scholarly journals What matters to patients: Parental and caregiver opinions on International Consortium for Health Outcomes Measurements overall health outcomes for children in Singapore

2020 ◽  
pp. 201010582097932
Author(s):  
Moira Suyin Chia ◽  
John Yeow Yang Wong ◽  
Irene Pheck Mui Chan ◽  
Kee Chong Ng
Keyword(s):  
Health Care ◽  
Child Health ◽  
Health Outcomes ◽  
Working Group ◽  
Online Survey ◽  
Measurement Tools ◽  
Open Review ◽  
Standard Set ◽  
Paediatric Health ◽  
Parents And Caregivers

Background: Health in children is multifaceted. More than just the absence of disease, good child health also comprises psychological well-being and social functioning. In paediatrics, optimal health care is a partnership between caregivers and doctors. Value-based medicine strengthens this partnership. Monitoring and tracking these patient-reported outcomes using validated measurement tools in a life-course manner helps us to understand and ultimately improve overall child health better. Objectives: This study aimed to assess parental opinions in Singapore on recommended outcome measures and approach recommended by the International Consortium for Health Outcomes Measurements (ICHOM) Overall Pediatric Health (OPH) working group. Methods: An international working group comprising 25 experts in paediatric health was formed under the auspices of ICHOM. Through a series of literature reviews, patient focus groups and open review periods, a set of health outcomes and case-mix variables was proposed, with the aim of improving paediatric care globally. Parents and caregivers were invited to participate in this survey from around the world, including from the USA, UK, Colombia and Singapore. The survey covered domains that were included in the ICHOM OPH Standard Set. An international anonymised online patient validation survey tool online survey was initiated to evaluate caregiver opinions of these proposed ICHOM OPH outcomes, and this was conducted from November 2019 to January 2020. Singapore participated in this caregiver survey on overall paediatric health outcomes. Of the 270 respondents in this ICHOM OPH consumer international open review online survey, 160 were from Singapore. We report here a cross-sectional study with data from the Singapore group of respondents. Results: Of the 160 responses from Singapore, 73.8% had no more than two children, and 38.8% of caregivers had children between 0 and 5 years old. In general, 76.9% of caregivers were satisfied with the health care that they received, and 60% of caregivers had had between one and four health-care appointments in the last 12 months. Assessment was done on a scale of 1 to 9, with importance defined as a score of ⩾7. All outcome measures were ranked to be important, with an overall mean score of 7.9 on a scale ranging from 1 to 9. Development was assessed as being the most important ( M=8.34±0.93), and sexual health was assessed as being the least important ( M=7.09±1.71). Almost all respondents felt that the list of ICHOM-recommended outcomes proposed was complete. Parents and caregivers in Singapore placed development and mental health as the most important across all age groups surveyed. They felt that the framework provided by the ICHOM OPH working group was adequate in addressing their concerns. Most parents and caregivers were satisfied with the health care they had received. Conclusion: Child health is a continuum that requires longitudinal attention from both the family and the clinician, and should take a life-course approach, utilising validated measurement tools to monitor and track key parameters. Parents and caregivers in Singapore place high importance on their child’s development and mental functioning. While there has been much community effort on development and mental functioning in children, more can be done in these two areas and to increase the emphasis and awareness on sex education both within the home and in schools. A framework for evaluating children during follow-up clinic visits would be helpful in continuing longitudinal care of children to provide holistic care and to improve adult health in the long term, guided by the framework set down by the ICHOM OPH standard set. As we recognise and embrace the importance not just of health care but the health of the next generation, we will need to use validated measurement tools to monitor and track these importance parameters in the journey of our children, so that we can identify and improve these outcomes in a timely manner.

scholarly journals Improving the Measurement of Health System Performance across the Rural-Urban Continuum

2018 ◽  
Vol 3 (4) ◽  
Author(s):  
Naushaba Degani ◽  
Sharon Gushue ◽  
Alex Yurkiewich ◽  
Emmalin Buajitti ◽  
Matthew Kumar ◽  
...  
Keyword(s):  
Health Care ◽  
Health Outcomes ◽  
Health System ◽  
Performance Indicators ◽  
System Performance ◽  
Working Group ◽  
Geographic Location ◽  
Key Performance Indicators ◽  
Health System Performance ◽  
The Impact

IntroductionWe report on key performance indicators to highlight quality and variation in health care. Given Ontario’s diverse geography, we have prioritized improving measurement across the rural-urban continuum. This will improve our ability to discern the impact of geography on health care and health status to inform planning and decision making. Objectives and ApproachBuilding on previous work to advance measurement of equity in health care, we struck a technical working group of experts to review methods for stratifying health system performance data by geographic location in the Ontario context. These methods were applied to a set of key performance indicators. The working group’s review of the results of this analysis will lead to recommendations for the best method to refine and standardize how geographic location is measured and stratified. This will improve our ability to discern the impact of geography on health system performance and health status for our suite of public-reporting products. ResultsThe technical working group identified three methodologies for consideration that used linked postal code data: Population Centre (POPCTR), Statistical Area Classification (SAC) and a hybrid POPCTR/SAC methodology. These methods were tested against a set of key performance indicators across dimensions of quality including timeliness, effectiveness, population health and health outcomes. The results show that, in the health system performance dimensions of effectiveness and timeliness, as well as for a subset of health outcomes, there is variation in performance across the urban-rural continuum, though not always in a linear way. This may reflect differences in health care access, health risk factors, sociodemographic or socioeconomic characteristics across the urban-rural continuum. More definitive conclusions and recommendations will be available when the working group meets to review the results. Conclusion/ImplicationsIdentifying a robust methodology for measuring performance across geographic locations will improve our ability to discern the impact of geography on health care including where geography may impact access and effectiveness of services as well as health outcomes. This information will enable better health system planning and decision-making.

