scholarly journals A Nationwide Enumeration of the Surgical Workforce, its Production and Disparities in Operative Productivity in Liberia

2021 ◽  
Author(s):  
H. A. Adde ◽  
A. J. van Duinen ◽  
L. M. Sherman ◽  
B. C. Andrews ◽  
Ø. Salvesen ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Nationwide Survey ◽  
Well Being ◽  
Good Health ◽  
Full Time ◽  
Full Time Equivalent ◽  
Surgical Workforce ◽  
Different Types ◽  
Care System

Abstract Background Any health care system that strives to deliver good health and well-being to its population relies on a trained workforce. The aim of this study was to enumerate surgical provider density, describe operative productivity and assess the association between key surgical system characteristics and surgical provider productivity in Liberia. Methods A nationwide survey of operation theatre logbooks, available human resources and facility infrastructure was conducted in 2018. Surgical providers were counted, and their productivity was calculated based on operative numbers and full-time equivalent positions. Results A total of 286 surgical providers were counted, of whom 67 were accredited specialists. This translated into a national density of 1.6 specialist providers per 100,000 population. Non-specialist physicians performed 58.3 percent (3607 of 6188) of all operations. Overall, surgical providers performed a median of 1.0 (IQR 0.5–2.7) operation per week, and there were large disparities in operative productivity within the workforce. Most operations (5483 of 6188) were categorized as essential, and each surgical provider performed a median of 2.0 (IQR 1.0–5.0) different types of essential procedures. Surgical providers who performed 7–14 different types of essential procedures were more than eight times as productive as providers who performed 0–1 essential procedure (operative productivity ratio = 8.66, 95% CI 6.27–11.97, P < 0.001). Conclusion The Liberian health care system struggles with an alarming combination of few surgical providers and low provider productivity. Disaggregated data can provide a high-resolution picture of local challenges that can lead to local solutions.

scholarly journals Rural Michigan Farmers’ Health Concerns and Experiences: A Focus Group Study

2021 ◽  
Vol 12 ◽  
pp. 215013272110535
Author(s):  
Nathan Wright ◽  
Marylee Scherdt ◽  
Michelle L. Aebersold ◽  
Marjorie C. McCullagh ◽  
Barbara R. Medvec ◽  
...  
Keyword(s):  
Health Care ◽  
Focus Groups ◽  
Health Care System ◽  
Health Care Services ◽  
Well Being ◽  
The United States ◽  
Full Time ◽  
Rural Residents ◽  
Care Services ◽  
Care System

Objectives: Rural residents comprise approximately 15% of the United States population. They face challenges in accessing and using a health care system that is not structured to meet their unique needs. It is important to understand rural residents’ perceptions of health and experiences interacting with the health care system to identify gaps in care. Methods: Our team conducted focus groups with members of the Michigan Farm Bureau during their 2019 Annual Meeting. Topics explored included resources to manage health, barriers to virtual health care services, and desired changes to localized healthcare delivery. Surveys were used to capture demographic and internet access information. Conclusion: Analysis included data from 2 focus groups (n = 14). Participants represented a wide age range and a variety of Michigan counties. The majority were full-time farm owners with most—93% (n = 13)—reporting they had access to the internet in their homes and 86% (n = 12) reporting that their cellphones had internet capabilities. Participants identified challenges and opportunities in 4 categories: formal health care; health and well-being supports; health insurance experiences; and virtual health care. Conclusion: The findings from this study provide a useful framework for developing interventions to address the specific needs of rural farming residents. Despite the expressed challenges in access and use of health care services and resources, participants remained hopeful that innovative approaches, such as virtual health platforms, can address existing gaps in care. The study findings should inform the design and evaluation of interventions to address rural health disparities.

scholarly journals Development by a Large Integrated Health Care System of an Objective Methodology for Evaluation of Medical Oncology Service Sites

2012 ◽  
Vol 8 (2) ◽  
pp. 70-70
Author(s):  
Marija Bjegovich-Weidman ◽  
Jill Kahabka ◽  
Amy Bock ◽  
Jacob Frick ◽  
Helga Kowalski ◽  
...  
Keyword(s):  
Health Care ◽  
Employee Engagement ◽  
Health Care System ◽  
Patient Experience ◽  
Primary Care Physicians ◽  
Medical Oncology ◽  
Cost Savings ◽  
Full Time ◽  
Medical Oncologists ◽  
Care System

