Examining the Knowledge, Awareness, and Perceptions of Palliative Care in the General Public Over Time: A Scoping Literature Review

2019 ◽  
Vol 37 (6) ◽  
pp. 481-487 ◽  
Author(s):  
Priya Patel ◽  
Laura Lyons
Keyword(s):  
Health Care ◽  
Palliative Care ◽  
Literature Review ◽  
General Public ◽  
The United States ◽  
Close Friend ◽  
Poor Knowledge ◽  
The Public ◽  
Scoping Literature Review ◽  
Over Time

Background: The field of palliative care (PC) is growing as the world population ages and burden of chronic diseases increases. Thus, it is important that the general public is knowledgeable about PC and the benefits PC provides. Objective: The aim of this study is to describe the public’s knowledge, awareness, and perceptions of PC and determine whether these have changed over time. Methods: A scoping literature review was conducted from 1968 to May 2019 using PubMed, EMBASE, and MEDLINE databases. Results: Thirteen studies met inclusion criteria that originated from the United States, Canada, Scotland, Italy, New Zealand, Ireland, United Kingdom, Korea, and Sweden between years 2003 and 2019. Participants were adults and mostly younger than 64 years, women, and Caucasian. The majority of studies reported the public having poor knowledge (7/9 articles) and awareness (4/6 articles) of PC over the past 16 years. Top characteristics associated with increased levels of knowledge and/or awareness of PC included women (6/8 articles), age 40+ (6/8 articles), experience with a close friend and/or relative requiring PC (4/8 articles), and working in health-care and/or PC (4/8 articles). The most common perceptions of PC were associated with patients who have terminal illnesses and end-of-life care. Participants commonly received information about PC from the media, having a close friend or relative requiring PC, and working in a health-care setting. Conclusions: The public has poor knowledge and awareness about PC and several misperceptions exist. These findings have remained constant over time despite growth in the field of PC, which highlights the strong need for focused educational interventions.

The New Economic Populism and the Future of Inequality in the United States

2017 ◽  
Author(s):  
William W. Franko ◽  
Christopher Witko
Keyword(s):  
United States ◽  
Federal Government ◽  
Labor Unions ◽  
Republican Party ◽  
The United States ◽  
The Public ◽  
Empirical Results ◽  
Income Disparities ◽  
The Face ◽  
Over Time

The authors conclude the book by recapping their arguments and empirical results, and discussing the possibilities for the “new economic populism” to promote egalitarian economic outcomes in the face of continuing gridlock and the dominance of Washington, DC’s policymaking institutions by business and the wealthy, and a conservative Republican Party. Many states are actually addressing inequality now, and these policies are working. Admittedly, many states also continue to embrace the policies that have contributed to growing inequality, such as tax cuts for the wealthy or attempting to weaken labor unions. But as the public grows more concerned about inequality, the authors argue, policies that help to address these income disparities will become more popular, and policies that exacerbate inequality will become less so. Over time, if history is a guide, more egalitarian policies will spread across the states, and ultimately to the federal government.

Health Care Cost Containment in Large American Cities

1989 ◽  
Vol 18 (1) ◽  
pp. 87-100 ◽  
Author(s):  
Perry Moore
Keyword(s):  
Health Care ◽  
Cost Containment ◽  
Local Governments ◽  
Health Care Cost ◽  
The United States ◽  
Public Agencies ◽  
The Public ◽  
Survey Results ◽  
The Cost ◽  
American Cities

This research provides information about the health care cost containment efforts of local governments and agencies across the United States, particularly in large American cities. Survey results indicate that while the public sector lags behind the private sector, public agencies are beginning to match the cost containment efforts of private employers. While initiation of these efforts represents considerable recent progress, their tangible benefits are not yet apparent.

scholarly journals Trends and Patterns in the Public Awareness of Palliative Care, Euthanasia, and End-of-Life Decisions in 3 Central European Countries Using Big Data Analysis From Google: Retrospective Analysis (Preprint)

