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1
Duron, Rebecca, Michael Mugavero, and Andrew Westfall. "2497." Journal of Clinical and Translational Science 1, S1 (September 2017): 81. http://dx.doi.org/10.1017/cts.2017.286.
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OBJECTIVES/SPECIFIC AIMS: Approximately 50% of people who have been diagnosed with HIV are either not linked to a care provider or not retained in medical care. This has substantial implications for both individual and public health outcomes. On an individual level, being retained in care is necessary for continuous receipt of antiretroviral therapy and sustained viral suppression. The public health implications of poor retention in HIV care are also serious, as it is estimated that people with HIV who are not retained in medical care are responsible for a majority of HIV transmissions, even more than the number of transmissions attributable to those who are HIV infected but undiagnosed. State departments of health routinely collect surveillance data including positive HIV test results, CD4 counts and viral load measures for monitoring trends in HIV infection. A shift in the use of these surveillance measures, guided by the CDC, has brought forth the opportunity to use these data for direct patient services and, more specifically, to direct re-engagement and retention in care efforts. Although the risk factors for poor retention in HIV care have been characterized using information from individual or multiple clinics, this study seeks to incorporate state surveillance data into the retention measures. METHODS/STUDY POPULATION: This retrospective cohort study was performed at the University of Alabama at Birmingham 1917 HIV/AIDS Clinic among patients with at least one attended HIV primary care visit during the calendar year of 2015. Retention during the calendar year of 2016 was then measured as whether or not a patient had 2 or more completed clinic visits which were separated by more than 90 days (in accordance with the Health Resources and Services Administration or HRSA guidelines, a National HIV Quality Indicator). For patients who did not have any primary care visit in 2016, the Alabama Department of Public Health will provide a status of care (out of care, in care elsewhere, died, moved out of state, and cannot locate) based on HIV laboratory results reported from all clinics and labs across the state and/or mortality information. A multinominal regression model of the status of care will be fitted to demographic, clinical, laboratory, and behavioral patient reported outcomes captured during an index visit in 2015. RESULTS/ANTICIPATED RESULTS: Data were recently obtained and is currently being analyzed on 3107 patients included in this study. We anticipate that there will be differences in the factors significantly associated with patients classified as out of care, poorly retained (patients who have only one completed clinic visit), and retained in care by the HRSA measure during calendar year 2016. DISCUSSION/SIGNIFICANCE OF IMPACT: By incorporating state surveillance data into our analysis, we expect to obtain a more precise picture of the risk factors for poor retention among HIV patients. For the first time, we will be able to determine if patients lost to our HIV clinic (~10% annually) are entirely lost to medical care or are seeking care elsewhere as indicated by HIV lab data reported to public health via surveillance. Identified risk factors will then be able to better inform the efforts to proactively improve the efficiency for HIV patient retention and re-engagement, and therefore lead to better individual outcomes for HIV patients and reduce the incidence of new HIV cases.
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Brand, Nathan R., Nicholas Wolf, John Flanigan, Richard Njoroge, and Alfred Karagu. "Histology and Cytopathology Capacity in the Public Health Sector in Kenya." Journal of Global Oncology, no. 4 (December 2018): 1–7. http://dx.doi.org/10.1200/jgo.17.00122.
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Purpose Histology and cytopathology services are necessary for cancer diagnosis and treatment. However, the current capacity of Kenya’s pathology laboratories is unknown. A national survey was conducted among public sector pathology laboratories to assess their capacity to perform histology, fine-needle aspiration, and bone marrow aspiration. Methods Between April and June 2017, we identified all public hospitals that provide pathology services in Kenya. In total, two national and 13 county referral hospitals met the inclusion criteria and were sent a standardized, pretested, self-administered questionnaire. Results A total of 11 hospitals (73%) completed the survey. The reported total caseload of histology, fine-needle aspiration, and bone marrow aspiration for 2016 was 26,472. All of the facilities staffed a pathologist and were providing cancer-related diagnostic services. Nine (82%) of the hospitals maintain a register of diagnosed cancer cases, but only one (11%) of those uses an electronic system. Six (55%) of the surveyed hospitals were able to perform histology with a median turnaround time of 14 days. Six (55%) laboratories regularly referred some specimens elsewhere for interpretation, but three of these centers relied on patients for transportation of the specimen to the referral institution. No laboratories were accredited by an external organization; however, 10 (91%) of the laboratories were working toward achieving accreditation, but only for clinical pathology services. Conclusion This study describes the current status of histology and cytopathology capacity in Kenya’s public sector hospitals. It provides useful baseline information needed by the Ministry of Health to develop necessary capacity building and referral-strengthening interventions. A high proportion of hospitals are working to achieve accreditation points toward their commitment to providing quality services to the Kenyan public.
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Pipe, Andrew L., William Evans, and Sophia Papadakis. "Smoking cessation: health system challenges and opportunities." Tobacco Control 31, no. 2 (March 2022): 340–47. http://dx.doi.org/10.1136/tobaccocontrol-2021-056575.
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The systematic integration of evidence-based tobacco treatment has yet to be broadly viewed as a standard-of-care. The Framework Convention on Tobacco Control recommends the provision of support for tobacco cessation. We argue that the provision of smoking cessation services in clinical settings is a fundamental clinical responsibility and permits the opportunity to more effectively assist with cessation. The role of clinicians in prioritising smoking cessation is essential in all settings. Clinical benefits of implementing cessation services in hospital settings have been recognised for three decades—but have not been consistently provided. The Ottawa Model for Smoking Cessation has used an ‘organisational change’ approach to its introduction and has served as the basis for the introduction of cessation programmes in hospital and primary care settings in Canada and elsewhere. The significance of smoking cessation dwarfs that of many preventive interventions in primary care. Compelling evidence attests to the importance of providing cessation services as part of cancer treatment, but implementation of such programmes has been slow. We recognise that the provision of such services must reflect the realities and resources of a particular health system. In low-income and middle-income countries, access to treatment facilities pose unique challenges. The integration of cessation programmes with tuberculosis control services may offer opportunities; and standardisation of peri-operative care to include smoking cessation may not require additional resources. Mobile phones afford unique opportunities for interactive cessation programming. Health system change is fundamental to improving the provision of cessation services; clinicians can be powerful advocates for such change.
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Sices, Laura, Jeffrey S. Harman, and Kelly J. Kelleher. "Health-Care Use and Expenditures for Children in Special Education with Special Health-Care Needs: Is Dual Classification a Marker for High Use?" Public Health Reports 122, no. 4 (July 2007): 531–40. http://dx.doi.org/10.1177/003335490712200415.
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Objectives. Children with special health-care needs are an important group for policy and research planning. Special education engages a group of children with increased utilization of services related to education. While increased service utilization in education or health-care settings is often used to classify children as having special needs, considerable heterogeneity exists within each group. The extent to which being identified in two functionally defined systems—special education and health care—relates to health-care utilization is unknown. We sought to determine health-care and mental health utilization and expenditures for children dually classified as receiving special education and having special health-care needs (SHCN) compared with those who only have SHCN, only are in special education, or don't fall into either category. Methods. A nationally representative sample of children aged 5–17 years from the Medical Expenditure Panel Survey was used to compare mean health-care and mental health utilization and expenditures for the four groups. Results. Dually classified children had significantly higher mean utilization of health-care services than the other three groups ( p,0.05). Mean 12-month total health-care expenditures were highest for dually classified children ($3,891/year) ( p,0.05) and higher for children classified only as having SHCN ($1,426/year) than for children with neither classification ($644/year, p,0.05). Conclusions. Children dually classified as receiving special education and having SHCN represent a subgroup of children with SHCN with high levels of health-care utilization and expenditures. This information can assist policy makers in identifying characteristics that place children at risk for very high expenditures, and in allocating health-care resources.
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Macdonald, John. "Primary Health Care or Primary Medical Care: In Reality." Australian Journal of Primary Health 13, no. 2 (2007): 18. http://dx.doi.org/10.1071/py07019.
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Despite considerable rhetoric, comprehensive primary health care remains largely a matter of a paper exercise. The theory promotes horizontal and vertical integration and the active participation of people in planning. Experience in Australia and elsewhere indicates that what is in place in health services is often primary medical care: the management of the needs of presenting individuals. The arguments for upstream interventions remain valid, bolstered by research on the social determinants of health. Two examples are given of primary health care that attempt to work upstream, before clinical interventions become necessary and illustrate the need for both horizontal and vertical integration. Consequences for policy and training are drawn.
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Dolja-Gore, Xenia, Deborah Loxton, Catherine D'Este, and Julie E. Byles. "Transitions in health service use among women with poor mental health: a 7-year follow-up." Family Medicine and Community Health 10, no. 2 (June 2022): e001481. http://dx.doi.org/10.1136/fmch-2021-001481.
