Improving the evaluation of homeopathy: economic considerations and impact on health

2000 ◽  
Vol 89 (S 01) ◽  
pp. S27-S30 ◽  
Author(s):  
G Chaufferin
Keyword(s):  
Health Insurance ◽  
Evaluation Model ◽  
Healthcare Providers ◽  
Public Authorities ◽  
Policy Makers ◽  
Patient Profile ◽  
General Evaluation ◽  
Health Strategy ◽  
Epidemiological Impact ◽  
Health Care Strategies

AbstractObjectives: The financial crisis of health insurance systems sometimes drives public policy-makers to take precipitate action dominated by economic imperatives. The question addressed here consists in defining homeopathy’s scope of intervention, its place in health care strategies, recourse to treatment, and especially economic data appraising homeopathy’s impact on expenditures and outlay covered by health insurance in France.Method: We used the General Evaluation Model to define the study (to whom is the evaluation made, situations, criteria, measurement of these criteria, quality and precision).Results: The main results are in terms of costs, as follows:The differences observed cannot be explained by the patient profile or the diseases treated. Furthermore, a study carried out in France showed that 87% of patients whose physicians had prescribed homeopathic treatment did not see another physician for the same problem.Conclusions: Once basic analysis has been done, so that the economic and epidemiological impact of a certain health strategy can be determined, it is necessary to proceed further, helping healthcare providers and public authorities to make decisions. Various possibilities exist and should be investigated.

scholarly journals The Impact of the COVID-19 Pandemic on the Working Conditions, Employment, Career Development and Well-Being of Refugee Researchers

Societies ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 71
Author(s):  
Ourania Tzoraki ◽  
Svetlana Dimitrova ◽  
Marin Barzakov ◽  
Saad Yaseen ◽  
Vasilis Gavalas ◽  
...  
Keyword(s):  
Online Survey ◽  
Negative Impact ◽  
Well Being ◽  
Appropriate Technology ◽  
Public Authorities ◽  
Policy Makers ◽  
Home Setting ◽  
The Public ◽  
Work From Home ◽  
The Impact

The ongoing ‘refugee crisis’ of the past years has led to the migration of refugee researchers (RRs) to European countries. Due to the COVID-19 pandemic, RRs often had to work from home and/or to continue their social, cultural and economic integration process under new conditions. An online survey carried out to explore the impact of the pandemic on the refugee researchers showed that RRs found it difficult to adapt their everyday working life to the ‘home’ setting. The majority have had neither a suitable work environment at home nor the appropriate technology. Although they stated that they are rather pleased with the measures taken by the public authorities, they expressed concern about their vulnerability due to their precarious contracts and the bureaucratic asylum procedures, as the pandemic has had a negative impact on these major issues. The majority of RRs working in academia seem not to have been affected at all as far as their income is concerned, while the majority of those employed in other sectors became unemployed during the pandemic (58%). Recommendations are provided to the public authorities and policy makers to assist RRs to mitigate the consequences of the pandemic on their life.

scholarly journals Ten-year trends in epidemiology and outcomes of pediatric kidney replacement therapy in Europe: data from the ESPN/ERA-EDTA Registry

2021 ◽  
Author(s):  
Marjolein Bonthuis ◽  
Enrico Vidal ◽  
Anna Bjerre ◽  
Özlem Aydoğ ◽  
Sergey Baiko ◽  
...  
Keyword(s):  
Replacement Therapy ◽  
Cox Regression ◽  
Patient Survival ◽  
Healthcare Providers ◽  
Resource Planning ◽  
Policy Makers ◽  
Age Related ◽  
Kidney Replacement Therapy ◽  
Over Time ◽  
Related Population

