International differences in the value for money provided by institutions in european countries at different stages of deinstitutionalisation and with different economies

2011 ◽  
Vol 26 (S2) ◽  
pp. 2146-2146
Author(s):  
T.L. Taylor

BackgroundIndividuals with a diagnosis of schizophrenia or schizoaffective disorder may require longer term care. Due to the complexities of caring for this population and the high resource cost of care, it is important to ensure that mental health services are efficient and effective.AimsThis investigation aims to examine international differences in quality of care and service user experience when compared to national health expenditure and the degree of deinstitutionalisation in 10 countries.MethodsThe quality of care provided in 213 units was measured using the Quality Indicator for Rehabilitative Care (QuIRC). Service users living in these units (N = 1750) were asked to assess the care they received. Multilevel models were used to examine the relationships between quality (QuIRC domain ratings), level of deinstitutionalisation and national health care expenditure. As no formalised assessment of deinstitutionalisation has been published, a quantitative tool was developed and validated. Percentage of gross domestic product spent on health care and per capita total health care spend was taken from World Health Organisation data to assess national health care expenditure.ResultsMultilevel models examining the relationships between deinstitutionalisation levels, health care expenditure, quality and service user experience will be presented. Results were adjusted for unit (type and size) and service user (age, gender and level of functioning) characteristics.ConclusionsRecommendations on the best use of resources within a facility providing longer term care and how best to increase the quality of care provided without additional financial expenditure will be discussed in relation to the results.

2021 ◽  
Vol 8 ◽  
pp. 237437352098147
Author(s):  
Temitope Esther Olamuyiwa ◽  
Foluke Olukemi Adeniji

Introduction: Patient satisfaction is a commonly used indicator for measuring the quality of health care. This study assessed patients’ satisfaction with the quality of care at the National Health Insurance Scheme (NHIS) clinic in a tertiary facility. Methods: It was a descriptive cross-sectional study in which 379 systematically selected participants completed an interviewer-administered, semi-structured questionnaire. Data were analyzed using Statistical Package for Social Sciences (SPSS) version 23. Bivariate analysis was performed using Pearson χ2 with a P value set at ≤ .05. Results: The study found out that about half (193, 50.9%) of the respondents were satisfied with the availability of structure. Patients were not satisfied with waiting time in the medical records, account, laboratory, and pharmacy sections. Overall, 286 (75.5%) of the respondents were satisfied with the outcome of health care provided at the NHIS clinic. A statistically significant association ( P = .00) was observed between treatment outcome and patient satisfaction. Conclusion: There is a need to address structural deficiencies and time management at the clinic.


2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
P Margozzini ◽  
A Passi ◽  
M Kruk ◽  
G Danaei

Abstract Background Chilean Health System has fully implemented Universal Health Coverage (UHC) for acute cardiovascular events since 2005. Age-adjusted cardiovascular mortality has decreased, but there is limited information about coverage and quality of chronic health care given to cardiovascular disease (CVD) survivors at the national level. Purpose To assess the prevalence and quality of care in Chilean adult CVD survivors. Methods Chilean National Health Survey 2016–2017 (ENS 2016–2017) is a random stratified multistage sample of non-institutionalized population over 14 years (n=6240). Age, education, gender, rural/urban and geographical area weighted prevalence of CVD survivors (self-reported medical diagnosis of myocardial infarction or cerebrovascular attack) were calculated. High quality of care was defined as meeting six criteria simultaneously: under 70mg% LDL- C level, statin use, aspirin use, blood pressure under 130/80 mmHg, HgA1C<7 or 8 (>74-year-old) and non-smoking. Quality of care was explored using multivariate linear and logistic regression adjusting by age, gender, education and year of diagnosis (before or after UHC). Results Weighted national prevalence of CVD survivors in over 20-year-old population was 6.1%. The sample size for the CVD survivor analyses was n=455. 28.7% of CVS had their first event before the year 2005 (n=141). Overall 27.9% had LDL-C under 70mg%, 37.8% used statins, 41.4% used aspirin, 37.8% had controlled blood pressure, 78.3% were non-smokers and 84.3% had good glycemic control. National “high quality of care” prevalence in CVD survivors was 0.3%, 0.4% and 0.1% for men and women respectively. LDL and Blood pressure control prevalence (meet both criteria simultaneously) was 4,4%. In the adjusted multivariate model age was associated to a higher number of quality criteria achievement. Conclusion The number of CVD survivors in Chile is a huge challenge for the health care system. Universal coverage does not guarantee the quality of chronic life long care. Specific surveillance in high-risk population is needed to assess the system's effectiveness and accountability. Acknowledgement/Funding ENS 2016-2017 was funded by the chilean Ministry of Health (MINSAL)


