Comparing Primary Health-Care Service Delivery Disruptions Across Disasters

Abstract Objective: The aim of this study was to compare primary care appointment disruptions around Hurricanes Ike (2008) and Harvey (2017) and identify patterns that indicate differing continuity of primary care or care systems across events. Methods: Primary care appointment records covering 5 wk before and after each storm were identified for Veterans Health Affairs (VA) facilities in the greater Houston and surrounding areas and a comparison group of VA facilities located elsewhere. Appointment disposition percentages were compared within and across storm events to assess care disruptions. Results: For Hurricane Harvey, 14% of primary care appointments were completed during the week of landfall (vs 33% for Hurricane Ike and 69% in comparison clinics), and 49% were completed the following week (vs 58% for Hurricane Ike and 71% for comparison clinics). By the second week after Hurricane Ike and third week after Harvey, the scheduled appointment completion percentage returned to prestorm levels of approximately 60%. Conclusions: There were greater and more persistent care disruptions for Hurricane Harvey relative to Hurricane Ike. As catastrophic emergencies including major natural disasters and infectious disease pandemics become a more recognized threat to primary and preventive care delivery, health-care systems should consider implementing strategies to monitor and ensure primary care appointment continuity.

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463 - Evaluating the Implementation of a Memory Clinic using the RE-AIM model. The experience of the “Memory and Neuropsychiatry Clinic” in Hospital del Salvador, Chile

International Psychogeriatrics ◽

10.1017/s1041610220003154 ◽

2020 ◽

Vol 32 (S1) ◽

pp. 184-185

Author(s):

T. Leon ◽

L. Castro ◽

F. Mascayano ◽

BA. Lawlor ◽

A. Slachevsky

Keyword(s):

Primary Care ◽

Health Care ◽

Latin American ◽

Care Service ◽

Care Center ◽

Health Care Service ◽

Multidisciplinary Teams ◽

Outpatient Services ◽

Health Care Center ◽

Dementia Patients

AbstractThe prevalence of dementia in Chile is 1.06 %, meaning that over 200,000 people are affected. In 2017, the Ministry of Health launched the National Plan of Dementia, which proposed establishing a range of health-care services from primary care to Memory Units (MU).MUs have emerged as a new health care service composed of multidisciplinary teams with the goal of improving diagnosis and management of dementia patients.The creation and implementation of a MU should take into consideration the organization of a particular healthcare system. In this context, the evaluation of a Chilean MU might provide information for the standardization and replication of such a health service on a regional basis.The objective of this paper was to evaluate the implementation processes of a MU using the RE-AIM model, a multi-component model aimed to assist the evaluation of the implementation of ongoing programs.Regarding “R” (Reach): from March 2018 up to June 2019, a total of 510 patients were referred and assessed at the Hospital del Salvador. Most patients came from primary care (51.9 %) and from outpatient services at the Hospital (39.2 %), particularly from the Neurology (63.3%) and Psychiatry (16.0 %) departments. We estimated that the MU assessed 5.39% of dementia patients living in the area of referral.In relationship with “E” (Effectiveness): of patients evaluated by the MU, 60 (11%) were discharged. Of these, 41 (66%) were referred to primary health care, 9 (17%) to other outpatient services, 6 (10%) to a specialized mental health care center, and 4 (7%) to a daycare center.Due to the short lifespan of our MU, no other RE-AIM dimensions could be evaluated yet.This was the first evaluation of the implementation of a MU in Chile as part of the Chilean Dementia Plan. It showed that it is possible to implement a MU in a Latin American country and improve access to dementia diagnosis, management, and treatment. Ongoing challenges include continuing to collect clinical data, creating research projects as part of the MU, and developing a MU protocol that can be adopted elsewhere in Chile and other Latin American countries.

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mHealth and Health Care Service Delivery in Africa: A Systematic Review

Global Journal of Health Science ◽

10.5539/gjhs.v13n2p123 ◽

2021 ◽

Vol 13 (2) ◽

pp. 123

Author(s):

Austin Eze Egede ◽

Cajetan Ikechukwu Ilo ◽

Maryjane Ikechukwu-Nwobodo ◽

Tessy Amaka Nnaji ◽

Rita Ihuoma Anaba ◽

...

