Caring for care: Online feedback in the context of public healthcare services

AbstractThis article examines how recent judgments of the European Court of Justice have interpreted the concept of a service of general interest in Article 86(2) EC in the delivery of healthcare services. The article explores how and why the Court has afforded greater latitude to Member States in organizational matters by not applying competition rules. By contrast, the Court has actively promoted patient mobility and has not applied the derogation in Article 86(2) EC where it would restrict the free movement of services. Does the Court's policy of protecting individual rights undermine the ability of Member States to deliver a universal healthcare service within finite resources?

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Innovation in healthcare services: notes on the limits of field research

Cadernos de Saúde Pública ◽

10.1590/0102-311x00151915 ◽

2016 ◽

Vol 32 (suppl 2) ◽

Author(s):

Laís Silveira Costa

Keyword(s):

Population Aging ◽

Field Research ◽

Healthcare Services ◽

Healthcare Systems ◽

Public Healthcare ◽

Social Changes ◽

Public And Private ◽

Disease Characteristics ◽

Health And Disease ◽

Current Article

Abstract: The contemporary context of population aging, itsthe population's different health and disease characteristics, and the growing incorporation of technologies by healthcare systems have highlighted the need to adjust the healthcare structure as a whole. The defense of a democratic and sustainable system reveals the importance of understanding how changes in healthcare take place. The current article aims to contribute to the understanding of innovation in healthcare services. The study's results indicate that the existence of certain knowledge gaps means that public policies tend to overlook a whole rangeseries of innovations normally associated with social changes, with a consequentwith an impact on human development, social cohesion, equality, and equity, allcentral issues that are central toin the field of collective public healthcare field. The article concludes that the lack of a mature theoretical framework negatively impacts the formulation of such policies, further aggravated in Brazil by growing differences in quality and access between population segments that depend on the public and private healthcare systems.

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Persuasion Tactics in the Implementation of Large-Scale EHR Suites in Public Healthcare

10.3233/shti210632 ◽

2021 ◽

Author(s):

Gunnar Ellingsen ◽

Bente Christensen ◽

Morten Hertzum

Keyword(s):

Large Scale ◽

Healthcare Services ◽

Governance Structure ◽

Public Healthcare ◽

Technical Literature ◽

Health Authorities ◽

To Come ◽

Regional Health Authorities ◽

Entrepreneurial Role ◽

The U.S

Large-scale electronic health record (EHR) suites have the potential to cover a broad range of use needs across various healthcare domains. However, a challenge that must be solved is the distributed governance structure of public healthcare: Regional health authorities regulate hospitals, municipalities are responsible for first-line healthcare services, and general practitioners (GPs) have an independent entrepreneurial role. In such settings, EHR program owners cannot enforce municipalities and GPs to come on board. Thus, we examine what tactics owners of large-scale EHR suite programs apply to persuade municipalities to participate, how strongly these tactics are enforced, and the consequences. Empirically, we focus on the Health Platform program in Central Norway where the goal is to implement the U.S. Epic EHR suite in 2022. Theoretically, the paper is positioned in the socio-technical literature.

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ICT Framework to Support a Patient-Centric approach in Public Healthcare

The Journal of Community Informatics ◽

10.15353/joci.v16i0.3494 ◽

2020 ◽

Vol 16 ◽

pp. 45-76

Author(s):

Richard Pankomera ◽

Darelle Van Greunen

Keyword(s):