Abstract Background For 10 consecutive years, the ESPN/ERA-EDTA Registry has included data on children with stage 5 chronic kidney disease (CKD 5) receiving kidney replacement therapy (KRT) in Europe. We examined trends in incidence and prevalence of KRT and patient survival. Methods We included all children aged <15 years starting KRT 2007–2016 in 22 European countries participating in the ESPN/ERA-EDTA Registry since 2007. General population statistics were derived from Eurostat. Incidence and prevalence were expressed per million age-related population (pmarp) and time trends studied with JoinPoint regression. We analyzed survival trends using Cox regression. Results Incidence of children commencing KRT <15 years remained stable over the study period, varying between 5.5 and 6.6 pmarp. Incidence by treatment modality was unchanged over time: 2.0 for hemodialysis (HD) and peritoneal dialysis (PD) and 1.0 for transplantation. Prevalence increased in all age categories and overall rose 2% annually from 26.4 pmarp in 2007 to 32.1 pmarp in 2016. Kidney transplantation prevalence increased 5.1% annually 2007–2009, followed by 1.5% increase/year until 2016. Prevalence of PD steadily increased 1.4% per year over the entire period, and HD prevalence started increasing 6.1% per year from 2011 onwards. Five-year unadjusted patient survival on KRT was around 94% and similar for those initiating KRT 2007–2009 or 2010–2012 (adjusted HR: 0.98, 95% CI:0.71–1.35). Conclusions We found a stable incidence and increasing prevalence of European children on KRT 2007–2016. Five-year patient survival was good and was unchanged over time. These data can inform patients and healthcare providers and aid health policy makers on future resource planning of pediatric KRT in Europe.

scholarly journals Predictors of poor health and functional recovery following road trauma: protocol of a British Columbian inception cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e049623
Author(s):  
Leona K Shum ◽  
Herbert Chan ◽  
Shannon Erdelyi ◽  
Lulu X Pei ◽  
Jeffrey R Brubacher
Keyword(s):  
Resource Use ◽  
Healthcare Resource ◽  
Healthcare Providers ◽  
Healthcare Resource Use ◽  
Physical And Mental Health ◽  
Inception Cohort ◽  
Policy Makers ◽  
Productivity Costs ◽  
Poor Outcome ◽  
Lost Productivity

IntroductionRoad trauma (RT) is a major public health problem affecting physical and mental health, and may result in prolonged absenteeism from work or study. It is important for healthcare providers to know which RT survivors are at risk of a poor outcome, and policy-makers should know the associated costs. Unfortunately, outcome after RT is poorly understood, especially for RT survivors who are treated and released from an emergency department (ED) without the need for hospital admission. Currently, there is almost no research on risk factors for a poor outcome among RT survivors. This study will use current Canadian data to address these knowledge gaps.Methods and analysisWe will follow an inception cohort of 1500 RT survivors (16 years and older) who visited a participating ED within 24 hours of the accident. Baseline interviews determine pre-existing health and functional status, and other potential risk factors for a poor outcome. Follow-up interviews at 2, 4, 6, and 12 months (key stages of recovery) use standardised health-related quality of life tools to determine physical and mental health outcome, functional recovery, and healthcare resource use and lost productivity costs.Ethics and disseminationThe Road Trauma Outcome Study is approved by our institutional Research Ethics Board. This study aims to provide healthcare providers with knowledge on how quickly RT survivors recover from their injuries and who may be more likely to have a poor outcome. We anticipate that this information will be used to improve management of all road users following RT. Healthcare resource use and lost productivity costs will be collected to provide a better cost estimate of the effects of RT. This information can be used by policy-makers to make informed decisions on RT prevention programmes.

scholarly journals A qualitative inquiry of access to and quality of primary healthcare in seven communities in East and West Africa (SevenCEWA): perspectives of stakeholders, healthcare providers and users

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Soter Ameh ◽  
Bolarinwa Oladimeji Akeem ◽  
Caleb Ochimana ◽  
Abayomi Olabayo Oluwasanu ◽  
Shukri F. Mohamed ◽  
...  
Keyword(s):  
Health Insurance ◽  
West Africa ◽  
Primary Healthcare ◽  
A Priori ◽  
Healthcare Providers ◽  
Health Coverage ◽  
Health Seeking ◽  
East And West ◽  
Universal Health