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ObjectiveWomen suffering from mental health problems require varied needs of mental health service utilisation. Transition between general practitioner and mental health services use are available through the Better Access Scheme initiative, for those in need of treatment. The study’s aim was to identify trajectories of mental health service utilisation by Australian women.DesignThe Australian Longitudinal Study on Women’s Health data linked to the administrative medical claims dataset were used to identify subgroups of women profiled by their mental health service use from 2006 to 2013. Latent growth mixture model is a statistical method to profile subgroups of individuals based on their responses to a set of observed variables allowing for changes over time. Latent class groups were identified, and used to examine predisposing factors associated with patterns of mental health service use change over time.SettingThis study was conducted in Australia.ParticipantsNational representative sample of women of born in 1973–1978, who were aged between 28 and 33 years at the start of our study period.ResultsSix latent class trajectories of women’s mental health service use were identified over the period 2006–2013. Approximately, one-quarter of the sample were classified as the most recent users, while approximate equal proportions were identified as either early users, late/low user or late-high users. Additional, subgroups were defined as the consistent-reduced user and the late-high users, over time. Only 7.2% of the sample was classified as consistent high users who potentially used the services each year.ConclusionThese findings suggest that use of the Better Access Scheme mental health services through primary care was varied over time and may be tailored to each individual’s needs for the treatment of depressive symptoms.
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Emmett, Edward A. "Asbestos in High-Risk Communities: Public Health Implications." International Journal of Environmental Research and Public Health 18, no. 4 (February 7, 2021): 1579. http://dx.doi.org/10.3390/ijerph18041579.
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Asbestos-related diseases (ARDs)—mesothelioma, lung cancer, and asbestosis—are well known as occupational diseases. As industrial asbestos use is eliminated, ARDs within the general community from para-occupational, environmental, and natural exposures are more prominent. ARD clusters have been studied in communities including Broni, Italy; Libby, Montana; Wittenoom, Western Australia; Karain, Turkey; Ambler, Pennsylvania; and elsewhere. Community ARDs pose specific public health issues and challenges. Community exposure results in higher proportions of mesothelioma in women and a younger age distribution than occupational exposures. Exposure amount, age at exposure, fiber type, and genetic predisposition influence ARD expression; vulnerable groups include those with social and behavioral risk, exposure to extreme events, and genetic predispositions. To address community exposure, regulations should address all carcinogenic elongated mineral fibers. Banning asbestos mining, use, and importation will not reduce risks from asbestos already in place. Residents of high-risk communities are characteristically exposed through several pathways differing among communities. Administrative responsibility for controlling environmental exposures is more diffuse than for workplaces, complicated by diverse community attitudes to risk and prevention and legal complexity. The National Mesothelioma Registries help track the identification of communities at risk. High-risk communities need enhanced services for screening, diagnosis, treatment, and social and psychological support, including for retired asbestos workers. Legal settlements could help fund community programs. A focus on prevention, public health programs, particularization to specific community needs, and participation is recommended.
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Sophia Mei G, Letada Krystine, Bucalon Erika U., Enopia Jeminabelle N., Lambungog Lara M., Mama Bai Sharjah Ayen T. Taer, Giovanni G., Togonon Apple Joy T., Yana Aleya Bernadeene G., and Erwin M. Faller. "Emerging Roles of Community Pharmacist in Public Health: A Review on ASIA." International Journal of Research Publication and Reviews 03, no. 12 (2022): 1133–53. http://dx.doi.org/10.55248/gengpi.2022.31229.
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This study's aim was to conduct a comprehensive review of previously published research publications related to the emerging roles of community pharmacists in public health in Asia. It aims to analyze the new roles that community pharmacists are being called upon to fill in Asian regions in public health with also a focus on maximizing the full capacity of pharmacist skills and development to public health, a continuing advocate, and first-line empowerment of providing pharmacy information queries. The written works of this study utilized a systematic search of existing literature, including articles reporting on the emerging roles of community pharmacists in public health, using the following databases: Cochrane, Google Scholar, Science Direct, PubMed/Medline, and Research Gate. Hand searching relevant articles on the research topic were employed to help ensure the confinement of all necessary existing literature/articles. The intervention or services types are classified based on the following: smoking cessation services, weight management services, alcohol reduction services, chronic disease management, drug misuse prevention and management services, and immunization and vaccination services; each comprises different major processes aiming to improve an individual's health status providing ways upon validation that are crucial for the betterment of public healthcare. In accordance with the studies, community pharmacist-led public-health programs markedly strengthened the efficiency, steadfastness, and cost-effectiveness of the allocation of public health resources whilst still optimizing the health of clients and patients, specifically whenever it arrives at assessing prospective issues and individuals who seek specialized care. Notwithstanding such, community pharmacy operations still necessitate modification to satisfy the evolving demands of consumers of modern medications. Training must attempt to boost pharmacists' confidence in supplying these services if community pharmacies are to elevate the public health services they serve. A proactive approach to the delivery of public health care by confident, well-trained pharmacists should have a favorable impact on client attitudes and health.
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Jean, Gillian, Estie Kruger, and Marc Tennant. "Universal access to oral health care for Australian children: comparison of travel times to public dental services at consecutive census dates as an indicator of progressive realisation." Australian Journal of Primary Health 26, no. 2 (2020): 109. http://dx.doi.org/10.1071/py19148.
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Progressive realisation of equitable access to health services is a fundamental measure of a state’s resolve to achieve universal health coverage. The World Health Organization has reprioritised the importance of oral health services as an integral element of the roadmap towards health equity. This study sought to determine whether there is an indication of progressive realisation of equitable spatial access to public dental services for Australians <18 years of age through a comparison of travel times to the nearest public dental clinic at successive census dates. The distribution of children classified by rural remoteness and level of socioeconomic disadvantage, as well as the location of public dental clinics at the 2011 and 2016 Australian Bureau of Statistics censuses, was mapped using geographic imaging software. OpenRouteService software was used to calculate the travel time by car between each statistical census district and the nearest public dental clinic. There has been an improvement in the percentage of the population <18 years of age living within a reasonable travel time of a public dental clinic. The most socioeconomically disadvantaged groups in more densely populated areas have better spatial access to publicly funded dental services than less disadvantaged groups. Children living in very remote areas continue to experience lengthy travel times to access fixed oral health services.
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Fisk, M. J. "A Comparison of Personal Response Services in Canada and the UK." Journal of Telemedicine and Telecare 1, no. 3 (September 1995): 145–56. http://dx.doi.org/10.1177/1357633x9500100304.
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Personal response services operating over public telephone networks are now widespread in Western Europe and North America. They serve the needs of a million people in the UK and a further two to three million elsewhere. While most clients are elderly, the scope of such services is extending to people with support needs of all ages, especially where there are medical risks or a likelihood of falls. Such services are, therefore, on a convergent course with those concerned with telemedicine. A study of two personal response services was carried out, one based in Ottawa (Canada) and the other in Oldham (UK). The parallels and contrasts were examined through a survey involving personal interviews with samples of clients. Thirty-eight valid personal interviews were completed, 20 in Ottawa and 18 in Oldham, representing 14% and 53% respectively of all service clients in the survey areas. It is concluded that services established within the health sector (such as many in Canada) are better placed to accommodate change. Convergence with telemedicine will, as a result, be facilitated. In the UK, health authorities and trusts are likely to develop their own telemedicine services in competition with current providers of personal response services, thus delaying convergence.
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Patten, San, Craig Mitton, and Cam Donaldson. "From the trenches: views from decision-makers on health services priority setting." Health Services Management Research 18, no. 2 (May 1, 2005): 100–108. http://dx.doi.org/10.1258/0951484053723117.
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Due to resource scarcity, health organizations worldwide must decide what services to fund and, conversely, what services not to fund. One approach to priority setting, which has been widely used in Britain, Australia, New Zealand and Canada, is programme budgeting and marginal analysis (PBMA). To date, such activity has primarily been based at a micro level, within programmes of care. In order to institute and refine the PBMA framework at a macro level across major service areas within a single health authority, researchers and decision-makers in Alberta embarked on a participatory action research project together. This paper identifies key issues of importance to decision-makers in a real-world priority-setting context. Themes discussed include making comparisons across disparate patient groups, dealing with political factors, using relevant forms of evidence, recognizing innovations and involving the public. The in-depth insight gained through this qualitative analysis will enable future refinement of PBMA at a macro level in the health authority under study, and should also serve to inform priority-setting activity in regionalized contexts elsewhere. In identifying aspects of priority setting that are important to decision-makers, researchers can also be better informed with respect to realworld processes.
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Van Teijlingen, Edwin, Cecilia Benoit, Ivy Bourgeault, Raymond DeVries, Jane Sandall, and Sirpa Wrede. "Learning from health care in other countries: the prospect of comparative research." Health Prospect 14, no. 1 (July 23, 2015): 8–12. http://dx.doi.org/10.3126/hprospect.v14i1.13036.
