scholarly journals Impact of macro-socioeconomic determinants on sustainable perinatal health care in Portugal: a qualitative study on the opinion of healthcare professionals and experts

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Julia Nadine Doetsch ◽  
Sandra C. S. Marques ◽  
Thomas Krafft ◽  
Henrique Barros
Keyword(s):  
Health Care ◽  
Health Care Quality ◽  
Healthcare Professionals ◽  
Healthcare Quality ◽  
Care Quality ◽  
Perinatal Health ◽  
Vlbw Infants ◽  
Socioeconomic Determinants ◽  
Perinatal Health Care ◽  
The Impact

Abstract Background The WHO identified the importance of macro-socioeconomic determinants and political context as interlinked key factors affecting healthcare quality and health equity. As a response to the recent economic and financial crisis, Portugal approved in 2011 the Economic Adjustment Programme (EAP) to obtain financial assistance from the Troika in order to reduce public debt. This study aims to analyse the impact of the economic crisis and the EAP on perinatal healthcare quality for very preterm (VPT) and/or very low birth weight (VLBW) infants, as perceived by healthcare professionals and experts, within the health administrative regions of the two major metropolitan areas in Portugal. Methods A qualitative approach was applied to receive an in-depth understanding and accomplish perspective variability. A purposive sampling technique was used. Semi-structured interviews were conducted with twenty-one healthcare professionals and experts between October 2018–July 2019. Inductive thematic analysis was performed which encompassed a five-step categorization procedure. Data analysis was undertaken by utilizing Nvivo2011 software. Evolved themes were then associated with WHO’s Quality Standards on Maternal and New-born Care. A framework on the impact of macro-socioeconomic determinants on perinatal health care quality was developed. Results Although participants did not perceive the quality of perinatal care had deteriorated, the analysis of their accounts on work experience revealed that it was indeed adversely modified in all WHO Quality Standards. Health care provision was perceived as detrimental in five main areas: 1) Availability of human resources; 2) Functional referral systems; 3) Competent and motivated human resources; 4) Emotional support; and 5) Essential physical resources available. Policy reforms by the EAP resulted in reduced timeliness of care, increased waiting times, cuts in sequence and duration of consultations, and deficiencies in follow-up care for VPT/VLBW infants and their mothers. The EAP directly influenced working environment of healthcare professionals by causing stress, burnout, work absence, and brain drain. Conclusion An interrelation between macro-socioeconomic determinants and perinatal health care quality was disclosed. The economic crisis and EAP have adversely modified equitable perinatal health care quality for VPT/VLBW infants and their mothers. Our findings underlined the negative impact of austerity policies on vulnerable populations.

scholarly journals Komunitas Masyarakat Dan Perawatan Kesehatan Dalam Peningkatan Kualitas Hidup

2020 ◽  
Vol 10 (1) ◽  
pp. 11-24
Author(s):  
Agustinus Hermino
Keyword(s):  
Quality Of Life ◽  
Health Care ◽  
Health Care Quality ◽  
Health Sector ◽  
Well Being ◽  
Individual Variability ◽  
Care Quality ◽  
Global Era ◽  
The Impact

