scholarly journals Health service provision for women 50+: the “Frauen 5.0” project in the north-east region in Germany

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
L Dini ◽  
F Pruetz
Keyword(s):  
Health Care ◽  
Health Care Services ◽  
Research Policy ◽  
Health Care Provision ◽  
Care Provision ◽  
Policy And Practice ◽  
Policy Makers ◽  
Care Services ◽  
North East ◽  
Improve Health

Abstract Background A higher life expectancy for women in Germany coincides with shortages in health professionals. Besides gynecologists (Gyn), the main providers of ambulatory healthcare services for women 50+ are general practitioners (GPs), which are not providing any gynecological services. The project “Frauen 5.0” aims to identify strategies for improving health care provision for women 50+ in three north-east states of Germany by analyzing health system indicators and exploring the perspective of service providers, users, practitioners and policy makers. Methods Mixed-methods combined with participatory research including 1) secondary data analysis (Robert Koch-Institute and Zentralinstitut); 2) postal quantitative survey of all Gyn (n = 1.031) and of a randomized sample of 66% of GPs (n = 3.514); 3) qualitative interviews of women 50 + (n = 25); and 4) round tables with practitioners and policy makers. Results In Germany 25% of the population are women 50+, from which 41% do not use Gyn services. Users expressed the need that GPs/Gyn actively address women’s health issues during consultation. The survey (response rate 51% Gyn; 25% GPs) revealed a high willingness to collaborate among GPs and Gyn. Barriers and synergies in organizational, professional and user aspects were identified. Task-sharing between GP and Gyn, delegation to non-medical personnel and the introduction of financial incentives showed to be a key element to improve health care services for women 50+. Dissusion In the SDG era of “leaving no one behind” acknowledging and addressing the unmet needs of women 50+ is from a public health perspective an issue of utmost urgency as is closing the gap between research, policy and practice. Conclusions New strategies to improve health care services for women 50+ were developed by integrating the evidence from actual data in meaningfull dialogues between research, policy and practice. Key messages New models of health care provision are required to adress and improve the health of women 50+. Closer collaboration between research policy and practice can be achieved by participatory methods.

The Changing Landscape of Health Care Provision to American Indian Nations

2015 ◽  
Vol 39 (1) ◽  
pp. 1-24 ◽  
Author(s):  
Stephanie Rainie ◽  
Miriam Jorgensen ◽  
Stephen Cornell ◽  
Jaime Arsenault
Keyword(s):  
United States ◽  
Health Care ◽  
American Indian ◽  
Alaska Native ◽  
Health Care Services ◽  
The United States ◽  
Health Care Provision ◽  
Care Provision ◽  
Health Service Provision ◽  
Care Services

Health service provision has been an aspect of indigenous-United States relationships for over two hundred years, yet America's First Peoples continue to suffer from poor health outcomes when compared with other racial or ethnic groups in the United States. An important change over recent decades is that more and more tribes are managing their own health care services—a realignment of administration and authority that has the potential to substantially improve American Indian and Alaska Native health in years to come. This paper describes the history of health care provision to federally recognized American Indian tribes. It continues by documenting the sparse research literature on tribal management of health care services and identifying information still needed to bring knowledge of this topic up-to-date. Five challenges for tribal management of health-care services that should be considered by tribes and policymakers in their health-care efforts and brought to bear on future research are discussed. By addressing both tribal control of health-care services and the role of tribes in changes to federally provided health care, this paper adds the lens of tribal sovereignty to current discussions of the history and policy context for American Indian and Alaska Native health.

scholarly journals The situation of elderly with cognitive impairment living at home during lockdown in the Corona-pandemic in Germany

2020 ◽  
Author(s):  
Jochen René Thyrian ◽  
Friederike Kracht ◽  
Angela Nikelski ◽  
Melanie Boekholt ◽  
Fanny Schumacher-Schönert ◽  
...  
Keyword(s):  
Health Care ◽  
Cognitive Impairment ◽  
Elderly People ◽  
Health Care Services ◽  
Health Care Provision ◽  
Social Activities ◽  
Care Provision ◽  
Social Distancing ◽  
Care Services ◽  
At Home

