Healthcare quality and medicine reimbursement criteria in Iran

2017 ◽  
Vol 11 (4) ◽  
pp. 455-470
Author(s):  
Hamidreza Khalili ◽  
Ardalan Sameti
Keyword(s):  
Public Health ◽  
Health Insurance ◽  
The Elderly ◽  
Time Frame ◽  
Insurance Companies ◽  
Cross Sectional ◽  
Content Type ◽  
Evidence Quality ◽  
Life Threatening ◽  
Reimbursement List

Purpose This study aims to measure the quality of services provided to elderly people at the most crowded governmental ambulatory clinics of Tehran Province using the SERVQUAL scale (Study 1). Moreover, the research indicates the medicine reimbursement criteria to inform the decision-makers of public health insurance organizations using the Borda method (Study 2). Design/methodology/approach This study was done as a cross-sectional research on 425 elderly patients who came to the clinics during 2014 and 2015. Finally, using the paired t-test, Friedman test, Borda method, SPSS, Matlab software and Delphi method, the collected data were analysed. Findings Regarding the perceived quality, the services assurance dimension was ranked as having the highest quality (4.48) and the accessibility dimension as the lowest one (3.22). Based on the Borda method, the most important criterion for the Iranian health insurance companies to accept a medicine in their reimbursement list is the “life-threatening conditions” factor. On the other hand, “evidence quality” is accounted as the fifth important factor. Research limitations/implications The main limitation was the senility of participants that makes it difficult for understanding and completing the questionnaires. Practical implications The results can be useful for healthcare policy makers and related authorities. Besides, public health insurers can use the findings for decision-making about the elderly diseases and the problems such as the medical expenses. Originality/value The present research has been done in a two-year time frame, and it is more recent than other related studies. Thus, the results are far more authentic and applicable.

scholarly journals Which health-related reasons lead to prehospital emergency care and how does subjective emergency status connect to subsequent care?

2021 ◽  
Author(s):  
Silke Piedmont ◽  
Anna Katharina Reinhold ◽  
Jens-Oliver Bock ◽  
Enno Swart ◽  
Bernt-Peter Robra
Keyword(s):  
Health Insurance ◽  
Emergency Care ◽  
Third Party ◽  
Insurance Companies ◽  
Prehospital Emergency Care ◽  
Health Related ◽  
Life Threatening ◽  
Prehospital Emergency ◽  
Health Insurance Companies ◽  
Reported Data

Abstract Objectives/Background In many countries, the use of emergency medical services (EMS) increases steadily each year. At the same time, the percentage of life-threatening complaints decreases. To redesign the system, an assessment and consideration of the patients’ perspectives is helpful. Methods We conducted a paper-based survey of German EMS patients who had at least one case of prehospital emergency care in 2016. Four health insurance companies sent out the questionnaire to 1312 insured persons. We linked the self-reported data of 254 respondents to corresponding claims data provided by their health insurance companies. The analysis focuses a.) how strongly patients tend to call EMS for themselves and others given different health-related scenarios, b.) self-perceived health complaints in their own index case of prehospital emergency care and c.) subjective emergency status in combination with so-called “objective” characteristics of subsequent EMS and inpatient care. We report principal diagnoses of (1) respondents, (2) 57,240 EMS users who are not part of the survey and (3) all 20,063,689 inpatients in German hospitals. Diagnoses for group 1 and 2 only cover the inpatient stay that started on the day of the last EMS use in 2016. Results According to the survey, the threshold to call an ambulance is lower for someone else than for oneself. In 89% of all cases during their own EMS use, a third party called the ambulance. The most common, self-reported complaints were pain (38%), problems with heart and circulation (32%), and loss of consciousness (17%). The majority of respondents indicated that their EMS use was due to an emergency (89%). We could detect no or only weak associations between patients’ subjective urgency and different items for objective care. Conclusion Dispatchers can possibly optimize or reduce the disposition of EMS staff and vehicles if they spoke directly to the patients more often. Nonetheless, there is need for further research on how strongly the patients’ perceived urgency may affect the disposition, rapidness of the service and transport targets.

