scholarly journals Variations in user-oriented elderly care: a multilevel approach

2017 ◽  
Vol 9 (2) ◽  
pp. 138-147 ◽  
Author(s):  
Ali Kazemi ◽  
Petri Kajonius
Keyword(s):  
Elderly Care ◽  
Care Quality ◽  
Satisfaction With Care ◽  
Content Type ◽  
National Board ◽  
Care Services ◽  
Care Workers ◽  
Interpersonal Care ◽  
Sources Of Variation

Purpose National Board of Health and Welfare claims that the quality of elderly care services differ considerably between municipalities in Sweden. This study aims to analyze to what extent these variations can be accounted for by the older person’s municipality affiliation (i.e. receiving elderly care in a certain municipality). Design/methodology/approach Addressing this issue, national survey data from 78,538 older respondents receiving elderly care services in Sweden were analyzed using multilevel modeling (MLM). Findings The results showed that municipality affiliation only marginally explained the variance in satisfaction with care, i.e. its variations were larger within than between municipalities. Instead, user-oriented care accounted for the variation in satisfaction with care. Specifically, the way the care workers behave toward the older person proved to be much more crucial for satisfaction with care than municipality affiliation. Moreover, random effects analyses revealed that the effects of user-oriented care on satisfaction with care varied across municipalities. Care setting (i.e. home care or nursing home) only marginally accounted for its variance. Practical implications Developing care quality should start and primarily be discussed at the interpersonal care level, and not, as is customary, at the municipality level. Originality/value The present research is the first in its kind to quantitatively investigate the sources of variation in perceived quality of Swedish elderly care using MLM.

Advancing the Big Five of user-oriented care and accounting for its variations

2016 ◽  
Vol 29 (2) ◽  
pp. 162-176 ◽  
Author(s):  
Petri Kajonius ◽  
Ali Kazemi
Keyword(s):  
Big Five ◽  
Elderly Care ◽  
Process Quality ◽  
Care Process ◽  
Content Type ◽  
Care Services ◽  
Care Workers ◽  
Wide Range ◽  
Care Worker ◽  
Quality Variation

Purpose – Care process quality (i.e. how care is enacted by a care worker toward a client at the interpersonal level) is a strong predictor of satisfaction in a wide range of health care services. The purpose of this paper is to describe the basic elements of care process quality as user-oriented care. Specifically, the questions of how and why quality in user-oriented care varies were investigated in the context of elderly care. Design/methodology/approach – Two municipalities were selected for in-depth field studies. First, in each municipality, the authors interviewed and observed care workers’ interactions with the older persons in both home care and nursing homes during two weeks (Study 1). Second, in an attempt to gain a deeper understanding of why process quality in terms of user-oriented care varies, the authors conducted interviews with care workers and care unit managers (Study 2). Findings – A new taxonomy for categorizing process quality variation, the Big Five of user-oriented care (task-focus, person-focus, affect, cooperation, and time-use), is proposed. In addition, the perceived reasons for process quality variation are reported in our own developed Quality Agents Model, suggesting that variations in care process evaluations may be explained from different perspectives at multiple levels (i.e., older person, care worker-, unit-, department-, and municipality level). Originality/value – The proposed taxonomy and model are useful for describing user-oriented care quality and the reasons for its variations. These findings are of relevance for future quality developments of elderly care services, but also may be adapted to applications in any other enterprise employing a user-oriented approach.

Asian Care Certificate (ACC): a care quality assurance framework

2018 ◽  
Vol 31 (3) ◽  
pp. 260-264
Author(s):  
Tony Talaie
Keyword(s):  
Care Service ◽  
Elderly Care ◽  
Quality Care ◽  
The Elderly ◽  
Care Quality ◽  
Quality Level ◽  
Content Type ◽  
Asian Populations ◽  
Care Worker

Purpose Quality assuring elderly care through a viable and feasible standard framework is a major challenge for Asian governments. Although several attempts have been made to tackle foreign care worker (FCW) shortage, assuring the quality of the care they provide has been overlooked. The original framework allowed a better control over service quality to assure the elderly about their care according to the agreed standards. The paper aims to discuss these issues. Design/methodology/approach Through several Japanese Governmental meetings, a new Asian Care Certificate (ACC) program is discussed based on the Japanese Care Certificate (JCC). The governments’ representatives adopted the JCC to form the ACC, which enables the ACC board to evaluate care workers and to intervene whenever the desired quality level is not achieved. Findings The author describes a new program. The findings of this paper will be confirmed when the ACC is implemented. Practical implications Using the ACC framework, the challenge in providing a high-quality care service using FCWs across Asia would be partly resolved. FCWs’ quality of life might also gradually improve especially regarding to their human rights. Originality/value The ACC provides a new framework. Its value is recognized if one considers that many Asian populations are rapidly aging and many governments compromise quality by employing overseas workers to solve care worker shortages.

