scholarly journals The efficiency of the local health systems: investigating the roles of health administrations and health care providers

2017 ◽  
Vol 13 (1) ◽  
pp. 10-32 ◽  
Author(s):  
Laura Anselmi ◽  
Mylène Lagarde ◽  
Kara Hanson
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Health Systems ◽  
Health Care Providers ◽  
National Health ◽  
Local Level ◽  
Local Health ◽  
Care Providers ◽  
Frontier Analysis ◽  
Decision Making Unit

AbstractThe analysis of efficiency in health care has largely focussed either on individual health care providers, or on sub-national health systems conceived as a unique decision-making unit. However, in hierarchically organized national health services, two separate entities are responsible for turning financial resources into services at the local level: health administrations and health care providers. Their separate roles and the one of health administrations in particular have not been explicitly considered in efficiency analysis. We applied stochastic frontier analysis to district-level panel data from Mozambique (2008-2011) to assess district efficiency in delivering outpatient care. We first assessed the efficiency of the whole district considered as an individual decision-making unit, and then we assessed separately the efficiency of health administrations and health care providers within the same district. We found that on average only 73% of the outpatient consultations deliverable using available inputs were realized, with large differences in performance across districts. Individual districts performed differently in administrative or health care delivery functions. On average, a reduction of administrative inefficiency by 10 percentage points, for a given expenditure would increase by 0.2% the volume of services delivered per thousand population per year. Identifying and targeting the specific drivers of administrative inefficiencies can contribute to increase service.

scholarly journals Improving Communications With Patients and Families in Geriatric Care. The How, When, and What

2021 ◽  
Vol 8 ◽  
pp. 237437352110340
Author(s):  
Shirley Chien-Chieh Huang ◽  
Alden Morgan ◽  
Vanessa Peck ◽  
Lara Khoury
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Family Caregivers ◽  
Health Care Providers ◽  
Tertiary Care ◽  
Care Providers ◽  
Telephone Interviews ◽  
Written Information ◽  
Geriatric Unit ◽  
Patient Health

There has been little published literature examining the unique communication challenges older adults pose for health care providers. Using an explanatory mixed-methods design, this study explored patients’ and their family/caregivers’ experiences communicating with health care providers on a Canadian tertiary care, inpatient Geriatric unit between March and September 2018. In part 1, the modified patient–health care provider communication scale was used and responses scored using a 5-point scale. In part 2, one-on-one telephone interviews were conducted and responses transcribed, coded, and thematically analyzed. Thirteen patients and 7 family/caregivers completed part 1. Both groups scored items pertaining to adequacy of information sharing and involvement in decision-making in the lowest 25th percentile. Two patients and 4 family/caregivers participated in telephone interviews in part 2. Interview transcript analysis resulted in key themes that fit into the “How, When, and What” framework outlining the aspects of communication most important to the participants. Patients and family/caregivers identified strategic use of written information and predischarge family meetings as potentially valuable tools to improve communication and shared decision-making.

scholarly journals Plain Language Summary: Opioid Prescribing for Analgesia After Common Otolaryngology Operations

2021 ◽  
Vol 164 (4) ◽  
pp. 704-711
Author(s):  
Samantha Anne ◽  
Sandra A. Finestone ◽  
Allison Paisley ◽  
Taskin M. Monjur
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Clinical Practice ◽  
Pain Management ◽  
Health Care Providers ◽  
Clinical Practice Guideline ◽  
Shared Decision ◽  
Care Providers ◽  
Plain Language ◽  
Opioid Prescribing

This plain language summary explains pain management and careful use of opioids after common otolaryngology operations. The summary applies to patients of any age who need treatment for pain within 30 days after having a common otolaryngologic operation (having to do with the ear, nose, or throat). It is based on the 2021 “Clinical Practice Guideline: Opioid Prescribing for Analgesia After Common Otolaryngology Operations.” This guideline uses available research to best advise health care providers, and it includes recommendations that are explained in this summary. Recommendations may not apply to every patient but can be used to facilitate shared decision making between patients and their health care providers.

