Implementation of WHO package of essential non-communicable disease interventions in the occupied Palestinian territory: assessment of patient perceptions to changes in quality of care with participatory ranking methods

Abstract Objective To determine the association between the utilization of the Ghana National Health Insurance Scheme (NHIS) and patient perceptions of quality of care. Methods Ghana Demographic and Health Survey (GDHS) 2014 had 19 questions on perceptions of quality of care received during the last reported health visit (n = 4332). These questions were summarized into an overall 100-point perception score using item response theory (IRT). Patients were divided into three utilization categories: those paying with their NHIS card fully, those paying with their card and out-of-pocket (OOP), and those paying fully OOP. A multiple linear regression model was used to measure the association between NHIS utilization and overall perception. Results In general, NHIS utilization was negatively associated with overall perception, and the difference across utilization categories was higher among private facility users than public facility users. Among private facilities, those who paid fully with NHIS reported five points lower than those who paid fully OOP (P = 0.005). Among public facilities, the difference is only 1.7 (P = 0.4342). Conclusion NHIS utilization was a negative predictor for patient perceptions, but the differences are more nuanced according to type of facility. Future GDHS rounds should continue measuring perceptions in aid of policy to improve service delivery under the NHIS.

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Characteristics of Syrian and Lebanese Diabetes and Hypertension Patients in Lebanon

The Open Hypertension Journal ◽

10.2174/1876526201810010060 ◽

2018 ◽

Vol 10 (1) ◽

pp. 60-75 ◽

Cited By ~ 2

Author(s):

Shannon Doocy ◽

Emily Lyles ◽

Zeina Fahed ◽

Abdalla Mkanna ◽

Kaisa Kontunen ◽

...

Keyword(s):

Cohort Study ◽

Quality Of Care ◽

Health Status ◽

Treatment Guidelines ◽

Communicable Disease ◽

Low Cost ◽

Health Care Facilities ◽

Longitudinal Cohort Study ◽

Longitudinal Cohort

Background:Given the protracted nature of the crisis in Syria, the large caseload of Syrian refugee patients with non-communicable diseases, and the high costs of providing non-communicable disease care, implications for Lebanon’s health system are vast.Objective:To provide a profile of the health status of diabetes and hypertension patients enrolled in a longitudinal cohort study in Lebanon.Methods:A longitudinal cohort study was implemented from January 2015 through August 2016 to evaluate the effectiveness of treatment guidelines and an mHealth application on the quality of care and health outcomes for patients in primary health care facilities in Lebanon offering low-cost services serving both Syrian refugees and Lebanese host communities. This paper presents baseline characteristics of enrolled patients, providing an overall health status profile.Results:Among participants, 11.5% of patients with hypertension and 9.7% of patients with diabetes were previously undiagnosed. Quality of care, measured as the proportion of patients with biometrics reported and whose condition is controlled, is less than ideal and varied by geographic location. Controlled blood pressure measurements were observed in 64.2% of patients with hypertension; HbA1C values indicated diabetes control in 43.5% of the patients.Conclusion:Differences in diagnostic history and disease control between Syrian and Lebanese patients and across geographic regions were observed, which could be applied to inform strategies aimed at improving diagnosis and quality of care for hypertension and diabetes in primary care settings in Lebanon.

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The Effect of Socio-Economic Status on Food Quality in West of Iran

10.21203/rs.3.rs-141402/v1 ◽

2021 ◽

Author(s):

Mahin Amini ◽

farid najafi ◽

yahya pasdar ◽

mehnoosh samadi ◽

ali kazemi karyani ◽

...

Keyword(s):

Low Socioeconomic Status ◽

Communicable Disease ◽

Economic Status ◽

Population Based ◽

Healthy Eating Index ◽

Low Socioeconomic ◽

Socio Economic Status ◽

Health Related ◽

Non Communicable Disease

Abstract BackgroundSocio-economic status affects many health-related outcomes and one of the most important factors is the pattern and quality of nutrition. Thus, this study is carried out to investigate the effect of socio-economic status on the quality of nutrition based on healthy Eating Index (HEI).MethodsThis is a population-based study using the baseline data from Ravansar Non-Communicable Disease cohort study. HEI calculated from Food Frequency Questionnaire. The quality of nutrition was assessed based on HEI-2015 which evaluates 13 food groups.ResultsThe mean of age of the participants was 48.02 (SD = ±8.27) years. The median and mean of HEI in the studied population were 53 and 53.69 (SD = ±7.34), respectively. Women, the educated, city dwellers, people of higher socioeconomic classes, and non-smokers had greater odds of having higher quality of nutrition. The worst score among all components of HEI were for the refined grains and then the whole grain, and the highest score was obtained for the tatal protein foods. ConclusionsDue to low nutritional quality and its adverse effects, especially in people with low socioeconomic status and villagers, the quality of nutrition, especially in the poor, should be promoted with proper interventions so as to reduce disparity in the society.

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Provider interruptions and patient perceptions of care: an observational study in the emergency department

BMJ Quality & Safety ◽

10.1136/bmjqs-2018-007811 ◽

2018 ◽

Vol 28 (4) ◽

pp. 296-304

Author(s):

Anna Schneider ◽

Markus Wehler ◽

Matthias Weigl

Keyword(s):

Emergency Department ◽

Quality Of Care ◽

Multiple Testing ◽

Linear Models ◽

Waiting Times ◽

Patient Perceptions ◽

Tertiary Referral Hospital ◽

Positive Effects ◽

Perceptions Of Care

BackgroundInterruptions are endemic in healthcare work environments. Yet, they can have positive effects in some instances and negative in others, with their net effect on quality of care still poorly understood. We aimed to distinguish beneficial and detrimental forms of interruptions of emergency department (ED) providers using patients’ perceptions of ED care as a quality measure.MethodsAn observational design was established. The study setting was an interdisciplinary ED of an academic tertiary referral hospital. Frequencies of interruption sources and contents were identified in systematic expert observations of ED physicians and nurses. Concurrently, patients rated overall quality of care, ED organisation, patient information and waiting times using a standardised survey. Associations were assessed with hierarchical linear models controlling for daily ED workload. Regression results were adjusted for multiple testing. Additionally, analyses were computed for ED physicians and nurses, separately.ResultsOn 40 days, 160 expert observation sessions were conducted. 1418 patients were surveyed. Frequent interruptions initiated by patients were associated with higher overall quality of care and ED organisation. Interruptions relating to coordination activities were associated with improved ratings of ED waiting times. However, interruptions containing information on previous cases were associated with inferior ratings of ED organisation. Specifically for nurses, overall interruptions were associated with superior patient reports of waiting time.ConclusionsProvider interruptions were differentially associated with patient perceptions of care. Whereas coordination-related and patient-initiated interruptions were beneficial to patient-perceived efficiency of ED operations, interruptions due to case-irrelevant communication were related to inferior patient ratings of ED organisation. The design of resilient healthcare systems requires a thorough consideration of beneficial and harmful effects of interruptions on providers’ workflows and patient safety.

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