Purpose: Aurora Health Care (AHC) is the largest health care system in Wisconsin, with 14 acute care hospitals. In early 2010, a group of 18 medical oncologists became affiliated with AHC. This affiliation added 13 medical oncology infusion clinics to our existing 12 sites. In the era of health care reform and declining reimbursement, we need an objective method and criteria to evaluate our 25 outpatient medical oncology sites. We developed financial, clinical, and strategic tools for the evaluation and management of our cancer subservice lines and outpatient sites. The key to our success has been the direct involvement of stakeholders with a vested interest in the services in the selection of the criteria and evaluation process. Methods: We developed our objective metrics for evaluation based on strategic, financial, operational, and patient experience criteria. Strategic criteria included: population trends, full-time equivalent (FTE) medical oncologists/primary care physicians, FTE radiation oncologists, FTE oncologic surgeons, new annual cases of patients with cancer, and market share trends. Financial criteria per site included: physician work relative value units, staff FTE by type, staff salaries, and profit and loss. Operational criteria included: facility by type (clinic v hospital based), hours of operation, and facility detail (eg, No. of chairs, No. of procedure and examination rooms, square footage). Patient experience criteria included: nursing model primary/nurse navigators, multidisciplinary support at site, Press Ganey (South Bend, IN; health care performance improvement company) results, and employee engagement score. Results: The outcome of our data analysis has resulted in the development of recommendations for AHC senior leadership and geographic market leadership to consider the consolidation of four sites (phase one, four sites; phase two, two sites) and priority strategic sites to address capacity issues that limit growth. The recommendations if implemented would result in significant cost savings, currently being quantified as a result of consolidation and improved efficiency. A reinvestment of these cost savings would be required to address facility expansion and program enhancement to maximize patient-centered expert care consistently across all of our remaining sites of service.

scholarly journals Integrating staff well-being into the Primary Health Care system: a case study in post-conflict Kosovo

2015 ◽  
Vol 9 (1) ◽  
Author(s):  
Albertien van der Veen ◽  
Tineke van Pietersom ◽  
Barbara Lopes Cardozo ◽  
Feride Rushiti ◽  
Genc Ymerhalili ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Care System ◽  
Well Being ◽  
Primary Health Care System ◽  
System A ◽  
Post Conflict ◽  
Primary Health ◽  
Care System

scholarly journals Governance of health care systems in an ageing world – the case of Australia

2015 ◽  
Vol 13 (1) ◽  
pp. 729-735 ◽  
Author(s):  
Ewa Banasik
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Health Care Systems ◽  
Well Being ◽  
World Health ◽  
The Political ◽  
Central Component ◽  
Australian Health ◽  
Care Systems ◽  
Care System

The main argument of this paper is that because the burden of diseases increases with age, a greater numbers of older individuals will increase the demand for health care, and whether this demand will be met very much depends on how health care systems are governed. This task is particularly complex in jurisdictions with multi-layer governing systems such as the Australian health care system. Governance, described in terms of stewardship of the well-being of the population and as a central component for building effective health care systems, is increasingly considered to be very important for a well performing health care system (World Health Organization, 2000, 2007). Governance is, however, the least studied function in a health care system (Alliance 2009). Furthermore, the limited governance frameworks and assessments that have been developed thus far fail to include the political context in which health care systems operate (Baez-Camargo and Jacobs, 2011). This paper intends to fill this knowledge gap by exploring the political dynamics of the Australian health care system’s governance and its accountability. Furthering the discourse on governance is especially important in times when health care systems are confronted with the challenges of ageing populations

scholarly journals Book Review: The Australian health care system

2008 ◽  
Vol 32 (2) ◽  
pp. 371
Author(s):  
Gary Day
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Health Workforce ◽  
Health Financing ◽  
Good Health ◽  
Australian Health ◽  
The Future ◽  
Reflective Questions ◽  
Key Aspects ◽  
Care System

THIS IS THE THIRD edition of one of the seminal local texts on the Australian health care system. Over the last seven years, this text has proved a basis for helping students, casual readers and health professionals understand Australia?s sometimes difficult to understand health care system. The text is divided into ten chapters that deal with key aspects of Australia?s health care system, namely: � Frameworks for analysis � The Australian population and its health � Financing health care � The health workforce � Departmental and intergovernmental structures � Hospitals � Public health � Primary and community care � Pharmaceuticals � Policy challenges for the Australian health care system. There are several key reasons why this text has been widely used in the past and will continue to be of value well into the future. The author has been able to accurately describe the complexities of the Australian health care system in an easily digestible way. This is a feat in itself and worthy of praise. There is an appropriate use of tables and figures to support the written content. Finally, the author provides excellent conclusions that bring together the salient points and issues in each chapter. The publisher promotes that this edition includes new material on health workforce, patient safety and medical and health insurance. The Australian health care system delivers on this claim, providing useful insights and a deeper understanding of the issues that confront the future direction and delivery of health services in this country. This text is a useful addition to any library as well as a staple for students needing to more clearly understand the complexities and challenges of the Australian health care system. My only suggestion is that the text could have been enhanced by the inclusion of revision or reflective questions at the end of each chapter. In summary, a must-have as part of a good health-related library.

scholarly journals Poverty Alleviation Programme and Poverty Reduction in Anambra State. Evidence from Women Business Ownership