Abstract Background: The outbreak of the Corona virus is a challenge for health care systems worldwide. Elderly people with comorbidities are at a higher risk and the different levels of government in Germany reacted jointly to the challenge with social distancing and a lockdown. Little empirical evidence exists about the psychosocial situation of elderly people during this time. Thus, the aim of this study is to analyze a) knowledge about, and feelings related to the Corona-pandemic. Describe b) loneliness, depression and anxiety, and, c) the perceived, immediate impact of the lockdown on frequency of social contacts and quality of health care provision of people with cognitive impairment during social distancing and lockdown in the primary care system and daily living at home in Germany. Methods: This analysis is based on data from standardized telephone interviews in a convenience sample of n=141 people with known cognitive impairment in the primary care setting. Participants were recruited from currently running interventional trials. Therefore, data on e.g. cognitive and psychological status prior to the pandemic was available. Attitudes, knowledge about and perceived personal impact of the pandemic, social support, loneliness, anxiety, depression, frequency of social activities due to the pandemic and perceived impact of the pandemic on health care services were assessed during the time of lockdown. Results: The vast majority of participants consider themselves sufficiently informed about Corona (85%) and most think that the measures taken are appropriate (64%). A total of 11% shows one main symptom of a depression according to DSM-V. The frequency of depressive symptoms has not increased between the time before pandemic and lockdown in almost all participants. The sample shows minimal (65.0%) or low levels of anxiety (25%). The prevalence of loneliness is 10%. On average seven activities have decreased in frequency due to the pandemic. Social activities related to meeting people, dancing or birthday visits have decreased significantly. Talking with friends by phone and activities like gardening have increased. Utilization of health care services like day clinics, relief services and prescribed therapies are reported to have worsened due to the pandemic. Also visits to general practitioners decreased. Discussion: The study shows a limited impact of the pandemic on psychological variables including depression, anxiety and loneliness in the short-term. People are well informed but not especially concerned about themselves or others. There is a decrease in social activities as expected, in line with the restrictions imposed. The impact on health care provision is prominent. There is a need for longitudinal studies to assess longer-term effects of the pandemic and social distancing on elderly people with cognitive impairment living at home and their caregivers. There is also a need for qualitative, in-depth studies to further interpret the results. In general, elderly people in the setting under examination and with the limitations of this specific study seem to compensate restrictions during the time of lockdown in Germany rather well.

Innovation in ICT-Based Health Care Provision

2011 ◽  
Vol 6 (2) ◽  
pp. 14-27 ◽  
Author(s):  
Synnøve Thomassen Andersen ◽  
Arild Jansen
Keyword(s):  
Health Care ◽  
Rural Areas ◽  
Health Care Services ◽  
Innovation Process ◽  
Care Provision ◽  
Power Structures ◽  
Mobile Phone Technology ◽  
Existing Structures ◽  
Care Services ◽  
Decentralized Model

This paper describes a project redesigning psychiatric services for children and adolescents, introducing a new decentralized model into the ordinary structures of health care services in rural areas in Norway by using mobile phone technology. The authors apply a multilayer and dialectic perspective in the analysis of the innovation process that created the ICT solution that supports this treatment model. The salient challenges of the project were related to the contradictions between the existing, dominant power structures and the emergent structures in the different layers of the design structures. As a result of the development process, a new model emerged with a larger potential for creating a new innovation path than if it had been linked to existing structures. This paper contributes to the understanding of how user-driven innovation can break with existing power structures through focusing on different layers in the change processes.

Confined to Obscurity: Health Challenges of Pregnant Women in Jail

2020 ◽  
Vol 45 (3) ◽  
pp. 177-185
Author(s):  
Susan J Rose ◽  
Thomas P LeBel
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Substance Use ◽  
Physical Health ◽  
Pregnant Women ◽  
Mental Health Treatment ◽  
Health Care Services ◽  
Background Characteristics ◽  
Policy And Practice ◽  
Care Services

Abstract Research about pregnant women in jail is scant. This exploratory study begins to fill this gap by examining the demographics; background characteristics; and self-reported physical health, mental health, and substance use challenges reported by 27 pregnant women incarcerated in a large midwestern county jail. It further reports on the prenatal care before and during their incarceration, plans of these pregnant women for delivery of their child, caring for their infant after their release from jail, and their expectations of paternal or family support post-release. Among the sample, 66.7 percent reported a physical health care problem, 48.2 percent had received mental health treatment, and 18.5 percent had substance use treatment in the previous year, but only 51.9 percent had seen a health care professional before their incarceration. All women expected the father of their child to provide financial support, but only 76.9 percent expected the father to be involved with the child. The authors also discuss implications of the findings for jail health care services and reintegration policy and practice for pregnant women.

scholarly journals Remote Health Care Provision in Care Homes in England: An Exploratory Mixed Methods Study of Yorkshire and the Humber

Technologies ◽  
2019 ◽  
Vol 7 (1) ◽  
pp. 24 ◽  
Author(s):  
Louise Newbould ◽  
Gail Mountain ◽  
Steven Ariss ◽  
Mark Hawley
Keyword(s):  
Health Care ◽  
Mixed Methods ◽  
Urban Areas ◽  
Health Care Services ◽  
Qualitative Interviews ◽  
Care Home ◽  
Mixed Methods Study ◽  
Care Homes ◽  
Health Care Provision ◽  
Care Provision

