scholarly journals Demand-based models and market failure in health care: projecting shortages and surpluses in doctors and nurses

2018 ◽  
Vol 14 (2) ◽  
pp. 291-294 ◽  
Author(s):  
Stephen Birch
Keyword(s):  
Health Care ◽  
Market Failure ◽  
Health Care Systems ◽  
Public Intervention ◽  
Care Workers ◽  
Workforce Policy ◽  
Care Systems ◽  
The One ◽  
System Sustainability ◽  
Demand For Health

AbstractModels for projecting the demand for and supply of health care workers are generally based on objectives of meeting demands for health care and assumptions of status quo in all but the demographic characteristics of populations. These models fail to recognise that public intervention in health care systems arises from market failure in health care and the absence of an independent demand for health care. Hence projections of demand perpetuate inefficiencies in the form of overutilisation of services on the one hand and unmet needs for care on the other. In this paper the problems with basing workforce policy on projected demand are identified and the consequences for health care system sustainability explored. Integrated needs-based models are offered as alternative approaches that relate directly to the goals of publicly funded health care systems and represent an important element of promoting sustainability in those systems.

scholarly journals The future of health economics: The potential of behavioral and experimental economics

2015 ◽  
Vol 3 (1) ◽  
pp. 68-86 ◽  
Author(s):  
Fredrik Hansen ◽  
Anders Anell ◽  
Ulf-G Gerdtham ◽  
Carl Hampus Lyttkens
Keyword(s):  
Health Care ◽  
Health Economics ◽  
Experimental Economics ◽  
Health Care Organizations ◽  
Health Care Systems ◽  
Income Levels ◽  
Care Systems ◽  
Changing Demographics ◽  
Demand For Health ◽  
Economics Research

Health care systems around the globe are facing great challenges. The demand for health care is increasing due to the continuous development of new medical technologies, changing demographics, increasing income levels, and greater expectations from patients. The possibilities and willingness to expand health care resources, however, are limited. Consequently, health care organizations are increasingly required to take economic restrictions into account, and there is an urgent need for improved efficiency. It is reasonable to ask whether the health economics field of today is prepared and equipped to help us meet these challenges. Our aim with this article is twofold: to introduce the fields of behavioral and experimental economics and to then identify and characterize health economics areas where these two fields have a promising potential. We also discuss the advantages of a pluralistic view in health economics research, and we anticipate a dynamic future for health economics.Published: Online May 2015. In print December 2015.

scholarly journals Initial experiences of US neurologists in practice during the COVID-19 pandemic via survey

Neurology ◽  
2020 ◽  
Vol 95 (5) ◽  
pp. 215-220 ◽  
Author(s):  
Akanksha Sharma ◽  
Christina R. Maxwell ◽  
Jill Farmer ◽  
Diana Greene-Chandos ◽  
Kathrin LaFaver ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Systems ◽  
The United States ◽  
Survey Study ◽  
Practice Model ◽  
Safety Measures ◽  
Public Health Emergencies ◽  
Care Workers ◽  
Rapid Changes ◽  
Care Systems

ObjectiveTo test the hypothesis that US neurologists were experiencing significant challenges with lack of personal protective equipment (PPE), rapid changes in practice, and varying institutional protocols, we conducted this survey study. The current coronavirus disease of 2019 (COVID-19) pandemic has caused widespread disease and death. Rapid increases in patient volumes have exposed weaknesses in health care systems and challenged our ability to provide optimal patient care and adequate safety measures to health care workers (HCWs).MethodsA 36-item survey was distributed to neurologists around the United States through various media platforms.ResultsOver a 1-week period, 567 responses were received. Of these, 56% practiced in academia. A total of 87% had access to PPE, with 45% being asked to reuse PPE due to shortages. The pandemic caused rapid changes in practice, most notably a shift toward providing care by teleneurology, although a third experienced challenges in transitioning to this model. Wide variations were noted both in testing and in the guidance provided for the exposed, sick, or vulnerable HCWs. Notably, 59% of respondents felt that their practices were doing what they could, although 56% did not feel safe taking care of patients.ConclusionsResults from our survey demonstrate significant variability in preparedness and responsiveness to the COVID-19 pandemic in neurology, affected by region, health care setting, and practice model. Practice guidelines from professional societies and other national entities are needed to improve protection for physicians and their patients, promote recommended practice changes during a pandemic, and optimize future preparedness for public health emergencies.

