Dynamic, robust models to quantify the impact of decentralization in post-disaster health care facility location decisions

2017 ◽  
Vol 12 ◽  
pp. 43-59 ◽  
Author(s):  
Luke Muggy ◽  
Jessica L. Heier Stamm
Keyword(s):  
Health Care ◽  
Facility Location ◽  
Care Facility ◽  
Health Care Facility ◽  
Location Decisions ◽  
The Impact ◽  
Post Disaster

scholarly journals The impact of introducing ambulance and delivery fees in a rural hospital in Tanzania.

2020 ◽  
Author(s):  
Corinna Vossius ◽  
Estomih Md ◽  
Robert Moshiro ◽  
Paschal M ◽  
Jan Terje Kvaløy ◽  
...  
Keyword(s):  
Health Care ◽  
Access To Health Care ◽  
Low Birthweight ◽  
Care Facility ◽  
Health Care Facility ◽  
Skilled Birth Attendance ◽  
Health Care Facilities ◽  
Birth Attendance ◽  
Vaginal Deliveries ◽  
The Impact

Abstract Background: Access to health care facilities is a key requirement to enhance safety for mothers and newborns during labour and delivery. Haydom Lutheran Hospital (HLH) is a regional hospital in rural Tanzania with a catchment area of about two million inhabitants. Up to June 2013 ambulance transport and delivery at HLH were free of charge, while a user fee for both services was introduced from January 2014. We aimed to explore the impact of introducing user fees on the population of women giving birth at HLH in order to document potentially unwanted consequences in the period after introduction of fees . Methods: Retrospective analysis of data from a prospective observational study. Data was compared between the period before introduction of fees from February 2010 through June 2013 and the period after from January 2014 through January 2017. Logistic regression modelling was used to construct risk-adjusted variable-life adjusted display (VLAD) and cumulative sum (CUSUM) plots to monitor changes. Results: A total of 28,601 births were observed. The monthly number of births was reduced by 17.3% during the post-introduction period. Spontaneous vaginal deliveries were registered less frequently, while labour complication and caesarean sections were more frequent. There was a reduction of newborns with birth weight less than 2500 grams. The observed changes were stable over time. For most variables, a significant change could be detected after a few weeks. Conclusion: After the introduction of ambulance and delivery fees an increase in labour complications and caesarean sections of about 80 per 1000 births and a decrease in non-cephalic presentations and newborns with low birthweight of about 17 per 1000 births each was observed. This might indicate that women delay the decision to seek skilled birth attendance or do not seek help at all, possibly due to financial reasons. Lower rates of births in a safe health care facility like HLH is of great concern, as access to skilled birth attendance is a key requirement in order to further reduce perinatal mortality. Therefore, free delivery care should be a high priority.

scholarly journals Nursing dress code and perception of a nurse by patients

2019 ◽  
Vol 18 (1) ◽  
pp. 60-67
Author(s):  
Piotr Pawłowski ◽  
Paulina Mazurek ◽  
Magdalena Zych ◽  
Katarzyna Zuń ◽  
Beata Dobrowolska
Keyword(s):  
Health Care ◽  
Care Facility ◽  
Health Care Facility ◽  
Dress Code ◽  
Medical Interventions ◽  
Online Databases ◽  
Administrative Employees ◽  
Strategy Planning ◽  
Professional Image ◽  
The Impact