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It is widely accepted that policy-makers (in Nepal and elsewhere) can learn valuable lessons from the way other countries run their health and social services. We highlight some of the specific contributions the discipline of sociology can make to cross-national comparative research in the public health field. Sociologists call attention to often unnoticed social and cultural factors that influence the way national reproductive health care systems are created and operated. In this paper we address questions such as: ‘Why do these health services appear to be operating successfully in one country, but not another?’; ‘What is it in one country that makes a particular public health intervention successful and how is the cultural context different in a neighbouring country?’ The key examples in this paper focus on maternity care and sex education in the Netherlands and the UK, as examples to highlight the power of cross-national research. Our key messages are: a) Cross-national comparative research can help us to understand the design and running of health services in one country, say Nepal, by learning from a comparison with other countries, for example Sri Lanka or India. b) Cultural factors unique to a country affect the way that reproductive health care systems operate. c) Therefore,we need to understand why and how services work in a certain cultural context before we start trying to implement them in another cultural context.
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Khan, Zubeda, Ghulam Y. Soomro, and Samina Soomro. "Mother's Education and Utilisation of Health Care Services in Pakistan." Pakistan Development Review 33, no. 4II (December 1, 1994): 1155–66. http://dx.doi.org/10.30541/v33i4iipp.1155-1166.
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Education is one of the crucial social development variables especially for mothers which enriches their mind about their social and reproductive experiences and broadens their understanding to make better choices for themselves and rearing and bearing of their children. In many developing countries there is evidence that mother's education plays an important role in determining child mortality even in situations where the medical facilities are scanty [Berrera (1990); Caldwell (1979, 1981)]. Education, it is argued influences women's beliefs about the good health, causes and cures of diseases that increases the demand of the utilisation of modern health care facilities. Therefore, educated mothers are more likely to seek medical treatment for themselves and for their children resulting in higher intensity of the use of a better quality modern care that grows with the advancement of education. Evidence from the research done elsewhere suggests that mother's education has individual positive effect on the use of health care facilities Abbas and Walker (1986); Berrera (1990) and Caldwell (1979) have pointed out that educated mothers are more likely to take advantage of the modern health facilities than their uneducated counterparts in compliance to the recommended treatments primarily due to the different attitudes in regard to the knowledge and perceptions of the importance of the modern medicine in the care of their children. Berrera (1990) in a study of child nutrition in the Philippines found that the children of educated mothers took more advantage of the public health care facilities than the children of uneducated mothers.
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Abo-Rass, Fareeda, Sarah Abu-Kaf, and Ora Nakash. "Barriers to Mental Health Service Use among Palestinian-Arab Women in Israel: Psychological Distress as Moderator." International Journal of Environmental Research and Public Health 19, no. 19 (October 1, 2022): 12557. http://dx.doi.org/10.3390/ijerph191912557.
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Background: Many studies indicate that ethnic minority women, including women from the disadvantaged Palestinian-Arab minority in Israel, experience higher rates of psychological distress but are less likely to use mental health services. This study examined psychological distress and its role as a moderator in the relationship between mental health service use and stigma-related, attitudinal, and instrumental barriers. Method: Cross-sectional study of 146 Palestinian-Arab women who completed measures of psychological distress, mental health service use, the Barriers to Care Evaluation scale, and sociodemographic characteristics. Results: Participants who did not utilize mental health services reported higher levels of all barrier types compared to participants who reported previous use, but lower levels of psychological distress. Psychological distress was a significant moderator only in the relationship between attitudinal barriers and mental health service use. Conclusions: This study highlights the role of psychological distress in the relationship between barriers to and utilization of mental health services, helping professionals and policymakers increase mental health service use among Palestinian-Arab women in Israel and other vulnerable women elsewhere.
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Chililov, A. M., F. N. Kadyrov, and O. V. Obuhova. "Labour Remuneration in Public Health System in Time of Digital Transformation of Medical Services." Vestnik of the Plekhanov Russian University of Economics, no. 2 (April 13, 2022): 136–48. http://dx.doi.org/10.21686/2413-2829-2022-2-136-148.
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Different aspects of using tele-medical technologies recognized as one of key lines in the development of the advanced public health system are highlighted more and more widely in academic literature. However, prospects of this trend depend not only on progress in the development of medical and information technologies and finance investment in the sphere, but also on economic interest in it on the part of concrete medical workers and it can be directly connected with remuneration systems of workers who render tele-medical services. During the research the authors identified key factors that influence on labour remuneration of workers, who participate in tele-medical technologies. Situations of rendering medical aid were classified in view of the following criteria: time, when telemedical services are to be used (principle and extra); whether the job is included in the job description of a concrete worker; whether remuneration components affect the basic pay of the worker, etc. The authors put forward methodological approaches to working out systems of remuneration aimed at the development of tele-medical technologies by state power bodies and public health institutions.
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MacRorie, R. A. "Births, Deaths and Medical Emergencies in the District: A Rapid Participatory Appraisal in Nepal." Tropical Doctor 28, no. 3 (July 1998): 162–65. http://dx.doi.org/10.1177/004947559802800312.
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Two qualitative rapid appraisal techniques were used in a community-based study to investigate health beliefs, attitudes and practices in a rural district in Nepal. Pregnancy and childbirth remain non-medical activities managed at home. Deaths may be avoided by better access to hospital emergency services. Health awareness of some problems, e.g. oral rehydration in diarrhoeal disease, is high; but of others, e.g. association of haemoptysis with tuberculosis, is poor. These methods require few resources, are efficient in time and manpower required, and generate useful relevant information on a target population. They are recommended for district health development programmes elsewhere.
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Konuralp, Emrah, and Nurten Dayioğlu. "Analysing the implications of the Health Transformation Program on perceptions of the welfare state and public services in Turkey." Acta Oeconomica 72, no. 2 (June 23, 2022): 153–74. http://dx.doi.org/10.1556/032.2022.00009.
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Abstract The neoliberal structural adjustment policies in Turkey moved on to a new phase with the Health Transformation Program (HTP) that came into effect in 2003. In this study, 5,002 people, who used the services of the public hospitals in Istanbul, participated in a face-to-face survey to find out the impact of the HTP on the public's understanding of the welfare state and also the impact on their opinions over the healthcare services offered by the state. The data were classified into two topics: First, the transformation of the welfare state and second, the adequacy of the public healthcare services. Interestingly, the participants took a much more explicit stance against the neoliberal transformation of the welfare state than against the adequacy of the public healthcare service provision. The primary purpose of this research was to expose this paradox.
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Guerra, Mariana, and Andréa de Oliveira Gonçalves. "Model of Allocating Public Financial Resources to Brazilian Hospital Organizations that Provide Highly Complex Health Care Services." Open Medicine Journal 1, no. 1 (December 31, 2014): 78–89. http://dx.doi.org/10.2174/1874220301401010078.
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The general objective of this paper was to propose a model of allocating public financial resources to Brazilian hospital organizations that provide highly complex health care services on behalf of the Brazilian Unified Health System (SUS). The main theoretical background was built on Carr-Hill et al. [1] Focusing on the highly complex health care services provided by the hospitals, the study underscored factors such as supply (or productivity and accessibility/availability of services/beds), demand (or need for health care), use (or utilization/consumption of services/beds), and complexity segmentation of the service in Brazil. The sample comprised 251 organizations offering at least type-II adult and type-II newborn Intensive Care Units in 23 Brazilian states and classified as general and/or specialized hospitals. The Carr-Hill et al. [1] model was adapted to propose a simplified theoretical model of supply that could represent the relationship between the variables included in the final equation of the model, namely: mean inpatient cost, availability of basic health care services, bed occupancy rate, organization type, and organization nature. The results pointed out that the significant determinants empirically confirm the arguments that are rejected by sanitarians in the theoretical field – that the model of resource allocation is based on productivity.
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Kim, Jiyoun, Jiyeon Song, Donguk Kim, and Jinho Park. "The Development of ICT-Based Exercise Rehabilitation Service Contents for Patients with Musculoskeletal Disorders and Stroke." International Journal of Environmental Research and Public Health 19, no. 9 (April 20, 2022): 5022. http://dx.doi.org/10.3390/ijerph19095022.
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Exercise rehabilitation services connecting hospitals and communities increase patient participation and improve quality of life by reducing medical expenses. South Korea’s multi-ministerial governments have been working together to develop ICT-based hospital-community-linked services to create an exercise program that the public can easily use. This study aims to develop the exercise rehabilitation service components for the application and prescription of ICT-based exercise programs implemented in hospitals and communities. A literature review was conducted, and an expert committee was comprised to classify the components of exercise rehabilitation services. As a result, we classified the first components as functional classification, rehabilitation area, equipment uses, exercise type, frequency, and intensity. Subsequently, exercise programs were developed by applying the first components. Based on the purpose of exercise rehabilitation, we classified the representative standard exercise and grouped the same exercise movements using tools and exercise machines. The finding of this study will help to give the correct exercise prescription and manage patients’ improvement process for exercise instructors. In addition, it guides patients in need of exercise rehabilitation to participate in an accurate and safe exercise in the community. This study is a novel attempt to develop ICT based hospital-community-linked exercise rehabilitation service for patients.
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Bambarén, Celso, and Maria del Socorro Alatrista. "A Review of State Public Health Emergency Declarations in Peru: 2014-2016." Prehospital and Disaster Medicine 33, no. 2 (February 13, 2018): 197–200. http://dx.doi.org/10.1017/s1049023x18000092.
