: Our analysis indicates that public sector health service utilization needs to be improved. OOP health care expenditures at public sector institutions should to be curtailed to improve utilization of poorer segments of population. Greater availability of medicines in public sector and regulation of their prices provide a unique opportunity to reduce public

  4. The challenge of nurse innovation in the Australian context of universal health care.

    PubMed

    Cashin, Andrew

    2015-01-01

    As nursing pushes further into the realm of primary health care in Australia, an understanding of the challenges to achieving reasonable federal funding of nursing services needs to be understood. This understanding is underpinned by a comprehensive understanding of the concept of universal health care, how the concept relates to the Australian health care context, and the resultant challenges to innovation in health care service delivery in Australia. Universal health care is a global mission and was the most recent theme for the International Council of Nurses Congress in Australia. Universal health care as a concept represents a fundamental shift from the development and funding of discrete interventions or programmes, to that of developing systems of health care. The three critical elements required are a clear definition of what is considered health care and funded for who, how the system is financed, and evaluation. Australia has a system of universal health care and all three elements are addressed. Organised medicine, a key objector to the introduction of the current approach to universal health care in Australia, soon adapted to it, and now fiercely resists change. Medico centricity poses challenges to sustainability as innovation is inhibited. This challenge is illustrated through consideration of the implementation of the financial policy that gave Nurse Practitioners access as providers and prescribers within Medicare funded services.

  5. The challenge of nurse innovation in the Australian context of universal health care.

    PubMed

    Cashin, Andrew

    2015-01-01

    As nursing pushes further into the realm of primary health care in Australia, an understanding of the challenges to achieving reasonable federal funding of nursing services needs to be understood. This understanding is underpinned by a comprehensive understanding of the concept of universal health care, how the concept relates to the Australian health care context, and the resultant challenges to innovation in health care service delivery in Australia. Universal health care is a global mission and was the most recent theme for the International Council of Nurses Congress in Australia. Universal health care as a concept represents a fundamental shift from the development and funding of discrete interventions or programmes, to that of developing systems of health care. The three critical elements required are a clear definition of what is considered health care and funded for who, how the system is financed, and evaluation. Australia has a system of universal health care and all three elements are addressed. Organised medicine, a key objector to the introduction of the current approach to universal health care in Australia, soon adapted to it, and now fiercely resists change. Medico centricity poses challenges to sustainability as innovation is inhibited. This challenge is illustrated through consideration of the implementation of the financial policy that gave Nurse Practitioners access as providers and prescribers within Medicare funded services. PMID:26552203

  6. The Impact of Human Rights on Universalizing Health Care in Vermont, USA.

    PubMed

    MacNaughton, Gillian; Haigh, Fiona; McGill, Mariah; Koutsioumpas, Konstantinos; Sprague, Courtney

    2015-01-01

    In 2010, Vermont adopted a new law embracing human rights principles as guidelines for health care reform, and in 2011, Vermont was the first state in the US to enact framework legislation to establish a universal health care system for all its residents. This article reports on the Vermont Workers' Center's human rights-based approach to universal health care and the extent to which this approach influenced decision makers. We found the following: (1) by learning about the human right to health care and sharing experiences, Vermonters were motivated to demand universal health care; (2) mobilizing Vermonters around a unified message on the right to health care made universal health care politically important; (3) using the human rights framework to assess new proposals enabled the Vermont Workers' Center to respond quickly to new policy proposals; (4) framing health care as a human right provided an alternative to the dominant economics-based discourse; and (5) while economics continues to dominate discussions among Vermont leaders, both legislative committees on health care use the human rights principles as guiding norms for health care reform. Importantly, the principles have empowered Vermonters by giving them more voice in policymaking and have been internalized by legislators as democratic principles of governance. PMID:26766864

  7. The Impact of Human Rights on Universalizing Health Care in Vermont, USA.

    PubMed

    MacNaughton, Gillian; Haigh, Fiona; McGill, Mariah; Koutsioumpas, Konstantinos; Sprague, Courtney

    2015-12-10

    In 2010, Vermont adopted a new law embracing human rights principles as guidelines for health care reform, and in 2011, Vermont was the first state in the US to enact framework legislation to establish a universal health care system for all its residents. This article reports on the Vermont Workers' Center's human rights-based approach to universal health care and the extent to which this approach influenced decision makers. We found the following: (1) by learning about the human right to health care and sharing experiences, Vermonters were motivated to demand universal health care; (2) mobilizing Vermonters around a unified message on the right to health care made universal health care politically important; (3) using the human rights framework to assess new proposals enabled the Vermont Workers' Center to respond quickly to new policy proposals; (4) framing health care as a human right provided an alternative to the dominant economics-based discourse; and (5) while economics continues to dominate discussions among Vermont leaders, both legislative committees on health care use the human rights principles as guiding norms for health care reform. Importantly, the principles have empowered Vermonters by giving them more voice in policymaking and have been internalized by legislators as democratic principles of governance.

  8. 75 FR 48235 - Rural Health Care Universal Service Support Mechanism

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-09

    ...) by filing paper copies. See Electronic Filing of Documents in Rulemaking Proceedings, 63 FR 24121... broadband infrastructure for health care purposes, incorporating lessons learned from the Pilot Program. 6... be selected for funding each year. One of the lessons learned from the Pilot Program is that...

  9. Community health workers for universal health-care coverage: from fragmentation to synergy.

    PubMed

    Tulenko, Kate; Møgedal, Sigrun; Afzal, Muhammad Mahmood; Frymus, Diana; Oshin, Adetokunbo; Pate, Muhammad; Quain, Estelle; Pinel, Arletty; Wynd, Shona; Zodpey, Sanjay

    2013-11-01

    To achieve universal health coverage, health systems will have to reach into every community, including the poorest and hardest to access. Since Alma-Ata, inconsistent support of community health workers (CHWs) and failure to integrate them into the health system have impeded full realization of their potential contribution in the context of primary health care. Scaling up and maintaining CHW programmes is fraught with a host of challenges: poor planning; multiple competing actors with little coordination; fragmented, disease-specific training; donor-driven management and funding; tenuous linkage with the health system; poor coordination, supervision and support, and under-recognition of CHWs' contribution. The current drive towards universal health coverage (UHC) presents an opportunity to enhance people's access to health services and their trust, demand and use of such services through CHWs. For their potential to be fully realized, however, CHWs will need to be better integrated into national health-care systems in terms of employment, supervision, support and career development. Partners at the global, national and district levels will have to harmonize and synchronize their engagement in CHW support while maintaining enough flexibility for programmes to innovate and respond to local needs. Strong leadership from the public sector will be needed to facilitate alignment with national policy frameworks and country-led coordination and to achieve synergies and accountability, universal coverage and sustainability. In moving towards UHC, much can be gained by investing in building CHWs' skills and supporting them as valued members of the health team. Stand-alone investments in CHWs are no shortcut to progress.

  10. Community health workers for universal health-care coverage: from fragmentation to synergy.

    PubMed

    Tulenko, Kate; Møgedal, Sigrun; Afzal, Muhammad Mahmood; Frymus, Diana; Oshin, Adetokunbo; Pate, Muhammad; Quain, Estelle; Pinel, Arletty; Wynd, Shona; Zodpey, Sanjay

    2013-11-01

    To achieve universal health coverage, health systems will have to reach into every community, including the poorest and hardest to access. Since Alma-Ata, inconsistent support of community health workers (CHWs) and failure to integrate them into the health system have impeded full realization of their potential contribution in the context of primary health care. Scaling up and maintaining CHW programmes is fraught with a host of challenges: poor planning; multiple competing actors with little coordination; fragmented, disease-specific training; donor-driven management and funding; tenuous linkage with the health system; poor coordination, supervision and support, and under-recognition of CHWs' contribution. The current drive towards universal health coverage (UHC) presents an opportunity to enhance people's access to health services and their trust, demand and use of such services through CHWs. For their potential to be fully realized, however, CHWs will need to be better integrated into national health-care systems in terms of employment, supervision, support and career development. Partners at the global, national and district levels will have to harmonize and synchronize their engagement in CHW support while maintaining enough flexibility for programmes to innovate and respond to local needs. Strong leadership from the public sector will be needed to facilitate alignment with national policy frameworks and country-led coordination and to achieve synergies and accountability, universal coverage and sustainability. In moving towards UHC, much can be gained by investing in building CHWs' skills and supporting them as valued members of the health team. Stand-alone investments in CHWs are no shortcut to progress. PMID:24347709

  11. Universal and culturally dependent issues in health care ethics.

    PubMed

    Andersson, Margareta; Mendes, Isabel Amelia Costa; Trevizan, Maria Auxiliadora

    2002-01-01

    Our beliefs about morality are culturally embedded in social, religious, and political ideologies that influence individuals and communities. Ethical issues in health and medical care are often discussed in articles and at international conferences without explicit consideration of cultural assumptions that influence our beliefs about the significance and relevance of ethical concepts and principles. Helping people in need of care or denying people this help is dependent on values related to political decisions and organisational matters as well as professional and personal interpretations of moral obligations. In this paper we argue that explicit self-critical attention to the meaning of concepts and their cultural contexts is crucial in fostering mutual respect and understanding for different cultural frames of reference. This is especially important in the rapid development of international co-operation and globalisation.

  12. Performance of private sector health care: implications for universal health coverage.

    PubMed

    Morgan, Rosemary; Ensor, Tim; Waters, Hugh

    2016-08-01

    Although the private sector is an important health-care provider in many low-income and middle-income countries, its role in progress towards universal health coverage varies. Studies of the performance of the private sector have focused on three main dimensions: quality, equity of access, and efficiency. The characteristics of patients, the structures of both the public and private sectors, and the regulation of the sector influence the types of health services delivered, and outcomes. Combined with characteristics of private providers-including their size, objectives, and technical competence-the interaction of these factors affects how the sector performs in different contexts. Changing the performance of the private sector will require interventions that target the sector as a whole, rather than individual providers alone. In particular, the performance of the private sector seems to be intrinsically linked to the structure and performance of the public sector, which suggests that deriving population benefit from the private health-care sector requires a regulatory response focused on the health-care sector as a whole. PMID:27358251

  13. The impact of Universal Health Coverage on health care consumption and risky behaviours: evidence from Thailand.

    PubMed

    Ghislandi, Simone; Manachotphong, Wanwiphang; Perego, Viviana M E

    2015-07-01

    Thailand is among the first non-OECD countries to have introduced a form of Universal Health Coverage (UHC). This policy represents a natural experiment to evaluate the effects of public health insurance on health behaviours. In this paper, we examine the impact of Thailand's UHC programme on preventive activities, unhealthy or risky behaviours and health care consumption using data from the Thai Health and Welfare Survey. We use doubly robust estimators that combine propensity scores and linear regressions to estimate differences-in-differences (DD) and differences-in-DD models. Our results offer important insights. First, UHC increases individuals' likelihood of having an annual check-up, especially among women. Regarding health care consumption, we observe that UHC increases hospital admissions by over 2% and increases outpatient visits by 13%. However, there is no evidence that UHC leads to an increase in unhealthy behaviours or a reduction of preventive efforts. In other words, we find no evidence of ex ante moral hazard. Overall, these findings suggest positive health impacts among the Thai population covered by UHC. PMID:25116081

  14. Human rights from the grassroots up: Vermont's campaign for universal health care.

    PubMed

    McGill, Mariah

    2012-06-15

    In 2008, the Vermont Workers' Center launched the "Healthcare Is a Human Right Campaign," a grassroots campaign to secure the creation of a universal health care system in Vermont. Campaign organizers used a human rights framework to mobilize thousands of voters in support of universal health care. In response to this extraordinary grassroots effort, the state legislature passed health care legislation that incorporates human rights principles into Vermont law and provides a framework for universal health care. The United States has often lagged behind other nations in recognizing economic, social, and cultural (ESC) rights, including the right to health. Nonetheless, activists have begun to incorporate ESC rights into domestic advocacy campaigns, and state and local governments are beginning to respond where the federal government has not. Vermont serves as a powerful example of how a human rights framework can inform health care policy and inspire grassroots campaigns in the United States. This three-part article documents the Vermont Workers' Center campaign and discusses the impact that human rights activity at the grassroots level may have on attitudes towards ESC rights in the United States. The first part describes the Vermont health care crisis and explains why the center adopted international human rights principles for their campaign. The article then goes on to discuss the three-year campaign and analyze the health care reform bill that the Vermont legislature passed. Finally, the article discusses the campaign's local and national impact.

  15. Human rights from the grassroots up: Vermont's campaign for universal health care.

    PubMed

    McGill, Mariah

    2012-01-01

    In 2008, the Vermont Workers' Center launched the "Healthcare Is a Human Right Campaign," a grassroots campaign to secure the creation of a universal health care system in Vermont. Campaign organizers used a human rights framework to mobilize thousands of voters in support of universal health care. In response to this extraordinary grassroots effort, the state legislature passed health care legislation that incorporates human rights principles into Vermont law and provides a framework for universal health care. The United States has often lagged behind other nations in recognizing economic, social, and cultural (ESC) rights, including the right to health. Nonetheless, activists have begun to incorporate ESC rights into domestic advocacy campaigns, and state and local governments are beginning to respond where the federal government has not. Vermont serves as a powerful example of how a human rights framework can inform health care policy and inspire grassroots campaigns in the United States. This three-part article documents the Vermont Workers' Center campaign and discusses the impact that human rights activity at the grassroots level may have on attitudes towards ESC rights in the United States. The first part describes the Vermont health care crisis and explains why the center adopted international human rights principles for their campaign. The article then goes on to discuss the three-year campaign and analyze the health care reform bill that the Vermont legislature passed. Finally, the article discusses the campaign's local and national impact. PMID:22773094

  16. Economic crisis and counter-reform of universal health care systems: Spanish case

    PubMed Central

    Fortes, Paulo Antônio de Carvalho; Carvalho, Regina Ribeiro Parizi; Louvison, Marília Cristina Prado

    2015-01-01

    The economic crisis that has been affecting Europe in the 21st century has modified social protection systems in the countries that adopted, in the 20th century, universal health care system models, such as Spain. This communication presents some recent transformations, which were caused by changes in Spanish law. Those changes relate to the access to health care services, mainly in regards to the provision of care to foreigners, to financial contribution from users for health care services, and to pharmaceutical assistance. In crisis situations, reforms are observed to follow a trend which restricts rights and deepens social inequalities. PMID:26083942

  17. Achieving Effective Universal Health Coverage And Diagonal Approaches To Care For Chronic Illnesses.

    PubMed

    Knaul, Felicia Marie; Bhadelia, Afsan; Atun, Rifat; Frenk, Julio

    2015-09-01

    Health systems in low- and middle-income countries were designed to provide episodic care for acute conditions. However, the burden of disease has shifted to be overwhelmingly dominated by chronic conditions and illnesses that require health systems to function in an integrated manner across a spectrum of disease stages from prevention to palliation. Low- and middle-income countries are also aiming to ensure health care access for all through universal health coverage. This article proposes a framework of effective universal health coverage intended to meet the challenge of chronic illnesses. It outlines strategies to strengthen health systems through a "diagonal approach." We argue that the core challenge to health systems is chronicity of illness that requires ongoing and long-term health care. The example of breast cancer within the broader context of health system reform in Mexico is presented to illustrate effective universal health coverage along the chronic disease continuum and across health systems functions. The article concludes with recommendations to strengthen health systems in order to achieve effective universal health coverage. PMID:26355053

  18. Achieving Effective Universal Health Coverage And Diagonal Approaches To Care For Chronic Illnesses.

    PubMed

    Knaul, Felicia Marie; Bhadelia, Afsan; Atun, Rifat; Frenk, Julio

    2015-09-01

    Health systems in low- and middle-income countries were designed to provide episodic care for acute conditions. However, the burden of disease has shifted to be overwhelmingly dominated by chronic conditions and illnesses that require health systems to function in an integrated manner across a spectrum of disease stages from prevention to palliation. Low- and middle-income countries are also aiming to ensure health care access for all through universal health coverage. This article proposes a framework of effective universal health coverage intended to meet the challenge of chronic illnesses. It outlines strategies to strengthen health systems through a "diagonal approach." We argue that the core challenge to health systems is chronicity of illness that requires ongoing and long-term health care. The example of breast cancer within the broader context of health system reform in Mexico is presented to illustrate effective universal health coverage along the chronic disease continuum and across health systems functions. The article concludes with recommendations to strengthen health systems in order to achieve effective universal health coverage.

  19. Primary Care Screening of Depression and Treatment Engagement in a University Health Center: A Retrospective Analysis

    ERIC Educational Resources Information Center

    Klein, Michael C.; Ciotoli, Carlo; Chung, Henry

    2011-01-01

    Objectives: This retrospective study analyzed a primary care depression screening initiative in a large urban university health center. Depression detection, treatment status, and engagement data are presented. Participants: Participants were 3,713 graduate and undergraduate students who presented consecutively for primary care services between…

  20. Will universal access to antiretroviral therapy ever be possible? The health care worker challenge.

    PubMed

    Maddison, André R; Schlech, Walter F

    2010-01-01

    The United Nations millennium development goal of providing universal access to antiretroviral therapy (ART) for patients living with HIV/AIDS by 2010 is unachievable. Currently, four million people are receiving ART, of an estimated 13.7 million who need it. A major challenge to achieving this goal is the shortage of health care workers in low-income and low-resource areas of the world. Sub-Saharan African countries have 68% of the world's burden of illness from AIDS, yet have only 3% of health care workers worldwide. The shortage of health care providers is primarily caused by a national and international 'brain drain,' poor distribution of health care workers within countries, and health care worker burnout.Even though the millennium development goal to provide universal access to ART will not be met by 2010, it is imperative to continue to build on the momentum created by these humanitarian goals. The present literature review was written with the purpose of attracting research and policy attention toward evidence from small-scale projects in sub-Saharan Africa, which have been successful at increasing access to ART. Specifically, a primary-care model of ART delivery, which focuses on decentralization of services, task shifting and community involvement will be discussed. To improve the health care worker shortage in sub-Saharan Africa, the conventional model of health care delivery must be replaced with an innovative model that utilizes doctors, nurses and community members more effectively.

  1. [What is the real cost of universal health care in Haiti?].

    PubMed

    Alfred, Jean-Patrick

    2012-01-01

    Haiti is the poorest country in the Americas and continues to suffer from glaring inequalities. 75 % of Haitians live on less than $2.50 a day [1]. Half the population has no access to formal health care because of the financial barriers created by the direct payment system at the point of delivery [2]. The earthquake of January 12, 2010 only compounded the problem, destroying 60 % of hospitals in the three affected departments. The Ministry of Public Health and Population (MSPP) policy is based on the values of equity, solidarity and social justice [3]. Compliance with these commitments requires the introduction of universal health care, which remains a distant prospect. The objective of universal health care will only be achieved when all Haitians have access to a comprehensive range of high-quality health services in a system in which the ability to pay is not a barrier to access. The real cost of the various policy options for introducing free health care is not known. There is an urgent need to focus the attention of the scientific community on this issue in order to provide better guidance to policy-makers. Cost analysis is a key step in the introduction of universal health care, particularly in Haiti, where resources are limited.

  2. Towards achievement of universal health care in India by 2020: a call to action

    PubMed Central

    Reddy, K Srinath; Patel, Vikram; Jha, Prabhat; Paul, Vinod K; Shiva Kumar, A K; Dandona, Lalit

    2016-01-01

    To sustain the positive economic trajectory that India has had during the past decade, and to honour the fundamental right of all citizens to adequate health care, the health of all Indian people has to be given the highest priority in public policy. We propose the creation of the Integrated National Health System in India through provision of universal health insurance, establishment of autonomous organisations to enable accountable and evidence-based good-quality health-care practices and development of appropriately trained human resources, the restructuring of health governance to make it coordinated and decentralised, and legislation of health entitlement for all Indian people. The key characteristics of our proposal are to strengthen the public health system as the primary provider of promotive, preventive, and curative health services in India, to improve quality and reduce the out-of-pocket expenditure on health care through a well regulated integration of the private sector within the national health-care system. Dialogue and consensus building among the stakeholders in the government, civil society, and private sector are the next steps to formalise the actions needed and to monitor their achievement. In our call to action, we propose that India must achieve health care for all by 2020. PMID:21227489

  3. College Health Surveillance Network: Epidemiology and Health Care Utilization of College Students at US 4-Year Universities

    ERIC Educational Resources Information Center

    Turner, James C.; Keller, Adrienne

    2015-01-01

    Objective: This description of the College Health Surveillance Network (CHSN) includes methodology, demography, epidemiology, and health care utilization. Participants: Twenty-three universities representing approximately 730,000 enrolled students contributed data from January 1, 2011, through May 31, 2014. Methods: Participating schools uploaded…

  4. The financial crisis and health care systems in Europe: universal care under threat? Trends in health sector reforms in Germany, the United Kingdom, and Spain.

    PubMed

    Giovanella, Lígia; Stegmüller, Klaus

    2014-11-01

    The paper analyzes trends in contemporary health sector reforms in three European countries with Bismarckian and Beveridgean models of national health systems within the context of strong financial pressure resulting from the economic crisis (2008-date), and proceeds to discuss the implications for universal care. The authors examine recent health system reforms in Spain, Germany, and the United Kingdom. Health systems are described using a matrix to compare state intervention in financing, regulation, organization, and services delivery. The reforms' impacts on universal care are examined in three dimensions: breadth of population coverage, depth of the services package, and height of coverage by public financing. Models of health protection, institutionality, stakeholder constellations, and differing positions in the European economy are factors that condition the repercussions of restrictive policies that have undermined universality to different degrees in the three dimensions specified above and have extended policies for regulated competition as well as commercialization in health care systems. PMID:25493982

  5. Income-based disparities in health care utilisation under universal health coverage in Brazil, 2002-2003.

    PubMed

    Cataife, Guido; Courtemanche, Charles

    2014-01-01

    Since Brazil's adoption of universal health care in 1988, the country's health care system has consisted of a mix of private providers and free public providers. We test whether income-based disparities in medical visits and medications remain in Brazil despite universal coverage using a nationally representative sample of over 48,000 households. Additional income is associated with less public sector utilisation and more private sector utilisation, both using simple correlations and regressions controlling for household characteristics and local area fixed effects. Importantly, the increase in private care use is greater than the drop in public care use. Also, income and unmet medical needs are negatively associated. These results suggest that access limitations remain for low-income households despite the availability of free public care.

  6. Universal Coverage without Universal Access: Institutional Barriers to Health Care among Women Sex Workers in Vancouver, Canada

    PubMed Central

    Socías, M. Eugenia; Shoveller, Jean; Bean, Chili; Nguyen, Paul; Montaner, Julio; Shannon, Kate

    2016-01-01

    Background Access to health care is a crucial determinant of health. Yet, even within settings that purport to provide universal health coverage (UHC), sex workers’ experiences reveal systematic, institutionally ingrained barriers to appropriate quality health care. The aim of this study was to assess prevalence and correlates of institutional barriers to care among sex workers in a setting with UHC. Methods Data was drawn from an ongoing community-based, prospective cohort of women sex workers in Vancouver, Canada (An Evaluation of Sex Workers’ Health Access). Multivariable logistic regression analyses, using generalized estimating equations (GEE), were employed to longitudinally investigate correlates of institutional barriers to care over a 44-month follow-up period (January 2010-August 2013). Results In total, 723 sex workers were included, contributing to 2506 observations. Over the study period, 509 (70.4%) women reported one or more institutional barriers to care. The most commonly reported institutional barriers to care were long wait times (54.6%), limited hours of operation (36.5%), and perceived disrespect by health care providers (26.1%). In multivariable GEE analyses, recent partner- (adjusted odds ratio [AOR] = 1.46, % 95% Confidence Interval [CI] 1.10–1.94), workplace- (AOR = 1.31, 95% CI 1.05–1.63), and community-level violence (AOR = 1.41, 95% CI 1.04–1.92), as well as other markers of vulnerability, such as self-identification as a gender/sexual minority (AOR = 1.32, 95% CI 1.03–1.69), a mental illness diagnosis (AOR = 1.66, 95% CI 1.34–2.06), and lack of provincial health insurance card (AOR = 3.47, 95% CI 1.59–7.57) emerged as independent correlates of institutional barriers to health services. Discussion Despite Canada’s UHC, women sex workers in Vancouver face high prevalence of institutional barriers to care, with highest burden among most marginalized women. These findings underscore the need to explore new models of care

  7. A measles outbreak at university medical settings involving health care providers.

    PubMed Central

    Sienko, D G; Friedman, C; McGee, H B; Allen, M J; Simonsen, W F; Wentworth, B B; Shope, T C; Orenstein, W A

    1987-01-01

    In 1985, a measles outbreak involved 14 students and non-student contacts in Michigan. Eight transmissions occurred at university medical facilities; five of these were likely airborne transmissions. Medical students and a medical resident were involved in the outbreak's propagation. Health care providers need to be immune to measles. Measles should be suspected in young adults with compatible illnesses; persons suspected to have measles should be placed in stringent respiratory isolation to preclude airborne transmission. PMID:3618860

  8. The accountable health care act of Massachusetts: mixed results for an experiment in universal health care coverage.

    PubMed

    Norbash, Alexander; Hindson, David; Heineke, Janelle

    2012-10-01

    The affordable health care act of Massachusetts, signed into law in 2006, resulted in 98% of Massachusetts residents' having some form of insurance coverage by 2011, the highest coverage rate for residents of any state in the nation. With a strong economy, a low unemployment rate, a robust health care delivery system, an extremely low number of undocumented immigrants, and a low baseline uninsured rate, Massachusetts was well positioned for such an effort. Ingredients included mandates, the creation of separate insurance vehicles directed to both poverty-level and non-poverty-level residents, and the reallocation of the former free care pool. The mandates included consumer mandates and employer mandates; the consumer mandate applies to all Massachusetts residents at the risk of losing personal state tax exemptions, and the employer mandate applies to all Massachusetts businesses with 10 or more employees at the risk of per employee financial penalties. The insurance vehicles were created with premiums allocated on the basis of ability to pay by income classes. Unexpected effects included escalating taxpayer health care costs, with taxpayers shouldering the burden for the newly insured, continuing escalating health care costs at a rate greater than the national average, overburdening primary caregivers as newly insured sought new primary care gatekeepers in a system with primary caregiver shortages, and deprivation of support to the safety-net hospitals as a result of siphoned commonwealth free care pool funds. This exercise demonstrates specific benefits and shortfalls of the Massachusetts health care reform experiment, given the conditions and circumstances found in Massachusetts at the time of implementation. PMID:23025869

  9. Health care agents

    MedlinePlus

    Durable power of attorney for health care; Health care proxy; End-of-life - health care agent; Life support treatment - ... Respirator - health care agent; Ventilator - health care agent; Power of attorney - health care agent; POA - health care ...

  10. Gatekeeper Training and Access to Mental Health Care at Universities and Colleges

    PubMed Central

    Lipson, Sarah Ketchen; Speer, Nicole; Brunwasser, Steven; Hahn, Elisabeth; Eisenberg, Daniel

    2014-01-01

    Purpose Gatekeeper-training programs (GKTs) are an increasingly popular approach to addressing access to mental health care in adolescent and young adult populations. This study evaluates the effectiveness of a widely used GKT program, Mental Health First Aid (MHFA), in college student populations. Methods A randomized control trial was conducted on 32 colleges and universities between 2009 and 2011. Campus residence halls were assigned to the intervention (MHFA plus preexisting trainings) or control condition (pre-existing trainings only) using matched pair randomization. The trainings were delivered to resident advisors (RAs). Outcome measures include service utilization, knowledge and attitudes about services, self-efficacy, intervention behaviors, and mental health symptoms. Data come from two sources: (1) surveys completed by the students (RAs and residents) (N=2,543), 2-3 months pre- and post-intervention; and (2) utilization records from campus mental health centers, aggregated by residence. Results The training increases trainees’ self-perceived knowledge (regression-adjusted effect size (ES)=0.38, p<0.001), self-perceived ability to identify students in distress (ES=0.19, p=0.01), and confidence to help (ES=0.17, p=0.04). There are no apparent effects, however, on utilization of mental health care in the student communities in which the trainees live. Conclusions Although GKTs are widely used to increase access to mental health care, these programs may require modifications in order to achieve their objectives. PMID:25043834

  11. College Health Surveillance Network: Epidemiology and Health Care Utilization of College Students at US 4-Year Universities

    PubMed Central

    Turner, James C.; Keller, Adrienne

    2015-01-01

    Abstract Objective: This description of the College Health Surveillance Network (CHSN) includes methodology, demography, epidemiology, and health care utilization. Participants: Twenty-three universities representing approximately 730,000 enrolled students contributed data from January 1, 2011, through May 31, 2014. Methods: Participating schools uploaded de-identified electronic health records from student health services monthly. Results: During this study, just over 800,000 individuals used the health centers, comprising 4.17 million patient encounters. Sixty percent of visits included primary care, 13% mental health, 9% vaccination, and 31% other miscellaneous services. The 5 most common specific diagnostic categories (with annual rates per 100 enrolled students) were preventive (16); respiratory (12); skin, hair, and nails; infectious non–sexually transmitted infection (5 each); and mental health (4). Utilization and epidemiologic trends are identified among subpopulations of students. Conclusions: CHSN data establish trends in utilization and epidemiologic patterns by college students and the importance of primary and behavioral health care services on campuses. PMID:26086428

  12. A university and health care organization partnership to prepare nurses for evidence-based practice.

    PubMed

    Missal, Bernita; Schafer, Beth Kaiser; Halm, Margo A; Schaffer, Marjorie A

    2010-08-01

    This article describes a partnership model between a university and health care organizations for teaching graduate nursing research from a framework of evidence-based practice. Nurses from health care organizations identified topics for graduate students to search the literature and synthesize evidence for guiding nursing practice. Nurse educators mentored graduate students in conducting critical appraisals of the literature. Students learned how to search for the evidence, summarize the existing research findings, and translate the findings into practice recommendations. Through presenting and discussing their findings with key stakeholders, students learned how nurses planned to integrate the evidence into practice. Nurses used the evidence-based results to improve their practice in the two partner hospitals. The partnership stimulated action for further inquiry into best practices.

  13. A Comprehensive Assessment of Health Care Utilization Among Homeless Adults Under a System of Universal Health Insurance

    PubMed Central

    Chambers, Catharine; Chiu, Shirley; Katic, Marko; Kiss, Alex; Redelmeier, Donald A.; Levinson, Wendy

    2013-01-01

    Objectives. We comprehensively assessed health care utilization in a population-based sample of homeless adults and matched controls under a universal health insurance system. Methods. We assessed health care utilization by 1165 homeless single men and women and adults in families and their age- and gender-matched low-income controls in Toronto, Ontario, from 2005 to 2009, using repeated-measures general linear models to calculate risk ratios and 95% confidence intervals (CIs). Results. Homeless participants had mean rates of 9.1 ambulatory care encounters (maximum = 141.1), 2.0 emergency department (ED) encounters (maximum = 104.9), 0.2 medical–surgical hospitalizations (maximum = 14.9), and 0.1 psychiatric hospitalizations per person-year (maximum = 4.8). Rate ratios for homeless participants compared with matched controls were 1.76 (95% CI = 1.58, 1.96) for ambulatory care encounters, 8.48 (95% CI = 6.72, 10.70) for ED encounters, 4.22 (95% CI = 2.99, 5.94) for medical–surgical hospitalizations, and 9.27 (95% CI = 4.42, 19.43) for psychiatric hospitalizations. Conclusions. In a universal health insurance system, homeless people had substantially higher rates of ED and hospital use than general population controls; these rates were largely driven by a subset of homeless persons with extremely high-intensity usage of health services. PMID:24148051

  14. Using economic levers to change behaviour: the case of Thailand's universal coverage health care reforms.

    PubMed

    Hughes, David; Leethongdee, Songkramchai; Osiri, Sunantha

    2010-02-01

    Thailand's universal coverage health care policy has been presented as a knowledge-based reform involving substantial pre-planning, including expert economic analysis of the financing mechanism. This paper describes the new financing system introduced from 2001 in which the Ministry of Public Health allocated monies to local Contracted Units for Primary Care (CUPs) on the basis of population. It discusses the policy intention to use capitation funding to change incentive structures and engineer a transfer of professional staff from over-served urban areas to under-served rural areas. The paper utilises qualitative data from national policy makers and health service staff in three north-eastern provinces to tell the story of the reforms. We found that over time government moved away from the original capitation funding model as the result of (a) a macro-allocation problem arising from system disturbance and professional opposition, and (b) a micro-allocation problem that emerged when local budgets were not shared equitably. In many CUPs, the hospital directors controlling resource allocation channelled funds more towards curative services than community facilities. Taken together the macro and micro problems led to the dilution of capitation funding and reduced the re-distributive effects of the reforms. This strand of policy foundered in the face of structural and institutional barriers to change.

  15. Using economic levers to change behaviour: the case of Thailand's universal coverage health care reforms.

    PubMed

    Hughes, David; Leethongdee, Songkramchai; Osiri, Sunantha

    2010-02-01

    Thailand's universal coverage health care policy has been presented as a knowledge-based reform involving substantial pre-planning, including expert economic analysis of the financing mechanism. This paper describes the new financing system introduced from 2001 in which the Ministry of Public Health allocated monies to local Contracted Units for Primary Care (CUPs) on the basis of population. It discusses the policy intention to use capitation funding to change incentive structures and engineer a transfer of professional staff from over-served urban areas to under-served rural areas. The paper utilises qualitative data from national policy makers and health service staff in three north-eastern provinces to tell the story of the reforms. We found that over time government moved away from the original capitation funding model as the result of (a) a macro-allocation problem arising from system disturbance and professional opposition, and (b) a micro-allocation problem that emerged when local budgets were not shared equitably. In many CUPs, the hospital directors controlling resource allocation channelled funds more towards curative services than community facilities. Taken together the macro and micro problems led to the dilution of capitation funding and reduced the re-distributive effects of the reforms. This strand of policy foundered in the face of structural and institutional barriers to change. PMID:19914757

  16. Universal Mental Health Screening in Pediatric Primary Care: A Systematic Review

    PubMed Central

    Wissow, Lawrence S.; Brown, Jonathan; Fothergill, Kate E.; Gadomski, Anne; Hacker, Karen; Salmon, Peter; Zelkowitz, Rachel

    2013-01-01

    Objective Universal mental health screening in pediatric primary care is recommended, but studies report slow uptake and low rates of patient follow-through after referral to specialized services. This review examined possible explanations related to the process of screening, focusing on how parents and youth are engaged and how providers evaluate and use screening results. Method Narrative synthesis following a systematic review of three databases (plus follow-up of citations, expert recommendations, and checks for multiple publications about the same study). Searching identified 1,188 titles; 186 full-text papers were reviewed. Two authors extracted data from 45 papers meeting inclusion criteria. Results Published studies report few details about how mental health screens were administered including how clinicians explain their purpose or confidentiality, or whether help was provided for language, literacy, or disability problems. Though not addressed directly in the studies reviewed, uptake and detection rates appeared to vary with means of administration. Screening framed as universal, confidential, and intended to optimize attention to patient concerns increased acceptability. Studies said little about how providers were taught to explore screen results. Screening increased referrals, but many still followed negative screens, in some cases because of parent concerns apparently not reflected by screen results but possibly stemming from screen-prompted discussions. Conclusions Little research has addressed the process of engaging patients in mental health screening in pediatric primary care or how clinicians can best use screening results. The literature does offer suggestions for better clinical practice and research that may lead to improvements in uptake and outcome. PMID:24157388

  17. Faculty of Dentistry, Kuwait University, designated as a World Health Organization Collaborating Centre for Primary Oral Health Care.

    PubMed

    Behbehani, J M

    2014-01-01

    The Faculty of Dentistry, Kuwait University, was designated as a World Health Organization (WHO) Collaborating Centre for Primary Oral Health Care (POHC) in 2011. This article aimed to describe the following: (1) the background for this nomination, (2) the WHO Collaborating Centre for POHC, its terms of reference and 5 activities, (3) the primary health care concept as it was established in Alma-Ata, (4) the oral health situation in Kuwait and in the Middle-East region and, finally, (5) how POHC policy should be implemented in Kuwait and this region. It can be concluded that, because the caries experience is very high in Kuwait and in the other countries of the Eastern Mediterranean region, good POHC programmes should be designed and implemented in this region. The Faculty of Dentistry will strengthen its research tradition and as a WHO Collaborating Centre for POHC will try to collect information and experience from POHC in this region and exchange ideas between POHC experts in this region on how these programmes could be further developed. This will happen according to the terms of reference and activity plans of the WHO Collaborating Centre for POHC approved by the WHO Global Oral Health Programme.

  18. Rural Health Care Information Access and the Use of the Internet: Opportunity for University Extension

    ERIC Educational Resources Information Center

    Das, Biswa R.; Leatherman, John C.; Bressers, Bonnie M.

    2015-01-01

    The Internet has potential for improving health information delivery and strengthening connections between rural populations and local health service providers. An exploratory case study six rural health care markets in Kansas showed that about 70% of adults use the Internet, with substantial use for accessing health information. While there are…

  19. The perceptions and readiness toward interprofessional education among female undergraduate health-care students at King Saud University.

    PubMed

    Al-Eisa, Einas; Alderaa, Asma; AlSayyad, Arwa; AlHosawi, Fatimah; AlAmoudi, Shahad; AlTaib, Sara; Mahmoud, Sara; AlGhanim, Tarfah; Alghadir, Ahmad; Anwer, Shahnawaz

    2016-04-01

    [Purpose] Interprofessional education (IPE) is an important academic approach for preparing health-care professionals to provide patient care in a collaborative team environment. This study aimed to measure the perceptions and readiness toward IPE among female undergraduate health-care students at King Saud University (KSU). [Subjects and Methods] A cross-sectional study carried out using a survey in the form of an electronic questionnaire: The Readiness for Interprofessional Learning Scale (RIPLS). The questionnaire was distributed to the students via e-mail and social media networks. [Results] The RIPLS was completed by 296 female health-care students at KSU who valued the importance of IPE. The differences between health-care disciplines in the perceptions and readiness toward IPE were statistically significant, but there were no differences between students of different years of study in their perception and readiness toward IPE. [Conclusion] Administering a course of interprofessional teamwork in the health-care curriculum is a major challenge for the clinical education community. IPE offers an opportunity to address the multi-disciplinary concept in hospitals. Our findings indicate that undergraduate health-care students have high perception and readiness toward IPE. PMID:27190442

  20. The perceptions and readiness toward interprofessional education among female undergraduate health-care students at King Saud University

    PubMed Central

    Al-Eisa, Einas; Alderaa, Asma; AlSayyad, Arwa; AlHosawi, Fatimah; AlAmoudi, Shahad; AlTaib, Sara; Mahmoud, Sara; AlGhanim, Tarfah; Alghadir, Ahmad; Anwer, Shahnawaz

    2016-01-01

    [Purpose] Interprofessional education (IPE) is an important academic approach for preparing health-care professionals to provide patient care in a collaborative team environment. This study aimed to measure the perceptions and readiness toward IPE among female undergraduate health-care students at King Saud University (KSU). [Subjects and Methods] A cross-sectional study carried out using a survey in the form of an electronic questionnaire: The Readiness for Interprofessional Learning Scale (RIPLS). The questionnaire was distributed to the students via e-mail and social media networks. [Results] The RIPLS was completed by 296 female health-care students at KSU who valued the importance of IPE. The differences between health-care disciplines in the perceptions and readiness toward IPE were statistically significant, but there were no differences between students of different years of study in their perception and readiness toward IPE. [Conclusion] Administering a course of interprofessional teamwork in the health-care curriculum is a major challenge for the clinical education community. IPE offers an opportunity to address the multi-disciplinary concept in hospitals. Our findings indicate that undergraduate health-care students have high perception and readiness toward IPE. PMID:27190442

  1. An experiment with regulated competition and individual mandates for universal health care: the new Dutch health insurance system.

