Challenges of Providing Health Care in Complex Emergencies: A Systematic Review

2021 ◽  
pp. 1-5
Author(s):  
Hesam Seyedin ◽  
Morteza Rostamian ◽  
Fahimeh Barghi Shirazi ◽  
Haleh Adibi Larijani
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Health Services ◽  
Health Care Providers ◽  
Health Care Delivery ◽  
Qualitative Content Analysis ◽  
Care Delivery ◽  
Information Access ◽  
Care Providers ◽  
Complex Emergencies

Abstract Providing health care in times of complex emergencies (CEs) is one of the most vital needs of people. CEs are situations in which a large part of the population is affected by social unrest, wars, and food shortages. This systematic review study was conducted to identify the challenges of health-care delivery in CEs. We searched terms related to health-care delivery and CEs in PubMed, Web of Sciences, Science Direct, and Google scholar databases, as well as Persian databases SID and Magiran. The searching keywords included: “Health Care, Complex Crises, War, Humanitarian, Refugees, Displaced Persons, Health Services, and Challenges.” Of 409 records, we selected 6 articles based on the Preferred Reporting Items for Systematic Reviews (PRISMA) checklist. Studies were analyzed through qualitative content analysis. The results show that CEs affect health-care delivery in 4 primary areas: the workforce, infrastructure, information access, and organization of health services. These areas can pose potential threats for health-care providers and planners at times of emergencies. Thus, they should be informed about these challenges to strengthen the health-care system.

Nurse Practitioner Challenges to the Orthodox Structure of Health Care Delivery: Regulation and Restraints on Trade

1985 ◽  
Vol 11 (2) ◽  
pp. 195-225
Author(s):  
Karla Kelly
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Health Care Delivery ◽  
Nurse Practitioners ◽  
Nurse Practitioner ◽  
Allied Health ◽  
Care Delivery ◽  
The United States ◽  
Care Providers ◽  
Allied Health Care

AbstractUntil recently, physicians have been the primary health care providers in the United States. In response to the rising health care costs and public demand of the past decade, allied health care providers have challenged this orthodox structure of health care delivery. Among these allied health care providers are nurse practitioners, who have attempted to expand traditional roles of the registered nurse.This article focuses on the legal issues raised by several major obstacles to the expansion of nurse practitioner services: licensing restrictions, third party reimbursement policies, and denial of access to medical facilities and physician back-up services. The successful judicial challenges to discriminatory practices against other allied health care providers will be explored as a solution to the nurse practitioners’ dilemma.

Incentivising improvements in health care delivery

2015 ◽  
Vol 10 (3) ◽  
pp. 327-343 ◽  
Author(s):  
Adam Oliver
Keyword(s):  
Health Care ◽  
Health Economics ◽  
Performance Management ◽  
Health Care Providers ◽  
Health Care Delivery ◽  
Care Delivery ◽  
Special Section ◽  
Care Providers ◽  
Improved Performance

AbstractThis Special Section of Health Economics, Policy and Law begins with an article on the different ways in which one might incentivise improved performance among health care providers. I asked five experts on performance management, Gwyn Bevan, Tim Doran, Peter Smith, Sandra Tanenbaum and Karsten Vrangbaek, to write brief reactions to the article and to the notion of performance management in health care in general. The commentators were given an open remit to be as critical as they wished to be, and their reactions can be found in the pages that follow. I would like to thank Albert Weale for reviewing all of the articles, and Katie Brennan for serving as the catalyst for this collection.

