The role of transformative healthcare technology on quality of life during the COVID-19 pandemic

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Mohammad Asif Salam ◽  
Saleh Bajaba
Keyword(s):  
Quality Of Life ◽  
Health Care ◽  
Saudi Arabia ◽  
Service Delivery ◽  
Health Care System ◽  
Service System ◽  
Content Type ◽  
Care System

Purpose The purpose of this study is to investigate the role of the COVID-19 health-care system quality (HSQ) and its impact on the individual (satisfaction) and social (quality of life [QOL]) outcomes in the context of a transformative health-care delivery system using service-dominant logic (SDL). Design/methodology/approach A sample consisting of 1,008 individuals who have experienced the COVID-19 health-care system was drawn from four different regions of Saudi Arabia using the simple random sampling technique. The survey was conducted using an online survey and 1,008 respondents answered, based on their experience and knowledge of the COVID-19 health-care system. Partial least squares structural equation modeling was applied to test the proposed research model. Findings The study findings suggest that service system satisfaction (SAT) significantly mediates the role of the HSQ in delivering and enhancing the QOL. HSQ also has a significant role to play on the SAT as well as the QOL. These findings contribute to the body of knowledge on SDL in the context of HSQ in understanding the significant role of technologies can play in enhancing service satisfaction and better QOL during a crisis such as COVID-19. This study also improves the understanding of the importance of customer-centricity, real-time visibility through tracking and tracing of service flow, agile decision-making, fewer but better-defined service objectives, and finally shaping mindsets and behaviors of all the relevant parties involved in the HSQ service delivery process. Research limitations/implications One of the major limitations of this study is that, although COVID-19 is an ongoing global pandemic, cross-sectional data were collected in only one country. The findings may not be generalizable across subsequent waves of the pandemic. The best practices of HSQ could be studied around the globe and the results used to support continuous improvement. Originality/value This study advances the understanding of the SDL in the context of a transformative health-care system for a transitional economy by focusing on individual and social well-being during an unexpected crisis such as the COVID-19 pandemic. This study also contributes toward the understanding of the roles of enabling technologies to improve the service delivery system which results in an improved SAT, as well as better QOL for the society at large. Based on SDL this research validates the HSQ model, relevant measures and its overall impact on SAT and QOL in the context of a transformative health-care service system in Saudi Arabia.

Assisting People With Their Living, Not Their Dying: Health Professionals’ Perspectives of Palliative Care and Opioids in ILD

2021 ◽  
pp. 104990912110186
Author(s):  
Lauren Russo ◽  
Karen Willis ◽  
Natasha Smallwood
Keyword(s):  
Quality Of Life ◽  
Health Care ◽  
Palliative Care ◽  
Health Care System ◽  
Therapeutic Relationships ◽  
Specialist Palliative Care ◽  
Cross Sectional ◽  
Symptom Palliation ◽  
Care System

Objectives: Interstitial lung disease (ILD) is a debilitating and life-limiting condition, requiring multi-disciplinary care. While guidelines recommend early specialist palliative care referral to improve symptoms and quality of life, few patients access such care towards the end-of-life. This study aimed to explore clinicians’ perspectives regarding specialist palliative care and opioids to understand barriers to optimal care and guide clinical practice improvement initiatives. Methods: A cross-sectional, exploratory, qualitative study was undertaken with Australian respiratory clinicians caring for people with ILD (n = 17). In-depth, semi-structured interviews were audio-recorded, transcribed verbatim and coded. Thematic analysis was undertaken to extrapolate recurring ideas from the data. Results: Four themes were identified: 1) understanding how to improve patient care and support, 2) the need to dispel stigmatized beliefs and misconceptions, 3) the importance of trusted relationships and good communication and 4) the challenges of navigating the health-care system. Participants discussed the need to implement early specialist palliative care and symptom palliation to alleviate symptoms, provide emotional support and augment quality of life. Participants described challenges accessing palliative care and opioids due to stigmatized beliefs amongst patients and clinicians and difficulties navigating the health-care system. Trusted therapeutic relationships with patients and strong inter-disciplinary partnerships with collaborative education and communication were perceived to improve patients’ access to symptom palliation. Conclusion: Specialist palliative care and opioids were believed to improve patients’ quality of life, however, many barriers can make accessing such care challenging. To address these issues, multi-disciplinary collaboration, high-quality communication and trusted therapeutic relationships are crucial throughout the ILD illness journey.

