scholarly journals Understanding patient health-seeking behaviour to optimise the uptake of cataract surgery in rural Kenya, Zambia and Uganda: findings from a multisite qualitative study

2021 ◽  
Author(s):  
Stevens Bechange ◽  
Emma Jolley ◽  
Patrick Tobi ◽  
Eunice Mailu ◽  
Juliet Sentongo ◽  
...  
Keyword(s):  
Cataract Surgery ◽  
Visual Impairment ◽  
Healthcare Delivery ◽  
Healthcare Providers ◽  
Health Seeking ◽  
Healthcare Delivery System ◽  
Group Discussions ◽  
Patient Health ◽  
Rural Kenya ◽  
Rural Zambia

Abstract Background Cataract is a major cause of visual impairment globally, affecting 15.2 million people who are blind, and another 78.8 million who have moderate or severe visual impairment. This study was designed to explore factors that influence the uptake of surgery offered to patients with operable cataract in a free-of-charge, community-based eye health programme. Methods Focus group discussions and in-depth interviews were conducted with patients and healthcare providers in rural Zambia, Kenya and Uganda during 2018–2019. We identified participants using purposive sampling. Thematic analysis was conducted using a combination of an inductive and deductive team-based approach. Results Participants consisted of 131 healthcare providers and 294 patients. Two-thirds of patients had been operated on for cataract. Two major themes emerged: (1) surgery enablers, including a desire to regain control of their lives, the positive testimonies of others, family support, as well as free surgery, medication and food; and (2) barriers to surgery, including cultural and social factors, as well as the inadequacies of the healthcare delivery system. Conclusions Cultural, social and health system realities impact decisions made by patients about cataract surgery uptake. This study highlights the importance of demand segmentation and improving the quality of services, based on patients’ expectations and needs, as strategies for increasing cataract surgery uptake.

PATIENT SATISFACTION WITH HEALTHCARE SERVICES: A CRITICAL REVIEW

2021 ◽  
Vol 6 (12) ◽  
pp. 81-97
Author(s):  
Sibel ORHAN ◽  
Muhammet GÜMÜŞ ◽  
Emine KIZILKAYA ◽  
Ayşenur C EYLAN
Keyword(s):  
Patient Satisfaction ◽  
Critical Review ◽  
Complex Structure ◽  
Healthcare Delivery ◽  
Healthcare Providers ◽  
Healthcare Services ◽  
Healthcare Systems ◽  
Healthcare Delivery System ◽  
Patient Health ◽  
Satisfaction Measures

As healthcare systems move from pay-per-service to alternative payment models and consumers gain access to more healthcare options, patient satisfaction becomes increasingly important to the financial performance of healthcare providers and to patient health. In this context, patient satisfaction is a complex structure. A critical review of articles published in the Quality Management Journal (QMJ) on patient satisfaction is included to assist researchers and general practitioners. Researchers use the basic holistic quality framework as a preliminary step to evaluate the contributions and shortcomings of studies. In previous studies, it was concluded that the QMJ research focused on patient satisfaction from the perspective of the healthcare delivery system. However, the following criteria are less frequently mentioned: First; to understand patients' perceptions of their experiences and how these perceptions affect satisfaction and perceived quality. The second one is; to determine the expectations of the patients regarding what features should be provided during healthcare services. In this study, first of all, studies in the literature on the subject have been reached, and the findings of the research have been compiled and made into a report. The details of the studies carried out for patient satisfaction measurements and quality practices are tabulated. In this table created for the study, the name of the study, the names of the authors, the type of the study, the problem of the study, the number of participants in the study, the purpose of the study, the analyzes made in the study, where the study was applied, the findings obtained from the study and the results to be obtained from the study are included. As a result, widely used satisfaction measures, including consumer evaluation surveys of healthcare providers and healthcare systems, have fallen short. The study review is expected to guide researchers in developing further research agendas to understand patient satisfaction.