Latar belakang: Seiring dengan perkembangan jaman, dalam beberapa tahun terakhir ini banyak perhatian yang difokuskan pada eksplorasi dampak penyakit fisik dan mental pada kualitas hidup seseorang baik secara individu maupun masyarakat secara keseluruhan. Sifat subyektif dari 'kualitas hidup' individu, merupakan konsep yang dinamis untuk diukur dan didefinisikan, tetapi bahwa secara umum dapat dipandang sebagai konsep multidimensi yang menekankan pada persepsi diri dari keadaan pikiran seseorang saat iniTujuan: penulisan ini bertujuan untuk memberikan pemahaman tentang peran masyarakat dalam memahani pentingnya kesehatan di era global ditinjau dari perspektif akademis. Pada sektor kesehatan pemahaman kesehatan menjadi sangat pentingnya karena akan menunjukkan pada kualitas hidup seseorang, tetapi hal ini tidak cukup secara individu karena diperlukan pemahaman secara menyeluruh terhadap masyarakat tentang makna kesehatan dan perawatan kesehatan.Metode: penulisan ilmiah ini adalah dengan melakukan analisa akademis dari dari berbagai sumber rujukan relevan sehingga menemukan makna teoritis baru dalam rangka menjawab tantangan yang terjadi di masyarakat.Hasil: Berdasarkan berbagai sumber rujukan yang ada, dapat disimpulkan bahwa kesehatan merupakan gaya hidup yang bertujuan untuk mencapai kesejahteraan fisik, emosional, intelektual, spiritual, dan lingkungan. Penggunaan langkah-langkah kesehatan dapat meningkatkan stamina, energi, dan harga diri, kemudian meningkatkan kualitas hidup. Dengan demikian maka konsep kesehatan memungkinkan adanya variabilitas individu. Kesehatan dapat dianggap sebagai keseimbangan aspek fisik, emosional, psikologis, sosial dan spiritual dari kehidupan seseorang. Kata kunci: masyarakat, perawatan kesehatan, kualitas hidup Society Community and Health Care in Improving Quality of LifeAbstract Background: Along with the development of the era, in recent years there has been a lot of attention focused on exploring the impact of physical and mental illness on the quality of life of a person both individually and as a whole. The subjective nature of an individual's 'quality of life' is a dynamic concept to measure and define, but that in general can be seen as a multidimensional concept that emphasizes self-perception of one's current state of mindAim: purpose of this study is to provide an understanding the role of community in understanding the importance of health in the global era from an academic perspective. In the health sector understanding of health is very important because it will show the quality of life of a person, but this is not enough individually because a comprehensive understanding of the meaning of health and health care is needed. Method: The method of scientific writing is to carry out academic analysis from various relevant reference sources, and find new theoretical meanings in order to answer the challenges that occur in society. Keyword: Community, Society,Health Care, Quality oflife Resullt : Based on various academic reference, it can be concluded that health is a lifestyle that aims to achieve physical, emotional, intellectual, spiritual, and environmental well-being. The use of health measures can increase stamina, energy, and self-esteem, then improve the quality of life. Thus the concept of health allows for individual variability. Health can be considered as a balance of physical, emotional, psychological, social and spiritual aspects of one's life. Keywords: community, health care, quality of life 

Medical Errors

2017 ◽  
pp. 33-60
Author(s):  
Jayita Poduval
Keyword(s):  
Health Care ◽  
Medical Errors ◽  
Health Care Professionals ◽  
Health Care Quality ◽  
Service Providers ◽  
Care Quality ◽  
System Failures ◽  
Root Cause ◽  
The Impact ◽  
Improving Health Care

The impact of medical errors on the delivery of health care is massive, and it significantly reduces health care quality. They could be largely attributed to system failures and not human weakness. Therefore improving health care quality and ensuring quality control in health care would mean making systems function in a better manner. In order to achieve this all sections of society as well as industry must be involved. Reporting of medical error needs to be encouraged and this may be ensured if health care professionals as well as administrators and health consumers come forward without fear of being blamed. To get to the root of the problem- literally and metaphorically- a root cause analysis and audit must be carried out whenever feasible. Persons outside the medical care establishment also need to work with medical service providers to set standards of performance, competence and excellence.

scholarly journals The Impact of Discharge Decisions on Health Care Quality

1998 ◽  
Vol 44 (3) ◽  
pp. 400-415 ◽  
Author(s):  
Emre Berk ◽  
Kamran Moinzadeh
Keyword(s):  
Health Care ◽  
Health Care Quality ◽  
Care Quality ◽  
The Impact

Nurse/patient ratio increase and the impact on health care quality and cost in a center of a public hospital intensive care and teaching

2017 ◽  
Vol 42 ◽  
pp. 401
Author(s):  
Andreza Werli-Alvarenga ◽  
Fernando Antônio Botoni ◽  
Daniela Mascarenhas de Paula ◽  
Edna Marileia Meireles Leite
Keyword(s):  
Health Care ◽  
Intensive Care ◽  
Health Care Quality ◽  
Public Hospital ◽  
Care Quality ◽  
Ratio Increase ◽  
The Impact

Healthcare quality through the eyes of bloggers: content analysis of non-solicited narratives about patient experiences with healthcare (Preprint)

2021 ◽  
Author(s):  
Mátyás Osváth ◽  
Orsolya Varga ◽  
Karolina Kósa
Keyword(s):  
Health Care ◽  
Content Analysis ◽  
Health Care Quality ◽  
Qualitative Content Analysis ◽  
Tertiary Care ◽  
Healthcare Quality ◽  
Patient Experiences ◽  
Care Quality ◽  
Patient Reports ◽  
Patient Narratives