Keyword(s):

Systematic Review ◽

Health Care ◽

Science Citation Index ◽

Citation Index ◽

Care Delivery ◽

Care Service ◽

Health Care Service ◽

Text Messages ◽

Science Citation ◽

Services Delivery

We conducted a systematic review of studies on mHealth and health care services delivery that were carried out within Africa. Our search process was through MEDLINE, and then on PubMed, we searched key terms based on various keywords: “Whatsapp, health, Africa, Text messages, health impact, Africa, mHealth tools, Africa”. This was done in December of 2018. Only English written articles from journals indexed in Science Citation Index Expanded and Social Science Citation Index were incorporated in this review. In line with our inclusion criteria, only a total of 19 out of 155 studies were relevant. Inferences from these studies showed that mHealth tools are speedy and quality means for health care delivery in Africa. We also found out that there is less usage of internet devices in Africa as suspected. There is a serious need for improvement in the use of other online based mHealth tools as it was found that the use of Short Messaging Service (SMS) has been the nearly the sole mHealth intervention utilized in Africa. This, it is believed would foster better wider intervention and implementation of quality health outcomes in Africa, and other low and middle-income regions of the world.

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Evaluation of a Care Coordination/Home-Telehealth Program for Veterans with Diabetes

Evaluation & the Health Professions ◽

10.1177/0163278705281079 ◽

2005 ◽

Vol 28 (4) ◽

pp. 464-478 ◽

Cited By ~ 48

Author(s):

Neale R. Chumbler ◽

Britta Neugaard ◽

Rita Kobb ◽

Patricia Ryan ◽

Haijing Qin ◽

...

Keyword(s):

Health Care ◽

Care Coordination ◽

Care Service ◽

Controlled Trial ◽

Health Care Service ◽

Bodily Pain ◽

Future Research ◽

Veterans Health ◽

Health Administration ◽

Regression To The Mean

We evaluated a Veterans Health Administration (VHA) care coordination/ hometelehealth (CC/HT) programon the utilization of health care services and health-related quality of life (HRQL) in veterans with diabetes. Administrative records of 445 veterans with diabetes were reviewed to compare health care service utilization in the 1-year period before and 1-year period postenrollment and also examined self-reported HRQL at enrollment and 1 year later. Multivariate analyses indicated a statistically significant reduction in the proportion of patients who were hospitalized (50% reduction), emergency room use (11% reduction), reduction in the average number of bed days of care (decreased an average of 3.0 days), and improvement in the HRQL role-physical functioning, bodily pain, and social functioning. The results need to be interpreted with caution because we used a single-group study design that may be influenced by regression to the mean. Ideally, future research should use a randomized controlled trial design.

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The Future is Now: The IMPACT of Regulatory and Health Care Reform on Speech-Language Pathology Practice - Part One

Perspectives of the ASHA Special Interest Groups ◽

10.1044/persp1.sig15.84 ◽

2016 ◽

Vol 1 (15) ◽

pp. 84-92

Author(s):

Erin Knoepfel ◽

Joanne Wisely

Keyword(s):

Health Care ◽

Care Delivery ◽

Care Service ◽

Health Care Service ◽

Health Care Team ◽

Motor Speech ◽

The Future ◽

Language Pathology ◽

Key Events ◽

The Impact

Throughout Parts 1 and 2 of this article, we will provide the knowledge and insight we have gained over the years, specific to this ever-changing health care arena. We will highlight key events that have shaped the American care delivery system and discuss current actions that lay the foundation for the future of the health care service environment. As professional members of the health care team, our goal is to ensure that we continue to provide high-quality services to those with communication, cognitive-communication, motor speech, voice, and swallowing impairments.