How Research Will Adapt to HIPAA: A View from Within the Healthcare Delivery System

2002 ◽  
Vol 28 (4) ◽  
pp. 491-502
Author(s):  
Mary L. Durham
Keyword(s):  
Health Information ◽  
Healthcare Delivery ◽  
Healthcare Providers ◽  
The United States ◽  
Personal Health Information ◽  
Personal Health ◽  
Business Associations ◽  
Electronic Information ◽  
Healthcare Delivery System ◽  
Institutional Review

While the new Health Insurance Privacy and Accountability Act (HIPAA) research rules governing privacy, confidentiality and personal health information will challenge the research and medical communities, history teaches us that the difficulty of this challenge pales in comparison to the potential harms that such regulations are designed to avoid. Although revised following broad commentary from researchers and healthcare providers around the country, the HIPAA privacy requirements will dramatically change the way healthcare researchers do their jobs in the United States. Given our reluctance to change, we risk overlooking potentially valid reasons why access to personal health information is restricted and regulated. In an environment of electronic information, public concern, genetic information and decline of public trust, regulations are ever-changing. Six categories of HIPAA requirements stand out as transformative: disclosure accounting/tracking, business associations, institutional review board (IRB) changes, minimum necessary requirements, data de-identification, and criminal and civil penalties.

Hepatitis C elimination in Pakistan is a distant dream unless government controls the health sector

2020 ◽  
pp. 1-8
Author(s):  
Arshad Altaf ◽  
Safdar Kamal Pasha
Keyword(s):  
Hepatitis C ◽  
Delivery System ◽  
Healthcare Delivery ◽  
Healthcare Providers ◽  
Health Sector ◽  
World Health Organisation ◽  
World Health ◽  
Short Report ◽  
Healthcare Delivery System ◽  
The Government

Abstract The World Health Organisation (WHO) has set an ambitious target to eliminate hepatitis C virus (HCV) by 2030. Pakistan is one of the focused countries because of the high prevalence of HCV. The prices of direct-acting antiviral drugs(DAA)have significantly reduced to between 11-25 dollars for a month’s treatment. To achieve the 2030 elimination target, Pakistan has to provide treatment to one million HCV-infected patients every year, beginning from 2018. This short report highlights a key barrier to achieve this target,i.e. the unsafe practices by regulated and unregulated healthcare delivery system comprising trained and untrained healthcare providers who can continue to churn out new patients with their unsafe healthcare practices and increase the possibility of re-infection in those who have been treated. Only the government has the power and authority to regulate and control the healthcare delivery system. Continuous...  

scholarly journals Examining Stakeholder’s Views On Refugee Healthcare Needs, Current Barriers in Accessing Healthcare Services and Future Healthcare Direction in New Zealand: A Qualitative Phenomenological Approach

2021 ◽  
Author(s):  
Bafreen Sherif ◽  
Ahmed Awaisu ◽  
Nadir Kheir
Keyword(s):  
New Zealand ◽  
Health Services ◽  
Qualitative Methodology ◽  
Healthcare Delivery ◽  
Healthcare Providers ◽  
Healthcare Services ◽  
Healthcare Personnel ◽  
Structured Interviews ◽  
Health Seeking ◽  
Healthcare Needs

Abstract Background The annual New Zealand refugee quota was increased to 1500 places from 2020 onwards as a response to the global refugee crisis. The specific healthcare needs of refugees are not clearly understood globally and communication between healthcare providers and refugees remains poor. Methods A phenomenological qualitative methodology was employed to conduct semi-structured interviews among purposively selected stakeholders who work in refugee organisations and relevant bodies in New Zealand. Results The participants indicated the need for a national framework of inclusion, mandating cultural competency training for frontline healthcare and non-healthcare personnel, creation of a national interpretation phone line, and establishing health navigators. Barriers to accessing health services identified included some social determinants of health such as housing and community environment; health-seeking behaviour and health literacy; and social support networks. Future healthcare delivery should focus on capacity building of existing services, including co-design processes, increased funding for refugee-specific health services, and whole government approach. Conclusion Policymakers and refugee organisations and their frontline personnel should seek to address the deficiencies identified in order to provide equitable, timely and cost-effective healthcare services for refugees in New Zealand.

