Leveraging value-based care principles in developing eHealth systems: A teaching case

2022 ◽  
pp. 204388692110632
Author(s):  
Noor Fadzlina Mohd Fadhil ◽  
SayYen Teoh ◽  
Nilmini Wickramasinghe
Keyword(s):  
Developing Countries ◽  
Quality Of Care ◽  
Healthcare Providers ◽  
Well Being ◽  
Public Hospitals ◽  
Sufficient Evidence ◽  
Electronic Health ◽  
Value Based Care

Recently, many countries, including developing countries, have struggled to manage rising healthcare costs and challenges around decreasing quality of care. Previous studies suggest that electronic health systems could significantly improve the quality of care and facilitate better access to care. However, there is still a lack of studies providing sufficient evidence around how this can be achieved. This case study examines how a hospital uses its electronic health (eHealth) systems to offer better access, quality, and value by leveraging the principles of value-based care for its patients. This case study provides critical insights for healthcare stakeholders, public hospitals, especially in developing countries, healthcare providers and policymakers and proffers an approach to leverage the principles of value-based care when developing eHealth systems to offer better overall health and well-being services to their patients.

Abstract 242: Can Belief Enhance Relief? A Multicenter Study

2018 ◽  
Vol 11 (suppl_1) ◽  
Author(s):  
Abbas Alshami ◽  
America Avila ◽  
Carlos Romero ◽  
Raphael Villarreal ◽  
Sharon Einav ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Patient Care ◽  
Ethical Issues ◽  
Belief Systems ◽  
Statistical Significance ◽  
Healthcare Providers ◽  
Well Being ◽  
Physical Symptoms ◽  
Personal Beliefs

Purpose: While caring for patients, it is important to recognize more than just the apparent physical symptoms. Their emotional well-being, level of comfort, and spiritual concerns are relevant and should be taken into consideration. We aimed to identify if a greater commitment to spiritual belief systems by healthcare providers could have an effect on the patient care they provided. Methods: The Ethics in Intensive Care Study (ETHICS) was conducted in multiple centers all over the world utilizing a confidential survey. Questions were related to personal opinions on ethical issues, including personal beliefs, and patient care. We hypothesized that the personal beliefs of the healthcare providers should not affect the quality of care provided. Pearson’s correlation was used to ascertain statistical significance. Results: A total of 9,720 healthcare providers rated their level of spirituality from 1 (least) to 10 (greatest), and answered whether their beliefs affected their patient care. The majority of the people surveyed (65.6%; n=6,378) assessed themselves between 5 and 8 out of 10. In each individual level, most physicians felt patient care was not affected. However, on closer inspection and analysis, an interesting trend emerged. Only 11.4% (n=45) of those who rated themselves in level 1 of spirituality (n=394) stated their patient care was affected by their personal beliefs. Of people in level 5 (n=1,300), 13.3% (n=173) felt their beliefs affect the quality of care provided, and surprisingly, that number increased to 21.4% (n=193) among those healthcare provider rated in level 10 (n=899) [ p <0.001, Pearson’s R correlation 0.94]. Conclusions: A significant number of physicians identify themselves as religious, whether by belief in God, or based on a level of spirituality. We found a strong correlation between the level of spirituality a provider feels and the perception of how much his/her patient care is affected. We are not aware if this translates into real differences in patient care.

scholarly journals Effective coverage and budget implications of skill-mix change to improve neonatal nursing care: an explorative simulation study in Kenya

2019 ◽  
Vol 4 (6) ◽  
pp. e001817 ◽  
Author(s):  
Apostolos Tsiachristas ◽  
David Gathara ◽  
Jalemba Aluvaala ◽  
Timothy Chege ◽  
Edwine Barasa ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Neonatal Mortality ◽  
Nursing Care ◽  
Public Hospitals ◽  
Sensitivity Analyses ◽  
Full Time ◽  
Skill Mix ◽  
Neonatal Nursing ◽  
Low Middle Income Countries