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Health Information for Consumers in Developing Nations

International Journal of User-Driven Healthcare ◽

10.4018/ijudh.2013010104 ◽

2013 ◽

Vol 3 (1) ◽

pp. 22-32 ◽

Cited By ~ 2

Author(s):

Vasumathi Sriganesh

Keyword(s):

Health Care ◽

Health Information ◽

Health Professionals ◽

Care Delivery ◽

Care Service ◽

Health Care Service ◽

Sources Of Information ◽

Information Time ◽

Structured Approach ◽

Actual Health

Health information, both professional as well as consumer oriented, is an important component of the health care service. Professionals constantly need information for academics, research, preventive care, treatment and also to stay updated and to create and update health policies. Consumers need health information to stay healthy and to manage diseases and conditions. Generic search engines like Google and Yahoo answers are utilized extensively for getting health information (Akerkar & Bichile, 2004). However while utilizing these engines information seekers most often have to sift through volumes of data that often includes questionable sources of information. Health professionals face lacunae in receiving training about information resources and databases, and structured approach to searching these. Both consumers and health professionals spend far too much time searching for information, time that could be utilized much better in the actual health care delivery process. This article describes a medical librarian’s journey from being a health information consumer to a health information provider both to health professionals and consumers.

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Organizational cultural competence consultation to a mental health institution

Transcultural Psychiatry ◽

10.1177/1363461512439740 ◽

2012 ◽

Vol 49 (2) ◽

pp. 165-184 ◽

Cited By ~ 35

Author(s):

Kenneth Fung ◽

Hung-Tat (Ted) Lo ◽

Rani Srivastava ◽

Lisa Andermann

Keyword(s):

Mental Health ◽

Health Care ◽

Cultural Competence ◽

Mental Health Care ◽

Care Delivery ◽

Care Service ◽

Health Care Organization ◽

Health Care Service ◽

Care Organization ◽

Organizational Cultural Competence

Cultural competence is increasingly recognized as an essential component of effective mental health care delivery to address diversity and equity issues. Drawing from the literature and our experience in providing cultural competence consultation and training, the paper will discuss our perspective on the foundational concepts of cultural competence and how it applies to a health care organization, including its programs and services. Based on a recent consultation project, we present a methodology for assessing cultural competence in health care organizations, involving mixed quantitative and qualitative methods. Key findings and recommendations from the resulting cultural competence plan are discussed, including core principles, change strategies, and an Organizational Cultural Competence Framework, which may be applicable to other health care institutions seeking such changes. This framework, consisting of eight domains, can be used for organizational assessment and cultural competence planning, ultimately aiming at enhancing mental health care service to the diverse patients, families, and communities.

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Patient motives for contacting out-of-hours care in Denmark: a cross-sectional study

10.21203/rs.2.10729/v2 ◽

2020 ◽

Author(s):

Linda Huibers ◽

Anders H Carlsen ◽

Grete Moth ◽

Helle C Christensen ◽

Ingunn S Riddervold ◽

...

Keyword(s):

Primary Care ◽

Health Care ◽

Emergency Medical Services ◽

Service Providers ◽

Care Service ◽

Health Care Service ◽

Medical Services ◽

Cross Sectional ◽

Out Of Hours ◽

Emergency Medical

Abstract Background Patients in need of acute health care do not always contact the most suitable health care service provider. Contacting out-of-hours primary care for an urgent problem may delay care, whereas contacting emergency medical services for a non-urgent problem could ultimately affect patient safety. More insight into patient motives for contacting a specific health care provider may help optimise patient flows. This study aims to explore patient motives for contacting out-of-hours primary care and the emergency medical services in Denmark.Methods We conducted a cross-sectional observational study by sending a questionnaire to patients contacting out-of-hours primary care and emergency medical services, both of which can be directly contacted by patients, in two of five Danish regions in 2015. As we aimed to focus on the first access point, the emergency department was not included. The questionnaire included items on patient characteristics, health problem and 26 pre-defined motives. Descriptive analyses of patient characteristics and motives were conducted, stratified by the two health care service providers. Factors associated with contacting each of the two service providers were explored in a modified Poisson regression analysis, and adjusted risk ratios were calculated.Results Three key motives for contacting the two service providers were identified: ‘unpleasant symptoms’, ‘perceived need for prompt action’ and ‘perceived most suitable health care provider’. Other important motives were ‘need arose outside office hours’ and ‘wanted to talk to a physician’ (out-of-hours primary care) and ‘expected need for ambulance’ and ‘worried’ (emergency medical services). Higher probability of contacting the emergency medical services versus out-of-hours primary care was seen for most motives relating to own assessment and expectations, previous experience and knowledge, and own needs and wishes. Lower probability was seen for most motives relating to perceived barriers and benefits.Conclusions Patient motives for contacting the two health care service providers were partly overlapping. The study contributes with new knowledge on the complex decision-making process of patients in need of acute health care. This knowledge could help optimise existing health care services, such as patient safety and the service level, without increasing health care costs.