Creating Academic and Health Care Partnerships that Impact Public Health

2015 ◽  
Vol 4 (4) ◽  
pp. 378-384
Author(s):  
Peter W. Grandjean ◽  
Burritt W. Hess ◽  
Nicholas Schwedock ◽  
Jackson O. Griggs ◽  
Paul M. Gordon
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Care Providers ◽  
Professional Training ◽  
Local Health ◽  
Care Providers ◽  
Research Partnerships ◽  
Local Health Care ◽  
Training Community ◽  
The University

Kinesiology programs are well positioned to create and develop partnerships within the university, with local health care providers, and with the community to integrate and enhance the activities of professional training, community service, public health outreach, and collaborative research. Partnerships with medical and health care organizations may be structured to fulfill accreditation standards and the objectives of the “Exercise is Medicine®” initiative to improve public health through primary prevention. Barriers of scale, location, time, human resources, and funding can be overcome so all stakeholder benefits are much greater than the costs.

scholarly journals Generating Evidence From Contextual Clinical Research in Low- to Middle Income Countries: A Roadmap Based on Theory of Change

2021 ◽  
Vol 9 ◽  
Author(s):  
Babar S. Hasan ◽  
Muneera A. Rasheed ◽  
Asra Wahid ◽  
Raman Krishna Kumar ◽  
Liesl Zuhlke
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Theory Of Change ◽  
Health Priorities ◽  
Global Health Research ◽  
Local Health ◽  
Care Providers ◽  
Middle Income ◽  
Middle Income Countries ◽  
Health Ministries

Along with inadequate access to high-quality care, competing health priorities, fragile health systems, and conflicts, there is an associated delay in evidence generation and research from LMICs. Lack of basic epidemiologic understanding of the disease burden in these regions poses a significant knowledge gap as solutions can only be developed and sustained if the scope of the problem is accurately defined. Congenital heart disease (CHD), for example, is the most common birth defect in children. The prevalence of CHD from 1990 to 2017 has progressively increased by 18.7% and more than 90% of children with CHD are born in Low and Middle-Income Countries (LMICs). If diagnosed and managed in a timely manner, as in high-income countries (HICs), most children lead a healthy life and achieve adulthood. However, children with CHD in LMICs have limited care available with subsequent impact on survival. The large disparity in global health research focus on this complex disease makes it a solid paradigm to shape the debate. Despite many challenges, an essential aspect of improving research in LMICs is the realization and ownership of the problem around paucity of local evidence by patients, health care providers, academic centers, and governments in these countries. We have created a theory of change model to address these challenges at a micro- (individual patient or physician or institutions delivering health care) and a macro- (government and health ministries) level, presenting suggested solutions for these complex problems. All stakeholders in the society, from government bodies, health ministries, and systems, to frontline healthcare workers and patients, need to be invested in addressing the local health problems and significantly increase data to define and improve the gaps in care in LMICs. Moreover, interventions can be designed for a more collaborative and effective HIC-LMIC and LMIC-LMIC partnership to increase resources, capacity building, and representation for long-term productivity.

scholarly journals Assessment of the Implementation of Tuberculosis and Diabetes Care in health systems: A Situational Analysis in Western Nigeria for consideration

2019 ◽  
Author(s):  
ASAGA MAC PETER ◽  
JUDE OSAGIE Aighobahi.
Keyword(s):  
Health Care ◽  
Health Systems ◽  
Health Care Providers ◽  
Health Facilities ◽  
Situational Analysis ◽  
Care Providers ◽  
Cross Sectional ◽  
Attitudes And Practices ◽  
Low Middle Income Countries ◽  
Diabetes Patients

Abstract Background: Tuberculosis (TB) coexists with other non-communicable diseases (NCDs), including Diabetes Mellitus (DM). Smoking increases the risk of TB as well as DM. Health systems are poorly prepared in many low middle income countries (LMICs) and are currently facing the "triple burden of smoking, TB, and DM" that drives these countries into the vicious cycle of poverty. Methods: A cross-sectional study method was carried out to assess the proportion of TB care centers that included integration measures for diabetic care as well as those providing DM care that included integration measures for TB. A list of 49 health care centers in Lagos offering TB care and managing Diabetes patients were recruited. A focus Group Discussion(FGD) and Individual interviews were conducted to investigate health care providers ' knowledge, attitudes and practices and the barriers encountered in the process of integrating TB and DM care. Results: Out of the 49 health care centres recruited in this study, 6% of health care units are aware of a surveillance to screen for diabetes in tuberculosis patients, while 2% of health facilities confirmed awareness of a surveillance to screen for tuberculosis in diabetes patients. 91% of health centres either verified the lack of or no understanding of monitoring of both diseases. The percentage of health facilities that have existing guideline on TB and DM screening was evaluated, it was perceived that 8% of health facilities had implemented a guideline to screen for DM in TB patients, while 4% of these Care Centres have implemented a guideline for diabetes patients to be screened for TB. Conclusion TB/DM integrative screening, treatment and management could be better attained if both co-morbidities integration program is initiated in the healthcare centres and policies of western states and Nigeria as a whole.