Who is a “Senior”? Looking for a definition in the healthcare system

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Monica Consolandi
Keyword(s):  
Quality Of Life ◽  
Health Care ◽  
Healthcare System ◽  
Health Care System ◽  
Design Methodology ◽  
Social Role ◽  
Content Type ◽  
The Core ◽  
Starting Point

Purpose Seniors are nowadays at the core of important reflections to understand both how to ensure them a proper quality of life and better recognize their social role, providing them services and proper health care to value them as persons and resources. This paper aims to find a through definition about who is a senior, in the author’s opinion the starting point to help them flourishing. Design/methodology/approach As an example of definitions, an online dictionary and two geriatric text-books are quoted, highlighting qualities and rights referred to seniors especially in the delicate context of the health-care system. Findings The lack of a commonly shared perspective on this delicate kind of patient entails the difficulty to reach a coherent and satisfying definition about who a senior is. Originality/value The lack of a commonly shared definition leads to inevitable misunderstandings and could explain the arduousness of considering seniors in all their aspects. Further investigations are suggested.

EVALUATION OF QUALITY OF LIFE OF PATIENTS WITH PRIMARY BRONCHIAL ASTHMA IN THE HEALTH CARE SYSTEM

2021 ◽  
Vol 2 (4) ◽  
pp. 51-54
Author(s):  
Dilrabo Alikulova ◽  
◽  
Rixsi Salikhodjaeva
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
Health Care ◽  
Primary Health Care ◽  
Health Care System ◽  
Bronchial Asthma ◽  
Primary Health ◽  
Close Relatives ◽  
Care System

The study of risk factors leading to the development of asthma, conducted in the form of a survey and interviews. 52% of patients with a diagnosis of asthma noted the presence of the disease among close relatives. Among the risk factors leading to bronchial asthma, the most common are pollen and tobacco (49.1%). 59.2% of patients diagnosed with asthma do not follow the diet. Keywords:asthma, nurses, primary health care, prevention, risk factors

scholarly journals Association between Oral Health-Related Quality of Life in People with Rare Diseases and Their Satisfaction with Dental Care in the Health System of the Federal Republic of Germany

2018 ◽  
Vol 15 (8) ◽  
pp. 1732 ◽  
Author(s):  
Marcel Hanisch ◽  
Sabrina Wiemann ◽  
Lauren Bohner ◽  
Johannes Kleinheinz ◽  
Susanne Jung
Keyword(s):  
Quality Of Life ◽  
Health Care ◽  
Health Care System ◽  
Rare Diseases ◽  
Dental Care ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
Care System

Background: The aim of this study was to examine the current dental care situation in Germany from the perspective of those affected by a rare disease, especially concerning their satisfaction with the German dental health care system, and thus assess the relationship between their perspective and their oral health-related quality of life (OHRQoL). Methods: A questionnaire regarding their experiences with the dental assistance and the health care system, such as the OHIP-14, was sent to the member associations of the organization of self-help groups for rare diseases ACHSE e.V. The correlation between OHIP-14 values and patient’s perspective was statistically analyzed by the non-parametric Tau de Kendall test (p < 0.05). Results: There was a statistically significant correlation between the OHIP score and the patient’s perspective regarding dental assistance and health care system (p < 0.05). For those surveyed who were satisfied with the support of the health care system, an average OHIP score of 8.54 ± 10.45 points (range: 0–48) was determined. The group that did not feel sufficiently supported by the health care system had an average OHIP score of 16.07 ± 13.43 points (range: 0–56). Discussion: The majority of respondents with rare diseases are dissatisfied with the German health care system and its support with regard to dental care.

scholarly journals Iron Supplementation Adjunct to Erythropoiesis Stimulating Agents Is Cost Saving for Chemotherapy-Related Anemia in the Era of Biosimilars

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 2165-2165
Author(s):  
Monia Marchetti ◽  
Giovanni Barosi ◽  
Paolo Pedrazzoli
Keyword(s):  
Quality Of Life ◽  
Health Care ◽  
Health Care System ◽  
Intravenous Iron ◽  
Therapeutic Strategies ◽  
Improve Quality ◽  
Care Costs ◽  
Esa Therapy ◽  
Care System