BACKGROUND Patient experiences constitute an independent dimension of health care quality that can be solicited by structured surveys or at dedicated online platforms. Unsolicited spontaneous patient narratives are much less used but potentially valuable means for gauging patient experiences. OBJECTIVE Our aim was to explore patient experiences in spontaneous patient blogs submitted during one decade to an online health forum. METHODS 1662 non-solicited individual blogs on patient experiences posted between 2009 and 2018 on a Hungarian internet forum were randomly sampled. 20% (n=346) of the blogs were used for qualitative content analysis. A coding framework was constructed based on previous research and taxonomies to analyse content, including specific experiences or episodes. Major categories and subcategories were constructed within the three major dimensions (structure, process, outcome) of Donabedian’s framework for health care quality. RESULTS Majority of blogs described a specific experience (94.2%) in healthcare; almost 40% occurred in tertiary care; 29.5% of the blogs even identified a specific hospital or department. 55.2% of the bloggers were patients themselves, and the majority (92.7%) were dissatisfied with the reported experience. Issues were most frequently related to physicians (65.2%). In terms of Donabedian’s dimensions, problems with human resources dominated “Structure” (74.1%) such as not enough or incompetent staff. Waiting time and access to care (69.19%) comprised the most frequent complaints of material resources within “Structure”. Within “Process”, episodes related to examination (42.86%) accounted for most of the complaints. Outcomes were identified in 60% of the blogs, and deterioration, complication, readmission, or death was reported in 62% of these episodes. CONCLUSIONS Donabedian’s model of healthcare quality was appropriate for the categorization of patient experiences. Regular monitoring of spontaneous patient reports is recommended to utilize them for healthcare quality improvement especially if reports provide specific details.

Capitation, Advances in Medical Technology, and the Advent of a New Era in Medical Ethics

1996 ◽  
Vol 22 (2-3) ◽  
pp. 331-360 ◽  
Author(s):  
Michael J. Malinowski
Keyword(s):  
Health Care ◽  
Health Care Quality ◽  
The United States ◽  
Care Quality ◽  
Care Needs ◽  
New Era ◽  
For Profit ◽  
Zero Sum ◽  
The Impact ◽  
Care Costs

Health care is being capitated throughout the United States, and much of the spread of capitation is attributable to the efforts of insurers to contain costs. The present lack of comprehensive studies evaluating the impact of capitation on overall health care quality leaves vast room for speculation.Capitation does, however, carry a very fundamental certainty with broad implications. Whether the arrangement calls for a fixed sum for treating a particular ailment, a set fee for meeting all of an individual patient’s health care needs, or a standard charge for supplying all the medication for a specific condition, capitation sets limits. Because the health care costs for any given patient or condition are in reality zero-sum rather than fixed, capitation is about pooling patients and rationing. It involves denying services to some patients despite a general contractual commitment to coverage, presumably so that more patients can be covered or receive better care. The implications of capitation are even more significant when set fully in the context of the overall health care reform now underway. Simultaneously and comprehensively, health care is being managed, made for-profit, and consolidated.

The Impact Of Pay-For-Performance On Health Care Quality In Massachusetts, 2001–2003

2008 ◽  
Vol 27 (4) ◽  
pp. 1167-1176 ◽  
Author(s):  
Steven D. Pearson ◽  
Eric C. Schneider ◽  
Ken P. Kleinman ◽  
Kathryn L. Coltin ◽  
Janice A. Singer
Keyword(s):  
Health Care ◽  
Health Care Quality ◽  
Pay For Performance ◽  
Care Quality ◽  
The Impact

Attitudes and perceptions of registered nurses during and shortly after acute care restructuring in Newfoundland and Labrador

2005 ◽  
Vol 10 (2_suppl) ◽  
pp. 22-30 ◽  
Author(s):  
Christine Way ◽  
Deborah Gregory ◽  
Norma Baker ◽  
Sandra Lefort ◽  
Brendan Barrett ◽  
...  
Keyword(s):  
Health Care ◽  
Registered Nurses ◽  
Acute Care ◽  
Newfoundland And Labrador ◽  
Health Care Quality ◽  
Personal Characteristics ◽  
Care Quality ◽  
Adverse Impact ◽  
Workplace Conditions ◽  
The Impact

Objectives To monitor changes in registered nurses' perceptions of the impact of seven years of health care restructuring in Newfoundland and Labrador (NL) and to measure the attitudinal and behavioural reactions over four years comparing the St John's region, where hospital aggregation occurred, to other regions of the province. Methods Data were collected on acute care nurses' personal characteristics and perceptions of the importance of reform and its impact on workplace conditions and health care quality in 1995, 1999, 2000 and 2002. Nurses' attitudes and intentions were monitored across three time periods (i.e.1999, 2000 and 2002). Results Perceived workplace conditions and health care quality, as well as attitudes and behaviours were generally negative. However, there was some improvement over time. The temporal sequence of scores suggests that restructuring had an adverse impact on nurses' attitudes. Few significant regional differences were observed. Conclusions Although health services restructuring had an adverse impact on nurses'attitudes, aggregation of hospitals in St John's region was achieved without further deterioration. Provincial wide initiatives are needed to promote more positive work environments and increase the organizational effectiveness.