IntroductionNeonatal mortality is an urgent policy priority to improve global population health and reduce health inequality. As health systems in Kenya and elsewhere seek to tackle increased neonatal mortality by improving the quality of care, one option is to train and employ neonatal healthcare assistants (NHCAs) to support professional nurses by taking up low-skill tasks.MethodsMonte-Carlo simulation was performed to estimate the potential impact of introducing NHCAs in neonatal nursing care in four public hospitals in Nairobi on effectively treated newborns and staff costs over a period of 10 years. The simulation was informed by data from 3 workshops with >10 stakeholders each, hospital records and scientific literature. Two univariate sensitivity analyses were performed to further address uncertainty.ResultsStakeholders perceived that 49% of a nurse full-time equivalent could be safely delegated to NHCAs in standard care, 31% in intermediate care and 20% in intensive care. A skill-mix with nurses and NHCAs would require ~2.6 billionKenyan Shillings (KES) (US$26 million) to provide quality care to 58% of all newborns in need (ie, current level of coverage in Nairobi) over a period of 10 years. This skill-mix configuration would require ~6 billion KES (US$61 million) to provide quality of care to almost all newborns in need over 10 years.ConclusionChanging skill-mix in hospital care by introducing NHCAs may be an affordable way to reduce neonatal mortality in low/middle-income countries. This option should be considered in ongoing policy discussions and supported by further evidence.

scholarly journals Sterilization regret in India: Is quality of care a matter of concern?

2020 ◽  
Vol 5 (1) ◽  
Author(s):  
Anjali Bansal ◽  
Laxmi Kant Dwivedi
Keyword(s):  
Quality Of Care ◽  
Family Planning ◽  
Health Facility ◽  
Fold Increase ◽  
Well Being ◽  
Poor Quality ◽  
Public Health Facility ◽  
The Family ◽  
Planning Methods

Abstract Background According to United Nations, 19% of females in the world relied only on the permanent method of family planning, with 37% in India according to NFHS-4. Limited studies tried to measure the sterilization regret, and its correlated factors. The study tried to explore the trend of sterilization regret in India from 1992 to 2015 and to elicit the determining effects of various factors on sterilization regret, especially in context to perceived quality of care in the sterilization operations and type of providers. Data and methods The pooled data from NFHS-1, NFHS-3 and NFHS-4 was used to explore the regret by creating interaction between time and all the predictors. Predicted probabilities were calculated to show the trend of sterilization regret amounting to quality of care, type of health provider at the three time periods. Results The sterilization regret was increased from 5 % in NFHS-1 to 7 % in NFHS-4. According to NFHS-4, for those whose sterilization was performed in private health facility the regret was found to be less (OR-0.937; 95% CI- (0.882–0.996)) compared to public health facility. Also, the results show a two-fold increase in regret when women reported bad quality of care. The results from predicted probabilities provide enough evidence that the regret due to bad quality of care in sterilization operation had increased with each subsequent round of NFHS. Conclusion Many socio-economic and demographic factors have influenced the regret, but the poor quality of care contributed maximum to the regret from 1992 to 2015. The health facilities have seriously strayed from improving the health and well-being of women in providing the family planning methods. In addition, to public facilities, the regret amounting to private facilities have also increased from NFHS-1 to 4. The quality of care provided in the family planning operation should be standardized in every hospital to strengthen the health systems in the country. The couple should be motivated to adopt more of spacing methods.

scholarly journals Understanding the Link between Family Caregiver Quality of Life and the Care Provided to Older People With Dementia

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 153-154
Author(s):  
Afeez Hazzan
Keyword(s):  
Quality Of Life ◽  
Quality Of Care ◽  
Older People ◽  
Family Caregivers ◽  
Family Caregiver ◽  
Well Being ◽  
The United States ◽  
People With Dementia ◽  
The Impact