scholarly journals Factors Associated with Mental Health Outcomes in Oman during COVID19: Frontline vs Non-frontline Healthcare Workers

2020 ◽  
Author(s):  
Muna Alshekaili ◽  
Walid Hassan ◽  
Nazik Al Said ◽  
Fatima Alsulaimani ◽  
Sathish Kumar Jayapal ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Health Outcomes ◽  
Online Survey ◽  
Psychosocial Interventions ◽  
Severity Index ◽  
Cross Sectional Study ◽  
Mental Health Outcomes ◽  
Chi Square ◽  
Cross Sectional

OBJECTIVE: This study aims to assess and compare demographic and psychological factors and sleep status of frontline HCWs in relation to non-frontline HCWs DESIGN, SETTINGS, AND PARTICIPANTS This cross-sectional study was conducted using an online survey from the 8th to the 17th of April 2020 across varied health care settings in Oman accruing 1139 HCWS. MAIN OUTCOMES AND MEASURES Mental health status was assessed using Depression, Anxiety, and Stress Scales (DASS-21), and insomnia was evaluated by the Insomnia Severity Index (ISI). Samples were categorized into the frontline and non-frontline groups. Chi-square, odds ratio, and independent t-tests were used to compare groups by demographic and mental health outcomes. Results This study included 1139 HCWs working in Oman. There was a total of 368 (32.3%), 388 (34.1%), 271 (23.8%), and 211 (18.5%) respondents reported to have depression, anxiety, stress, and insomnia, respectively while working during the pandemic period. HCWs in the frontline group were 1.4 times more likely to have anxiety (OR=1.401, p=0.007) and stress (OR=1.404, p=0.015) as compared to those working in the non-frontline group. On indices of sleep-wake cycles, HCWs in the frontline group were 1.37 times more likely to report insomnia (OR=1.377, p=0.037) when compared to those working in the non-frontline group. No significant differences in depression status between workers in the frontline and non-frontline groups were found (p=0.181). CONCLUSIONS AND RELEVANCE To our knowledge, this is the first study to explore the differential impacts of the COVID-19 pandemic on different grades of HCWs. This study suggests that frontline HCWs are disproportionally affected compared to non-frontline HCWs. The problem with managing sleep-wake cycles and anxiety symptoms were highly endorsed among frontline HCWs. As psychosocial interventions are likely to be constrained owing to the pandemic, mental health care must first be directed to frontline HCWs.

The Healthy Liverpool Children’s Programme

2016 ◽  
Vol 24 (3) ◽  
pp. 124-138 ◽  
Author(s):  
Axel Kaehne
Keyword(s):  
Health Care ◽  
Working Group ◽  
Online Survey ◽  
Collaborative Work ◽  
Preliminary Evaluation ◽  
Group Model ◽  
Health Care Planning ◽  
Content Type ◽  
Positive Effects ◽  
Over Time

Purpose – The purpose of this paper is to report the preliminary evaluation findings of an integration programme in the children’s health care sector in the North West of England. The programme was led by the local Clinical Commissioning Group (CCG) utilising a semi-autonomous working group model. It comprised horizontal and vertical integration. The evaluation reflects the emerging policy context of CCG leadership in the field of health care planning and commissioning. Design/methodology/approach – The evaluation used a mixed method observational study design to obtain the views and opinions of stakeholders and measured their change over time. A series of initial semi-structured interviews was conducted with purposively selected key professionals in strategic positions to assist in designing a survey instrument. An online survey was launched at programme inception and repeated at five months. Respondents were members of five implementation working groups. Survey responses were subjected to a descriptive analysis and tests of correlation. Findings – The data showed high levels of commitment and perceptions of shared vision and goals amongst respondents which were relatively stable over time. Responses also indicated that the programme was perceived to have a considerable impact on collaborative work but that this initial effect decreased over time. There were no significant attitudinal differences across sectors or professional groups. Originality/value – The study demonstrates the strengths and weaknesses of the multi-agency working group model to implement change. Whilst confirming initial positive effects of integration programmes on collaborative work, over time this appears to wear off to be replaced by increased levels of skepticism amongst participants. The author findings have implications for service commissioners and service planners engaging in vertical or horizontal integration of children’s services.

