scholarly journals How did general practices organize care during the COVID-19 pandemic: the protocol of the cross-sectional PRICOV-19 study in 38 countries

2022 ◽  
Vol 23 (1) ◽  
Author(s):  
E. Van Poel ◽  
P. Vanden Bussche ◽  
Z. Klemenc-Ketis ◽  
S. Willems

Abstract Background General practitioners (GPs) play a crucial role in the fight against the COVID-19 pandemic as the first point of contact for possibly infected patients and are responsible for short and long-term follow-up care of the majority of COVID-19 patients. Nonetheless, they experience many barriers to fulfilling this role. The PRICOV-19 study investigates how GP practices in 38 countries are organized during the COVID-19 pandemic to guarantee safe, effective, patient-centered, and equitable care. Also, the shift in roles and tasks and the wellbeing of staff members is researched. Finally, PRICOV-19 aims to study the association with practice- and health care system characteristics. It is expected that both characteristics of the GP practice and health care system features are associated with how GP practices can cope with these challenges. This paper describes the protocol of the study. Methods Using a cross-sectional design, data are collected through an online questionnaire sent to GP practices in 37 European countries and Israel. The questionnaire is developed in multiple phases, including a pilot study in Belgium. The final version includes 53 items divided into six sections: patient flow (including appointments, triage, and management for routine care); infection prevention; information processing; communication; collaboration and self-care; and practice and participant characteristics. In the countries where data collection is already finished, between 13 and 636 GP practices per country participated in the study. Questionnaire data are linked with OECD and HSMR data regarding national policy responses to the pandemic and analyzed using multilevel models considering the system- and practice-level. Discussion To the best of our knowledge, the PRICOV-19 study is the largest and most comprehensive study that examines how GP practices function during the COVID-19 pandemic. Its results can significantly contribute to better preparedness of primary health care systems across Europe for future major outbreaks of infectious diseases.

Author(s):  
Santhanathan S Rajendram ◽  
Muhamad Danial Muhamad Hamdan

Dispensing separation in Malaysia has been a widely discussed topic among the medical fraternity. It is a highly sensitive topic as it involves both professional and economic considerations for doctors, pharmacists, and the general public. There has been no decision made thus far but the discussion is ongoing, making a study on this topic very relevant. The subjects of this study, final year students of Bachelor of Pharmacy Programme in Malaysian universities, are chosen to reflect their awareness, preparedness, and knowledge on dispensing separation, which will affect their future in the pharmacy profession. The study was conducted among all 20 Public and Private Institutions of Higher Learning recognized by the Pharmacy Board, Malaysia. This was a cross-sectional study design, and data was collected using a convenience sampling method. The research instrument was an online questionnaire. The first part of the questionnaire covers the demographic information about the respondent, like name, age, gender, and institution. The second part covers the knowledge, awareness and perspectives of respondents towards the implementation of the separation of prescribing and dispensing activities in Malaysia. The final part of the survey focuses on suggestions or problems arising. There were 126 respondents to the survey, way above the 96 respondents needed to make the survey valid. The majority of them are aware of and understand the dispensing separation. Most of them agree that the government should legalize the dispensing separation activities as they believe pharmacists are more knowledgeable and better equipped to dispense drugs. The majority of them believe by implementing dispensing separation, the health care system will be better optimized, and the service will be better. They also believe that patients can accept and adapt to the role of the pharmacist in dispensing medication. The majority of them also agree that the price of medicine will be lowered by the implementation of dispensing separation. Based on the study, these students who are future pharmacists are very knowledgeable on the dispensing separation issue. They believe strongly that the implementation of dispensing separation in Malaysia will bring more beneficial changes to the health care system. The patients will also benefit from this. With such a positive attitude, the implementation of dispensing separation in Malaysia could be imminent  


2018 ◽  
Vol 24 (1) ◽  
pp. 37-43 ◽  
Author(s):  
Dahai Zhao ◽  
Hongyu Zhao ◽  
Paul D Cleary

Objectives Despite increasing research attention on public trust in health care systems, empirical evidence on this topic in the developing world is limited and inconclusive. This paper examines the level and determinants of public trust in the health care system in China. Methods We used data from a survey conducted with a sample of 5347 adults in all Chinese provincial areas between January and February 2016. Trust in the health care system was assessed with a question used by the 2011–2013 International Social Survey Programme (ISSP) to assess public trust in the health care systems of 29 industrialized countries and regions (‘In general, how much confidence do you have in the health care system in your country?’). Results Only 28% of respondents reported that they had a great deal or complete trust in China’s health care system. Respondents who reported to have more trust in other people in society, more trust in the local government and who were more satisfied with their most recent health care system experience and their health insurance were significantly more likely to trust the country’s health care system. Furthermore, respondents who reported a higher level of happiness, better health status and positive attitudes towards social equity were more likely to trust the health care system in China. Conclusions Our findings suggest that low public trust in China’s health care system is a potential problem. Improving health care experiences may be the most practical and effective way of improving trust in the health care system in China.