Abstract Background Universal health coverage is one of the Sustainable Development Goal targets known to improve population health and reduce financial burden. There is little qualitative data on access to and quality of primary healthcare in East and West Africa. The aim of this study was to describe the viewpoints of healthcare users, healthcare providers and other stakeholders on health-seeking behaviour, access to and quality of healthcare in seven communities in East and West Africa. Methods A qualitative study was conducted in four communities in Nigeria and one community each in Kenya, Uganda and Tanzania in 2018. Purposive sampling was used to recruit: 155 respondents (mostly healthcare users) for 24 focus group discussions, 25 healthcare users, healthcare providers and stakeholders for in-depth interviews and 11 healthcare providers and stakeholders for key informant interviews. The conceptual framework in this study combined elements of the Health Belief Model, Health Care Utilisation Model, four ‘As’ of access to care, and pathway model to better understand the a priori themes on access to and quality of primary healthcare as well as health-seeking behaviours of the study respondents. A content analysis of the data was done using MAXQDA 2018 qualitative software to identify these a priori themes and emerging themes. Results Access to primary healthcare in the seven communities was limited, especially use of health insurance. Quality of care was perceived to be unacceptable in public facilities whereas cost of care was unaffordable in private facilities. Health providers and users as well as stakeholders highlighted shortage of equipment, frequent drug stock-outs and long waiting times as major issues, but had varying opinions on satisfaction with care. Use of herbal medicines and other traditional treatments delayed or deterred seeking modern healthcare in the Nigerian sites. Conclusions There was a substantial gap in primary healthcare coverage and quality in the selected communities in rural and urban East and West Africa. Alternative models of healthcare delivery that address social and health inequities, through affordable health insurance, can be used to fill this gap and facilitate achieving universal health coverage.

scholarly journals An Investigation into the Implementation Processes of Ghana’s Primary Health Care Strategy: The Community-Based Health Planning and Services Programme.

2021 ◽  
Author(s):  
Matthew Kwame Edusei ◽  
Kofi Bobi Barimah ◽  
Samuel Kwadwo Asibuo
Keyword(s):  
Health Planning ◽  
Exploratory Research ◽  
Community Based ◽  
Policy Makers ◽  
Implementation Challenges ◽  
The Public ◽  
Implementation Processes ◽  
Health Goals ◽  
Health Strategy ◽  
District Assemblies

Abstract Background: Ghana has adopted the community-based health planning and services (CHPS) programme as the public health strategy for meeting its universal health goals. The programme is facing implementation challenges that are affecting its expansion within the communities. This research was undertaken to examine the implementation processes of CHPS and suggest solutions to improve its scaling-up within the communities.Method : An exploratory research design was used with a mixed method approach that involved the testing of a hypothesis. Results : The study found that in places with on-going CHPS programmes, there is statistically significant (p<0.001) evidence that the implementation processes are not flawed. However, the district assemblies were selective in the allocation of CHPS zones within the communities. Conclusion : Chieftaincy conflicts within the communities are impeding the community entry aspect of the CHPS policy implementation processes and needs to be addressed by policy makers in the relevant government agencies.

scholarly journals Occurrence of Medical Cases and Utilisation among Enrollees of Private Health Insurance Programme in Kaduna, Nigeria

2020 ◽  
pp. 30-37
Author(s):  
Oni, Oluwatobi Dapo ◽  
Zakari, Mustapha Mohammed ◽  
Okemmiri, Innocentia Chidinma
Keyword(s):  
Health Insurance ◽  
Private Health Insurance ◽  
Healthcare Providers ◽  
Healthcare Services ◽  
Health Coverage ◽  
Primary Case ◽  
Health Maintenance ◽  
Insurance Programme ◽  
Chi Square Analysis ◽  
Health Insurance Programme