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AbstractPeru has different legal mechanisms of emergency, one of which is the Public Health Emergency that is applicable when: there is high-risk for, or the existence of an outbreak, epidemic, or pandemic; the occurrence of cases of a disease classified as eliminated or eradicated; the occurrence of emerging or re-emerging infectious diseases with high epidemic potential; the occurrence of rapid disseminated epidemics that simultaneously affect more than one department; as well as the existence of an event that affects the continuity of health services.From July 2014 to December 2016, 23 Public Health Emergencies were declared, out of which 57% were in the high-risk or existence of epidemics, 30% were due to some natural or anthropic events that generate a sudden decrease in the operative capacity of health services, and 13% were due to the existence of a rapid spreading epidemic that could affect more than one department in the country. The risk or occurrence of epidemiological outbreaks, mainly of Dengue, was the main cause of emergency declaration. One-hundred and forty million US dollars were allocated to implement the action plans that were part of the declaration, of which 72% was used to keep the operational capacity of health services and 28% to vector and epidemiological control measures.BambarénC, AlatristaMdS. A review of state public health emergency declarations in Peru: 2014-2016. Prehosp Disaster Med. 2018;33(2):197–200.
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Santos, Luzia Aparecida dos, Fabiana Villela Mamede, Maria José Clapis, and Juliana Villela Bueno Bernardi. "Nutritional guidance during prenatal care in public health services in Ribeirão Preto: discourse and care practice." Revista Latino-Americana de Enfermagem 14, no. 5 (October 2006): 688–94. http://dx.doi.org/10.1590/s0104-11692006000500008.
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This study aimed to verify if pregnant women attended in prenatal care services at Basic Health Units in Ribeirão Preto-SP, Brazil, received nutritional guidance and if this guidance was pertinent to their nutritional status. Ninety-one pregnant women participated. The pregnant women were classified according to their nutritional condition, using a weight, height and pregnancy stage table established by the Brazilian Health Ministry's technical prenatal care manual. We found pregnant women with weight under (13.19%) and exceeding normal levels (37.36%). Independently of their nutritional condition, most of them (60.43%) declared they did not receive nutrition guidance. The mean number of prenatal visits did not influence the nutritional status. The results reveal deficiencies in the contents and quality of nutritional care. This suggests the need for care changes so as to turn discourse into practice.
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Ridgway, Jessica P., Jessica Schmitt, Ellen Almirol, Monique Millington, Erika Harding, and David Pitrak. "Electronic data sharing between public health department and clinical providers improves accuracy of HIV retention data." Open Forum Infectious Diseases 4, suppl_1 (2017): S421—S422. http://dx.doi.org/10.1093/ofid/ofx163.1059.
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Abstract Background Retention in care is critical for treatment and prevention of HIV. Many HIV care clinics measure retention rate, but data are often incomplete for patients who are classified as lost to follow-up but may be actually in care elsewhere, moved, or died. The Data to Care (D2C) initiative supports data sharing between health departments and HIV providers to confirm patient care status and facilitate reengagement efforts for out of care HIV patients. Methods The University of Chicago Medicine (UCM) provided an electronic list to the Chicago Department of Public Health (CDPH) of adult HIV-positive patients whose retention status was not certain. Retention in care was defined as at least 2 visits >90 days apart within the prior 12 months. CDPH matched this list of patients with data from the Chicago electronic HIV surveillance database. Matches were based on patient name, including alternative spellings and phonetics, and birth date. CDPH also cross-checked patient names with the CDC’s national enhanced HIV-AIDS Reporting System (eHARS) database. CDPH provided UCM with patient current care status, i.e., patient was in care elsewhere (as verified by lab data), moved out of state, or deceased. Results 780 HIV-positive patients received care in the UCM adult HIV clinic from January 1, 2013 to March 31, 2017. Of these, 360 were retained in care as of March 2017. We shared data with CDPH for 492 patients. Of these, 294 (59.8%) were matched, and 168 (34.1%) had a date of last medical care provided. See Table 1 for patient dispositions, before and after data sharing. 24 (13.4%) of patients believed to be lost to follow up according to UCM records were confirmed either transferred care or deceased according to health department data. Conclusion Data sharing between the health department and HIV providers can improve data accuracy regarding retention in care among people living with HIV. Disclosures J. P. Ridgway, Gilead FOCUS: Grant Investigator, Grant recipient; D. Pitrak, Gilead Sciences FOCUS: Grant Investigator, Grant recipient
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Chaiton, Michael, Rebecca Billington, Ilana Copeland, Luc Grey, and Alex Abramovich. "Mental Health and Addiction Services Exclusive to LGBTQ2S+ during COVID-19: An Environmental Scan." International Journal of Environmental Research and Public Health 19, no. 10 (May 13, 2022): 5919. http://dx.doi.org/10.3390/ijerph19105919.
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Background: Youth who are lesbian, gay, bisexual, trans, queer, 2-spirit, and of other identities (LGBTQ2S+) experience mental health disparities and higher rates of substance use when compared to their cisgender and heterosexual peers and yet also experience more barriers to access to services. The purpose of this paper is to determine the types of mental health and substance use programs and services exclusive to LGBTQ2S+ youth in Ontario during the pandemic. Methods: An environmental scan was conducted to identify existing programs and services in Ontario, Canada that offered exclusive mental health and addiction services to LGBTQ2S+ individuals aged 16–29, either by offering services to all or subgroups within the population. Organizations, services and programs were classified by the geographical distribution of services, populations served, types of programming or services, methods of service delivery, and program criteria. Results: In total, 113 organizations and 240 programs and services were identified as providing mental health and substance use services exclusively to LGBTQ2S+ youth. Identified adaptations for the COVID-19 pandemic included cancelling in-person services, increasing online and telephone services, and expansion to province wide from local availability. Conclusions: The findings highlight the importance of offering services that provide culturally inclusive care for LGBTQ2S+ youth, and these results can also be used by policy makers to inform policies. In particular, there was a lack of culturally relevant clinical services for youth requiring a greater intensity of treatment.
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Retamal C., Pedro, and Derek Humphreys. "Occurrence of suicide and seasonal variation." Revista de Saúde Pública 32, no. 5 (October 1998): 408–12. http://dx.doi.org/10.1590/s0034-89101998000500002.
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OBJECTIVE: To review the estimated suicide rates for the Region Metropolitan, the main socio-political center in Chile, for the period 1979-1994, and to determine whether they follow a seasonal pattern. METHOD: Data available for the period 1979-94 at the Forensic Services in Chile was analyzed using ANOVA. RESULTS: It was register 5.386 suicides. While the "warm" months (October, November, December & January) concentrated 39.0% of cases, the so called "cold" months reported 28,7%. This contrast is made even clearer by the month-to-month analysis, showing the highest suicide rate in December (10.9%) against the lowest rate in June (7.0%). Further statistical analysis revealed these differences to be significant. CONCLUSION: The study shows that in Chile, representing as it does the Southern Hemisphere, the suicide rates tend to present a seasonal variation as has elsewhere been determined for in the North Hemisphere.
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Yunus, Samiha, Sabrina Sharmin, Nafisa Lira Huq, Fariha Haseen, Md Ali Imam, and Quamrun Nahar. "Expectations of adolescents to receive reproductive health information and services from health service system: A qualitative study in Bangladesh." South East Asia Journal of Public Health 7, no. 2 (November 28, 2018): 19–26. http://dx.doi.org/10.3329/seajph.v7i2.38852.
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Adolescents, aged 10-19 years, constitute one fifth of Bangladesh's total population of 158 million. Similar to adolescents elsewhere, Bangladeshi adolescents also have special sexual and reproductive health (SRH) information and service needs; however, these needs are not adequately addressed by the existing health service system. The present study was conducted to identify adolescents’ expectations of and preferences for receiving SRH information and services. This qualitative study was conducted in six purposively selected areas of Bangladesh using 20 Key Informant Interviews (KII) during September-November 2012. Key informants aged between 15 to 19 years were leaders of youth organizations or class monitors in school. Informants were unmarried and married, males and females, and from rural and urban areas. This study identified that there is a strong need for SRH services for adolescents. Irrespective of their residence and gender, adolescents preferred health service providers to be qualified medical doctors, who are experienced, well-trained and polite. Availability of doctors, maintaining privacy and treatment through counseling were mentioned as their priorities. Both urban and rural adolescents recommended establishing adolescent friendly environment in every government and NGO health service facility. They also asked for gender specific service provider for female and male adolescents. Urban adolescents expressed the need for school health program with provision of school health clinics. On the other hand, rural adolescents recommended for community health workers to raise awareness on adolescent sexual and reproductive health (ASRH) issues with parents and families. The adolescents also expected to receive SRH information through mass media, school curriculum, and booklets on adolescent SRH, and peer educator. Addressing the expectations of adolescents will open a new skylight to policy makers to design highly accessible health services for adolescents in BangladeshSouth East Asia Journal of Public Health Vol.7(2) 2017: 19-26
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Yang, Jianxiu, Xing Ma, Xueyan Zhao, and Wenqing Li. "Spatiotemporal of the Coupling Relationship between Ecosystem Services and Human Well-Being in Guanzhong Plain Urban Agglomeration." International Journal of Environmental Research and Public Health 19, no. 19 (October 1, 2022): 12535. http://dx.doi.org/10.3390/ijerph191912535.