Corruption and Healthcare Delivery: Towards a Progressive Intervention in Nigerian Correctional Centres

2020 ◽  
Vol 18 (2) ◽  
pp. 103-116
Author(s):  
Ahmad Hassan Ahmad ◽  
Muktar M. Koya
Keyword(s):  
Healthcare Delivery ◽  
Healthcare Providers ◽  
Sampling Technique ◽  
Simple Random Sampling ◽  
General Context ◽  
Healthcare Delivery System ◽  
Correctional Setting ◽  
Depth Interview ◽  
Global Concern ◽  
Correctional Healthcare

Corruption is a complex and multifaceted challenge of global concern. The correctional setting in Nigeria is not exempted from the more general context of this issue. Nigeria has a poorly structured service for correctional healthcare system driven by a collection of socioeconomic and legal factors especially corruption. One of the pressing challenges in Nigerian public health is to provide services to those who need them the most, particularly those behind bars and therefore hard to reach. Yet, it remains obvious that, a significant majority of those with health problems are incarcerated in the correctional centers of Nigeria. This study which is anchored on Economic Theory of Corruption examined corrupt practices associated with healthcare delivery in Kano Central and Goron Dutse Correctional Centers. The study utilized quantitative and qualitative methods in eliciting data from convicted and awaiting trial inmates and healthcare providers. Thus, a total of 350 inmates were sampled across convicts and awaiting trial inmates through the simple random sampling technique using Wiseman’s 1999 table of sample size. In addition, two respondents (healthcare officials) were purposively sampled for in-depth interview. The findings revealed some level of negation especially as it concerns referrals and the inmates’ treatment charges outside the correctional setting. The study recommends the need for complete overhaul of the correctional healthcare delivery system in line with recommended global best practices.

Developing a Charter of Spiritual Care for patients

2020 ◽  
Author(s):  
Akram Heidari ◽  
Abdolhasan Kazemi ◽  
Mohammad Abbasi ◽  
Seyed Hasan Adeli ◽  
Hoda Ahmari-Tehran ◽  
...  
Keyword(s):  
Literature Review ◽  
Delivery System ◽  
Expert Opinion ◽  
Systematic Literature Review ◽  
Spiritual Care ◽  
Care Delivery ◽  
Healthcare Delivery ◽  
Healthcare Providers ◽  
Spiritual Needs ◽  
Healthcare Delivery System

Abstract Background Spirituality is recognized as an important issue in healthcare, and every individual has spiritual needs. Despite increased knowledge about spiritual care and its necessity, there is no unique agreed upon framework for spiritual care among the practitioners. This study aimed to explore the concept from the viewpoint of both healthcare providers and patients within the Iranian social, cultural and overall context and present a charter for providing spiritual care. Methods The study consisted of a systematic literature review, two qualitative studies on the components of spiritual care from the perspective of healthcare providers and its dimensions as perceived by patients. The findings were then integrated to make up a charter draft that was accredited through expert opinion. Results The review of literatures led to the identification of 2 main themes and 10 themes. Perspectives of healthcare providers were categorized into 4 main themes and 10 themes and patients’ opinions were classified into 3 main themes and 11 themes. The themes and their subthemes were integrated to build the concepts and form the proposed charter with 30 statements. Conclusion The charter of spiritual care for patients is intended to present an agreed upon framework for spiritual care delivery and resolve some of the problems in this path. This can improve healthcare delivery system.

scholarly journals Smoking behaviour among adult patients presenting to health facilities in four provinces of Vietnam

