Reorienting Health Services to People with Chronic Health Conditions: Diabetes and Stroke Services in Malaysia, Sri Lanka and Thailand

It is unknown how health services staff (school nurse or school physician) or school characteristics are associated with the number of services provided for chronic health conditions in schools. Using data from the 2014 School Health Policies and Practices Study, four services (identification or school-based management, tracking, case management, and referrals) were analyzed using a multivariable ordered logistic regression. Approximately 57.2% of schools provided all four, 17.5% provided three, 10.1% provided two, 5.8% provided one, and 9.4% did not provide any such services. Schools with a school nurse were 51.5% ( p < .001) more likely to provide all four, and schools with access to consult with a school physician were 15.4% ( p < .05) more likely, compared to schools without one. Schools comprised of mostly racial/ethnic minority students (less than or equal to 50% non-Hispanic White) were 14.7% ( p < .05) less likely to provide all four, compared to schools with greater than 50% White students.

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Responding to the needs of children with chronic health conditions in an era of health services reform

Canadian Medical Association Journal ◽

10.1503/cmaj.1040019 ◽

2004 ◽

Vol 171 (11) ◽

pp. 1366-1367 ◽

Cited By ~ 7

Author(s):

A. R. Miller

Keyword(s):

Health Services ◽

Chronic Health Conditions ◽

Health Conditions ◽

Chronic Health

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British adults with chronic health conditions or impairments face significant barriers to accessing health services

Public Health ◽

10.1016/j.puhe.2012.08.003 ◽

2012 ◽

Vol 126 (11) ◽

pp. 920-927 ◽

Cited By ~ 29

Author(s):

L. Allerton ◽

E. Emerson

Keyword(s):

Health Services ◽

Chronic Health Conditions ◽

Health Conditions ◽

Chronic Health

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Health service provision for disease control among prisoners: a conceptual note

Journal of Health Research ◽

10.1108/jhr-04-2019-0068 ◽

2020 ◽

Vol 34 (4) ◽

pp. 353-358

Author(s):

Behnam Farhoudi ◽

SeyedAhmad SeyedAlinaghi ◽

Omid Dadras ◽

Mehrzad Tashakoriyan ◽

Mohammad Nazari Pouya ◽

...

Keyword(s):

Health Service ◽

Health Services ◽

Service Provision ◽

Healthcare Providers ◽

Chronic Health Conditions ◽

Health Conditions ◽

Noncommunicable Diseases ◽

Health Service Provision ◽

Chronic Health ◽

Content Type

PurposeThe aim of present study was to integrate vital noncommunicable diseases (coronary artery disease, hypertension, diabetes mellitus and mental health disorders) into Prison-Based Active Health Services Provision (PAHSP).Design/methodology/approachOn Jan 1, 2018, there were 230,000 prisoners in Iran. Timely and systematic detection and diagnosis of chronic health conditions among this population are imperative. The collaboration between healthcare providers in prison and members of the multidisciplinary team of the healthcare community outside prison initiated an active health service provision approach for HIV and tuberculosis (TB). Guidelines for the control of HIV and TB in prison were piloted, and the finalized version was named “Prison-based Active Health Services Provision” (PAHSP), which has been scaled up in 16 of 260 Iranian prisons.FindingThe PAHSP approach emphasizes the importance of early identification of key symptoms and risk factors. This approach provides an opportunity for improved prevention and treatment, enabling prisoners identified at risk or those who have been diagnosed with a target disease to be followed up and receive the appropriate health care.Originality/valueInitiatives such as screening for chronic health conditions coupled with treatment will reduce the burden of chronic illness among prisoners and the broader community, thereby saving on healthcare costs and lives.

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The Role of School Health Services in Addressing the Needs of Students With Chronic Health Conditions

The Journal of School Nursing ◽

10.1177/1059840516678909 ◽

2016 ◽

Vol 33 (1) ◽

pp. 64-72 ◽

Cited By ~ 24

Author(s):

Zanie C. Leroy ◽

Robin Wallin ◽

Sarah Lee

Keyword(s):

Health Services ◽

School Health ◽

The United States ◽

Chronic Health Conditions ◽

Health Conditions ◽

Food Allergies ◽

School Health Services ◽

Chronic Health ◽

K 12

Children and adolescents in the United States spend many hours in school. Students with chronic health conditions (CHCs) may face lower academic achievement, increased disability, fewer job opportunities, and limited community interactions as they enter adulthood. School health services provide safe and effective management of CHCs, often for students with limited access to health care. A systematic review to assess the role of school health services in addressing CHCs among students in Grades K–12 was completed using primary, peer-reviewed literature published from 2000 to 2015, on selected conditions: asthma, food allergies, diabetes, seizure disorders, and poor oral health. Thirty-nine articles met the inclusion criteria and results were synthesized; however, 38 were on asthma. Direct access to school nursing and other health services, as well as disease-specific education, improved health and academic outcomes among students with CHCs. Future research needs to include standardized definitions and data collection methods for students with CHCs.

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Experiencing Financial Hardship Associated With Medical Bills and Its Effects on Health Care Behavior: A 2-Year Panel Study

Health Education & Behavior ◽

10.1177/1090198117739671 ◽

2017 ◽

Vol 45 (4) ◽

pp. 616-624 ◽

Cited By ~ 5

Author(s):

Sunha Choi

Keyword(s):

Health Care ◽

Health Status ◽

Health Services ◽

Moderated Mediation ◽

Chronic Health Conditions ◽

Financial Hardship ◽

Health Conditions ◽

Chronic Health ◽

Medical Bills ◽

Chronic Health Status

Using 2-year panel data, this study examined (1) whether experiencing financial hardship associated with out-of-pocket medical expenditures affected delaying/missing necessary health care in the following year; (2) whether such financial hardship mediated the effects of predisposing, enabling, and need characteristics on timely health care access (i.e., significant indirect effects); and (3)whether such mediating effects are different by chronic health status (i.e., moderated mediation) among U.S. adults. The 2011 National Health Interview Survey was linked to the 2012 Medical Expenditure Panel Survey. The sample includes 8,993 adults aged between 26 and 64 years. Among them, 1,089 reported having at least one chronic health condition that had caused activity limitations. Multiple-group path analysis was conducted using Mplus 7.2. Approximately 35% experienced financial difficulties paying medical bills, including 28% who were currently paying off medical debts. Almost 14% of the respondents reported delayed/missed necessary medical treatments. In addition to direct effects, predisposing, enabling, and need factors affected access to care indirectly via financial hardship, although significant moderated mediation was found by chronic health status. However, different from the Andersen’s behavioral model of health service utilization, the effect of financial hardship due to medical bills as a barrier to the timely use of necessary health services was not smaller among adults with chronic health conditions. Policy alternatives should be explored to provide affordable financing programs and adequate safety net health services to reduce the financial burden of health care for those who are financially vulnerable, especially those suffering from chronic health conditions.

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