scholarly journals Everybody S***s: how defecation stigma reduces care quality in dementia

2020 ◽  
Vol 21 (2) ◽  
pp. 79-87
Author(s):  
Leah Hewer-Richards ◽  
Dawn Goodall
Keyword(s):  
Quality Of Life ◽  
Faecal Incontinence ◽  
Design Methodology ◽  
Care Quality ◽  
Dementia Care ◽  
Content Type ◽  
Invisible Work ◽  
Care Workers ◽  
Practical Implications

Purpose This paper aims to raise awareness of the ways in which faecal incontinence can impact the provision of dementia care by examining this through the lens of stigma. Design/methodology/approach This paper contains a scoping review of available literature relating to faecal incontinence, dementia and stigma. Findings Literature was organised into three themes: the origins of the stigma, the purpose of stigma and the care context. Research limitations/implications Limitations of this paper include the lack of literature discussing faecal incontinence and dementia in relation to stigma. Practical implications Stigma regarding faecal incontinence has the potential to impact quality of life of people with a dementia and contributes towards the invisible work of unqualified care workers. Originality/value Stigma and faecal incontinence have only a small amount of research around them in residential dementia care.

Cost effectiveness in palliative care setting

2018 ◽  
Vol 21 (2) ◽  
pp. 62-71
Author(s):  
Henry O’Lawrence ◽  
Rohan Chowlkar
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
End Of Life ◽  
Hospice Care ◽  
Home Health ◽  
Data Set ◽  
Content Type ◽  
Care Services ◽  
The Cost

Purpose The purpose of this paper is to determine the cost effectiveness of palliative care on patients in a home health and hospice setting. Secondary data set was utilized to test the hypotheses of this study. Home health care and hospice care services have the potential to avert hospital admissions in patients requiring palliative care, which significantly affects medicare spending. With the aging population, it has become evident that demand of palliative care will increase four-fold. It was determined that current spending on end-of-life care is radically emptying medicare funds and fiscally weakening numerous families who have patients under palliative care during life-threatening illnesses. The study found that a majority of people registering for palliative and hospice care settings are above the age group of 55 years old. Design/methodology/approach Different variables like length of stay, mode of payment and disease diagnosis were used to filter the available data set. Secondary data were utilized to test the hypothesis of this study. There are very few studies on hospice and palliative care services and no study focuses on the cost associated with this care. Since a very large number of the USA, population is turning 65 and over, it is very important to analyze the cost of care for palliative and hospice care. For the purpose of this analysis, data were utilized from the National Home and Hospice Care Survey (NHHCS), which has been conducted periodically by the Centers for Disease Control and Prevention’s National Center for Health Statistics. Descriptive statistics, χ2 tests and t-tests were used to test for statistical significance at the p<0.05 level. Findings The Statistical Package for Social Sciences (SPSS) was utilized for this result. H1 predicted that patients in the age group of 65 years and up have the highest utilization of home and hospice care. This study examined various demographic variables in hospice and home health care which may help to evaluate the cost of care and the modes of payments. This section of the result presents the descriptive analysis of dependent, independent and covariate variables that provide the overall national estimates on differences in use of home and hospice care in various age groups and sex. Research limitations/implications The data set used was from the 2007 NHHCS survey, no data have been collected thereafter, and therefore, gap in data analysis may give inaccurate findings. To compensate for this gap in the data set, recent studies were reviewed which analyzed cost in palliative care in the USA. There has been a lack of evidence to prove the cost savings and improved quality of life in palliative/hospice care. There is a need for new research on the various cost factors affecting palliative care services as well as considering the quality of life. Although, it is evident that palliative care treatment is less expensive as compared to the regular care, since it eliminates the direct hospitalization cost, but there is inadequate research to prove that it improves the quality of life. A detailed research is required considering the additional cost incurred in palliative/hospice care services and a cost-benefit analysis of the same. Practical implications While various studies reporting information applicable to the expenses and effect of family caregiving toward the end-of-life were distinguished, none of the previous research discussed this issue as their central focus. Most studies addressed more extensive financial effect of palliative and end-of-life care, including expenses borne by the patients themselves, the medicinal services framework and safety net providers or beneficent/willful suppliers. This shows a significant hole in the current writing. Social implications With the aging population, it has become evident that demand of palliative/hospice care will increase four-fold. The NHHCS have stopped keeping track of the palliative care requirements after 2007, which has a negative impact on the growing needs. Cost analysis can only be performed by analyzing existing data. This review has recognized a huge niche in the evidence base with respect to the cost cares of giving care and supporting a relative inside a palliative/hospice care setting. Originality/value The study exhibited that cost diminishments in aggressive medications can take care of the expenses of palliative/hospice care services. The issue of evaluating result in such a physically measurable way is complicated by the impalpable nature of large portions of the individual components of outcome. Although physical and mental well-being can be evaluated to a certain degree, it is significantly more difficult to gauge in a quantifiable way, the social and profound measurements of care that help fundamentally to general quality of care.