2020 ◽  
Vol 7 (1) ◽  
pp. 217-229
Author(s):  
Joan N. Ozoh ◽  
Amaka G. Metu ◽  
Chukwuka Stephen M. ◽  
Chinwe Madueke
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Poverty Reduction ◽  
Sampling Technique ◽  
Good Health ◽  
Poor People ◽  
Anambra State ◽  
The Government ◽  
Good Health Care ◽  
Care System

The fight against poverty is one of the key components of the development of any country. If the percentage of poor people is high, there will be slow development. The government policies and program such as YOUWIN, Better Life is aimed at encouraging entrepreneurship and supporting women into business. Despite these efforts, poverty incidence still increases among women in micro business. This study examined government alleviation programs and dimension of poverty among women into micro business in Anambra state, Nigeria. It is a descriptive survey research. Probability and non- probability sampling technique were employed in which the samples were drawn using multi-stage sampling and purposive sampling technique. Questionnaire was used as an instrument for data collection. Data were analyzed using descriptive statistics, chi-square and Multidimensional Poverty Index (MPI). The findings of this study showed that most women participating in micro business are not aware of poverty reduction programs and do not have access to such programs. The study also found out that most of the women still experience hardship, no access to infrastructure, no good health care system and low standard of living which indicates that poverty has not reduced. The study recommended among others that the government should target its reduction policies towards the multidimensional indicators (good infrastructure, good health care system etc.) of poverty in order to eradicate poverty.

scholarly journals Whither economic evaluation in the case of COVID-19: What can the field of mental health economics contribute within the Australian context?

2020 ◽  
Vol 54 (12) ◽  
pp. 1157-1161
Author(s):  
Cathrine Mihalopoulos ◽  
Mary Lou Chatterton ◽  
Lidia Engel ◽  
Long Khanh-Dao Le ◽  
Yong Yi Lee
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Decision Making ◽  
Health Care System ◽  
Disease Outbreaks ◽  
Well Being ◽  
Australian Health ◽  
Life Years ◽  
Mental Health Economics ◽  
Care System

COVID-19 has resulted in broad impacts on the economy and aspects of daily life including our collective mental health and well-being. The Australian health care system already faces limitations in its ability to treat people with mental health diagnoses. Australia has responded to the COVID-19 outbreak by, among other initiatives, providing reimbursement for telehealth services. However, it is unclear if these measures will be enough to manage the psychological distress, depression, anxiety and post-traumatic distress shown to accompany infectious disease outbreaks and economic shocks. Decision making has focused on the physical health ramifications of COVID-19, the avoidance of over-burdening the health care system and saving lives. We propose an alternative framework for decision making that combines life years saved with impacts on quality of life. A framework that simultaneously includes mental health and broader economic impacts into a single decision-making process would facilitate transparent and accountable decision making that can improve the overall welfare of Australian society as we continue to address the considerable challenges that the COVID-19 pandemic is creating.

scholarly journals The “little big things”: A qualitative study of ovarian cancer survivors and their experiences with the health care system.

2016 ◽  
Vol 34 (3_suppl) ◽  
pp. 252-252
Author(s):  
Ana Isabel Tergas ◽  
Ana Angarita ◽  
Angelica Cristello ◽  
Melissa Lippitt ◽  
Amanda Nickles Fader ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Health Care ◽  
Cancer Survivors ◽  
Health Care System ◽  
Well Being ◽  
Care Team ◽  
Cancer Center ◽  
Team Approach ◽  
Efficient Delivery ◽  
Care System

252 Background: Navigating a complex and ever-changing health care system can be stressful and detrimental to psychosocial well-being for patients with serious illness. This study explored women’s experiences navigating the health care system during treatment of ovarian cancer. Methods: Focus groups moderated by trained investigators were conducted with ovarian cancer survivors at an academic cancer center. Personal experiences with cancer treatment, provider relationships, barriers to care, and the health care system were explored. Sessions were audiotaped, transcribed, and coded using grounded theory. Subsequent one-on-one interviews were conducted to further evaluate common themes. Results: Sixteen ovarian cancer survivors with a median age of 59 years participated in the focus group study.Provider consistency, personal touch, and patient advocacy positively impacted care experience.Treatment with a known provider, who was well acquainted with the individual’s medical history, was deemed an invaluable aspect of care. Negative experiences that burdened patients, referred to as the “Little Big Things”, included systems-based challenges: scheduling, wait times, pharmacy, transportation, parking, financial, insurance and discharge. Consistency, a “care-team” approach, effective communication, and efficient connection to resources were suggested as ways to improve patients’ experiences. Conclusions: Systems-based challenges were perceived as burdens to ovarian cancer survivors. The role of a consistent, accessible care team and efficient delivery of resources in the care of women with ovarian cancer should be explored further.

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