Changes in the Perception of Health Care Policy and Delivery Among Manitoba Elders During the Downsizing of the Hospital Sector

2000 ◽  
Vol 19 (1) ◽  
pp. 18-34 ◽  
Author(s):  
Evelyn Shapiro ◽  
Robert B. Tate ◽  
Brock Wright ◽  
Joy Plohman
Keyword(s):  
Health Care ◽  
Older Persons ◽  
Health Care Policy ◽  
Special Interest Groups ◽  
Qualité Des Soins ◽  
Political Issue ◽  
Hospital Sector ◽  
Soins De Santé ◽  
One Year

RésuméDans un monde où l'assurance des soins de santé est universelle, la fermeture de lits d'hôpitaux se transforme inévitablement en un dossier politique chaud et les médias deviennent le véhicule du débat et des pressions exercées par certains groupes d'intérêt. Cette étude repose sur les données d'une interview d'aîné(e)s du Manitoba avant, puis un an après, la diminution substantielle du secteur hospitalier à Winnipeg. Nous comparons les réponses des résidents de Winnipeg à celles de résidents de l'extérieur de Winnipeg à des questions sur leurs opinions concernant la qualité générale des soins de santé et l'aecès aux soins hospitaliers. Nous comparons également les réponses aux mêmes questions données par des aîné(e)s qui ont été hospitalisés avant la première interview, par d'autres qui ont été hospitalisés avant la seconde interview et enfin par des aîné(e)s qui n'ont pas été hospitalisés. Bien qu'il n'y ait pas eu de fermeture de lits d'hôpitaux à l'extérieur de Winnipeg, l'opinion sur la qualité des soins chez les citoyens de Winnipeg et ceux de l'extérieur était moins positive après la réduction de Winnipeg et la publicité négative dont l'événement a été entouré. Cependant, les opinions sur la qualité et l'accès de ceux qui avaient été hospitalisés alors que les lits se fermaient étaient sensiblement plus positives que celles des ainé(e)s qui avaient été hospitalisés avant la fermeture ou qui n'avaient pas été hospitalisés.AbstractIn a universally-insured health care system, closing hospital beds inevitably becomes a hot political issue and the media often become the vehicle for debate and pressure from special interest groups. This study uses data from a representative sample of Manitoba older persons, interviewed before and again one year after the substantial downsizing of the hospital sector in Winnipeg. We compare the responses of Winnipeg residents with those of non-Winnipeg residents to questions about their opinion regarding the overall quality of health care and access to hospital care. Also compared were the responses to the same questions by older persons who were hospitalized before the first interview, those hospitalized before the second interview and those who were not hospitalized. Despite experiencing no bed closures outside Winnipeg, the opinions about the overall quality of care among both non-Winnipeggers and Winnipeggers were less favourable after the Winnipeg downsizing and the accompanying negative publicity. However, the opinions about quality and access among those who were actually hospitalized when most of the beds were being closed were significantly more favourable than among those hospitalized before the bed closures or not hospitalized at all.

scholarly journals Consequences of anxiety in older persons: its effect on disability, well-being and use of health services

1999 ◽  
Vol 29 (3) ◽  
pp. 583-593 ◽  
Author(s):  
E. de BEURS ◽  
A. T. F. BEEKMAN ◽  
A. J. L. M. van BALKOM ◽  
D. J. H. DEEG ◽  
R. van DYCK ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Health Care ◽  
Anxiety Disorder ◽  
Older Persons ◽  
Well Being ◽  
Anxiety Symptoms ◽  
Appropriate Care ◽  
Older Subjects ◽  
Use Of Health Services

Background. Although anxiety is quite prevalent in late life, its impact on disability, well-being, and health care utilization of older persons has not been studied. Older persons are a highly relevant age group for studying the consequences of anxiety, since their increasing numbers put an extra strain on already limited health care resources.Methods. Data of a large community-based random probability sample (N=659) of older subjects (55–85 year) in the Netherlands were used to select three groups: subjects with a diagnosed anxiety disorder, subjects with merely anxiety symptoms and a reference group without anxiety. These groups were compared with regard to their functioning, subjective well-being, and use of health care services, while controlling for potentially confounding variables.Results. Anxiety was associated with increased disability and diminished well-being. Older persons with a diagnosed anxiety disorder were equally affected in their functioning as those with merely anxiety symptoms. Although use of health services was increased in anxiety sufferers, their use of appropriate care was generally low.Conclusions. Anxiety has a clear negative impact on the functioning and well-being of older subjects. The similarity of participants with an anxiety disorder and those having merely anxiety symptoms regarding quality of life variables and health care use was quite striking. Finally, in spite of its grave consequences for the quality of life, appropriate care for anxiety is seldom received. Efforts to improve recognition, disseminate effective treatments in primary care, and referring to specialized care may have positive effects on the management of anxiety in late life.

Legal and policy lessons from the Schiavo case: Is our right to choose the medical care we want seriously at risk?