scholarly journals Factors associated with mothers’ health care-seeking behaviours for childhood fever in Burkina Faso: Findings from repeated cross-sectional household surveys

2021 ◽  
Author(s):  
Hermann Badolo ◽  
Aristide Romaric Bado ◽  
Hervé Hien ◽  
Nicolas Méda ◽  
Appunni Sathiya Susuman
Keyword(s):  
Health Care ◽  
Burkina Faso ◽  
Health Care Quality ◽  
Household Wealth ◽  
Care Quality ◽  
Health Care Seeking ◽  
Care Seeking ◽  
Factors Associated ◽  
The Impact ◽  
Childhood Fever

Abstract IntroductionFever is one of the most frequent reasons for paediatric consultations in Burkina Faso, but health care-seeking behaviours and the factors associated with health care-seeking in the event of childhood fever are poorly documented. This study aims to help fill this gap.MethodsThis study used the data from the baseline and endline surveys conducted to evaluate the impact of the Performance-Based Financing (PBF) program in Burkina Faso. Univariate and multivariate binary logistic regression analyses were used to identify the factors associated with appropriate healthcare-seeking for childhood fever. Odds ratios (ORs) were estimated to assess the strength of associations and used 95% confidence intervals for significance tests. Data were cleaned, coded and analysed using Stata software version 16.1.ResultsAmong the children under five who had a fever, 75.19% and 79.76 sought appropriate health care in 2013 and 2017, respectively. Being 24–59 months old (AOR: 0.344, 95% CI: 0.182–0.649 in 2013) and 79,2% (AOR: 0. 208, 95% CI: 0.115–0.376 in 2017), living in a very wealthy household households (AOR: 2.014, 95% CI: 1.149–3.531 in 2013 and AOR: 2.165, 95% CI: 1.223–3.834 in 2017), having a mother with a secondary or higher level of education or having made at least four antenatal care visits were significantly associated with seeking appropriate health care for childhood fever. Living in an area where the health facility is safe was also significantly associated with seeking appropriate care for childhood fevers.ConclusionThe findings underscore the need for interventions that would improve appropriate health care-seeking among mothers for their children. These interventions could include mothers’ sensitization to the benefits of modern health care use, increasing women’s education, improving household wealth status, improving the level of prenatal and postnatal care use and improving health care quality and safety in health facilities.

scholarly journals A qualitative study of old patients’ experiences of the quality of the health services in hospital and 30 days after hospitalization

2019 ◽  
Author(s):  
Ingvild Lilleheie ◽  
Jonas Debesay ◽  
Asta Bye ◽  
Astrid Bergland
Keyword(s):  
Health Care ◽  
Health Services ◽  
Older People ◽  
Everyday Life ◽  
Health Care Quality ◽  
Care Quality ◽  
World Health ◽  
Old Patients ◽  
The Impact

Abstract Background The number of people aged 80 years and above is projected to triple over the next 30 years. People in this age group normally have at least two chronic conditions (multimorbidity). The impact of multimorbidity is often significantly greater than expected from the sum of the effects of each condition. The World Health Organization has indicated that health care systems must prepare for a change in the focus of clinical care for older people. The WHO defines health care quality as care that is effective, efficient, integrated, patient centered, equitable and safe. The degree to which health care quality can be defined as acceptable is determined by services’ ability to meet the needs of users and adapt to patients’ expectations and perceptions. This study explores experiences of the quality of the health services in hospital and the first 30 days at home after discharge by patients over 80 years of age. Method We took a phenomenological perspective to explore older patients’ subjective experiences and conducted semistructured individual interviews. Eighteen patients (aged from 82 to 100 years) were interviewed twice after discharge from hospital. The interview transcriptions were analyzed thematically. Results The patients found their meetings with the health service to be complex and demanding. They reported attempting to restore a sense of security and meaning in everyday life, balancing their own needs against external requirements. Five overarching themes emerged from the interviews: hospital stay and the person behind the diagnosis, poor communication and coordination, life after discharge, relationship with their next of kin, and organizational and systemic determinants. Conclusion According to the WHO, to deliver quality health care, services must include all six of the dimensions listed above. Our findings show that they do not. Health care focused on measurable values and biomedical inquiries. Few opportunities for participation, scant information and suboptimal care coordination left the patients with a feeling of being in limbo, where they struggled to find balance in their everyday life. Further work must be done to ensure that integrated services are provided without a financial burden, centered on the needs and rights of older people.

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