2017 ◽  
Vol 42 ◽  
pp. 95-102 ◽  
Author(s):  
T. Taylor Salisbury ◽  
H. Killaspy ◽  
M. King

AbstractBackgroundThe process of deinstitutionalization (community-based care) has been shown to be associated with better quality of life for those with longer-term mental health problems compared to long stay hospitals. This project aimed to investigate the relationship between national progress towards deinstitutionalization and (1) quality of longer-term mental health care (2) service users’ ratings of that care in nine European countries.MethodsQuality of care was assessed in 193 longer-term hospital- and community-based facilities in Bulgaria, Germany, Greece, Italy, the Netherlands, Poland, Portugal, Spain and the UK. Data on users’ ratings of care were collected from 1579 users of these services. Country level variables were compiled from publicly available data. Multilevel models were fit to assess associations with quality of care and service user experiences of care.ResultsSignificant positive associations were found between deinstitutionalization and (1) five of seven quality of care domains; and (2) service user autonomy. A 10% increase in expenditure was associated with projected clinically important improvements in quality of care.ConclusionsGreater deinstitutionalization of mental health mental health services is associated with higher quality of care and better service user autonomy.


2013 ◽  
Vol 28 (6) ◽  
pp. 719-726 ◽  
Author(s):  
A. Langenbruch ◽  
M. Radtke ◽  
N. Franzke ◽  
J. Ring ◽  
R. Foelster-Holst ◽  
...  

2014 ◽  
Vol 23 (3) ◽  
pp. 182-4 ◽  
Author(s):  
Tokihiko Sawada ◽  
Hirohisa Kawahara

Japan has long operated a government-based health insurance system covering the entire population, and has been focusing on strategies for balancing viable national health care services with the need to minimize national health care expenditure. Hemodialysis (HD) is a representative form of medical treatment that is expected to expand in Indonesia in the near future, and which will require sustained financial support from the national health insurance system. In this report, consecutive to our previous one, we describe how the Japanese government has attempted to minimize medical expenditure in the past, focusing especially on HD.


Author(s):  
M. R. Roopashree

Background: As the rural Indian health care sector is providing patient care to the community at large, evaluating the quality of services gives an insight into the level of care provided. The primary health care chose the audit evaluation voluntarily. Objectives: The aim of the study was to assess the service quality provided in the primary health care Centre. The study was to help understand the skill set requirements in improving the quality of care and to identify the service quality gaps and to provide the best possible solutions for the gap closures by nominating the responsible personnel. Methods: The quality of care was evaluated in three ways: staff interview, record review, and observations conducted. Six departments were chosen for evaluation: the out-patient department, in-patient department, labor room, laboratory, National health programs, and general administration. By a prepared specific checklist comprised of standards and measurable elements, an evaluation was performed. The scoring was provided as 0, 1and 2, which implied noncompliance, partial compliance, and full compliance. Results: As per evaluation, national health program areas scored the least, whereas the inpatient departments scored the highest.  There were multiple gaps in the service provision areas and manpower allocation. The average mean score was 77.48. Conclusion: Keeping the national standards and guidelines, an audit evaluation was performed. Quality has to be imbibed with the optimization of resource allocation and with the mindset to provide the best possible care in the interest of the individual's wellbeing.


2021 ◽  
Author(s):  
Jenny Ploeg ◽  
Sharon Kaasalainen ◽  
Carrie McAiney ◽  
Ruth Martin-Misener ◽  
Faith Donald ◽  
...  

Background Research evidence supports the positive impact on resident outcomes of nurse practitioners (NPs) working in long term care (LTC) homes. There are few studies that report the perceptions of residents and family members about the role of the NP in these settings. The purpose of this study was to explore the perceptions of residents and family members regarding the role of the NP in LTC homes. Methods The study applied a qualitative descriptive approach. In-depth individual and focus group interviews were conducted with 35 residents and family members from four LTC settings that employed a NP. Conventional content analysis was used to identify themes and sub-themes. Results Two major themes were identified: NPs were seen as providing resident and family-centred care and as providing enhanced quality of care. NPs established caring relationships with residents and families, providing both informational and emotional support, as well as facilitating their participation in decision making. Residents and families perceived the NP as improving availability and timeliness of care and helping to prevent unnecessary hospitalization. Conclusions The perceptions of residents and family members of the NP role in LTC are consistent with the concepts of person-centred and relationship-centred care. The relationships NPs develop with residents and families are a central means through which enhanced quality of care occurs. Given the limited use of NPs in LTC settings, there is an opportunity for health care policy and decision makers to address service inadequacies through strategic deployment of NPs in LTC settings. NPs can use their expert knowledge and skill to assist residents and families to make informed choices regarding their health care and maintain a positive care experience


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