Hearing Health Care Delivery Outside the Booth

2021 ◽  
pp. 1-14
Author(s):  
Kathy Gates ◽  
Quintin A. Hecht ◽  
Marjorie A. M. Grantham ◽  
Andrew J. Fallon ◽  
Malisha Martukovich
Keyword(s):  
Health Care ◽  
Hearing Loss ◽  
Health Care Providers ◽  
Health Care Delivery ◽  
Health Care Services ◽  
Care Delivery ◽  
Review Article ◽  
Care Providers ◽  
Technical Specifications ◽  
Hearing Health

Purpose The purpose of this review article is to discuss how boothless audiometry may help address changes in hearing health care services and provide progressive tools to expand beyond traditional audiology clinic visits. The primary drivers for these changes include the COVID-19 pandemic, our aging population, comorbid effects of unidentified hearing loss, and the critical need for effective communication between patients and providers. This review article highlights key features and technical specifications of boothless audiometry, provides an overview of Food and Drug Administration (FDA)–approved boothless audiometry products, and describes how to leverage these products to increase access to hearing health services across the continuum of health care. Method Boothless audiometry literature was reviewed using PubMed and audiometry technology websites. FDA-approved boothless audiometry products were reviewed, and audiological features were categorized. Civilian and Department of Defense subject matter experts were consulted. Conclusions Boothless audiometry technology introduces opportunities for early audiometric assessment outside of the audiology clinic, in settings where traditional testing has been less possible, or even impossible, such as military environments, clinic waiting areas, schools, and nursing homes. This technology allows health care providers to identify individuals with significant hearing loss early and seek comprehensive services to prevent and treat hearing loss. By expanding the current hearing health care delivery model via boothless audiometry technology, the following benefits may be achieved, which can result in better outcomes overall: increased access to care, early identification and treatment of hearing loss, and reduced impact from the comorbid effects of hearing impairment.

Emerging Issues in Medical Ethics

1991 ◽  
Vol 158 (S10) ◽  
pp. 9-16 ◽  
Author(s):  
Carol C. Nadelson
Keyword(s):  
Health Care ◽  
Medical Ethics ◽  
Health Care Providers ◽  
Health Care Delivery ◽  
New Technologies ◽  
Care Delivery ◽  
Care Providers ◽  
Societal Context ◽  
Values And Beliefs ◽  
Emerging Issues

Ethical principles are influenced by personal values and beliefs, and by societal context. They are not immutable. In medicine, as new technologies have developed and changes in health-care delivery have resulted, historically held views about the responsibilities, obligations and relationships between health-care providers and patients have been challenged.

scholarly journals Satisfaction of patients attending a rural hospital of Darjeeling district in West Bengal, India

2017 ◽  
Vol 4 (6) ◽  
pp. 1932 ◽  
Author(s):  
Priti Agarwal ◽  
Romy Biswas
Keyword(s):  
Health Care ◽  
Patient Satisfaction ◽  
Health Care Providers ◽  
Health Care Delivery ◽  
Health Care Services ◽  
Care Delivery ◽  
Rural Hospital ◽  
Care Providers ◽  
Cross Sectional Survey ◽  
Cross Sectional

Background: Patient satisfaction is a means of measuring the effectiveness of health care delivery. This serves as a means of improvement among health care providers to give an acceptable level of patient satisfaction. Aims and Objectives: To assess the level of satisfaction and reasons of dissatisfaction among patients regarding health care services in a rural hospital of Darjeeling District, West Bengal.Methods: A cross-sectional survey was done on 110 patients with the help of PSQ-18 questionnaire. The samples were drawn by systematic random sampling            .Results: The overall mean satisfaction score was 3.57 and S.D. ±0.69. The mean score was highest in general satisfaction domain which was found to be 3.76 with S.D ± 1.08 and lowest in time spent with doctor where mean score was 2.92 and S.D. ±1.07. 69.3% of the patients were satisfied with the services offered by the hospital. The time spent by the doctor with the patient was less and this was the major reason of dissatisfaction.Conclusions: More than half of the patients were satisfied with the services provided by the hospital. The findings of the study can facilitate the development of targeted, objectively prioritized programs for the improvement and advancement of health care delivery systems. 

scholarly journals TRADITIONAL BIRTH ATTENDANTS AND REPRODUCTIVE HEALTH SERVICES IN THE CONTEXT OF COVID-19: A SCOPING REVIEW