Cross-sectional study of the quality of neonatal care services in Armenia

2019 ◽  
Vol 32 (8) ◽  
pp. 1145-1161
Author(s):  
Suren H. Galstyan ◽  
Hrant Z. Kalenteryan ◽  
Arshak S. Djerdjerian ◽  
Hovhannes S. Ghazaryan ◽  
Naira T. Gharakhanyan ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Quality Assessment ◽  
Neonatal Care ◽  
Health Facilities ◽  
Cross Sectional ◽  
Content Type ◽  
Neonatal Deaths ◽  
Live Births ◽  
Care Services

Purpose The purpose of this paper is to report the assessment results of the quality of neonatal care services in Armenia and to describe the identified obstacles to improving the quality of care for newborn infants. Design/methodology/approach The study carried out a cross-sectional descriptive design. The data were collected in health facilities with different levels of neonatal care that were selected employing a multi-stage, stratified purposeful sampling design. The quality of neonatal services was assessed using the generic WHO tool. Data collection was performed using face-to-face semi-structured interviews, hospital statistics, medical records and direct observations. Findings In 31 study hospitals, 31,976 deliveries were performed resulting in 31,701 live births and 734 stillbirths. About 85 percent of all neonatal deaths was attributable to early neonatal deaths with over 48 percent occurring during the first 24 h of life. The proportion of neonatal deaths was highest in infants with low birth weight constituting 92.8 percent of all neonatal deaths. The total neonatal mortality rate was 3.50 per 1,000 live births, whereas stillbirth rate and perinatal mortality rate were 22.60 and 25.26 per 1,000 total births in 2015. Specific indicators with relatively lower mean scores included neonatal resuscitation, early breastfeeding, monitoring of newborn conditions, neonatal sepsis, feeding standards, total parenteral nutrition, and infection treatment. Originality/value Given the limited scope of research on quality assessment, this paper provides valuable information on the status of quality of neonatal care services in Armenian health facilities. This work also extends the existing studies focused on quality assessment through applying the model of Avedis Donabedian with the structure–process–outcomes approach as a theoretical basis.

Managed care Medicaid

2017 ◽  
Vol 11 (2) ◽  
pp. 198-210 ◽  
Author(s):  
William Trombetta
Keyword(s):  
Health Care ◽  
Managed Care ◽  
Health Care Delivery ◽  
Care Delivery ◽  
Care Quality ◽  
Market Segment ◽  
Economic Aspects ◽  
Content Type ◽  
The Poor

Purpose Providing health care to the poor is evolving in the new US marketplace. The Affordable Care Act has set goals enhancing access to health care, lowering costs and improving patient outcomes. A key segment in this evolution is the most vulnerable health-care population of all: Medicaid. This paper aims to provide a general review of how providing health care to Medicaid patients is changing including how socio-economic aspects of this vulnerable population affects the quality of the health care provided. Design/methodology/approach The paper is entirely secondary research; no primary research has been conducted. Findings Managed care Medicaid provides a risk-based model to treating a vulnerable health-care market segment. The jury is still out on whether managed care Medicaid (MCM) is improving health-care quality and saving cost, but the provision of health care to the Medicaid segment is definitely shifting from a fee-for-service model to value based payment. Very recent developments of new health-care delivery approaches present a positive outlook for improving quality and containing costs going forward. Research limitations/implications At this stage, whether or not MCM saves money or provides better health-care quality to this vulnerable population is a work in progress. Health-care marketing can impact socio-economic aspects of health care for the poor. There is a need to follow up on the positive results being documented in demonstration health-care delivery models. Practical implications At this point, there has been no long-term study of whether managed care Medicaid offers better quality of health care and cost savings. The research to date suggest that the quality of health-care delivery to the poor is improving at a lower cost to payers. Social implications Medicaid patients are an underserved market segment. Managed care Medicaid offers a new model that has the potential to provide quality care at acceptable cost. Critical to this vulnerable market segment is the need to integrate socio-economic aspects of the population with the delivery of health care. Originality/value There has been very little discussion of Medicaid overall in the marketing literature, much less any discussion of managed care Medicaid.