AbstractIntroduction. Professional image of the nurse in the opinion of the patient community is conditioned by many variables, including professional attire. A worthy representation of the nurse profession is the responsibility of all those who care for the patient.Aim. Determining the impact of dress code on shaping the professional image of nurses in the opinion of patients.Material and methods. Non-systematic review method of the literature available. The data was obtained by searching online databases, such as: Google Scholar, PubMed, CINAHL Complete as well as electronic resources of nursing magazines.Results. In the perception of hospitalized patients, the nursing dress code affects the level of trust in those who care for patients, it also constitutes an important element in assessing their professionalism, knowledge or confidence when performing specific medical interventions. Adapted to the needs, a suitably selected style of professional attire of a nurse employed in a given health care facility enables her proper identification of them against the background of other members of the therapeutic team or administrative employees. In addition, the comfort of nurses is a significant factor for patients in dress code strategy planning; it often determines professionalism and quality of services provided.Conclusions. There is a relationship between the external appearance of nurses and their professional image and the patients’ perception of their professional skills as well as the level of their professionalism. Dress code in a health care facility may constitute a significant element of image policy for both a health care facility itself and a group of nurses.

scholarly journals The impact of introducing ambulance and delivery fees in a rural hospital in Tanzania.

2020 ◽  
Author(s):  
Corinna Vossius ◽  
Hege Ersdal ◽  
Jan Terje Kvaløy ◽  
Paschal M ◽  
Estomih Md ◽  
...  
Keyword(s):  
Health Care ◽  
Access To Health Care ◽  
Low Birthweight ◽  
Care Facility ◽  
Health Care Facility ◽  
Skilled Birth Attendance ◽  
Health Care Facilities ◽  
Birth Attendance ◽  
Vaginal Deliveries ◽  
The Impact

Abstract Background: Access to health care facilities is a key requirement to enhance safety for mothers and newborns during labour and delivery. Haydom Lutheran Hospital (HLH) is a regional hospital in rural Tanzania with a catchment area of about two million inhabitants. Up to June 2013 ambulance transport and delivery at HLH were free of charge, while a user fee for both services was introduced from January 2014. We aimed to explore the impact of introducing user fees on the population of women giving birth at HLH in order to document potentially unwanted consequences in the period after introduction of fees . Methods: Retrospective analysis of data from a prospective observational study. Data was compared between the period before introduction of fees from February 2010 through June 2013 and the period after from January 2014 through January 2017. Logistic regression modelling was used to construct risk-adjusted variable-life adjusted display (VLAD) and cumulative sum (CUSUM) plots to monitor changes. Results: A total of 28,601 births were observed. The monthly number of births was reduced by 17.3% during the post-introduction period. Spontaneous vaginal deliveries were registered less frequently, while labour complication and caesarean sections were more frequent. There was a reduction of newborns with birth weight less than 2500 grams and an increase in newborns weighing more than 4000 grams. The observed changes were stable over time. For most variables, a significant change could be detected after a few weeks. Conclusion: After the introduction of ambulance and delivery fees an increase in labour complications and caesarean sections of about 80 per 1000 births and a decrease in non-cephalic presentations and newborns with low birthweight of about 17 per 1000 births each was observed. This might indicate that women delay the decision to seek skilled birth attendance or do not seek help at all, possibly due to financial reasons. Lower rates of births in a safe health care facility like HLH is of great concern, as access to skilled birth attendance is a key requirement in order to further reduce perinatal mortality. Therefore, free delivery care should be a high priority.

scholarly journals The impact of introducing ambulance and delivery fees in a rural hospital in Tanzania

2020 ◽  
Author(s):  
Corinna Vossius ◽  
Estomih Md ◽  
Robert Moshiro ◽  
Paschal M ◽  
Jan Terje Kvaløy ◽  
...  
Keyword(s):  
Health Care ◽  
Access To Health Care ◽  
Low Birthweight ◽  
Care Facility ◽  
Health Care Facility ◽  
Skilled Birth Attendance ◽  
Health Care Facilities ◽  
Birth Attendance ◽  
Vaginal Deliveries ◽  
The Impact