Abstract Background: International guidelines recommend erythropoiesis stimulating agents (ESA) to improve chemotherapy-related anemia (CRA), however, two meta-analyses proved that intravenous iron (II) improves the chance of obtaining a response to ESA by 28% (Gafter-Gvili 2013, Petrelli 2012). Recently, biosimilar ESAs have been approved for CRA, we therefore aimed at comparing the cost-effectiveness of different therapeutic strategies for CRA eventually including II and/or biosimilar ESAs. Methods: A decision model was built comparing 5 strategies: no ESA, brand ESA, brand ESA plus II, biosimilar ESA, biosimilar ESA plus II. Ferric gluconate was assumed to be administered 125 mg per week for 6 weeks overall: 4 infusions were planned in days different from chemotherapy administration. ESA was started at hemoglobin values lower than 11 g/dl. The model included a Markov tree of 13 health states representing hemoglobin level during 26 therapy weeks. Weekly probability of hemoglobin improvement by 1 g/dL was estimated to be 10% with ESA and 15% with ESA plus II but null without ESA. The efficacy of biosimilar ESA was assumed to be the same as ESA. Weekly probability of death was assumed to be 0.4% (Pedrazzoli 2008). The rate of severe events during II infusion was assumed to be 0.2% per week without fatal events. Quality of life at different hemoglobin levels was driven from literature. The economic analysis was run in the perspective of the Health Care System and of the society. II administration was charged €50 and blood transfusion €400. Indirect costs for iron infusions and transfusions planned in days not devoted to chemotherapy was estimated to be €100 for transportation and care-giver time. Based on local data, the per-unit cost of biosimilar ESA versus brand ESA was considered to be 1 in 5.All the analyses were run TreeAgePro2014. Microsimulations and first-order MonteCarlo analysis were run. Results: ESA improve quality-adjusted survival of patients from 14.51 to 14.82 quality-adjusted weeks but II adjunct increased the gain to 15.20 weeks. In the perspective of the health-care system, the management of cancer-related anemia without ESA costs €1,550, while ESA therapy increased the costs by €618 (biosimilars) and €2,933 (brand); ESA plus II increased the costs by €359 and €2,437, respectively. Therefore, the adjunct of II reduced overall health-care costs by €259 in the biosimilar strategy and €496 in the brand ESA strategy. Societal costs similarly increased with ESA use, but the increment was lower: €584 with biosimilar ESA and €2,866 with brand ESA. II allowed to achieve minimal savings in the biosimilar strategy, while savings were €288 in the brand ESA strategy. Savings to the health-care system and to the society were even higher (further €300 to the healthcare-system and €90 to the society) in the hypothesis that liposomial oral iron (30 mg per day for 60 days) achieved similar results as II, at €1 per day charged to the patient (in Italy liposomal iron it is not refunded). Ferric carboxymaltose 750 mg single administration at a cost of €280 might compete with multiple ferric gluconate administrations. Finally, we explored the efffect of threshold hemoglobin: starting ESA at hemoglobin levels lower than 10 g/dl instead of 11 g/dl allowed to reduce health-care costs of ESA therapy by €172, but quality of life was increased by only 0.14 and 0.59 weeks, without and with II, respectively. Conclusions: Rational allocation of health-care resources imposes to choose the most convenient therapeutic strategy among those recommended by practice guidelines. Intravenous iron allows to save health-care and society resources and to improve quality of life by a more rapid hematopoietic response to ESA. Different iron formulations need to be tested in association with ESA in this setting in order to improve the efficiency of avilable therapeutic strategies. Cost-effectiveness analyses should be shared by clinicians and hospital pharmacy to adopt the most effective and efficient therapeutic strategies. Disclosures No relevant conflicts of interest to declare.