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Understanding the complex relationship between ecosystem services and human well-being during the rapid development of urban agglomerations can promote the sustainable development of urban agglomerations. In this paper, the InVEST model and ArcGIS10.2 were used to analyze the spatial and temporal evolution characteristics of ecosystem services and human well-being in the Guanzhong Plain urban agglomeration. On this basis, the coupling coordination index is used to reveal the spatiotemporal coupling relationship between them. (1) From 2010 to 2018, the water conservation services, soil conservation services, and carbon sequestration services of the Guanzhong Plain urban agglomeration showed a fluctuating downward trend. The spatial differences of ecosystem services were significant. (2) From 2010 to 2018, human well-being in the Guanzhong Plain urban agglomeration showed a fluctuating downward trend, with a decrease of 17%, and regional differences tended to narrow. (3) The coupling coordination degree between ecosystem services and human well-being has slightly decreased while maintaining the basic coordination state. The results show that there was a significant relationship between the decline of ecosystem services and the rapid development of the Guanzhong Plain urban agglomeration, and policies should be classified according to the coupling coordination types of human well-being and ecosystem services to promote the sustainable development of urban agglomerations.
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Atorkey, Prince, Christine Paul, John Wiggers, Billie Bonevski, Aimee Mitchell, and Flora Tzelepis. "Barriers and Facilitators to the Uptake of Online and Telephone Services Targeting Health Risk Behaviours among Vocational Education Students: A Qualitative Study." International Journal of Environmental Research and Public Health 18, no. 17 (September 3, 2021): 9336. http://dx.doi.org/10.3390/ijerph18179336.
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Uptake of online and telephone services targeting health behaviours is low among vocational education students and barriers and facilitators are unknown. This study aimed to explore barriers and facilitators to uptake of online and telephone services for smoking, nutrition, alcohol, and physical activity (SNAP) risk behaviours via semi-structured individual telephone interviews with fifteen vocational education students. Two authors independently completed thematic analysis, classified themes according to the COM-B (Capability, Opportunity, Motivation, Behaviour) framework, and discussed disagreements until consensus was reached. Facilitators to uptake of online (e.g., desire to learn something new, cost-free, accessible) and telephone services (e.g., prefer to talk to provider, complements online support) primarily related to capability and opportunity. For telephone services, difficulty understanding accent/language was a capability-related barrier. Opportunity-related barriers for online and telephone services were preference for face-to-face interaction and lack of time, while preference for apps/online programs was a barrier for telephone services. For online and telephone services, not wanting to change SNAP behaviours was a motivation-related barrier and being able to change SNAP risk behaviours themselves was a motivation-related barrier for online services. Barriers and facilitators to online and telephone services are relevant for designing interventions vocational education students are more likely to use.
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Khamis, Noraziani, Intan Syafinaz Saimy, Nor Hayati Ibrahim, Nur Khairah Badaruddin, Nor Zam Azihan Mohd Hassan, Faridah Kusnin, Sukhvinder Singh Sandhu, and Masitah Mohamed. "Progression of the Pathway for Public Health Care during the COVID-19 Outbreak at District Health Office." International Journal of Environmental Research and Public Health 18, no. 19 (October 7, 2021): 10533. http://dx.doi.org/10.3390/ijerph181910533.
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Public health activities under district health offices (DHOs) play a major role in Malaysia’s fight against COVID-19. This article aims to describe and illustrate the public health activity pathway in combating the COVID-19 pandemic, and a team of public health workers who are familiar with DHO work settings was created in April 2020 for that purpose. Review of documents and the Ministry of Health’s updates was carried out, followed by a series of discussions with stakeholders. Based on the steps in the outbreak investigation tasks, the flow of activities from January to May 2020 was listed in line with the phases of the country’s National Movement Control Order 2020. Results show that the activities can be classified into three different sections—namely, the main action areas, category of cases, and level of care. The main process flow of activities comprised the case management and support activities. Case management flow was split into tasks for patients under investigation and persons under surveillance, while the support services existed throughout the phases. The pathways illustrate that the progression of the pandemic translated directly to changes in the pattern of activities, with additional subgroups of activities in accordance with all imposed guidelines.
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Iliffe, Steve, and Penny Lenihan. "Integrating Primary Care and Public Health: Learning from the Community-Oriented Primary Care Model." International Journal of Health Services 33, no. 1 (January 2003): 85–98. http://dx.doi.org/10.2190/40hl-u1b9-f7k7-kk64.
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Community-oriented primary care (COPC), a 50-year-old widely applied innovative approach to primary care development, seems to be the same combination of public health and general practice perspectives currently sought in the formation of primary care trusts in Britain's NHS. The article reviews the experience of implementing COPC methods, the outcomes, and the applicability to and implications for primary care policy, taking the current British reforms as an example. The COPC model has been developed mainly in underserved populations to integrate public health objectives and primary care through interdisciplinary approaches, with active involvement of the target population. COPC methods are time consuming, can create problems with professional boundaries, and are vulnerable to socioeconomic changes. They can also deliver complex packages of care for target populations, particularly in poor areas underserved by traditional medical services. British primary care reforms may be seen as an unplanned, uncontrolled, nationwide experiment in applying COPC methods. They differ from COPC as applied elsewhere because change has been introduced from above rather than below, into a well-developed primary care system rather than underserved communities. International experience suggests the need for attention to factors promoting and impeding success and to reliable outcome measures. If this experiment succeeds, COPC methodology may facilitate similar changes in other health care systems.
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Pettigrew, Simone. "Older Patients' Expectations of a "Senior-Friendly Hospital"." Australian Journal of Primary Health 12, no. 3 (2006): 52. http://dx.doi.org/10.1071/py06045.
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With the ageing of populations around the world, hospitals seeking to maximise the satisfaction of their patients will need to ensure their services meet the expectations of the growing segment of older patients. Four focus groups were conducted in Perth, Western Australia, to explore those aspects of a hospital stay that are considered to be most important to older patients. The focus group participants nominated nursing care, meals, admission procedures, communication processes and physical facilities as those aspects of hospital service that are of particular importance to older patients. They noted that these issues are likely to be relevant to some degree to all patients but that, due to the needs of older patients, they become especially critical in later years. These findings have similarities with those generated by other studies but are more extensive than described elsewhere and thus provide more detailed guidance for hospital managers seeking to ensure their facilities are senior-friendly.
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Liamputtong Rice, Pranee. "Childhood Health and Illness: Cultural Beliefs and Practices among the Hmong in Victoria." Australian Journal of Primary Health 4, no. 4 (1998): 44. http://dx.doi.org/10.1071/py98060.
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This paper examines the cultural construction of childhood illness among Hmong refugees from Laos who are living in Australia. It focuses on traditional patterns of beliefs and practices related to health and illness of newborn infants and young children. The Hmong treat childhood health and illness seriously, and for them there are several causes of childhood illness, including nature, souls, supernatural beings and human aggression. The roles of traditional healers who play an important part in childhood health and illness are also discussed. Lastly, the paper attempts to make clear some implications for child health services for immigrants such as the Hmong in Australia and elsewhere. The paper intends to contribute an anthropological perspective on child health which is particularly important in a multicultural society. A clear understanding by health professionals of cultural beliefs and expectations is essential if misunderstanding is to be avoided, and culturally appropriate and sensitive health care for immigrant children, such as the Hmong to be available.
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Masaki, Motofumi, and Akira Koizumi. "Demographic characteristics and their genetic implications in a small island." Journal of Biosocial Science 20, no. 2 (April 1988): 225–34. http://dx.doi.org/10.1017/s0021932000017454.
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SummaryThe family registration records from a village population in a small island of Japan are used to assess the effect of demographic differentiation within a population on genetic measures. When the couples studied are classified by birth cohorts and origins, wives of the couples where one spouse came from elsewhere were older at marriage and had a shorter duration of marriage or registration than wives where both spouses were natives of the village. The mean number of offspring is statistically smaller in the former except for the latest cohort, due mainly to out-migration during the reproductive ages which also resulted in low rates of marriage among the offspring within the village. This leads to a small effective population size and an increased likelihood of genetic drift in the overall population.
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Marutha, Ngoako Solomon, and Mpho Ngoepe. "Medical records management framework to support public healthcare services in Limpopo province of South Africa." Records Management Journal 28, no. 2 (July 16, 2018): 187–203. http://dx.doi.org/10.1108/rmj-10-2017-0030.