2021 ◽  
Author(s):  
Matthias Huemer ◽  
Daniela Jahn-Kuch ◽  
Guenter Hofmann ◽  
Elisabeth Andritsch ◽  
Clemens Farkas ◽  
...  
Keyword(s):  
Health Care ◽  
Palliative Care ◽  
End Of Life ◽  
Assisted Suicide ◽  
Public Awareness ◽  
End Of Life Decisions ◽  
The Public ◽  
Care Services ◽  
Life Decisions ◽  
Advance Health Care Directives

BACKGROUND End-of-life decisions, specifically the provision of euthanasia and assisted suicide services, challenge traditional medical and ethical principles. Austria and Germany have decided to liberalize their laws restricting assisted suicide, thus reigniting the debate about a meaningful framework in which the practice should be embedded. Evidence of the relevance of assisted suicide and euthanasia for the general population in Germany and Austria is limited. OBJECTIVE The aim of this study is to examine whether the public awareness documented by search activities in the most frequently used search engine, Google, on the topics of <i>palliative care, euthanasia</i>, and <i>advance health care directives</i> changed with the implementation of palliative care services and new governmental regulations concerning end-of-life decisions. METHODS We searched for policies, laws, and regulations promulgated or amended in Austria, Germany, and Switzerland between 2004 and 2020 and extracted data on the search volume for each search term topic from Google Trends as a surrogate of public awareness and interest. Annual averages were analyzed using the Joinpoint Regression Program. RESULTS Important policy changes yielded significant changes in search trends for the investigated topics. The enactment of laws regulating advance health care directives coincided with a significant drop in the volume of searches for the topic of euthanasia in all 3 countries (Austria: −24.48%, <i>P</i>=.02; Germany: −14.95%, <i>P</i><.001; Switzerland: −11.75%, <i>P</i>=.049). Interest in palliative care increased with the availability of care services and the implementation of laws and policies to promote palliative care (Austria: 22.69%, <i>P</i>=.01; Germany: 14.39, <i>P</i><.001; Switzerland: 17.59%, <i>P</i><.001). The search trends for advance health care directives showed mixed results. While interest remained steady in Austria within the study period, it increased by 3.66% (<i>P</i><.001) in Switzerland and decreased by 2.85% (<i>P</i><.001) in Germany. CONCLUSIONS Our results demonstrate that legal measures securing patients’ autonomy at the end of life may lower the search activities for topics related to euthanasia and assisted suicide. Palliative care may be a meaningful way to raise awareness of the different options for end-of-life care and to guide patients in their decision-making process regarding the same.

scholarly journals Differences in Perceptions of Health Information Between the Public and Health Care Professionals: Nonprobability Sampling Questionnaire Survey (Preprint)

2019 ◽  
Author(s):  
Anat Gesser-Edelsburg ◽  
Nour Abed Elhadi Shahbari ◽  
Ricky Cohen ◽  
Adva Mir Halavi ◽  
Rana Hijazi ◽  
...  
Keyword(s):  
Health Care ◽  
Social Networks ◽  
New Media ◽  
Health Information ◽  
Health Care Professionals ◽  
Questionnaire Survey ◽  
General Public ◽  
The Public ◽  
Search For Information