Abstract Dementia is one of the most rapidly growing diseases in the United States. In 2018, the direct costs to American society of caring for older people with dementia was approximately $277 billion. Primary informal caregivers are mainly responsible for the care of older people with dementia including Alzheimer’s disease. Caregivers perform a myriad of duties ranging from shopping for their loved ones’ groceries, helping with medications, and managing finances. The caregiving role becomes more demanding as the disease progresses over time, and studies have shown that the quality-of-life (QoL) experienced by caregivers of older adults who have dementia is lower than the QoL of caregivers for older people who do not have dementia. To the best of our knowledge, there has been no research conducted to investigate whether lower caregiver QoL affects the level or quality of care that caregivers provide to persons with dementia. In the current study, we interviewed family caregivers living in Rochester, New York to inquire about their quality of life and the care provided to older people living with dementia. Further, caregivers completed the 36-item Short Form Health Survey (SF-36) as well as a draft questionnaire for measuring the quality of care provided to older people living with dementia. Both quantitative and qualitative findings from this study reveals important relationships between family caregiver QoL and the care provided, including the impact of social support and financial well-being. The study findings could have significant impact, particularly for the provision of much needed support for family caregivers.

scholarly journals Satisfaction With Health Care by Dual Sensory Impairment Status

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 798-798
Author(s):  
Lama Assi ◽  
Ahmed Shakarchi ◽  
Bonnielin Swenor ◽  
Nicholas Reed
Keyword(s):  
Quality Of Care ◽  
Healthcare Providers ◽  
Health Determinants ◽  
Sensory Impairment ◽  
Medicare Beneficiaries ◽  
The Past ◽  
Patient Provider Communication ◽  
Care Satisfaction ◽  
Dual Sensory Impairment

Abstract Sensory impairment is a barrier to patient-provider communication and access to care, which may impact satisfaction with care. Satisfaction with the quality of care received in the past year was assessed in the 2017 Medicare Current Beneficiary Survey (weighted sample=53,905,182 Medicare beneficiaries). Self-reported sensory impairment was categorized as no sensory impairment, hearing impairment (HI)-only, vision impairment (VI)-only, and dual sensory impairment (DSI) – concurrent HI and VI. In a model adjusted for sociodemographic characteristics and health determinants, having DSI was associated with higher odds of dissatisfaction with the quality of care received (Odds Ratio [OR]=1.53, 95%Confidence Interval [CI]=1.14-2.06) relative to no sensory impairment; however, having HI-only or VI-only were not (OR=1.33, 95%CI=1.94-1.89, and OR=1.32, 95%CI=0.95-1.93, respectively). These findings have implications for healthcare providers as Medicare shifts to value-based reimbursement. Moreover, previous work that singularly focused on HI or VI alone may have failed to recognize the compounded effect of DSI.

scholarly journals Coaches’ implementation strategies in providing social support to Singaporean university athletes: A case study

2019 ◽  
Vol 14 (5) ◽  
pp. 681-693
Author(s):  
Koon Teck Koh ◽  
Marja Kokkonen ◽  
Heng Rang Bryan Law
Keyword(s):  
Social Support ◽  
Implementation Strategies ◽  
Well Being ◽  
Implementation Framework ◽  
Support Strategies ◽  
Individual Sports ◽  
Sport Coaches ◽  
University Athletes

Coaches are effective providers of social support to their athletes. Although sport-specific measures of social support have been developed to better understand athletes’ perceptions of available support, limited amount of research has addressed how sport coaches implement specific social support strategies. The purpose of this study was to examine university coaches’ implementation strategies in providing various forms of social support to their athletes. A total of eight sport coaches from team and individual sports (four from each sport) were purposefully selected for this study. Coaches were individually interviewed. The interview transcripts were analysed using a thematic analysis. The results revealed that coaches from different sports shared similar strategies across emotional, esteem, informational and tangible dimensions, but with some distinguishable differences in the way these strategies were implemented. In documenting the lived experiences of sport coaches, key strategies valued highly among these coaches were highlighted, providing important implications for coaches to know how to incorporate these strategies into their coaching practice to better support athletes’ well-being and improve the quality of coaching. The findings also provide an implementation framework of social support that emphasizes key strategies for coaches to focus on in their coaching approaches.

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