HUBUNGAN TINGKAT PENGETAHUAN MENGENAI DIET HIPERTENSI TERHADAP KEJADIAN HIPERTENSI PADA LANSIA DI PUSKESMAS BALOI PERMAI BATAM KOTA

2020 ◽  
Vol 9 (1) ◽  
pp. 50-60
Author(s):  
Brain Guntoro ◽  
Kasih Purwati
Keyword(s):  
Public Health ◽  
Health Center ◽  
The Elderly ◽  
P Value ◽  
Chi Square ◽  
Cross Sectional ◽  
Public Health Center ◽  
Chi Square Test ◽  
History Of ◽  
Level Of Knowledge

Hypertension is one of the number one causes of death and disability in the world. Hypertension contributes nearly 9.4 million deaths from cardiovascular disease each year. Hypertension can cause undesirable effects, it needs good handling, one of them is by doing a hypertension diet. To carry out a hypertension diet requires knowledge, lack of knowledge can increase risk factors for hypertension. This study aims to determine the relationship of the level of knowledge about hypertension diet to the incidence of hypertension in the elderly at the Baloi Permai Public Health Center Batam City. This research method is an analytic observational with a cross-sectional approach conducted at the Baloi Permai Public Health Center Batam City 2018. Sampling technique is a total sampling with a sample of 64 people in 2018 determined by inclusion and exclusion criteria. The results of the study were analyzed with frequency distribution and then tested with the Chi-square test. Based on the results of this study indicate that of the 64 respondents found elderly who have a good level of knowledge are 41 people (64.1%), 48 people (75.0%) have an age range between 60-70 years. 27 people (42.2%) elderly have the last high school education and 40 people (62.5%) have jobs as entrepreneurs. Elderly people who have normal blood pressure are 40 people (62.5%), and those affected by hypertension are 24 people (37.5%). The elderly who have a family history of hypertension is 21 people (32.8%) and those who do not have a history of hypertension are 43 people (67.2%). Chi-Square Test analysis results show the significance value p = 0.009. This number is significant because the p-value is smaller than the significance level (α) ≤ 5% (0.05), so H0 is rejected and Ha is accepted. Therefore it can be concluded that there is a significant relationship about the level of knowledge about the hypertension diet to the incidence of hypertension in the elderly. From the results of this study it was concluded that there was a relationship between the level of knowledge about the hypertension diet and the incidence of hypertension in the elderly at the Baloi Permai Public Health Center Batam City in 2016.

scholarly journals Comparison of Sarcopenia with Modified Frailty Index as a Predictor of Adverse Outcomes in Critically Ill Elderly Patients

2021 ◽  
pp. 200-206
Author(s):  
Shrirang Bhurchandi ◽  
Sachin Agrawal ◽  
Sunil Kumar ◽  
Sourya Acharya
Keyword(s):  
Elderly Patients ◽  
Critically Ill ◽  
Health Care Cost ◽  
Frailty Index ◽  
The Elderly ◽  
Time Frame ◽  
Adverse Outcomes ◽  
Cross Sectional ◽  
Parametric Data ◽  
Modified Frailty Index

Background: Ageing is a global fact affecting both developed and developing countries.It brings out various catabolic changes in body resulting in frailty(i.e. the person is not able to with stand minor stresses of the environment, due to reduced reserves in psychologicalreserve of several organ system).Thus causing a great burden of disease, dependence & health care cost. Sarcopenia is the leading component for frailty in the elderly population, but very few studies have been done in India for correlating frailty with sarcopenia. Aim: To compare sarcopenia with modified frailty index (MFI) as a predictor of adverse outcomes in critically ill elderly patients. Methodology: Cross-sectional study will be performed on all the critically ill geriatric subjects/patients coming to all the ICU's of AVBRH, Sawangi (M), Wardha who will satisfy various inclusion and exclusion criteria for selection and all standard parametric & non-parametric data will be assessed by using standard descriptive & inferential statistics. Expected Results: In our study, we are anticipating that the Modified frailty index to be a better predictor of adverse outcomes in terms of mortality as compared to sarcopenia in the critically ill elderly patients. Also, we are anticipating that sarcopenia to be the most important contributor of frailty in critically ill elderly patients and the prevalence of frailty will be high in critically ill elderly patients. Limitation: Due to limited time frame & resources we will not be able to follow up the patients.

scholarly journals Public health insurance and birth outcomes: evidence from Punjab, Pakistan

2020 ◽  
Author(s):  
Najam uz Zehra Gardezi
Keyword(s):  
Public Health ◽  
Health Insurance ◽  
Low Income ◽  
Fixed Effects ◽  
Insurance Coverage ◽  
Birth Certificate ◽  
Household Survey ◽  
Public Health Insurance ◽  
Health Seeking ◽  
Cross Sectional

Abstract Public health insurance targeted towards low-income households has gained traction in many developing countries. However, there is limited evidence as to the effectiveness of these programs in countries where institutional constraints may limit participation by the eligible population. This paper evaluates a recent health insurance initiative introduced in Pakistan and discusses whether eligibility for the programme improves maternal health seeking behaviour. The Prime Minister National Health Program provides free insurance coverage to low-income families. The programme is in the early phases of implementation and has, since 2016, only been rolled out in a few eligible districts within the country. This allows for a comparison of eligible households in districts where the programme has been introduced to those that are eligible to receive insurance at a future date. Using repeated cross-sectional data from multiple rounds of representative household survey, a difference-in-difference model has been estimated. Results show that at least for a specific beneficiary group (i.e. pregnant women), there has been a positive increase in utilization of hospital services. Furthermore, we provide evidence using mother fixed effects that the programme increased the likelihood of a child’s birth being documented. Since possession of a birth certificate can secure civic rights for a child, this is an unintended but positive outcome of the programme.