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Purpose This study aims to develop a framework for the management of medical records in support of health-care service delivery in the hospitals in the Limpopo province of South Africa. Design/methodology/approach The study was predominantly quantitative and has used the questionnaires, system analysis, document analysis and observation to collect data in 40 hospitals of Limpopo province. The sample of 49 per cent (306) records management officials were drawn out of 622 (100 per cent) total population. The response rate was 71 per cent (217) out of the entire sample. Findings The study discovered that a framework for management of medical records in the public hospitals is not in place because of several reasons and further demonstrates that public health-care institutions need an integrative framework for the proper management of medical records of all forms and in all media. Originality/value The study develops and suggests a framework to embed medical records management into the health-care service delivery workflow for effective records management and ease of access. It is hoped that such a framework will help hospitals in South Africa and elsewhere to improve their medical records management to support health-care service provision.
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Lee, Soo-Bi, Min-Ji Yu, and Myeong-Sook Yoon. "A Longitudinal Change Patterns of Depression and Its Relationship with Socioeconomic Deprivation among Middle-Aged Adults in South Korea." International Journal of Environmental Research and Public Health 18, no. 24 (December 8, 2021): 12957. http://dx.doi.org/10.3390/ijerph182412957.
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This study aimed to identify the longitudinal pattern changes of South Koreans’ midlife depression and determine the impact of socioeconomic deprivation on the observed change in patterns. In total, 3975 middle-aged individuals were examined by conducting a latent class growth analysis and multinomial logistic regression analysis on seven years of Korea Welfare Panel data (2012–2018) using STATA 16.0 (StataCorp LLC, College Station, TX, USA). The change patterns of midlife depression were classified into normal depression reduction group, mild depression maintenance group, and serious depression increase group. The impact of the experience of socioeconomic deprivation on the classified change patterns was examined using the normal depression reduction group as the reference group. It was found that the higher an individual’s nutritional, housing, occupational/economic, and healthcare deprivation, the higher their risk of mild depression maintenance or serious depression increase. The serious depression increase group showed higher relative risk ratios in all domains. Comprehensive and integrated social welfare services, such as stable income, housing welfare, and healthcare services, should be provided along with appropriate clinical interventions for depression alleviation that account for the pattern changes in midlife depression.
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Delisle, Hélène. "The Human Resources for Health Program in Rwanda – Reflections on Achievements and Challenges Comment on "Health Professional Training and Capacity Strengthening Through International Academic Partnerships: The First Five Years of the Human Resources for Health Program in Rwanda"." International Journal of Health Policy and Management 8, no. 2 (November 21, 2018): 128–31. http://dx.doi.org/10.15171/ijhpm.2018.114.
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This commentary is a further discussion of a paper published in this journal on the health professional training initiative led by the Government of Rwanda since 2012 and presented as a case study. According to the authors, the partnership program with international academic institutions may serve as model for other countries to address the shortage of health professionals and to strengthen institutional capacity, based on the competencybased and innovative training programs, the numbers of graduates, the improved quality of health services and institution strengthening. However, the conditions may not be as optimal elsewhere. A supportive government policy, massive funding and an academic consortium comprised of 19 United States academic institutions have contributed to the success of the program. We also noted that the trained professionals were clinicians almost exclusively, at the expense of public health specialists and other health professionals who can better address emerging issues such as non-communicable diseases (NCDs) particularly for their prevention, which is now compelling. Among others, the training of more nutritionists as members of the health team is needed.
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Barger, Brian, Catherine Rice, Christina Anne Simmons, and Rebecca Wolf. "A Systematic Review of Part C Early Identification Studies." Topics in Early Childhood Special Education 38, no. 1 (December 20, 2016): 4–16. http://dx.doi.org/10.1177/0271121416678664.
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Authors conducted a systematic literature review on early identification steps leading at-risk young children to connect with Part C services. Authors classified data collection settings as primary (settings for general population) or specialized (settings for children at risk of developmental delay) and according to the phases of early identification in the study: (a) original population of children aged 0 to 6 years who had received Part C services, (b) screening and/or referral and/or developmental assessment from 0 through age 2 years, and (c) were deemed eligible and/or received Part C services. Authors identified 43 articles including at least two phases of the early identification process. The literature about connecting children to Part C early intervention (EI) is sparse and fragmented; few studies document the full process from community monitoring to service receipt. Results indicate opportunities for development of systems to better track and improve the identification of young children in need of EI.
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Hayatie, Marliza Noor, Astia Putriana, and Gati Anjaswari. "Always Better Control Method as Controlling for Medicine Inventory in Public Health Office." International Journal of Research in Vocational Studies (IJRVOCAS) 2, no. 2 (August 26, 2022): 07–14. http://dx.doi.org/10.53893/ijrvocas.v2i2.110.
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The purpose of this study is to control medicine supplies with the implementation of the Always Better Control (ABC) method in the Pharmaceutical Field of the Tanah Laut Regency Health Office. The availability of the medicine is part of the assessment the level of patient satisfaction with the health services of government agencies. Therefore, control of medicine supplies is important to do well so as not to cause financial losses to the country due to the accumulation of expired medicine in the inventory warehouse. This research is quantitative descriptive research. The data collected is primary data in the form of reports on medicine intake and medicine expenditure at the Tanah Laut Regency Health Office from January to December 2019. Numerically analyze data using the microsoft excel program. The results of this study showed that using the ABC method, the supply of medicine can be classified into three levels. Medicine that belongs to group A are types of medicine that are classified as having high use or sales (fast moving) as many as 6 types. Medicines that belong to group B are types of medicine with moderate sales of 6 types. Meanwhile, for medicine that belong to group C is a type of medicine whose sales are low (slow moving) as many as 8 types. The existence of medicine control with the ABC method provides convenience for management to consider the right investment value in ordering medicine needed by the people so as to improve the financial performance of the institution.
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Barrios-Ipenza, Fernando, Arturo Calvo-Mora, Fernando Criado-García, and Walter H. Curioso. "Quality Evaluation of Health Services Using the Kano Model in Two Hospitals in Peru." International Journal of Environmental Research and Public Health 18, no. 11 (June 7, 2021): 6159. http://dx.doi.org/10.3390/ijerph18116159.
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Public–private partnerships (PPP) represent an alternative model of health management focused on improving the quality of health services, particularly in emerging countries. To date, a systematic method to improve the perceived quality of health services by healthcare users in Peru has not been established. The purpose of this study was to evaluate the quality of health services in two PPP hospitals in Peru using the Kano model. A prospective cross-sectional descriptive observational study was carried out through a health service satisfaction survey using the Kano model methodology, measuring six categories of attributes. A total of 250 users of the health services were surveyed in the two PPP hospitals, located in Lima and Callao, using non-probability convenience sampling. Of the 31 attributes evaluated by the patients, 27 (81%) were classified as having a one-dimensional-type attribute, 3 (10%) were reported as mandatory, and 1 (3%) was considered as inverse. These results suggest that the presence of most of the attributes evaluated was relevant to maintaining the level of user satisfaction and that the absence of these attributes generated dissatisfaction in the users. The results showed that the users’ evaluation of health services was multidimensional—namely, their evaluation was focused not only on the interaction space between the patient and medical personnel but also addressed other interaction services.
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Iyer, Hari S., Nicholas G. Wolf, John S. Flanigan, Marcia C. Castro, Lee F. Schroeder, Kenneth Fleming, Edda Vuhahula, and Charles Massambu. "Evaluating urban–rural access to pathology and laboratory medicine services in Tanzania." Health Policy and Planning 36, no. 7 (July 1, 2021): 1116–28. http://dx.doi.org/10.1093/heapol/czab078.
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Abstract Placement of pathology and laboratory medicine (PALM) services requires balancing efficiency (maximizing test volume) with equitable urban–rural access. We compared the association between population density (proxy for efficiency) and travel time to the closest facility (proxy for equitable access) across levels of Tanzania’s public sector health system. We linked geospatial data for Tanzania from multiple sources. Data on facility locations and other geographic measures were collected from government and non-governmental databases. We classified facilities assuming increasing PALM availability by tier: (1) dispensaries, (2) health centres, (3) district hospitals and (4) regional/referral hospitals. We used the AccessMod 5 algorithm to estimate travel time to the closest facility for each tier across Tanzania with 500-m resolution. District-level average population density and travel time to the closest facility were calculated and presented using medians and interquartile ranges. Spatial correlations between these variables were estimated using the global Moran’s I and bivariate Local Indicator of Spatial Autocorrelation, specifying a queen’s neighbourhood matrix. Spatial analysis was restricted to 171 contiguous districts. The study included 5406 dispensaries, 675 health centres, 186 district hospitals and 37 regional/referral hospitals. District-level travel times were shortest for Tier 1 (median: [IQR]: 45.4 min [30.0–74.7]) and longest for Tier 4 facilities (160.2 min [107.3–260.0]). There was a weak spatial autocorrelation across tiers (Tier 1: −0.289, Tier 2: −0.292, Tier 3: −0.271 and Tier 4: −0.258) and few districts were classified as significant spatial outliers. Across tiers, geographic patterns of populated districts surrounded by neighbours with short travel time and sparsely populated districts surrounded by neighbours with long travel time were observed. Similar spatial correlation measures across health system levels suggest that Tanzania’s health system reflects equitable urban–rural access to different PALM services. Longer travel times to hospital-based care could be ameliorated by shifting specialized diagnostics to more accessible lower tiers.
