scholarly journals Does higher health literacy lead to higher trust in public hospitals?

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Maja Bertram ◽  
Urs Steiner Brandt ◽  
Rikke Klitten Hansen ◽  
Gert Tinggaard Svendsen
Keyword(s):  
Game Theory ◽  
Health Care ◽  
Health Literacy ◽  
Health Care System ◽  
Empirical Data ◽  
Health Care Professionals ◽  
Social Groups ◽  
Public Hospitals ◽  
Future Research ◽  
Care System

Abstract Background Does higher health literacy lead to higher trust in public hospitals? Existing literature suggests that this is the case since a positive association between the level of health literacy and the level of trust in physicians and the health care system has been shown. This study aims to challenge this assumption. Methods Based on theoretical arguments from game theory and analysis of empirical data, we argue that the association is better described as an inversely u-shaped curve, suggesting that low and high levels of health literacy lead to a lower level of trust than a medium level of health literacy does. The empirical analysis is based on a study of the Danes’ relationship to the overall health care system. More than 6000 Danes have been asked about their overall expectations of the health service, their concrete experiences and their attitudes to a number of change initiatives. Results Game theory analysis show that the combined perceived cooperation and benefit effects can explain an inversely u-shaped relationship between social groups and trust in the health care system. Based on quantitative, binary regression analyses of empirical data, the lowest degree of trust is found among patients from the lowest and highest social groups, while the highest degree of trust is found in the middle group. The main driver for this result is that while patients having low health literacy perceive that the health care system is not cooperative, patients with a high level of health literacy have high expectations about the quality, which the health care system might not be able to provide. This reduces the perceived benefit from their encounter with the health care system. Conclusion It is important that health care professionals understand that some patient groups have a higher chance of cooperation (e.g., agreeing on the choice of treatment) or defection (e.g. passing a complaint) than others. In perspective, future research should undertake further qualitative examinations of possible patient types and their demands in relation to different health care sectors, focusing specifically on the opportunities to improve the handling of different patient types.

scholarly journals Does higher health literacy lead to higher trust in public hospitals?

2021 ◽  
Author(s):  
Maja Bertram ◽  
Urs Steiner Brandt ◽  
Rikke Klitten Hansen ◽  
Gert Tinggaard Svendsen
Keyword(s):  
Game Theory ◽  
Health Care ◽  
Health Literacy ◽  
Health Care System ◽  
Empirical Data ◽  
Health Care Professionals ◽  
Social Groups ◽  
Public Hospitals ◽  
Future Research ◽  
Care System

Abstract Background: Does higher health literacy lead to higher trust in public hospitals? Existing literature suggests that this is the case since a positive association between the level of health literacy and the level of trust in physicians and the health care system has been shown. This study aims to challenge this assumption. Methods: Based on theoretical arguments from game theory and analysis of empirical data, we argue that the association is better described as an inversely u-shaped curve, suggesting that low and high levels of health literacy lead to a lower level of trust than a medium level of health literacy does. The empirical analysis is based on a study of the Danes’ relationship to the overall health care system. More than 6,000 Danes have been asked about their overall expectations of the health service, their concrete experiences and their attitudes to a number of change initiatives. Results: Game theory analysis show that the combined perceived cooperation and benefit effects can explain an inversely u-shaped relationship between social groups and trust in the health care system. Based on quantitative, binary regression analyses of empirical data, the lowest degree of trust is found among patients from the lowest and highest social groups, while the highest degree of trust is found in the middle group. The main driver for this result is that while patients having low health literacy perceive that the health care system is not cooperative, patients with a high level of health literacy have high expectations about the quality, which the health care system might not be able to provide. This reduces the perceived benefit from their encounter with the health care system. Conclusion: It is important that health care professionals understand that some patient groups have a higher chance of cooperation (e.g., agreeing on the choice of treatment) or defection (e.g. passing a complaint) than others. In perspective, future research should undertake further qualitative examinations of possible patient types and their demands in relation to different health care sectors, focusing specifically on the opportunities to improve the handling of different patient types.