Did the time frame associated with the implementation of the Patient Protection and Affordable Care Act noticeably impact consumer bankruptcy filings?

2017 ◽  
Vol 44 (12) ◽  
pp. 1957-1972
Author(s):  
Donald D. Hackney ◽  
Daniel Friesner ◽  
Erica H. Johnson
Keyword(s):  
Health Insurance ◽  
Affordable Care Act ◽  
Dynamic Change ◽  
Time Frame ◽  
Insurance Premium ◽  
Skewed Distribution ◽  
Structural Dynamic ◽  
Content Type ◽  
Patient Protection ◽  
The Impact

Purpose The purpose of this paper is to examine whether the timing associated with the implementation of the health insurance-related provisions of the Patient Protection and Affordable Care Act (ACA) altered the presence and distribution of medical/non-medical debts accumulated by different types of bankruptcy filers. Design/methodology/approach Data were drawn from the US Bankruptcy Court’s Eastern Washington District over the years 2009, 2011 and 2014 using interval random sampling. Binary probit and Tobit analyses were used to model the existence, and distribution, of medical debts and total debts, respectively, at the time of filing. The impact of the time frame associated with the ACA was operationalized via a Chow test for structural dynamic change. Findings Chapter 13 filers in 2014 (post-ACA-based health exchange implementation) were more likely to report medical debts than Chapter 7 filers in the pre-intervention period, and were also more likely to report a larger proportion of outstanding debts owed to a single creditor. Filers claiming health insurance premium expenses in 2011 were (at the 10 percent significance level) more likely to report a more skewed distribution of medical debts. Originality/value The time frame associated with the implementation of the ACA impacts the distribution of medical debts among filers who have sufficient net disposable income to fund a Chapter 13 plan. The polarization of outstanding medical debts may indicate coverage gaps in existing health insurance policies, whose costs would be disproportionately borne by patients operating on thin financial margins.

Coordination between hospitals and insurers in developing economies: an interpretive structural modeling approach

2020 ◽  
Vol 14 (3) ◽  
pp. 471-490
Author(s):  
Manimay Dev ◽  
Dinesh Kumar ◽  
Dharmendra Patel
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Urban Areas ◽  
Developing Economies ◽  
Health Care Systems ◽  
Healthcare Providers ◽  
Structural Modeling ◽  
Insurance Companies ◽  
Interpretive Structural Modeling ◽  
Content Type

Purpose The purpose of this paper is to identify the factors that influence hospitals’ selection by health-care insurers in India and to establish a hierarchical model representing the relationship among different factors and their influence on the entire scenario. Design/methodology/approach A survey with a set of questionnaires was conducted with different health-care insurer executives of reputed health insurance companies. The data has been gathered by using a five-point Likert scale. Their opinions were converted into a reachability matrix and an interpretive structural modeling was constructed. The final results obtained were verified by using fuzzy Matriced Impacts Croises-Multiplication Applique and Classement analysis. Findings The results suggested three key driving factors, National Accreditation Board for Hospitals & Healthcare Providers accreditation of the hospital, purchasing power of people in the region and national and international recognition of the hospital among the eleven factors selected for the study. Research limitations/implications The research mainly focuses on the health insurance benefits provided by privately owned insurance companies and do not comment on any government’s mass health insurance scheme. Practical implications With a small proportion of people under the umbrella of health insurance in India, these factors will assist and expedite insurer’s effort to penetrate deep into rural and urban areas enhancing availability and escalating affordability. Originality/value This paper presents key factors responsible for better coordination between health-care systems and insurance companies.

scholarly journals Technological advancements to address elderly loneliness: practical considerations and community resilience implications for COVID-19 pandemic

2020 ◽  
Vol 24 (4) ◽  
pp. 257-264 ◽  
Author(s):  
Kristina M. Conroy ◽  
Srikripa Krishnan ◽  
Stacy Mittelstaedt ◽  
Sonny S. Patel
Keyword(s):  
Public Health ◽  
Older Adults ◽  
Environmental Factors ◽  
Social Engagement ◽  
The Elderly ◽  
Advanced Technology ◽  
Health Concern ◽  
Specific Situation ◽  
Content Type ◽  
Elderly Populations