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Barrett, Brendan, Christine Way, Jackie McDonald, and Patrick Parfrey. "Hospital utilization, efficiency and access to care during and shortly after restructuring acute care in Newfoundland and Labrador." Journal of Health Services Research & Policy 10, no. 2_suppl (October 2005): 31–37. http://dx.doi.org/10.1258/135581905774424537.
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Objectives Since the 1990s restructuring, including regionalization and downsizing, has largely been driven by a desire for cost containment. Regionalization, hospital closure and changes in management processes occurred in Newfoundland and Labrador (NL), Canada between 1995 and 2000. The objectives of the current study were: to describe trends in the utilization of acute care hospital services by residents of NL during and shortly after restructuring; to examine trends in the efficiency of utilization of acute care beds in the province during the same time frame; and to compare the trends in St John's with the rest of the province, taking account of confounding events, in an attempt to understand the impact of aggregation of hospitals in this region. Methods Hospital discharge and day surgical data were analysed for all facilities in NL from 1995/96 to 2000/01. Analyses were by facility of service and also by region of residence directly standardized to the provincial population for 1996. Efficiency of bed utilization was examined on three occasions by concurrent utilization review using a modified version of the Appropriateness Evaluation Protocol. Trends in the St John's region (where most tertiary services are located and greater aggregation of hospitals occurred) were compared with the rest of the province. Results Admissions declined by 14% in St John's facilities and by 17% elsewhere. Inpatient days fell by 9% in St John's and by 12% elsewhere. Average length of stay and Resource Intensity Weight changed little, apart from a rise in the final study year, with the largest change in St John's. Standardized hospital admission rates declined by 10% and inpatient days by 5.6% for residents of St John's region, and by 16% and 14% respectively for residents of other regions. There was no change over time in the use of day surgery. Efficiency of acute care bed use improved in 2002 in St John's, but was unchanged in other regions. Use of acute care beds by elderly patients for extended stay, or when an alternate level of care would have been appropriate, was greater in St John's with the disparity persisting over time. Waiting time for continuing care in the StJohn's region was unchanged comparing 1995/96 and 1999/00. Conclusions Regionalization in Newfoundland and Labrador facilitated aggregation of hospitals, but did not control the number of front-line workers and, consequently, total acute care expenditure. Expenditure increased significantly between1995 and 2002, at a rate which exceeded the increase in government revenues. The government's ability to pay for acute care will not be achieved unless employee costs are controlled or provincial income increases.
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Costa, Clarisse Melo Franco Neves, Micheline Rosa Silveira, Francisco de Assis Acurcio, Augusto Afonso Guerra Junior, Ione Aquemi Guibu, Karen Sarmento Costa, Margô Gomes de Oliveira Karnikowski, et al. "Use of medicines by patients of the primary health care of the Brazilian Unified Health System." Revista de Saúde Pública 51 (September 22, 2017): 18s. http://dx.doi.org/10.11606/s1518-8787.2017051007144.
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OBJECTIVE: To characterize the use of medicines by patients of the primary health care of the Brazilian Unified Health System (SUS). METHODS: This is a cross-sectional, exploratory, and descriptive study, part of the Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos – Serviços, 2015 (PNAUM – National Survey on Access, Use and Promotion of Rational Use of Medicines – Services, 2015). Interviews were carried out with patients present in the services by semi-structured questionnaires. Sociodemographic, clinical, and use of medicines variables were assessed and the use of medicines in the 30 days prior to the interview was also verified. The population was stratified into three age groups: 18 to 44, 45 to 64, and 65 years or more. The differences between the age groups were verified using the Student’s t-test for continuous variables and chi-square test for the categorical ones. The complex samples analysis plan was employed. The medicines were classified according to the Anatomical Therapeutic Chemical Classification System. RESULTS: Of the 8,803 patients interviewed, 6,511 (76.2%) reported to have used medicines in the 30 days prior to the interview. On average, each patient used 2.32 medicines, without difference between the sexes. Among medicine users, 18.2% were aged 65 years or more. Compared to the other age groups, older adults presented more comorbidities, used more medicines, and self-reported worse health conditions. They were also less educated, reported worse economic situation, and lived alone. The medicines that were mostly used were “other analgesics and antipyretics” (3rd ATC level) and Losartan (5th ATC level). CONCLUSIONS: Most medicine users had lower education level and presented comorbidities. The most used medicines were the antihypertensive ones. Self-medication was higher among young people. Most patients reported to use generic medicines. The average number of medicines and the prevalence of use increased with age. Due to the characteristics observed and the difficulties in the use of medicines, older adults are in a situation of greater vulnerability
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Wattanapisit, Apichai, Tida Sottiyotin, Jaruporn Thongruch, Sanhapan Wattanapisit, Siranee Yongpraderm, and Pichawee Kowaseattapon. "Self-Care Practices of Patients with Non-Communicable Diseases during the COVID-19 Pandemic: A Qualitative Study." International Journal of Environmental Research and Public Health 19, no. 15 (August 7, 2022): 9727. http://dx.doi.org/10.3390/ijerph19159727.
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Individuals with chronic non-communicable diseases (NCDs) have a higher risk of morbidity and mortality. This study explores the lived experience of patients with NCDs during the COVID-19 pandemic and the impact of COVID-19 on their self-care. An interpretive phenomenological analysis approach was used that involved in-depth interviews with patients who received medical services from a family medicine clinic, along with caregivers who responded on their behalf. An inductive thematic approach was utilized to analyze the data. Interview respondents included 17 patients with NCDs and four caregivers. The patients had a mean age of 65.7 ± 11.3 years and were diagnosed with an NCD, a mean of 4.8 ± 1.1 years previously. Self-care practices used during the pandemic were classified as therapeutic or preventive. Patients responded to changes in healthcare services by seeking in-person services for their acute illnesses and accepting remote services for underlying chronic conditions. The COVID-19 pandemic influenced the self-care practices of patients with NCDs. Most patients paid more attention to self-care during this time, while some became more concerned with other aspects of their life.
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Hawrysz, Liliana, Grażyna Gierszewska, and Agnieszka Bitkowska. "The Research on Patient Satisfaction with Remote Healthcare Prior to and during the COVID-19 Pandemic." International Journal of Environmental Research and Public Health 18, no. 10 (May 17, 2021): 5338. http://dx.doi.org/10.3390/ijerph18105338.
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The issue of research on patient satisfaction with healthcare services took on a completely new dimension due to the COVID-19 pandemic and the developing telehealth services. This results from the fact that during the pandemic, remote healthcare was often the only possible form of care provision to the patient. The COVID-19 pandemic has substantially accelerated the implementation of remote healthcare in healthcare institutions and made it an essential tool for providing healthcare services. The objective of the literature review was to study the research on patient satisfaction with remote healthcare services prior to and during the pandemic. The study featured a literature review of electronic databases, such as: Medline, ProQuest, PubMED, Ebsco, Google Scholar, WoS. The identified empirical papers were classified in two groups concerning the research on patient satisfaction prior to and during the COVID-19 pandemic, and were divided and descriptively synthesised. Certain limitations to the methodical quality of the research were demonstrated as result of the conducted analyses. It was also ascertained that researchers lack clarity on the method of defining and measuring satisfaction prior to and during the COVID-19 pandemic.
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Morales-Gabardino, José Antonio, Laura Redondo-Lobato, João Meireles Ribeiro, and Francisco Buitrago. "Geographical Distribution of Emergency Services Times in Traffic Accidents in Extremadura." Portuguese Journal of Public Health 39, no. 2 (2021): 78–87. http://dx.doi.org/10.1159/000519858.
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Objective: To analyze the response time and transport time taken by the emergency medical services (EMS), considering their urban or rural location, to attend traffic accident casualties that occurred in the different geographical areas of Extremadura (Spain) from 2012 to 2015. Methods: This was a cross-sectional study of the data recorded by the Emergency Response Coordination Center 112 (ERCC-112) from traffic accidents attended by EMS. Response time was defined as the time elapsed from the request-for-care receipt until arrival of the EMS at the accident scene, and transport time as that from leaving the scene until arrival to the referral hospital. Rural EMS were those based in locations where there is no hospital, and urban EMS those located in towns or cities with a hospital. Results: During the 4-year period studied, 5,572 traffic accidents requested assistance through the ERCC-112. From the 2,875 accidents (51.9%) in which EMS were mobilized, 55.4% occurred in urban roads and the remaining in interurban ones. A total of 113 people (mean age 48.4 ± 19.0 years, range 15–84 years) died at the accident scene or before arrival to the hospital, 88.5% of them in interurban accidents. The average response time of urban and rural EMS was 10.7 ± 7.3 and 18.0 ± 12.6 min (p < 0.001), respectively, and the average transport time was 13.2 ± 11.7 and 45.2 ± 25.0 min (p = 0.009). Response time was longer than the 30-min optimum only in the most peripheral areas of Extremadura, while transport time exceeded the optimum of 90 min in the eastern regions of two health areas (Cáceres and Don Benito-Villanueva). 19.1% of the victims attended by rural EMS were classified as having a serious prognosis or as having died, as compared with 11.2% (p = 0.048) of those attended by urban EMS. Conclusions: The geographical location of EMS in Extremadura (Spain) guarantees adequate response times in traffic accidents, both in rural and urban areas. However, recommended transport times were occasionally exceeded in the most peripheral areas, due to hospital location.