Public Health ◽

Information And Communication Technologies ◽

Health Sector ◽

Cost Effective ◽

Healthcare Services ◽

Healthcare Sector ◽

Public Healthcare ◽

Structured Interviews ◽

Poor Countries ◽

Patient Centric

Although Information and Communication Technologies (ICTs) in the healthcare sector are extensively deployed globally, they are not used effectively in developing countries. Many resource poor countries face numerous challenges in implementing the ICT interventions. For instance, many health applications that have been deployed are not user-centric. As a result, such ICT interventions do not benefit many health consumers. The lack of an ICT framework to support patient-centric healthcare services in Malawi renders the e-health and mhealth interventions less sustainable and less cost effective. The aim of the study was therefore to develop an ICT Framework that could support patient-centric healthcare services in the public health sector in Malawi. The comprehensive literature review and semi-structured interviews highlighted many challenges underlying ICT development in Malawi. An ICT framework for patient-centric healthcare services is therefore proposed to ensure that eHealth and mobile health interventions are more sustainable and cost effective. The framework was validated by five experts selected from different areas of expertise including mhealth application developers, ICT policy makers and public health practitioners. Results show that the framework is relevant, useful and applicable within the setting of Malawi. The framework can also be implemented in various countries with similar settings.

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Intimate Labor at Biomedical Frontlines: Situated Knowledges of Female Community Health Workers in the Management of COVID-19 in India

Catalyst Feminism Theory Technoscience ◽

10.28968/cftt.v7i1.34781 ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Sanghamitra Das ◽

Samhita Das

Keyword(s):

Community Health ◽

Community Health Workers ◽

Health Workers ◽

Medical Knowledge ◽

Healthcare Services ◽

Care Work ◽

Professional Status ◽

Public Healthcare ◽

The Public ◽

Female Community

Media reports of the COVID-19 pandemic in India have highlighted the important role that India’s female community health workers, the Accredited Social Health Activists (ASHAs), have played in managing COVID infections in India. This paper explores the epistemic basis of ASHA work to understand the significance of their role. Through a discourse analysis of textual media articles, we show that the ASHAs’ routine and COVID-related caregiving practices are a form of embodied, intimate labor rooted in their situated, community-oriented knowledge. This labor is devalued as emotional and feminized care work, which denies the ASHAs professional status in the public healthcare system of India and, in turn, reflects a hierarchy among health practitioners that stems from the status of objectivity/disembodiment in biomedicine. We find that, despite their low status in the public health system, ASHA workers develop a self-concept that enables them to self-identify as healthcare professionals, motivating them to continue providing essential healthcare services during the pandemic. We argue that an official recognition of the epistemic value of ASHA work would help to overcome the age-old nature/culture dichotomy that informs what counts as valuable, legitimate, formal medical knowledge. Furthermore, our analysis provides a critique of the gendered devaluation of care work within a political economy of health increasingly dictated by a neoliberal logic.

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A comparison of the levels of satisfaction with the medical services provided by primary healthcare centers in selected communes in Lubelskie Voivodeship

Polish Journal of Public Health ◽

10.1515/pjph-2016-0002 ◽

2016 ◽

Vol 126 (1) ◽

pp. 8-12

Author(s):

Daria Przybylska ◽

Piotr Przybylski ◽

Bartłomiej Drop ◽

Krzysztof Czarnocki ◽

Wojciech Przybylski ◽

...

Keyword(s):

Family Medicine ◽

Primary Healthcare ◽

The Elderly ◽

Healthcare Services ◽

Medical Services ◽

Public Healthcare ◽

Healthcare Facilities ◽

Primary Type ◽

Primary Healthcare Centers

Abstract Introduction. Family medicine remains the primary type of medical services in Poland and it is supposed to treat both individual patients and the society as a whole. Due to the growing commercialization of the health service, most primary healthcare centers have transformed into non-public healthcare facilities. The public ones (called SPZOZ in Polish) account only for a small fraction of the whole number of primary healthcare facilities. The quality of medical services provided by such facilities, as patients see it, remains one of the key elements determining the development of family medicine centers. Aim. The aim of this paper was to assess patient satisfaction levels regarding the healthcare services they received in two primary healthcare institutions, both of the NZOZ and SPZOZ type, in a small town located close to Lublin. Material and methods. An anonymous survey was filled out by 30 patients of both a public and non-public healthcare center located in Niemce (Niemce Commune, Lublin District). The quality of services was assessed using an original questionnaire in the form of a poll. Results. The results obtained indicate a clear relationship between one’s trust to the physician, diagnosis accuracy and visiting the particular center again, in order to continue the treatment. For older subjects, it was nurses’ kindness and politeness that was the most important. The elderly appreciated the kindness and politeness of the nurses in particular. No significant differences were found between the institutions in respect of the overall perception of satisfaction with services. In terms of infrastructure assessment, the majority of positive feedback was provided for NZOZ. Conclusions. The findings above suggest that it is essential to conduct surveys on a regular basis, in order to check patients’ assessment of the service quality in various institutons.

