scholarly journals Impacts of chronic disease prevention programs implemented by private health insurers: a systematic review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sithara Wanni Arachchige Dona ◽  
Mary Rose Angeles ◽  
Natasha Hall ◽  
Jennifer J. Watts ◽  
Anna Peeters ◽  
...  
Keyword(s):  
Chronic Disease ◽  
Disease Prevention ◽  
Chronic Diseases ◽  
Hospital Admissions ◽  
Grey Literature ◽  
Significant Proportion ◽  
Chronic Disease Prevention ◽  
Public Healthcare ◽  
Prevention Interventions ◽  
Health Insurers

Abstract Background Chronic diseases contribute to a significant proportion (71%) of all deaths each year worldwide. Governments and other stakeholders worldwide have taken various actions to tackle the key risk factors contributing to the prevalence and impact of chronic diseases. Private health insurers (PHI) are one key stakeholders, particularly in Australian health system, and their engagement in chronic disease prevention is growing. Therefore, we investigated the impacts of chronic disease prevention interventions implemented by PHI both in Australia and internationally. Method We searched multiple databases (Business Source Complete, CINAHL, Global Health, Health Business Elite, Medline, PsycINFO, and Scopus) and grey literature for studies/reports published in English until September 2020 using search terms on the impacts of chronic disease prevention interventions delivered by PHIs. Two reviewers assessed the risk of bias using a quality assessment tool developed by Effective Public Healthcare Panacea Project. After data extraction, the literature was synthesised thematically based on the types of the interventions reported across studies. The study protocol was registered in PROSPERO, CRD42020145644. Results Of 7789 records, 29 studies were eligible for inclusion. There were predominantly four types of interventions implemented by PHIs: Financial incentives, health coaching, wellness programs, and group medical appointments. Outcome measures across studies were varied, making it challenging to compare the difference between the effectiveness of different intervention types. Most studies reported that the impacts of interventions, such as increase in healthy eating, physical activity, and lower hospital admissions, last for a shorter term if the length of the intervention is shorter. Interpretation Although it is challenging to conclude which intervention type was the most effective, it appeared that, regardless of the intervention types, PHI interventions of longer duration (at least 2 years) were more beneficial and outcomes were more sustained than those PHI interventions that lasted for a shorter period. Funding Primary source of funding was Geelong Medical and Hospital Benefits Association (GMHBA), an Australian private health insurer.

scholarly journals A Conceptual Framework for Chronic Disease Prevention Based on Multilevel Approach

2018 ◽  
Vol 10 (5) ◽  
pp. 175
Author(s):  
Fadumo Abdi Noor ◽  
Gabriel Gulis ◽  
Jens Soendergaard
Keyword(s):  
Chronic Disease ◽  
Disease Prevention ◽  
Health System ◽  
Conceptual Framework ◽  
Chronic Diseases ◽  
Chronic Disease Prevention ◽  
Structural Level ◽  
Grey Zone ◽  
Multilevel Approach ◽  
Multiple Levels

AIM: The aim of this paper is to present a conceptual framework for the analysis of chronic disease prevention work according to the principles of a multilevel approach to T2DM in Denmark.METHOD: We conducted a review of published papers using PubMed, EMBASE, Web of Science, Google, Google Scholar, NICE Evidence Search, and we extended our search to include grey zone literature. We chose to focus our literature review on the collaboration between the different actors in the health system and the prevention and management of type 2 diabetes. We reviewed abstracts, and our search yielded a final total of 52 papers, of which we retained 18 and eliminated papers which were not related explicitly to the subject.RESULTS: Results showed that prevention and management of type T2DM must address multiple factors at multiple levels (intrapersonal, interpersonal and structural level) and within multiple settings (medical settings, communities/municipalities, regions and government). To analyze chronic disease prevention from a multilevel approach perspective, a conceptual framework was developed, which would guide the analytical process. Interventions should tackle specific risk factors within specific populations and by different actors who need to act in a coordinated manner.CONCLUSION: It is becoming increasingly clear that a multilevel approach is needed to prevent chronic diseases. Working at multiple levels with multiple actors in the health system will hopefully help fight the increasing numbers of chronic diseases.