scholarly journals Framing the Shades of Sustainability in Health Care: Pitfalls and Perspectives from Western EU Countries

2018 ◽  
Vol 10 (12) ◽  
pp. 4439 ◽  
Author(s):  
Elio Borgonovi ◽  
Paola Adinolfi ◽  
Rocco Palumbo ◽  
Gabriella Piscopo
Keyword(s):  
Health Care ◽  
Health Care Organizations ◽  
Health Care Systems ◽  
Financial Economic ◽  
Point Of View ◽  
Health Care Environment ◽  
Health Gains ◽  
Care Systems ◽  
The One ◽  
The Individual

Sustainability is momentous for the appropriate functioning of health care systems. In fact, health and sustainability are two strictly related values, which could not be separately sought. While studies discussing the contextualization of this issue with respect to the distinguishing attributes of health care systems are rapidly blooming, there is still little agreement about what is ultimately meant by sustainability in the health care arena. On the one hand, attention is primarily focused on the proper use of available financial resources; on the other hand, people engagement and empowerment are gradually arising as a crucial step to enhance the viability of the health care system. This paper tries to identify, from a conceptual point of view inspired by the European integrative movement, the different shades of sustainability in health care and proposes a recipe to strengthen the long-term viability of health care organizations. The balanced mix of financial, economic, political, and social sustainability is compelling to increase the ability of health care organizations to create meaningful value for the population served. However, the focus on a single dimension of sustainability is thought to engender several side effects, which compromise the capability of health care organizations to guarantee health gains at the individual and collective levels. From this standpoint, further conceptual and practical developments are envisioned, paving the way for a full-fledged understanding of sustainability in the health care environment.

Commitment to Change Among Health Care Workers in Pakistan

2020 ◽  
Vol 22 (3) ◽  
pp. 330-347
Author(s):  
Haroon Bakari ◽  
Ahmed Imran Hunjra ◽  
Stephen Jaros
Keyword(s):  
Health Care ◽  
Factor Analysis ◽  
Organizational Change ◽  
Health Care Workers ◽  
Health Care Systems ◽  
Change Initiative ◽  
Commitment To Change ◽  
Research Attention ◽  
Care Workers ◽  
Care Systems

Commitment to organizational change as an important focus of commitment has received greater attention in the literature of action commitments. Research indicates that this construct represents employee attitude towards change initiative and may be a greater predictor of support for change. This is of particular import in health care systems, globally, and in developing nations, in particular, which are constantly seeking to change and adapt to new medical and administrative advances. However, commitment to change (C2C) has received very little research attention from Asian health care systems. Therefore, this study answers the call for validation, by validating a culture-specific translated version of the C2C scale in a sample drawn from the privatization context of public sector hospitals in Pakistan. The goals are to: (a) examine some psychometric properties of the major Western-derived measures of C2C in Pakistan to see if they are valid and reliable there; and (b) draw implications from our results for the management of change efforts in Pakistani health care systems. Thus, exploratory factor analysis and confirmatory factor analysis (CFA) were conducted using SPSS and analysis of moment structures (AMOS) to provide evidence of reliability, construct validity and predictive validity of C2C among Pakistani health care workers. Results found evidence of the measure’s cross-cultural validity and revealed a positive correlation between C2C and three dimensions of behavioural support for change. This study is a significant contribution to the literature, being the first to provide comprehensive evidence of validity of the C2C scale in Pakistan, a developing country. An important implication for leaders of organizational change in Pakistan is that they may use this construct to unearth employee level of understanding and attitude towards change initiative to envisage mechanisms to foster employee support for change. Researchers may also use this construct in Pakistan’s context to assess employee C2C.

scholarly journals The Psychosocial Impact of Compounding Humanitarian Crises Caused by War and COVID-19 Informing Future Disaster Response