2021 ◽  
pp. 1-10 ◽  
Author(s):  
Iris Wallenburg ◽  
Jan-Kees Helderman ◽  
Patrick Jeurissen ◽  
Roland Bal

Abstract The Covid-19 pandemic has put policy systems to the test. In this paper, we unmask the institutionalized resilience of the Dutch health care system to pandemic crisis. Building on logics of crisis decision-making and on the notion of ‘tact’, we reveal how the Dutch government initially succeeded in orchestrating collective action through aligning public health purposes and installing socio-economic policies to soften societal impact. However, when the crisis evolved into a more enduring one, a more contested policy arena emerged in which decision-makers had a hard time composing and defending a united decision-making strategy. Measures have become increasingly debated on all policy levels as well as among experts, and conflicts are widely covered in the Dutch media. With the 2021 elections ahead, this means an additional test of the resilience of the Dutch socio-political and health care systems.


Author(s):  
Lauren Russo ◽  
Karen Willis ◽  
Natasha Smallwood

Objectives: Interstitial lung disease (ILD) is a debilitating and life-limiting condition, requiring multi-disciplinary care. While guidelines recommend early specialist palliative care referral to improve symptoms and quality of life, few patients access such care towards the end-of-life. This study aimed to explore clinicians’ perspectives regarding specialist palliative care and opioids to understand barriers to optimal care and guide clinical practice improvement initiatives. Methods: A cross-sectional, exploratory, qualitative study was undertaken with Australian respiratory clinicians caring for people with ILD (n = 17). In-depth, semi-structured interviews were audio-recorded, transcribed verbatim and coded. Thematic analysis was undertaken to extrapolate recurring ideas from the data. Results: Four themes were identified: 1) understanding how to improve patient care and support, 2) the need to dispel stigmatized beliefs and misconceptions, 3) the importance of trusted relationships and good communication and 4) the challenges of navigating the health-care system. Participants discussed the need to implement early specialist palliative care and symptom palliation to alleviate symptoms, provide emotional support and augment quality of life. Participants described challenges accessing palliative care and opioids due to stigmatized beliefs amongst patients and clinicians and difficulties navigating the health-care system. Trusted therapeutic relationships with patients and strong inter-disciplinary partnerships with collaborative education and communication were perceived to improve patients’ access to symptom palliation. Conclusion: Specialist palliative care and opioids were believed to improve patients’ quality of life, however, many barriers can make accessing such care challenging. To address these issues, multi-disciplinary collaboration, high-quality communication and trusted therapeutic relationships are crucial throughout the ILD illness journey.


2021 ◽  
pp. 194173812110215
Author(s):  
Gillian R. Currie ◽  
Raymond Lee ◽  
Amanda M. Black ◽  
Luz Palacios-Derflingher ◽  
Brent E. Hagel ◽  
...  

Background: After a national policy change in 2013 disallowing body checking in Pee Wee ice hockey games, the rate of injury was reduced by 50% in Alberta. However, the effect on associated health care costs has not been examined previously. Hypothesis: A national policy removing body checking in Pee Wee (ages 11-12 years) ice hockey games will reduce injury rates, as well as costs. Study Design: Cost-effectiveness analysis alongside cohort study. Level of Evidence: Level 3. Methods: A cost-effectiveness analysis was conducted alongside a cohort study comparing rates of game injuries in Pee Wee hockey games in Alberta in a season when body checking was allowed (2011-2012) with a season when it was disallowed after a national policy change (2013-2014). The effectiveness measure was the rate of game injuries per 1000 player-hours. Costs were estimated based on associated health care use from both the publicly funded health care system and privately paid health care cost perspectives. Probabilistic sensitivity analysis was conducted using bootstrapping. Results: Disallowing body checking significantly reduced the rate of game injuries (−2.21; 95% CI [−3.12, −1.31] injuries per 1000 player-hours). We found no statistically significant difference in public health care system (−$83; 95% CI [−$386, $220]) or private health care costs (−$70; 95% CI [−$198, $57]) per 1000 player-hours. The probability that the policy of disallowing body checking was dominant (with both fewer injuries and lower costs) from the perspective of the public health care system and privately paid health care was 78% and 92%, respectively. Conclusion: Given the significant reduction in injuries, combined with lower public health care system and private costs in the large majority of iterations in the probabilistic sensitivity analysis, our findings support the policy change disallowing body checking in ice hockey in 11- and 12-year-old ice hockey leagues.