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Wan-Chun Huang ◽  
Ngoc Yen Pham ◽  
Thu Anh Nguyen ◽  
Van Giap Vu ◽  
Quy Chau Ngo ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Healthcare Delivery ◽  
Healthcare Providers ◽  
Smoking Behaviour ◽  
Health Facilities ◽  
Healthcare Delivery System ◽  
Cross Sectional ◽  
Healthcare Facilities ◽  
District Hospitals ◽  
Quit Attempts

Abstract Background Attendance at healthcare facilities provides an opportunity for smoking cessation interventions. However, the smoking behaviours of patients seeking healthcare in Vietnam are not well-understood. We aimed to evaluate behaviours related to smoking among patients presenting to health facilities in Vietnam. Methods We conducted a cross-sectional study in 4 provinces of Vietnam. Consecutive patients aged ≥15 years presenting to 46 health facilities were assessed. Current smokers were randomly selected to complete a full survey about smoking behaviour, quit attempts, and preparedness to quit. Results Among 11,245 patients who sought healthcare, the prevalence of current smoking was 18.6% (95% CI: 17.8–19.4%) overall, 34.6% (95% CI: 33.2–36.0%) among men and 1.1% (95% CI: 0.8–1.3%) among women. Current smokers who were asked about smoking by healthcare providers in the last 12 months were more likely to make quit attempts than those not asked (40.6% vs 31.8%, p = 0.017). Current smokers who attempted to quit in the past 12 months made limited use of cessation aids: counselling (1.9%) and nicotine replacement therapy (10%). A higher proportion of patients wanted to quit in the next month at national/provincial hospitals (30.3%) than those visiting district hospitals (11.3%, p < 0.001) and commune health centres (11.1%, p = 0.004). Conclusions Smoking is common among male patients presenting to healthcare facilities in Vietnam. Formal smoking cessation supports are generally not used or offered. This population is likely to benefit from routine smoking cessation interventions that are integrated within the routine healthcare delivery system.

scholarly journals Do informed consumers in Taiwan favour larger hospitals? A 10-year population-based study on differences in the selection of healthcare providers among medical professionals, their relatives and the general population

BMJ Open ◽  
2019 ◽  
Vol 9 (5) ◽  
pp. e025202 ◽  
Author(s):  
Raymond N Kuo ◽  
Wanchi Chen ◽  
Yuting Lin
Keyword(s):  
General Population ◽  
Cataract Surgery ◽  
Medical Profession ◽  
Healthcare Delivery ◽  
Healthcare Providers ◽  
Population Based ◽  
Medical Professionals ◽  
Admission Rates ◽  
Significant Difference ◽  
General Populations

ObjectivesExploring whether medical professionals, who are considered to be ‘informed consumers’ in the healthcare system, favour large providers for elective treatments. In this study, we compare the inclination of medical professionals and their relatives undergoing treatment for childbirth and cataract surgery at medical centres, against those of the general population.DesignRetrospective study using a population-based matched cohort data.ParticipantsPatients who underwent childbirth or cataract surgery between 1 January 2004 and 31 December 2013.Primary and secondary outcomes measuresWe used multiple logistic regression to compare the ORs of medical professionals and their relatives undergoing treatment at medical centres, against those of the general population. We also compared the rate of 14-day re-admission (childbirth) and 14-day reoperation (cataract surgery) after discharge between these groups.ResultsMultivariate analysis showed that physicians were more likely than patients with no familial connection to the medical profession to undergo childbirth at medical centres (OR 5.26, 95% CI 3.96 to 6.97, p<0.001), followed by physicians’ relatives (OR 2.68, 95% CI 2.20 to 3.25, p<0.001). Similarly, physicians (OR 1.63, 95% CI 1.21 to 2.19, p<0.01) and their relatives (OR 1.43, 95% CI 1.13 to 1.81, p<0.01) were also more likely to undergo cataract surgery at medical centres. Physicians also tended to select healthcare providers who were at the same level or above the institution at which they worked. We observed no significant difference in 14-day re-admission rates after childbirth and no significant difference in 14-day reoperation rates after cataract surgery across patient groups.ConclusionsMedical professionals and their relatives are more likely than the general population to opt for service at medical centres. Understanding the reasons that medical professionals and general populations both have a preferential bias for larger medical institutions could help improve the efficiency of healthcare delivery.