2021 ◽  
Vol 15 (1) ◽  
pp. 1-12
Author(s):  
Gadanya MA ◽  
◽  
Adamu KA ◽  
Ibrahim UM
Keyword(s):  
Health Care ◽  
Reproductive Health ◽  
Health Services ◽  
Health Care Delivery ◽  
Care Delivery ◽  
Traditional Birth Attendants ◽  
Care Providers ◽  
Reproductive Health Services ◽  
Community Based ◽  
Birth Attendants

Background: In developing countries, the lack of accessible, affordable and acceptable orthodox care makes a significant proportion of the populace patronize the nearby available and cheap traditional birth attendants (TBAs) that share similar local custom and tradition. Although there are widely diverging shreds of evidence regarding their effectiveness as health care providers, they may have a limited role as a workforce during the ongoing COVID-19 pandemic where the more community-based distribution of commodities is increasingly considered due to movement restrictions. However, it is still doubtful if their integration into the formal health system may substantially contribute to basic health care delivery especially in the rural often hard to reach areas. Objectives: To explore the various roles of TBAs in reproductive health service delivery with implication for redefining their roles especially with the advent of the COVID-19 pandemic. Methodology: We searched and reviewed relevant literature on TBAs in PubMed, Africa Journals Online (AJOL) and Google scholar and relevant institutional websites for the role of TBAs pre and during the pandemic. The databases searched yielded 92 articles of potential significance to this review. After title/abstract review, 65 articles were moved to full document review. Nineteen articles explicitly and strictly focusing on TBAs concerning reproductive health were included in this review. Results: TBAs are providers of a wide range of reproductive health services and training to expand their roles and makes them safer is necessary for any consideration of their engagement; this implies the fight against COVID-19. TBAs should only be engaged if the gap in the resources for health must be filled by leveraging on their existing traditional roles and acceptance in the community. Conclusion: TBAs are widely utilised providers of care to their communities especially in the area of maternal care. With increasing emphasis on community-based services in healthcare delivery and the emergence of COVID-19, their roles must be reviewed and updated regularly to redefine their role in the health care delivery system especially because of the myriad personal and technical limitations associated with them. Any engagement with them should be with caution and as a stop-gap measur.

The Cardiovascular Intensive Care Unit—An Evolving Model for Health Care Delivery

2016 ◽  
Vol 32 (2) ◽  
pp. 116-123 ◽  
Author(s):  
John Loughran ◽  
Tauqir Puthawala ◽  
Brad S. Sutton ◽  
Lorrel E. Brown ◽  
Peter J. Pronovost ◽  
...  
Keyword(s):  
Health Care ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Health Care Providers ◽  
Health Care Delivery ◽  
Care Delivery ◽  
General Medicine ◽  
Physical Space ◽  
Lessons Learned ◽  
Care Providers

Prior to the advent of the coronary care unit (CCU), patients having an acute myocardial infarction (AMI) were managed on the general medicine wards with reported mortality rates of greater than 30%. The first CCUs are believed to be responsible for reducing mortality attributed to AMI by as much as 40%. This drastic improvement can be attributed to both advances in medical technology and in the process of health care delivery. Evolving considerably since the 1960s, the CCU is now more appropriately labeled as a cardiac intensive care unit (CICU) and represents a comprehensive system designed for the care of patients with an array of advanced cardiovascular disease, an entity that reaches far beyond its early association with AMI. Grouping of patients by diagnosis to a common physical space, dedicated teams of health care providers, as well as the development and implementation of evidence-based treatment algorithms have resulted in the delivery of safer, more efficient care, and most importantly better patient outcomes. The CICU serves as a platform for an integrated, team-based patient care delivery system that addresses a broad spectrum of patient needs. Lessons learned from this model can be broadly applied to address the urgent need to improve outcomes and efficiency in a variety of health care settings.

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