2021 ◽  
pp. 1-5
Author(s):  
Hakob Harutyunyan ◽  
Artak Mukhaelyan ◽  
Attila J. Hertelendy ◽  
Amalia Voskanyan ◽  
Todd Benham ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Workers ◽  
Disaster Response ◽  
Large Scale ◽  
Health Care Systems ◽  
Influenza Pandemic ◽  
Care Workers ◽  
Care Systems ◽  
The Republic ◽  
1918 Influenza

Abstract The coronavirus disease 2019 (COVID-19) pandemic has caused the greatest global loss of life and economic impact due to a respiratory virus since the 1918 influenza pandemic. While health care systems around the world faced the enormous challenges of managing COVID-19 patients, health care workers in the Republic of Armenia were further tasked with caring for the surge of casualties from a concurrent, large-scale war. These compounding events put a much greater strain on the health care system, creating a complex humanitarian crisis that resulted in significant psychosocial consequences for health care workers in Armenia.

scholarly journals Sleep deficit in COVID-19 health-care workers may increase the infection risk

2021 ◽  
pp. 140349482110076
Author(s):  
Isabela A. Ishikura ◽  
Daniela S. Rosa ◽  
Helena Hachul ◽  
Gabriel N. Pires ◽  
Sergio Tufik ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Workers ◽  
Health Care Professionals ◽  
Health Care Systems ◽  
Negative Effects ◽  
Care Workers ◽  
Care Systems ◽  
As Stress ◽  
Sleep Deficit ◽  
Inflammatory Milieu

The COVID-19 pandemic has had negative effects on health-care workers. The rapid growth of the disease has led to overwhelmed health-care systems, overcrowded hospitals, an insufficient number of health-care professionals and shortages of medical equipment. The potential exposure of front-line health-care workers during the COVID-19 outbreak has led to self-isolation and the appearance of adverse feelings such as stress, anxiety and fear. All these factors, combined with an increased workload and extra and changed shifts, are determinants of a sleep-loss process that may result in insomnia. The exacerbated pro-inflammatory milieu caused by insomnia and sleep deprivation present in health professionals may therefore make them more prone to developing severe COVID-19 if infected and/or aggravate the symptoms of the disease. Keeping these professionals healthy and doing everything possible to prevent them from being infected with COVID-19 should be a top priority. As part of this effort, we must be aware of the important effects of insomnia on the immune systems of these professionals and take all possible measures to counter these effects.

scholarly journals Management of Stroke During COVID-19 Pandemic: The Challenges in Nepal

2021 ◽  
Vol 19 (1) ◽  
pp. 218-220
Author(s):  
Subash Phuyal ◽  
Ritesh Lamsal ◽  
Gentle Sunder Shrestha ◽  
Raju Paudel ◽  
Lekhjung Thapa
Keyword(s):  
Health Care ◽  
South Asian ◽  
Health Care Workers ◽  
Care Delivery ◽  
Health Care Systems ◽  
Stroke Management ◽  
Stroke Patients ◽  
Care Workers ◽  
Care Systems ◽  
Baseline Health

The COVID-19 pandemic has significantly affected health care delivery globally. COVID-19 is associated with varied neurological manifestations including acute ischemic stroke. In densely populated South Asian nations like Nepal that have suboptimal baseline health care systems, we foresee unique challenges during this pandemic to ensure effective stroke management as well as the safety of health care workers involved in the management of stroke patients. Keywords: COVID-19; health care workers; safety; stroke management.

scholarly journals Validation of Training Need Assessment Questionnaire Among Health Care Workers in Reproductive, Maternal and Newborn Health Care in Low-Income Countries

2020 ◽  
Author(s):  
Tumbwene Elieza Mwansisya ◽  
Columba Mbekenga ◽  
Kahabi Isangula ◽  
Loveluck Mwasha ◽  
Eunice Pallangyo ◽  
...  
Keyword(s):  
Health Care ◽  
Needs Assessment ◽  
Health Care Workers ◽  
Health Care Systems ◽  
Training Needs ◽  
Assessment Tools ◽  
Training Needs Assessment ◽  
Care Workers ◽  
Care Systems ◽  
Assessment Questionnaire