2017 ◽  
Vol 53 (2) ◽  
pp. 107-112
Author(s):  
Daniel Ślęzak ◽  
Przemysław Żuratyński ◽  
Klaudiusz Nadolny ◽  
Marlena Robakowska ◽  
Alicja Kalis

Health care systems face challenges related to the technological advances in medicine, demographic changes and limited opportunities for growth funding for health, necessitating greater involvement in the search for more efficient systems. The authors present the functioning of the Polish health care system based on social, historical outline of the healthcare system in Poland and the functioning of the National Health Fund (NFZ). Poland has undergone many reforms of the health care system, the Bismarck model, the model Siemaszko, and finally to a model of universal health insurance. So everyone has the same right to health care services financed by the NFZ or directly from the state budget (eg. The system of state emergency medical services). The National Health Fund allows anyone insured to free healthcare and reimbursement of medicines. Introduced information about information programs.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Roya Malekzadeh ◽  
Samereh Yaghoubian ◽  
Edris Hasanpoor ◽  
Matina Ghasemi

Purpose Responsiveness is a reaction to the reasonable expectations of patients regarding ethical and non-clinical aspects of the health-care system. Responsiveness is a characteristic of health-care system and the observance of the patient’s rights. The purpose of this study is to compare the responsiveness of the health-care system based on the hospital ownership in Mazandaran province in Iran. Design/methodology/approach The cross-sectional study design was used on 1,083 patients referred to public and private hospitals and hospitals affiliated to social security organization in Mazandaran province in 2017. The World Health Organization’s responsibility questionnaire was used to collect data. Data were analyzed by using SPSS version 21. Descriptive statistics and one-way ANOVA results are presented is the results section. Findings All responsiveness dimensions were salient for respondents. The response rate in the selected hospitals was very close, which ranged from 85.7 to 90.2%, and there was no significant difference between public, private and social security hospitals (p > 0.05). The most crucial responsiveness dimension in hospitals was autonomy. Originality/value In the current study, the dimensions of communication and confidentiality were identified as priority dimensions based on the least score for breeding actions to improve the responsiveness of the health-care system. At the end, some useful recommendations such as re-engineering the processes, training to engage the employees with patients and encouraging them to fill the gap were suggested.


2002 ◽  
Vol 10 (3) ◽  
pp. 392-400 ◽  
Author(s):  
Rachel Z. Booth

A worldwide shortage of nurses has been acknowledged by the multidisciplinary Global Advisory Group of the World Health Organization. The shortage is caused by an increased demand for nurses, while fewer people are choosing nursing as a profession and the current nurses worldwide are aging. The shortage applies to nurses in practice as well as the nurse faculty who teach students. The inter-country recruitment and migration of nurses from developing countries to developed countries exacerbates the problem. Although public opinion polls identifies the nurse as the person who makes the health care system work for them, the conditions of the work environment in which the nurse functions is unsatisfactory and must change. Numerous studies have shown the positive effects on the nurse of a healthy work environment and the positive relationships between nursing care and patient outcomes. It is important that government officials, insurance companies, and administrators and leaders of health care systems acknowledge and operationalize the value of nurses to the health care system in order to establish and maintain the integrity and viability of that system.


2021 ◽  
Vol 10 (2) ◽  
pp. 1064-1082
Author(s):  
Claudia I. Henschke ◽  
David F. Yankelevitz ◽  
Artit Jirapatnakul ◽  
Rowena Yip ◽  
Vivian Reccoppa ◽  
...  

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
R Pinchas-Mizrachi ◽  
N Daoud

Abstract Background The objective of this study was to examine the level of trust towards Israel’s health care services (HCS) among Palestinian-Arab minority, Jewish immigrant, and non-immigrant Jewish citizens. Previous studies have shown that minorities and immigrants have less trust in health care system (HCSys), which might represent a barrier in access to, and utilization of HCS. Methods We obtained cross-sectional nationwide census data from the 2017 Social Survey of the Israel Central Bureau of Statistics. We studied levels of trust in the HCSys based on a survey question: ’Do you have trust in the healthcare system?” We conducted logistic regression analysis within and between the study groups to compare levels of trust, after adjustment for different relevant covariates in different models. Results Compared to non-immigrant Jews, Arabs had higher trust in the HCS (odds ratio (OR)=3.08, 95% confidence intervals (CI)=3.06,3.10) and compared to non-immigrant Jews, immigrant Jews had more trust (OR = 1.96, 95% CI = 1.94,1.98), even after adjusting for gender, age, education level, religiosity level, perceived discrimination, self-rated health status, HCS use, and having private health insurance. The variables that predicted trust in the HCSys were different in each ethnic group. Conclusions Contrary to our hypothesis and to previous research, Arab and immigrant Jewish respondents in our study had greater trust in the HCS compared to non-immigrant Jews. This might relate to different expectations among our study groupsof the patient-caregiver relations which might affect the access to and utilization of HCS and finally might affect the quality of care. Key messages Exceptionally, in Israel, the Arab minority and Jewish immigrants have more trust in the health care system compared with non-immigrant Jews. More research is needed to understand how trust among minority groups relates to the patterns of utilization of HCS and raises question regarding the quality of care.


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