Hospital in the Home in Victoria: Factors Influencing Allocation Decisions

1999 ◽  
Vol 5 (1) ◽  
pp. 60 ◽  
Author(s):  
Genevieve Cooper

There is a question surrounding the funding of Hospital in the Home (HITH) as to whether the allocation policy was driven by customer service preference or was largely a financial imperative. HITH has the capacity to increase the throughput and therefore the efficiency of acute care facilities which is attractive to Government and Health Service Managers. There is insufficient evidence to indicate that this is true in all circumstances. Hospital in the Home is a desirable and safe option for some clients. Hospital in the Home has the potential to provide a more cost effective mode of delivery of acute care than hospital facilities. However, there is a need for identification of which clients, with which conditions and care needs, will benefit from being part of a HITH program in emotional, health and financial terms. Health professionals are still grappling with the impact that HITH has on their roles and relationships with other health care providers. More qualitative and quantitative research needs to be undertaken to identify the best models of HITH in both organisational and financial tems, and its impact on the wellbeing of clients and carers.

2014 ◽  
Vol 3 (4) ◽  
pp. 25 ◽  
Author(s):  
Moriah Ellen ◽  
G. Ross Baker ◽  
Adalsteinn Brown

Systematic reviews have found that clinical practice guidelines (CPGs) are associated with lower lengths of stay (LOS), but a secondary analysis of Ontario acute care hospitals found few significant relationships between CPGs and LOS. This research explored possible reasons for these findings and what other factors may impact the CPG-LOS relationship. Semi-structured interviews were conducted with staff from nine hospitals whose jobs dealt with developing, implementing, monitoring, updating, or evaluating CPGs. Interviews were analyzed utilizing methods outlined by Aurebach. A variety of leaders and hospital types were represented. Five main factors influencing relationships between CPGs and LOS were identified: 1) the purpose of implementation, 2) evidence base for CPG content and selection, 3) health care professionals’ response to change and compliance, 4) dissemination strategies, and 5) organizational support and resources. The interviews suggested possible reasons why CPGs are not realizing their full potential impact on LOS in Ontario hospitals, ranging from poor compliance to resistance from health care providers. CPGs themselves are not perceived to be the reason for ineffectiveness; rather, organizational- and individual-level barriers seem to be the causes.


Author(s):  
Hrushikesh Das ◽  
Sasmita Panigrahi ◽  
Dharitri Swain

Tele-information and communication have led a global revolution in solving the scarcity of health care workers. In the vision of health for all, different global leaders have initiated many public health reforms to address the health care needs of citizens, like e-Sanjeevani in India. COVID-19 created an acute shortage of nurses, as well as the rising cost of care and hospital occupancy which are major hurdles to address basic health needs. Telenursing is a novel field that utilizes innovative technologies to offer safe, effective, and ethical care promptly by providing. Telenursing may provide a means to overcome some of the challenges faced by patients by providing easier access to cost-effective care and equitable distribution of health care providers. Globally, telenursing is an emerging and rapidly expanding area for professionals and offers unlimited opportunities for its members.


Author(s):  
Diah Ramadhani ◽  
Urip Harahap ◽  
Azizah Nasution

 Objectives: To determine the effect of counseling on effectiveness and cost of the treatment for outpatient with primary hypertension (HTN) in Cut Meutia Hospital, Indonesia.Methods: This 6-month prospective quasi-experimental study was undertaken to analyze the impact of counseling toward cost and effectiveness in the treatment in patients with primary HTN and evaluation of each month at Cut Meutia Hospital, Indonesia. The study sample consisted of 22 patients for each group. A cost analysis was conducted from the perspective of the health-care providers. The cost in the treatment of both groups was analyzed by calculating the cost-effectiveness ratio (CER) and incremental CER (ICER).Results: Most of the patients with HTN (54.55%) were males with ages ranging from 35 to 64 years old (77.27%). Patients who achieved a blood pressure <140/90 mmHg on HTN treatment: With counseling, 77.27%; without counseling, 18.18%. CER for HTN treatment with and without counseling were Rp 1,756,117,86 and Rp 6,704,247,91, respectively. The ICER was Rp 233,745.13.Conclusion: Treatment of HTN with counseling was more cost-effective than without counseling.