Abstract Background:Access to health care facilities is a key requirement to enhance safety for mothers and newborns during labour and delivery. Haydom Lutheran Hospital (HLH) is a regional hospital in rural Tanzania with a catchment area of about two million inhabitants. Up to June 2013 ambulance transport and delivery at HLH were free of charge, while a user fee for both services was introduced from January 2014. We aimed to explore the impact of introducing user fees on the population of women giving birth at HLH in order to document potentially unwanted consequences in the period after introduction of fees.Methods:Retrospective analysis of data from a prospective observational study. Data was compared between the period before introduction of fees from February 2010 through June 2013 and the period after from January 2014 through January 2017. Logistic regression modelling was used to construct risk-adjusted variable-life adjusted display (VLAD) and cumulative sum (CUSUM) plots to monitor changes.Results:A total of 28,601 births were observed. The monthly number of births was reduced by 17.3% during the post-introduction period. Spontaneous vaginal deliveries were registered less frequently with a decrease of about 17/1000 births in non-cephalic presentations. Labour complications and caesarean sections increased with about 80/1000 births. There was a reduction in newborns with birth weight less than 2500 grams. The observed changes were stable over time. For most variables, a significant change could be detected after a few weeks.Conclusion:After the introduction of ambulance and delivery fees, an increase in labour complications and caesarean sections and newborns with low birthweight were observed. This might indicate that women delay the decision to seek skilled birth attendance or do not seek help at all, possibly due to financial reasons. Lower rates of births in a safe health care facility like HLH is of great concern, as access to skilled birth attendance is a key requirement in order to further reduce perinatal mortality. Therefore, free delivery care should be a high priority.

scholarly journals The impact of reducing financial barriers on utilisation of a primary health care facility in Rwanda

2012 ◽  
Vol 7 (1) ◽  
pp. 71-86 ◽  
Author(s):  
Ranu S. Dhillon ◽  
Matthew H. Bonds ◽  
Max Fraden ◽  
Donald Ndahiro ◽  
Josh Ruxin
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Care Facility ◽  
Health Care Facility ◽  
Primary Health Care Facility ◽  
Financial Barriers ◽  
Primary Health ◽  
The Impact

scholarly journals Gut microbiota composition in health-care facility-and community-onset diarrheic patients with Clostridioides difficile infection

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Giovanny Herrera ◽  
Laura Vega ◽  
Manuel Alfonso Patarroyo ◽  
Juan David Ramírez ◽  
Marina Muñoz
Keyword(s):  
Health Care ◽  
Gut Microbiota ◽  
Care Facility ◽  
Health Care Facility ◽  
Influential Factors ◽  
Clostridioides Difficile ◽  
Clostridioides Difficile Infection ◽  
The Impact ◽  
Positive Groups ◽  
Community Onset

AbstractThe role of gut microbiota in the establishment and development of Clostridioides difficile infection (CDI) has been widely discussed. Studies showed the impact of CDI on bacterial communities and the importance of some genera and species in recovering from and preventing infection. However, most studies have overlooked important components of the intestinal ecosystem, such as eukaryotes and archaea. We investigated the bacterial, archaea, and eukaryotic intestinal microbiota of patients with health-care-facility- or community-onset (HCFO and CO, respectively) diarrhea who were positive or negative for CDI. The CDI-positive groups (CO/+, HCFO/+) showed an increase in microorganisms belonging to Bacteroidetes, Firmicutes, Proteobacteria, Ascomycota, and Opalinata compared with the CDI-negative groups (CO/−, HCFO/−). Patients with intrahospital-acquired diarrhea (HCFO/+, HCFO/−) showed a marked decrease in bacteria beneficial to the intestine, and there was evidence of increased Archaea and Candida and Malassezia species compared with the CO groups (CO/+, CO/−). Characteristic microbiota biomarkers were established for each group. Finally, correlations between bacteria and eukaryotes indicated interactions among the different kingdoms making up the intestinal ecosystem. We showed the impact of CDI on microbiota and how it varies with where the infection is acquired, being intrahospital-acquired diarrhea one of the most influential factors in the modulation of bacterial, archaea, and eukaryotic populations. We also highlight interactions between the different kingdoms of the intestinal ecosystem, which need to be evaluated to improve our understanding of CDI pathophysiology.

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