An increasing demand for care homes in the UK, has necessitated the evaluation of innovative methods for delivering more effective health care. Videoconferencing may be one way to meet this demand. However, there is a lack of literature on the provision of videoconferencing in England. This mixed-methods study aimed to map current attitudes, knowledge and provision of videoconferencing in the Yorkshire and Humber region of England. Qualitative interviews with care home managers, a scoping review and field notes from a Special Interest Group (SIG) informed the development of a descriptive convenience survey which was sent out to care home managers in the Yorkshire and Humber region of England. The survey had a 14% (n = 124) response rate. Of those who responded, 10% (n = 12) reported using videoconferencing for health care; with over 78% (n = 97) of respondents’ care homes being based in urban areas. Approximately 62% (n = 77) of the 124 respondents had heard of videoconferencing for health care provision. Of those who reported not using videoconferencing (n = 112), 39% (n = 48) said they would consider it but would need to know more. The top ranked reason for not introducing videoconferencing was the belief that residents would not be comfortable using videoconferencing to consult with a healthcare professional. The main reason for implementation was the need for speedier access to services. Those already using videoconferencing rated videoconferencing overall as being very good (50%) (n = 6) or good (42%) (n = 5). Those who were not using it in practice appeared sceptical before implementing videoconferencing. The main driver of uptake was the home’s current access to and satisfaction with traditionally delivered health care services.

scholarly journals Video Retrieval System for Meniscal Surgery to Improve Health Care Services

2018 ◽  
Vol 2018 ◽  
pp. 1-10
Author(s):  
Sana Amanat ◽  
Muhammad Idrees ◽  
Muhammad Usman Ghani Khan ◽  
Zahoor Rehman ◽  
Hangbae Chang ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Services ◽  
Retrieval System ◽  
Video Retrieval ◽  
Meniscal Tear ◽  
Human Beings ◽  
Improve Health Care ◽  
Care Services ◽  
Meniscal Surgery ◽  
Improve Health

Meniscal surgery is considered the most general orthopedic process that deals with the treatment of meniscus tears for human health care. It leads to a communal contusion to the cartilage that stabilizes and cushions the knee joints of human beings. Such tears can be classified into different categories based on age group, region, and occupation. Further, a large number of sportsmen and heavy weightlifters even in developed countries are affected by meniscus injuries. These patients are subjected to arthroscopic surgery, and during surgical treatment, the perseverance of meniscus is a very crucial task. Current research provides a significant ratio of meniscal tear patients around the globe, the critical expanse is considered as having strikingly risen with a mean annual of 0.066% due to surgery failure. To decumbent this ratio, an innovative training mechanism is proposed through video retrieval system in this research. This research work is focussed on developing a corpus and video retrieval system for meniscus surgery. Using the proposed system, surgeons can access guidance by watching the videos of surgeries performed by an expert and their seniors. The proposed system is comprised of four approaches to the spatiotemporal methodology to improve health care services. It entails key point, statistical modeling, PCA-scale invariant feature transform (SIFT), and PCA-Gaussian mixture model (GMM) with a combination of sparse-optical flow. The real meniscal surgery dataset is used for testing purposes and evaluation. The results conclude that using PCA-SIFT approach improves the results with an average precision of 0.78.

The Use of Australian Health Care Services by Overseas Visitors: Some Data-Related Problems for Policy Makers

1992 ◽  
Vol 22 (2) ◽  
pp. 51-55 ◽  
Author(s):  
Simon Barraclough ◽  
Carol McBain
Keyword(s):  
Health Care ◽  
Federal Government ◽  
Government Policy ◽  
Health Care Services ◽  
Current Level ◽  
Australian Government ◽  
Policy Makers ◽  
Australian Health ◽  
Care Services ◽  
Level Of Use

Very little is known about the usage of Australian health care services by overseas visitors. This is despite the fact that may visitors are entitled to treatment under Medicare due to the Federal government's policy of encouraging reciprocal health care agreements with a number of countries and the increased promotion of health care as an export commodity. It is therefore difficult to develop an overall picture of both the current level of use of Australian health care services by foreigners or to estimate projections of future demand. The absence of such data also means that it is not possible to be sure of the consequences of policies such as the easing of restrictions on medical visas and the promotion by the Australian government of a network of bilateral reciprocal health care agreements. In this article, federal government policy on the access of non-citizen visitors to Australian health care services is examined, various categories of visitors eligible for treatment under the Medicare scheme identified, and current methods of collecting data on visitors using Australian health services critically examined.

Physician Agency and Adoption of Generic Pharmaceuticals

2012 ◽  
Vol 102 (6) ◽  
pp. 2826-2858 ◽  
Author(s):  
Toshiaki Iizuka
Keyword(s):  
Health Care ◽  
Health Care Services ◽  
State Dependence ◽  
Brand Name ◽  
Policy Makers ◽  
Patient Costs ◽  
Static Efficiency ◽  
Care Services ◽  
Physician Agency ◽  
Generic Pharmaceuticals

I examine physician agency in health care services in the context of the choice between brand-name and generic pharmaceuticals. I examine micro-panel data from Japan, where physicians can legally make profits by prescribing and dispensing drugs. The results indicate that physicians often fail to internalize patient costs, explaining why cheaper generics are infrequently adopted. Doctors respond to markup differentials between the two versions, indicating another agency problem. However, generics' markup advantages are short-lived, which limits their impact on increasing generic adoption. Additionally, state dependence and heterogeneous doctor preferences affected generics' adoption. Policy makers can target these factors to improve static efficiency. (JEL D82, I11, J44, L65)

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