BACKGROUND In the new media age, the public searches for information both online and offline. Many studies have examined how the public reads and understands this information but very few investigate how people assess the quality of journalistic articles as opposed to information generated by health professionals. OBJECTIVE The aim of this study was to examine how public health care workers (HCWs) and the general public seek, read, and understand health information and to investigate the criteria by which they assess the quality of journalistic articles. METHODS A Web-based nonprobability sampling questionnaire survey was distributed to Israeli HCWs and members of the public via 3 social media outlets: Facebook, WhatsApp, and Instagram. A total of 979 respondents participated in the online survey via the Qualtrics XM platform. RESULTS The findings indicate that HCWs find academic articles more reliable than do members of the general public (44.4% and 28.4%, respectively, P<.001). Within each group, we found disparities between the places where people search for information and the sources they consider reliable. HCWs consider academic articles to be the most reliable, yet these are not their main information sources. In addition, HCWs often use social networks to search for information (18.2%, P<.001), despite considering them very unreliable (only 2.2% found them reliable, P<.001). The same paradoxes were found among the general public, where 37.5% (P<.001) seek information via social networks yet only 8.4% (P<.001) find them reliable. Out of 6 quality criteria, 4 were important both to HCWs and to the general public. CONCLUSIONS In the new media age where information is accessible to all, the quality of articles about health is of critical importance. It is important that the criteria examined in this research become the norm in health writing for all stakeholders who write about health, whether they are professional journalists or citizen journalists writing in the new media.

scholarly journals A cross-sectional study of neurosurgical department chairs in the United States

2018 ◽  
Vol 129 (5) ◽  
pp. 1342-1348 ◽  
Author(s):  
Patrick M. Flanigan ◽  
Arman Jahangiri ◽  
Joshua L. Golubovsky ◽  
Jaret M. Karnuta ◽  
Francis J. May ◽  
...  
Keyword(s):  
United States ◽  
Health Care ◽  
San Francisco ◽  
Residency Program ◽  
Department Chair ◽  
Department Chairs ◽  
Temporal Trends ◽  
The United States ◽  
Advanced Degrees ◽  
Over Time

OBJECTIVEThe position of neurosurgery department chair undergoes constant evolution as the health care landscape changes. The authors’ aim in this paper was to characterize career attributes of neurosurgery department chairs in order to define temporal trends in qualities being sought in neurosurgical leaders. Specifically, they investigated the hypothesis that increased qualifications in the form of additional advanced degrees and research acumen are becoming more common in recently hired chairs, possibly related to the increased complexity of their role.METHODSThe authors performed a retrospective study in which they collected data on 105 neurosurgeons who were neurosurgery department chairs as of December 31, 2016, at accredited academic institutions with a neurosurgery residency program in the United States. Descriptive data on the career of neurosurgery chairs, such as the residency program attended, primary subspecialty focus, and age at which they accepted their position as chair, were collected.RESULTSThe median age and number of years in practice postresidency of neurosurgery chairs on acceptance of the position were 47 years (range 36–63 years) and 14 years (range 6–33 years), respectively, and 87% (n = 91) were first-time chairs. The median duration that chairs had been holding their positions as of December 31, 2016, was 10 years (range 1–34 years). The most common subspecialties were vascular (35%) and tumor/skull base (27%), although the tendency to hire from these specialties diminished over time (p = 0.02). More recently hired chairs were more likely to be older (p = 0.02), have more publications (p = 0.007), and have higher h-indices (p < 0.001) at the time of hire. Prior to being named chair, 13% (n = 14) had a PhD, 4% (n = 4) had an MBA, and 23% (n = 24) were awarded a National Institutes of Health R01 grant, tendencies that were stable over time (p = 0.09–0.23), although when additional degrees were analyzed as a binary variable, chairs hired in 2010 or after were more likely to have an MBA and/or PhD versus those hired before 2010 (26% vs 10%, p = 0.04). The 3 most common residency programs attended by the neurosurgery chairs were Massachusetts General Hospital (n = 8, 8%), University of California, San Francisco (n = 8, 8%), and University of Michigan (n = 6, 6%). Most chairs (n = 63, 61%) attended residency at the institution and/or were staff at the institution before they were named chair, a tendency that persisted over time (p = 0.86).CONCLUSIONSMost neurosurgery department chairs matriculated into the position before the age of 50 years and, despite selection processes usually involving a national search, most chairs had a previous affiliation with the department, a phenomenon that has been relatively stable over time. In recent years, a large increase has occurred in the proportion of chairs with additional advanced degrees and more extensive research experience, underscoring how neurosurgical leadership has come to require scientific skills and the ability to procure grants, as well as the financial skills needed to navigate the ever-changing financial health care landscape.