Aims: This study examines the occurrence of various medical cases presented by enrollees that have subscribed to access healthcare from a network of healthcare providers (HCPs) managed by a Health Maintenance Organisation (HMO) under its Private Health Insurance Programme (PHIP). Study Design:  A descriptive cross-sectional design was employed. Methodology: Secondary data from collected or submitted medical encounters in form of bills of registered enrollees (principals and their dependants) who have visited and received treatment from their chosen healthcare providers in Kaduna State between the month of January and December 2019 were purposively compiled and analysed. Cases were classified using the National Health Insurance Scheme (NHIS) Operational Guideline. Frequency tables, charts, percentages and Chi-Square analysis were used with the aid of Statistical Package for Social Sciences (SPSS) 22 at P=.05 level of significance. Results: A total of 11,156 medical cases were recorded after attrition, 9,525 (85.38%) primary cases and 1,632 (14.62%) secondary cases. Malaria (41.23%) and Respiratory Tract Infection (11.98%) led the primary case table while Hypertension (3.83%) Urology related cases (2.49%) and Diabetes (0.79%) were among the leading secondary cases. Female enrollees had slightly more cases and therefore higher tendencies to seek medical treatment than their male counterpart even though there was no significant relation between gender and type of case. Conclusion: The study concludes that the awareness and utilization of healthcare services are gradually growing among enrollees under the Private Health Insurance Programme (PHIP). In ensuring that there is an improvement in the health sector of Nigeria and achieving universal health coverage, focus should be on the primary healthcare services with high consideration for research, proper data management and periodic sharing of trends, observations and outcome of researches with the growing health community.

scholarly journals The conceptualisation of patient-centred care: A case study of diabetes management in public facilities in southern Malawi

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Martha Makwero ◽  
Adamson Muula ◽  
Felix C. Anyawu ◽  
Jude Igumbor
Keyword(s):  
Diabetes Management ◽  
Healthcare Providers ◽  
Major Elements ◽  
Relationship Building ◽  
Exploratory Research ◽  
Framework Analysis ◽  
Policy Makers ◽  
Patient Centred Care ◽  
Group Interviews ◽  
Relational Framework

Background: Patient-centred care (PCC) is one of the pillars of Malawi’s quality of care policy initiatives. The role of PCC in facilitating quality service delivery is well documented, and its importance may heighten in chronic disease management. Yet, PCC conceptualisation is known to be context specific.Aim: The study aimed to understand the conceptualisation of PCC amongst patients, healthcare providers (HCP) and policy makers in Diabetes Mellitus (DM) management.Setting: This study was conducted in DM clinics in Southern Malawi.Methods: Our qualitative exploratory research study design used in-depth and focus group interviews. We interviewed patients with DM, HCPs and policy makers. The study used framework analysis guided by Mead and Bower’s work.Results: Patient-centred care conceptualisations from groups of participants showed convergence. However, they differed in emphasis in some elements. The prominent themes emerging from the participants’ conceptualisation of PCC included the following: meeting individual needs, goals and expectations, accessing medication, supporting relationship building, patient involvement, information sharing, holistic care, timeliness and being realistic.Conclusion: Patient-centred care conceptualisation in Malawi goes beyond the patient–HCP relational framework to include the technical aspects of care. Contrary to the global view, accessing medication and timeliness are major elements in PCC conceptualisation in Malawi. Whilst PCC conceptualisation is contextual, meeting expectations and needs of patients is fundamental.

scholarly journals Health Communication and Inter-professional Care in Context of Multimorbidity Management: Assessment of Health Professional Curricular Focus in India

2021 ◽  
Vol 6 ◽  
Author(s):  
Sanghamitra Pati ◽  
Rajeshwari Sinha ◽  
Pranab Mahapatra
Keyword(s):  
Health Communication ◽  
Health Professional ◽  
Healthcare Providers ◽  
Multidisciplinary Care ◽  
Term Care ◽  
Policy Makers ◽  
Competency Based ◽  
Professional Care ◽  
Care Demands