2013 ◽  
Vol 31 (31_suppl) ◽  
pp. 151-151
Author(s):  
Jennifer L. Harper ◽  
Anna-Maria A. de Costa ◽  
Elizabeth Garrett-Mayer ◽  
Katherine W. Sterba

151 Background: The Medical University of South Carolina implemented a “patient-centered” multidisciplinary breast clinic program (MDBC) in August 2012. The structure of this care model facilitates a coordinated set of specialist visits, diagnostic studies, and care plan development on the day of initial consultation. In this study, we examined patient satisfaction with MDBC care delivery and communication with health care providers to inform the refinement of the MDBC program. Methods: During the first 10 months of the MDBC, patients were asked to complete a post-consultation telephone survey assessing overall satisfaction with care quality and the MDBC clinical team as well as satisfaction with various aspects of the MDBC model (e.g., time, explanation of treatment options, communication about practical and psychosocial factors). A statistical analysis was performed to explore potential associations between age (linear regression), race (Wilcoxon rank sum test), and stage (Fisher's exact test) with overall patient satisfaction scores. Results: Overall, patients (N=52, 56% W, 42% AA, 2% H; mean age=61 yrs) were highly satisfied with the MDBC consultation visit (mean=4.7, range 1-5), felt comfortable with their plan of care (mean= 4.4, range 1-5) and were satisfied with explanations about the cancer and treatment options (mean=3.7, range 1-4). Communication with treatment staff was scored highly. No statistically significant differences in overall satisfaction were found by age, race, or stage. However, patient responses were commonly “No” or “Yes, but not as much as I would like,” when asked if the care team addressed the impact of their diagnosis on their personal relationships (40.4%) or emotional health (28.9%). Conclusions: Results demonstrate that patients were highly satisfied with the care they received in the MDBC program. Participants were highly satisfied with practical care delivery factors such as time spent with clinical team and physician-patient communication. Findings suggest that this model is well suited to a diverse patient population and have highlighted potential quality improvement targets such as increased emphasis on provider's communication about psychosocial issues.


2020 ◽  
Vol 32 (S1) ◽  
pp. 123-123
Author(s):  
Ken Schwartz ◽  
Robert Madan ◽  
Anna Berall ◽  
Marsha Natadira ◽  
Anna Santiago

Background:Responsive behaviours in dementia are associated with poor outcomes for the person with dementia (PWD) and caregiver burnout. Family caregivers need a variety of tools to manage responsive behaviours. The Baycrest Quick-Response Caregiver Tool was developed to provide caregivers with a tool that can be used in real time. In this study, the feasibility, impact, and effectiveness of this new tool were studied in family caregivers and health care providers (HCP) using quantitative and qualitative measures.Methods:Family caregivers were recruited and were asked to complete a pre-survey before being sent the link to the educational tool. One month after the telephone survey, caregivers were sent an online post-survey to gather their feedback on the tool and the impact of the tool on caregiver well -being. Healthcare providers were also recruited and reviewed the tool through an online feedback survey. The feasibility, impact, and effectiveness of the tool were assessed using quantitative and qualitative measures.Results:Caregivers had a moderate degree of and reported a high level of competence - these scores were maintained throughout the study. Caregivers reported that tool positively impacted their compassion towards the person with dementia (PWD), and that their interactions with improved. 100% of HCP who completed the feedback survey would recommend the tool to other HCP and to caregivers of PWD. The caregivers and HCP provided specific suggestions for improvement.Conclusions:The Baycrest Quick-Response Caregiver Tool was found to be feasible and helpful. It provides caregivers and HCP with an additional approach for responsive behaviours.