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Improving service engagement in healthcare through internet of things based healthcare systems

Journal of Science and Technology Policy Management ◽

10.1108/jstpm-03-2021-0040 ◽

2021 ◽

Vol ahead-of-print (ahead-of-print) ◽

Author(s):

Vaidik Bhatt ◽

Samyadip Chakraborty

Keyword(s):

Health Care ◽

Decision Making ◽

Service Delivery ◽

Care Delivery ◽

Care Service ◽

Health Care Service ◽

Content Type ◽

Service Engagement ◽

Physician Patient ◽

Health Care Service Delivery

Purpose The purpose of the study was to empirically validate the linkages between IoT adoption and how it overarched influenced the patient care service engagement. This contributes to the body of knowledge and helps hospital managers to understand the relationship and relevance of IoT adoption; otherwise healthcare sector are late movers towards technology adoption. This gives a nuanced framework towards establishing empirically validated framework which will motivate healthcare services providers to be motivated to adopt and implement IoT enabled care delivery. The physician patient interaction and alignment during decision making will foster positive word of mouth, superior care service and reduce extra overheads for healthcare providers without compromise or rather with increment in service delivery proposition. Design/methodology/approach The study theoretically and empirically describes that with the adoption of internet of things (IoT) devices in health care, better services can be provided to patients by using partial least square – structure equation modelling-based robust technique and explains the better understanding of the health-care process with the help of information pervasiveness, physician-patient orientation and improved patient and physician involvement in the decision-making process. Findings This study shows that wearable IoT device adoption in health-care service delivery opens new opportunities and disrupts the conventional and traditional way of health-care service delivery by empowering the patient to take part in decision-making and enhancing their engagement in health-care service delivery. Research limitations/implications The study might influence by generalizability. Perception-based cross-examination knowledge from the patient’s perspective. It is likely that patients who use these devices will grow accustomed to using them and become more capable of using them. Thus, time-series tests have not been used to catch enhanced skills. New patients’ experiences will be altered over time. Regardless, non-response bias and traditional process bias received excessive interest. Practical implications The study aims at unravelling how the adoption of IoT enabled practices and usage of IoT devices bolsters the available data points in the context of healthcare especially with respect to patient care delivery. The study conceptualizes and empirically validates how the usage of IoT interface enabled technology enables better patient treatment and caregiver participation. The study puts forth a nuanced understanding regarding how pervasively available ubiquitous care information fosters shared decision making. This study further emphasizes that importance of ensuring a reliable computing environment devoid of privacy and security risks. The study attempts at Emphasizing empirically how the enhanced information pervasiveness catapults the patient-provider interactions, through health data exchange. Highlighting the importance of search feature in cloud storage and recovery mechanisms. The study not only fulfills the overarching linkage between enhanced service engagement with IoT adoption, it provides a mental map and ready to refer framework for hospital and healthcare experts to refer to, which prescribes thar care providers must build new methods aimed at empowerment of patients to participate and take more inclusive role. This unique confluence between patients and physicians will unravel the sync; helping not only avoid costly decision errors, but also improve patient care delivery environment. Patients should be permitted to participate in decision-making,inspire patients to be participatory. Originality/value The study efforts to empirically investigate and discover the link between how wearable sensor-based IoT enhances health-care service engagement is underway. Using primary data this linkage validation allows the community and readers at large to gain a nuanced understanding of how superior interaction is enabled by a digital-health-care process with the help of IoT-enabled information pervasiveness, physician-patient orientation and empowered involvement.

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