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Ummer, Osama, Kerry Scott, Diwakar Mohan, Arpita Chakraborty, and Amnesty Elizabeth LeFevre. "Connecting the dots: Kerala’s use of digital technology during the COVID-19 response." BMJ Global Health 6, Suppl 5 (July 2021): e005355. http://dx.doi.org/10.1136/bmjgh-2021-005355.
Full textAbstract:
Digital tools are increasingly being applied to support the response to the ongoing COVID-19 pandemic in India and elsewhere globally. This article draws from global frameworks to explore the use of digital tools in the state of Kerala across the domains of communication, surveillance, clinical management, non-clinical support, and core health system readiness and response. Kerala is considered India’s first digital state, with the highest percentage of households with computers (24%) and the internet (51%) in India, 95% mobile phone penetration, 62% smartphone penetration and 75% digital literacy. Kerala has long been a model for the early adoption of digital technology for education and health. As part of the pandemic response, technology has been used across private and public sectors, including law enforcement, health, information technology and education. Efforts have sought to ensure timely access to health information, facilitate access to entitlements, monitor those under quarantine and track contacts, and provide healthcare services though telemedicine. Kerala’s COVID-19 pandemic response showcases the diverse potential of digital technology, the importance of building on a strong health system foundation, the value of collaboration, and the ongoing challenges of data privacy and equity in digital access.
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Shrivastava, Saurabh Rambiharilal, Prateek Saurabh Shrivastava, and Jegadeesh Ramasamy. "Implementation of public health practices in tribal populations of India: challenges and remedies." Healthcare in Low-resource Settings 1, no. 1 (January 31, 2013): 3. http://dx.doi.org/10.4081/hls.2013.e3.
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<p>Large inequities in health exist between indigenous and non-indigenous populations worldwide. This <em>health divide</em> has also been demonstrated in India, where indigenous groups are officially classified as scheduled tribes (STs). India has one of the largest tribal populations in the world. Tribal communities in general and primitive tribal groups in particular are highly disease prone and their misery is compounded by poverty, illiteracy, ignorance of causes of diseases, hostile environment, poor sanitation, lack of safe drinking water, blind beliefs, etc. As per the estimates of National Family Health Survey-3 (NFHS-3), the likelihood of having received care from a doctor is lowest for ST mothers (only 32.8% compared to India of 50.2%). While many strategies have been attempted over the years to discuss some of the economic, social, and physical factors preventing tribal population to get access to healthcare services, the ultimate outcome has remained far less than the expectations. Considering that these ST groups are culturally and economically heterogeneous, the methods to tackle their health problems should not only be integrated and multi-fold, but also specific to the individual groups as feasibly as possible. Measures like strengthening of the existing human resources, bringing health services within the reach of remote populations, promotion of health awareness, facilitation of community participation using innovative strategies, bringing about a change in the behavior of health care providers, implementation of measures for the empowerment of ethnic groups by carrying out administrative reforms and finally by ensuring the sustainability of all above recommended measures. <strong></strong></p>
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Skinner, Mark W., and Mark W. Rosenberg. "Co-Opting Voluntarism? Exploring the Implications of Long-Term Care Reform for the Nonprofit Sector in Ontario." Environment and Planning C: Government and Policy 23, no. 1 (February 2005): 101–21. http://dx.doi.org/10.1068/c0434.
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Within public policy discourse on health care restructuring and voluntarism, the nonprofit sector is now expected to play an active and direct role in the provision of health care services. The viability of the nonprofit sector to take up this role, however, remains unclear. This paper explores the changing role of nonprofit organisations with respect to the provision of long-term care in Ontario, Canada, where extensive restructuring of public services occurred during the 1990s. Drawing on a critical review of legislation, government policies and documents, and stakeholder reports, the authors present a comparative study of two distinct long-term care reform models, featuring public and private provision, respectively, which were developed by ideologically opposed provincial governments. The results indicate that despite unanimous promotion of voluntarism (and the attendant ascendancy of the nonprofit sector) as a central feature of health care restructuring, the divergent reform models actually trap nonprofit organisations between direct incorporation within public provision on the one hand, and direct free-market competition on the other. The findings suggest that underscoring long-term care reform in Ontario, and elsewhere, is the co-option of the nonprofit sector, which resonates with concern for its ability to replace effectively the public provision of health care services. The results also point to the need to conceptualise the consequent actions taken by nonprofit organisations in order to inform current debates surrounding health care restructuring and voluntarism.
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Nardino, Marianna, Letizia Cremonini, Teodoro Georgiadis, Emanuele Mandanici, and Gabriele Bitelli. "Microclimate Classification of Bologna (Italy) as a Support Tool for Urban Services and Regeneration." International Journal of Environmental Research and Public Health 18, no. 9 (May 4, 2021): 4898. http://dx.doi.org/10.3390/ijerph18094898.
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A microclimate classification of the entire Bologna Municipality has been carried out in order to give a tool to the local administration in the drafting of the General Urbanistic Plan (PUG). The city was classified considering the variation of air temperature as a function of the surface characteristics, the vegetation fraction, the building density and the H/W ratio (height to width). Starting from the microclimate analysis carried out with fluid-dynamic modeling (Envi-met) for some areas of the city of urban interest, the air temperature variation was correlated to the physiological equivalent temperature (PET) in order to make a classification of physiological well-being for the resident population. An urban map of a normalized microclimate well-being index (BMN) has been obtained to give support when private, and public actors want to regenerate part of the city, taking into account the climate-centered approach for the development of a sustainability city.
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Mehra, Devika, Rahul Rajak, Sujata Deo, Qazi Najmuddin, Kshetrimayum Surmala Devi, Suresh Kumar Rathi, and Sunil Mehra. "Centres of Excellence for Adolescent Health and Development: A Case Study from Uttar Pradesh, India." International Journal of Environmental Research and Public Health 20, no. 4 (February 9, 2023): 3042. http://dx.doi.org/10.3390/ijerph20043042.
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Adolescents and young adult comprise a significant proportion of India’s population. Although, this group of the population faces serious challenges to their health and well-being. To promote their health and well-being, Centre of Excellence (CoE) at King George’s Medical University, Lucknow, India, serves as an advanced care facility for 10–24-year-old adolescents and young adult women. This paper reports the socio-demographic characteristics of, and health services availed to adolescents and young adults who are visiting the CoE in Lucknow, India. A total of 6038 beneficiaries received clinical services during June 2018–March 2022. Out of total clinical services, 38.37% counselling and 37.53% referral services were utilised. Menstruation (46.29%), sexual and reproductive (28.19%), nutrition (5.91%), and mental health (1.67%) related problems were highly reported. The age of beneficiaries is classified into three categories, i.e., 10–14, 15–19, and 20–24 years. Prevalence of overweight was highest among adolescents aged 20–24 years compared to other age groups. Other than nutrition, late-adolescent girls (15–19) faced more health problems than their counterparts. The percentage of beneficiaries decreased significantly during and post the COVID-19 period (<0.001). Therefore, age-specific programs are currently needed, and interventions need to be designed accordingly.
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Rehm, Jürgen, Mindaugas Štelemėkas, Carina Ferreira-Borges, Huan Jiang, Shannon Lange, Maria Neufeld, Robin Room, Sally Casswell, Alexander Tran, and Jakob Manthey. "Classifying Alcohol Control Policies with Respect to Expected Changes in Consumption and Alcohol-Attributable Harm: The Example of Lithuania, 2000–2019." International Journal of Environmental Research and Public Health 18, no. 5 (March 2, 2021): 2419. http://dx.doi.org/10.3390/ijerph18052419.
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Due to the high levels of alcohol use, alcohol-attributable mortality and burden of disease, and detrimental drinking patterns, Lithuania implemented a series of alcohol control policies within a relatively short period of time, between 2008 and 2019. Based on their expected impact on alcohol consumption and alcohol-attributable harm, as well as their target population, these policies have been classified using a set of objective criteria and expert opinion. The classification criteria included: positive vs. negative outcomes, mainly immediate vs. delayed outcomes, and general population vs. specific group outcomes. The judgement of the alcohol policy experts converged on the objective criteria, and, as a result, two tiers of intervention were identified: Tier 1—highly effective general population interventions with an anticipated immediate impact; Tier 2—other interventions aimed at the general population. In addition, interventions directed at specific populations were identified. This adaptable methodological approach to alcohol control policy classification is intended to provide guidance and support for the evaluation of alcohol policies elsewhere, to lay the foundation for the critical assessment of the policies to improve health and increase life expectancy, and to reduce crime and violence.