2016 ◽  
Vol 27 (7) ◽  
pp. 994-1005 ◽  
Author(s):  
Dolores Angela Castelli Dransart

The objective of this study is to identify patterns (components and processes) of reconstruction of suicide survivors. In-depth interviews were conducted with 50 survivors of suicide in Switzerland. Data were analyzed using ATLAS.ti and according to the Grounded Theory principles. Survivors of suicide face four major challenges: dealing with the impact of suicide, searching for meaning, clarifying responsibility, and finding a personal style of reaction and coping. The various ways in which survivors fare through the specific processes of the challenges result in various patterns of reconstruction: the vulnerability, transformation, commitment, and hard blow. The unique characteristics and dynamics of each of them are highlighted. Health care providers would benefit from an approach based on the dynamics of the various patterns of reconstruction in providing appropriate support to survivors of suicide.


2016 ◽  
Vol 33 (10) ◽  
pp. 972-976 ◽  
Author(s):  
Sadie P. Hutson

Little is known about the health access and end-of-life (EOL) concerns of persons living with HIV/AIDS (PLWHA) in Appalachia, where religious and cultural values are largely traditional. A qualitative, descriptive study with 9 participants was undertaken to assess EOL care needs among those from South Central Appalachian PLWHA. The focus of the study was to examine subjective data regarding EOL needs assessment related to advanced care planning. Five men and 4 women self-acknowledged a diagnosis of HIV/AIDS and completed a 2-hour face-to-face interview with the nurse researcher. Data were analyzed using qualitative descriptive content analysis methods, including data coding for emergent themes and metaphors. A common metaphor tied content to both struggle and triumph as well as the beauty and ruggedness of the Appalachian region: “Climbing Back up the Mountain.” Rich descriptions of the significance of the metaphor match with stigma as the greatest hurdle to overcome in planning and interacting with others, including health care providers and significant others, about EOL care needs and advanced planning preferences. Further, the metaphor was derived directly from quotes offered by participants. Sources of stigma were often intersecting: the disease itself, associations with “promiscuity,” sexual minority status, illicit drug use, and so on. Strong spiritual images were contrasted with a common avoidance and disdain of organized religion. Findings were used in refining plans for a larger study of EOL care needs and concerns on the population of PLWHA in 2 Southern Appalachian states. Comparison with other research and insights for providers is included.


Author(s):  
Fatemeh Rahmanian ◽  
Soheila Nazarpour ◽  
Masoumeh Simbar ◽  
Ali Ramezankhani ◽  
Farid Zayeri

AbstractBackgroundA dimension of reproductive health services that should be gender sensitive is reproductive health services for adolescents.ObjectiveThis study aims to assess needs for gender sensitive reproductive health care services for adolescents.MethodsThis was a descriptive cross-sectional study on 341 of health care providers for adolescents in health centers and hospitals affiliated to Shiraz University of Medical Sciences in Iran in 2016. The subjects of the study were recruited using a convenience sampling method. The tools for data collection were: (1) a demographic information questionnaire and; (2) a valid and reliable questionnaire to Assess the Needs of Gender-Sensitive Adolescents Reproductive Health Care Services (ANQ-GSARHS) including three sections; process, structure and policy making for the services. Data were analyzed using SPSS 21.ResultsThree hundred and forty-one health providers with an average working experience of 8.77 ± 5.39 [mean ± standard deviation (SD)] years participated in the study. The results demonstrated the highest scores for educational needs (92.96% ± 11.49%), supportive policies (92.71% ± 11.70%) and then care needs (92.37% ± 14.34%) of the services.ConclusionsProviding gender sensitive reproductive health care services for adolescents needs to be reformed as regards processes, structure and policies of the services. However, the gender appropriate educational and care needs as well as supportive policies are the priorities for reform of the services.


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