scholarly journals Development of an international standard set of outcome measures for patients with atrial fibrillation: a report of the International Consortium for Health Outcomes Measurement (ICHOM) atrial fibrillation working group

2020 ◽  
Vol 41 (10) ◽  
pp. 1132-1140 ◽  
Author(s):  
William H Seligman ◽  
Zofia Das-Gupta ◽  
Adedayo O Jobi-Odeneye ◽  
Elena Arbelo ◽  
Amitava Banerjee ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Health Outcomes ◽  
Health Professionals ◽  
Working Group ◽  
Case Mix ◽  
Outcomes Measurement ◽  
International Consortium ◽  
Patient Reported ◽  
Icd Codes ◽  
Standard Set

Abstract Aims As health systems around the world increasingly look to measure and improve the value of care that they provide to patients, being able to measure the outcomes that matter most to patients is vital. To support the shift towards value-based health care in atrial fibrillation (AF), the International Consortium for Health Outcomes Measurement (ICHOM) assembled an international Working Group (WG) of 30 volunteers, including health professionals and patient representatives to develop a standardized minimum set of outcomes for benchmarking care delivery in clinical settings. Methods and results Using an online-modified Delphi process, outcomes important to patients and health professionals were selected and categorized into (i) long-term consequences of disease outcomes, (ii) complications of treatment outcomes, and (iii) patient-reported outcomes. The WG identified demographic and clinical variables for use as case-mix risk adjusters. These included baseline demographics, comorbidities, cognitive function, date of diagnosis, disease duration, medications prescribed and AF procedures, as well as smoking, body mass index (BMI), alcohol intake, and physical activity. Where appropriate, and for ease of implementation, standardization of outcomes and case-mix variables was achieved using ICD codes. The standard set underwent an open review process in which over 80% of patients surveyed agreed with the outcomes captured by the standard set. Conclusion Implementation of these consensus recommendations could help institutions to monitor, compare and improve the quality and delivery of chronic AF care. Their consistent definition and collection, using ICD codes where applicable, could also broaden the implementation of more patient-centric clinical outcomes research in AF.

Private Health Care Expenditure and Child Health Outcomes in the World’s Poorest Countries

2018 ◽  
Vol 17 (5-6) ◽  
pp. 557-574
Author(s):  
Jehad Yasin ◽  
Azmat Gani
Keyword(s):  
Health Care ◽  
Child Health ◽  
Health Outcomes ◽  
Mortality Rates ◽  
Policy Implications ◽  
Health Care Spending ◽  
Annual Data ◽  
Private Health Care ◽  
Under Five ◽  
Child Health Outcomes

AbstractEmpirical studies investigating the direct effects of private health expenditure on child health outcomes for the world’s poorest countries are rare. This study attempts to fill this gap. The methodology includes empirical estimations of cross-country annual data for the period 1995-2010 for several low-income countries. The results obtained through fixed-effects estimation provide strong evidence that private health care spending has the expected negative and statistically significant effect on neonatal, infant and under-five mortality rates. The findings also reveal that other than private health care spending, income, nutrition, urbanization, family size, immunization against measles, and access to an improved water supply and sanitation as other strong determinants of neonatal, infant and under-five mortality rates. Some policy implications are drawn.

Development of an international standard set of clinical and patient-reported outcomes for children and adults with congenital heart disease: A report from the International Consortium for Health Outcomes Measurement Congenital Heart Disease Working Group

2021 ◽  
Author(s):  
Kevin Hummel ◽  
Sarah Whittaker ◽  
Nick Sillett ◽  
Amy Basken ◽  
Malin Berghammer ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Health Outcomes ◽  
Working Group ◽  
Congenital Heart ◽  
Case Mix ◽  
Outcomes Measurement ◽  
Outcome Set ◽  
Case Mix Adjustment ◽  
Standard Set

Abstract Aims Congenital heart disease (CHD) is the most common congenital malformation. Despite the worldwide burden to patient wellbeing and health system resource utilization, tracking of long-term outcomes is lacking, limiting the delivery and measurement of high-value care. To begin transitioning to value-based healthcare in CHD, the International Consortium for Health Outcomes Measurement aligned an international collaborative of CHD experts, patient representatives, and other stakeholders to construct a standard set of outcomes and risk-adjustment variables that are meaningful to patients. Methods and results The primary aim was to identify a minimum standard set of outcomes to be used by health systems worldwide. The methodological process included four key steps: 1) develop a working group representative of all CHD stakeholders; 2) conduct extensive literature reviews to identify scope, outcomes of interest, tools used to measure outcomes, and case-mix adjustment variables; 3) create the outcome set using a series of multi-round Delphi processes; and 4) disseminate set worldwide. The WG established a 15-item outcome set, incorporating physical, mental, social, and overall health outcomes accompanied by tools for measurement and case-mix adjustment variables. Patients with any CHD diagnoses of all ages are included. Following an open review process, over 80% of patients and providers surveyed agreed with the set in its final form. Conclusion This is the first international development of a stakeholder-informed standard set of outcomes for CHD. It can serve as a first step for a lifespan outcomes measurement approach to guide benchmarking and improvement among health systems.

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