    PubMed

    Rosenau, Pauline Vaillancourt; Lako, Christiaan J

    2008-12-01

    The 2006 Enthoven-inspired Dutch health insurance reform, based on regulated competition with a mandate for individuals to purchase insurance, will interest U.S. policy makers who seek universal coverage. This ongoing experiment includes guaranteed issue, price competition for a standardized basic benefits package, community rating, sliding-scale income-based subsidies for patients, and risk equalization for insurers. Our assessment of the first two years is based on Dutch Central Bank statistics, national opinion polls, consumer surveys, and qualitative interviews with policy makers. The first lesson for the United States is that the new Dutch health insurance model may not control costs. To date, consumer premiums are increasing, and insurance companies report large losses on the basic policies. Second, regulated competition is unlikely to make voters/citizens happy; public satisfaction is not high, and perceived quality is down. Third, consumers may not behave as economic models predict, remaining responsive to price incentives. Finally, policy makers should not underestimate the opposition from health care providers who define their profession as more than simply a job. If regulated competition with individual mandates performs poorly in auspicious circumstances such as the Netherlands, how will this model fare in the United States, where access, quality, and cost challenges are even greater? Might the assumptions of economic theory not apply in the health sector?

  2. Health Care Crossroads: What's the Right Solution? Putting Consumer-Driven Ideas to Work at Louisiana State University

    ERIC Educational Resources Information Center

    Benedict, Forest; Guinn, Shayla

    2006-01-01

    Idling at the crossroads and faced with ever-increasing health care costs, the Louisiana State University System chose the road less traveled and instituted a consumer-driven benefits plan. In this article, the authors provide an overview of the consumer-driven programs LSU has adopted and how these programs have helped curb costs and improve the…

  3. Universal health care for children: why every self-interested person should support it.

    PubMed

    Churchill, L R

    2001-04-01

    By comparison to other developed nations, both the health care and the health status of children in the U.S. are poor. Ethical arguments for covering all children for health services are numerous, but most of them require the suppression of self-interested motivations. Drawing from and developing the arguments of David Hume, this essay argues that self-interested motives need not work against an inclusive system, and can strengthen the case for covering children in particular. Anyone who hopes to benefit from the inter-generational transfers currently required by Social Security and Medicare policies should be an advocate for health care for all children.

  4. Alcohol Use in Students Seeking Primary Care Treatment at University Health Services

    ERIC Educational Resources Information Center

    Zakletskaia, Larissa; Wilson, Ellen; Fleming, Michael Francis

    2010-01-01

    Objective: Given the high rate of at-risk drinking in college students, the authors examined drinking behaviors and associated factors in students being seen in student health services for primary care visits from October 30, 2004, to February 15, 2007. Methods: Analyses were based on a Health Screening Survey completed by 10,234 college students…

  5. Convergent innovation for sustainable economic growth and affordable universal health care: innovating the way we innovate.

    PubMed

    Dubé, Laurette; Jha, Srivardhini; Faber, Aida; Struben, Jeroen; London, Ted; Mohapatra, Archisman; Drager, Nick; Lannon, Chris; Joshi, P K; McDermott, John

    2014-12-01

    This paper introduces convergent innovation (CI) as a form of meta-innovation-an innovation in the way we innovate. CI integrates human and economic development outcomes, through behavioral and ecosystem transformation at scale, for sustainable prosperity and affordable universal health care within a whole-of-society paradigm. To this end, CI combines technological and social innovation (including organizational, social process, financial, and institutional), with a special focus on the most underserved populations. CI takes a modular approach that convenes around roadmaps for real world change-a portfolio of loosely coupled complementary partners from the business community, civil society, and the public sector. Roadmaps serve as collaborative platforms for focused, achievable, and time-bound projects to provide scalable, sustainable, and resilient solutions to complex challenges, with benefits both to participating partners and to society. In this paper, we first briefly review the literature on technological innovation that sets the foundations of CI and motivates its feasibility. We then describe CI, its building blocks, and enabling conditions for deployment and scaling up, illustrating its operational forms through examples of existing CI-sensitive innovation. PMID:25294668

  6. Convergent innovation for sustainable economic growth and affordable universal health care: innovating the way we innovate.

    PubMed

    Dubé, Laurette; Jha, Srivardhini; Faber, Aida; Struben, Jeroen; London, Ted; Mohapatra, Archisman; Drager, Nick; Lannon, Chris; Joshi, P K; McDermott, John

    2014-12-01

    This paper introduces convergent innovation (CI) as a form of meta-innovation-an innovation in the way we innovate. CI integrates human and economic development outcomes, through behavioral and ecosystem transformation at scale, for sustainable prosperity and affordable universal health care within a whole-of-society paradigm. To this end, CI combines technological and social innovation (including organizational, social process, financial, and institutional), with a special focus on the most underserved populations. CI takes a modular approach that convenes around roadmaps for real world change-a portfolio of loosely coupled complementary partners from the business community, civil society, and the public sector. Roadmaps serve as collaborative platforms for focused, achievable, and time-bound projects to provide scalable, sustainable, and resilient solutions to complex challenges, with benefits both to participating partners and to society. In this paper, we first briefly review the literature on technological innovation that sets the foundations of CI and motivates its feasibility. We then describe CI, its building blocks, and enabling conditions for deployment and scaling up, illustrating its operational forms through examples of existing CI-sensitive innovation.

  7. Drug information pharmacists at health-care facilities, universities, and pharmaceutical companies.

    PubMed

    Gong, S D; Millares, M; VanRiper, K B

    1992-05-01

    A national survey was conducted to provide a profile of drug information pharmacists. Questionnaires were mailed to 436 drug information pharmacists whose names were obtained from directors of drug information centers (DICs) at health-care facilities, universities, and pharmaceutical companies. The net response rate was 64% (278 usable replies). Most respondents were 30 to 39 years of age and had practiced in drug information for four years or less. There were equal numbers of male and female respondents. More than half had a doctor of pharmacy (Pharm.D.) degree, and about half had completed a postgraduate residency or fellowship. Respondents with a Pharm.D. degree or postgraduate training reported a more favorable professional outcome, including position, income, and job satisfaction. Respondents reported a high level of professional involvement, including faculty appointment, publishing, and professional membership. Common reasons cited for choosing a career in drug information were an opportunity to continually learn, job satisfaction, and regular work hours. More than 70% of respondents were either very satisfied or extremely satisfied with their current job position. The most frequently reported income range was $40,000-44,999; distribution of income differed significantly among geographic regions. Drug information pharmacists report a high level of job satisfaction and involvement in professional activities; they often have completed advanced pharmacy education or postgraduate training.

  8. The University of Toronto “Sioux Lookout Project”—a model of health care delivery

    PubMed Central

    Bain, H. W.; Goldthorpe, Gary

    1972-01-01

    The University of Toronto's Sioux Lookout Project is described in detail. The scheme is a collaborative one in which universities, governments, doctors, dentists, nurses, communities and consumers participate. After three years of operation it appears to be a feasible model for delivery of health care in a remote area under extremely adverse conditions. It is suggested that a modified version would be applicable to other underdoctored areas. The individual roles of the various participants are outlined. Universities, by giving some preference in their postgraduate training programs to doctors who have spent a year in practice, especially in remote areas, would make a major step towards correcting the maldistribution of doctors. PMID:5057009

  9. Universal health care coverage in the United States: is it "slip slidin' away"?

    PubMed

    Doherty, Robert B

    2011-01-18

    With passage of the Affordable Care Act, affordable health insurance for all Americans is in sight, yet politics could cause it to slip away. A resurgent Republican Party will mount a sustained challenge at the federal and state levels, but the new Congress will not bring about the Affordable Care Act's repeal. More likely, the law's effectiveness could be undermined by congressional restrictions on its implementation, underfunding of programs to improve public health and train more primary care physicians, and resistance by many states to its mandates. Congress could instead seek a bipartisan accord on improving the law, such as by giving the states more options, but this is unlikely in the current polarized environment. This debate is occurring even as the United States faces an unprecedented crisis in access to health insurance coverage, affecting nearly every demographic group, yet the uninsured have largely become an afterthought. Medical professionalism requires a commitment to improving access to care, and physicians could play a crucial role in informing lawmakers that providing all Americans with affordable health care coverage is a moral and medical imperative to prevent needless suffering and death, and must not be allowed to slip away.

  10. Home Health Care

    MedlinePlus

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

  11. Achieving Universal Health Coverage by Focusing on Primary Care in Japan: Lessons for Low- and Middle-Income Countries

    PubMed Central

    Ikegami, Naoki

    2016-01-01

    When the Japanese government adopted Western medicine in the late nineteenth century, it left intact the infrastructure of primary care by giving licenses to the existing practitioners and by initially setting the hurdle for entry into medical school low. Public financing of hospitals was kept minimal so that almost all of their revenue came from patient charges. When social health insurance (SHI) was introduced in 1927, benefits were focused on primary care services delivered by physicians in clinics, and not on hospital services. This was reflected in the development and subsequent revisions of the fee schedule. The policy decisions which have helped to retain primary care services might provide lessons for achieving universal health coverage in low- and middle-income countries (LMICs). PMID:27239877

  12. Achieving Universal Health Coverage by Focusing on Primary Care in Japan: Lessons for Low- and Middle-Income Countries.

    PubMed

    Ikegami, Naoki

    2016-01-01

    When the Japanese government adopted Western medicine in the late nineteenth century, it left intact the infrastructure of primary care by giving licenses to the existing practitioners and by initially setting the hurdle for entry into medical school low. Public financing of hospitals was kept minimal so that almost all of their revenue came from patient charges. When social health insurance (SHI) was introduced in 1927, benefits were focused on primary care services delivered by physicians in clinics, and not on hospital services. This was reflected in the development and subsequent revisions of the fee schedule. The policy decisions which have helped to retain primary care services might provide lessons for achieving universal health coverage in low- and middle-income countries (LMICs). PMID:27239877

  13. Hindering Health? The Influence of Health Service Organization on the Delivery of Care for Eating Disorders in a University Setting.

    ERIC Educational Resources Information Center

    McKinney, Kristen J.

    A case study is presented which seeks to understand the provision of health services to university students, specifically in situations that require an integration of treatment. The relationship of the effects of traditional bureaucratic structures on quality of services provided for students is explored by looking at the relationship between…

  14. The impact of university provided nurse electronic medical record training on health care organizations: an exploratory simulation approach.

    PubMed

    Abrahamson, Kathleen; Anderson, James G; Borycki, Elizabeth M; Kushniruk, Andre W; Malovec, Shannon; Espejo, Angela; Anderson, Marilyn

    2015-01-01

    Training providers appropriately, particularly early in their caregiving careers, is an important aspect of electronic medical record (EMR) implementation. Considerable time and resources are needed to bring the newly hired providers 'up to speed' with the actual use practices of the organization. Similarly, universities lose valuable clinical training hours when students are required to spend those hours learning organization-specific EMR systems in order to participate in care during clinical rotations. Although there are multiple real-world barriers to university/health care organization training partnerships, the investment these entities share in training care providers, specifically nurses, to use and understand EMR technology encourages a question: What would be the cumulative effect of integrating a mutually agreed upon EMR system training program in to nursing classroom training on downstream hospital costs in terms of hours of direct caregiving lost, and benefits in terms of number of overall EMR trained nurses hired? In order to inform the development of a large scale study, we employed a dynamic systems modeling approach to simulate the theoretical relationships between key model variables and determine the possible effect of integrating EMR training into nursing classrooms on hospital outcomes. The analysis indicated that integrating EMR training into the nursing classroom curriculum results in more available time for nurse bedside care. Also, the simulation suggests that efficiency of clinical training can be potentially improved by centralizing EMR training within the nursing curriculum.

  15. [Economics, health, and health care].

    PubMed

    Lema Devesa, M C

    2003-12-01

    Since the seventies the growing of sanitary expenses has become the first worry for our authorities and the seeking of solutions has brought the presence of economists to solve the health problems. Therefore the health economy studies the production and distribution of health and sanitary attention in two senses: one like a discipline (usually located in universities and publications in the area of economy) and another one to the resolution of health problems and care, favouring interdisciplinary cooperation and its application to management. When speaking about the relation ship between economy and health, it is necessary to consider three areas: first that of basic concepts in economy: demand, offer, elasticity, market faults and state intervention in economy. The second aspect goes to the specific characteristics of sanitary care from economic perspective and the application of economic concepts to health field. And finally the third one is the field of the most important techniques of economic evaluation for sanitary programs and the analysis of sanitary systems reforms in some countries.

  16. Respiratory Home Health Care

    MedlinePlus

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

  17. Planning Campus Health Care Services 2.

    ERIC Educational Resources Information Center

    Douglas, Bruce L.

    1975-01-01

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

  18. Defining competencies for education in health care value: recommendations from the University of California, San Francisco Center for Healthcare Value Training Initiative.

    PubMed

    Moriates, Christopher; Dohan, Daniel; Spetz, Joanne; Sawaya, George F

    2015-04-01

    Leaders in medical education have increasingly called for the incorporation of cost awareness and health care value into health professions curricula. Emerging efforts have thus far focused on physicians, but foundational competencies need to be defined related to health care value that span all health professions and stages of training. The University of California, San Francisco (UCSF) Center for Healthcare Value launched an initiative in 2012 that engaged a group of educators from all four health professions schools at UCSF: Dentistry, Medicine, Nursing, and Pharmacy. This group created and agreed on a multidisciplinary set of comprehensive competencies related to health care value. The term "competency" was used to describe components within the larger domain of providing high-value care. The group then classified the competencies as beginner, proficient, or expert level through an iterative process and group consensus. The group articulated 21 competencies. The beginner competencies include basic principles of health policy, health care delivery, health costs, and insurance. Proficient competencies include real-world applications of concepts to clinical situations, primarily related to the care of individual patients. The expert competencies focus primarily on systems-level design, advocacy, mentorship, and policy. These competencies aim to identify a standard that may help inform the development of curricula across health professions training. These competencies could be translated into the learning objectives and evaluation methods of resources to teach health care value, and they should be considered in educational settings for health care professionals at all levels of training and across a variety of specialties.

  19. Is health care racist?

    PubMed

    Funkhouser, S W; Moser, D K

    1990-01-01

    Many health care inequalities seem to be racially based. Racism nad racial conflict in American can be explained in the context of three historical time periods and the prevailing economic systems of those times. The problem of access to basic health care for the black underclass is enormous. Traditional solutions of health education, health promotion, and low-cost health care have done very little to change the outcomes of increased morbidity and mortality. Health care professionals need to confront the real problem of inadequate life chances and limited economic resources for the underclass through research and the restructuring of our health care delivery system.

  20. Universal health coverage in emerging economies: findings on health care utilization by older adults in China, Ghana, India, Mexico, the Russian Federation, and South Africa

    PubMed Central

    Peltzer, Karl; Williams, Jennifer Stewart; Kowal, Paul; Negin, Joel; Snodgrass, James Josh; Yawson, Alfred; Minicuci, Nadia; Thiele, Liz; Phaswana-Mafuya, Nancy; Biritwum, Richard Berko; Naidoo, Nirmala; Chatterji, Somnath

    2014-01-01

    Background and objective The achievement of universal health coverage (UHC) in emerging economies is a high priority within the global community. This timely study uses standardized national population data collected from adults aged 50 and older in China, Ghana, India, Mexico, the Russian Federation, and South Africa. The objective is to describe health care utilization and measure association between inpatient and outpatient service use and patient characteristics in these six low- and middle-income countries. Design Secondary analysis of data from the World Health Organization’s Study on global AGEing and adult health Wave 1 was undertaken. Country samples are compared by socio-demographic characteristics, type of health care, and reasons for use. Logistic regressions describe association between socio-demographic and health factors and inpatient and outpatient service use. Results In the pooled multi-country sample of over 26,000 adults aged 50-plus, who reported getting health care the last time it was needed, almost 80% of men and women received inpatient or outpatient care, or both. Roughly 30% of men and women in the Russian Federation used inpatient services in the previous 3 years and 90% of men and women in India used outpatient services in the past year. In China, public hospitals were the most frequently used service type for 52% of men and 51% of women. Multivariable regression showed that, compared with men, women were less likely to use inpatient services and more likely to use outpatient services. Respondents with two or more chronic conditions were almost three times as likely to use inpatient services and twice as likely to use outpatient services compared with respondents with no reported chronic conditions. Conclusions This study provides a basis for further investigation of country-specific responses to UHC. PMID:25363363

  1. Knowledge about complementary, alternative and integrative medicine (CAM) among registered health care providers in Swedish surgical care: a national survey among university hospitals

    PubMed Central

    2012-01-01

    Background Previous studies show an increased interest and usage of complementary and alternative medicine (CAM) in the general population and among health care workers both internationally and nationally. CAM usage is also reported to be common among surgical patients. Earlier international studies have reported that a large amount of surgical patients use it prior to and after surgery. Recent publications indicate a weak knowledge about CAM among health care workers. However the current situation in Sweden is unknown. The aim of this study was therefore to explore perceived knowledge about CAM among registered healthcare professions in surgical departments at Swedish university hospitals. Method A questionnaire was distributed to 1757 registered physicians, nurses and physiotherapists in surgical wards at the seven university hospitals in Sweden from spring 2010 to spring 2011. The questionnaire included classification of 21 therapies into conventional, complementary, alternative and integrative, and whether patients were recommended these therapies. Questions concerning knowledge, research, and patient communication about CAM were also included. Result A total of 737 (42.0%) questionnaires were returned. Therapies classified as complementary; were massage, manual therapies, yoga and acupuncture. Alternative therapies; were herbal medicine, dietary supplements, homeopathy and healing. Classification to integrative therapy was low, and unfamiliar therapies were Bowen therapy, iridology and Rosen method. Therapies recommended by > 40% off the participants were massage and acupuncture. Knowledge and research about CAM was valued as minor or none at all by 95.7% respectively 99.2%. Importance of possessing knowledge about it was valued as important by 80.9%. It was believed by 61.2% that more research funding should be addressed to CAM research, 72.8% were interested in reading CAM-research results, and 27.8% would consider taking part in such research. Half of the

  2. [Perceived quality of care among health professionals at the University Hospital of Oran (EHUO)].

    PubMed

    Chougrani, Saada; Ali, Abdessamed Dali

    2011-01-01

    Created in 2003 as a profit organization, the University Hospital of Oran (Etablissement Hospitalier Universitaire d'Oran-EHUO) is currently in the process of developing a 'Quality' project aimed at assessing staff perception of quality. 20% of staff members representing the various professional categories working at EHUO (medical, nursing and administrative staff) were selected using quota sampling. Face-to-face interviews were conducted in March 2009 with 117 staff members from 25 medical and 5 non-medical units. The average length of service among medical and administrative staff was higher than the average length of service of nursing staff (8.3 vs 5.8 years; p = 0.9 Kruskal-Wallis H test). In discussing the question of quality, it was found that all categories of staff emphasized their specific professional experiences, standards and frames of reference. All staff members showed a greater preference for the various dimensions of the "are process" (mostly physicians and nurses rather than administrative staff (p=0.01)) than for the "structure" or "organization" components of the quality plan. In this sense, there appears to be a greater focus on technical rather than management aspects, as shown by the fact that two thirds of staff members were ill-informed about the hospital's quality assurance program (quality management, blood safety, complaints management...). While they appeared to be fully supportive of audit and certification procedures, 50% of health staff members were reluctant to support patient involvement in the management of the 'Quality' project. Finally, there appears to be a lack of awareness of quality concepts, standards and methodologies among hospital staff. This study suggests that there is a need for greater awareness, further training, and greater monitoring of practices based on concrete actions. PMID:22365045

  3. Vacation health care

    MedlinePlus

    ... page: //medlineplus.gov/ency/article/001937.htm Vacation health care To use the sharing features on this page, ... and help you avoid problems. Talk to your health care provider or visit a travel clinic 4 to ...

  4. American Health Care Association

    MedlinePlus

    ... Governors, Directors at Annual Convention in Nashville American Health Care Association Files Court Challenge to Arbitration Rule AHCA ... this Page | Privacy Policy | Terms and Conditions © American Health Care Association Google Plus .

  5. National Health Care Survey

    Cancer.gov

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

  6. Creating an integrated clinical enterprise at the University of Kentucky: the emergence of UK HealthCare.

    PubMed

    Karpf, Michael; Perman, Jay; Lofgren, Richard; Melgar, Sergio; Butler, Frank; Day, Zed; Clark, Murray; Claypool, Joseph O; Gilbert, Peter; Gombeski, William; Higdon, Courtney M

    2007-12-01

    If the medical system in the United States is to change, as has been recommended, academic medical centers must, in fact, lead this change process. To prepare for the future, the University of Kentucky decided to move aggressively toward developing an integrated clinical enterprise branded as UK HealthCare, where leadership of the various components of the academic medical center make strategic and financial decisions together to achieve common organizational goals. The authors discuss senior leadership's development of the vision for the enterprise and the governance structure that was established to engage board members and faculty of the institution. They examine the rigorous strategic, facilities, financial, and academic planning that ensued, and the early successes achieved. The authors introduce some of the lessons learned by the organization during the emergence of UK HealthCare and describe the corporate structure and senior management team that was established to support the quick and efficient implementation of the planning strategies. It was this corporate structure and senior management team which has proven to be an effective agent of change and a key to the successful development of a truly integrated clinical enterprise. PMID:18046120

  7. Factors influencing patients seeking oral health care in the oncology dental support clinic at an urban university dental school setting.

    PubMed

    Corrigan, Dale M; Walker, Mary P; Liu, Ying; Mitchell, Tanya Villalpando

    2014-01-01

    The purpose of this study was to identify predictors and/or factors associated with medically compromised patients seeking dental care in the oncology dental support clinic (ODSC) at the University of Missouri-Kansas City (UMKC) School of Dentistry. An 18-item survey was mailed to 2,541 patients who were new patients to the clinic from 2006 to 2011. The response rate was approximately 18% (n = 450). Analyses included descriptive statistics of percentages/frequencies as well as predictors based on correlations. Fifty percent of participants, 100 females and 119 males, identified their primary medical diagnosis as cancer. Total household income (p < .001) and the importance of receiving dental care (p < .001) were significant factors in relation to self-rated dental health. Perceived overall health (p < .001) also had a significant association with cancer status and the need for organ transplants. This study provided the ODSC at UMKC and other specialty clinics with vital information that can contribute to future planning efforts.

  8. Retrospective Review of Nurse-Midwifery Care at a Large University Health System.

    PubMed

    Roosevelt, Lee; Motino Bailey, Joanne; Kane Low, Lisa

    2015-01-01

    The purpose of the study is to characterize practice trends, outcomes, and changes over time of a full-scope midwifery service over the past 30 years from 1983 to 2013. The types of clients served and the evolution of the services provided and resulting outcomes are described as an exemplar of the changing nature of providing midwifery services in a tertiary care hospital setting. The overall data reveal that despite small increases in intervention practices, such as epidurals, inductions, and cesarean births, midwives have a commitment to providing safe, evidenced-based, woman-centered care within a collaborative practice model at a tertiary care center. The role of midwives as leaders in supporting physiologic birth in this setting and encouraging opportunities for interprofessional education and collaborative is demonstrated. PMID:26505846

  9. Health Care Indicators

    PubMed Central

    Donham, Carolyn S.; Maple, Brenda T.; Sivarajan, Lekha

    1993-01-01

    This regular feature of the journal includes a discussion of each of the following four topics community hospital statistics; employment, hours, and earnings in the private health sector; health care prices; and national economic indicators. These statistics are valuable in their own right for understanding the relationship between the health care sector and the overall economy. In addition, they allow us to anticipate the direction and magnitude of health care cost changes prior to the availability of more comprehensive data. PMID:25372708

  10. Health care in China.

    PubMed

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

    1984-05-01

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

  11. 47 CFR 54.633 - Health care provider contribution.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 47 Telecommunication 3 2014-10-01 2014-10-01 false Health care provider contribution. 54.633... (CONTINUED) UNIVERSAL SERVICE Universal Service Support for Health Care Providers Healthcare Connect Fund § 54.633 Health care provider contribution. (a) Health care provider contribution. All health...

  12. 47 CFR 54.633 - Health care provider contribution.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 47 Telecommunication 3 2013-10-01 2013-10-01 false Health care provider contribution. 54.633... (CONTINUED) UNIVERSAL SERVICE Universal Service Support for Health Care Providers Healthcare Connect Fund § 54.633 Health care provider contribution. (a) Health care provider contribution. All health...

  13. Defining competencies for education in health care value: recommendations from the University of California, San Francisco Center for Healthcare Value Training Initiative.

    PubMed

    Moriates, Christopher; Dohan, Daniel; Spetz, Joanne; Sawaya, George F

    2015-04-01

    Leaders in medical education have increasingly called for the incorporation of cost awareness and health care value into health professions curricula. Emerging efforts have thus far focused on physicians, but foundational competencies need to be defined related to health care value that span all health professions and stages of training. The University of California, San Francisco (UCSF) Center for Healthcare Value launched an initiative in 2012 that engaged a group of educators from all four health professions schools at UCSF: Dentistry, Medicine, Nursing, and Pharmacy. This group created and agreed on a multidisciplinary set of comprehensive competencies related to health care value. The term "competency" was used to describe components within the larger domain of providing high-value care. The group then classified the competencies as beginner, proficient, or expert level through an iterative process and group consensus. The group articulated 21 competencies. The beginner competencies include basic principles of health policy, health care delivery, health costs, and insurance. Proficient competencies include real-world applications of concepts to clinical situations, primarily related to the care of individual patients. The expert competencies focus primarily on systems-level design, advocacy, mentorship, and policy. These competencies aim to identify a standard that may help inform the development of curricula across health professions training. These competencies could be translated into the learning objectives and evaluation methods of resources to teach health care value, and they should be considered in educational settings for health care professionals at all levels of training and across a variety of specialties. PMID:25354077

  14. Assessment of knowledge, attitude and practice of hand washing among health care workers in Ain Shams University hospitals in Cairo.

    PubMed

    Abd Elaziz, K M; Bakr, I M

    2009-03-01

    Most nosocomial infections are thought to be transmitted by the hands of health care workers. The aim of this work was to assess the knowledge, attitude and practice of hand washing among health care workers (HCW) in Ain-Shams University hospitals and to investigate the presence of the necessary facilities and supplies required for hand washing (HW) in ten wards. A cross-sectional descriptive and observational study was conducted for six months from June till November 2006. Observation of the HCW for hand washing practice was done at any opportunity of contact with the patients in the different wards by members of the infection control team. Knowledge & attitude of HCW towards hand hygiene was done through self-administered questionnaire to HCW in 10 different departments. The total opportunities observed were 2189 opportunities. Doctors showed a significantly higher compliance (37.5%) than other groups of HCW (P = 0.000), however only 11.6% of the opportunities observed for doctors were done appropriately. The most common type of HW practiced among HCW was the routine HW (64.2%) and the least was the antiseptic HW (3.9%). Having a short contact time and improper drying (23.2%) were the most common errors that lead to inappropriate HW. Most of the wards had available sinks (80%) but none of them had available paper towels. The mean knowledge score was higher in nurses compared to doctors (42.6 +/- 1.7 versus 39.1 +/- 10.5). Most of the nurses (97.3%) believe that administrative orders and continuous observation can improve hand washing practices. Implementation of multifaceted interventional behavioral hand hygiene program with continuous monitoring and performance feedback, increasing the supplies necessary for HW and institutional support are important for improving the compliance of hand hygiene guidelines. PMID:19771756

  15. Home health care

    MedlinePlus

    ... Skilled nursing - home care; Physical therapy - at home; Occupational therapy - at home; Discharge - home health care ... medicines that you may be taking. Physical and occupational therapists can make sure your home is set ...

  16. Health care in Brazil.

    PubMed Central

    Haines, A

    1993-01-01

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

  17. HealthCare.gov

    MedlinePlus

    ... ask for more info Site Search Search Need health insurance? See if you qualify You can enroll in ... September 01 Start the school year strong with health insurance See More Footer Resources About the Affordable Care ...

  18. 47 CFR 54.601 - Health care provider eligibility.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 47 Telecommunication 3 2014-10-01 2014-10-01 false Health care provider eligibility. 54.601... (CONTINUED) UNIVERSAL SERVICE Universal Service Support for Health Care Providers Defined Terms and Eligibility § 54.601 Health care provider eligibility. (a) Eligible health care providers. (1) Only an...

  19. 47 CFR 54.601 - Health care provider eligibility.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 47 Telecommunication 3 2013-10-01 2013-10-01 false Health care provider eligibility. 54.601... (CONTINUED) UNIVERSAL SERVICE Universal Service Support for Health Care Providers Defined Terms and Eligibility § 54.601 Health care provider eligibility. (a) Eligible health care providers. (1) Only an...

  20. Attitudes toward the Elderly among Students of Health Care Related Studies at the University of Salamanca, Spain

    ERIC Educational Resources Information Center

    Bernardini Zambrini, Diego A.; Moraru, Manuela; Hanna, Minna; Kalache, Alex; Macias Nunez, Juan F.

    2008-01-01

    Introduction: This study uses a cross-sectional approach in terms of evaluating attitudes toward the elderly among health sciences students. The aim of this study was to measure attitudes among final year pregraduate students of seven health care careers. Method: A cross-sectional study was conducted with final year students of medicine (M),…

  1. Rebuilding TRUST: A Community, Multi-Agency, State, and University Partnership to Improve Behavioral Health Care for American Indian Youth, their Families, and Communities

    PubMed Central

    Goodkind, Jessica R.; Ross-Toledo, Kimberly; John, Susie; Lee Hall, Janie; Ross, Lucille; Freeland, Lance; Colleta, Ernest; Becenti-Fundark, Twila

    2014-01-01

    American Indian/Alaska Native youth represent the strength and survival of many Nations and Tribes. However, the aftermath of colonialism has resulted in numerous health disparities and challenges for Native youth, including the highest rate of suicide in the United States. With the aims of elucidating the causes of behavioral health disparities, eliminating them, and improving behavioral health care for Native youth, a partnership of providers, community members, and university faculty and staff completed a comprehensive literature review; conducted advisory meetings with 71 American Indian youth, parents, and elders; surveyed 25 service providers; and engaged in ongoing consultation with traditional practitioners. Results from the multiple sources were synthesized and are reported with 20 policy, provider, and research recommendations that recognize the importance of moving beyond exclusive reliance on western models of care and that seek to foster transformation of individuals, families, communities, behavioral health service systems of care, and social structures. PMID:25076801

  2. Prevalence and risk factors for Staphylococcus aureus in health care workers at a university hospital of Recife-PE.

    PubMed

    Silva, Eduardo Caetano Brandão Ferreira da; Antas, Maria das Graças C; Monteiro B Neto, Armando; Rabelo, Marcelle Aquino; Melo, Fábio Lopes de; Maciel, Maria Amélia Vieira

    2008-12-01

    Staphylococcus aureus is the main human pathogen that colonizes individuals in general population. The objective of the study was evaluate the epidemiological and sensitivity profile of S. aureus lineage, isolated in health care workers (HCW) of a University Hospital in Pernambuco state, Brazil. Biological samples of hands and nasal cavities were sown in agar sheep blood. Colonies under suspicion of being S. aureus were identified using Gram staining, catalase test and coagulase, mannitol-salty agar fermentation and DNAse agar. The resistance to mupirocin was analyzed through the Kirby Bauer technique. In relation to methicillin and vancomycin the determination was by the minimum inhibitory concentration method (E-test). From the 202 HCW evaluated, 52 were colonized by S. aureus (25,7%). The factors associated to the colonization by S. aureus were: age-group, professional category, use of individual protection equipments (frequency and numbers). All S. aureus isolate lineages were sensitive to mupirocin and vancomycin, and three of them were identified as methicillin-resistant. The prevalence of MSSA and MRSA among HCW was considered low and was below the results described in the literature. The isolate S. aureus lineages have shown low resistance profile.

  3. Coming Together To Cut Health Care Costs.

    ERIC Educational Resources Information Center

    Heron, W. David; Donatelli, Ben

    2003-01-01

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

  4. Spanish for Health Care Personnel

    ERIC Educational Resources Information Center

    Palmer, Joe L.; Shawl, James R.

    1978-01-01

    Because a degree of competency in Spanish has become recognized as an essential skill for persons involved in health care activities, Northern Illinois University has developed a Spanish course tailored to the background and abilities of pre-service and in-service medical personnel. (Author/NCR)

  5. Health care marketing management.

    PubMed

    Cooper, P D

    1979-01-01

    Health Care Marketing Management is the process of understanding the needs and the wats of a target market. Its purpose is to provide a viewpoint from which to integrate the analysis, planning, implementation (or organization) and control of the health care delivery system.

  6. Health care-associated infections surveillance in an intensive care unit of a university hospital in China, 2010-2014: Findings of International Nosocomial Infection Control Consortium.

    PubMed

    Peng, Hui; Tao, Xiu-Bin; Li, Yan; Hu, Qiang; Qian, Li-Hua; Wu, Qun; Ruan, Jing-Jing; Cai, Dong-Zhen

    2015-12-01

    Using a standardized methodology by the National Nosocomial Infection Surveillance System, a continuous health care-associated infections (HAIs) surveillance was conducted in our mixed intensive care unit at a Chinese teaching hospital. During the study period (2010-2014), 4,013 patients were hospitalized for 32,924 bed days and acquired 427 HAIs (482 HAI events), with an overall rate of 10.64% and 14.640 HAIs per 1,000 bed days. Ventilator-associated pneumonia was the most common device-associated health care-acquired infection, with an incidence rate of 19.561 per 1,000 mechanical ventilator days.

  7. Health care utilisation in India.

    PubMed

    Duggal, R

    1994-02-01

    India has a plurality of health care systems as well as different systems of medicine. The government and local administrations provide public health care in hospitals and clinics. Public health care in rural areas is concentrated on prevention and promotion services to the detriment of curative services. The rural primary health centers are woefully underutilized because they fail to provide their clients with the desired amount of attention and medication and because they have inconvenient locations and long waiting times. Public hospitals provide 60% of all hospitalizations, while the private sector provides 75% of all routine care. The private sector is composed of an equal number of qualified doctors and unqualified practitioners, with a greater ratio of unqualified to qualified existing in less developed states. In rural areas, qualified doctors are clustered in areas where government services are available. With a population barely able to meet its nutritional needs, India needs universalization of health care provision to assure equity in health care access and availability instead of a large number of doctors who are profiting from the sicknesses of the poor. PMID:12288588

  8. Universal tetanus, diphtheria, acellular pertussis (Tdap) vaccination of adults: What Canadian health care providers know and need to know.

    PubMed

    MacDougall, D; Halperin, B A; MacKinnon-Cameron, D; Li, L; McNeil, S A; Langley, J M; Halperin, S A

    2015-01-01

    The tetanus, diphtheria, and acellular pertussis vaccine (Tdap) is recommended for all adults in both Canada and the United States. There are few data on the proportion of Canadian adults vaccinated with Tdap; however, anecdotal reports indicate that uptake is low. This study aimed to explore the knowledge, attitudes, beliefs, and behaviors of Canadian health care providers (HCPs) in an attempt to identify potential barriers and facilitators to Tdap uptake. HCPs were surveyed and a geographic and practice representative sample was obtained (N =1,167). In addition, 8 focus groups and 4 interviews were conducted nationwide. Results from the survey indicate that less than half (47.5%) of all respondents reported being immunized with Tdap themselves, while 58.5% routinely offer Tdap to their adult patients. Knowledge scores were relatively low (63.2% correct answers). The best predictor of following the adult Tdap immunization guidelines was awareness of and agreement with those recommendations. Respondents who were aware of the recommendations were more likely to think that Tdap is safe and effective, that their patients are at significant risk of getting pertussis, and to feel that they have sufficient information (p < 0.0001 for each statement). Focus group data supported the survey results and indicated that there are substantial gaps in knowledge of pertussis and Tdap among Canadian HCPs. Lack of public knowledge about adult immunization, lack of immunization registries, a costing differential between Td and Tdap, workload required to deliver the vaccine, and vaccine hesitancy were identified as barriers to compliance with the national recommendations for universal adult immunization, and suggestions were provided to better translate recommendations to front-line practitioners.