Navigating the health care system: perceptions of patients with chronic pain

2009 ◽  
Vol 29 (4) ◽  
pp. 162-168
Author(s):  
AL Dewar ◽  
K Gregg ◽  
MI White ◽  
J Lander
Keyword(s):  
Health Care ◽  
Chronic Pain ◽  
Health Care System ◽  
Health Care Professionals ◽  
Primary Care Physicians ◽  
Treatment Compliance ◽  
Care Utilization ◽  
Semistructured Interviews ◽  
The Individual ◽  
Care System

A new framework is needed for patients with chronic pain and their primary care physicians that acknowledges the individual’s experiences and provides evidence-informed education and better linkages to community-based resources. This study describes the experience of 19 chronic-pain sufferers who seek relief via the health care system. Their experiences were recorded through in-depth semistructured interviews and analyzed through qualitative methods. The participants reported early optimism, then disillusionment, and finally acceptance of living with chronic pain. Both individuals with chronic pain and their health care professionals need evidence-informed resources and information on best practices to assist them to manage pain. Empathetic communication between health care professionals and individuals with chronic pain is crucial because insensitive communication negatively affects the individual, reduces treatment compliance and increases health care utilization.

The importance of health literacy for self-management: A scoping review of reviews

2021 ◽  
pp. 174239532110354
Author(s):  
Marieke van der Gaag ◽  
Monique Heijmans ◽  
Cristina Spoiala ◽  
Jany Rademakers
Keyword(s):  
Health Care ◽  
Health Literacy ◽  
Health Care System ◽  
Medical Management ◽  
Self Management ◽  
Limited Health Literacy ◽  
Limited Health ◽  
Behavioural Aspects ◽  
The Relationship ◽  
Care System

Objectives Self-management of chronic diseases is rather complex, especially for patients with limited health literacy. In this review, we aim to disentangle the specific difficulties patients with limited health literacy face in relation to self-management and their associated needs with respect to self-management support. Methods We performed a literature search in five databases. We used a broad definition of health literacy and self-management was categorized into four types of activities: medical management, changing lifestyle, communicating and navigating through the health care system and coping. Included reviews described the relationship between health literacy and different domains of self-management and were published after 2010. Results A total of 28 reviews were included. Some clear difficulties of patients with limited health literacy emerged, predominantly in the area of medical management (especially adherence), communication and knowledge. Other associations between health literacy and self-management were inconclusive. Barriers from the patients’ perspective described mainly medical management and the communication and navigation of the health care system. Discussion Patients with limited health literacy experience difficulties with specific domains of self-management. For a better understanding of the relationship between health literacy and self-management, a broader conceptualization of health literacy is warranted, including both cognitive and behavioural aspects.

Stratification and “Universality”

2017 ◽  
Author(s):  
Tiffany D. Joseph
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Low Income ◽  
Health Care Professionals ◽  
State Level ◽  
Universal Health Care System ◽  
Documentation Status ◽  
Health Organization ◽  
Universal Health ◽  
Care System

Tiffany D. Joseph’s chapter examines how stratification of access by immigration status effectively undermined a “universal” health policy. While the ACA only extended coverage to U.S. citizens and eligible documented immigrants, Massachusetts pursued a universal health care system at the state level and offered coverage to all residents, regardless of documentation status. Despite this policy that aimed for inclusion, immigrants in Massachusetts were still more likely than non-immigrants to remain uninsured. Joseph interviewed Brazilian and Dominican immigrants, health care professionals, and immigrant/health organization employees to find out why immigrants remained uninsured. She identified immigration-related, health care system, and bureaucratic barriers that prevented individuals from effectively accessing care. Massachusetts serves as both a model and a cautionary tale for ACA implementation, with barriers exacerbated for immigrant, low-income, and minority populations.

