Chemsex case study: is it time to recommend routine screening of sexualised drug use in men who have sex with men?

This case discusses a gay male participating in sexualised drug use. It raises several important issues and strengthens the case for routine screening for sexualised drug use in men who have sex with men so that healthcare professionals can provide better-informed and higher-quality health care to this population.

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Comparison of health care utilization among patients affiliated and not affiliated with healthcare professionals in China

BMC Health Services Research ◽

10.1186/s12913-020-05895-y ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Yafei Si ◽

Zhongliang Zhou ◽

Min Su ◽

Han Hu ◽

Zesen Yang ◽

...

Keyword(s):

Health Care ◽

Health Care Utilization ◽

Healthcare Professionals ◽

Outpatient Visit ◽

Labour Force ◽

Care Utilization ◽

Exact Matching ◽

Quality Health Care ◽

Cross Sectional ◽

Quality Health

Abstract Background Doing “more” in healthcare can be a major threat to the delivery of high-quality health care. It is important to identify the supplier-induced demand (SID) of health care. This study aims to test SID hypothesis by comparing health care utilization among patients affiliated with healthcare professionals and their counterpart patients not affiliated with healthcare professionals. Methods We used coarsened exact matching to compare the health care utilization and expenditure between patients affiliated and not affiliated with healthcare professionals. Using cross-sectional data of the China Labour-force Dynamics Survey (CLDS) in 2014, we identified 806 patients affiliated with healthcare professionals and 22,788 patients not affiliated with healthcare professionals. The main outcomes were outpatient proportion and expenditure as well as inpatient proportion and expenditure. Results The matched outpatient proportion of patients not affiliated with healthcare professionals was 0.6% higher (P = 0.754) than that of their counterparts, and the matched inpatient proportion was 1.1% lower (P = 0.167). Patients not affiliated with healthcare professionals paid significantly more (680 CNY or 111 USD, P < 0.001) than their counterparts did per outpatient visit (1126 CNY [95% CI 885–1368] vs. 446 CNY [95% CI 248–643]), while patients not affiliated with healthcare professionals paid insignificantly less (2061 CNY or 336 USD, P = 0.751) than their counterparts did per inpatient visit (15583 CNY [95% CI 12052–19115] vs. 17645 CNY [95% CI 4884–30406]). Conclusion Our results lend support to the SID hypothesis and highlight the need for policies to address the large outpatient care expenses among patients not affiliated with healthcare professionals. Our study also suggests that as the public becomes more informed, the demand of health care may persist while heath care expenditure per outpatient visit may decline sharply due to the weakened SID. To address misbehaviors and contain health care costs, it is important to realign provider incentives.

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Developing an innovative business model for hospital services in Iran: a case study of Moheb Hospitals

Leadership in Health Services ◽

10.1108/lhs-10-2017-0063 ◽

2019 ◽

Vol 32 (1) ◽

pp. 129-147 ◽

Cited By ~ 1

Author(s):

Marjan Miremadi ◽

Kamyar Goudarzi

Keyword(s):

Health Care ◽

Business Model ◽

Health Care Services ◽

Business Models ◽

Single Case ◽

Quality Health Care ◽

Content Type ◽

Study Results ◽

Quality Health

PurposeThis paper aims to focus on the role of hospital business models by examining the innovative business model of Moheb Hospitals, which have successfully achieved the goal of reducing costs and delivering high-quality health-care services in Iran by encouraging public–private partnership.Design/methodology/approachThis paper is a single case study.FindingsThe study results illustrate the hospital’s current business model and its underlying elements. After presenting the findings, this paper is concluded by presenting the standing issues that should also be addressed and how improvements and adjustments can be made.Originality/valueThis study offers new insight to identify and analyze the shortcomings of health-care sector in Iran and introduces new methods to efficiently use current competencies.

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Going Way Upstream: How One Foundation Redefined Its Work to Improve Population Health

The Practical Playbook II ◽

10.1093/med/9780190936013.003.0032 ◽

2019 ◽

pp. 301-314

Author(s):

Peter Long ◽

Brittany Imwalle

Keyword(s):

Primary Care ◽

Health Care ◽

Domestic Violence ◽

Health Care Services ◽

Safety Net ◽

Quality Health Care ◽

Care Services ◽

Quality Health ◽

Access And Quality

This chapter presents a case study from the Blue Shield of California Foundation (BSCF) which in 2016 achieved considerable success in its work to expand access to high-quality health care and to end domestic violence in California. The case of BSCF demonstrates how to integrate disparate health care services, such as primary care and specialty care, and behavioral health and primary care, to improve access and quality while potentially lowering costs. BSCF created networks of established leaders within the health care and domestic violence safety nets in California and influenced safety net systems in California to think and act differently. However, despite these notable successes, BSCF struggled to sustain, scale, and spread these innovations to other organizations and systems or to embed them into policy changes. The chapter analyses why.