Abstract Background: Continuous professional development (CPD) trainings have been reported to enhance health care workers’ knowledge and skills, improve retention and recruitment, improve quality of patient care and reduce patients’ mortality. This calls for validated training needs assessment tools for facilitating the design of effective CPD programs. Methods: A cross-sectional survey was conducted using self-administered questionnaires. The survey involved selected Reproductive, Maternal and Neonatal Health (RMNH) health care workers from 7 hospitals, 12 of 51 health centers and 17 of 292 dispensaries within eight districts of Mwanza Region, Tanzania. The training needs assessment (TNA) tool adapted from the Hennessy-Hicks’ Training Needs Assessment Questionnaire (TNAQ) was used for data collection. Results: A total of 153 healthcare workers participated in this study. The majority of participants were females 83% (127) with average age of 39 years. Nurses formed a majority of participants 76% (n=115) with relatively similar mean duration in service or in RMNH of 7.9 years. The reliability of the adapted TNAQ was found to be 0.954. Relatedly, indexes for construct validity indicated that CFI was equal to 1, Chi-square Mean/Degree of Freedom (CMIN/DF) was equal to 0.000 and Mean Square Error Approximation (RMSEA) was equal to 0.185. Conclusion: The adapted TNAQ appear to be reliable and valid for identifying professional training needs of health care workers in RMNH health care settings. The tool has a considerable level of psychometric properties that makes it suitable for assessing the training needs among health care workers of different cadres. However, the applicability of the TNAQ in the wider health care systems remains unclear. Future studies with a large sample size are required to test the use of TNAQ in wider health care systems and learning opportunities.

scholarly journals Did hydroxychloroquine played crucial role as prophylactic drug against SARS-CoV-2 infection in resource-constrained and overloaded health care systems in countries like India: a prospective multicentre study in dedicated COVID hospitals

2020 ◽  
Vol 8 (1) ◽  
pp. 1
Author(s):  
Dhaval Dalal ◽  
Ankush Govindwar ◽  
Gaurav Gangwani ◽  
Komal Dalal ◽  
Humeshwari Nipane ◽  
...  
Keyword(s):  
Health Care ◽  
Statistical Analysis ◽  
Health Care Workers ◽  
Crucial Role ◽  
Health Care Systems ◽  
Resource Constrained ◽  
Igg Antibody ◽  
Prospective Multicentre Study ◽  
Care Workers ◽  
Care Systems

Background: The Indian council medical research (ICMR) recommended to use hydroxychloroquine (HCQ) as a prophylactic agent against Severe acute respiratory syndrome coronavirus-2019 (SARS-COV-2) infection to cater need to protect high-risk individuals considering its pre-clinical data. This study explores role of HCQ in health care workers serving in coronavirus-2019 (COVID-19) pandemic.Methods: The study was planned as multi center observational study, conducted from April, 2020 to August 2020 at COVID-19 hospitals in India. HCQ 400 mg twice a day on day-1 followed by 400 mg once weekly for next 7 weeks was administered to Health care workers (HCW). RTPCR test was conducted at 3 months post last dose of prophylaxis in symptomatic health care workers. IgG test was conducted in all participants at 3 months.Results: We enrolled 1310 asymptotic frontline healthcare workers, of which 585 (45%) were male and 725 (55%) were female. Chi-Sqaure test statistical analysis in RTPCR Test showed p=0.515, p=0.634, p=0.00 in doctor and nurse, housekeeping and other staff respectively. Chi-Sqaure test statistical analysis in IgG antibody tests showed p=0.305, p=0.449 and p=o.345 in doctor and Nurse, Housekeeping and Other staff respectively.Conclusions: HCQ did not provide statistically significant pre exposure prophylaxis to doctors, nurses and housekeeping staff. However for, “other staff members category” it showed highly statistically significant prophylaxis effect with respect to RTPCR positive test results in comparison with HCW who did not consume HCQ prophylaxis. And hence HCQ could certainly play a crucial role in resource-constrained and overloaded health care systems in countries like India.

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