To meet the long term care demands of chronic diseases as well as multimorbidity, healthcare providers from different disciplines need to work collaboratively in practice. This requires healthcare providers to be appropriately trained on delivery of inter-professional care (IPC) and health communication aspects during formative professional years. In this study, we have looked at the prevailing undergraduate and postgraduate healthcare professional curricula to understand the focus on health communication and on IPC for the delivery of multidisciplinary care for multimorbidity management. We observe that while there are exclusive courses on health communication being delivered at different levels, the focus on IPC is still in stages of infancy. The IPC component is just beginning to be woven into the health professional curricula through elements like competency-based curriculum, rotational posting, inter-departmental engagements. At the same time, the need to put curricular attention on multimorbidity is also highlighted here. There remains wider scope for strengthening learning on health communication and IPC among different disciplines within the curricula in the context of multimorbidity. We expect our findings to provide key inputs to academic planners and policy makers towards the introduction of adequate curricular components for addressing multimorbidity along with necessary prescriptions for health communication and IPC in India.

scholarly journals To live and age as who we really are

2020 ◽  
Vol 3 ◽  
pp. 6
Author(s):  
Lorna Roe ◽  
Miriam Galvin ◽  
Laura Booi ◽  
Lenisa Brandao ◽  
Jorge Leon Salas ◽  
...  
Keyword(s):  
Lived Experience ◽  
Trinity College ◽  
Healthcare Providers ◽  
Open Letter ◽  
Brain Health ◽  
Policy Makers ◽  
Trinity College Dublin ◽  
Multidisciplinary Group ◽  
Lgbt People ◽  
Global Brain

This Open Letter discusses the theme of ‘diversity in brain health’ in research, practice and policy for older LGBT+ people. It is written by a multidisciplinary group of Atlantic Fellows for Equity in Brain Health at the Global Brain Health Institute in Trinity College Dublin (TCD), from a variety of disciplines (health economics, human geography, anthropology, psychology, gerontology) and professions (researcher, clinicians, writers, practicing artists). The group developed a workshop to explore the theme of ‘Diversity and Brain Health’ through the lens of non-normative gender identities and sexualities. Guided by two advisors (Prof Agnes Higgins, TCD; Mr Ciaran McKinney, Age and Opportunity), we invited older LGBT+ people and those interested in the topic of LGBT+ and ageing, healthcare providers, policy makers and interested members of the research community. We partnered with colleagues in the School of Law to include socio-legal perspectives. Following the workshop, Roe and Walrath wrote an opinion editorial, published in the Irish Times during the 2019 PRIDE festival, and were subsequently invited by HRB Open Access to provide a more detailed expansion of that work. In this Open Letter we describe the theme of ‘diversity and brain health’ and some of the lessons we learned from listening to the lived experience of older LGBT+ people in Ireland today. We illustrate why it’s important to understand the lived experience of older LGBT+ people and highlight the failure of the State to evaluate the experience of LGBT+ people in policy implementation. We call on researchers, clinicians, service planners and policy makers, to recognize and address diversity as an important way to address health inequities in Ireland.

We Can Trust without Data, But We Are Accountable Only through Measurement

2017 ◽  
pp. 255-270
Author(s):  
Vahé A. Kazandjian
Keyword(s):  
Healthcare Providers ◽  
Quality And Safety ◽  
Policy Makers ◽  
The Core ◽  
Measurement Tools ◽  
Key Dimensions ◽  
Local Traditions ◽  
Analytical Tools ◽  
Probabilistic Nature ◽  
Nature Of Medicine

Traditional expectations about healthcare continue to be challenged by the umbrella concerns about accountability and trust. The core of this challenge is two-fold: healthcare providers have seen the absolute trust placed into their intentions and practices erode through the quantification of quality and safety of care, and, the recipients of care have been empowered with timely and specific data to demand accountability rather than unquestionably trust providers. The purpose of this chapter is to review the key dimensions of the operationalization of performance measurement and the translation of its findings to statements about quality and safety of care. The past four decades have seen the continuous discovery and refining of analytical tools to quantify what once was taken for granted: that patients always receive the best care possible. These tools have uncovered the probabilistic nature of medicine and the resulting nature of the relationships outcomes have to processes. Hence the expectations of patients, payers of care and policy makers require being continuously modified to reflect the limitations of medicine and healthcare. The education of various audiences as to what the measures mean not only is a necessary requisite for sound project design but also will determine how the accountability model is shaped in each environment based on the generic measurement tools results, local traditions of care and caring, and expectations about outcomes.

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