Implementing E-Health

2016 ◽  
Author(s):  
Bill Doolin
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Point Of Care ◽  
Health Care Organization ◽  
Technical Problem ◽  
Local Health ◽  
Care Organization ◽  
Care Providers ◽  
Health Care Information ◽  
Local Health Care

The application of information and communication technology to support health care organization, management, and delivery is high on the health policy agenda in many countries, and its implementation has become a significant issue. Despite optimistic expectations and increasing investment in e-health, the anticipated benefits are often elusive. This chapter reviews the factors driving the development of e-health before introducing a conceptualization of e-health focused on the management and use of health care information at the point of care, between health care providers and, ultimately, by health care consumers. The chapter then explores a range of issues that render e-health implementation problematic. In particular, implementing e-health is both a complex and emergent process that requires consideration of local health care contexts, and a socio-technical problem involving changes in work processes, interactions, and behaviors.

The determination of data collection tools that can measure and document the cooperation of local health care providers

2020 ◽  
Author(s):  
Beáta Erika Nagy ◽  
Róza Oláh ◽  
Erika Zombor ◽  
Péter Boris ◽  
Anna Szabina Szele
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Health Care Providers ◽  
Health Improvement ◽  
Local Health ◽  
Care Providers ◽  
Structured Interviews ◽  
Daily Work ◽  
Local Health Care ◽  
Institutional Relations

Abstract Background The overall objective of the study is to improve the mental health of the age group below 18 years through the investigation of the intra-and inter-sectoral cooperation between local suppliers and to make the intensity and quality of collaborations measurable. In this paper, based on Hungarian and international literature, we aim at describing the current and future optimal cooperation between the members of the mental health care system and examine the possibilities for documenting and measuring cooperation. Methods Semi-structured interviews were recorded with the leaders or representatives of 12 public educational institutions, six social and six health institutions involvement of the relevant experts (N = 24). Results The function of the institutions belonging to these systems, as well as the daily work of the professionals working there, have a significant impact on the mental health of children in either positive or negative directions. After exploring the current situation, the cooperation of local suppliers and inter-institutional relations can highly increase the mental health improvement of the youth. Conclusion According to the results, the developing progress can be more effective through organising the different forms of care, sectors and professionals together to achieve a common goal.

Patient Choice and Patient Empowerment in Northern European Health Systems: A Conceptual Framework

1994 ◽  
Vol 24 (2) ◽  
pp. 201-229 ◽  
Author(s):  
Richard B. Saltman
Keyword(s):  
Health Care ◽  
Health Systems ◽  
Health Care Providers ◽  
Health Care Systems ◽  
Patient Empowerment ◽  
Patient Choice ◽  
Care Providers ◽  
Care Systems ◽  
European Health ◽  
The Impact

The issue of patient choice presents a complicated challenge to publicly operated health systems. Increased patient choice can strengthen the citizen's commitment to traditional welfare state objectives, or alternatively, it can severely damage that commitment, depending upon the design of the choice mechanism and the structural context within which patient choice occurs. For patient choice to be linked to true empowerment, choice must reinforce rather than undercut the accountability of health care providers to the population they serve. This article explores the basic issues involved in empowering patients within publicly operated health systems. The author first reviews the conceptual components that could or should be incorporated within the notion of empowered patients, then examines what would be required to actually empower patients within health systems, defined in terms of expanding not only logistical choice but also clinical influence and decision-making participation. The article concludes with a wide-ranging analysis of the impact of potential policies and mechanisms on the long-term objectives of achieving democratically accountable health care systems.

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