  9. Primary health care models

    PubMed Central

    Brown, Judith Belle; French, Reta; McCulloch, Amy; Clendinning, Eric

    2012-01-01

    Abstract Objective To explore the knowledge and perceptions of fourth-year medical students regarding the new models of primary health care (PHC) and to ascertain whether that knowledge influenced their decisions to pursue careers in family medicine. Design Qualitative study using semistructured interviews. Setting The Schulich School of Medicine and Dentistry at The University of Western Ontario in London. Participants Fourth-year medical students graduating in 2009 who indicated family medicine as a possible career choice on their Canadian Residency Matching Service applications. Methods Eleven semistructured interviews were conducted between January and April of 2009. Data were analyzed using an iterative and interpretive approach. The analysis strategy of immersion and crystallization assisted in synthesizing the data to provide a comprehensive view of key themes and overarching concepts. Main findings Four key themes were identified: the level of students’ knowledge regarding PHC models varied; the knowledge was generally obtained from practical experiences rather than classroom learning; students could identify both advantages and disadvantages of working within the new PHC models; and although students regarded the new PHC models positively, these models did not influence their decisions to pursue careers in family medicine. Conclusion Knowledge of the new PHC models varies among fourth-year students, indicating a need for improved education strategies in the years before clinical training. Being able to identify advantages and disadvantages of the PHC models was not enough to influence participants’ choice of specialty. Educators and health care policy makers need to determine the best methods to promote and facilitate knowledge transfer about these PHC models. PMID:22518904

  10. Introducing a Primary Health Care nurse training course at the University of Limpopo: Experiences and views of trainees

    PubMed Central

    Mamogobo, Pamela M.; Marincowitz, Gert JO.; Decock (In memoriam), Rika; Depoorter, AnneMarie

    2011-01-01

    Abstract Background A new post-basic Primary Health Care (PHC) nurse training was piloted at the University of Limpopo in rural South Africa in order to reinforce PHC services and to address the backlog of trained PHC nurses. The training comprised residential and decentralised training modules based on the principles of problem based learning and community based education, and a patient-centred care approach developed in the field of family medicine was applied for acquiring consultation skills. Clinical reasoning was improved through on-site supervision by individual preceptors. Objective The aim of the study was to describe the satisfaction, experiences and views of trainees in the first year of implementing the new PHC nurse training programme. Method The study had a descriptive, exploratory and cross-sectional design, and used quantitative and qualitative methods for data collection that included a semi-structured survey questionnaire and focus group discussion. A purposive sample of trainees enrolled in the pilot programme (n = 15) was recruited for this study. Results were analysed quantitatively for the survey questionnaire and content analysis was used for qualitative data. Results Results revealed trainee satisfaction with the quality of community based visits and classroom lectures and dissatisfaction with on-site supervision and training material. Qualitative findings indicated a need to improve information and communication of supervisors and preceptors, and to provide more training material. Factors related to the work environment were identified as barriers to implement learning, but the use of tools developed in family medicine curricula was perceived as beneficial. Lessons learnt included the need for strong programme coordination and stakeholder commitment, as well as the need to develop a competence framework for PHC nursing. Conclusion The implementation of a pilot programme for PHC nurse training had the outcomes of trainee satisfaction with

  11. Continuing Trends in Health and Health Care

    ERIC Educational Resources Information Center

    Wilson, Ronald W.; And Others

    1978-01-01

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

  12. Preventive health care

    MedlinePlus

    ... high cholesterol and obesity Discuss alcohol use and safe drinking and tips on how to quit smoking Encourage a healthy lifestyle, such as healthy eating and exercise Update vaccinations Maintain a relationship with your health care provider ...

  13. Health care automation companies.

    PubMed

    1995-12-01

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

  14. Health care automation companies.

    PubMed

    1995-12-01

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

  15. Identifying health care quality attributes.

    PubMed

    Ramsaran-Fowdar, Roshnee R

    2005-01-01

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

  16. 47 CFR 54.602 - Health care support mechanism.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 47 Telecommunication 3 2014-10-01 2014-10-01 false Health care support mechanism. 54.602 Section... (CONTINUED) UNIVERSAL SERVICE Universal Service Support for Health Care Providers Defined Terms and Eligibility § 54.602 Health care support mechanism. (a) Telecommunications Program. Rural health...

  17. 47 CFR 54.602 - Health care support mechanism.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 47 Telecommunication 3 2013-10-01 2013-10-01 false Health care support mechanism. 54.602 Section... (CONTINUED) UNIVERSAL SERVICE Universal Service Support for Health Care Providers Defined Terms and Eligibility § 54.602 Health care support mechanism. (a) Telecommunications Program. Rural health...

  18. Utilizing international medical graduates in health care delivery: brain drain, brain gain, or brain waste? A win-win approach at University of California, Los Angeles.

    PubMed

    Dowling, Patrick T; Bholat, Michelle Anne

    2012-12-01

    After identifying many unlicensed Hispanic international medical graduates (IMGs) legally residing in southern California, University of California, Los Angeles developed an innovative program to prepare these sidelined physicians to enter family medicine residency programs and become licensed physicians. On completion of a 3-year family medicine residency-training program, these IMGs have an obligation to practice in a federally designated underserved community in the state for 2 to 3 years. As the US health care system moves from physician-centered practices to patient-focused teams, with primary care serving as the foundation for building patient-centered medical homes, attention to educating IMGs in these concepts is crucial. PMID:23148957

  19. Utilizing international medical graduates in health care delivery: brain drain, brain gain, or brain waste? A win-win approach at University of California, Los Angeles.

    PubMed

    Dowling, Patrick T; Bholat, Michelle Anne

    2012-12-01

    After identifying many unlicensed Hispanic international medical graduates (IMGs) legally residing in southern California, University of California, Los Angeles developed an innovative program to prepare these sidelined physicians to enter family medicine residency programs and become licensed physicians. On completion of a 3-year family medicine residency-training program, these IMGs have an obligation to practice in a federally designated underserved community in the state for 2 to 3 years. As the US health care system moves from physician-centered practices to patient-focused teams, with primary care serving as the foundation for building patient-centered medical homes, attention to educating IMGs in these concepts is crucial.

  20. Mercury and health care.

    PubMed

    Rustagi, Neeti; Singh, Ritesh

    2010-08-01

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

  1. Mercury and health care

    PubMed Central

    Rustagi, Neeti; Singh, Ritesh

    2010-01-01

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

  2. Controlling Health Care Costs

    ERIC Educational Resources Information Center

    Dessoff, Alan

    2009-01-01

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

  3. Health care and AIDS.

    PubMed

    Peck, J; Bezold, C

    1992-07-01

    The acquired immune deficiency syndrome (AIDS) is a harbinger for change in health care. There are many powerful forces poised to transform the industrialized health care structure of the twentieth century, and AIDS may act as either a catalyst or an amplifier for these forces. AIDS could, for example, swamp local resources and thereby help trigger national reform in a health care system that has already lost public confidence. AIDS can also hasten the paradigm shift that is occurring throughout health care. Many of the choices society will confront when dealing with AIDS carry implications beyond health care. Information about who has the disease, for example, already pits traditional individual rights against group interests. Future information systems could make discrimination based upon medical records a nightmare for a growing number of individuals. Yet these systems also offer the hope of accelerated progress against not only AIDS but other major health threats as well. The policy choices that will define society's response to AIDS can best be made in the context of a clearly articulated vision of a society that reflects our deepest values. PMID:10119289

  4. Health care technology assessment

    NASA Astrophysics Data System (ADS)

    Goodman, Clifford

    1994-12-01

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

  5. Containing Health Care Costs

    PubMed Central

    Derzon, Robert A.

    1980-01-01

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

  6. Teaching Primary Health Care: An Interdisciplinary Approach.

    ERIC Educational Resources Information Center

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

    1998-01-01

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

  7. Ensuring optimal health care for LGBT patients.

    PubMed

    Glasper, Alan

    2016-07-14

    Emeritus Professor Alan Glasper, from the University of Southampton, discusses a Royal College of Nursing policy that highlights the complexities of providing high-quality and non-discriminatory health care. PMID:27409790

  8. Health care reforms

    PubMed Central

    Prevolnik Rupel, Valentina

    2016-01-01

    Abstract In large systems, such as health care, reforms are underway constantly. The article presents a definition of health care reform and factors that influence its success. The factors being discussed range from knowledgeable personnel, the role of involvement of international experts and all stakeholders in the country, the importance of electoral mandate and governmental support, leadership and clear and transparent communication. The goals set need to be clear, and it is helpful to have good data and analytical support in the process. Despite all debates and experiences, it is impossible to clearly define the best approach to tackle health care reform due to a different configuration of governance structure, political will and state of the economy in a country. PMID:27703543

  9. Health care clinics in Cambodia.

    PubMed

    Wollschlaeger, K

    1995-04-01

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

  10. Burnout and health care utilization.

    PubMed

    Jackson, C N; Manning, M R

    1995-01-01

    This study explores the relationship between burnout and health care utilization of 238 employed adults. Burnout was measured by the Maslach Burnout Inventory and health care utilization by insurance company records regarding these employees' health care costs and number of times they accessed health care services over a one year period. ANOVAs were conducted using Golembiewski and Munzenrider's approach to define the burnout phase. Significant differences in health care costs were found. PMID:10152340

  11. Higher Education and Health Care at a Crossroads

    ERIC Educational Resources Information Center

    Kirch, Darrell G.

    2011-01-01

    As major providers and consumers of health care, higher-education institutions have an important role to play in improving health and the nation's health-care system. Health care is a complex issue for colleges and universities. Not only do institutions of higher education provide health insurance to faculty members, staff members, and students,…

  12. Health care in the Yemen Arab Republic.

    PubMed

    Lambeth, S

    1988-01-01

    The Yemen Arab Republic has health-care problems similar to other developing countries yet lacks the abundant oil reserves of its Arabian peninsula neighbors to address these problems. An ambitious 5 year health plan developed in 1977 has been impeded by a lack of material and human resources. The infant mortality rate remains one of the highest in the world, schistosomiasis drains the energy of the people, and tuberculosis and malaria remain endemic. Progress is, however, being made in health-care educational programs within Sanaa University and the Health Manpower Institutes to develop the resources of the Yemeni people to meet the health-care needs of their country. PMID:3225123

  13. Information in Health Care.

    ERIC Educational Resources Information Center

    Mayeda, Tadashi A.

    The report stresses the fact that while there is unity in the continuum of medicine, information in health care is markedly different from information in medical education and research. This difference is described as an anomaly in that it appears to deviate in excess of normal variation from needs common to research and education. In substance,…

  14. Moving forward on human resources for health: next steps for scaling up toward universal access to HIV/AIDS prevention, treatment, and care.

    PubMed

    Gormley, Wilma; McCaffery, James; Quain, Estelle E

    2011-08-01

    In 2008, the Global Health Workforce Alliance commissioned a technical working group to examine the human resources for health implications of scaling up to reach the Millennium Development Goal 6 of universal access to HIV/AIDS prevention, treatment, care, and support by 2010. The analysis and interventions recommended in the working group report, which was launched at the Second Global Forum on Human Resources for Health in Bangkok, Thailand, in January 2011, are based on two research methods: literature reviews covering the period from 2000 to 2008 and a rapid situational analysis produced by teams working in 5 countries (Côte d'Ivoire, Ethiopia, Mozambique, Thailand, and Zambia). The authors' intent in this article is to assist the Alliance in maintaining the momentum of the forum and the enthusiasm generated by the working group's report to make a difference at the country level by moving from recommendation to action.

  15. Health care in the Netherlands.

    PubMed

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

    2012-03-01

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

  16. Care for the Health Care Provider.

    PubMed

    Kunin, Sharon Brown; Kanze, David Mitchell

    2016-03-01

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

  17. Care for the Health Care Provider.

    PubMed

    Kunin, Sharon Brown; Kanze, David Mitchell

    2016-03-01

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

  18. Cost vs. care: American's health care dilemma wrongly considered.

    PubMed

    Marmor, T R; Klein, R

    1986-01-01

    The state dilemma of American medical care is rapidly increasing costs that threaten both quality of care and equal access to care. A frequently cited example of what the United States can expect as the crunch between cost and care gets worse is rationing, as used in the British National Health Service. The introduction of the British National Health Service, according to this analysis, is inappropriate and clouds the relevant issues. The example of national health insurance in Canada--a country much more similar to the United States in size, geography, and governmental and social structure--is a much more appropriate model to examine. Canada, comparably large, wealthy, and socially heterogeneous, spends approximately 20% less of its GNP on medicine, yet has both universal national health insurance and no serious rationing problem. Their example is reason to question the stark dilemma of cost vs. care in American medicine.

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

    ERIC Educational Resources Information Center

    Fadope, Cece Modupe; And Others

    1994-01-01

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

  20. Child Care Health Connections, 2002.

    ERIC Educational Resources Information Center

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

    2002-01-01

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

  1. National Health Care Skill Standards.

    ERIC Educational Resources Information Center

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

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

  2. Mobile documentation: optimizing technology to do more with less. How the University of Missouri Health System adapted its barcode-scanning system for mobile bedside documentation to enhance the quality and safety of patient care.

    PubMed

    Prestigiacomo, Jennifer

    2012-12-01

    When the University of Missouri Health System sought to optimize its bedside documentation work-flows, it chose to enhance its current medication administration devices to allow mobile point-of-care documentation, an innovation that has led to a dramatic advance in speed to documentation of patient data, ultimately improving patient care.

  3. Seamless health care for chronic diseases in a dual health care system: managed care and the role of family physicians.

    PubMed

    Lee, A

    1998-01-01

    Neither private nor state run health care systems are perfect. Although there is increasing evidence that Health Maintenance Organizations (HMOs) provide comparable care at lower cost, HMOs tend to select healthy patients. The dual health care system in Hong Kong spends about 3.9 per cent of GDP, with health indices among the best in the world. Hong Kong still faces the problem of escalating health care expenditure. One should take advantage of the dual health care system to evolve a new paradigm for a primary-led seamless health care service. The Diabetes Centre of a university teaching hospital together with the University of Community and Family Medicine has started a structured shared care programme in diabetes mellitus, involving general practitioners in both the private and public sectors integrating the primary and secondary care, and the private and public sectors. This programme starts to develop an infrastructure for providing quality care at an affordable cost for a large pool of patients with chronic disease. Unlike other "managed care schemes", this one is not run by profit-oriented companies, but by health professionals with an interest in providing best possible care at an affordable cost. The "disease management" approach needs a care delivery system without traditional boundaries; and a continuous improvement process which develops and refines the knowledge base, guidelines and delivery system. PMID:10351265

  4. Outbreaks in Health Care Settings.

    PubMed

    Sood, Geeta; Perl, Trish M

    2016-09-01

    Outbreaks and pseudo-outbreaks in health care settings can be complex and should be evaluated systematically using epidemiologic tools. Laboratory testing is an important part of an outbreak evaluation. Health care personnel, equipment, supplies, water, ventilation systems, and the hospital environment have been associated with health care outbreaks. Settings including the neonatal intensive care unit, endoscopy, oncology, and transplant units are areas that have specific issues which impact the approach to outbreak investigation and control. Certain organisms have a predilection for health care settings because of the illnesses of patients, the procedures performed, and the care provided. PMID:27515142

  5. The retailing of health care.

    PubMed

    Paul, T; Wong, J

    1984-01-01

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

  6. Health care reform and family planning services.

    PubMed

    Policar, M

    1993-01-01

    With the reforms expected for US health care, the question remains as to the impact on family planning services. Although the focus is on health care finance reform, the mix of patients seen, the incentives for decision making, and the interactions between health care providers will change. Definition of key concepts is provided for universal access, managed competition, and managed care. The position of the obstetrician/gynecologist (Ob/Gyn) does not fit well within the scheme for managed health care, because Ob/Gyns are both primary care providers and specialists in women's health care. Most managed health care systems presently consider Ob/Gyn to be a specialty. Public family planning clinics, which have a client constituency of primarily uninsured women, may have to compete with traditional private sector providers. "Ambulatory health care providers" have developed a reputation for high quality, cost effective preventive health care services; this record should place providers with a range of services in a successful position. Family planning providers in a managed competition system will be at a disadvantage. 3 scenarios possible under managed competition are identified as the best case, out of the mainstream, and most likely. The best case is when primary reproductive health care services, contraception, sexually transmitted disease screening and management, and preventive services are all obtained directly from reproductive health care providers. Under managed care, this means allowing for an additional entry gatekeeper to specialized services. The benefits are to clients who prefer seeing reproductive health care providers first; reproductive services would be separated from medical services. The out of the mainstream scenario would place contraceptive services and other preventive services as outside the mandated benefits. The government would still provide Title X type programs for the indigent. The most likely scenario is one where primary care providers

  7. Health care reform: prospects and progress.

    PubMed

    Rockefeller, J

    1992-03-01

    No longer can the health care community and the politicians work separately as they usually did until just a generation ago. Now, with or without the frustrations involved, both groups need one another and must work together to fulfill their common goal of caring for people. The U.S. economy can no longer sustain the immense and mounting costs of health care: the system must change drastically before the end of the century or there will be revolution or a collapse of the system. For the first time, there is a strong constituency calling for health care reform. The politicians and the health care community must stop ignoring that constituency and instead work together on a health care bill to head off the coming crisis. Such a bill will exact sacrifices and compromises from all sectors, and must control costs and provide universal access to health care. The author outlines proposed bills and other activities that are now being considered, describes a bill that he has helped craft and introduce, and notes that the Bush administration has done an about-face and is now promising a health care bill. He challenges academic medicine to help produce more primary care physicians, gives examples of efforts that are fostering primary care, especially in rural areas, and explains why having more primary care physicians is vital and also a key to cost containment. He ends by again urging the health care community to participate in defining what can be done to avert the coming crisis and establish a workable and equitable health care system.

  8. Betting against health care.

    PubMed

    Appleby, C

    1996-06-20

    Health care firms of all types helped fuel the biggest short-selling frenzy in the New York Stock Exchange's history, recently hitting a record 2.2 billion shares. While some analysts say this means nothing, the fact is that many investors are "shorting" the stock; in other words, they're betting against it. What appears as a lack of confidence may be nothing more than a simple quirk of Wall Street. Good, bad or indifferent, selling short is no tall tale.

  9. Nursing challenges for universal health coverage: a systematic review1

    PubMed Central

    Schveitzer, Mariana Cabral; Zoboli, Elma Lourdes Campos Pavone; Vieira, Margarida Maria da Silva

    2016-01-01

    Objectives to identify nursing challenges for universal health coverage, based on the findings of a systematic review focused on the health workforce' understanding of the role of humanization practices in Primary Health Care. Method systematic review and meta-synthesis, from the following information sources: PubMed, CINAHL, Scielo, Web of Science, PsycInfo, SCOPUS, DEDALUS and Proquest, using the keyword Primary Health Care associated, separately, with the following keywords: humanization of assistance, holistic care/health, patient centred care, user embracement, personal autonomy, holism, attitude of health personnel. Results thirty studies between 1999-2011. Primary Health Care work processes are complex and present difficulties for conducting integrative care, especially for nursing, but humanizing practices have showed an important role towards the development of positive work environments, quality of care and people-centered care by promoting access and universal health coverage. Conclusions nursing challenges for universal health coverage are related to education and training, to better working conditions and clear definition of nursing role in primary health care. It is necessary to overcome difficulties such as fragmented concepts of health and care and invest in multidisciplinary teamwork, community empowerment, professional-patient bond, user embracement, soft technologies, to promote quality of life, holistic care and universal health coverage. PMID:27143536

  10. Integrating Behavioral Health into Primary Care.

    PubMed

    McGough, Peter M; Bauer, Amy M; Collins, Laura; Dugdale, David C

    2016-04-01

    Depression is one of the more common diagnoses encountered in primary care, and primary care in turn provides the majority of care for patients with depression. Many approaches have been tried in efforts to improve the outcomes of depression management. This article outlines the partnership between the University of Washington (UW) Neighborhood Clinics and the UW Department of Psychiatry in implementing a collaborative care approach to integrating the management of anxiety and depression in the ambulatory primary care setting. This program was built on the chronic care model, which utilizes a team approach to caring for the patient. In addition to the patient and the primary care provider (PCP), the team included a medical social worker (MSW) as care manager and a psychiatrist as team consultant. The MSW would manage a registry of patients with depression at a clinic with several PCPs, contacting the patients on a regular basis to assess their status, and consulting with the psychiatrist on a weekly basis to discuss patients who were not achieving the goals of care. Any recommendation (eg, a change in medication dose or class) made by the psychiatrist was communicated to the PCP, who in turn would work with the patient on the new recommendation. This collaborative care approach resulted in a significant improvement in the number of patients who achieved care plan goals. The authors believe this is an effective method for health systems to integrate mental health services into primary care. (Population Health Management 2016;19:81-87). PMID:26348355

  11. Access to health care

    PubMed Central

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

    2005-01-01

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

  12. Reflections on curative health care in Nicaragua.

    PubMed Central

    Slater, R G

    1989-01-01

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

  13. THE NEOLIBERAL TURN IN AMERICAN HEALTH CARE.

    PubMed

    Gaffney, Adam

    2015-01-01

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

  14. THE NEOLIBERAL TURN IN AMERICAN HEALTH CARE.

    PubMed

    Gaffney, Adam

    2015-01-01

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

  15. Care of the elderly program at the University of Alberta

    PubMed Central

    Charles, Lesley; Dobbs, Bonnie; Triscott, Jean; McKay, Rhianne

    2014-01-01

    Abstract Problem addressed The population is aging rapidly and there are implications for health care delivery in the face of few physicians specializing in care of the elderly (COE). Objective of program To train physicians wishing to provide COE services. Program description The COE program at the University of Alberta in Edmonton is an enhanced skills diploma program lasting 6 months to 1 year, with core program requirements including geriatric inpatient care, geriatric psychiatry, ambulatory care, continuing care, and outreach. There is a longitudinal clinic component and a research project requirement. The program is designed to cover the 85 core competencies in the CanMEDS– Family Medicine roles. Conclusion There is a need for COE physicians to provide clinical care as well as fill educational, administrative, and research roles to meet the health care needs of medically complex seniors. These physicians require alternative funding and a departmental home within a university if they are to provide an academic service. PMID:25551143

  16. Help, care and support during a mental health crisis.

    PubMed

    Glasper, Alan

    Emeritus professor Alan Glasper, from the University of Southampton, discusses the recently published Care Quality Commission (CQC) report Right here, right now, which documents people's experiences of help, care and support during a mental health crisis. PMID:26450676

  17. Transformational leadership in health care.

    PubMed

    Trofino, J

    1995-08-01

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

  18. National Health Care Skill Standards.

    ERIC Educational Resources Information Center

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

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

  19. Strengthening of oral health systems: oral health through primary health care.

    PubMed

    Petersen, Poul Erik

    2014-01-01

    Around the globe many people are suffering from oral pain and other problems of the mouth or teeth. This public health problem is growing rapidly in developing countries where oral health services are limited. Significant proportions of people are underserved; insufficient oral health care is either due to low availability and accessibility of oral health care or because oral health care is costly. In all countries, the poor and disadvantaged population groups are heavily affected by a high burden of oral disease compared to well-off people. Promotion of oral health and prevention of oral diseases must be provided through financially fair primary health care and public health intervention. Integrated approaches are the most cost-effective and realistic way to close the gap in oral health between rich and poor. The World Health Organization (WHO) Oral Health Programme will work with the newly established WHO Collaborating Centre, Kuwait University, to strengthen the development of appropriate models for primary oral health care.

  20. Longitudinal Rates of Colon Cancer Screening Use in Winnipeg, Canada: The Experience of a Universal Health-Care System with an Organized Colon Screening Program

    PubMed Central

    Decker, Kathleen M; Demers, Alain A; Nugent, Zoann; Biswanger, Natalie; Singh, Harminder

    2015-01-01

    OBJECTIVES: We examined trends in colorectal cancer (CRC) screening (fecal occult blood test (FOBT), colonoscopy, and flexible sigmoidoscopy (FS)) and differences in CRC screening by income in a population with an organized CRC screening program and universal health-care coverage. METHODS: Individuals who had an FOBT, colonoscopy, or FS were identified from the provincial Physician Claims database and the population-based colon cancer screening registry. Trends in age-standardized rates were determined. Logistic regression was performed to explore the association between CRC screening and income quintiles by year. RESULTS: Up-to-date CRC screening (FOBT, colonoscopy, or FS) increased over time for men and women, all age groups, and all income quintiles. Up-to-date CRC screening was very high among 65- to 69- and 70- to 74-year-olds (70% and 73%, respectively). There was a shift toward the use of an FOBT for CRC screening for individuals in the lower income quintiles. The disparity in colonoscopy/FS coverage by income quintile was greater in 2012 than in 1995. Overall, there was no reduction in disparities by income in up-to-date CRC screening nor did the rate of increase in up-to-date CRC screening or FOBT use change after the introduction of the organized provincial CRC screening program. CONCLUSIONS: CRC screening is increasing over time for both men and women and all age groups. However, a disparity in up-to-date CRC screening by income persisted even with an organized CRC screening program in a universal health-care setting. PMID:26169513

  1. Information Technology Outside Health Care

    PubMed Central

    Tuttle, Mark S.

    1999-01-01

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

  2. Gypsies and health care.

    PubMed Central

    Sutherland, A

    1992-01-01

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

  3. Flourishing in Health Care.

    PubMed

    Edgar, Andrew; Pattison, Stephen

    2016-06-01

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

  4. Unlearning in health care

    PubMed Central

    Rushmer, R; Davies, H

    2004-01-01

    Learning in health care is essential if healthcare organisations are to tackle a challenging quality of care agenda. Yet while we know a reasonable amount about the nature of learning, how learning occurs, the forms it can take, and the routines that encourage it to happen within organisations, we know very little about the nature and processes of unlearning. We review the literature addressing issues pivotal to unlearning (what it is, why it is important, and why it is often neglected), and go further to explore the conditions under which unlearning is likely to be encouraged. There is a difference between routine unlearning (and subsequent re-learning) and deep unlearning—unlearning that requires a substantive break with previous modes of understanding, doing, and being. We argue that routine unlearning merely requires the establishment of new habits, whereas deep unlearning is a sudden, potentially painful, confrontation of the inadequacy in our substantive view of the world and our capacity to cope with that world competently. PMID:15576685

  5. [Health care insurance for Africa].

    PubMed

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

    2007-12-01

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

  6. Health and Disability: Partnerships in Health Care

    ERIC Educational Resources Information Center

    Tracy, Jane; McDonald, Rachael

    2015-01-01

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

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

    PubMed

    Kern, Josipa; Strnad, Marija

    2005-01-01

    Informatization process of the Croatian health care system started relatively early. Computer processing of data of persons not covered by health insurance started in 1968 in Zagreb. Remetinec Health Center served as a model of computer data processing (CDP) in primary health care and Sveti Duh General Hospital in inpatient CDP, whereas hospital administration and health service were first introduced to Zagreb University Hospital Center and Sestre Milosrdnice University Hospital. At Varazdin Medical Center CDP for health care services started in 1970. Several registries of chronic diseases have been established: cancer, psychosis, alcoholism, and hospital registries as well as pilot registries of lung tuberculosis patients and diabetics. Health statistics reports on healthcare services, work accidents and sick-leaves as well as on hospital mortality started to be produced by CDP in 1977. Besides alphanumeric data, the modern information technology (IT) can give digital images and signals. Communication in health care system demands a standardized format of all information, especially for telemedicine. In 2000, Technical Committee for Standardization in Medical Informatics was founded in Croatia, in order to monitor the activities of the International Standardization Organization (ISO) and Comite Européen de Normalisation (CEN), and to implement their international standards in the Croatian standardization procedure. The HL7 Croatia has also been founded to monitor developments in the communication standard HL7. So far, the Republic of Croatia has a number of acts regulating informatization in general and consequently the informatization of the health care system (Act on Personal Data Confidentiality, Act on Digital Signature, Act of Standardization) enacted. The ethical aspect of data security and data protection has been covered by the Code of Ethics for medical informaticians. It has been established by the International Medical Informatics Association (IMIA

  8. The Effectiveness of Screening with Interferon-Gamma Release Assays in a University Health Care Setting with a Diverse Global Population

    ERIC Educational Resources Information Center

    Birch, Samantha J.; Golbeck, Amanda L.

    2015-01-01

    Objective: This analysis examined the effectiveness of utilizing interferon-gamma release assay (IGRA) technology in a TB (TB) screening program at a university. Participants: Participants were 2299 students at a Montana university who had presented to the university health center for TB screening during 2012 and 2013. Methods: A retrospective…

  9. Lesbian and bisexual health care.

    PubMed Central

    Mathieson, C. M.

    1998-01-01

    OBJECTIVE: To explore lesbian and bisexual women's experiences with their family physicians to learn about barriers to care and about how physicians can provide supportive care. DESIGN: Qualitative study that was part of a larger study of lesbian and bisexual women's health care. SETTING: The province of Nova Scotia, both urban and rural counties. PARTICIPANTS: Ninety-eight self-identified lesbian or bisexual women who volunteered through snowball sampling. Women were interviewed by lesbian, bisexual, or heterosexual female interviewers. METHOD: Semistructured, audiotaped, face-to-face interviews, exploring questions about demographic information, sexual orientation, general health care patterns, preferences for health care providers, disclosure issues, health care information, access issues, and important health care services. Transcription of audiotapes of interviews was followed by content, thematic, and discourse analyses. Thematic analysis is reported in this paper. MAIN OUTCOME FINDINGS: Three themes important for family physicians emerged: the importance of being gay positive, barriers to care, and strategies for providing appropriate care. CONCLUSIONS: Family physicians are in a pivotal position to ensure supportive care for lesbian and bisexual women. Physicians need to recognize barriers to care and to use gay-positive strategies, paying attention to self-education, health history, and clinic environment. PMID:9721419

  10. Space age health care delivery

    NASA Technical Reports Server (NTRS)

    Jones, W. L.

    1977-01-01

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

  11. Strategic, value-based delivery in global health care: innovations at Harvard University and Brigham and Women's Hospital.

    PubMed

    Weintraub, Rebecca L; Talbot, Julie; ole-MoiYoi, Kileken; Wachter, Keri; Sullivan, Erin; House, Amy; Baron, Jennifer; Beals, Aaron; Beauvais, Sophie; Rhatigan, Joseph

    2011-01-01

    Investments in global health have more than doubled over the past decade, generating a cadre of new institutions. To date, most of the funded research in global health has focused on discovery, and, more recently, on the development of new tools, which has tightened the implementation bottleneck. This article introduces the concept of global health delivery and the need to catalog and analyze current implementation efforts to bridge gaps in delivery. Global health delivery is complex and context-dependent and requires an interdisciplinary effort, including the application of strategic principles. Furthermore, delivery is necessary to ensure that the investments in research, discovery, and development generate value for patients and populations. This article discusses the application of value-based delivery to global health. It provides some examples of approaches to aggregating implicit knowledge to inform practice. With global health delivery, the aim is to transform global health scale-up from a series of well-intentioned but often disconnected efforts to a value-based movement based upon 21st-century technology, standards, and efficiency.

  12. Congress enacts health care reform.

    PubMed

    2010-03-01

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

  13. Online Collaborative Learning in Health Care Education

    ERIC Educational Resources Information Center

    Westbrook, Catherine

    2012-01-01

    At our University, the Faculty of Health, Social Care and Education has delivered a variety of undergraduate and postgraduate courses via flexible distance learning for many years. Distance learning can be a lonely experience for students who may feel isolated and unsupported. However e-learning provides an opportunity to use technology to…

  14. [Effective access to health services: operationalizing universal health coverage].

    PubMed

    Fajardo-Dolci, Germán; Gutiérrez, Juan Pablo; García-Saisó, Sebastián

    2015-01-01

    The right to health and its operational form, as an organized social response to health: the right to health protection, are the mainstay for the global push towards universal health coverage. The path to achieve this goal is particular to each country and relates to the baseline and specific context in relation to what is feasible. In practical terms, universal coverage involves the correlation between demand and supply of services (promotion, prevention, and care), expressed by the ability for each individual to make use of services when these are required. In those terms universal coverage is then effective access. The objective of the paper is to explore the conceptualization of effective access to health services and propose a definition that allows its operationalization thereof. This definition considers key elements of supply and demand of services, including the availability of resources and adequate provision (quality), as well as barriers to use them. PMID:26235780

  15. Foster Care and Child Health.

    PubMed

    McDavid, Lolita M

    2015-10-01

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

  16. Foster Care and Child Health.

    PubMed

    McDavid, Lolita M

    2015-10-01

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

  17. The Politics of Health Care.

    ERIC Educational Resources Information Center

    Anderson, John B.

    Before the mid-1960's the Federal role in health care was extremely limited, but technological breakthroughs, the new importance of hospitals, and the recognition that the poor and elderly have been underserved prompted Congress to pass the Medicare and Medicaid package in 1966. Since then the Federal share of the health care dollar has risen by…

  18. Contagious Ideas from Health Care

    ERIC Educational Resources Information Center

    Chaffee, Ellen

    2009-01-01

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

  19. Pharmacists' Role in Health Care

    ERIC Educational Resources Information Center

    Maronde, Robert F.

    1977-01-01

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

  20. Women Veterans Health Care: Frequently Asked Questions

    MedlinePlus

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

  1. Allying health care and housing.

    PubMed

    Murphy, Lillian

    2005-01-01

    There is a wealth of evidence that health is inextricably linked to housing. For instance, research has shown that those in substandard housing have poorer health outcomes than other groups, and they often must forgo costly medication in order to pay for housing. Further, the health care and housing concerns faced by the underserved often compound one another--people with poor health often have trouble maintaining housing, and those with substandard homes, in turn, often have trouble maintaining their health. Three groups are especially vulnerable to the health care risks associated with housing issues: children, seniors, and the chronically homeless. As the research suggests, substandard housing is a contributing factor to the U.S. health care crisis. Therefore, as part of its efforts to reform the nation's health care system, the ministry should address housing issues as well. Seven Catholic health systems are doing this through the Strategic Health Care Partnership. The partnership, in collaboration with Mercy Housing, enables the seven organizations to work together to create healthy communities. The partnership's key goal is to increase access to affordable housing and health care. Just providing homes often is not enough, however. A holistic approach, through which supportive services are offered to the underserved, is most effective.

  2. The national health care imperative.

    PubMed

    Halamandaris, V J

    1990-03-01

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

  3. Health care's service fanatics.

    PubMed

    Merlino, James I; Raman, Ananth

    2013-05-01

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

  4. Pastoralist health care in Kenya

    PubMed Central

    Duba, Huka H.; Mur-Veeman, Ingrid M.; van Raak, Arno

    2001-01-01

    Abstract Health care for the Kenyan pastoralist people has serious shortcomings and it must be delivered under difficult circumstances. Often, the most basic requirements cannot be met, due to the limited accessibility of health care provisions to pastoralists. This adds major problems to the daily struggle for life, caused by bad climatic circumstances, illiteracy and poverty. We argue that strong, integrated and community based primary health care could provide an alternative for these inadequacies in the health system. The question then is how primary health care, which integrates a diversity of basic care provisions, such as pharmaceutical provision, child delivery assistance, mother and childcare and prevention activities, can be implemented. In our view, an appropriate mix of decentralisation forms, warranting better conditions on the one hand and relying on the current community and power structures and culture on the other hand, would be the best solution for the time being. PMID:16896413

  5. Teens, technology, and health care.

    PubMed

    Leanza, Francesco; Hauser, Diane

    2014-09-01

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

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

    ERIC Educational Resources Information Center

    Beatty, Rebecca M.

    2000-01-01

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

  7. Changing an organization's culture: Louisiana State University Health Sciences Center School of Dentistry's TigerCare program.

    PubMed

    Pousson, Rebecca G; Hovland, Eric J

    2006-03-01

    Studies have shown that the culture of an organization could be the difference between success and failure in achieving its overall corporate goals and mission. Although some aspects of an organization's culture are visible and tangible, such as the physical structure or overall cleanliness of the facility, other aspects are less tangible but just as apparent, like the helpfulness of the staff and the overall "attitude" of the organization. Private industry discovered many years ago that the key to creating a friendly and productive culture lies in the hands of the employees. TigerCare is a program that engages the civil service employees and provides them with the knowledge and motivation necessary to excel in their jobs and deliver the highest standard of customer service and job performance. It has helped the LSUHSC School of Dentistry develop employees who deliver excellent customer care. This article reports on the specific steps taken to improve the customer service culture and describes the results of the program after two years of implementation. PMID:16522750

  8. Changing an organization's culture: Louisiana State University Health Sciences Center School of Dentistry's TigerCare program.

    PubMed

    Pousson, Rebecca G; Hovland, Eric J

    2006-03-01

    Studies have shown that the culture of an organization could be the difference between success and failure in achieving its overall corporate goals and mission. Although some aspects of an organization's culture are visible and tangible, such as the physical structure or overall cleanliness of the facility, other aspects are less tangible but just as apparent, like the helpfulness of the staff and the overall "attitude" of the organization. Private industry discovered many years ago that the key to creating a friendly and productive culture lies in the hands of the employees. TigerCare is a program that engages the civil service employees and provides them with the knowledge and motivation necessary to excel in their jobs and deliver the highest standard of customer service and job performance. It has helped the LSUHSC School of Dentistry develop employees who deliver excellent customer care. This article reports on the specific steps taken to improve the customer service culture and describes the results of the program after two years of implementation.

  9. Positive rights, negative rights and health care.

    PubMed

    Bradley, Andrew

    2010-12-01

    In the current debate about healthcare reform in the USA, advocates for government-ensured universal coverage assume that health care is a right. Although this position is politically popular, it is sometimes challenged by a restricted view of rights popular with libertarians and individualists. The restricted view of rights only accepts 'negative' rights as legitimate rights. Negative rights, the argument goes, place no obligations on you to provide goods to other people and thus respect your right to keep the fruits of your labour. A classic enumeration of negative rights includes life, liberty, and the pursuit of happiness. Positive rights, by contrast, obligate you either to provide goods to others, or pay taxes that are used for redistributive purposes. Health care falls into the category of positive rights since its provision by the government requires taxation and therefore redistribution. Therefore, the libertarian or individualist might argue that health care cannot be a true right. This paper rejects the distinction between positive and negative rights. In fact, the protection of both positive and negative rights can place obligations on others. Furthermore, because of its role in helping protect equality of opportunity, health care can be tied to the rights to life, liberty, and the pursuit of happiness. There is, therefore, good reason to believe that health care is a human right and that universal access should be guaranteed. The practical application, by governments and non-governmental organisations, of several of the arguments presented in this paper is also discussed.

  10. Hepatitis C virus infection and risk factors in health-care workers at Ain Shams University Hospitals, Cairo, Egypt.

    PubMed

    Okasha, O; Munier, A; Delarocque-Astagneau, E; El Houssinie, M; Rafik, M; Bassim, H; Hamid, M Abdel; Mohamed, M K; Fontanet, A

    2015-03-01

    The objectives of this study were to document the background prevalence and incidence of HCV infection among HCWs in Ain Shams University Hospitals in Cairo and analyse the risk factors for HCV infection. A cross-sectional survey was conducted in 2008 among 1770 HCWs. Anti-HCV prevalence was age-standardized using the Cairo population. A prospective cohort was followed for a period of 18 months to estimate HCV incidence. The crude anti-HCV prevalence was 8.0% and the age-standardized seroprevalence was 8.1%. Risk factors independently associated with HCV seropositivity were: age, manual worker, history of blood transfusions and history of parenteral anti-schistosomiasis treatment. The estimated incidence of HCV infection was 7.3 per 1000 person-years. HCWs in this setting had a similar high HCV seroprevalence as the general population of greater Cairo.