2006 ◽  
Vol 4 (2) ◽  
pp. 145-153 ◽  
Author(s):  
ZITA LAZZARINI ◽  
STEPHEN ARONS ◽  
ALICE WISNIEWSKI
Keyword(s):  
Health Care ◽  
Medical Care ◽  
Health Care Policy ◽  
Legal Status ◽  
Medical Futility ◽  
Medical Practitioners ◽  
Political Interests ◽  
Quality Of Medical Care ◽  
The Individual

The article explores the individual patient's right to refuse, withdraw, or insist on medical treatment where there is conflict over these issues involving health care personnel or institutions, family members, legal requirements, or third parties concerned with public policy or religious/ideological/political interests. Issues of physician assistance in dying and medical futility are considered. The basis and the current legal status of these rights is examined, and it is concluded that threats to the autonomy of patients, to the privacy of the doctor/patient relationship, and to the quality of medical care should be taken seriously by individuals, medical practitioners, and others concerned with developing and maintaining reasonable, effective, and ethical health care policy.

Planning criteria for multicentre, multilingual telemedicine conferences

1998 ◽  
Vol 4 (1) ◽  
pp. 47-55 ◽  
Author(s):  
N. Magnus Hjelm ◽  
Joseph C. K. Lee ◽  
Albert K. K. Li ◽  
Clarke B. Hazlett
Keyword(s):  
Health Care ◽  
Medical Staff ◽  
Lead Time ◽  
Financial Resources ◽  
Remote Locations ◽  
Medical Consultations ◽  
Time Zones ◽  
Target Date ◽  
One Year

The international telemedicine conference Chinese TeleMed 96 was held in November 1996. This three-way teleconference included delegates in London where the international telemedicine conference TeleMed 96 was taking place and medical staff from one Beijing hospital and one Hong Kong medical faculty. In total, over 1000 health-care personnel across eight time zones participated. The event demonstrated that the quality of teleconferencing technology was suitable for medical teaching, for providing medical consultations to remote locations and for stimulating medical exchanges. In general, planning a telemedicine conference requires a longer lead time, a wider representation of expertise in the organizing committee and more financial resources than conventional conferences. It is recommended that the aim and format of a telemedicine conference be determined at least one year before the target date. Criteria for improving the preparation of such conferences have been identified and a set of guidelines for future conference organizers has been drawn up.

scholarly journals Theoretical Perspectives of Hospitalized Older Patients and Their Health-Related Problems and Quality of Care: Systematic Literature Review

2017 ◽  
Vol 10 (1) ◽  
pp. 215-225 ◽  
Author(s):  
Atef Hasan Khatib ◽  
Ayman M. Hamdan-Mansour ◽  
Manar Ali Bani Hani
Keyword(s):  
Quality Of Life ◽  
Health Care ◽  
Quality Of Care ◽  
Elderly Patients ◽  
Older Patients ◽  
Older Persons ◽  
Elderly Care ◽  
Quality Of Healthcare ◽  
Emotional Wellbeing

Introduction:The proportion of aged people is growing worldwide. Older persons are affected by a number of physical, psychological and social factors that influence their health and quality of life. These factors are usually multiple and are often masked by sensory and cognitive impairments.Purpose:The purpose of this study was to examine the available literature emphasizing older persons’ care, care-related problems, and older persons’ quality of healthcare. Also, the paper aimed at exploring the future direction of research needs.Results:Good quality older patients’ care involves safety, professional interventions, recognition and management of physical and emotional wellbeing. Care of older patients requires addressing the aging process itself, the expected decrease in functionality, and diminished cognitive ability. Little statistical data were found to address the quality of hospitalized elderly patients in particular as well as study on healthcare facilities and nursing homes. Literature does not provide much guidance to the effectiveness of care strategies.Conclusion:The results assert that elderly health care is a priority. However, health care systems are not specific about elderly patients’ needs, leading to low quality of elderly care. There is a need to use an integrated model of care to improve the quality of life and quality of care provided to hospitalized older patients.

scholarly journals Quality of Basic Care During Neonatal Resuscitation Among Health Care Providers at Three District Hospitals in Kigali

2020 ◽  
Vol 3 (2) ◽  
pp. 225-237
Author(s):  
Kellen Muganwa ◽  
Alice Muhayimana ◽  
Joella Mukashyaka ◽  
Pamela Meharry
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Work Experience ◽  
Neonatal Resuscitation ◽  
Care Providers ◽  
Cross Sectional ◽  
Basic Care ◽  
District Hospitals ◽  
One Year