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Managers do it their way: How managers act in a decentralised healthcare services provider organisation – a mixed methods study

Health Services Management Research ◽

10.1177/09514848211065467 ◽

2021 ◽

pp. 095148482110654

Author(s):

Mikael Ohrling ◽

Sara Tolf ◽

Karin Solberg-Carlsson ◽

Mats Brommels

Keyword(s):

Content Analysis ◽

Service Delivery ◽

Healthcare Delivery ◽

Healthcare Services ◽

Management Model ◽

Public Healthcare ◽

Healthcare Organisation ◽

Programme Theory ◽

Local Conditions ◽

Community Healthcare

Purpose: Decentralisation is considered a way to get managers more committed and more prone to respond to local needs. This study analyses how managers perceive a decentralised management model within a large public healthcare delivery organisation in Sweden. Design/methodology/approach: A programme theory evaluation was performed applying direct content analysis to in-depth interviews with healthcare managers. Balance score card data were used in a blinded comparative content analysis to explore relations between performance and how the delegated authority was perceived and used by the managers. Findings: Managers’ perceptions of the decentralised management model supported its intentions to enable the front-line to make decisions to better meet customer needs and flexibly adapt to local conditions. The managers appreciated and used their delegated authority. Central policies and control on human resources and investments were accepted as those are to the benefit of the whole organisation. Leadership development and organisation-wide improvement programmes were of support. Units showing high organisational performance had proactive managers, although differences in manager perceptions across units were small. Originality: This, one of the first of its kind, study of a decentralisation in service delivery organisation shows a congruence between the rationale of a management model, the managers’ perceptions of the authority and accountability as well as management practises. These observations stemming from a large public primary and community healthcare organisation has not, to our knowledge, been reported and provide research-informed guidance on decentralisation as one strategy for resolving challenges in healthcare service delivery organisations.

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Assessment of Healthcare Service Quality

Advances in Human Services and Public Health - Global Issues and Innovative Solutions in Healthcare, Culture, and the Environment ◽

10.4018/978-1-7998-3576-9.ch014 ◽

2020 ◽

pp. 271-291

Author(s):

Segufta Dilshad ◽

Afsana Akhtar ◽

S. S. M. Sadrul Huda ◽

Nandeeta Samad

Keyword(s):

Service Quality ◽

Quality Measurement ◽

Healthcare Services ◽

Public Hospitals ◽

Public Healthcare ◽

Research Approach ◽

Healthcare Facilities ◽

Level Of Satisfaction ◽

Related Quality ◽

Private And Public

The service quality measurement of healthcare services is always a big concern for the hospitals, patient rights activists, regulators, and general patients. This study deals with quality assessment of healthcare facilities concerning the private and public health facilities of Dhaka, Bangladesh. This study follows the survey research approach. Using the purposive sampling method, the individuals have been selected from households who have received healthcare services from public or private hospitals of Dhaka city in last year. The study collected data among 410 respondents. Standard statistical software (i.e., SPSS and STATA) have been used to analyze the data. This study confirms existing evidence that Bangladeshi patients have a growing concern with lower level of satisfaction in public healthcare services. The respondents faced multi-dimensional problems, characterized by a low level of overall service quality, interpersonal service quality, and technical or treatment-related quality at public hospitals. Further research is recommended to analyze the issues further.

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