  11. School Readiness Goal Begins with Health Care Reform.

    ERIC Educational Resources Information Center

    Penning, Nick

    1992-01-01

    Currently 59 bills are awaiting Congressional action. Meanwhile, a national coalition of economists and medical specialists (the National Leadership Coalition for Health Care Reform) are circulating a sensible consensus health reform plan proposing national practice guidelines; universal health care access; and efficient cost control, delivery,…

  12. Medicalization of global health 4: the universal health coverage campaign and the medicalization of global health

    PubMed Central

    Clark, Jocalyn

    2014-01-01

    Universal health coverage (UHC) has emerged as the leading and recommended overarching health goal on the post-2015 development agenda, and is promoted with fervour. UHC has the backing of major medical and health institutions, and is designed to provide patients with universal access to needed health services without financial hardship, but is also projected to have ‘a transformative effect on poverty, hunger, and disease’. Multiple reports and resolutions support UHC and few offer critical analyses; but among these are concerns with imprecise definitions and the ability to implement UHC at the country level. A medicalization lens enriches these early critiques and identifies concerns that the UHC campaign contributes to the medicalization of global health. UHC conflates health with health care, thus assigning undue importance to (biomedical) health services and downgrading the social and structural determinants of health. There is poor evidence that UHC or health care alone improves population health outcomes, and in fact health care may worsen inequities. UHC is reductionistic because it focuses on preventative and curative actions delivered at the individual level, and ignores the social and political determinants of health and right to health that have been supported by decades of international work and commitments. UHC risks commodifying health care, which threatens the underlying principles of UHC of equity in access and of health care as a collective good. PMID:24848662

  13. Trends in Health Care Systems Delivery.

    ERIC Educational Resources Information Center

    Hughes, Edward F. X.

    1989-01-01

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

  14. Two models of primary health care training.

    PubMed

    Hill, P; Samisoni, J

    1993-01-01

    In 1991, the Fiji School of Medicine restructured the training of its medical students, dividing the 7-year course into two phases. Students now undertake a 3-year community-oriented primary care practitioners course, after which they may elect to continue practice in a primary health care role, or to undertake further hospital-based training to complete their medical degree. The course responds to the health needs of the South Pacific, and the local patterns of morbidity and mortality, rather than measuring itself against the curricular demands of its more developed neighbours, Australia and New Zealand. At the same time, the Tropical Health Program of the University of Queensland Medical School responded to demands from the Aboriginal and Torres Strait Islander community to develop primary health care training at degree level. This was intended to complement other strategies undertaken by the Aboriginal and Torres Strait Islander Studies Unit such as the recruitment and support of indigenous students through mainstream health professional education. There was a need to address health priorities that are very different to those of the Australian population as a whole, as well as the sociopolitical and cultural context as it affects both students themselves and health issues in their communities. Both institutions have chosen problem-based teaching/learning as appropriate to their courses, and content is also similar, though with emphases that reflect the differing contexts. The two courses are examples of innovative responses by centres with university medical faculties to specific issues in health education. PMID:8433664

  15. Hope for health and health care.

    PubMed

    Stempsey, William E

    2015-02-01

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

  16. [A Maternal Health Care System Based on Mobile Health Care].

    PubMed

    Du, Xin; Zeng, Weijie; Li, Chengwei; Xue, Junwei; Wu, Xiuyong; Liu, Yinjia; Wan, Yuxin; Zhang, Yiru; Ji, Yurong; Wu, Lei; Yang, Yongzhe; Zhang, Yue; Zhu, Bin; Huang, Yueshan; Wu, Kai

    2016-02-01

    Wearable devices are used in the new design of the maternal health care system to detect electrocardiogram and oxygen saturation signal while smart terminals are used to achieve assessments and input maternal clinical information. All the results combined with biochemical analysis from hospital are uploaded to cloud server by mobile Internet. Machine learning algorithms are used for data mining of all information of subjects. This system can achieve the assessment and care of maternal physical health as well as mental health. Moreover, the system can send the results and health guidance to smart terminals. PMID:27382731

  17. Health Care in Rural America.

    ERIC Educational Resources Information Center

    Ahearn, Mary C.

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

  18. Finding Health Care Services

    Cancer.gov

    If you have been diagnosed with cancer, finding a doctor and treatment facility for your cancer care is an important step to getting the best treatment possible. Learn tips for choosing a doctor and treatment facility to manage your cancer care.

  19. Defining the role of University of Kentucky HealthCare in its medical market--how strategic planning creates the intersection of good public policy and good business practices.

    PubMed

    Karpf, Michael; Lofgren, Richard; Bricker, Timothy; Claypool, Joseph O; Zembrodt, Jim; Perman, Jay; Higdon, Courtney M

    2009-02-01

    In response both to national pressures to reduce costs and improve health care access and outcomes and to local pressures to become a top-20 public research university, the University of Kentucky moved toward an integrated clinical enterprise, UK HealthCare, to create a common vision, shared goals, and an effective decision-making process. The leadership formed the vision and then embarked on a comprehensive and coordinated planning process that addressed financial, clinical, academic, and operational issues. The authors describe in depth the strategic planning process and specifically the definition of UK HealthCare's role in its medical marketplace. They began a rigorous process to assess and develop goals for the clinical programs and followed the progress of these programs through meetings driven by data and attended by the organization's senior leadership. They describe their approach to working with rural and community hospitals throughout central, eastern, and southern Kentucky to support the health care infrastructure of the state. They review the early successes of their strategic approach and describe the lessons they learned. The clinical successes have led to academic gains. The experience of UK HealthCare suggests that good business practices and good public policy are synergistic.

  20. Preventive Care in Women's Health.

    PubMed

    Blanchard, Anita K; Goodall, Perpetua

    2016-06-01

    Specialists in general obstetrics and gynecology are key providers of primary care in women. They diagnose and provide the initial management of many medical conditions unrelated to reproductive health. Most importantly they can impact the overall health of patients through incorporating preventive approaches in the annual well-woman visit. This article defines preventive care and identifies leading causes of mortality in women. A framework for identifying key elements of the well-woman examination is summarized. Examples of prevention are provided, which focus on major health care issues that affect adult women. PMID:27212087

  1. Who pays for health care in Ghana?

    PubMed Central

    2011-01-01

    Background Financial protection against the cost of unforeseen ill health has become a global concern as expressed in the 2005 World Health Assembly resolution (WHA58.33), which urges its member states to "plan the transition to universal coverage of their citizens". An important element of financial risk protection is to distribute health care financing fairly in relation to ability to pay. The distribution of health care financing burden across socio-economic groups has been estimated for European countries, the USA and Asia. Until recently there was no such analysis in Africa and this paper seeks to contribute to filling this gap. It presents the first comprehensive analysis of the distribution of health care financing in relation to ability to pay in Ghana. Methods Secondary data from the Ghana Living Standard Survey (GLSS) 2005/2006 were used. This was triangulated with data from the Ministry of Finance and other relevant sources, and further complemented with primary household data collected in six districts. We implored standard methodologies (including Kakwani index and test for dominance) for assessing progressivity in health care financing in this paper. Results Ghana's health care financing system is generally progressive. The progressivity of health financing is driven largely by the overall progressivity of taxes, which account for close to 50% of health care funding. The national health insurance (NHI) levy (part of VAT) is mildly progressive and formal sector NHI payroll deductions are also progressive. However, informal sector NHI contributions were found to be regressive. Out-of-pocket payments, which account for 45% of funding, are regressive form of health payment to households. Conclusion For Ghana to attain adequate financial risk protection and ultimately achieve universal coverage, it needs to extend pre-payment cover to all in the informal sector, possibly through funding their contributions entirely from tax, and address other issues

  2. Operationalizing universal health coverage in Nigeria through social health insurance.

    PubMed

    Okpani, Arnold Ikedichi; Abimbola, Seye

    2015-01-01

    Nigeria faces challenges that delay progress toward the attainment of the national government's declared goal of universal health coverage (UHC). One such challenge is system-wide inequities resulting from lack of financial protection for the health care needs of the vast majority of Nigerians. Only a small proportion of Nigerians have prepaid health care. In this paper, we draw on existing evidence to suggest steps toward reforming health care financing in Nigeria to achieve UHC through social health insurance. This article sets out to demonstrate that a viable path to UHC through expanding social health insurance exists in Nigeria. We argue that encouraging the states which are semi-autonomous federating units to setup and manage their own insurance schemes presents a unique opportunity for rapidly scaling up prepaid coverage for Nigerians. We show that Nigeria's federal structure which prescribes a sharing of responsibilities for health care among the three tiers of government presents serious challenges for significantly extending social insurance to uncovered groups. We recommend that rather than allowing this governance structure to impair progress toward UHC, it should be leveraged to accelerate the process by supporting the states to establish and manage their own insurance funds while encouraging integration with the National Health Insurance Scheme. PMID:26778879

  3. Operationalizing universal health coverage in Nigeria through social health insurance.

    PubMed

    Okpani, Arnold Ikedichi; Abimbola, Seye

    2015-01-01

    Nigeria faces challenges that delay progress toward the attainment of the national government's declared goal of universal health coverage (UHC). One such challenge is system-wide inequities resulting from lack of financial protection for the health care needs of the vast majority of Nigerians. Only a small proportion of Nigerians have prepaid health care. In this paper, we draw on existing evidence to suggest steps toward reforming health care financing in Nigeria to achieve UHC through social health insurance. This article sets out to demonstrate that a viable path to UHC through expanding social health insurance exists in Nigeria. We argue that encouraging the states which are semi-autonomous federating units to setup and manage their own insurance schemes presents a unique opportunity for rapidly scaling up prepaid coverage for Nigerians. We show that Nigeria's federal structure which prescribes a sharing of responsibilities for health care among the three tiers of government presents serious challenges for significantly extending social insurance to uncovered groups. We recommend that rather than allowing this governance structure to impair progress toward UHC, it should be leveraged to accelerate the process by supporting the states to establish and manage their own insurance funds while encouraging integration with the National Health Insurance Scheme.

  4. Operationalizing universal health coverage in Nigeria through social health insurance

    PubMed Central

    Okpani, Arnold Ikedichi; Abimbola, Seye

    2015-01-01

    Nigeria faces challenges that delay progress toward the attainment of the national government's declared goal of universal health coverage (UHC). One such challenge is system-wide inequities resulting from lack of financial protection for the health care needs of the vast majority of Nigerians. Only a small proportion of Nigerians have prepaid health care. In this paper, we draw on existing evidence to suggest steps toward reforming health care financing in Nigeria to achieve UHC through social health insurance. This article sets out to demonstrate that a viable path to UHC through expanding social health insurance exists in Nigeria. We argue that encouraging the states which are semi-autonomous federating units to setup and manage their own insurance schemes presents a unique opportunity for rapidly scaling up prepaid coverage for Nigerians. We show that Nigeria's federal structure which prescribes a sharing of responsibilities for health care among the three tiers of government presents serious challenges for significantly extending social insurance to uncovered groups. We recommend that rather than allowing this governance structure to impair progress toward UHC, it should be leveraged to accelerate the process by supporting the states to establish and manage their own insurance funds while encouraging integration with the National Health Insurance Scheme. PMID:26778879

  5. A Practical Method of Monitoring the Results of Health Care

    PubMed Central

    Daugharty, G. D.

    1979-01-01

    To meet our goal of improving health care through more productive use of the data we are collecting about the delivery of health care we need to define our concepts of health and quality. The WHO definition of health allows the design of useful functional outcome criteria which give us measurable standards for the outcome of the health care. By recording, retrieving, and reviewing pertinent information from the structure and the process of health care for a valid comparison with its outcome, the most effective and efficient health care is identified. A practical system is presented which identifies the better methods of management and produces the motivation for change that results in improved care. The successful use of this system in a private practice supports its universal adaptability for health care providers. The initial encouraging results suggest that future trials in other types of practices will be even more encouraging.

  6. Knowledge for medicine and health care--laudation at the occasion of the honorary doctorate bestowed to Donald A. B. Lindberg by UMIT, University for Health Sciences, Medical Informatics and Technology in Innsbruck, Tyrol, Austria.

    PubMed

    van Bemmel, Jan H

    2005-01-01

    Dr. Donald A. B. Lindberg, Director of the U.S. National Library of Medicine, received an honorary doctorate from UMIT, the University for Health Sciences, Medical Informatics and Technology in Innsbruck, Tyrol. The celebration took place on September 28, 2004 at an academic event during a conference of the Austrian, German, and Swiss Societies of Medical Informatics, GMDS2004. Dr. Lindberg has been a pioneer in the field of computers in health care from the early 1960s onwards. In 1984 he became the Director of the National Library of Medicine in Bethesda, the world's largest fully computerized biomedical library. Dr. Lindberg has been involved in the early activities of the International Medical Informatics Association (IMIA), among others being the chair of the Organizing Committee for MEDINFO 86 in Washington D.C. He was elected the first president of the American Medical Informatics Association (AMIA), and served as an editor of Methods of Information in Medicine.

  7. Five Steps to Safer Health Care

    MedlinePlus

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

  8. 8 ways to cut health care costs

    MedlinePlus

    ... health care provider if you can switch to generic medicines. They have the same active ingredient, but ... Trust for America's Health. A Healthy America 2013: Strategies to Move From Sick Care to Health Care ...

  9. Rural health care: redefining access.

    PubMed

    Collins, Chris

    2015-01-01

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

  10. Day care health risks

    MedlinePlus

    ... after going to the bathroom or changing a diaper, and then preparing food. In addition to good ... washing, important policies include: Preparing food and changing diapers in different areas Making sure day care staff ...

  11. Health Care Reform: Lessons From Canada

    PubMed Central

    Deber, Raisa Berlin

    2003-01-01

    Although Canadian health care seems to be perennially in crisis, access, quality, and satisfaction in Canada are relatively high, and spending is relatively well controlled. The Canadian model is built on a recognition of the limits of markets in distributing medically necessary care. Current issues in financing and delivering health care in Canada deserve attention. Key dilemmas include intergovernmental disputes between the federal and provincial levels of government and determining how to organize care, what to pay for (comprehensiveness), and what incentive structures to put in place for payment. Lessons for the United States include the importance of universal coverage, the advantages of a single payer, and the fact that systems can be organized on a subnational basis. PMID:12511378

  12. Politics and Universal Health Coverage--The Post-2015 Global Health Agenda.

    PubMed

    Gupta, Vin; Kerry, Vanessa B; Goosby, Eric; Yates, Robert

    2015-09-24

    What political, social, and economic factors allow a movement toward universal health coverage to take hold in some low- and middle-income countries? Can we use that knowledge to help other such countries achieve health care for all?

  13. Types of health care providers

    MedlinePlus

    ... medicine (FNP), pediatrics (PNP), adult care (ANP), or geriatrics (GNP). Others are trained to address women's health ... anesthetists (CRNAs) have training in the field of anesthesia. Anesthesia is the process of putting a patient ...

  14. Understanding your health care costs

    MedlinePlus

    ... share costs with you: Copayment. This is the payment you make for certain health care provider visits ... before your insurance company will start to make payments. Co-insurance. This is a percentage you pay ...

  15. HIV infection control in health care settings.

    PubMed

    Shriniwas; Srivastva, L; Sengupta, D; Lal, S

    1994-01-01

    If health care workers abide by universal precautions when dealing with blood and body fluids, the risk of HIV transmission from infected patients to health care workers is minimal. Few health care workers have become infected with HIV via needle stick injuries or exposure to mucous membranes. HIV-1 and HIV-2 are inactivated by heating at 60 degrees Celsius for 20 minutes, by disinfectants such as 70% alcohol for 2 minutes, and by high doses of ultraviolet irradiation. HIV reservoirs are blood, semen, vaginal secretions, breast milk, epithelial cells, cerebrospinal fluid, organs, and tissues. Health care workers should concentrate on preventing needle stick injuries and injuries due to sharp instruments. Health care workers should immediately and thoroughly wash hands and other parts of the body exposed to blood and body fluids with soap and water. They should also wash hands after removing protective gloves and in between handling of patients. They should wear gloves for all direct contact with blood and body fluids and during cleaning and decontaminating procedures. A face shield or mask, eye glasses, and waterproof gowns should be worn during all procedures where splashing of blood may occur. No one should perform mouth pipetting of blood or other body fluids. Health workers should reduce the number of unnecessary injections. They should use single-use syringes and needles and discard of them in puncture-proof containers. If single-use equipment is not available, all equipment needs to be autoclaved before reuse. If a wound occurs due to injury from contaminated equipment, bleeding should be encouraged. The health care worker must also wash it with soap and much water. Health care workers should immerse vaginal speculums, proctoscopes, nasal speculums, and instruments used for laryngeal and tracheal exams in a suitable disinfectant (e.g., embalming fluid) for at least 20 minutes.

  16. Model Child Care Health Policies.

    ERIC Educational Resources Information Center

    Aronson, Susan; Smith, Herberta

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

  17. Child Day Care Health Handbook.

    ERIC Educational Resources Information Center

    Fookson, Maxine; And Others

    Developed to meet Washington State Day Care Minimum Licensing Requirements, guidelines in this handbook concern 10 health topics. Discussion focuses on (1) preventing illness in day care settings; (2) illnesses, their treatment, ways to limit their spread, and what caregivers can do when they have a sick child at their center; (3) caregivers'…

  18. [Corruption and health care system].

    PubMed

    Marasović Šušnjara, Ivana

    2014-06-01

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

  19. [Corruption and health care system].

    PubMed

    Marasović Šušnjara, Ivana

    2014-06-01

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

  20. Primary care at Swiss universities - current state and perspective

    PubMed Central

    2014-01-01

    Background There is increasing evidence that a strong primary care is a cornerstone of an efficient health care system. But Switzerland is facing a shortage of primary care physicians (PCPs). This pushed the Federal Council of Switzerland to introduce a multifaceted political programme to strengthen the position of primary care, including its academic role. The aim of this paper is to provide a comprehensive overview of the situation of academic primary care at the five Swiss universities by the end of year 2012. Results Although primary care teaching activities have a long tradition at the five Swiss universities with activities starting in the beginning of the 1980ies; the academic institutes of primary care were only established in recent years (2005 – 2009). Only one of them has an established chair. Human and financial resources vary substantially. At all universities a broad variety of courses and lectures are offered, including teaching in private primary care practices with 1331 PCPs involved. Regarding research, differences among the institutes are tremendous, mainly caused by entirely different human resources and skills. Conclusion So far, the activities of the existing institutes at the Swiss Universities are mainly focused on teaching. However, for a complete academic institutionalization as well as an increased acceptance and attractiveness, more research activities are needed. In addition to an adequate basic funding of research positions, competitive research grants have to be created to establish a specialty-specific research culture. PMID:24885148

  1. 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 ...

  2. Child Poverty and the Health Care System.

    PubMed

    Racine, Andrew D

    2016-04-01

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

  3. Child Poverty and the Health Care System.

    PubMed

    Racine, Andrew D

    2016-04-01

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

  4. Health care entrepreneurship: financing innovation.

    PubMed

    Grazier, Kyle L; Metzler, Bridget

    2006-01-01

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

  5. Health care entrepreneurship: financing innovation.

    PubMed

    Grazier, Kyle L; Metzler, Bridget

    2006-01-01

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

  6. Agents of Change for Health Care Reform

    ERIC Educational Resources Information Center

    Buchanan, Larry M.

    2007-01-01

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

  7. A palliative care initiative in Dokuz Eylul University Hospital.

    PubMed

    Mutafoglu, Kamer

    2011-04-01

    Turkey is among the countries with only "capacity building activity" in terms of palliative care development according to the mapping levels reported by the International Observatory on End of Life Care (http://www.eolc-observatory.net/global/pdf/world_map.pdf). Palliative care units are lacking even in major hospitals. Although some medical oncologists and pain specialists have been providing pain control and symptom relief to some extend, all these interventions remain a fragmented approach to care since there are no palliative care programs. Establishing palliative care services should be a priority in the development of comprehensive cancer care, particularly in a country where more than 60% of the cancer patients present with advanced stage disease. Like all the other university hospitals in the country, palliative care services have not been established so far in Dokuz Eylul University Hospital for several reasons although almost all the modern cancer treatment modalities have been provided to cancer patients. A group of health professionals have recently started a palliative care initiative in the hospital with an aim to raise awareness and to implement basic palliative care interventions to the current cancer care. This paper aims to tell the story of how this initiative get started and which step were taken so far.

  8. The essential role of generalists in health care systems.

    PubMed

    Ferrer, Robert L; Hambidge, Simon J; Maly, Rose C

    2005-04-19

    Viewing primary care as merely one of the many niches in individual patient care fosters a narrow perspective that neither accounts for the full value of primary care nor offers proper guidance for reforming it. Instead, a systems view better articulates primary care's essential role in increasing the effectiveness and efficiency of other health care services. Primary care improves health care system functioning through such services as managing and triaging undifferentiated symptoms, matching patient needs to health care resources, and enhancing the system's ability to adapt to new circumstances. By acting as an appropriate filter for high-technology care, primary care helps ensure that it is appropriately applied, a major determinant of outcomes. Furthermore, because primary care is the most financially and geographically accessible arm of the health care system, it reduces socioeconomic and geographic disparities across the population. Even in the de facto health system that exists in the United States, these functions are necessary for the efficient, equitable, and sustainable delivery of health care and the adaptability and resilience of the system as a whole. As primary care reforms proceed, it will be important to explicitly consider how to support and strengthen its system-level benefits. Needed reforms include enabling universal access to primary care and providing the leadership, training, and infrastructure support to improve its performance as a central hub in the network of patients, clinicians, and communities. It is important that health systems realize the essential integrative function of primary care. PMID:15838088

  9. Help Yourself to Health Care.

    ERIC Educational Resources Information Center

    Snyder, Sarah

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

  10. Advancing the role of nonprofit health care.

    PubMed

    Metcalfe, Marcia

    2002-01-01

    This article comes out of a series of discussions among a diverse group of chief executive officers (CEOs) and other leaders of nonprofit hospitals, long-term care facilities, health maintenance organizations, and other insurance providers, including several nonprofit Blue Cross Blue Shield (BCBS) plans. The group was convened as part of Howard Berman's Walter J. McNerney Fellowship project. (Berman is CEO of Excellus, Inc., a nonprofit Blue Cross Blue Shield affiliate that insures the health of more than 2.15 million people in upstate New York. He was awarded the McNerney Fellowship in April 2001 by the Health Research and Educational Trust, an American Hospital Association affiliate. The Fellowship goes annually to at least one fellow to highlight or pursue work that will provide new insights into how different sectors of the health care system can better work together for improved outcomes.) The group has met several times over the past year around a shared concern: the current challenges to nonprofit health care organizations and the future role for nonprofits in the re-visioning and creation of an American health care system that is characterized by universal access, patient-centered quality, and national affordability. Members have supported the public relations campaign of the "Alliance for Advancing Nonprofit Health Care," an effort initiated by the Caucus, an independent group of nonprofit BCBS plans. The group continues to explore the need for a broad-based coalition of providers, insurers, and other organizations to effectively protect and enhance the role of nonprofit health care.

  11. Health care fraud and abuse.

    PubMed

    Kalb, P E

    In recent years, health care fraud and abuse have become major issues, in part because of the rising cost of health care, industry consolidation, the emergence of private "whistle-blowers," and a change in the concept of fraud to include an emerging concern about quality of care. The 3 types of conduct that are generally prohibited by health care fraud laws are false claims, kickbacks, and self-referrals. False claims are subject to several criminal, civil, and administrative prohibitions, notably the federal civil False Claims Act. Kickbacks, or inducements with the intent to influence the purchase or sale of health care-related goods or services, are prohibited under the federal Anti-Kickback statute as well as by state laws. Finally, self-referrals-the referral of patients to an entity with which the referring physician has a financial relationship-are outlawed by the Ethics in Patient Referral Act as well as numerous state statutes. Consequences of violations of these laws can include, in addition to imprisonment and fines, civil monetary penalties, loss of licensure, loss of staff privileges, and exclusion from participation in federal health care programs. Federal criminal and civil statutes are enforced by the US Department of Justice; administrative actions are pursued by the Department of Health and Human Services' Office of Inspector General; and all state actions are pursued by the individual states. In addition, private whistle-blowers may, acting in the name of the United States, file suit against an entity under the False Claims Act. Enforcement of health care fraud and abuse laws has become increasingly commonplace and now affects many mainstream providers. This trend is likely to continue.

  12. Health Care of Incarcerated Youth: State Programs & Initiatives.

    ERIC Educational Resources Information Center

    Thompson, Linda S.; Sheahan, Paula M.

    This report presents the analysis and results of a survey of states' progress in meeting the goals and objectives of their state action plans on the health care of incarcerated youth. The survey questioned 48 juvenile justice professionals, health care professionals, and university faculty from across the nation concerning state progress toward…

  13. Health Care Provider Initiative Strategic Plan

    ERIC Educational Resources Information Center

    National Environmental Education & Training Foundation, 2012

    2012-01-01

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

  14. Training Health Care Paraprofessionals

    ERIC Educational Resources Information Center

    Linton, Corinne B.

    1977-01-01

    This review of the allied health occupations training programs offered by Brevard Community College (Cocoa, Florida) covers organization of the division, objectives, selection and admission process, instructional delivery system, clinical facilities, advisory committees, high school relations, continuing education programs, and program success.…

  15. Marketing occupational health care.

    PubMed

    Norris, M J; Harris, J C

    1981-01-01

    A very basic part of marketing success is determining areas of your business in which you have a competitive advantage. In drafting a marketing plan for the Denver Clinic, the competitive advantages group practices have in the area of occupational health were quickly realized. This competitive edge is presented along with the Denver Clinic's marketing strategies and plans to capitalize on occupational healthcare advantages.

  16. Treatment diets in Estonian health care institutions.

    PubMed

    Kiisk, Liidia; Kaarma, Helje; Ots, Mai

    2008-01-01

    New system and nomenclature of diets for Estonian health care institutions have been developed in the university hospital based on theoretical and practical experience obtained over several years of cooperation with medical scientists from different fields of specialization. The nomenclature of diets includes ordinary food and eight groups of diet food with subgroups. The normative values of the basic nutrients are in accordance with the Estonian and Nordic nutritional recommendations. The whole system includes the menus and recipes of nutritional food portions. The system of treatment diets helps to optimize proper nutrition in different departments and organize better patient care. PMID:18791334

  17. reDefined contribution health care.

    PubMed

    Lair, Tamra

    2004-01-01

    To combat rising health care costs and a society increasingly unsatisfied with employer-sponsored health care services, reDefined Contribution Health Care suggests a process to create a more consumer-driven health care market. To create this value-sensitive market requires a planned, staged approach that will include immediate actions and work toward fundamental, long-term changes. PMID:15146751

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

    PubMed

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

    2008-01-01

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

  19. A right to health care.

    PubMed

    Eleftheriadis, Pavlos

    2012-01-01

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

  20. Health promotion and primary health care: examining the discourse.

    PubMed

    Ashcroft, Rachelle

    2015-01-01

    The health promotion discourse is comprised of assumptions about health and health care that are compatible with primary health care. An examination of the health promotion discourse illustrates how assumptions of health can help to inform primary health care. Despite health promotion being a good fit for primary health care, this analysis demonstrates that the scope in which it is being implemented in primary health care settings is limited. The health promotion discourse appears largely compatible with primary health care-in theory and in the health care practices that follow. The aim of this article is to contribute to the advancement of theoretical understanding of the health promotion discourse, and the relevance of health promotion to primary health care.

  1. University of California San Diego's Program in Medical Education-Health Equity (PRIME-HEq): Training Future Physicians to Care for Underserved Communities.

    PubMed

    Powell, Tamara; Garcia, Katherine Arias; Lopez, Alexis; Bailey, Jacob; Willies-Jacobo, Lindia

    2016-01-01

    The Program in Medicine-Health Equity (PRIME-HEq) at the University of California, San Diego prepares physicians to clinically serve and publicly advocate for underserved communities. In this article we share some of PRIME-HEq's defining features, such as our admissions process, student-directed service-focused elective courses, active community engagement, and multi-disciplinary Master's training. PMID:27524742

  2. Health reform: setting the agenda for long term care.

    PubMed

    Hatch, O G; Wofford, H; Willging, P R; Pomeroy, E

    1993-06-01

    The White House Task Force on National Health Care Reform, headed by First Lady Hillary Rodham Clinton, is expected to release its prescription for health care reform this month. From the outset, Clinton's mandate was clear: to provide universal coverage while reining in costs for delivering quality health care. Before President Clinton was even sworn into office, he had outlined the major principles that would shape the health reform debate. Global budgeting would establish limits on all health care expenditures, thereby containing health costs. Under a system of managed competition, employers would form health alliances for consumers to negotiate for cost-effective health care at the community level. So far, a basic approach to health care reform has emerged. A key element is universal coverage--with an emphasis on acute, preventive, and mental health care. Other likely pieces are employer-employee contributions to health care plans, laws that guarantee continued coverage if an individual changes jobs or becomes ill, and health insurance alliances that would help assure individual access to low-cost health care. What still is not clear is the extent to which long term care will be included in the basic benefits package. A confidential report circulated by the task force last month includes four options for long term care: incremental Medicaid reform; a new federal/state program to replace Medicaid; a social insurance program for home and community-based services; or full social insurance for long term care. Some work group members have identified an additional option: prefunded long term care insurance.(ABSTRACT TRUNCATED AT 250 WORDS)

  3. Health reform: setting the agenda for long term care.

    PubMed

    Hatch, O G; Wofford, H; Willging, P R; Pomeroy, E

    1993-06-01

    The White House Task Force on National Health Care Reform, headed by First Lady Hillary Rodham Clinton, is expected to release its prescription for health care reform this month. From the outset, Clinton's mandate was clear: to provide universal coverage while reining in costs for delivering quality health care. Before President Clinton was even sworn into office, he had outlined the major principles that would shape the health reform debate. Global budgeting would establish limits on all health care expenditures, thereby containing health costs. Under a system of managed competition, employers would form health alliances for consumers to negotiate for cost-effective health care at the community level. So far, a basic approach to health care reform has emerged. A key element is universal coverage--with an emphasis on acute, preventive, and mental health care. Other likely pieces are employer-employee contributions to health care plans, laws that guarantee continued coverage if an individual changes jobs or becomes ill, and health insurance alliances that would help assure individual access to low-cost health care. What still is not clear is the extent to which long term care will be included in the basic benefits package. A confidential report circulated by the task force last month includes four options for long term care: incremental Medicaid reform; a new federal/state program to replace Medicaid; a social insurance program for home and community-based services; or full social insurance for long term care. Some work group members have identified an additional option: prefunded long term care insurance.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:10126659

  4. Reproductive health in India's primary health care system.

    PubMed

    Rao, M

    1997-01-01

    India's family planning program having reached a dead end, the government of India appointed an expert group to develop a new population policy for the country. While the group's report, submitted in May 1994, proclaimed a new orientation described as pro-poor, pro-nature, and pro-women, the recommendations of the report were criticized as not being serious about gender equity. The government of India, describing a new reproductive health care approach, envisions a paradigm shift in the family planning program strategy. Reproductive health is defined as a state in which people can reproduce and regulate their fertility, women are able to go through pregnancy and childbirth safely, the outcome of pregnancy is successful with regard to maternal and infant survival and well-being, and couples are able to have sexual relations free of the fear of pregnancy and of contracting disease. To further the discussion on the newly initiated reproductive health care approach, the faculty of the Center of Social Medicine and Community Health, School of Social Sciences, Jawaharlal Nehru University, New Delhi, organized a workshop for November 4-5, 1996, on the place of reproductive health in India's primary health care. The workshop brought together public health persons, clinicians, and health and women's rights activists. The author outlines the content of papers presented at the workshop.

  5. Reproductive health in India's primary health care system.

    PubMed

    Rao, M

    1997-01-01

    India's family planning program having reached a dead end, the government of India appointed an expert group to develop a new population policy for the country. While the group's report, submitted in May 1994, proclaimed a new orientation described as pro-poor, pro-nature, and pro-women, the recommendations of the report were criticized as not being serious about gender equity. The government of India, describing a new reproductive health care approach, envisions a paradigm shift in the family planning program strategy. Reproductive health is defined as a state in which people can reproduce and regulate their fertility, women are able to go through pregnancy and childbirth safely, the outcome of pregnancy is successful with regard to maternal and infant survival and well-being, and couples are able to have sexual relations free of the fear of pregnancy and of contracting disease. To further the discussion on the newly initiated reproductive health care approach, the faculty of the Center of Social Medicine and Community Health, School of Social Sciences, Jawaharlal Nehru University, New Delhi, organized a workshop for November 4-5, 1996, on the place of reproductive health in India's primary health care. The workshop brought together public health persons, clinicians, and health and women's rights activists. The author outlines the content of papers presented at the workshop. PMID:9230606

  6. Phytotherapy in primary health care

    PubMed Central

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

    2014-01-01

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

  7. Health Care Procedure Considerations and Individualized Health Care Plans

    ERIC Educational Resources Information Center

    Heller, Kathryn Wolff; Avant, Mary Jane Thompson

    2011-01-01

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

  8. 47 CFR 54.613 - Limitations on supported services for rural health care providers.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... health care providers. 54.613 Section 54.613 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED) UNIVERSAL SERVICE Universal Service Support for Health Care Providers § 54.613 Limitations on supported services for rural health care providers. (a) Upon submitting...

  9. 47 CFR 54.613 - Limitations on supported services for rural health care providers.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... health care providers. 54.613 Section 54.613 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED) UNIVERSAL SERVICE Universal Service Support for Health Care Providers § 54.613 Limitations on supported services for rural health care providers. (a) Upon submitting...

  10. 47 CFR 54.613 - Limitations on supported services for rural health care providers.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... health care providers. 54.613 Section 54.613 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED) UNIVERSAL SERVICE Universal Service Support for Health Care Providers § 54.613 Limitations on supported services for rural health care providers. (a) Upon submitting...

  11. Innovation in Health Care Delivery.

    PubMed

    Sharan, Alok D; Schroeder, Gregory D; West, Michael E; Vaccaro, Alexander R

    2016-02-01

    As reimbursement transitions from a volume-based to a value-based system, innovation in health care delivery will be needed. The process of innovation begins with framing the problem that needs to be solved along with the strategic vision that has to be achieved. Similar to scientific testing, a hypothesis is generated for a new solution to a problem. Innovation requires conducting a disciplined form of experimentation and then learning from the process. This manuscript will discuss the different types of innovation, and the key steps necessary for successful innovation in the health care field.

  12. Improving Educational Preparation for Transcultural Health Care.

    ERIC Educational Resources Information Center

    Le Var, Rita M. H.

    1998-01-01

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

  13. Good Health Before Pregnancy: Preconception Care

    MedlinePlus

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

  14. Obamacare Paying Off with Improved Health Care

    MedlinePlus

    ... fullstory_159906.html Obamacare Paying Off With Improved Health Care: Report But gains between 2011 and 2014 were ... 15, 2016 (HealthDay News) -- A new report finds health care improved in much of the United States between ...

  15. Oral health care in residential aged care services: barriers to engaging health-care providers.

    PubMed

    Hearn, Lydia; Slack-Smith, Linda

    2015-01-01

    The oral health of older people living in residential aged care facilities has been widely recognised as inadequate. The aim of this paper is to identify barriers to effective engagement of health-care providers in oral care in residential aged care facilities. A literature review was conducted using MEDline, CINAHL, Web of Science, Academic Search Complete and PsychInfo between 2000 and 2013, with a grey literature search of government and non-government organisation policy papers, conference proceedings and theses. Keywords included: dental/oral care, residential aged care, health-care providers, barriers, constraints, and limitations. A thematic framework was used to synthesise the literature according to a series of oral health-care provision barriers, health-care provider barriers, and cross-sector collaborative barriers. A range of system, service and practitioner level barriers were identified that could impede effective communication/collaboration between different health-care providers, residents and carers regarding oral care, and these were further impeded by internal barriers at each level. Findings indicated several areas for investigation and consideration regarding policy and practice improvements. While further research is required, some key areas should be addressed if oral health care in residential aged care services is to be improved. PMID:25155109

  16. Prospective Health: Duke's Approach to Improving Employee Health and Managing Health Care Costs

    ERIC Educational Resources Information Center

    Davidson, H. Clint, Jr.

    2004-01-01

    If developing a healthy workforce is critical to reining in the skyrocketing cost of health care, then why have so many attempts at preventive health or disease management fallen short? How can employers connect with employees to engage them in changing unhealthy habits or lifestyles? Duke University has launched an innovative new approach called…

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

    ERIC Educational Resources Information Center

    Lewis, John; Dempsey, Joanne R.

    1984-01-01

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

  18. Mandatory influenza vaccination for health care workers as the new standard of care: a matter of patient safety and nonmaleficent practice.

    PubMed

    Cortes-Penfield, Nicolas

    2014-11-01

    A growing body of literature defends the efficacy of seasonal influenza vaccination for health care workers in reducing the mortality of hospitalized patients. I review the evidence concerning influenza vaccination, concluding that universal vaccination of health care workers against influenza should be considered standard patient care and that nonvaccination represents maleficent care. I further argue that the ethical responsibility to ensure universal vaccination of staff against seasonal influenza lies not only with individual health care providers but with each individual health care institution.

  19. Mental health care in Cambodia.

    PubMed Central

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

    1999-01-01

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

  20. Relationship marketing in health care.

    PubMed

    Wagner, H C; Fleming, D; Mangold, W G; LaForge, R W

    1994-01-01

    Building relationships with patients is critical to the success of many health care organizations. The authors profile the relationship marketing program for a hospital's cardiac center and discuss the key strategic aspects that account for its success: a focus on a specific hospital service, an integrated marketing communication strategy, a specially designed database, and the continuous tracking of results.

  1. Reengineering health care materials management.

    PubMed

    Connor, L R

    1998-01-01

    Health care executives across the country, faced with intense competition, are being forced to consider drastic cost cutting measures as a matter of survival. The entire health care industry is under siege from boards of directors, management and others who encourage health care systems to take actions ranging from strategic acquisitions and mergers to simple "downsizing" or "rightsizing," to improve their perceived competitive positions in terms of costs, revenues and market share. In some cases, management is poorly prepared to work within this new competitive paradigm and turns to consultants who promise that following their methodologies can result in competitive advantage. One favored methodology is reengineering. Frequently, cost cutting attention is focused on the materials management budget because it is relatively large and is viewed as being comprised mostly of controllable expenses. Also, materials management is seldom considered a core competency for the health care system and the organization performing these activities does not occupy a strongly defensible position. This paper focuses on the application of a reengineering methodology to healthcare materials management. PMID:9785300

  2. Hedging opportunities in health care.

    PubMed

    Hayes, J A

    1990-03-01

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

  3. Where Is Health Care Headed?

    PubMed

    Bland, Jeffrey

    2016-06-01

    Looking at the trends, developments, and discoveries points us toward the future, but it is only when we consider these in the context of our understanding about the origins of disease that we can truly gain a clearer view of where health care is headed. This is the view that moves us from a focus on the diagnosis and treatment of a disease to an understanding of the origin of the alteration in function in the individual. This change in both perspective and understanding of the origin of disease is what will lead us to a systems approach to health care that delivers personalized and precision care that is based on the inherent rehabilitative power that resides within the genome. PMID:27547161

  4. The Effect of Entry Regulation in the Health Care Sector: the Case of Home Health.

    PubMed

    Polsky, Daniel; David, Guy; Yang, Jianing; Kinosian, Bruce; Werner, Rachel

    2014-02-01

    The consequences of government regulation in the post-acute care sector are not well understood. We examine the effect of entry regulation on quality of care in home health care by analyzing the universe of hospital discharges during 2006 for publicly insured beneficiaries (about 4.5 million) and subsequent home health admissions to determine whether there is a significant difference in home health utilization, hospital readmission rates, and health care expenditures in states with and without Certificate of Need laws (CON) regulating entry. We identify these effects by looking across regulated and nonregulated states within Hospital Referral Regions, which characterize well-defined health care markets and frequently cross state boundaries. We find that CON states use home health less frequently, but system-wide rehospitalization rates, overall Medicare expenditures, and home health practice patterns are similar. Removing CON for home health would have negligible system-wide effects on health care costs and quality.