THE ROLE OF HEALTH FINANCING IN VARIOUS COUNTRIES OF THE WORLD

2020 ◽  
Author(s):  
Natalia Vladimirovna Lazareva ◽  
Keyword(s):  
Quality Of Life ◽  
Health Care ◽  
Health Care System ◽  
Health Financing ◽  
The State ◽  
Life Index ◽  
The World ◽  
Quality Of Life Index

In this article, the authors consider the state of the health care system of various countries that were included in the sample based on their place in the ranking on the quality of life index of the population.

scholarly journals Diabetic macular edema: a literature review

2020 ◽  
Vol 45 (Suppl.3) ◽  
pp. e020108
Author(s):  
Wellington Fernando Risso ◽  
Matheus Roque Pinheiro ◽  
Leonardo Amarante Pereira ◽  
Júlio Zaki Abucham-Neto ◽  
Glaucia Luciano da Veiga ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Health Care ◽  
Literature Review ◽  
Disease Control ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Health Care System ◽  
Active Population ◽  
Care System

Diabetic Macular Edema is a major cause of visual impairment in economically active population, being responsible for a significant impact in quality of life in the affected population, as well as high costs to the health care system. Over decades, some studies have compared treatments using Laser, Anti-VEGF and intravitreous corticosteroids, establishing protocols to reach effectives therapies. Thus, it is essential an entire understanding of available therapies to reach the goal of disease control, in an individual basis and in a collective health care system, as efficient as possible.

Improving Quality of Care and Promoting Health Care System Change: The Role of Community-Based Coalitions

2006 ◽  
Vol 7 (2_suppl) ◽  
pp. 87S-95S ◽  
Author(s):  
Marielena Lara ◽  
Michael D. Cabana ◽  
Christy R. Houle ◽  
James W. Krieger ◽  
Laurie L. Lachance ◽  
...  
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Health Care System ◽  
System Change ◽  
Community Based ◽  
Care System

Palliative radiotherapy referrals in the last days of cancer patients' life: Could we do better?

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e24008-e24008
Author(s):  
Leora Brazg Ferro ◽  
Eliya Shachar ◽  
Orit Gutfeld ◽  
Ido Wolf ◽  
Yasmin Natan Oz
Keyword(s):  
Quality Of Life ◽  
Health Care ◽  
End Of Life ◽  
Health Care System ◽  
Treatment Plan ◽  
Palliative Radiotherapy ◽  
Palliative Radiation ◽  
Number Of Patients ◽  
Care System

e24008 Background: The role of active cancer therapy towards the end of life (EOL) is debatable and may even be considered harmful. While palliative radiotherapy may be highly effective in reducing cancer-related symptoms of advanced disease, the beneficial effects are usually at least 2-4 weeks from completion of treatment. Thus, radiotherapy administered at the end of life is often ineffective, and may actually impair quality of life and be associated with an unnecessary burden to the health care system. The universal Israeli health care system enables the administration of radiotherapy without financial or regulatory barriers, even at EOL. We aimed to assess the use radiotherapy towards EOL in a tertiary care Israeli cancer center. Methods: We retrospectively analyzed data of patients receiving palliative radiation and died within 30 days of their simulation from March 2019 until September 2020. Results: Out of approximately 2,000 patients treated with radiotherapy during the study period, 148 (8%) patients were referred for palliative radiation and died within 30 days of their simulation. The majority (88, 59.5%) were male, the median age was 67.3 years and the most common malignancies patients suffered from were lung cancer (49, 33.1%), gastrointestinal tumors (28, 18.9%), genito-urinary malignancies (23, 15.5%) or breast cancer (15, 10.1%). The median ECOG PS was 3. Nineteen patients (12.8%) did not initiate radiation treatment plan, 24 patients (16.2%) completed less than half of the planned treatment and 89 patients (60.1%) completed the entire duration of treatment. Of the patients who completed the planned therapy, 34 patients (38.2%) received a single fraction protocol. The majority of patients (89, 60.1%) were referred to the radiation unit by their treating medical oncologists or hemato-oncologist. None of the patients were referred by palliative care team members at our center. Most (105, 70.9%) received previous systemic therapies; but less than half (48, 45.7%) were under active treatments within a month prior to the radiation simulation. Conclusions: Relatively large number of patients with advanced malignancies are referred for futile palliative radiotherapy during the last 30 days of their life, thus impairing their quality of life and creating an unnecessary burden on public health services. These patients are often being referred by their treating oncologists who are familiar with their oncological history. These findings call for the implementation of collaborative multi-disciplinary teams, primarily directed at optimizing care at the end of life, setting achievable treatment goals, and improving quality of life.

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