An intersectoral network for chronic disease prevention: the case of the Alberta Healthy Living Network

2009 ◽  
Vol 29 (4) ◽  
pp. 153-161
Author(s):  
R Geneau ◽  
B Legowski ◽  
S Stachenko
Keyword(s):  
Chronic Disease ◽  
Disease Prevention ◽  
Chronic Diseases ◽  
Causes Of Death ◽  
Qualitative Case Study ◽  
Chronic Disease Prevention ◽  
Policy Advocacy ◽  
Healthy Living

Chronic Diseases (CDs) are the leading causes of death and disability worldwide. CD experts have long promoted the use of integrated and intersectoral approaches to strengthen CD prevention efforts. This qualitative case study examined the perceived benefits and challenges associated with implementing an intersectoral network dedicated to CD prevention. Through interviewing key members of the Alberta Healthy Living Network (AHLN, or the Network), two overarching themes emerged from the data. The first relates to contrasting views on the role of the AHLN in relation to its actions and outcomes, especially concerning policy advocacy. The second focuses on the benefits and contributions of the AHLN and the challenge of demonstrating non-quantifiable outcomes. While the respondents agreed that the AHLN has contributed to intersectoral work in CD prevention in Alberta and to collaboration among Network members, several did not view this achievement as an end in itself and appealed to the Network to engage more in change-oriented activities. Managing contrasting expectations has had a significant impact on the functioning of the Network.

scholarly journals Primary Care Physicians’ Experience Using Advanced Electronic Medical Record Features to Support Chronic Disease Prevention and Management: Qualitative Study

10.2196/13318 ◽  
2019 ◽  
Vol 7 (4) ◽  
pp. e13318 ◽  
Author(s):  
Rana Melissa Rahal ◽  
Jay Mercer ◽  
Craig Kuziemsky ◽  
Sanni Yaya
Keyword(s):  
Primary Care ◽  
Chronic Disease ◽  
Disease Prevention ◽  
Medical Record ◽  
Chronic Diseases ◽  
Electronic Medical Record ◽  
Primary Care Physicians ◽  
Evaluation Framework ◽  
Chronic Disease Prevention

Background Chronic diseases are the leading cause of death worldwide. In Canada, more than half of all health care spending is used for managing chronic diseases. Although studies have shown that the use of advanced features of electronic medical record (EMR) systems improves the quality of chronic disease prevention and management (CDPM), a 2012 international survey found that Canadian physicians were the least likely to use 2 or more EMR system functions. Some studies show that maturity vis-à-vis clinicians’ EMR use is an important factor when evaluating the use of advanced features of health information systems. The Clinical Adoption Framework (CAF), a common evaluation framework used to assess the success of EMR adoption, does not incorporate the process of maturing. Nevertheless, the CAF and studies that discuss the barriers to and facilitators of the adoption of EMR systems can be the basis for exploring the use of advanced EMR features. Objective This study aimed to explore the factors that primary care physicians in Ontario identified as influencing their use of advanced EMR features to support CDPM and to extend the CAF to include primary care physicians’ perceptions of how their use of EMRs for performing clinical tasks has matured. Methods Guided by the CAF, directed content analysis was used to explore the barriers and facilitating factors encountered by primary care physicians when using EMR features. Participants were primary care physicians in Ontario, Canada, who use EMRs. Data were coded using categories from the CAF. Results A total of 9 face-to-face interviews were conducted from January 2017 to July 2017. Dimensions from the CAF emerged from the data, and one new dimension was derived: physicians’ perception of their maturity of EMR use. Primary care physicians identified the following key factors that impacted their use of advanced EMR features: performance of EMR features, information quality of EMR features, training and technical support, user satisfaction, provider’s productivity, personal characteristics and roles, cost benefits of EMR features, EMR systems infrastructure, funding, and government leadership. Conclusions The CAF was extended to include physicians’ perceptions of how their use of EMR systems had matured. Most participants agreed that their use of EMR systems for performing clinical tasks had evolved since their adoption of the system and that certain system features facilitated their care for patients with chronic diseases. However, several barriers were identified and should be addressed to further enhance primary care physicians’ use of advanced EMR features to support CDPM.

scholarly journals Long-term strict raw food diet is associated with favourable plasma β-carotene and low plasma lycopene concentrations in Germans

2008 ◽  
Vol 99 (6) ◽  
pp. 1293-1300 ◽  
Author(s):  
Ada L. Garcia ◽  
Corinna Koebnick ◽  
Peter C. Dagnelie ◽  
Carola Strassner ◽  
Ibrahim Elmadfa ◽  
...  
Keyword(s):  
Chronic Disease ◽  
Disease Prevention ◽  
Vitamin A ◽  
Chronic Diseases ◽  
Chronic Disease Prevention ◽  
Food Sources ◽  
Dietary Vitamin ◽  
Vitamin A Status ◽  
Β Carotene