Background Globally, about 10% of neonates require extra respiratory support to initiate breathing at birth. Over a million neonatal deaths could be prevented with quality basic care during neonatal resuscitation. Objective To determine the quality of care (QoC) of basic NR at birth among health care providers (HCPs) at three district hospitals in Kigali. Methods A descriptive cross-sectional study was conducted. Thirty-six HCPs were observed 2-3 times using a structured checklist. Descriptive and inferential statistics were used to analyze the data.  Results The majority had ‘good’ QoC scores for drying and stimulation (74.7%), and fair scores for airway clearance (85.1%). Some had poor scores for advanced bag and mask ventilation (BMV) (13%). Maternity work experience (1-5 years) was significantly associated with good quality drying and stimulation (p = 0.03), initial BMV (p = 0.02), and advanced BMV (p = 0.03), than HCPs with less than one-year experience.  Conclusion Maternity work experience of more than one year significantly improved the QoC during neonatal resuscitation. More NR support during the first year of work and regular NR refresher training would improve neonatal outcomes.  Rwanda J Med Health Sci 2020;3(2):225-237

scholarly journals Primary Health Care and Aging

2004 ◽  
Vol 2 (3) ◽  
pp. 99-108
Author(s):  
Martha Pelaez ◽  
Marilyn Rice
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Primary Health Care ◽  
Older People ◽  
Older Persons ◽  
Interdisciplinary Teams ◽  
Healthy Ageing ◽  
Policy Statement ◽  
Primary Health

From 21-25 February 2000, in San Jose, Costa Rica, a WHO Consultative Group was held on the topic of Primary Health Care for Older Persons, with representatives from 13 countries from around the world, as well as Headquarters and Regional offices of WHO and the private sector. In the policy statement that emerged from the meeting four basic principles were highlighted: universal accessibility and coverage on the basis of need, community and individual involvement, intersectoral action for health, and appropriate use of cost effective technologies in relation to the available resources. Three complementary integration functions are mentioned: functional with an integrated approach to the health needs of individuals over their life course taking precedence over episodic management of disease; organizational, with a focus on how health centers should function with interdisciplinary teams; and educational which addresses the knowledge and skills and attitudes needed by health professionals that will facilitate communication, networking, advocacy and mediation of resources. The proceedings go on to outline the objectives to be included in national plans on health of older people, as well as the extended benefits and outcomes to be expected from PHC strategies for older people. In promoting quality of care for older persons, positive and negative factors are mentioned, as are strategies to: stimulate interest in geriatric care, motivate general practitioners to focus on the care of elders, encourage teamwork among PHC staff, and encourage multi-sectoral collaboration in promoting the health of older persons. An example is provided of healthy ageing from Canada. The recommendations include defining and measuring an ageing friendly health center (with specific indicators for the latter), defining the role of the PHC team in promoting healthy ageing, characteristics that programs should have to promote “age friendly” services in the primary care setting, and outcome indicators for quality of care of elders at the PHC level.

Health care cost in hormone-naive and hormonally pretreated patients with prostate cancer treated with degarelix.

2012 ◽  
Vol 30 (5_suppl) ◽  
pp. 240-240
Author(s):  
Johannes Wolff ◽  
Alexander Tolle ◽  
Michael Gedamke
Keyword(s):  
Quality Of Life ◽  
Prostate Cancer ◽  
Health Care ◽  
Health Care Cost ◽  
Direct Costs ◽  
Pronounced Difference ◽  
Life Improvement ◽  
Pretreated Patients ◽  
One Year

240 Background: Degarelix, is a GnRH-antagonist, which is used in the treatment of prostate cancer since 2009. We performed a non-interventional study (NIS) with prostate cancer (PCA) patients treated routinely with degarelix. This NIS focused on pharmaco-economical data, quality of life as well as efficacy and safety in patients receiving degarelix as first or second line therapy. Methods: In the interims analysis of this ongoing NIS, data from 279 out of 670 PCA-patients treated with degarelix were included. The included cohort reflects advanced PCA patients (age: 72 years, PSA: 15.8 ng/ml (median values)).Testosterone and PSA values, quality of life and pharmaco-economical data were collected at baseline, 1, 3, 6, 9 and 12 months. Quality of life was assessed by EQ-5D. Pharmaco-economical data included direct costs for physicians, drugs, hospital, emergency treatment and others. Results: Treatment costs in hormon-naïve patients treated with degarelix were lower than in the hormonally pre-treated patients. Direct costs for six month were 498,- € for hormone naïve patients treated with degarelix in contrast to 1436,- € for hormonally pre-treated patients. As expected there was a marked difference in the PSA-decline between hormone-naïve patients and hormonally pre-treated patients. Hormone-naïve patients experienced a sharp median decrease in PSA by 80.7% (n=116) at month 1. This decline remained stable in 98.7% of the patients after one year. Median PSA reduction was significantly different (p=0.013) between hormone-naïve and pre-treated patients. Furthermore treatment of degarelix improved quality of life by 14% at one year compared to baseline. Testosterone was suppressed to a median of 0.2 ng/ml from month 1 to 12. Safety results mirrored the results of clinical trials. Conclusions: First-line treatment with degarelix was supported by a marked difference in health care costs between hormone naïve and pre-treated prostate cancer patients, who received degarelix. As expected a pronounced difference in the PSA-decrease in hormone naïve and pre-treated patients was seen. However a distinct quality of life improvement was noted in all patients.

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