  5. The Effect of Entry Regulation in the Health Care Sector: the Case of Home Health

    PubMed Central

    Polsky, Daniel; David, Guy; Yang, Jianing; Kinosian, Bruce; Werner, Rachel

    2013-01-01

    The consequences of government regulation in the post-acute care sector are not well understood. We examine the effect of entry regulation on quality of care in home health care by analyzing the universe of hospital discharges during 2006 for publicly insured beneficiaries (about 4.5 million) and subsequent home health admissions to determine whether there is a significant difference in home health utilization, hospital readmission rates, and health care expenditures in states with and without Certificate of Need laws (CON) regulating entry. We identify these effects by looking across regulated and nonregulated states within Hospital Referral Regions, which characterize well-defined health care markets and frequently cross state boundaries. We find that CON states use home health less frequently, but system-wide rehospitalization rates, overall Medicare expenditures, and home health practice patterns are similar. Removing CON for home health would have negligible system-wide effects on health care costs and quality. PMID:24497648

  6. Preserving community in health care.

    PubMed

    Emanuel, E J; Emanuel, L L

    1997-02-01

    There are two prominent trends in health care today: first, increasing demands for accountabilty, and second, increasing provision of care through managed care organizations. These trends promote the question: What form of account-ability is appropriate to managed care plans? Accountability is the process by which a party justifies its actions and policies. Components of accountability include parties that can be held or hold others accountable, domains and content areas being assessed, and procedures of assessment. Traditionally, the professional model of accountability has operated in medical care. In this model, physicians establish the standards of accountability and hold each other accountable through professional organizations. This form of accountability seems outdated and inapplicable to managed care plans. The alternatives are the economic and the political models of accountability. In the economic model, medicine becomes more like a commodity, and "exit" (consumers changing providers for reasons of cost and quality) is the dominant procedure of accountability. In the political model, medicine becomes more like a community good, and "voice" (citizens communicating their views in public forums or on policy committees, or in elections for representatives) is the dominant procedure of accountability. The economic model's advantages affirm American individualism, make minimal demands on consumers, and use a powerful incentive, money. Its disadvantages undermine health care as a nonmarket good, undermine individual autonomy, undermine good medical practice, impose significant demands on consumers to be informed, sustain differentials of power, and use indirect procedures of accountability. The political model's advantages affirm health care as a matter of justice, permit selecting domains other than price and quality for accountability, reinforce good medical practice, and equalize power between patients and physicians. Its disadvantages include inefficiency in

  7. Preserving community in health care.

    PubMed

    Emanuel, E J; Emanuel, L L

    1997-02-01

    There are two prominent trends in health care today: first, increasing demands for accountabilty, and second, increasing provision of care through managed care organizations. These trends promote the question: What form of account-ability is appropriate to managed care plans? Accountability is the process by which a party justifies its actions and policies. Components of accountability include parties that can be held or hold others accountable, domains and content areas being assessed, and procedures of assessment. Traditionally, the professional model of accountability has operated in medical care. In this model, physicians establish the standards of accountability and hold each other accountable through professional organizations. This form of accountability seems outdated and inapplicable to managed care plans. The alternatives are the economic and the political models of accountability. In the economic model, medicine becomes more like a commodity, and "exit" (consumers changing providers for reasons of cost and quality) is the dominant procedure of accountability. In the political model, medicine becomes more like a community good, and "voice" (citizens communicating their views in public forums or on policy committees, or in elections for representatives) is the dominant procedure of accountability. The economic model's advantages affirm American individualism, make minimal demands on consumers, and use a powerful incentive, money. Its disadvantages undermine health care as a nonmarket good, undermine individual autonomy, undermine good medical practice, impose significant demands on consumers to be informed, sustain differentials of power, and use indirect procedures of accountability. The political model's advantages affirm health care as a matter of justice, permit selecting domains other than price and quality for accountability, reinforce good medical practice, and equalize power between patients and physicians. Its disadvantages include inefficiency in

  8. Obama health care for all Americans: practical implications.

    PubMed

    Manchikanti, Laxmaiah; Hirsch, Joshua A

    2009-01-01

    Rapidly rising health care costs over the decades have prompted the application of business practices to medicine with goals of improving the efficiency, restraining expenses, and increasing quality. Average health insurance premiums and individual contributions for family coverage have increased approximately 120% from 1999 to 2008. Health care spending in the United States is stated to exceed 4 times the national defense, despite the wars in Iraq and Afghanistan. The U.S. health care system has been blamed for inefficiencies, excessive administrative expenses, inflated prices, inappropriate waste, and fraud and abuse. While many people lack health insurance, others who do have health insurance allegedly receive care ranging from superb to inexcusable. In criticism of health care in the United States and the focus on savings, methodologists, policy makers, and the public in general seem to ignore the major disadvantages of other global health care systems and the previous experiences of the United States to reform health care. Health care reform is back with the Obama administration with great expectations. It is also believed that for the first time since 1993, momentum is building for policies that would move the United States towards universal health insurance. President Obama has made health care a central part of his domestic agenda, with spending and investments in Children's Health Insurance Program (CHIP), American Recovery and Reinvestment Act of 2009, and proposed 2010 budget. It is the consensus now that since we have a fiscal emergency, Washington is willing to deal with the health care crisis. Many of the groups long opposed to reform, appear to be coming together to accept a major health care reform. Reducing costs is always at the center of any health care debate in the United States. These have been focused on waste, fraud, and abuse; administrative costs; improving the quality with health technology information dissemination; and excessive

  9. Obama health care for all Americans: practical implications.

    PubMed

    Manchikanti, Laxmaiah; Hirsch, Joshua A

    2009-01-01

    Rapidly rising health care costs over the decades have prompted the application of business practices to medicine with goals of improving the efficiency, restraining expenses, and increasing quality. Average health insurance premiums and individual contributions for family coverage have increased approximately 120% from 1999 to 2008. Health care spending in the United States is stated to exceed 4 times the national defense, despite the wars in Iraq and Afghanistan. The U.S. health care system has been blamed for inefficiencies, excessive administrative expenses, inflated prices, inappropriate waste, and fraud and abuse. While many people lack health insurance, others who do have health insurance allegedly receive care ranging from superb to inexcusable. In criticism of health care in the United States and the focus on savings, methodologists, policy makers, and the public in general seem to ignore the major disadvantages of other global health care systems and the previous experiences of the United States to reform health care. Health care reform is back with the Obama administration with great expectations. It is also believed that for the first time since 1993, momentum is building for policies that would move the United States towards universal health insurance. President Obama has made health care a central part of his domestic agenda, with spending and investments in Children's Health Insurance Program (CHIP), American Recovery and Reinvestment Act of 2009, and proposed 2010 budget. It is the consensus now that since we have a fiscal emergency, Washington is willing to deal with the health care crisis. Many of the groups long opposed to reform, appear to be coming together to accept a major health care reform. Reducing costs is always at the center of any health care debate in the United States. These have been focused on waste, fraud, and abuse; administrative costs; improving the quality with health technology information dissemination; and excessive

  10. Assessing Latin America's Progress Toward Achieving Universal Health Coverage.

    PubMed

    Wagstaff, Adam; Dmytraczenko, Tania; Almeida, Gisele; Buisman, Leander; Hoang-Vu Eozenou, Patrick; Bredenkamp, Caryn; Cercone, James A; Diaz, Yadira; Maceira, Daniel; Molina, Silvia; Paraje, Guillermo; Ruiz, Fernando; Sarti, Flavia; Scott, John; Valdivia, Martin; Werneck, Heitor

    2015-10-01

    Two commonly used metrics for assessing progress toward universal health coverage involve assessing citizens' rights to health care and counting the number of people who are in a financial protection scheme that safeguards them from high health care payments. On these metrics most countries in Latin America have already "reached" universal health coverage. Neither metric indicates, however, whether a country has achieved universal health coverage in the now commonly accepted sense of the term: that everyone--irrespective of their ability to pay--gets the health services they need without suffering undue financial hardship. We operationalized a framework proposed by the World Bank and the World Health Organization to monitor progress under this definition and then constructed an overall index of universal health coverage achievement. We applied the approach using data from 112 household surveys from 1990 to 2013 for all twenty Latin American countries. No country has achieved a perfect universal health coverage score, but some countries (including those with more integrated health systems) fare better than others. All countries except one improved in overall universal health coverage over the time period analyzed. PMID:26438747

  11. Assessing Latin America's Progress Toward Achieving Universal Health Coverage.

    PubMed

    Wagstaff, Adam; Dmytraczenko, Tania; Almeida, Gisele; Buisman, Leander; Hoang-Vu Eozenou, Patrick; Bredenkamp, Caryn; Cercone, James A; Diaz, Yadira; Maceira, Daniel; Molina, Silvia; Paraje, Guillermo; Ruiz, Fernando; Sarti, Flavia; Scott, John; Valdivia, Martin; Werneck, Heitor

    2015-10-01

    Two commonly used metrics for assessing progress toward universal health coverage involve assessing citizens' rights to health care and counting the number of people who are in a financial protection scheme that safeguards them from high health care payments. On these metrics most countries in Latin America have already "reached" universal health coverage. Neither metric indicates, however, whether a country has achieved universal health coverage in the now commonly accepted sense of the term: that everyone--irrespective of their ability to pay--gets the health services they need without suffering undue financial hardship. We operationalized a framework proposed by the World Bank and the World Health Organization to monitor progress under this definition and then constructed an overall index of universal health coverage achievement. We applied the approach using data from 112 household surveys from 1990 to 2013 for all twenty Latin American countries. No country has achieved a perfect universal health coverage score, but some countries (including those with more integrated health systems) fare better than others. All countries except one improved in overall universal health coverage over the time period analyzed.

  12. Financing the health care Internet.

    PubMed

    Robinson, J C

    2000-01-01

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

  13. Mental health and quality of mental health care.

    PubMed

    Taipale, V

    2001-01-01

    Mental health is an intrinsic part of health. Its prevailing position as secondary to physical health and its consequent neglect are based on inaccurate assumptions about mental health. Nowhere in the world, in either the developed or the developing countries, has mental health work been given priority as part of social policy, health policy or public policy. Yet all countries readily admit the major impact of mental health disturbances on the national economy and public health. The mentally sick are at the bottom of the list in service systems the world over, and the common attitude towards them tends to be highly negative. Meanwhile there is convincing evidence of the global and growing need for mental health services. The international debate on mental health policy has its origins in two arenas: in human rights issues and in service reform issues. The debate on human rights concerns legislation on mental health, compulsory treatment and coercive measures. As to the service reform process, the universal focus has been on the financing of health care, on cuts and downsizing, where no priority has been given to the quality of care. The social consequences of mental illnesses may be far more seriously marginalising for the patient than is the illness itself. They are caused by the inexperience and the exclusion mechanisms of the social community. They are evident also in non-institutional services, causing isolation and rejection. The state of mental health patients will not improve without the strong involvement of health policy planners, quality assurance developers and the medical and scientific community. We need far more studies and research in the field. We need also the empowerment of the patients themselves and their relatives.

  14. Education for sexual health care.

    PubMed

    Katzman, E M

    1990-03-01

    I have described the content of a sexuality course in a college of nursing and its professional application for 78 female and male nursing students. Responses to open-ended questions indicated that the course helped the students better deal with the sexual concerns of their patients and clients. As one participant said, "This class has led me to believe in sexual health care by nurses. I would have been content to leave it to the doctors or social workers who I thought were taking care of it. However, I was not aware of how little attention was given to the patients' sexual concerns by any health professional until I started looking for it. I now believe that nurses, more than anyone, can help bring about positive changes in these areas." Another student said, "I think more resources for sexuality teaching should be available for nurses. I have cared for many patients who could have used this type of intervention, but I was not prepared to give it." Given the AIDS epidemic, it is vital that nurses be prepared to deal with the sensitive aspects of sexuality in AIDS prevention, with people with AIDS, and with their significant others and caregivers. Of all health care professionals, nurses are in a unique position to help such patients and clients. A sexuality course can help nurses explore their own values and feelings as well as learn the effects of illness on patients' sexuality. Patients, their families, and nurses will all benefit.

  15. What is the health care product?

    PubMed

    France, K R; Grover, R

    1992-06-01

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

  16. Requiring Influenza Vaccination for Health Care Workers

    PubMed Central

    Anikeeva, Olga; Rogers, Wendy

    2009-01-01

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

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

    PubMed

    Guo, Kristina L

    2010-01-01

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

  18. Equity in Access to Health Care Services in Italy

    PubMed Central

    Glorioso, Valeria; Subramanian, S V

    2014-01-01

    Objective To provide new evidence on whether and how patterns of health care utilization deviate from horizontal equity in a country with a universal and egalitarian public health care system: Italy. Data Sources Secondary analysis of data from the Health Conditions and Health Care Utilization Survey 2005, conducted by the Italian National Institute of Statistics on a probability sample of the noninstitutionalized Italian population. Study Design Using multilevel logistic regression, we investigated how the probability of utilizing five health care services varies among individuals with equal health status but different SES. Data Collection/Extraction Respondents aged 18 or older at the interview time (n = 103,651). Principal Findings Overall, we found that use of primary care is inequitable in favor of the less well-off, hospitalization is equitable, and use of outpatient specialist care, basic medical tests, and diagnostic services is inequitable in favor of the well-off. Stratifying the analysis by health status, however, we found that the degree of inequity varies according to health status. Conclusions Despite its universal and egalitarian public health care system, Italy exhibits a significant degree of SES-related horizontal inequity in health services utilization. PMID:24949515

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

    ERIC Educational Resources Information Center

    Perez-Escamilla, Rafael

    2010-01-01

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

  20. Complementary therapies in health care.

    PubMed

    van der Riet, Pamela

    2011-03-01

    In the past two decades, complementary therapies have grown in popularity in Western countries. The interest in complementary therapies could be explained by a "new consciousness" and the shift to a postmodern society. These therapies, embracing holistic practice, are derived from traditions of Eastern healing. There are many advantages of the complementary therapies that are playing a therapeutic role in the health care of individuals and, through the use of such therapies, nursing is developing a richness in holistic care. However, there are still barriers to be overcome; namely, the reluctance to accept complementary therapies in many contemporary healthcare settings. Through research and education, these barriers can be overcome.

  1. Ambient intelligence in health care.

    PubMed

    Riva, Giuseppe

    2003-06-01

    Ambient Intelligence (AmI) is a new paradigm in information technology, in which people are empowered through a digital environment that is aware of their presence and context, and is sensitive, adaptive, and responsive to their needs, habits, gestures and emotions. The most ambitious expression of AmI is Intelligent Mixed Reality (IMR), an evolution of traditional virtual reality environments. Using IMR, it is possible to integrate computer interfaces into the real environment, so that the user can interact with other individuals and with the environment itself in the most natural and intuitive way. How does the emergence of the AmI paradigm influence the future of health care? Using a scenario-based approach, this paper outlines the possible role of AmI in health care by focusing on both its technological and relational nature. In this sense, clinicians and health care providers that want to exploit AmI potential need a significant attention to technology, ergonomics, project management, human factors and organizational changes in the structure of the relevant health service.

  2. Sustaining universal health coverage: the interaction of social, political, and economic sustainability.

    PubMed

    Borgonovi, Elio; Compagni, Amelia

    2013-01-01

    The sustainability of health care systems, particularly those supporting universal health care, is a matter of current discussion among policymakers and scholars. In this article, we summarize the controversies around the economic sustainability of health care. We attempt to extend the debate by including a more comprehensive conceptualization of sustainability in relation to health care systems and by examining the dimensions of social and political sustainability. In conclusion, we argue that policymakers when taking decisions around universal health care should carefully consider issues of social, political, and economic sustainability, their interaction, and often their inherent trade-offs.

  3. Health care reform and social movements in the United States.

    PubMed

    Hoffman, Beatrix

    2003-01-01

    Because of the importance of grassroots social movements, or "change from below," in the history of US reform, the relationship between social movements and demands for universal health care is a critical one. National health reform campaigns in the 20th century were initiated and run by elites more concerned with defending against attacks from interest groups than with popular mobilization, and grassroots reformers in the labor, civil rights, feminist, and AIDS activist movements have concentrated more on immediate and incremental changes than on transforming the health care system itself. However, grassroots health care demands have also contained the seeds of a wider critique of the American health care system, leading some movements to adopt calls for universal coverage.

  4. Health care reform and social movements in the United States.

    PubMed

    Hoffman, Beatrix

    2008-09-01

    Because of the importance of grassroots social movements, or "change from below," in the history of US reform, the relationship between social movements and demands for universal health care is a critical one. National health reform campaigns in the 20th century were initiated and run by elites more concerned with defending against attacks from interest groups than with popular mobilization, and grassroots reformers in the labor, civil rights, feminist, and AIDS activist movements have concentrated more on immediate and incremental changes than on transforming the health care system itself. However, grassroots health care demands have also contained the seeds of a wider critique of the American health care system, leading some movements to adopt calls for universal coverage.

  5. Health Care Reform and Social Movements in the United States

    PubMed Central

    Hoffman, Beatrix

    2003-01-01

    Because of the importance of grassroots social movements, or “change from below,” in the history of US reform, the relationship between social movements and demands for universal health care is a critical one. National health reform campaigns in the 20th century were initiated and run by elites more concerned with defending against attacks from interest groups than with popular mobilization, and grassroots reformers in the labor, civil rights, feminist, and AIDS activist movements have concentrated more on immediate and incremental changes than on transforming the health care system itself. However, grassroots health care demands have also contained the seeds of a wider critique of the American health care system, leading some movements to adopt calls for universal coverage. PMID:12511390

  6. Health care reform and social movements in the United States.

    PubMed

    Hoffman, Beatrix

    2008-09-01

    Because of the importance of grassroots social movements, or "change from below," in the history of US reform, the relationship between social movements and demands for universal health care is a critical one. National health reform campaigns in the 20th century were initiated and run by elites more concerned with defending against attacks from interest groups than with popular mobilization, and grassroots reformers in the labor, civil rights, feminist, and AIDS activist movements have concentrated more on immediate and incremental changes than on transforming the health care system itself. However, grassroots health care demands have also contained the seeds of a wider critique of the American health care system, leading some movements to adopt calls for universal coverage. PMID:18687625

  7. Health Care Reform and Social Movements in the United States

    PubMed Central

    Hoffman, Beatrix

    2008-01-01

    Because of the importance of grassroots social movements, or “change from below,” in the history of US reform, the relationship between social movements and demands for universal health care is a critical one. National health reform campaigns in the 20th century were initiated and run by elites more concerned with defending against attacks from interest groups than with popular mobilization, and grassroots reformers in the labor, civil rights, feminist, and AIDS activist movements have concentrated more on immediate and incremental changes than on transforming the health care system itself. However, grassroots health care demands have also contained the seeds of a wider critique of the American health care system, leading some movements to adopt calls for universal coverage. PMID:18687625

  8. [Universal coverage of health services in Mexico].

    PubMed

    2013-01-01

    The reforms made in recent years to the Mexican Health System have reduced inequities in the health care of the population, but have been insufficient to solve all the problems of the MHS. In order to make the right to health protection established in the Constitution a reality for every citizen, Mexico must warrant effective universal access to health services. This paper outlines a long-term reform for the consolidation of a health system that is akin to international standards and which may establish the structural conditions to reduce coverage inequity. This reform is based on a "structured pluralism" intended to avoid both a monopoly exercised within the public sector and fragmentation in the private sector, and to prevent falling into the extremes of authoritarian procedures or an absence of regulation. This involves the replacement of the present vertical integration and segregation of social groups by a horizontal organization with separation of duties. This also entails legal and fiscal reforms, the reinforcement of the MHS, the reorganization of health institutions, and the formulation of regulatory, technical and financial instruments to operationalize the proposed scheme with the objective of rendering the human right to health fully effective for the Mexican people.

  9. [Universal coverage of health services in Mexico].

    PubMed

    2013-01-01

    The reforms made in recent years to the Mexican Health System have reduced inequities in the health care of the population, but have been insufficient to solve all the problems of the MHS. In order to make the right to health protection established in the Constitution a reality for every citizen, Mexico must warrant effective universal access to health services. This paper outlines a long-term reform for the consolidation of a health system that is akin to international standards and which may establish the structural conditions to reduce coverage inequity. This reform is based on a "structured pluralism" intended to avoid both a monopoly exercised within the public sector and fragmentation in the private sector, and to prevent falling into the extremes of authoritarian procedures or an absence of regulation. This involves the replacement of the present vertical integration and segregation of social groups by a horizontal organization with separation of duties. This also entails legal and fiscal reforms, the reinforcement of the MHS, the reorganization of health institutions, and the formulation of regulatory, technical and financial instruments to operationalize the proposed scheme with the objective of rendering the human right to health fully effective for the Mexican people. PMID:24570037

  10. Health care organization drug testing.

    PubMed

    Brooks, J P; Dempsey, J

    1992-09-01

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

  11. Child Health Care in Canada

    PubMed Central

    Klein, Michael

    1985-01-01

    Canadian family medicine and pediatrics have much in common, yet increasing interspecialty competition in the U.S. threatens to spill over into Canada. Geographic, demographic and manpower considerations make it imperative that family physicians continue to provide most of the health care for children in this country. Restrictive entry into traditional specialty programs, subspecialty domination of pediatric training and a shift in the age structure of pediatricians vs family physicians will ensure that the primary care of children will remain with Canadian family doctors. Research has revealed no superiority of one type of provider. Nevertheless the training of family physicians in behavioral and ambulatory areas could be improved. Maintenance of obstetrical activity is key to continued involvement in child health. Areas of collaboration between the two disciplines are explored. PMID:21274143

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

    PubMed

    Sprumont, D

    1998-01-01

    The main goal of the Canada Health Act is to guarantee that Canadian residents have reasonable access to a comprehensive and universal health care plan. However, reduced federal funding for health care and increases in health care costs due to technical and scientific developments have created unprecedented financial pressures on provincial health care systems. The right to health care, once perceived as one of the pillars of Canadian society, may be imperiled. This article will provide a detailed analysis of the nature and scope of the right to health care from mainly a legal, but also from a political, perspective. Based on the premises that the Canada Health Act is basically a financial agreement between the Federal and provincial governments and that it does not enshrine a substantive right on which individuals may claim services, the author explores the nature and scope of this right under Québec legislation. Indeed, the Québec Health and Social Services Act has, since the 1960s, included various provisions that establish a right of access to health care services. This right, however, is fraught with regulatory, organizational and financial limits. The first part of this paper examines relevant regulation from an historical perspective, highlighting the relationships between federal and Québec provincial legislation. In the second part, the author explores exhaustively the principal provisions relevant to the right to health care. This entails the analysis of administrative regulations as well as of the responsibilities of the various provincial, regional, institutional and professional authorities involved. Ultimately, as this study will demonstrate, the availability of health care services depends more on a vague process than on a legal right to health care. This conclusion is further confirmed by the analysis of the adjudication process of patient complaints provided under the Québec Health and Social Services Act and by the limited case law on the

  13. Protocol for an economic evaluation alongside the University Health Network Whiplash Intervention Trial: cost-effectiveness of education and activation, a rehabilitation program, and the legislated standard of care for acute whiplash injury in Ontario

    PubMed Central

    2011-01-01

    Background Whiplash injury affects 83% of persons in a traffic collision and leads to whiplash-associated disorders (WAD). A major challenge facing health care decision makers is identifying cost-effective interventions due to lack of economic evidence. Our objective is to compare the cost-effectiveness of: 1) physician-based education and activation, 2) a rehabilitation program developed by Aviva Canada (a group of property and casualty insurance providers), and 3) the legislated standard of care in the Canadian province of Ontario: the Pre-approved Framework Guideline for Whiplash developed by the Financial Services Commission of Ontario. Methods/Design The economic evaluation will use participant-level data from the University Health Network Whiplash Intervention Trial and will be conducted from the societal perspective over the trial's one-year follow-up. Resource use (costs) will include all health care goods and services, and benefits provided during the trial's 1-year follow-up. The primary health effect will be the quality-adjusted life year. We will identify the most cost-effective intervention using the incremental cost-effectiveness ratio and incremental net-benefit. Confidence ellipses and cost-effectiveness acceptability curves will represent uncertainty around these statistics, respectively. A budget impact analysis will assess the total annual impact of replacing the current legislated standard of care with each of the other interventions. An expected value of perfect information will determine the maximum research expenditure Canadian society should be willing to pay for, and inform priority setting in, research of WAD management. Discussion Results will provide health care decision makers with much needed economic evidence on common interventions for acute whiplash management. Trial Registration http://ClinicalTrials.gov identifier NCT00546806 [Trial registry date: October 18, 2007; Date first patient was randomized: February 27, 2008] PMID

  14. From universal health insurance to universal healthcare? The shifting health policy landscape in Ireland since the economic crisis.

    PubMed

    Burke, Sara Ann; Normand, Charles; Barry, Sarah; Thomas, Steve

    2016-03-01

    Ireland experienced one of the most severe economic crises of any OECD country. In 2011, a new government came to power amidst unprecedented health budget cuts. Despite a retrenchment in the ability of health resources to meet growing need, the government promised a universal, single-tiered health system, with access based solely on medical need. Key to this was introducing universal free GP care by 2015 and Universal Health Insurance from 2016 onwards. Delays in delivering universal access and a new health minister in 2014 resulted in a shift in language from 'universal health insurance' to 'universal healthcare'. During 2014 and 2015, there was an absence of clarity on what government meant by universal healthcare and divergence in policy measures from their initial intent of universalism. Despite the rhetoric of universal healthcare, years of austerity resulted in poorer access to essential healthcare and little extension of population coverage. The Irish health system is at a critical juncture in 2015, veering between a potential path to universal healthcare and a system, overwhelmed by years of austerity, which maintains the status quo. This papers assesses the gap between policy intent and practice and the difficulties in implementing major health system reform especially while emerging from an economic crisis.

  15. From universal health insurance to universal healthcare? The shifting health policy landscape in Ireland since the economic crisis.

    PubMed

    Burke, Sara Ann; Normand, Charles; Barry, Sarah; Thomas, Steve

    2016-03-01

    Ireland experienced one of the most severe economic crises of any OECD country. In 2011, a new government came to power amidst unprecedented health budget cuts. Despite a retrenchment in the ability of health resources to meet growing need, the government promised a universal, single-tiered health system, with access based solely on medical need. Key to this was introducing universal free GP care by 2015 and Universal Health Insurance from 2016 onwards. Delays in delivering universal access and a new health minister in 2014 resulted in a shift in language from 'universal health insurance' to 'universal healthcare'. During 2014 and 2015, there was an absence of clarity on what government meant by universal healthcare and divergence in policy measures from their initial intent of universalism. Despite the rhetoric of universal healthcare, years of austerity resulted in poorer access to essential healthcare and little extension of population coverage. The Irish health system is at a critical juncture in 2015, veering between a potential path to universal healthcare and a system, overwhelmed by years of austerity, which maintains the status quo. This papers assesses the gap between policy intent and practice and the difficulties in implementing major health system reform especially while emerging from an economic crisis. PMID:26777302

  16. How Do Health Care Providers Diagnose Endometriosis?

    MedlinePlus

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

  17. How Do Health Care Providers Diagnose Pheochromocytoma?

    MedlinePlus

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

  18. How Do Health Care Providers Diagnose Hypoparathyroidism?

    MedlinePlus

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

  19. Accreditation Association for Ambulatory Health Care

    MedlinePlus

    ... Press Release Archives learn more » For Patients Your health care choices matter. Whether you're anticipating a surgical ... certificate of accreditation is a sign that a health care organization meets or exceeds nationally-recognized Standards. Learn ...

  20. Job satisfaction in health-care organizations

    PubMed Central

    Bhatnagar, Kavita; Srivastava, Kalpana

    2012-01-01

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

  1. Health care, ethics, and information technologies.

    PubMed

    Curtin, Leah

    2002-06-01

    This essay explores how ethics, computing, and health care intersect in medical informatics. It discusses the power technology places in the hands of health care professionals and the ethical problems they may encounter as a result of that power.

  2. Flat medicine? Exploring trends in the globalization of health care.

    PubMed

    Crone, Robert K

    2008-02-01

    Trailing nearly every other industry, health care is finally globalizing. Highly trained and experienced expatriate health care professionals are returning to their home countries from training in the West or are staying home to work in newly developed corporate health care delivery systems that can compete quite favorably with less-than-perfect providers in Europe and North America. In turn, these health care systems are attracting patients from around the world who are interested in exploring high-quality, lower-cost health care alternatives. Much of this activity is occurring in the emerging economies of the Middle East, South and Southeast Asia, and beyond. Three Harvard Medical International collaborations--in Dubai, Turkey, and India--highlight these trends and demonstrate the potential for new models of global health care, as well as potential ramifications for patients and providers in the established economies of the West, including the United States. Although globalization is not a cure-all solution to achieving universal access to health care, it is not only a significant first step for patients in these emerging economies, but may also present alternative solutions for those patients in wealthier nations who nonetheless lack adequate health care coverage. The increase in health care quality and competitiveness around the globe is important, but these improvements will need to be matched by the development of comprehensive payer solutions, to benefit as many people as possible.

  3. Women as health care decision-makers: implications for health care coverage in the United States.

    PubMed

    Matoff-Stepp, Sabrina; Applebaum, Bethany; Pooler, Jennifer; Kavanagh, Erin

    2014-11-01

    Women in the United States make approximately 80% of the health care decisions for their families, yet often go without health care coverage themselves. The implementation of the Affordable Care Act provides an historical opportunity for women to gain health care coverage for themselves and their families. The focus of this commentary is on women's leadership roles in the context of health care decision- making and Affordable Care Act education and outreach, and implications for reaching broader health and social goals. PMID:25418222

  4. [The coordination of care in health centres].

    PubMed

    Ribardière, Olivia

    2016-06-01

    Health centres are structurally designed to facilitate the coordination of care. However, evolutions in society have resulted in forms of consumption of health care which are not necessarily compatible with efficient care coordination. On a local level, teams are nevertheless organising and structuring themselves to offer the right form of care, to the right patient and at the right time.

  5. The right to preventive health care.

    PubMed

    Conly, Sarah

    2016-08-01

    The right to health care is a right to care that (a) is not too costly to the provider, considering the benefits it conveys, and (b) is effective in bringing about the level of health needed for a good human life, not necessarily the best health possible. These considerations suggest that, where possible, society has an obligation to provide preventive health care, which is both low cost and effective, and that health care regulations should promote citizens' engagement in reasonable preventive health care practices. PMID:27491748

  6. Interfaith Health Care Ministries, Providence, Rhode Island.

    PubMed

    Parker, D

    1999-01-01

    We enjoy considerable freedom in the creation of programs that meet the spiritual needs of people in the community. We minister in diverse settings--a university medical school, hospital, hospice, eldercare center, mental health center, state hospital, and parish/congregation. We are guided by our deep commitment to make sure that individuals and families whose life journey is hard receive quality spiritual care. We are equally committed to preparing caregivers, whether clergy, physicians, nurses, or laypersons so that they are both clinically competent and spiritually informed. Our ambitions are high and our resources are limited. PMID:10977358

  7. Communicating in Multicultural Health Care Organizations.

    ERIC Educational Resources Information Center

    Kreps, Gary L.; Kunimoto, Elizabeth

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

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

    ERIC Educational Resources Information Center

    McManus, Marilyn C., Ed.

    1996-01-01

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

  9. Health Care Delivery to Southeast Asian Refugees.

    ERIC Educational Resources Information Center

    Mattson, Susan

    1989-01-01

    Discusses the problems of providing sufficient health care for Southeast Asian refugees. Describes their unique languages and dialects, religious backgrounds, cultural behaviors, and health and illness beliefs so that health care professionals will be able to accommodate their needs and provide effective medical care for them. (JS)

  10. Oral health in the context of primary care in Brazil.

    PubMed

    Nascimento, Antonio C; Moysés, Simone T; Werneck, Renata I; Moysés, Samuel J

    2013-10-01

    This article presents an integrative literature review that analyses the advances and challenges in oral health care of the Brazilian primary health care system, based on a political agenda that envisages re-organising the unified health system (SistemaÚnico de Saúde - SUS). It is presumed that the actions suggested by the Alma-Ata Conference of 1978 are still up-to-date and relevant when adapted to the situation in Brazil. Several studies and policies are reviewed, including works demonstrating the importance of primary care as an organising platform in an integrated health-care network, Brazil's strategy for reorganising the primary care network known as the Family Health Strategy, and the National Oral Health Policy. This review discusses results obtained over the last twenty years, with special attention paid to changes in oral health-care practices, as well as the funding of action programmes and assistance cover. The conclusion is that oral healthcare in the Brazilian primary health care system has advanced over the past decades; however, serious obstacles have been experienced, especially with regard to the guarantee of universal access to services and funding. The continuous efforts of public managers and society should focus on the goal of achieving universal coverage for all Brazilians.

  11. Community financing of health care.

    PubMed

    Carrin, G

    1988-01-01

    This article discusses ways to lesson the restrictions on health development in sub-Saharan Africa caused by limited public health budgets. Health improvements can be funded by the implementation of health insurance, the use of foreign aid, the raising of taxes, the reallocation of public money, and direct contributions by users or households either in the form of charges for services received or prepayments for future services. Community financing, i.e. the direct financing of health care by households in villages or distinct urban communities, is seen as preferable to a national or regional plan. When community financing is chosen, a choice must then be made between direct payment, fee-for-service, and prepayment (insurance) systems. The 3 systems, using the example of an essential drugs program, are described. Theoretically, with direct payment the government receives full cost recovery, and the patients receive the drugs they need, thereby improving their health. Of course the poor may not be able to purchase the drugs, therefore a subsidy system must be worked out at the community level. Fee-for-service means charging for a consultation or course of treatment, including drugs. A sliding scale of fees or discounts for certain types of consultations (e.g. pre-and post natal) can be used. In fee-for-service the risk is shared; because the cost of drugs is financed by the fees, those who receive costly treatments are subsidized by those whose treatments are relatively inexpensive. With prepayment or health insurance the risk of illness is shifted from the patient to the insurance firm or state. 2 issues make insurance plans hard to implement. When patients are covered by insurance, they may demand "too much" medical care (moral hazard) and thus premiums may be too small to cover treatment costs. On the other hand, people in low-risk groups may be unwilling to pay a higher premium, thus leading to adverse selection. Eventually, premiums may rise to the point where

  12. Beneficence, justice, and health care.

    PubMed

    Kelleher, J Paul

    2014-03-01

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

  13. Contribution of Primary Care to Health Systems and Health

    PubMed Central

    Starfield, Barbara; Shi, Leiyu; Macinko, James

    2005-01-01

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

  14. Ethics of rural health care.

    PubMed

    Lyckholm, L J; Hackney, M H; Smith, T J

    2001-11-01

    One quarter of the US population live in areas designated as rural. Delivery of rural health care can be difficult with unique challenges including limited access to specialists such as oncologists. The Rural Cancer Outreach Program is an alliance between an academic medical center and five rural hospitals. Due to the presence of this program, the appropriate use of narcotics for chronic pain has increased, the number of breast conserving surgeries has more than doubled and accrual to clinical trials has gone from zero to nine over the survey period. An increase in adjuvant chemotherapy has been noted. The rural hospitals and the academic center have seen a positive financial impact. The most prominent ethical issues focus on justice, especially access to health care, privacy, confidentiality, medical competency, and the blurring of personal and profession boundaries in small communities. As medical care has become more complex with an increasing number of ethical issues intertwined, the rural hospitals have begun to develop mechanisms to provide help in difficult situations. The academic center has provided expertise and continued education for staff, both individually and within groups, regarding ethical dilemmas.

  15. Medicare, health care reform, and older adults.

    PubMed

    McCracken, Ann L

    2010-12-01

    Nurses will play a key role in health care reform, educating and engaging consumers, providing input into and monitoring implementation, and assisting organizations with transition to new policies. As the largest group of professional health care providers, nurses must be key players in the actualization of health care reform. This article addresses how The Patient Protection and Affordable Care Act of 2010 and the Health Care and Education Reconciliation Act of 2010 will affect the solvency of Medicare, what older adults will gain, effects on quality and effectiveness of care, cost reduction, changes in taxes, and the key provisions of special interest to nurses.

  16. Wholistic Health Care: Evolutionary Conceptual Analysis.

    PubMed

    Ziebarth, Deborah Jean

    2016-10-01

    While performing a data search to define "wholistic health care", it was evident that a definite gap existed in published literature. In addition, there are different definitions and several similar terms (whole person care, wholistic health, whole person health, wholism, etc.), which may cause confusion. The purpose of this paper was to present the analysis of "wholistic health care" using Rodgers' Evolutionary Method. The method allows for the historical and social nature of "wholistic health care" and how it changes over time. Attributes, antecedents, and consequences of wholistic health care were reduced using a descriptive matrix. In addition, attributes that consistently occurred in wholistic health care were presented as essential attributes. Definitions of Wholistic Health Care Provider(s), Wholistic Health, Wholistic Illness, Wholistic Healing, and Patient were created from the analysis of the literature review of attributes, antecedents, and consequences of wholistic health care. Wholistic Health Care is defined as the assessment, diagnosis, treatment and prevention of wholistic illness in human beings to maintain wholistic health or enhance wholistic healing. Identified wholistic health needs are addressed simultaneously by one or a team of allied health professionals in the provision of primary care, secondary care, and tertiary care. Wholistic health care is patient centered and considers the totality of the person (e.g., human development at a given age, genetic endowments, disease processes, environment, culture, experiences, relationships, communication, assets, attitudes, beliefs, and lifestyle behaviors). Patient centered refers to the patient as active participant in deciding the course of care. Essential attributes of wholistic health care are faith (spiritual) integrating, health promoting, disease managing, coordinating, empowering, and accessing health care. Wholistic health care may occur in collaboration with a faith-based organization to

  17. 47 CFR 54.613 - Limitations on supported services for rural health care providers.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... health care providers. 54.613 Section 54.613 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED) UNIVERSAL SERVICE Universal Service Support for Health Care Providers Telecommunications Program § 54.613 Limitations on supported services for rural health...