Dietary carotenoids are associated with a reduced risk of chronic diseases. Raw food diets are predominantly plant-based diets that are practised with the intention of preventing chronic diseases by virtue of their high content of beneficial nutritive substances such as carotenoids. However, the benefit of a long-term adherence to these diets is controversial since little is known about their adequacy. Therefore, we investigated vitamin A and carotenoid status and related food sources in raw food diet adherents in Germany. Dietary vitamin A, carotenoid intake, plasma retinol and plasma carotenoids were determined in 198 (ninety-two male and 106 female) strict raw food diet adherents in a cross-sectional study. Raw food diet adherents consumed on average 95 weight% of their total food intake as raw food (approximately 1800 g/d), mainly fruits. Raw food diet adherents had an intake of 1301 retinol activity equivalents/d and 16·7 mg/d carotenoids. Plasma vitamin A status was normal in 82 % of the subjects ( ≥ 1·05 μmol/l) and 63 % had β-carotene concentrations associated with chronic disease prevention ( ≥ 0·88 μmol/l). In 77 % of subjects the lycopene status was below the reference values for average healthy populations ( < 0·45 μmol/l). Fat contained in fruits, vegetables and nuts and oil consumption was a significant dietary determinant of plasma carotenoid concentrations (β-carotene r 0·284; P < 0·05; lycopene r 0·168; P = 0·024). Long-term raw food diet adherents showed normal vitamin A status and achieve favourable plasma β-carotene concentrations as recommended for chronic disease prevention, but showed low plasma lycopene levels. Plasma carotenoids in raw food adherents are predicted mainly by fat intake.

scholarly journals Comparing alternative design options for chronic disease prevention interventions

2014 ◽  
Vol 45 (1) ◽  
pp. 87-99 ◽  
Author(s):  
Mohammad Golfam ◽  
Reed Beall ◽  
Jamie Brehaut ◽  
Sara Saeed ◽  
Clare Relton ◽  
...  
Keyword(s):  
Chronic Disease ◽  
Disease Prevention ◽  
Chronic Disease Prevention ◽  
Alternative Design ◽  
Prevention Interventions ◽  
Design Options

scholarly journals Primary Care Physicians’ Experience Using Advanced Electronic Medical Record Features to Support Chronic Disease Prevention and Management: Qualitative Study (Preprint)

2019 ◽  
Author(s):  
Rana Melissa Rahal ◽  
Jay Mercer ◽  
Craig Kuziemsky ◽  
Sanni Yaya
Keyword(s):  
Primary Care ◽  
Chronic Disease ◽  
Disease Prevention ◽  
Medical Record ◽  
Chronic Diseases ◽  
Electronic Medical Record ◽  
Primary Care Physicians ◽  
Evaluation Framework ◽  
Chronic Disease Prevention

BACKGROUND Chronic diseases are the leading cause of death worldwide. In Canada, more than half of all health care spending is used for managing chronic diseases. Although studies have shown that the use of advanced features of electronic medical record (EMR) systems improves the quality of chronic disease prevention and management (CDPM), a 2012 international survey found that Canadian physicians were the least likely to use 2 or more EMR system functions. Some studies show that maturity vis-à-vis clinicians’ EMR use is an important factor when evaluating the use of advanced features of health information systems. The Clinical Adoption Framework (CAF), a common evaluation framework used to assess the success of EMR adoption, does not incorporate the process of maturing. Nevertheless, the CAF and studies that discuss the barriers to and facilitators of the adoption of EMR systems can be the basis for exploring the use of advanced EMR features. OBJECTIVE This study aimed to explore the factors that primary care physicians in Ontario identified as influencing their use of advanced EMR features to support CDPM and to extend the CAF to include primary care physicians’ perceptions of how their use of EMRs for performing clinical tasks has matured. METHODS Guided by the CAF, directed content analysis was used to explore the barriers and facilitating factors encountered by primary care physicians when using EMR features. Participants were primary care physicians in Ontario, Canada, who use EMRs. Data were coded using categories from the CAF. RESULTS A total of 9 face-to-face interviews were conducted from January 2017 to July 2017. Dimensions from the CAF emerged from the data, and one new dimension was derived: physicians’ perception of their maturity of EMR use. Primary care physicians identified the following key factors that impacted their use of advanced EMR features: performance of EMR features, information quality of EMR features, training and technical support, user satisfaction, provider’s productivity, personal characteristics and roles, cost benefits of EMR features, EMR systems infrastructure, funding, and government leadership. CONCLUSIONS The CAF was extended to include physicians’ perceptions of how their use of EMR systems had matured. Most participants agreed that their use of EMR systems for performing clinical tasks had evolved since their adoption of the system and that certain system features facilitated their care for patients with chronic diseases. However, several barriers were identified and should be addressed to further enhance primary care physicians’ use of advanced EMR features to support CDPM.

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