scholarly journals Monitoring strategies on patient safety practices among healthcare providers at Nakuru county referral hospital, Kenya

2020 ◽  
Vol 7 (8) ◽  
pp. 2938
Author(s):  
Fancy J. Kipkech ◽  
Stanley M. Makindi ◽  
Joseph Juma
Keyword(s):  
Patient Safety ◽  
Clinical Care ◽  
Healthcare Delivery ◽  
Healthcare Providers ◽  
Healthcare Services ◽  
Referral Hospital ◽  
Healthcare Delivery System ◽  
Cross Sectional ◽  
Safety Practices ◽  
Monitoring Strategies

Background: Quality care is achieved through combined efforts which include integration of all the components within the healthcare delivery system. Patient safety is one of the dimensions of enhancing quality healthcare. It involves increasing the awareness about the errors made due to human factors in the process of delivering healthcare services that may lead to harm and other adverse effects.Methods: This study was on assessment of monitoring strategies on patient safety practices among healthcare providers at Nakuru County Referral Hospital, Kenya. The study was anchored on Donabedian model for assessment of quality of care. The study design was a descriptive cross-sectional study. The sampling technique was purposive, stratified random sampling and proportionate with a sample size of 310 healthcare providers drawn from various departments. Data collection tools were questionnaire, interview schedule and observational checklist. Quantitative data was analysed using descriptive statistics (mean, mode and standard deviation).Results: The results of the study indicated and concluded that there is adherence to standardized clinical care protocols and guidelines as well as continuous and constant surveillance with clear assessments and evaluation of patient safety practices, accurate collection, storage, analysis and sharing of information on patient safety issues.Conclusions: The paper recommends the need for policy reviews on healthcare so as to ensure that patient safety issues are reviewed so as to mitigate risks in handling patients. There is need to establish clear guidelines on monitoring and evaluation standards of patient safety practices.

Collaborative Healthcare: Exploring its Meaning through Content Analysis in Social Media (Preprint)

2021 ◽  
Author(s):  
Tahereh Maghsoudi ◽  
Ana Beatriz Hernández-Lara ◽  
Rosalía Cascón-Pereira
Keyword(s):  
Social Media ◽  
Meaning Making ◽  
Healthcare Delivery ◽  
Healthcare Providers ◽  
Health Indicators ◽  
Healthcare Delivery System ◽  
The Social ◽  
Health Related ◽  
Multi Stakeholder ◽  
Evolution Of Meaning

BACKGROUND The healthcare delivery system is a multi-stakeholder and multi-player system aiming to provide services to promote, restore, and improve health indicators in communities. This highlights the importance of collaboration in the healthcare system. Collaborative healthcare is an emerging concept that has mainly been explored in terms of the practices of healthcare professionals. In an era when social media are becoming key to the evolution of meaning-making, there is a lack of knowledge on how collaborative healthcare meanings are being constructed in the social media discourse OBJECTIVE This paper aims to explore the meanings of collaborative healthcare on social media. METHODS We utilize a dual qualitative approach of visual and textual analysis of posts extracted from Instagram to examine the meanings of collaborative healthcare as perceived by both healthcare providers and laypeople. We use the web scraping technique to extract posts from Instagram. RESULTS wellness centers and health-related professionals were the main group of users who contributed to constructing the meaning of collaborative healthcare (38% and 36%, respectively). The study reveals that Instagram users highlight four main themes within the concept of collaborative healthcare, namely knowledge sharing, events, self-care, and advertising. Interestingly, we found that advertising has the highest frequency (262 posts); the term “collaborative” is used by wellness centers as a hallmark for advertising their services. CONCLUSIONS This study has contributed to unveiling the multiple meanings of collaborative healthcare shared by social media users and accordingly in developing some theoretical reflections and practical implications to improve public health.

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