  18. 47 CFR 54.613 - Limitations on supported services for rural health care providers.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... health care providers. 54.613 Section 54.613 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED) UNIVERSAL SERVICE Universal Service Support for Health Care Providers Telecommunications Program § 54.613 Limitations on supported services for rural health...

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

    ERIC Educational Resources Information Center

    Griesemer, Bernard A.; Hough, David L.

    1993-01-01

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

  20. Health Promotion Project for University Students at a South African University: Results of a Pilot Survey

    PubMed Central

    Heeren, G. Anita; Mandeya, Andrew; Marange, C. Show; Batidzirai, Jesca M.; Tyler, Joanne C.

    2014-01-01

    Globally, chronic diseases place a tremendous burden on health care systems all over the world. The increased prevalence of chronic diseases is mainly influenced by industrialization and decreased levels of physical activity. A cross-sectional qualitative and quantitative pilot survey, using a self-administered questionnaire and focus group discussions, was conducted with 73 students to assess the need for and feasibility of a health promotion program for university students at a rural South African university. The results of this survey suggest that there is a need for a health promotion program aimed at young adults who attend university. PMID:25635164

  1. Physical Health Problems and Barriers to Optimal Health Care Among Children in Foster Care.

    PubMed

    Deutsch, Stephanie Anne; Fortin, Kristine

    2015-10-01

    Children and adolescents in foster care placement represent a unique population with special health care needs, often resulting from pre-placement early adversity and neglected, unaddressed health care needs. High rates of all health problems, including acute and/or chronic physical, mental, and developmental issues prevail. Disparities in health status and access to health care are observed. This article summarizes the physical health problems of children in foster care, who are predisposed to poor health outcomes when complex care needs are unaddressed. Despite recognition of the significant burden of health care need among this unique population, barriers to effective and optimal health care delivery remain. Legislative solutions to overcome obstacles to health care delivery for children in foster care are discussed.

  2. Hurdles to health: immigrant and refugee health care in Australia.

    PubMed

    Murray, Sally B; Skull, Sue A

    2005-02-01

    Refugees and asylum seekers face a number of barriers to accessing health care and improved health status. These include language difficulties, financial need and unemployment, cultural differences, legal barriers and a health workforce with generally low awareness of issues specific to refugees. Importantly, current Australian government migration and settlement policy also impacts on access to health and health status. An adequate understanding of these 'hurdles to health' is a prerequisite for health providers and health service managers if they are to tailor health care and services appropriately. We include tables of available resources and entitlements to health care according to visa category to assist providers and managers. PMID:15683352

  3. Weight Bias in University Health Professions Students.

    PubMed

    Blanton, Cynthia; Brooks, Jennifer K; McKnight, Laura

    2016-01-01

    Negative attitudes toward people with high body weight have been documented in pre-professional health students, prompting concern that such feelings may manifest as poor patient care in professional practice. This study assessed weight bias in university students in the non-physician health professions. A convenience sample of 206 students completed an online survey composed of a validated 14-item scale (1-5 lowest to highest weight bias) and questions regarding personal experiences of weight bias. Respondents were grouped by discipline within graduate and undergraduate levels. Weight bias was present in a majority of respondents. Overall, the percentage of responses indicative of weight bias was 92.7%. The mean total score was 3.65. ± 0.52, and the rating exceeded 3 for all 14 scale descriptors of high-weight people. In graduate students, discipline had a significant main effect on total score (p=0.01), with lower scores in dietetics (3.17 ± 0.46) vs audiology/sign language/speech language pathology (3.84 ± 0.41) and physician assistant students (3.78 ± 0.51; p<0.05). These findings show that weight bias is prevalent in health professions students at a mountain west university. Well-controlled studies that track students into professional practice would help determine whether bias-reduction interventions in college improve provider behaviors and clinical outcomes. PMID:27585618

  4. Health of Children in Day Care: Public Health Profiles.

    ERIC Educational Resources Information Center

    Kansas State Dept. of Health and Environment, Topeka.

    Profiles are provided for innovative public health activities that focus on the health of children in day care. All are considered to be models worthy of replication. Profiles depict (1) child care in Arizona; (2) child day care licensing in Connecticut; (3) safeguarding children in day care in Kansas; (4) paired state and local inspection in…

  5. Health care infrastructure post-Katrina: disaster planning to return health care workers to their home communities.

    PubMed

    Griffies, W Scott

    2010-01-01

    One of the greatest challenges of restoring the New Orleans health care infrastructure since the post-Katrina disaster has been shortages of health care providers. Many providers had prolonged displacements or did not return to their practices, depleting the city of valuable resources. This Open Forum chronicles the displacement of Louisiana State University's Department of Psychiatry and discusses barriers to returning health care providers to their communities expeditiously. Predisaster planning and policy changes are proposed to facilitate a quicker return and decrease the attrition of health care providers after future disasters. A community's predisaster plans should include a mechanism to allow funds to follow patients instead of hospitals, to provide bridge funding that pays local health care providers to work as first responders and serve uninsured patients while these providers rebuild their practices, and to provide funds to quickly expand services and usable space in undamaged clinics and hospitals and to shore up reparable structures.

  6. The right to a decent minimum of health care.

    PubMed

    Buchanan, Allen E

    1984-01-01

    Buchanan examines, and finds inadequate, several philosophical approaches to justifying and specifying the content of a universal right to a decent minimum of health care: utilitarian arguments, Rawlsian ideal contract arguments, and Norman Daniels' equality of opportunity argument. Also rejecting the libertarian hypothesis that there is no right to a decent minimum of care, he contends that the claim that society should guarantee certain health care services can be supported by a pluralistic approach encompassing special right-claims, harm prevention, prudential arguments emphasizing public health benefits, and beneficence.

  7. The Future of Health Care for Blacks.

    ERIC Educational Resources Information Center

    Urban League Review, 1979

    1979-01-01

    Recommendations resulting from a 1977 conference, "Health Policy, Health Planning and Financing the Future of Health Care for Blacks in America," are presented. The recommendations concern changes in the health care system, community involvement, government regulation, the formation of Black interest groups and lobbies, and support for national…

  8. Establishment of primary health care in Vietnam.

    PubMed

    Birt, C A

    1990-08-01

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

  9. Rural Youth and the Health Care System

    ERIC Educational Resources Information Center

    McGruk, Lois F.

    1978-01-01

    Presenting a documentary statement regarding the background of rural youth health needs, this article includes definitions, barriers to health care for the rural poor (poverty, culture, isolation, immobility, and low priority for health services), and some alternatives (self-care, a wider view of health determinants, living patterns, etc.). (JC)

  10. Health care: a brave new world.

    PubMed

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

    2015-03-01

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

  11. Particularism in health care: challenging the authority of the aggregate.

    PubMed

    Tanenbaum, Sandra J

    2014-12-01

    In health care, particularism asserts the primacy of the individual case. Moral particularists, such as Jonsen and Toulmin, reject deduction from universal moral principles and instead seek warrants for action from the multiple sources unique to a given patient. Another kind of health care particularism, here referred to as the knowledge of particulars, is offered as a corrective to evidence-based medicine (EBM), its influence on health care practice and policy, and specifically to EBM's reliance on the aggregate. This paper describes the knowledge of particulars and identifies strategies for its legitimation in health care policy and practice. First, the paper documents the ascendancy of the aggregate through EBM's definition of 'what works' in health care. Second, it delineates the limits of health care knowledge based on the analysis of aggregates, not only for the care of individual patients but for the formulation of policies about patient care. Third, the paper analyses prominent rejections of the particular in contemporary health policy discourse and relates them to larger political purposes. Finally, it depicts the knowledge of particulars as the basis for clinical prudence and offers three potential strategies for promoting particularism as essential to high-quality care. PMID:25406384

  12. Controversies in faith and health care.

    PubMed

    Tomkins, Andrew; Duff, Jean; Fitzgibbon, Atallah; Karam, Azza; Mills, Edward J; Munnings, Keith; Smith, Sally; Seshadri, Shreelata Rao; Steinberg, Avraham; Vitillo, Robert; Yugi, Philemon

    2015-10-31

    Differences in religious faith-based viewpoints (controversies) on the sanctity of human life, acceptable behaviour, health-care technologies and health-care services contribute to the widespread variations in health care worldwide. Faith-linked controversies include family planning, child protection (especially child marriage, female genital mutilation, and immunisation), stigma and harm reduction, violence against women, sexual and reproductive health and HIV, gender, end-of-life issues, and faith activities including prayer. Buddhism, Christianity, Hinduism, Islam, Judaism, and traditional beliefs have similarities and differences in their viewpoints. Improved understanding by health-care providers of the heterogeneity of viewpoints, both within and between faiths, and their effect on health care is important for clinical medicine, public-health programmes, and health-care policy. Increased appreciation in faith leaders of the effect of their teachings on health care is also crucial. This Series paper outlines some faith-related controversies, describes how they influence health-care provision and uptake, and identifies opportunities for research and increased interaction between faith leaders and health-care providers to improve health care. PMID:26159392

  13. Controversies in faith and health care.

    PubMed

    Tomkins, Andrew; Duff, Jean; Fitzgibbon, Atallah; Karam, Azza; Mills, Edward J; Munnings, Keith; Smith, Sally; Seshadri, Shreelata Rao; Steinberg, Avraham; Vitillo, Robert; Yugi, Philemon

    2015-10-31

    Differences in religious faith-based viewpoints (controversies) on the sanctity of human life, acceptable behaviour, health-care technologies and health-care services contribute to the widespread variations in health care worldwide. Faith-linked controversies include family planning, child protection (especially child marriage, female genital mutilation, and immunisation), stigma and harm reduction, violence against women, sexual and reproductive health and HIV, gender, end-of-life issues, and faith activities including prayer. Buddhism, Christianity, Hinduism, Islam, Judaism, and traditional beliefs have similarities and differences in their viewpoints. Improved understanding by health-care providers of the heterogeneity of viewpoints, both within and between faiths, and their effect on health care is important for clinical medicine, public-health programmes, and health-care policy. Increased appreciation in faith leaders of the effect of their teachings on health care is also crucial. This Series paper outlines some faith-related controversies, describes how they influence health-care provision and uptake, and identifies opportunities for research and increased interaction between faith leaders and health-care providers to improve health care.

  14. Challenges for health care development in Croatia.

    PubMed

    Ostojić, Rajko; Bilas, Vlatka; Franc, Sanja

    2012-09-01

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

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

    ERIC Educational Resources Information Center

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

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

  16. [Motivational interviewing in health care].

    PubMed

    Lev-Ran, Shaul; Nitzan, Uri

    2011-09-01

    Harmful behaviors and low adherence to medical treatment significantly contribute to an increased rate of hospitalizations, mortality and morbidity. Leading health organizations worldwide are making great efforts to find and develop efficient strategies in order to recruit patients to adhere to medical treatment and adopt a healthier lifestyle. Motivational interviewing is an evidence-based approach that the physician can apply in numerous health care situations in order to increase patients' adherence to treatment. It is a patient-centered approach, based on principles of collaboration, autonomy and evocation. Research indicates that the patient's verbal commitment towards change is directly correlated to future behavioral change. Therefore, the approach includes learnable techniques which assist in allowing the patient to speak about the advantages of behavioral change and treatment. Thus, motivational interviewing helps patients adopt a healthier lifestyle while contributing to the professionalism of physicians and their sense of satisfaction from work. PMID:22026060

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

    PubMed

    Binder, A; Braun, G E

    2015-03-01

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

  18. Health care librarians and information literacy: an investigation.

    PubMed

    Kelham, Charlotte

    2014-09-01

    Until relatively recently, the concept of information literacy, and teaching the skills to enable it, was mainly a concern of academic libraries. Now, it is also seen to be of high importance within the context of health care libraries. Health care libraries and librarians can provide crucial support towards the implementation of evidence-based practice in patient care through both information literacy skills training and by conducting mediated searches on behalf of health care practitioners. This article reports the findings from an investigation conducted by Charlotte Kelham as part of her MA in Librarianship from the University of Sheffield. Her dissertation investigated how health care librarians understand the concept of information literacy, the implications of this for their role and their perceptions around how their role is valued. Charlotte graduated from Sheffield in 2013 and is currently job hunting. AM.

  19. Universal health coverage in Turkey: enhancement of equity.

    PubMed

    Atun, Rifat; Aydın, Sabahattin; Chakraborty, Sarbani; Sümer, Safir; Aran, Meltem; Gürol, Ipek; Nazlıoğlu, Serpil; Ozgülcü, Senay; Aydoğan, Ulger; Ayar, Banu; Dilmen, Uğur; Akdağ, Recep

    2013-07-01

    Turkey has successfully introduced health system changes and provided its citizens with the right to health to achieve universal health coverage, which helped to address inequities in financing, health service access, and health outcomes. We trace the trajectory of health system reforms in Turkey, with a particular emphasis on 2003-13, which coincides with the Health Transformation Program (HTP). The HTP rapidly expanded health insurance coverage and access to health-care services for all citizens, especially the poorest population groups, to achieve universal health coverage. We analyse the contextual drivers that shaped the transformations in the health system, explore the design and implementation of the HTP, identify the factors that enabled its success, and investigate its effects. Our findings suggest that the HTP was instrumental in achieving universal health coverage to enhance equity substantially, and led to quantifiable and beneficial effects on all health system goals, with an improved level and distribution of health, greater fairness in financing with better financial protection, and notably increased user satisfaction. After the HTP, five health insurance schemes were consolidated to create a unified General Health Insurance scheme with harmonised and expanded benefits. Insurance coverage for the poorest population groups in Turkey increased from 2·4 million people in 2003, to 10·2 million in 2011. Health service access increased across the country-in particular, access and use of key maternal and child health services improved to help to greatly reduce the maternal mortality ratio, and under-5, infant, and neonatal mortality, especially in socioeconomically disadvantaged groups. Several factors helped to achieve universal health coverage and improve outcomes. These factors include economic growth, political stability, a comprehensive transformation strategy led by a transformation team, rapid policy translation, flexible implementation with

  20. Equity in health care utilization in Chile.

    PubMed

    Núñez, Alicia; Chi, Chunhuei

    2013-01-01

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

  1. Equity in health care utilization in Chile.

    PubMed

    Núñez, Alicia; Chi, Chunhuei

    2013-08-12

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

  2. Equity in health care utilization in Chile

    PubMed Central

    2013-01-01

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

  3. Beware the Managed Health-Care Companies.

    ERIC Educational Resources Information Center

    Ashbaugh, John; Smith, Gary

    1996-01-01

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

  4. Primary Mental Health Care in the Americas.

    ERIC Educational Resources Information Center

    Lima, Bruno R.

    This paper outlines selected differences between the United States and Latin America health care systems as they relate to primary mental health care. It notes that historically both the United States and Latin America have relied on custodial psychiatric hospitals. The alternative of community care for psychiatric patients is described as it is…

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

    PubMed

    Guo, Kristina L

    2010-01-01

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

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

    PubMed

    Guo, Kristina L

    2010-01-01

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

  7. Is home health care a substitute for hospital care?

    PubMed

    Lichtenberg, Frank R

    2012-01-01

    A previous study used aggregate (region-level) data to investigate whether home health care serves as a substitute for inpatient hospital care and concluded that "there is no evidence that services provided at home replace hospital services." However, that study was based on a cross-section of regions observed at a single point of time and did not control for unobserved regional heterogeneity. In this article, state-level employment data are used to reexamine whether home health care serves as a substitute for inpatient hospital care. This analysis is based on longitudinal (panel) data--observations on states in two time periods--which enable the reduction or elimination of biases that arise from use of cross-sectional data. This study finds that states that had higher home health care employment growth during the period 1998-2008 tended to have lower hospital employment growth, controlling for changes in population. Moreover, states that had higher home health care payroll growth tended to have lower hospital payroll growth. The estimates indicate that the reduction in hospital payroll associated with a $1,000 increase in home health payroll is not less than $1,542, and may be as high as $2,315. This study does not find a significant relationship between growth in utilization of home health care and growth in utilization of nursing and residential care facilities. An important reason why home health care may serve as a substitute for hospital care is that the availability of home health care may allow patients to be discharged from the hospital earlier. Hospital discharge data from the Healthcare Cost and Utilization Project are used to test the hypothesis that use of home health care reduces the length of hospital stays. Major Diagnostic Categories with larger increases in the fraction of patients discharged to home health care tended to have larger declines in mean length of stay (LOS). Between 1998 and 2008, mean LOS declined by 4.1%, from 4.78 to 4.59 days

  8. Is home health care a substitute for hospital care?

    PubMed

    Lichtenberg, Frank R

    2012-01-01

    A previous study used aggregate (region-level) data to investigate whether home health care serves as a substitute for inpatient hospital care and concluded that "there is no evidence that services provided at home replace hospital services." However, that study was based on a cross-section of regions observed at a single point of time and did not control for unobserved regional heterogeneity. In this article, state-level employment data are used to reexamine whether home health care serves as a substitute for inpatient hospital care. This analysis is based on longitudinal (panel) data--observations on states in two time periods--which enable the reduction or elimination of biases that arise from use of cross-sectional data. This study finds that states that had higher home health care employment growth during the period 1998-2008 tended to have lower hospital employment growth, controlling for changes in population. Moreover, states that had higher home health care payroll growth tended to have lower hospital payroll growth. The estimates indicate that the reduction in hospital payroll associated with a $1,000 increase in home health payroll is not less than $1,542, and may be as high as $2,315. This study does not find a significant relationship between growth in utilization of home health care and growth in utilization of nursing and residential care facilities. An important reason why home health care may serve as a substitute for hospital care is that the availability of home health care may allow patients to be discharged from the hospital earlier. Hospital discharge data from the Healthcare Cost and Utilization Project are used to test the hypothesis that use of home health care reduces the length of hospital stays. Major Diagnostic Categories with larger increases in the fraction of patients discharged to home health care tended to have larger declines in mean length of stay (LOS). Between 1998 and 2008, mean LOS declined by 4.1%, from 4.78 to 4.59 days

  9. Primary Health Care and Narrative Medicine

    PubMed Central

    Murphy, John W

    2015-01-01

    Primary health care has received a lot of attention since the Alma Ata Conference, convened by the World Health Organization in 1978. Key to the strategy to improve health care outlined at the Alma Ata conference is citizen participation in every phase of service delivery. Although the goals of primary health care have not been achieved, the addition of narrative medicine may facilitate these ends. But a new epistemology is necessary, one that is compatible with narrative medicine, so that local knowledge is elevated in importance and incorporated into the planning, implementation, and evaluation of health programs. In this way, relevant, sustainable, and affordable care can be provided. The aim of this article is to discuss how primary health care might be improved through the introduction of narrative medicine into planning primary health care delivery. PMID:26222094

  10. Delivering distance training to rural health care professionals.

    PubMed

    Li, Jie; Runderson, Robert A; Burnham, Judy F; Staggs, Geneva Bush; Robertson, Justin C; Williams, Thomas L

    2005-01-01

    This article reports on a project that delivers distance training to rural health care professionals. Traveling to provide training on information-seeking skills to rural health professionals is time consuming and costly. In addition to face-to-face training, the University of South Alabama Biomedical Library's SAMNet project seeks to deliver multimedia training to rural health care professionals. The project uses information technology to package training courses combining PowerPoint slides and video instructions. This article describes the rationale, training module design and development, and the information technology and software used in the project. Multimedia packaged distance training courses provide a practical alternative to on-site training for rural health care professionals. It enables librarians to provide training without traveling long distance, thus saving time and money. Additionally, rural health care professionals may access the modules at a time convenient to them and proceed at a pace suitable to their learning style. PMID:15760832

  11. PAHO'S Strategy for Universal Access to Health and Universal Health Coverage: implications for health services and hospitals in LAC.

    PubMed

    Holder, Reynaldo; Fabrega, Ricardo

    2015-01-01

    Moving towards Universal Access to Health and Universal Health Coverage (UAH/UHC) is an imperative task on the health agenda for the Americas. The Directing Council of the Pan American Health Organization (PAHO) recently approved resolution CD53.R14, titled Strategy for Universal Access to Health and Universal Health Coverage. From the perspective of the Region of the Americas, UAH/UHC "imply that all people and communities have access, without any kind of discrimination, to comprehensive, appropriate and timely, quality health services determined at the national level according to needs, as well as access to safe, affordable, effective, quality medicines, while ensuring that the use of these services does not expose users to financial hardship, especially groups in conditions of vulnerability". PAHO's strategic approach to UAH/UHC sets out four specific lines of action toward effective universal health systems. The first strategic line proposes: a) implementation of integrated health services delivery networks (IHDSNs) based on primary health care as the key strategy for reorganizing, redefining and improving healthcare services in general and the role of hospitals in particular; and b) increasing the response capacity of the first level of care. An important debate initiated in 2011 among hospital and healthcare managers in the region tried to redefine the role of hospitals in the context of IHSDNs and the emerging UAH/UHC movement. The debates resulted in agreements around three main propositions: 1) IHSDNs cannot be envisioned without hospitals; 2) The status-quo and current hospital organizational culture makes IHSDNs inviable; and 3) Without IHSDNs, hospitals will not be sustainable. This process, that predates the approval of PAHO's UAH/UHC resolution, now becomes more relevant with the recognition that UAH/UHC cannot be attained without a profound change in healthcare service and particularly in hospitals. In this context, a set of challenges both for

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

    ERIC Educational Resources Information Center

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

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

  13. Revitalizing primary health care--another utopian goal?

    PubMed

    Marahatta, Sujan B

    2010-01-01

    The quest for greater efficiency, fairness and responsiveness to the expectation of the people that system serve have brought about three generations of health system reforms in the twentieth century. The first generation saw the founding of national health care systems and extension to middle income nations of social insurance systems in the 1940s and 1950s. By the late 1960s the rising costs of hospital based care, its usage by better off, inaccessibility by the poor and rural population of even the most basic services heralded second generation reforms promoting primary health care as a means of achieving the affordable universal coverage. It included the best public health strategy that is prevention and the highest ethical principle of public health that is equity. It was expected the best system for reaching households with essential and affordable care, and the best route towards universal coverage. The primary health care approach though adopted universally did not materialize its notion of translating ethos of Health for All by 2000. Overall, primary health care movement by the end of 20th century became lifeless. Since the Declaration of Alma-Ata, fundamental changes have occurred affecting health service delivery, such as economic development and financing approaches, globalization of trade and knowledge, and the shift to privatization. This is the time to develop a new vision, taking into consideration the many changes affecting global health and the strategic developments in health of recent years. With this recognition, the third generation of reforms now underway in many countries is driven by the idea of responding more to demand, assuring access for the poor and emphasizing financing rather than just provision within the public sector. The key concern is: how to translate ethos of revitalizing in the reality. Otherwise the revitalizing concept will turn into utopian goal so like HFA by 2000 strategy. PMID:22610741

  14. Child Care Health Connections. A Health and Safety Newsletter for California Child Care Professionals. Volume 17, Number 2. March-April 2004

    ERIC Educational Resources Information Center

    Zamani, A. Rahman, Ed.; Guralnick, Eva, Ed.; Lucich, Mardi, Ed.

    2004-01-01

    "Child Care Health Connections" is a bimonthly newsletter published by the California Childcare Health Program (CCHP), a community-based program of the University of California, San Francisco School of Nursing, Department of Family Health Care Nursing. The goals of the newsletter are to promote and support a healthy and safe environment for all…

  15. Child Care Health Connections: A Health and Safety Newsletter for California Child Care Professionals. Volume 19, Number 3, May-June 2006

    ERIC Educational Resources Information Center

    Zamani, A. Rahman, Ed.; Calder, Judy, Ed.; Rose, Bobbie, Ed.; Leonard, Victoria, Ed.; Gendell, Mara, Ed.

    2006-01-01

    "Child Care Health Connections" is a bimonthly newsletter published by the California Childcare Health Program (CCHP), a community-based program of the University of California, San Francisco School of Nursing, Department of Family Health Care Nursing. The goals of the newsletter are to promote and support a healthy and safe environment for all…

  16. Child Care Health Connections. A Health and Safety Newsletter for California Child Care Professionals. Volume 17, Number 4. July-August 2004

    ERIC Educational Resources Information Center

    Zamani, A. Rahman, Ed.; Guralnick, Eva, Ed.; Calder, Judy, Ed.; Kunitz, Judith Ed.; Lucich, Mardi, Ed.; Walsh, Eileen, Ed.

    2004-01-01

    "Child Care Health Connections" is a bimonthly newsletter published by the California Childcare Health Program (CCHP), a community-based program of the University of California, San Francisco School of Nursing, Department of Family Health Care Nursing. The goals of the newsletter are to promote and support a healthy and safe environment for all…

  17. Child Care Health Connections. A Health and Safety Newsletter for California Child Care Professionals. Volume 18, Number 6. November-December 2005

    ERIC Educational Resources Information Center

    Zamani, A. Rahman, Ed.; Calder, Judy, Ed.; Rose, Bobbie, Ed.

    2005-01-01

    "Child Care Health Connections" is a bimonthly newsletter published by the California Childcare Health Program (CCHP), a community-based program of the University of California, San Francisco School of Nursing, Department of Family Health Care Nursing. The goals of the newsletter are to promote and support a healthy and safe environment for all…

  18. Child Care Health Connections: A Health and Safety Newsletter for California Child Care Professionals. Volume 20, Number 3, May-June 2007

    ERIC Educational Resources Information Center

    Zamani, A. Rahman, Ed.; Calder, Judy, Ed.; Rose, Bobbie, Ed.; Leonard, Victoria, Ed.; Gendell, Mara, Ed.

    2007-01-01

    "Child Care Health Connections" is a bimonthly newsletter published by the California Childcare Health Program (CCHP), a community-based program of the University of California, San Francisco School of Nursing, Department of Family Health Care Nursing. The goals of the newsletter are to promote and support a healthy and safe environment for all…

  19. Child Care Health Connections. A Health and Safety Newsletter for California Child Care Professionals. Volume 20, Number 1. January-February 2007

    ERIC Educational Resources Information Center

    Zamani, A. Rahman, Ed.; Calder, Judy, Ed.; Rose, Bobbie, Ed.; Leonard, Victoria, Ed.; Gendell, Mara, Ed.

    2007-01-01

    "Child Care Health Connections" is a bimonthly newsletter published by the California Childcare Health Program (CCHP), a community-based program of the University of California, San Francisco School of Nursing, Department of Family Health Care Nursing. The goals of the newsletter are to promote and support a healthy and safe environment for all…

  20. Child Care Health Connections. A Health and Safety Newsletter for California Child Care Professionals. Volume 19, Number 1. January-February 2006

    ERIC Educational Resources Information Center

    Zamani, A. Rahman, Ed.; Calder, Judy, Ed.; Rose, Bobbie, Ed.; Gendell, Mara, Ed.

    2006-01-01

    "Child Care Health Connections" is a bimonthly newsletter published by the California Childcare Health Program (CCHP), a community-based program of the University of California, San Francisco School of Nursing, Department of Family Health Care Nursing. The goals of the newsletter are to promote and support a healthy and safe environment for all…

  1. Child Care Health Connections: A Health and Safety Newsletter for California Child Care Professionals. Volume 22, Number 4, July-August 2009

    ERIC Educational Resources Information Center

    Zamani, A. Rahman, Ed.; Rose, Bobbie, Ed.; Calder, Judy, Ed.; Garakani, Tahereh, Ed.; Leonard, Victoria, Ed.

    2009-01-01

    "Child Care Health Connections" is a bimonthly newsletter published by the California Childcare Health Program (CCHP), a community-based program of the University of California, San Francisco School of Nursing, Department of Family Health Care Nursing. The goals of the newsletter are to promote and support a healthy and safe environment for all…

  2. Child Care Health Connections. A Health and Safety Newsletter for California Child Care Professionals. Volume 21, Number 6. November-December 2008

    ERIC Educational Resources Information Center

    Zamani, A. Rahman, Ed.; Calder, Judy, Ed.; Rose, Bobbie, Ed.; Leonard, Victoria, Ed.

    2008-01-01

    "Child Care Health Connections" is a bimonthly newsletter published by the California Childcare Health Program (CCHP), a community-based program of the University of California, San Francisco School of Nursing, Department of Family Health Care Nursing. The goals of the newsletter are to promote and support a healthy and safe environment for all…

  3. Child Care Health Connections: A Health and Safety Newsletter for California Child Care Professionals. Volume 22, Number 2, March-April 2009

    ERIC Educational Resources Information Center

    Zamani, A. Rahman, Ed.; Rose, Bobbie, Ed.; Calder, Judy, Ed.; Garakani, Tahereh, Ed.; Leonard, Victoria, Ed.

    2009-01-01

    "Child Care Health Connections" is a bimonthly newsletter published by the California Childcare Health Program (CCHP), a community-based program of the University of California, San Francisco School of Nursing, Department of Family Health Care Nursing. The goals of the newsletter are to promote and support a healthy and safe environment for all…

  4. Child Care Health Connections: A Health and Safety Newsletter for California Child Care Professionals. Volume 21, Number 4, July-August 2008

    ERIC Educational Resources Information Center

    Zamani, A. Rahman, Ed.; Calder, Judy, Ed.; Rose, Bobbie, Ed.; Leonard, Victoria, Ed.

    2008-01-01

    "Child Care Health Connections" is a bimonthly newsletter published by the California Childcare Health Program (CCHP), a community-based program of the University of California, San Francisco School of Nursing, Department of Family Health Care Nursing. The goals of the newsletter are to promote and support a healthy and safe environment for all…

  5. Child Care Health Connections: A Health and Safety Newsletter for California Child Care Professionals. Volume 22, Number 1, January-February 2009

    ERIC Educational Resources Information Center

    Zamani, A. Rahman, Ed.; Calder, Judy, Ed.; Garakani, Tahereh, Ed.; Rose, Bobbie, Ed.; Leonard, Victoria, Ed.

    2009-01-01

    "Child Care Health Connections" is a bimonthly newsletter published by the California Childcare Health Program (CCHP), a community-based program of the University of California, San Francisco School of Nursing, Department of Family Health Care Nursing. The goals of the newsletter are to promote and support a healthy and safe environment for all…

  6. Child Care Health Connections. A Health and Safety Newsletter for California Child Care Professionals. Volume 22, Number 5, September-October 2009

    ERIC Educational Resources Information Center

    Zamani, A. Rahman, Ed.; Rose, Bobbie, Ed.; Calder, Judy, Ed.; Garakani, Tahereh, Ed.; Leonard, Victoria, Ed.

    2009-01-01

    "Child Care Health Connections" is a bimonthly newsletter published by the California Childcare Health Program (CCHP), a community-based program of the University of California, San Francisco School of Nursing, Department of Family Health Care Nursing. The goals of the newsletter are to promote and support a healthy and safe environment for all…

  7. Child Care Health Connections. A Health and Safety Newsletter for California Child Care Professionals. Volume 18, Number 2. March-April 2005

    ERIC Educational Resources Information Center

    Zamani, A. Rahman, Ed.; Guralnick, Eva, Ed.; Calder, Judy, Ed.; Walsh, Eileen, Ed.

    2005-01-01

    "Child Care Health Connections" is a bimonthly newsletter published by the California Childcare Health Program (CCHP), a community-based program of the University of California, San Francisco School of Nursing, Department of Family Health Care Nursing. The goals of the newsletter are to promote and support a healthy and safe environment for all…

  8. Child Care Health Connections: A Health and Safety Newsletter for California Child Care Professionals. Volume 22, Number 3, May-June 2009

    ERIC Educational Resources Information Center

    Zamani, A. Rahman, Ed.; Rose, Bobbie, Ed.; Calder, Judy, Ed.; Garakani, Tahereh, Ed.; Leonard, Victoria, Ed.

    2009-01-01

    "Child Care Health Connections" is a bimonthly newsletter published by the California Childcare Health Program (CCHP), a community-based program of the University of California, San Francisco School of Nursing, Department of Family Health Care Nursing. The goals of the newsletter are to promote and support a healthy and safe environment for all…

  9. Child Care Health Connections. A Health and Safety Newsletter for California Child Care Professionals. Volume 16, Number 1. January-February 2002

    ERIC Educational Resources Information Center

    Zamani, Rahman, Ed.; Guralnick, Eva, Ed.; Kunitz, Judith, Ed.

    2002-01-01

    "Child Care Health Connections" is a bimonthly newsletter published by the California Childcare Health Program (CCHP), a community-based program of the University of California, San Francisco School of Nursing, Department of Family Health Care Nursing. The goals of the newsletter are to promote and support a healthy and safe environment for all…

  10. Child Care Health Connections: A Health and Safety Newsletter for California Child Care Professionals. Volume 23, Number 3, May-June 2010

    ERIC Educational Resources Information Center

    Zamani, A. Rahman, Ed.; Rose, Bobbie, Ed.; Calder, Judy, Ed.; Garakani, Tahereh, Ed.; Leonard, Victoria, Ed.

    2010-01-01

    "Child Care Health Connections" is a bimonthly newsletter published by the California Childcare Health Program (CCHP), a community-based program of the University of California, San Francisco School of Nursing, Department of Family Health Care Nursing. The goals of this newsletter are to promote and support a healthy and safe environment for all…

  11. Child Care Health Connections: A Health and Safety Newsletter for California Child Care Professionals. Volume 20, Number 5, September-October 2007

    ERIC Educational Resources Information Center

    Zamani, A. Rahman, Ed.; Calder, Judy, Ed.; Rose, Bobbie, Ed.; Leonard, Victoria, Ed.; Gendell, Mara, Ed.

    2007-01-01

    "Child Care Health Connections" is a bimonthly newsletter published by the California Childcare Health Program (CCHP), a community-based program of the University of California, San Francisco School of Nursing, Department of Family Health Care Nursing. The goals of the newsletter are to promote and support a healthy and safe environment for all…

  12. Child Care Health Connections. A Health and Safety Newsletter for California Child Care Professionals. Volume 16, Number 3. May-June 2003

    ERIC Educational Resources Information Center

    Zamani, Rahman, Ed.; Guralnick, Eva, Ed.; Kunitz, Judith, Ed.

    2003-01-01

    "Child Care Health Connections" is a bimonthly newsletter published by the California Childcare Health Program (CCHP), a community-based program of the University of California, San Francisco School of Nursing, Department of Family Health Care Nursing. The goals of the newsletter are to promote and support a healthy and safe environment for all…

  13. Child Care Health Connections. A Health and Safety Newsletter for California Child Care Professionals. Volume 18, Number 4. July-August 2005

    ERIC Educational Resources Information Center

    Zamani, A. Rahman, Ed.; Guralnick, Eva, Ed.; Calder, Judy, Ed.; Walsh, Eileen, Ed.

    2005-01-01

    "Child Care Health Connections" is a bimonthly newsletter published by the California Childcare Health Program (CCHP), a community-based program of the University of California, San Francisco School of Nursing, Department of Family Health Care Nursing. The goals of the newsletter are to promote and support a healthy and safe environment for all…

  14. Child Care Health Connections. A Health and Safety Newsletter for California Child Care Professionals. Volume 16, Number 5. September-October 2003

    ERIC Educational Resources Information Center

    Zamani, A. Rahman, Ed.; Guralnick, Eva, Ed.; Jensen, Susan, Ed.; Lucich, Mardi, Ed.

    2003-01-01

    "Child Care Health Connections" is a bimonthly newsletter published by the California Childcare Health Program (CCHP), a community-based program of the University of California, San Francisco School of Nursing, Department of Family Health Care Nursing. The goals of the newsletter are to promote and support a healthy and safe environment for all…

  15. Child Care Health Connections. A Health and Safety Newsletter for California Child Care Professionals. Volume 20, Number 4. July-August 2007

    ERIC Educational Resources Information Center

    Zamani, A. Rahman, Ed.; Calder, Judy, Ed.; Rose, Bobbie, Ed.; Leonard, Victoria, Ed.; Gendell, Mara, Ed.

    2007-01-01

    "Child Care Health Connections" is a bimonthly newsletter published by the California Childcare Health Program (CCHP), a community-based program of the University of California, San Francisco School of Nursing, Department of Family Health Care Nursing. The goals of the newsletter are to promote and support a healthy and safe environment for all…

  16. Child Care Health Connections. A Health and Safety Newsletter for California Child Care Professionals. Volume 18, Number 5. September-October 2005

    ERIC Educational Resources Information Center

    Zamani, A. Rahman, Ed.; Guralnick, Eva, Ed.; Calder, Judy, Ed.; Walsh, Eileen, Ed.

    2005-01-01

    "Child Care Health Connections" is a bimonthly newsletter published by the California Childcare Health Program (CCHP), a community-based program of the University of California, San Francisco School of Nursing, Department of Family Health Care Nursing. The goals of the newsletter are to promote and support a healthy and safe environment for all…

  17. Child Care Health Connections. A Health and Safety Newsletter for California Child Care Professionals. Volume 16, Number 6. November-December 2003

    ERIC Educational Resources Information Center

    Zamani, A. Rahman, Ed.; Guralnick, Eva, Ed.; Jensen, Susan, Ed.; Lucich, Mardi, Ed.

    2003-01-01

    "Child Care Health Connections" is a bimonthly newsletter published by the California Childcare Health Program (CCHP), a community-based program of the University of California, San Francisco School of Nursing, Department of Family Health Care Nursing. The goals of the newsletter are to promote and support a healthy and safe environment for all…

  18. Child Care Health Connections: A Health and Safety Newsletter for California Child Care Professionals. Volume 19, Number 2, March-April 2006

    ERIC Educational Resources Information Center

    Zamani, A. Rahman, Ed.; Calder, Judy, Ed.; Rose, Bobbie, Ed.; Leonard, Victoria, Ed.; Gendell, Mara, Ed.

    2006-01-01

    "Child Care Health Connections" is a bimonthly newsletter published by the California Childcare Health Program (CCHP), a community-based program of the University of California, San Francisco School of Nursing, Department of Family Health Care Nursing. The goals of the newsletter are to promote and support a healthy and safe environment for all…

  19. Child Care Health Connections: A Health and Safety Newsletter for California Child Care Professionals. Volume 21, Number 3, May-June 2008

    ERIC Educational Resources Information Center

    Zamani, A. Rahman, Ed.; Calder, Judy, Ed.; Rose, Bobbie, Ed.; Leonard, Victoria, Ed.