Cost Containment in the Health Care Field and the Antitrust Laws

1982 ◽  
Vol 7 (4) ◽  
pp. 425-435
Author(s):  
David I. Shapiro
Keyword(s):  
Health Care ◽  
Supreme Court ◽  
The United States ◽  
Medical Society ◽  
The Public ◽  
The Supreme Court ◽  
Antitrust Laws ◽  
Care Field ◽  
Antitrust Analysis ◽  
Care Costs

AbstractThe Supreme Court of the United States and other courts currently are considering the question of the extent to which the health care field should be subject to antitrust rules. This Article explores the special characteristics of the health care field, and the problems they create for antitrust analysis. Two current cases—Arizona v. Maricopa County Medical Society (awaiting decision by the Supreme Court) and Kartell v. Blue Shield of Massachusetts, Inc. (pending in the District of Massachusetts)—illustrate the issues raised by efforts to contain health care costs through the setting of maximum fees. This Article suggests that traditional antitrust principles should and will prevail over arguments that such restraints are in the public interest.

From Public to Publics

2019 ◽  
pp. 243-259 ◽  
Author(s):  
Amnon Cavari ◽  
Guy Freedman
Keyword(s):  
United States ◽  
Foreign Policy ◽  
Research Design ◽  
General Public ◽  
Demographic Factors ◽  
The United States ◽  
Individual Level ◽  
The Public ◽  
Public Agenda ◽  
Socio Demographic Factors

A rich body of work examines the public agenda in democratic countries. These studies rely on aggregate responses to survey questions that ask respondents to report their issue priorities—commonly using topline data of the most important problem survey series (MIP). This research design, however, is not sensitive to differences in issue priorities between individuals and groups and, therefore, fails to account for the possible variation within the general public. To overcome this neglect in existing literature, we examine individual-level responses to the most important problem question in two countries—the United States and Israel—focusing specifically on economic and foreign policy priorities. We reveal that beyond aggregate trends in the public agenda, socio-demographic factors in both countries explain some of the variation in issue dynamics.

High–Tech, Aggressive Palliative Care: In the Service of Quality of Life

1993 ◽  
Vol 9 (1) ◽  
pp. 37-41 ◽  
Author(s):  
David M. Dush
Keyword(s):  
Quality Of Life ◽  
United States ◽  
Health Care ◽  
Palliative Care ◽  
Hospice Care ◽  
High Technology ◽  
The United States ◽  
High Tech ◽  
Hospice Movement

The hospice movement grew in part as a reaction to the perception that modern medical care had become too technological at the expense of being impersonal and insensitive to human psychological and spiritual concerns. In the United States, the institutionalization of hospice care under Medicare and other reimbursement systems has further established hospice as an alternative to high-technology, high-cost care. The present paper examines the question: What if hospice care becomes itself high-technology, aggressive, costly health care in order to remain true to its goal of maximizing quality of life? Implications for the goals and philosophical underpinnings of palliative care are discussed.

Current Issues in Health Care Technology Assessment

1989 ◽  
Vol 5 (1) ◽  
pp. 123-136 ◽  
Author(s):  
Frederick Mosteller ◽  
Elisabeth Burdick
Keyword(s):  
United States ◽  
Health Care ◽  
Technology Assessment ◽  
The United States ◽  
Health Care Technology ◽  
The Public ◽  
National System ◽  
Care Technology

This article presents an overview of technology assessment in the United States. The authors argue that while there are numerous institutions carrying out assessments, the United States requires an overall plan that would provide a national system for technology assessment. If technology assessment were more organized and systematized, the authors argue, it would be more efficient and would reach the public and the medical world effectively.

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