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Comparison of Health Care Utilization Among Patients Affiliated and Not Affiliated with Healthcare Professionals in China

10.21203/rs.3.rs-25999/v5 ◽

2020 ◽

Author(s):

Yafei Si ◽

Zhongliang Zhou ◽

Min Su ◽

Han Hu ◽

Zesen Yang ◽

...

Keyword(s):

Health Care ◽

Health Care Utilization ◽

Healthcare Professionals ◽

Outpatient Visit ◽

Labour Force ◽

Care Utilization ◽

Exact Matching ◽

Quality Health Care ◽

Cross Sectional ◽

Quality Health

Abstract Background Doing “more” in healthcare can be a major threat to the delivery of high-quality health care. It is important to identify the supplier-induced demand (SID) of health care. This study aims to test SID hypothesis by comparing health care utilization among patients affiliated with healthcare professionals and their counterpart patients not affiliated with healthcare professionals.Methods We used coarsened exact matching to compare the health care utilization and expenditure between patients affiliated and not affiliated with healthcare professionals. Using cross-sectional data of the China Labour-force Dynamics Survey (CLDS) in 2014, we identified 806 patients affiliated with healthcare professionals and 22788 patients not affiliated with healthcare professionals. The main outcomes were outpatient proportion and expenditure as well as inpatient proportion and expenditure.Results The matched outpatient proportion of patients not affiliated with healthcare professionals was 0.6% higher (P=0.754) than that of their counterparts, and the matched inpatient proportion was 1.1% lower (P=0.167). Patients not affiliated with healthcare professionals paid significantly more (680 CNY or 111 USD, P<0.001) than their counterparts did per outpatient visit (1126 CNY [95% CI 885-1368] vs. 446 CNY [95% CI 248-643]), while patients not affiliated with healthcare professionals paid insignificantly less (2061 CNY or 336 USD, P=0.751) than their counterparts did per inpatient visit (15583 CNY [95% CI 12052-19115] vs. 17645 CNY [95% CI 4884-30406]).Conclusion Our results lend support to the SID hypothesis and highlight the need for policies to address the large outpatient care expenses among patients not affiliated with healthcare professionals. Our study also suggests that as the public becomes more informed, the demand of health care may persist while heath care expenditure per outpatient visit may decline sharply due to the weakened SID. To address misbehaviors and contain health care costs, it is important to realign provider incentives.

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Experiences of Discrimination and HIV Risk Among Men Who Have Sex With Men in New York City

American Journal of Men s Health ◽

10.1177/1557988315575998 ◽

2016 ◽

Vol 10 (6) ◽

pp. 505-514 ◽

Cited By ~ 8

Author(s):

Kathleen H. Reilly ◽

Alan Neaigus ◽

Samuel M. Jenness ◽

Travis Wendel ◽

David M. Marshall ◽

...

Keyword(s):

Health Care ◽

New York ◽

New York City ◽

Hiv Risk ◽

York City ◽

Future Research ◽

Quality Health Care ◽

The Past ◽

Quality Health ◽

Sex With Men

The extent of gay-related discrimination in New York City (NYC) and the demographic and behavioral factors correlated with experiences of gay-related discrimination are not well understood. The Centers for Disease Control and Prevention–sponsored National HIV Behavioral Surveillance System, a cross-sectional study, was conducted in NYC in 2011. Men who have sex with men were venue-sampled, interviewed, and offered HIV testing. Frequencies of types of gay-related discrimination experienced in the past 12 months were calculated. Associations between types of discrimination and demographic and HIV risk variables were examined through the estimation of prevalence ratios (PRs) and 95% confidence intervals (CIs). More than half (53.2%) of all study participants reported having experienced any gay-related discrimination in the past 12 months; 45.0% reported that they had been called names or insulted; 23.6% reported receiving poorer services than other people in restaurants, stores, other businesses, or agencies; 22.0% reported being treated unfairly at work or school; 15.1% reported being physically attacked or injured; and 6.7% reported being denied or given lower quality health care. HIV-positive status (adjusted PR [aPR] = 2.9; 95% CI = 1.5, 5.6) and drug use in the past 12 months (aPR = 0.3; 95% CI = 0.1, 0.7) were independently associated with reports of having been denied or given lower quality health care. High rates of reported gay-related discrimination suggest that greater efforts are needed to reduce gay-related discrimination in affected communities. Future research is needed to better understand the extent of gay-related discrimination in NYC, particularly with regard to the relationship between HIV status and health care access.

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