    2008-01-01

    "Child Care Health Connections" is a bimonthly newsletter published by the California Childcare Health Program (CCHP), a community-based program of the University of California, San Francisco School of Nursing, Department of Family Health Care Nursing. The goals of this newsletter are to promote and support a healthy and safe environment for all…

  20. Child Care Health Connections: A Health and Safety Newsletter for California Child Care Professionals. Volume 23, Number 1, January-February 2010

    ERIC Educational Resources Information Center

    Zamani, A. Rahman, Ed.; Rose, Bobbie, Ed.; Calder, Judy, Ed.; Garakani, Tahereh, Ed.; Leonard, Victoria, Ed.

    2010-01-01

    "Child Care Health Connections" is a bimonthly newsletter published by the California Childcare Health Program (CCHP), a community-based program of the University of California, San Francisco School of Nursing, Department of Family Health Care Nursing. The goals of the newsletter are to promote and support a healthy and safe environment for all…

  1. Child Care Health Connections: A Health and Safety Newsletter for California Child Care Professionals. Volume 20, Number 2, March-April 2007

    ERIC Educational Resources Information Center

    Zamani, A. Rahman, Ed.; Calder, Judy, Ed.; Rose, Bobbie, Ed.; Leonard, Victoria, Ed.; Gendell, Mara, Ed.

    2007-01-01

    "Child Care Health Connections" is a bimonthly newsletter published by the California Childcare Health Program (CCHP), a community-based program of the University of California, San Francisco School of Nursing, Department of Family Health Care Nursing. The goals of the newsletter are to promote and support a healthy and safe environment for all…

  2. Child Care Health Connections. A Health and Safety Newsletter for California Child Care Professionals. Volume 18, Number 1. January-February 2005

    ERIC Educational Resources Information Center

    Zamani, A. Rahman, Ed.; Guralnick, Eva, Ed.; Calder, Judy, Ed.; Walsh, Eileen, Ed.

    2005-01-01

    "Child Care Health Connections" is a bimonthly newsletter published by the California Childcare Health Program (CCHP), a community-based program of the University of California, San Francisco School of Nursing, Department of Family Health Care Nursing. The goals of the newsletter are to promote and support a healthy and safe environment for all…

  3. Child Care Health Connections. A Health and Safety Newsletter for California Child Care Professionals. Volume 17, Number 5. September-October 2004

    ERIC Educational Resources Information Center

    Zamani, A. Rahman, Ed.; Guralnick, Eva, Ed.; Calder, Judy, Ed.; Lucich, Mardi, Ed.; Walsh, Eileen, Ed.

    2004-01-01

    "Child Care Health Connections" is a bimonthly newsletter published by the California Childcare Health Program (CCHP), a community-based program of the University of California, San Francisco School of Nursing, Department of Family Health Care Nursing. The goals of the newsletter are to promote and support a healthy and safe environment for all…

  4. Child Care Health Connections. A Health and Safety Newsletter for California Child Care Professionals. Volume 17, Number 6. November-December 2004

    ERIC Educational Resources Information Center

    Zamani, A. Rahman, Ed.; Guralnick, Eva, Ed.; Calder, Judy, Ed.; Lucich, Mardi, Ed.; Walsh, Eileen, Ed.

    2004-01-01

    "Child Care Health Connections" is a bimonthly newsletter published by the California Childcare Health Program (CCHP), a community-based program of the University of California, San Francisco School of Nursing, Department of Family Health Care Nursing. The goals of the newsletter are to promote and support a healthy and safe environment for all…

  5. Child Care Health Connections: A Health and Safety Newsletter for California Child Care Professionals. Volume 20, Number 6, November-December 2007

    ERIC Educational Resources Information Center

    Zamani, A. Rahman, Ed.; Calder, Judy, Ed.; Rose, Bobbie, Ed.; Leonard, Victoria, Ed.; Gendell, Mara, Ed.

    2007-01-01

    "Child Care Health Connections" is a bimonthly newsletter published by the California Childcare Health Program (CCHP), a community-based program of the University of California, San Francisco School of Nursing, Department of Family Health Care Nursing. The goals of this newsletter are to promote and support a healthy and safe environment for all…

  6. Child Care Health Connections: A Health and Safety Newsletter for California Child Care Professionals. Volume 19, Number 5, September-October 2006

    ERIC Educational Resources Information Center

    Zamani, A. Rahman, Ed.; Calder, Judy, Ed.; Rose, Bobbie, Ed.; Leonard, Victoria, Ed.; Gendell, Mara, Ed.

    2006-01-01

    "Child Care Health Connections" is a bimonthly newsletter published by the California Childcare Health Program (CCHP), a community-based program of the University of California, San Francisco School of Nursing, Department of Family Health Care Nursing. The goals of this newsletter are to promote and support a healthy and safe environment for all…

  7. Child Care Health Connections. A Health and Safety Newsletter for California Child Care Professionals. Volume 17, Number 3. May-June 2004

    ERIC Educational Resources Information Center

    Zamani, A. Rahman, Ed.; Guralnick, Eva, Ed.; Calder, Judy, Ed.; Kunitz, Judith, Ed.; Lucich, Mardi, Ed.

    2004-01-01

    "Child Care Health Connections" is a bimonthly newsletter published by the California Childcare Health Program (CCHP), a community-based program of the University of California, San Francisco School of Nursing, Department of Family Health Care Nursing. The goals of the newsletter are to promote and support a healthy and safe environment for all…

  8. Child Care Health Connections. A Health and Safety Newsletter for California Child Care Professionals. Volume 16, Number 4. July-August 2003

    ERIC Educational Resources Information Center

    Zamani, Rahman, Ed.; Guralnick, Eva, Ed.; Kunitz, Judith Ed.

    2003-01-01

    "Child Care Health Connections" is a bimonthly newsletter published by the California Childcare Health Program (CCHP), a community-based program of the University of California, San Francisco School of Nursing, Department of Family Health Care Nursing. The goals of the newsletter are to promote and support a healthy and safe environment for all…

  9. Child Care Health Connections: A Health and Safety Newsletter for California Child Care Professionals. Volume 23, Number 4, July-August 2010

    ERIC Educational Resources Information Center

    Zamani, A. Rahman, Ed.; Rose, Bobbie, Ed.; Calder, Judy, Ed.; Garakani, Tahereh, Ed.; Leonard, Victoria, Ed.

    2010-01-01

    "Child Care Health Connections" is a bimonthly newsletter published by the California Childcare Health Program (CCHP), a community-based program of the University of California, San Francisco School of Nursing, Department of Family Health Care Nursing. The goals of the newsletter are to promote and support a healthy and safe environment for all…

  10. Child Care Health Connections: A Health and Safety Newsletter for California Child Care Professionals. Volume 23, Number 2, March-April 2010

    ERIC Educational Resources Information Center

    Zamani, A. Rahman, Ed.; Rose, Bobbie, Ed.; Calder, Judy, Ed.; Garakani, Tahereh, Ed.; Leonard, Victoria, Ed.

    2010-01-01

    "Child Care Health Connections" is a bimonthly newsletter published by the California Childcare Health Program (CCHP), a community-based program of the University of California, San Francisco School of Nursing, Department of Family Health Care Nursing. The goals of the newsletter are to promote and support a healthy and safe environment for all…

  11. Child Care Health Connections. A Health and Safety Newsletter for California Child Care Professionals. Volume 21, Number 1. January-February 2008

    ERIC Educational Resources Information Center

    Zamani, A. Rahman, Ed.; Calder, Judy, Ed.; Rose, Bobbie, Ed.; Leonard, Victoria, Ed.; Turner, Debra, Ed.

    2008-01-01

    "Child Care Health Connections" is a bimonthly newsletter published by the California Childcare Health Program (CCHP), a community-based program of the University of California, San Francisco School of Nursing, Department of Family Health Care Nursing. The goals of the newsletter are to promote and support a healthy and safe environment for all…

  12. Child Care Health Connections: A Health and Safety Newsletter for California Child Care Professionals. Volume 22, Number 6, November-December 2009

    ERIC Educational Resources Information Center

    Zamani, A. Rahman, Ed.; Rose, Bobbie, Ed.; Calder, Judy, Ed.; Garakani, Tahereh, Ed.; Leonard, Victoria, Ed.

    2009-01-01

    "Child Care Health Connections" is a bimonthly newsletter published by the California Childcare Health Program (CCHP), a community-based program of the University of California, San Francisco School of Nursing, Department of Family Health Care Nursing. The goals of the newsletter are to promote and support a healthy and safe environment for all…

  13. Child Care Health Connections: A Health and Safety Newsletter for California Child Care Professionals. Volume 19, Number 6, November-December 2006

    ERIC Educational Resources Information Center

    Zamani, A. Rahman, Ed.; Calder, Judy, Ed.; Rose, Bobbie, Ed.; Leonard, Victoria, Ed.; Gendell, Mara, Ed.

    2006-01-01

    "Child Care Health Connections" is a bimonthly newsletter published by the California Childcare Health Program (CCHP), a community-based program of the University of California, San Francisco School of Nursing, Department of Family Health Care Nursing. The goals of this newsletter are to promote and support a healthy and safe environment for all…

  14. Child Care Health Connections. A Health and Safety Newsletter for California Child Care Professionals. Volume 17, Number 1. January-February 2004

    ERIC Educational Resources Information Center

    Zamani, A. Rahman, Ed.; Guralnick, Eva, Ed.; Lucich, Mardi, Ed.

    2004-01-01

    "Child Care Health Connections" is a bimonthly newsletter published by the California Childcare Health Program (CCHP), a community-based program of the University of California, San Francisco School of Nursing, Department of Family Health Care Nursing. The goals of the newsletter are to promote and support a healthy and safe environment for all…

  15. Child Care Health Connections. A Health and Safety Newsletter for California Child Care Professionals. Volume 21, Number 2. March-April 2008

    ERIC Educational Resources Information Center

    Zamani, A. Rahman, Ed.; Calder, Judy, Ed.; Rose, Bobbie, Ed.; Leonard, Victoria, Ed.

    2008-01-01

    "Child Care Health Connections" is a bimonthly newsletter published by the California Childcare Health Program (CCHP), a community-based program of the University of California, San Francisco School of Nursing, Department of Family Health Care Nursing. The goals of the newsletter are to promote and support a healthy and safe environment for all…

  16. Child Care Health Connections: A Health and Safety Newsletter for California Child Care Professionals. Volume 19, Number 4, July-August 2006

    ERIC Educational Resources Information Center

    Zamani, A. Rahman, Ed.; Calder, Judy, Ed.; Rose, Bobbie, Ed.; Leonard, Victoria, Ed.; Gendell, Mara, Ed.

    2006-01-01

    "Child Care Health Connections" is a bimonthly newsletter published by the California Childcare Health Program (CCHP), a community-based program of the University of California, San Francisco School of Nursing, Department of Family Health Care Nursing. The goals of the newsletter are to promote and support a healthy and safe environment for all…

  17. Child Care Health Connections. A Health and Safety Newsletter for California Child Care Professionals. Volume 18, Number 3. May-June 2005

    ERIC Educational Resources Information Center

    Zamani, A. Rahman, Ed.; Guralnick, Eva, Ed.; Calder, Judy, Ed.; Walsh, Eileen, Ed.

    2005-01-01

    "Child Care Health Connections" is a bimonthly newsletter published by the California Childcare Health Program (CCHP), a community-based program of the University of California, San Francisco School of Nursing, Department of Family Health Care Nursing. The goals of the newsletter are to promote and support a healthy and safe environment for all…

  18. Child Care Health Connections. A Health and Safety Newsletter for California Child Care Professionals. Volume 16, Number 2. March-April 2003

    ERIC Educational Resources Information Center

    Zamani, Rahman, Ed.; Guralnick, Eva, Ed.; Kunitz, Judith Ed.

    2003-01-01

    "Child Care Health Connections" is a bimonthly newsletter published by the California Childcare Health Program (CCHP), a community-based program of the University of California, San Francisco School of Nursing, Department of Family Health Care Nursing. The goals of the newsletter are to promote and support a healthy and safe environment for all…

  19. Ethics, Politics, and Religion in Public Health Care: A Manifesto for Health Care Chaplains in Canada.

    PubMed

    Lasair, Simon

    2016-03-01

    Health care chaplaincy positions in Canada are significantly threatened due to widespread health care cutbacks. Yet the current time also presents a significant opportunity for spiritual care providers. This article argues that religion and spirituality in Canada are undergoing significant changes. The question for Canadian health care chaplains is, then: how well equipped are they to understand these changes in health care settings and to engage them? This article attempts to go part way toward an answer.

  20. Health care-acquired infections in neonatal intensive care units: risk factors and etiology.

    PubMed

    Djordjevic, Zorana M; Markovic-Denic, Ljiljana; Folic, Marko M; Igrutinovic, Zoran; Jankovic, Slobodan M

    2015-01-01

    A 1-year prospective cohort study of health care-acquired infections was conducted at the neonatal intensive care unit of the University Clinical Centre Kragujevac, Serbia. The incidence rate of neonates with health care-acquired infections was 18.6%, and the incidence rate of the infections themselves was 19.4%. The incidence density of the health care-acquired infections was 9.1 per 1,000 patient days. The independent risk factors for health care-acquired infections were birth weight, length of hospitalization, duration of mechanical ventilation, and Apgar score. More than half of all isolated microorganisms were Klebsiella-Enterobacter (39.3%) and Escherichia coli (25.0%).

  1. Health care of homeless veterans.

    PubMed

    O'Toole, Thomas P; Conde-Martel, Alicia; Gibbon, Jeanette L; Hanusa, Barbara H; Fine, Michael J

    2003-11-01

    It is important to understand the needs of those veterans who are homeless. We describe characteristics of homeless male veterans and factors associated with needing VA benefits from a two-city, community survey of 531 homeless adults. Overall, 425 were male, of whom 127 were veterans (29.9%). Significantly more veterans had a chronic medical condition and two or more mental health conditions. Only 35.1% identified a community clinic for care compared with 66.8% of non-veterans (P <.01); 47.7% identified a shelter-based clinic and 59.1% reported needing VA benefits. Those reporting this need were less likely to report a medical comorbidity (58.7% vs 76.9%; P =.04), although 66.7% had a mental health comorbidity and 82.7% met Diagnosic Screening Manual (DSM)-IIIR criteria for substance abuse/dependence. They were also significantly more likely to access shelter clinics compared with veterans without this need. Homeless veterans continue to have substantial health issues. Active outreach is needed for those lacking access to VA services. PMID:14687279

  2. Health care economics and policy.

    PubMed

    Lubeck, D P

    1991-04-01

    It is difficult to objectively and comprehensively measure the effects of the rheumatic diseases or their treatment. The concept of patient outcome measurement now encompasses many components: physical health, mental health, everyday functioning, general perceptions of well-being, treatment side effects, and cost-versus-benefit. Accordingly, a major research effort has been directed toward developing methods for the measurement of health status and patient outcome in arthritis and other rheumatologic diseases. The intent of this effort is to produce standard measures for evaluating disease impact, treatment impact, and costs of care. Numerous questionnaire-based instruments have appeared for clinical researchers to use, but they are couched in unfamiliar jargon and use terms such as "indirect costs," "lost productivity," and "quality-of-life." As these articles appear in the literature and clinical investigators include such measures in their studies or clinical trials, a review of the terms and an evaluation of these measures appears timely. This report describes the present state of the art, emerging problems, and future directions.

  3. National Resource Center for Health and Safety in Child Care and Early Education

    MedlinePlus

    ... Health and Safety in Child Care and Early Education (NRC) at the University of Colorado College of ... Safety Performance Standards; Guidelines for Early Care and Education Programs, 3 rd Edition ( CFOC3 ) As a collaborator ...

  4. Paying for Health Care: The Unequal Burdens

    ERIC Educational Resources Information Center

    Myers, Beverlee A.

    1977-01-01

    This article addresses the issue of national health care. Neither Medicare nor Medicaid equitably meet the health needs of the entire population. The author suggests criteria which must be met by a national health program if it is to eliminate inequalities in costs, access to services and quality of care. (GC)

  5. Prospects for Flourishing in Contemporary Health Care.

    PubMed

    Pattison, Stephen; Edgar, Andrew

    2016-06-01

    This special issue of Health Care Analysis originated in an conference, held in Birmingham in 2014, and organised by the group Think about Health. We introduce the issue by briefly reviewing the understandings of the concept of 'flourishing', and introducing the contributory papers, before offering some reflections on the remaining issues that reflection on flourishing poses for health care provision. PMID:26857468

  6. Health Care Access among Deaf People

    ERIC Educational Resources Information Center

    Kuenburg, Alexa; Fellinger, Paul; Fellinger, Johannes

    2016-01-01

    Access to health care without barriers is a clearly defined right of people with disabilities as stated by the UN Convention on the Rights of People with Disabilities. The present study reviews literature from 2000 to 2015 on access to health care for deaf people and reveals significant challenges in communication with health providers and gaps in…

  7. Special Issue: The Family and Health Care.

    ERIC Educational Resources Information Center

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

    1985-01-01

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

  8. Predictors of Adolescent Health Care Utilization

    ERIC Educational Resources Information Center

    Vingilis, Evelyn; Wade, Terrance; Seeley, Jane

    2007-01-01

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

  9. The recovery of Bay State Health Care.

    PubMed

    Maltz, D L

    1994-03-01

    Blue Cross and Blue Shield of Massachusetts acquired Bay State Health Care after the HMO's tumultuous downturn. The case study described herein provides a useful lesson in the moves that must be made, particularly in an era of health care consolidation and intensive competition, to maintain health plan stability and reinforce its position in the marketplace. PMID:10133054

  10. Social networks in improvement of health care.

    PubMed

    Masic, Izet; Sivic, Suad; Toromanovic, Selim; Borojevic, Tea; Pandza, Haris

    2012-01-01

    Social network is a social structure made of individuals or organizations associated with one or more types of interdependence (friendship, common interests, work, knowledge, prestige, etc.) which are the "nodes" of the network. Networks can be organized to exchange information, knowledge or financial assistance under the various interest groups in universities, workplaces and associations of citizens. Today the most popular and widely used networks are based on application of the Internet as the main ICT. Depending on the method of connection, their field of activity and expertise of those who participate in certain networks, the network can be classified into the following groups: a) Social Networks with personal physical connectivity (the citizens' associations, transplant networks, etc.), b) Global social internet network (Facebook, Twitter, Skype), c) specific health internet social network (forums, Health Care Forums, Healthcare Industry Forum), d) The health community internet network of non professionals (DailyStrength, CaringBridge, CarePages, MyFamilyHealth), e) Scientific social internet network (BiomedExperts, ResearchGate, iMedExchange), f) Social internet network which supported professionals (HealthBoards, Spas and Hope Association of Disabled and diabetic Enurgi), g) Scientific medical internet network databases in the system of scientific and technical information (CC, Pubmed/Medline, Excerpta Medica/EMBASE, ISI Web Knowledge, EBSCO, Index Copernicus, Social Science Index, etc.). The information in the network are exchanged in real time and in a way that has until recently been impossible in real life of people in the community. Networks allow tens of thousands of specific groups of people performing a series of social, professional and educational activities in the place of living and housing, place of work or other locations where individuals are. Network provides access to information related to education, health, nutrition, drugs, procedures

  11. Social Networks in Improvement of Health Care

    PubMed Central

    Masic, Izet; Sivic, Suad; Toromanovic, Selim; Borojevic, Tea; Pandza, Haris

    2012-01-01

    Social network is a social structure made of individuals or organizations associated with one or more types of interdependence (friendship, common interests, work, knowledge, prestige, etc.) which are the “nodes” of the network. Networks can be organized to exchange information, knowledge or financial assistance under the various interest groups in universities, workplaces and associations of citizens. Today the most popular and widely used networks are based on application of the Internet as the main ICT. Depending on the method of connection, their field of activity and expertise of those who participate in certain networks, the network can be classified into the following groups: a) Social Networks with personal physical connectivity (the citizens’ associations, transplant networks, etc.), b) Global social internet network (Facebook, Twitter, Skype), c) specific health internet social network (forums, Health Care Forums, Healthcare Industry Forum), d) The health community internet network of non professionals (DailyStrength, CaringBridge, CarePages, MyFamilyHealth), e) Scientific social internet network (BiomedExperts, ResearchGate, iMedExchange), f) Social internet network which supported professionals (HealthBoards, Spas and Hope Association of Disabled and diabetic Enurgi), g) Scientific medical internet network databases in the system of scientific and technical information (CC, Pubmed/Medline, Excerpta Medica/EMBASE, ISI Web Knowledge, EBSCO, Index Copernicus, Social Science Index, etc.). The information in the network are exchanged in real time and in a way that has until recently been impossible in real life of people in the community. Networks allow tens of thousands of specific groups of people performing a series of social, professional and educational activities in the place of living and housing, place of work or other locations where individuals are. Network provides access to information related to education, health, nutrition, drugs

  12. Health care law versus constitutional law.

    PubMed

    Hall, Mark A

    2013-04-01

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

  13. Supporting positive dimensions of health, challenges in mental health care

    PubMed Central

    Jormfeldt, Henrika

    2011-01-01

    This paper will explore two contrasting paradigms in mental health care and their relationship to evidence-based practice. The biomedical perspective of pathogenesis and the health perspective of salotogenesis are two major diverse views in mental health care. Positive dimensions of health are traditionally viewed as software not suitable for statistical analysis, while absence of symptoms of disease are regarded as measurable and suitable for statistical analysis and appropriate as a foundation of evidence-based practice. If the main goal of mental health care is to enhance subjectively experienced health among patients, it will not be sufficient to evaluate absence of symptoms of disease as a measure of quality of care. The discussion focuses on the paradox of evidence-based absence of illness and disease versus subjectively experienced health and well-being as criterions of quality of care in mental health care. PMID:21637739

  14. Health care policy issues as a result of the genetic revolution: implications for public health.

    PubMed

    Ojha, Rohit P; Thertulien, Raymond

    2005-03-01

    The genetic revolution has spawned 4 distinct issues of universal importance to health care policy and society: genetic privacy, regulation and standardization of genetic tests, gene patenting, and education. Adequate policy advancements for these 4 areas are lacking. Stringent controls must be placed on individual health records to prevent their misuse. Genetic testing within the clinical setting should undergo thorough evaluation before it is implemented. Regulations are needed to prevent the monopolization of DNA sequences. Society and health care professionals must be educated about the scope of genetic testing because current trends indicate that genetic and molecular assessments are destined to become a routine component of health care.

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

    PubMed

    Kay, Margaret; Jackson, Claire; Nicholson, Caroline

    2010-01-01

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

  16. Health care and equity in India.

    PubMed

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

    2011-02-01

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

  17. Effective health care corporate compliance.

    PubMed

    Saum, T B; Byassee, J

    2000-01-01

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

  18. Effective health care corporate compliance.

    PubMed

    Saum, T B; Byassee, J

    2000-01-01

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

  19. Justice, welfare and health care.

    PubMed

    Telfer, E

    1976-09-01

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

  20. Early warnings: health care preparedness.

    PubMed

    Rebmann, Terri

    2005-11-01

    As nurses, we represent the backbone of the health care system. It is essential that we have a core understanding of infectious disease emergencies and begin to use the strengths that characterize nursing. These strengths include the ability to evaluate situations and use evidence on which to base our actions. Early identification of an infectious disease emergency is one example of using nursing skills to strengthen emergency preparedness. During an infectious disease emergency, nurses certainly will bear the burden of patient management. Because of this, the need for infectious disease emergency preparedness has become a national priority and a moral imperative for all nurses. One topic necessary for ED and OH nurses' preparedness has been discussed in this article, but nurses must take the initiative to learn more about disaster preparedness and incorporate these skills into everyday practice.

  1. The Health Implications of Grandparents Caring for Grandchildren in China

    PubMed Central

    Liu, Guangya

    2012-01-01

    Objectives. Caring for grandchildren is a common and normative experience for many Chinese grandparents. This study investigates the influence of child care provision on older adults’ health trajectories in China. Method. Using data from the China Health and Nutrition Survey (1991, 1993, 1997, 2000, 2004, and 2006), we apply growth curve models to examine the effect of living arrangements and intensity of caregiving for grandchildren on older adults’ health trajectories. We use propensity score weighting to take into account potential selection bias. Results. Grandparents living in skipped-generation households do not suffer from a deficit in self-reported health, particularly when they have higher family income. Those living in three-generation households experience a slightly more rapid health decline than older adults who live independently, although the paternal grandparents in this type of household have a significant health advantage over the maternal grandparents. Among the coresiding grandparents, high intensity care for younger grandchildren accelerates health declines, whereas a lighter level of care has a protective effect. In addition, rural grandparents and grandfathers engaging in high intensity care have worse self-reported health on average. Discussion. Our findings suggest that grandchild care does not have a universally beneficial or detrimental effect on health, but rather its effect depends on the form and level of caregiving and is further shaped by individual characteristics, as well as normative and structural contexts. PMID:22156630

  2. Distance education for the health care supervisor.

    PubMed

    Brownson, K

    1997-12-01

    Health care supervisors are being driven by the rapid changes in health care today. One demand is to complete their undergraduate degree or even a graduate degree. Few of us are able to devote the many hours required to attend on-campus classes full time. Now there is an alternative. Busy health care supervisors can now complete their undergraduate or graduate degrees from the comfort of their home--maintaining a job and family life. PMID:10174445

  3. Implementing TQM in the health care sector.

    PubMed

    Motwani, J; Sower, V E; Brashier, L W

    1996-01-01

    This article examines the issue of implementing TQM/CQI programs in the health care industry by grouping the prescriptive literature into four research streams. Based on the literature, a strategic programming model for implementing TQM/CQI in the health care industry is suggested. Finally, issues relating to TQM in the health care sector, which need to be addressed within each research stream in the future, are provided.

  4. Health Care Access Among Deaf People.

    PubMed

    Kuenburg, Alexa; Fellinger, Paul; Fellinger, Johannes

    2016-01-01

    Access to health care without barriers is a clearly defined right of people with disabilities as stated by the UN Convention on the Rights of People with Disabilities. The present study reviews literature from 2000 to 2015 on access to health care for deaf people and reveals significant challenges in communication with health providers and gaps in global health knowledge for deaf people including those with even higher risk of marginalization. Examples of approaches to improve access to health care, such as providing powerful and visually accessible communication through the use of sign language, the implementation of important communication technologies, and cultural awareness trainings for health professionals are discussed. Programs that raise health knowledge in Deaf communities and models of primary health care centers for deaf people are also presented. Published documents can empower deaf people to realize their right to enjoy the highest attainable standard of health.

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

    PubMed

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

    2013-12-01

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

  6. International Students, University Health Centers, and Memorable Messages about Health

    ERIC Educational Resources Information Center

    Carmack, Heather J.; Bedi, Shireen; Heiss, Sarah N.

    2016-01-01

    International students entering US universities often experience a variety of important socialization messages. One important message is learning about and using the US health system. International students often first encounter the US health system through their experiences with university health centers. The authors explore the memorable…

  7. Attending unintended transformations of health care infrastructure

    PubMed Central

    Wentzer, Helle; Bygholm, Ann

    2007-01-01

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

  8. Blogging and the health care manager.

    PubMed

    Malvey, Donna; Alderman, Barbara; Todd, Andrew D

    2009-01-01

    The use of blogs in the workplace has emerged as a communication tool that can rapidly and simultaneously connect managers with their employees, customers, their peers, and other key stakeholders. Nowhere is this connection more critical than in health care, especially because of the uncertainty surrounding health care reform and the need for managers to have access to timely and authentic information. However, most health care managers have been slow to join the blogging bandwagon. This article examines the phenomenon of blogging and offers a list of blogs that every health care manager should read and why. This article also presents a simplified step-by-step process to set up a blog.

  9. Finally, fixing health care: what's different now?

    PubMed

    Wyden, Ron; Bennett, Bob

    2008-01-01

    Is now the time to fix the U.S. health care system? Those who remember the failed attempts of the past would say no. We see it differently. Our optimism is rooted in new developments that didn't exist the last time Congress addressed health care. These include bipartisan support for our Healthy Americans Act; an ideological truce over the role of government in health care; common ground between business and labor; the realization that states can't go it alone on health care; the plight of employers in a global marketplace; and the need for coverage that is affordable, accessible, and portable.

  10. Fundamental mechanisms of managed behavioral health care.

    PubMed

    Mihalik, G; Scherer, M

    1998-01-01

    Making sense of managed behavioral health care organizations (MBHOs) is difficult as they rapidly evolve in response to payer, member, legislative, and market demands. This article describes the basic mechanisms involved in managed behavioral health care's evolution, including the nature of carve-out organizations, carved-in services, the array of payment mechanisms between payer and MBHO, and between MBHO and mental health care providers. Additionally, types of delivery systems and mechanisms used to control utilization are outlined in the context of continuing health care change.

  11. [Primary health care physician in modern conditions].

    PubMed

    Cindrić, Jasna

    2007-02-01

    Some basic considerations about the role and responsibilities of primary health care physician are presented. The attitude towards the patient and other activities of general practitioners are described. Rational, multidisciplinary and multifactorial dialogues and cooperation with other colleagues is also stressed. Team work and collaboration with other segments involved in the patient health care is an imperative. Working conditions are not equal in all health care settings, however, all health care personnel, regardless of their place of work, must implement rationalization of health care expenses and keep high professional level in urban and rural settings, even those distant from large medical centers. The possible misunderstandings of professional interests that can be destructive for working atmosphere are also mentioned. Primary health care is the cheapest and economically most efficient type of health care for a particular population. In this context, primary health care physicians/family doctors find their role and responsibilities, follow organizational principles, system and methods of work. To conclude, a more positive potential of primary health care and its affirmation is stressed.

  12. [Methodological education and care strategies in basic health care].

    PubMed

    Lopes, Marta Julia Marques; da Silva, João Luis Almeida

    2004-01-01

    This paper discusses methodological and care strategies or tools used in basic health care practice. It is based on the dialogue established between what we think and what we carry out at the Life Quality Promotion Outpatient Centers (APQVs). These centers are located at two basic health care centers in Porto Alegre/RS, Brazil. Its users are mostly adult and elderly patients with long-term illnesses. The proposal of this discussion arose from a research project financed by the Brazilian Council for Scientific and Technological Development--CNPq, and integrates a thematic network called Education and Care Methodologies to Promote Life Quality. Starting from this empirical and conceptual base, methodological tools were built to develop nursing consulting services in outpatient health care to individuals and groups. This article aims to present relational and operational concepts used in care at these services.

  13. Foundation for a natural right to health care.

    PubMed

    Eberl, Jason T; Kinney, Eleanor D; Williams, Matthew J

    2011-12-01

    Discussions concerning whether there is a natural right to health care may occur in various forms, resulting in policy recommendations for how to implement any such right in a given society. But health care policies may be judged by international standards including the United Nations' Universal Declaration of Human Rights (UDHR). The rights enumerated in the UDHR are grounded in traditions of moral theory, a philosophical analysis of which is necessary in order to adjudicate the value of specific policies designed to enshrine rights such as a right to health care. We begin with an overview of the drafting of the UDHR and highlight the primary influence of natural law theory in validating the rights contained therein. We then provide an explication of natural law theory by reference to the writings of Thomas Aquinas, as well as elucidate the complementary "capabilities approach" of Martha Nussbaum. We conclude that a right to health care ought to be guaranteed by the state.

  14. Role of Primary Health Care in Ensuring Access to Medicines

    PubMed Central

    Sambala, Evanson Z; Sapsed, Susan; Mkandawire, Mercy L

    2010-01-01

    To examine ways of ensuring access to health services within the framework of primary health care (PHC), since the goal of PHC to make universal health care available to all people has become increasingly neglected amid emerging themes of globalization, trade, and foreign policy. From a public health point of view, we argue that the premise of PHC can unlock barriers to health care services and contribute greatly to determining collective health through the promotion of universal basic health services. PHC has the most sophisticated and organized infrastructure, theories, and political principles, with which it can deal adequately with the issues of inequity, inequality, and social injustice which emerge from negative economic externalities and neo-liberal economic policies. Addressing these issues, especially the complex social and political influences that restrict access to medicines, may require the integration of different health initiatives into PHC. Based on current systems, PHC remains the only conventional health delivery service that can deal with resilient public health problems adequately. However, to strengthen its ability to do so, we propose the revitalization of PHC to incorporate scholarship that promotes human rights, partnerships, research and development, advocacy, and national drug policies. The concept of PHC can improve access; however, this will require the urgent interplay among theoretical, practical, political, and sociological influences arising from the economic, social, and political determinants of ill health in an era of globalization. PMID:20564760

  15. Role of primary health care in ensuring access to medicines.

    PubMed

    Sambala, Evanson Z; Sapsed, Susan; Mkandawire, Mercy L

    2010-06-01

    To examine ways of ensuring access to health services within the framework of primary health care (PHC), since the goal of PHC to make universal health care available to all people has become increasingly neglected amid emerging themes of globalization, trade, and foreign policy. From a public health point of view, we argue that the premise of PHC can unlock barriers to health care services and contribute greatly to determining collective health through the promotion of universal basic health services. PHC has the most sophisticated and organized infrastructure, theories, and political principles, with which it can deal adequately with the issues of inequity, inequality, and social injustice which emerge from negative economic externalities and neo-liberal economic policies. Addressing these issues, especially the complex social and political influences that restrict access to medicines, may require the integration of different health initiatives into PHC. Based on current systems, PHC remains the only conventional health delivery service that can deal with resilient public health problems adequately. However, to strengthen its ability to do so, we propose the revitalization of PHC to incorporate scholarship that promotes human rights, partnerships, research and development, advocacy, and national drug policies. The concept of PHC can improve access; however, this will require the urgent interplay among theoretical, practical, political, and sociological influences arising from the economic, social, and political determinants of ill health in an era of globalization.

  16. In place of fear: aligning health care planning with system objectives to achieve financial sustainability.

    PubMed

    Birch, Stephen; Murphy, Gail Tomblin; MacKenzie, Adrian; Cumming, Jackie

    2015-04-01

    The financial sustainability of publicly funded health care systems is a challenge to policymakers in many countries as health care absorbs an ever increasing share of both national wealth and government spending. New technology, aging populations and increasing public expectations of the health care system are often cited as reasons why health care systems need ever increasing funding as well as reasons why universal and comprehensive public systems are unsustainable. However, increases in health care spending are not usually linked to corresponding increases in need for care within populations. Attempts to promote financial sustainability of systems such as limiting the range of services is covered or the groups of population covered may compromise their political sustainability as some groups are left to seek private cover for some or all services. In this paper, an alternative view of financial sustainability is presented which identifies the failure of planning and management of health care to reflect needs for care in populations and to integrate planning and management functions for health care expenditure, health care services and the health care workforce. We present a Health Care Sustainability Framework based on disaggregating the health care expenditure into separate planning components. Unlike other approaches to planning health care expenditure, this framework explicitly incorporates population health needs as a determinant of health care requirements, and provides a diagnostic tool for understanding the sources of expenditure increase.

  17. The Italian health-care system.

    PubMed

    France, George; Taroni, Francesco; Donatini, Andrea

    2005-09-01

    Italy's national health service is statutorily required to guarantee the uniform provision of comprehensive care throughout the country. However, this is complicated by the fact that, constitutionally, responsibility for health care is shared between the central government and the 20 regions. There are large and growing differences in regional health service organisation and provision. Public health-care expenditure has absorbed a relatively low share of gross domestic product, although in the last 25 years it has consistently exceeded central government forecasts. Changes in payment systems, particularly for hospital care, have helped to encourage organisational appropriateness and may have contributed to containing expenditure. Tax sources used to finance the Servizio Sanitario Nazionale (SSN) have become somewhat more regressive. The limited evidence on vertical equity suggests that the SSN ensures equal access to primary care but lower income groups face barriers to specialist care. The health status of Italians has improved and compares favourably with that in other countries, although regional disparities persist.

  18. Health care delivery system reform: accountable care organizations.

    PubMed

    Dove, James T; Weaver, W Douglas; Lewin, Jack

    2009-09-01

    Health care reform is moving forward at a frantic pace. There have been 3 documents released from the Senate Finance Committee and proposed legislation from the Senate HELP Committee and the House of Representatives Tri-Committee on Health Reform. The push for legislative action has not been sidetracked by the economic conditions. Integrated health care delivery is the current favored approach to aligning resource use and cost. Accountable care organizations (ACOs), a concept included in health care reform legislation before both the House and Senate, propose to translate the efficiencies and lessons learned from large integrated systems and apply them to nonintegrated practices. The ACO design could be real or virtual integration of local delivery providers. This new structure is complicated, and clinicians, patients, and payers should have input regarding the design and function of it. Because most of health care is delivered in the ambulatory setting, it remains to be determined whether the ACOs are best developed in parallel among physician practices and hospitals or as partnerships between hospitals and physicians. Many are concerned that hospital-led ACOs will force physician employment by hospitals with possible unintended negative consequences for physicians, hospitals, and patients. Patients, physicians, other providers, and payers are in a better position to guide the redesign of the health care delivery system than government agencies, policy organizations, or elected officials, no matter how well intended. We strongly believe-and ACC has proclaimed-that change in health care delivery must be accomplished with patients and physicians at the table.

  19. Equity in health and health care: the Chinese experience.

    PubMed

    Liu, Y; Hsiao, W C; Eggleston, K

    1999-11-01

    This paper examines the changes in equality of health and health care in China during its transition from a command economy to market economy. Data from three national surveys in 1985, 1986, and 1993 are combined with complementary studies and analysis of major underlying economic and health care factors to compare changes in health status of urban and rural Chinese during the period of economic transition. Empirical evidence suggests a widening gap in health status between urban and rural residents in the transitional period, correlated with increasing gaps in income and health care utilization. These trends are associated with changes in health care financing and organization, including dramatic reduction of insurance cover for the rural population and relaxed public health. The Chinese experience demonstrates that health development does not automatically follow economic growth. China moves toward the 21st century with increasing inequality plaguing the health component of its social safety net system.

  20. [Latex allergy - an emerging health care problem.].