Enhancing data-driven elderly appointment services in domestic care communities under COVID-19

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
H.Y. Lam ◽  
G.T.S. Ho ◽  
Daniel Y. Mo ◽  
Valerie Tang
Keyword(s):  
Artificial Intelligence ◽  
Real Time ◽  
Care Service ◽  
The Elderly ◽  
Care Centre ◽  
Service Matching ◽  
Content Type ◽  
Care Services ◽  
Domestic Care

PurposeUnder the impact of Coronavirus disease 2019 (COVID-19), this paper contributes in the deployment of the Artificial Intelligence of Things (AIoT)-based system, namely AIoT-based Domestic Care Service Matching System (AIDCS), to the existing electronic health (eHealth) system so as to enhance the delivery of elderly-oriented domestic care services.Design/methodology/approachThe proposed AIDCS integrates IoT and Artificial Intelligence (AI) technologies to (1) capture real-time health data of the elderly at home and (2) provide the knowledge support for decision making in the domestic care appointment service in the community.FindingsA case study was conducted in a local domestic care centre which provided elderly oriented healthcare services to the elderly. By integrating IoT and AI into the service matching process of the mobile apps platform provided by the local domestic care centre, the results proved that customer satisfaction and the quality of the service delivery were improved by observing the key performance indicators of the transactions after the implementation of the AIDCS.Originality/valueFollowing the outbreak of COVID-19, this is a new attempt to overcome the limited research done on the integration of IoT and AI techniques in the domestic care service. This study not only inherits the ability of the existing eHealth system to automatically capture and monitor the health status of the elderly in real-time but also improves the overall quality of domestic care services in term of responsiveness, effectiveness and efficiency.

scholarly journals Impacts of a Care Robotics Project on Finnish Home Care Workers’ Attitudes towards Robots

2020 ◽  
Vol 17 (19) ◽  
pp. 7176
Author(s):  
Teemu Rantanen ◽  
Teppo Leppälahti ◽  
Jaakko Porokuokka ◽  
Sari Heikkinen
Keyword(s):  
Home Care ◽  
Elderly Care ◽  
Test Group ◽  
Home Care Services ◽  
Two Dimensions ◽  
Control Group ◽  
Care Services ◽  
Care Robots ◽  
Care Workers ◽  
Home Care Workers

Technological advances in elderly care have been rapid, and the introduction of robots in care will be a topical issue in the near future. There has been little research into the possibility of influencing care workers’ attitudes towards robots by project activities, and how to make the change easier for work communities. This study focuses on a robotics project that took place in elderly and home care services in one municipality in Finland (total of 45 care workers). During the project, four robotics workshops and one extended pilot session were implemented. The study follows quasi-experimental settings, and it included two measurements (before and after project activities) and a control group, but no randomization. The data were collected by questionnaires and were analyzed statistically. The project under study brought about minor positive changes in home care workers’ attitudes towards the usefulness of care robots. In the final measurement, the difference between the test group and the control group was significant in the two dimensions of positive attitudes. The research supports the hypothesis that project activities can be used to influence home care workers’ attitudes towards robots. This can also facilitate the introduction of care robots in home care services. However, the construction of a technology-positive care culture is a long-term process, which requires training and development, technological development and strong strategic management at various levels.

Patients’ perspectives of emergency care quality and priorities for care improvement

2017 ◽  
Vol 22 (4) ◽  
pp. 234-245 ◽  
Author(s):  
Lily Yarney ◽  
Roger Ayimbillah Atinga
Keyword(s):  
Emergency Care ◽  
Principal Component ◽  
Care Quality ◽  
Public Hospitals ◽  
Cross Sectional ◽  
Content Type ◽  
Logistic Regression Models ◽  
Central Regions ◽  
Care Improvement

Purpose Studies have examined strategies implemented to strengthen quality of emergency care in healthcare provider institutions in Ghana. But few studies have focused on what determines quality of emergency care from the patient’s perspective. The purpose of this paper is to fill that gap by examining factors salient to gauging quality of emergency care and priority areas for care improvement. Design/methodology/approach Cross-sectional data were collected from patients admitted in emergency units of public hospitals in two regions: Greater Accra and Central Regions. A structured questionnaire designed with inputs from emergency medicine physicians and patients was used to collect data from 381 patients. Principal component analysis (PCA) and logistic regression models were computed to respectively determine salient measures of emergency care quality and their association with patient overall perceived quality of emergency care. Findings Using the PCA, four factors (social and relational care, attentive prehospitalised care, ward quality and privacy and medical supplies) were derived as salient measures of emergency care quality. All the factors derived had statistically significant association with patient overall perception of quality. Originality/value Emergency care quality improvement strategies that incorporate the dimensions identified can produce effective therapeutic outcomes.

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