Purpose Loneliness has been a known severe public health concern among the elderly population during the COVID-19 pandemic. This paper aims to discuss the practicalities of using emerging technologies to address elderly loneliness and its implications and adaptations to the outbreak of corona virus disease–2019. Design/methodology/approach The authors draw on examples from the literature and their own observations from working with older adults, to provide an overview of possible ways technology could help this population in the current COVID-19 pandemic. Findings Technological advancements have offered remarkable opportunities to deliver care and maintain connections despite the need to stay physically separated. These tools can be integrated into crisis communications, public health responses and care programs to address loneliness among the elderly. However, it must be done strategically and informed by the type of loneliness at play, environmental factors, socioeconomics and technological literacy. Practical implications Care-providing organizations and policymakers should consider the risk of loneliness while responding to COVID-19 outbreak, particularly within elderly populations. As a part of a broader plan, technological solutions and low-tech approaches can make a difference in mitigating loneliness. Solutions should be accessible to and usable by older adults. Provision of equipment, training and guidance may be necessary to execute a technology-centric plan; for some communities and individuals, approaches that do not rely on advanced technology may be more effective. Originality/value Technological advancements can be a valuable tool in addressing known public health concerns, such as loneliness among the elderly populations. However, the use of this tool should be governed by the specific situation at hand, taking into consideration individual needs and environmental factors, especially the compounded effects caused by the coronavirus pandemic. Different technological programs and approaches are appropriate for different types of loneliness. For example, online therapy such as internet-based cognitive behavior therapy may mitigate loneliness caused by fear and online interaction such as videoconferencing may relieve loneliness caused by lack of social engagement.

Personal values and the features of psychological contracts

2019 ◽  
Vol 27 (4) ◽  
pp. 1111-1123 ◽  
Author(s):  
Maria Céu Santos ◽  
Filipe Coelho ◽  
Jorge F.S. Gomes ◽  
Carlos M.P. Sousa
Keyword(s):  
Psychological Contract ◽  
Personal Values ◽  
Time Frame ◽  
Psychological Contracts ◽  
Frontline Employees ◽  
Cross Sectional ◽  
Content Type ◽  
Contract Employees ◽  
Narrow Scope ◽  
Data Driven Approach

PurposeThis paper aims to investigate how personal values relate to the psychological contract employees establish with their employers.Design/methodology/approachThe sample consisted of 223 frontline employees from a major Portuguese company. The paper used stepwise regressions analysis to test the research hypotheses.FindingsCollectivistic-oriented values were generally related to psychological contract features such as long time frame, lower tangibility, flexibility, inequality and collective regulation. Conversely, individualistic-oriented values were generally associated with a short time frame and a more tangible, stable, equal and individually regulated type of contract with a narrow scope.Research limitations/implicationsThis study uses cross-sectional data collected from a single Portuguese company. While common method bias could potentially affect the results, various procedural remedies were used to control for it. Finally, the study relied on stepwise regression, which is a data-driven approach.Practical implicationsThe study supports the contentions that internal dispositions are related to psychological contracts.Originality/valueThis paper innovates by exploring how employees’ personal values are associated with the psychological contract from a feature-oriented approach. In addition, this study was carried out in Portugal, highlighting the importance of exploring existing models and theories in different cultural contexts.

New Directions in Health Insurance Design: Implications for Public Policy and Practice

2003 ◽  
Vol 31 (S4) ◽  
pp. 60-62
Author(s):  
Karen Pollitz ◽  
Donna Imhoff ◽  
Charles Scott ◽  
Sara Rosenbaum
Keyword(s):  
Public Health ◽  
Health Insurance ◽  
Private Health Insurance ◽  
Elderly Population ◽  
United States Public Health ◽  
Healthcare Spending ◽  
The Elderly ◽  
The United States ◽  
Policy And Practice ◽  
Insurance System

This is a volatile time for health insurance policy. Medicare and Medicaid are in turmoil, as is the private health insurance market. Public and private health insurance costs constitute eighty percent of healthcare spending in the United States. Public health professionals depend on the insurance system to behave in ways that are responsive to public health in prevention and crisis management.Seventy-five percent of the American population, excluding the elderly, has coverage through the private health insurance system. Ninety percent of this group receives their insurance through employer-sponsored programs, and the remaining ten percent buy their own coverage. Approximately ten percent of the non-elderly population has insurance through a government program, and fifteen percent of the non-elderly population, almost forty-one million Americans, is uninsured.

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