    PubMed

    Gislason, D; Bjornsdottir, U S

    1996-08-01

    Since immediate hypersensitivity reaction to natural rubber was described 17 years ago, the incidence of latex allergy has been increasing rapidly. This is in part due to a growing awareness of the problem along with improved diagnostic methods. Additionally, in accordance with universal health care plans and the HIV epidemic, more rubber products such as latex gloves and condoms are in general use. Changes in methods of rubber production may also contribute to the increasing prevalence in latex allergy. Individuals at greatest risk for developing latex allergy are patients who have undergone multiple operations. These include children with myelomeningocele (spina bifida) and congenital defects of the urinary tract. Another high risk group includes health care providers and individuals working in rubber production. Latex containing products are in general use in the hospital setting as well as in the home environment. They can therefore pose a great risk to sensitized patients if prophylactic measures are not undertaken. Defining high risk patients and subsequent diagnosis with appropriate skin tests are important. Patients with latex allergy must then be provided with self-administered adrenalin (Epi-pen) and instructed in avoidance measures. In this article we describe 23 individuals who have been diagnosed allergic to latex in Iceland. PMID:20065424

  1. Universal Health Coverage for Schizophrenia: A Global Mental Health Priority.

    PubMed

    Patel, Vikram

    2016-07-01

    The growing momentum towards a global consensus on universal health coverage, alongside an acknowledgment of the urgency and importance of a comprehensive mental health action plan, offers a unique opportunity for a substantial scale-up of evidence-based interventions and packages of care for a range of mental disorders in all countries. There is a robust evidence base testifying to the effectiveness of drug and psychosocial interventions for people with schizophrenia and to the feasibility, acceptability and cost-effectiveness of the delivery of these interventions through a collaborative care model in low resource settings. While there are a number of barriers to scaling up this evidence, for eg, the finances needed to train and deploy community based workers and the lack of agency for people with schizophrenia, the experiences of some upper middle income countries show that sustained political commitment, allocation of transitional financial resources to develop community services, a commitment to an integrated approach with a strong role for community based institutions and providers, and a progressive realization of coverage are the key ingredients for scale up of services for schizophrenia.

  2. Universal Health Coverage for Schizophrenia: A Global Mental Health Priority

    PubMed Central

    Patel, Vikram

    2016-01-01

    The growing momentum towards a global consensus on universal health coverage, alongside an acknowledgment of the urgency and importance of a comprehensive mental health action plan, offers a unique opportunity for a substantial scale-up of evidence-based interventions and packages of care for a range of mental disorders in all countries. There is a robust evidence base testifying to the effectiveness of drug and psychosocial interventions for people with schizophrenia and to the feasibility, acceptability and cost-effectiveness of the delivery of these interventions through a collaborative care model in low resource settings. While there are a number of barriers to scaling up this evidence, for eg, the finances needed to train and deploy community based workers and the lack of agency for people with schizophrenia, the experiences of some upper middle income countries show that sustained political commitment, allocation of transitional financial resources to develop community services, a commitment to an integrated approach with a strong role for community based institutions and providers, and a progressive realization of coverage are the key ingredients for scale up of services for schizophrenia. PMID:26245942

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

    PubMed Central

    2010-01-01

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

  4. Health care time of crisis, crises in health care--current reality in B&H Health Care System.

    PubMed

    Salihovic, H; Kulenovic, F; Tanovic-Mikulec, E

    2001-01-01

    In the period from 1945 till 1992 the health protection had constant growth of coverage, availability and quality of protection in the promotion of health care of the inhabitants, and the health care activity noticed spreading of the network of health care institutions, evidently staff improving of all profiles of health care workers, and supplying of equipment so said in the accordance with the movements in for developed countries. The detaching for health care in 1990 amounted 6.9 per cent of that time BDP. The period from 1991 till 1955 is difficulty to analyze, because of the disturbances which appear in all sphere of life and work, and the period from 1996 till 1999 can be analyzed, from the already known reasons, only for the area of the Federation. The correct amount of the means of payment spent for health care in the postwar period is impossible incorrectly to confirm, except detaching from BDP (1999 3.7 per cent) arrived the donations in equipment, drugs, sanitary material, training of staff, free of charge experts, means for the reconstruction of objects, to this in the future cannot be considered. Besides that the rate of detaching for the health care from BDP is less than before the war, BDP by it self is far lesser what means that the means of payment detached are far lesser. It is necessary the URGENT reform of health care financing system, evaluation strategy of the reform of health care which up-to-now did not show shifts, the bringing of instruments of planning in the health care, instruments of quality control, the legislator must define clearly the relations between the private practice, patients and state funds.

  5. A right to health care? Participatory politics, progressive policy, and the price of loose language.

    PubMed

    Reidy, David A

    2016-08-01

    This article begins by clarifying and noting various limitations on the universal reach of the human right to health care under positive international law. It then argues that irrespective of the human right to health care established by positive international law, any system of positive international law capable of generating legal duties with prima facie moral force necessarily presupposes a universal moral human right to health care. But the language used in contemporary human rights documents or human rights advocacy is not a good guide to the content of this rather more modest universal moral human right to health care. The conclusion reached is that when addressing issues of justice as they inevitably arise with respect to health policy and health care, both within and between states, there is typically little to gain and much to risk by framing deliberation in terms of the human right to health care.

  6. A right to health care? Participatory politics, progressive policy, and the price of loose language.

    PubMed

    Reidy, David A

    2016-08-01

    This article begins by clarifying and noting various limitations on the universal reach of the human right to health care under positive international law. It then argues that irrespective of the human right to health care established by positive international law, any system of positive international law capable of generating legal duties with prima facie moral force necessarily presupposes a universal moral human right to health care. But the language used in contemporary human rights documents or human rights advocacy is not a good guide to the content of this rather more modest universal moral human right to health care. The conclusion reached is that when addressing issues of justice as they inevitably arise with respect to health policy and health care, both within and between states, there is typically little to gain and much to risk by framing deliberation in terms of the human right to health care. PMID:27456664

  7. Health Care Revival Renews, Rekindles, and Revives

    PubMed Central

    Lawson, Erma; Young, Azzie

    2002-01-01

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

  8. The informatics of health care reform.

    PubMed Central

    Masys, D R

    1996-01-01

    Health care in the United States has entered a period of economic upheaval. Episodic, fee-for-service care financed by indemnity insurance is being replaced by managed care financed by fixed-price, capitated health plans. The resulting focus on reducing costs, especially in areas where there is competition fueled by oversupply of health services providers and facilities, poses new threats to the livelihood of medical libraries and medical librarians but also offers new opportunities. Internet services, consumer health education, and health services research will grow in importance, and organizational mergers will provide librarians with opportunities to assume new roles within their organizations. PMID:8938325

  9. Policy challenges in US health care system reform.

    PubMed

    Hussain, Aftab; Rivers, Patrick A

    2010-01-01

    Once again, efforts are being made to overhaul the US health care system. Democrats and Republicans have conflicting views on how to repair this ailing system. However, this is not a new phenomenon. Reformers have long struggled to form a universal health care system only to find themselves in conflict with groups whose financial stake is threatened as well as numerous labor associations who are concerned about a loss of power. This struggle is also caused by differences in ideologies. This article surveys social movements for national health insurance (NHI) that occurred in the United States and will examine features that prevented NHI policy formation. PMID:22329329

  10. The Future of Home Health Care

    PubMed Central

    Landers, Steven; Madigan, Elizabeth; Leff, Bruce; Rosati, Robert J.; McCann, Barbara A.; Hornbake, Rodney; MacMillan, Richard; Jones, Kate; Bowles, Kathryn; Dowding, Dawn; Lee, Teresa; Moorhead, Tracey; Rodriguez, Sally; Breese, Erica

    2016-01-01

    The Future of Home Health project sought to support transformation of home health and home-based care to meet the needs of patients in the evolving U.S. health care system. Interviews with key thought leaders and stakeholders resulted in key themes about the future of home health care. By synthesizing this qualitative research, a literature review, case studies, and the themes from a 2014 Institute of Medicine and National Research Council workshop on “The Future of Home Health Care,” the authors articulate a vision for home-based care and recommend a bold framework for the Medicare-certified home health agency of the future. The authors also identify challenges and recommendations for achievement of this framework. PMID:27746670

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

    PubMed Central

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

    2015-01-01

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

  12. A primary health care project in Sarawak.

    PubMed

    Chen, P C; Tan, Y K

    1982-03-01

    A joint pilot project between the Ministry of Health and the Dept. of Social and Preventive Medicine, University of Malaya, to test the value of village aides in extending the health care system into isolated Iban communities was begun in May 1979 in the Entabai District of Sarawak. A group of 15 village aides consisting of 11 traditional Iban manangs (medicine men) and 4 youths were trained to provide primary health care including simple curative care, preventive care, and to assist in the detection of malaria. Evaluation carreid out 2 years later showed the following. With regard to curative care, the village aides were each, on the average, treating 70.6 patients/month, the most common complaint being headache (30.4%), which along with abdominal pain, constipation, bodyache, diarrhea, vomiting, fever, worm infections, cough, and sore throat, accounted for 89% of all illnesses seen by them. Subsequent to the introduction of village aides in the project area, the number of seriously ill patients requiring admission to the rest beds of the klinik desa dropped by 43.8% and the number of emergency referrals to the backup divisional hospitals fell by 46.1% showing that patients were coming to the klink desa for treatment at an earlier stage. The 11 traditional Iban manangs, who had recently received training had, on their own accord, drastically reduced the use of traditional Iban modes of therapy in preference for modern medicine. During the 24 months immediately after the introduction of village aides into Entabai, 9 gravity feed water supply systems together with related health packages advocating general cleanliness, the use of latrines, and fences were affected, whereas only 6 such systems were installed in the previous 24 months, indicating that it is likely that the village aides were of some assistance in mobilizing the community with respect to self-help efforts. During the same period, the majority of longhouses in the area successfully established a number

  13. A primary health care project in Sarawak.

    PubMed

    Chen, P C; Tan, Y K

    1982-03-01

    A joint pilot project between the Ministry of Health and the Dept. of Social and Preventive Medicine, University of Malaya, to test the value of village aides in extending the health care system into isolated Iban communities was begun in May 1979 in the Entabai District of Sarawak. A group of 15 village aides consisting of 11 traditional Iban manangs (medicine men) and 4 youths were trained to provide primary health care including simple curative care, preventive care, and to assist in the detection of malaria. Evaluation carreid out 2 years later showed the following. With regard to curative care, the village aides were each, on the average, treating 70.6 patients/month, the most common complaint being headache (30.4%), which along with abdominal pain, constipation, bodyache, diarrhea, vomiting, fever, worm infections, cough, and sore throat, accounted for 89% of all illnesses seen by them. Subsequent to the introduction of village aides in the project area, the number of seriously ill patients requiring admission to the rest beds of the klinik desa dropped by 43.8% and the number of emergency referrals to the backup divisional hospitals fell by 46.1% showing that patients were coming to the klink desa for treatment at an earlier stage. The 11 traditional Iban manangs, who had recently received training had, on their own accord, drastically reduced the use of traditional Iban modes of therapy in preference for modern medicine. During the 24 months immediately after the introduction of village aides into Entabai, 9 gravity feed water supply systems together with related health packages advocating general cleanliness, the use of latrines, and fences were affected, whereas only 6 such systems were installed in the previous 24 months, indicating that it is likely that the village aides were of some assistance in mobilizing the community with respect to self-help efforts. During the same period, the majority of longhouses in the area successfully established a number

  14. Transitional Care: A Priority for Health Care Organizational Ethics.

    PubMed

    Naylor, Mary; Berlinger, Nancy

    2016-09-01

    Numerous studies have revealed that health care transitions for chronically ill older adults are frequently poorly managed, often with devastating human and economic consequences. And poorly managed transitions and their consequences also occur among younger, relatively healthy individuals who have adequate resources and are prepared to advocate on their own behalf. Despite the rich base of research confirming that evidence-based transitional care enhances patients' experiences, improves health and quality of life, and reduces costs, organizational, regulatory, financial, and cultural barriers have, until recently, prevented widespread adoption of these proven approaches. Provisions of the Affordable Care Act, such as reductions in Medicare payments to hospitals with very high thirty-day rehospitalization rates, have reduced barriers, but uptake of evidence-based transitional care beyond demonstration projects continues to be sporadic and far too slow. With a rich understanding about how to better anticipate and respond to the compelling problems experienced by patients, family caregivers, and health care professionals throughout episodes of acute illness, the time has come to frame transitional care as a system's ethical responsibility in an aging society. Embedding transitional care within the ethical obligations of a health care system requires the perspectives and involvement of nurses and nursing because of this profession's integral role in every aspect of care transitions. PMID:27649919

  15. University Opinion Poll 9: Child Care, MPIRG, Lettuce. Preliminary Report.

    ERIC Educational Resources Information Center

    Matross, Ronald; And Others

    The University Opinion Poll conducted a survey of student opinion on issues related to University-sponsored day care, the role of the Minnesota Public Interest Research Group (MPIRG) and the University's policy on buying lettuce for its food services. Four hundred fifty-two respondents, 76% of a random sample of University of Minnesota students,…

  16. Integration of mental health into primary care in Kenya.

    PubMed

    Jenkins, Rachel; Kiima, David; Njenga, Frank; Okonji, Marx; Kingora, James; Kathuku, Dammas; Lock, Sarah

    2010-06-01

    Integration of mental health into primary care is essential in Kenya, where there are only 75 psychiatrists for 38 million population, of whom 21 are in the universities and 28 in private practice. A partnership between the Ministry of Health, the Kenya Psychiatric Association and the World Health Organization (WHO) Collaborating Centre, Institute of Psychiatry, Kings College London was funded by Nuffield Foundation to train 3,000 of the 5,000 primary health care staff in the public health system across Kenya, using a sustainable general health system approach. The content of training was closely aligned to the generic tasks of the health workers. The training delivery was integrated into the normal national training delivery system, and accompanied by capacity building courses for district and provincial level staff to encourage the inclusion of mental health in the district and provincial annual operational plans, and to promote the coordination and supervision of mental health services in primary care by district psychiatric nurses and district public health nurses. The project trained 41 trainers, who have so far trained 1671 primary care staff, achieving a mean change in knowledge score of 42% to 77%. Qualitative observations of subsequent clinical practice have demonstrated improvements in assessment, diagnosis, management, record keeping, medicine supply, intersectoral liaison and public education. Around 200 supervisors (psychiatrists, psychiatric nurses and district public health nurses) have also been trained. The project experience may be useful for other countries also wishing to conduct similar sustainable training and supervision programmes. PMID:20671901

  17. Financing health care in the United Arab Emirates.

    PubMed

    Taha, Nabila Fahed; Sharif, Amer Ahmad; Blair, Iain

    2013-01-01

    Newcomers to the United Arab Emirates (UAE) health care system often enquire about the way in which UAE health services are financed particularly when funding issues affect eligibility for treatment. The UAE ranks alongside many western counties on measures of life expectancy and child mortality but because of the unique population structure spends less of its national income on health. In the past as a wealthy country the UAE had no difficulty ensuring universal access to a comprehensive range of services but the health needs of the UAE population are becoming more complex and like many countries the UAE health system is facing the twin challenges of quality and cost. To meet these challenges new models of health care financing are being introduced. In this brief article we will describe the evolution of UAE health financing, its current state and likely future developments. PMID:24228347

  18. Financing health care in the United Arab Emirates.

    PubMed

    Taha, Nabila Fahed; Sharif, Amer Ahmad; Blair, Iain

    2013-01-01

    Newcomers to the United Arab Emirates (UAE) health care system often enquire about the way in which UAE health services are financed particularly when funding issues affect eligibility for treatment. The UAE ranks alongside many western counties on measures of life expectancy and child mortality but because of the unique population structure spends less of its national income on health. In the past as a wealthy country the UAE had no difficulty ensuring universal access to a comprehensive range of services but the health needs of the UAE population are becoming more complex and like many countries the UAE health system is facing the twin challenges of quality and cost. To meet these challenges new models of health care financing are being introduced. In this brief article we will describe the evolution of UAE health financing, its current state and likely future developments.

  19. Rationing and competition in the Dutch health-care system.

    PubMed

    Schut, Frederik T; Van de Ven, Wynand P M M

    2005-09-01

    In this paper we examine the goals and effects of health-care policy in the Netherlands over the period 1980--2000. During this period Dutch health-care policy is marked by a peculiar combination of increasingly stringent cost-containment policies alongside a persistent pursuit of market-oriented reforms. The main goal of cost containment was to keep labour costs down under the restriction of universal equal access to health care. Supply and price control policies were quite successful in achieving cost containment, but in due course prolonged quantity rationing began to jeopardise universal physical access to health services. The main goal of market-oriented health-care reforms is to increase the system's efficiency and its responsiveness to patient's needs, while maintaining equal access. The feasibility of the reforms crucially hinges on the realisation of adequate methods of risk adjustment, product classification and quality measurement, an appropriate consumer information system and an effective competition policy. Realising these preconditions requires a lengthy and cautious implementation process. Although considerable progress has been made in setting the appropriate stage for regulated competition in Dutch health care, the role of the market is still limited. PMID:16161190

  20. Insights From Health Care in Germany

    PubMed Central

    Altenstetter, Christa

    2003-01-01

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

  1. Structural and racial barriers to health care.

    PubMed

    Burnes Bolton, Linda; Giger, Joyce Newman; Georges, C Alicia

    2004-01-01

    Limited access to health care and a system fraught with discriminatory practices inhibit some racial and ethnic minorities from gaining access to health care and assurance of equal treatment once they enter the health care system. The purpose of this chapter is to critically and systematically analyze the research literature to determine what impact individual and institutional racism has had on the prevailing health disparities across racial and ethnic minority groups. The chapter includes the following: (1) a review of the term racism and a brief overview of the history of racism in health care; (2) a review of the research literature analyzing the impact of racism on health disparities; and (3) recommendations to end the systematic institutional racism in scientific research, which is necessary to end health disparities.

  2. 78 FR 13935 - Rural Health Care Support Mechanism

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-01

    ... broadband services and, where necessary, HCP-constructed and owned facilities as part of networks, will best... Communications Commission reforms its universal service support program for health care, transitioning its... also be purchased from the Commission's duplicating contractor, Best Copy and Printing, Inc., 445...

  3. One Approach to Improving Indigenous Health Care through Medical Education.

    ERIC Educational Resources Information Center

    Hays, Richard

    2002-01-01

    Australia's newest medical school, located at James Cook University (Queensland), is committed to improving Aboriginal health care. At least five Indigenous students must be admitted per year, and Indigenous people sit on committees responsible for student selection, curriculum design, staff selection, training, and research. All staff receive…

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

    ERIC Educational Resources Information Center

    Kastner, Theodore A.; Walsh, Kevin K.

    2006-01-01

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

  5. Applying economic principles to health care.

    PubMed Central

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

    2001-01-01

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

  6. Ethics and health care ‘underfunding'

    PubMed Central

    Maynard, A.

    2001-01-01

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

  7. Segmenting the mental health care market.

    PubMed

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

    1990-03-01

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

  8. A Guide to Adolescent Health Care EPSDT.

    ERIC Educational Resources Information Center

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

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

  9. FastStats: Home Health Care

    MedlinePlus

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

  10. Child Health and Access to Medical Care

    ERIC Educational Resources Information Center

    Leininger, Lindsey; Levy, Helen

    2015-01-01

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

  11. e-Literacy in health care.

    PubMed

    Klecun, Ela; Lichtner, Valentina; Cornford, Tony

    2014-01-01

    This paper explores notions of e-Literacy (otherwise IT literacy or digital literacy) in health care. It proposes a multi-dimensional definition of e-Literacy in health care and provides suggestions for policy makers and managers as to how e-Literacy might be accounted for in their decisions. PMID:25160306

  12. Financial management in leading health care systems.

    PubMed

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

    2000-01-01

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

  13. Health Care Provider Physical Activity Prescription Intervention

    ERIC Educational Resources Information Center

    Josyula, Lakshmi; Lyle, Roseann

    2013-01-01

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

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

    ERIC Educational Resources Information Center

    BCEL Brief, 1991

    1991-01-01

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

  15. Mercy health promoter: a paradigm for just health care.

    PubMed

    Clark, Peter A; Schadt, Sam

    2013-01-01

    The foreign-born population in the United States, according to the "Current Populations Report" published in 2010, is estimated to exceed 39.9 million, or "12.9 percent of the U.S. population." The increase in foreign-born peoples and their need for health care is a complicated issue facing many cities, health systems and hospitals. Over the course of the past few years Mercy Hospital of Philadelphia has treated increasing numbers of foreign-born African patients. The majority have been presenting in the late stages of disease. The increase of foreign-born documented and undocumented African patients seen by Mercy Hospitals seems to reflect a foreign-born population "boom" in Philadelphia over the past decade. To meet the needs of this growing population, the Mercy Hospital Task Force on African Immigration and the Institute of Catholic Bioethics at Saint Joseph's University designed a program that centers on the third world concept of "Health Promoters." This program is intended to serve as one possible solution for hospitals to cost-effectively manage the care of this growing percentage of foreign-born individuals in the population. This notion of a "Health Promoter" program in Philadelphia is unique as one of those rare occasions when a third world concept is being utilized in a first world environment. It is also unique in that it can serve as a paradigm for other hospitals in the United States to meet the growing need of health care for the undocumented population. As of November 2012 the Mercy Hospital of Philadelphia clinic became operative for patients who were referred from the Health Promoter clinics. To date, a total of forty-two patients have actively participated in the screenings, sixteen of which have been referred to Mercy Hospital of Philadelphia clinic for further evaluation. More than 75% of patient referrals were a result of high blood pressure. According to the American Medical Association, readings of 140-159 mmHg and above are indicative of

  16. Mercy health promoter: A paradigm for just health care

    PubMed Central

    Clark, Peter A.; Schadt, Sam

    2013-01-01

    The foreign-born population in the United States, according to the “Current Populations Report” published in 2010, is estimated to exceed 39.9 million, or “12.9 percent of the U.S. population.” The increase in foreign-born peoples and their need for health care is a complicated issue facing many cities, health systems and hospitals. Over the course of the past few years Mercy Hospital of Philadelphia has treated increasing numbers of foreign-born African patients. The majority have been presenting in the late stages of disease. The increase of foreign-born documented and undocumented African patients seen by Mercy Hospitals seems to reflect a foreign-born population “boom” in Philadelphia over the past decade. To meet the needs of this growing population, the Mercy Hospital Task Force on African Immigration and the Institute of Catholic Bioethics at Saint Joseph’s University designed a program that centers on the third world concept of “Health Promoters.” This program is intended to serve as one possible solution for hospitals to cost-effectively manage the care of this growing percentage of foreign-born individuals in the population. This notion of a “Health Promoter” program in Philadelphia is unique as one of those rare occasions when a third world concept is being utilized in a first world environment. It is also unique in that it can serve as a paradigm for other hospitals in the United States to meet the growing need of health care for the undocumented population. As of November 2012 the Mercy Hospital of Philadelphia clinic became operative for patients who were referred from the Health Promoter clinics. To date, a total of forty-two patients have actively participated in the screenings, sixteen of which have been referred to Mercy Hospital of Philadelphia clinic for further evaluation. More than 75% of patient referrals were a result of high blood pressure. According to the American Medical Association, readings of 140–159 mmHg and

  17. Changing trends in health care tourism.

    PubMed

    Karuppan, Corinne M; Karuppan, Muthu

    2010-01-01

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

  18. Driving population health through accountable care organizations.

    PubMed

    Devore, Susan; Champion, R Wesley

    2011-01-01

    Accountable care organizations, scheduled to become part of the Medicare program under the Affordable Care Act, have been promoted as a way to improve health care quality, reduce growth in costs, and increase patients' satisfaction. It is unclear how these organizations will develop. Yet in principle they will have to meet quality metrics, adopt improved care processes, assume risk, and provide incentives for population health and wellness. These capabilities represent a radical departure from today's health delivery system. In May 2010 the Premier healthcare alliance formed the Accountable Care Implementation Collaborative, which consists of health systems that seek to pursue accountability by forming partnerships with private payers to evolve from fee-for-service payment models to new, value-driven models. This article describes how participants in the collaborative are building models and developing best practices that can inform the implementation of accountable care organizations as well as public policies.

  19. The health care reform in Italy: transition or turmoil.

    PubMed

    Taroni, F; Guerra, R; D'Ambrosio, M G

    1998-01-01

    Health care reform in Italy is transforming its centrally planned, vertically integrated National Health Service into a market-oriented system in which public funders contract directly with individual providers. A model is envisaged in which a plurality of public and private care providers compete for contracts with capitated health agencies responsible for assuring uniform levels of services for geographically defined populations. The ultimate goal of the reform is to guarantee universal coverage and secure global spending limits while, at the same time, promoting efficiency in the delivery of care and enhancing responsiveness to consumers. The emphasis upon incentives for the individual provider which will be introduced should, however, be considered against the quest for equity in health care which was the central tenet of the 1978 reform and is yet to be attained. The fragmentation of the National Health Service into many separate, competing delivery units might well damage the ability to plan strategically for addressing the substantial inequities in health status, health care utilization, and health service availability which still exist across the country. Competition between a plurality of providers and fee-for-service payment schemes add additional concerns about unnecessary care and supplier-induced demand. It creates the need for developing rules to make competition manageable and providing sound clinical and financial information that make enforcement possible. The poor record scored in managing the contractual relationships between the LHUs and the strong private health sector suggests that massive investment in promoting managerial skills and developing appropriate clinical and financial information systems are required. Careful experimentation in implementing the reform and continuous monitoring of its impact on the health care system are, therefore, the imperatives of the next two years.

  20. Towards universal health coverage for reproductive health services in Ethiopia: two policy recommendations.

    PubMed

    Onarheim, Kristine Husøy; Taddesse, Mieraf; Norheim, Ole Frithjof; Abdullah, Muna; Miljeteig, Ingrid

    2015-01-01

    Reproductive health services are crucial for maternal and child health, but universal health coverage is still not within reach in most societies. Ethiopia's goal of universal health coverage promises access to all necessary services for everyone while providing protection against financial risk. When moving towards universal health coverage, health plans and policies require contextualized knowledge about baseline indicators and their distributions. To understand more about the factors that explain coverage, we study the relationship between socioeconomic and geographic factors and the use of reproductive health services in Ethiopia, and further explore inequalities in reproductive health coverage. Based on these findings, we discuss the normative implications of these findings for health policy. Using population-level data from the Ethiopian Demographic and Health Survey (2011) in a multivariate logistic model, we find that family planning and use of antenatal care are associated with higher wealth, higher education and being employed. Skilled attendance at birth is associated with higher wealth, higher education, and urban location. There is large variation between Addis Ababa (the capital) and other administrative regions. Concentration indices show substantial inequalities in the use of reproductive health services. Decomposition of the concentration indices indicates that difference in wealth is the most important explanatory factor for inequality in reproductive health coverage, but other factors, such as urban setting and previous health care use, are also associated with inequalities. When aiming for universal health coverage, this study shows that different socioeconomic factors as well as health-sector factors should be addressed. Our study re-confirms the importance of a broader approach to reproductive health, and in particular the importance of inequality in wealth and geography. Poor, non-educated, non-employed women in rural areas are

  1. Implementing innovations in health care settings.

    PubMed

    MacDonald, V; Muir, J

    1996-10-01

    Innovations in health care settings are occurring at an unprecedented rate. New methods and ideas include computerized pumps, computer systems for documentation and communication, and alternative approaches to patient care. To be successfully adopted by nurses, innovations require well-planned administrative, educational and clinical support. A multi-agency research study has revealed factors that should be considered when planning innovations in health care settings. PMID:9118058

  2. Health care and civil rights: an introduction.

    PubMed

    Teitelbaum, Joel B

    2005-01-01

    This article offers a brief history of healthcare civil rights, describes a range of healthcare issues that have a civil rights component, and discusses the need for an expanded civil rights framework to guide the provision of health care. Unequal health care based on race and ethnicity has received renewed attention over the past several years, but healthcare discrimination based on socioeconomic status, disability, age, and gender also deserve careful attention.

  3. The promise of Lean in health care.

    PubMed

    Toussaint, John S; Berry, Leonard L

    2013-01-01

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

  4. The promise of Lean in health care.

    PubMed

    Toussaint, John S; Berry, Leonard L

    2013-01-01

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

  5. Investing in Nurses is a Prerequisite for Ensuring Universal Health Coverage.

    PubMed

    Kurth, Ann E; Jacob, Sheena; Squires, Allison P; Sliney, Anne; Davis, Sheila; Stalls, Suzanne; Portillo, Carmen J

    2016-01-01

    Nurses and midwives constitute the majority of the global health workforce and the largest health care expenditure. Efficient production, successful deployment, and ongoing retention based on carefully constructed policies regarding the career opportunities of nurses, midwives, and other providers in health care systems are key to ensuring universal health coverage. Yet nurses are constrained by practice regulations, workplaces, and career ladder barriers from contributing to primary health care delivery. Evidence shows that quality HIV care, comparable to that of physicians, is provided by trained nurses and associate clinicians, but many African countries' health systems remain dependent on limited numbers of physicians and fail to meet the demand for treatment. The World Health Organization endorses task sharing to ensure universal health coverage in HIV and maternal health, which requires an investment in nursing education, retention, and professional growth opportunities. Exemplars from Haiti, Rwanda, Republic of Georgia, and multi-country efforts are described. PMID:27086193

  6. Redistributive effects in public health care financing.

    PubMed

    Honekamp, Ivonne; Possenriede, Daniel

    2008-11-01

    This article focuses on the redistributive effects of different measures to finance public health insurance. We analyse the implications of different financing options for public health insurance on the redistribution of income from good to bad health risks and from high-income to low-income individuals. The financing options considered are either income-related (namely income taxes, payroll taxes, and indirect taxes), health-related (co-insurance, deductibles, and no-claim), or neither (flat fee). We show that governments who treat access to health care as a basic right for everyone should consider redistributive effects when reforming health care financing. PMID:18347823

  7. [Mental health care management after the 2011 tsunami disaster in Higashi-Matsushima, Japan].

    PubMed

    Araki, Tsuyoshi; Kuwabara, Hitoshi; Ando, Syuntaro; Kasai, Kiyoto

    2014-01-01

    The Department of Neuropsychiatry of Tokyo University continues to support mental health care in Higashi-Matsushima City, Miyagi, Japan. We participate in mental care from the acute to the chronic phase. We also provide mental care for children. In this paper, we summarize our activities during the two years since the disaster. We also state our views on management in disaster care.

  8. The doctor's role in rural health care.

    PubMed

    Taylor, C E

    1976-01-01

    A new pattern of health care in developing countries promises to meet the needs of rural people and still provide reasonable gratification for health workers. The service must have mutually strengthening linkages between all levels of the health care system. Reallocating roles in the health team requires turning routine medical care over to auxiliaries so that professionals can concentrate on more complex problems, such as community diagnosis and therapy. Young doctors are reasonable and willing to undertake a rural rotation early in their medical careers. This will help to identify those few who will provide leadership in improving rural services.

  9. The doctor's role in rural health care.

    PubMed

    Taylor, C E

    1976-01-01

    A new pattern of health care in developing countries promises to meet the needs of rural people and still provide reasonable gratification for health workers. The service must have mutually strengthening linkages between all levels of the health care system. Reallocating roles in the health team requires turning routine medical care over to auxiliaries so that professionals can concentrate on more complex problems, such as community diagnosis and therapy. Young doctors are reasonable and willing to undertake a rural rotation early in their medical careers. This will help to identify those few who will provide leadership in improving rural services. PMID:939619

  10. Fundamental ethical principles in health care.

    PubMed

    Thompson, I E

    1987-12-01

    In an attempt to clarify which requirements of morality are logically primary to the ethics of health care, two questions are examined: is there sufficient common ground among the medical, nursing, paramedical, chaplaincy, and social work professions to justify looking for ethical principles common to health care? Do sufficient logical grounds or consensus among health workers and the public exist to speak of "fundamental ethical principles in health care"? While respect for persons, justice, and beneficence are fundamental principles in a formal sense, how we view these principles in practice will depend on our particular culture and experience and the kinds of metaethical criteria we use for applying these principles.

  11. Barriers to automation in health care settings.

    PubMed

    Kunitz, S C

    1994-08-01

    Health information systems have changed little since the 1970s, and most are incapable of meeting the information demands of either their organization or outside organizations. Through literature reviews, interviews with staff in three hospitals, and a vendor study, the staff of Kunitz and Associates, Inc. examined barriers to implementing automated systems in hospitals. These barriers were found to be technical, organizational, and operational in nature and to involve issues of communication within the health care environment and between information system vendors and health care staff. Resolving these issues is dependent upon efforts by both the health care and technical communities.

  12. Transition Care for Children With Special Health Care Needs

    PubMed Central

    Davis, Alaina M.; Brown, Rebekah F.; Taylor, Julie Lounds; Epstein, Richard A.

    2014-01-01

    BACKGROUND: Approximately 750 000 children in the United States with special health care needs will transition from pediatric to adult care annually. Fewer than half receive adequate transition care. METHODS: We had conversations with key informants representing clinicians who provide transition care, pediatric and adult providers of services for individuals with special health care needs, policy experts, and researchers; searched online sources for information about currently available programs and resources; and conducted a literature search to identify research on the effectiveness of transition programs. RESULTS: We identified 25 studies evaluating transition care programs. Most (n = 8) were conducted in populations with diabetes, with a smaller literature (n = 5) on transplant patients. We identified an additional 12 studies on a range of conditions, with no more than 2 studies on the same condition. Common components of care included use of a transition coordinator, a special clinic for young adults in transition, and provision of educational materials. CONCLUSIONS: The issue of how to provide transition care for children with special health care needs warrants further attention. Research needs are wide ranging, including both substantive and methodologic concerns. Although there is widespread agreement on the need for adequate transition programs, there is no accepted way to measure transition success. It will be essential to establish consistent goals to build an adequate body of literature to affect practice. PMID:25287460

  13. 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

  14. Commodifying the polyvalent good of health care.

    PubMed

    Kaveny, M C

    1999-06-01

    This essay serves as an introduction to this issue of the Journal of Medicine and Philosophy on commodification and health care. The essay attempts to sharpen the articulation of generally expressed worries about the commodification of health care. It does so by defining commodification, analyzing three components of the good of health care, and attempting to assess how commodification might distort the shape of each of those components. Next, it explores how the good of health care might be distorted by the market-based principle of distributive justice, "to each according to ability to pay." Finally, it identifies two basic questions about the relationship of medicine and the market that merit further exploration. (1) How does the market-based language of "incentives" so pervasive in the world of managed care distort the complex patterns of virtue and vice that motivate actors in the health care arena? (2) If we recognize that we cannot eliminate the influence of money from the health care system, how can we insure that the good of health care remains, in Radin's terms, "incompletely commodified"?

  15. Health care for prisoners in Haiti.

    PubMed

    May, John P; Joseph, Patrice; Pape, Jean William; Binswanger, Ingrid A

    2010-09-21

    Prisoners have disproportionate health care needs. Meeting those needs in a prison environment is challenging, especially in such resource-poor countries as Haiti. Even so, before the January 2010 earthquake, local and international organizations, in collaboration with the Haitian government, had been making significant progress to provide for the health needs of prisoners. The effort screened and identified prisoners for infectious disease, initiated appropriate care and treatment, and prepared prisoners for release to the community. Not only is it possible to establish an adequate prison health care program in a resource-poor country, it is necessary. Without adequate management of prisoners' health needs, especially for such infectious diseases as HIV and tuberculosis, disease burden increases. Infectious disease can spread among prisoners and impact the public's health. Recovery for postearthquake Haiti, as any nation rebuilding following natural disaster or conflict, requires respect for rule of law. This includes humane detention and the delivery of justice and adequate health care for prisoners.

  16. An introduction to oral health care reform.

    PubMed

    Hathaway, Kristen L

    2009-07-01

    Oral health care reform is made up of several components, but access to care is central. Health care reform will occur in some fashion at some point, and how it will impact the entire dental sector is unclear. In the short term, there is likely to be a dental component during the reauthorization of State Children's Health Insurance Program in early 2009, and several federal oral health bills are expected to be reintroduced as well. Additional public funding for new programs and program expansions remains questionable, as federal funding will be tight. Fiscal conservancy will be occurring in the states as well; however, various proposals to expand dental hygienists' duties are likely, as are proposals related to student grants for dental schools. Regardless of one's political stance, the profile of oral health care has been elevated, offering countless opportunities for improvement in the oral health of the nation. PMID:19482130

  17. Health care for children: a community perspective.

    PubMed

    Callahan, D

    2001-04-01

    There are two puzzles about health care for children that need explanation. Why is it the sentimentality Americans express about children has not been backed by solid health care programs? If children are to have good health care, how can a case for their high priority be made, particularly in light of the fact that their health is the best of all age groups in the country? The first question is explored, but the second question is the focus of this paper. A priority system for health care is proposed, and at the same time an argument is presented for why children should have a high priority despite their generally good health. PMID:11376424

  18. Health care reform and the primary care workforce bottleneck.

    PubMed

    Schwartz, Mark D

    2012-04-01

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

  19. [Health care services in the Kingdom of Morocco].

    PubMed

    Sbai Idrissi, K

    2002-01-01

    Kingdom of Morocco is located in Northwestern Africa on the Atlantic Ocean and the Mediterranean Sea. Its surface area is 710,850 km2. In 2001 the estimated population of Morocco was 29,800,000 people who are not equally distributed over the territory. Population growth rate is changing with a tendency toward levels similar to those in developed countries. The health care system created in 1959 has undergone several reorganizations including the most recent reform now in progress. At the present time the health care system is organized into approximately 60 medical districts. It is subdivided into two networks, i.e., an ambulatory action network and a hospital action network. The ambulatory action network provides basic health care services. It includes 2128 basic care units. Most of these units have medical equipment designed mainly for preventive medicine. The hospital action network comprises 112 hospitals classified as zone hospitals, provincial hospitals, regional hospitals, and university hospitals. Both networks receive technical and scientific support from a network of institutes, laboratories, and specialized centers. Training for health care professionals in Morocco is provided by four medical schools and two health care institutes for paramedical care specialists. Morocco is in a period of epidemiological transition characterized by the coexistence of patients with developed and developing country diseases.

  20. Behavioral health and managed care contracting under SCHIP.

    PubMed

    Rosenbaum, Sara; Sonosky, Colleen; Shaw, Karen; Mauery, D Richard

    2002-09-01

    This Policy Brief examines behavioral health managed care contracting under separately administered State Children's Health Insurance Programs (SCHIP), i.e., programs that operate under the direct authority of Title XXI of the Social Security Act rather than as expansions of Medicaid. Most separate SCHIP programs buy managed care style health insurance for some or most of their enrolled children. Because Title XXI provides states with far greater administrative flexibility than Medicaid with respect to coverage and benefit design, provision of services, and administration of managed care arrangements,studying separate SCHIP managed care products sheds important light on how states might approach insurance and managed care design generally in the area of behavioral health were Medicaid modified through section 1115 demonstration or federal statutory authority to permit greater latitude. To conduct this analysis, two nationwide databases maintained by the George Washington University Center for Health Services Research and Policy (CHSRP) were used: a database consisting of all Medicaid MCO-style managed care contracts in use in Calendar Year 2000; and a nationwide database consisting of contracts used by separate SCHIP programs for the same calendar year. As of the point of collection in 2000 there were 33 such separate programs; according to CMS' latest website information, that total has now reached 35. Both sets of contracts were analyzed and separated into their components by lawyers experienced in managed care contract analysis and interpretation. The data were entered into working tables that organize the contents of the contracts into a series of searchable domains.