Public-private: unequal competition Israeli public hospitals vs the private health-care system following government reforms

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Lior Naamati Schneider
Keyword(s):  
Health Care ◽  
Health System ◽  
Health Care System ◽  
Data Gathering ◽  
State Regulation ◽  
Public Hospitals ◽  
Content Type ◽  
Creative Solutions ◽  
Government Reforms ◽  
Care System

Purpose This study aims to map perceptions and changes in public hospitals in response to competition with the private health system, describes solutions adopted by the public hospitals and considers their implications for the business and strategic management of those hospitals. Design/methodology/approach This paper opted for a qualitative study using the open-ended approach of grounded theory, including 40 in-depth interviews with key figures in the health system and administrators at various levels of management. Findings Public hospitals are constantly adopting changes because of state-mandated reforms and growing competition with private hospitals. Notable measures include making hospitals customer-oriented and adopting business-oriented behaviors and competitive and marketing strategies. However, because public hospitals are unable to institute radical changes, they typically introduce hybrid services (private services within public services) and other creative solutions such as business-funded research foundations operating alongside them. Research limitations/implications The main methodological limitation of this study was the difficulty in obtaining data because of the limited cooperation and lack of transparency of Israel’s health-care system. The interviewees expressed concerns that their department or hospital would appear in a negative light, especially as motivated solely by financial considerations. In anticipation of this difficulty, requests for participation were addressed individually and contained extensive detail regarding the study, the ethics committee’s approval, the data gathering and the strict maintenance of anonymity and confidentiality. Originality/value Adopting business-oriented behaviors in public hospitals is somewhat contrary to the principles of public medicine. Their adaptation to the market is partial, and their creative hybrid solutions require state regulation. The absence of controls leads to duplication and waste, causing various problems, including increased social inequality, costs and deficits.

scholarly journals Social and Health System Complexities Impacting on Decision-Making for Utilization of Oncology and Palliative Care in an African Context: A Qualitative Study

2019 ◽  
Vol 35 (3) ◽  
pp. 185-191 ◽  
Author(s):  
David A. Agom ◽  
Stuart Allen ◽  
Sarah Neill ◽  
Judith Sixsmith ◽  
Helen Poole ◽  
...  
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Palliative Care ◽  
Qualitative Study ◽  
Health Care System ◽  
Health Care Professionals ◽  
Care Delivery ◽  
Semistructured Interview ◽  
Design Data ◽  
Care System

Background: There is a dearth of research focusing on identifying the social complexities impacting on oncology and palliative care (PC), and no study has explored how the health-care system in Nigeria or other African contexts may be influencing utilization of these services. Aim: This study explored how social complexities and the organization of health-care influenced the decision-making process for the utilization of oncology and PC in a Nigerian hospital. Methods: This qualitative study used an interpretive descriptive design. Data were collected using semistructured interview guides with 40 participants, comprising health-care professionals, patients, and their families. Thematic analysis was conducted to generate and analyze patterns within the data. Findings: Three themes were identified: dysfunctional structural organization of the health-care delivery system, service-users’ economic status, and the influence of social networks. The interrelationship between the themes result in patients and their family members decisions either to present late to the hospital, miss their clinical appointments, or not to seek oncological health care and PC. Conclusion: This article offers insights into the role of the health-care system, as organized currently in Nigeria, as “autoinhibitory” and not adequately prepared to address the increasing burden of cancer. We therefore argue that there is a need to restructure the Nigerian health-care system to better meet the needs of patients with cancer and their families as failure to do so will strengthen the existing inequalities, discourage usage, and increase mortality.

Les motifs du suicide gériatrique: une étude exploratoire

2003 ◽  
Vol 22 (2) ◽  
pp. 197-205
Author(s):  
Luc Legris ◽  
Michel Préville
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Health Care Professionals ◽  
Basic Needs ◽  
The Elderly ◽  
Elderly Persons ◽  
Need To Belong ◽  
Psychological Autopsy ◽  
Structured Interviews ◽  
Care System

ABSTRACTFive semi-structured interviews were conducted, using the psychological autopsy method, in order to document the causes of geriatric suicide and to describe the interaction among suicidal elderly persons, their personal and social environments, and health care professionals. The results of this study support our hypothesis that elderly persons view suicide as a means of alleviating the psychological suffering associated with the frustration they experience on account of their inability to satisfy their basic needs. Three types of basic needs that affect the suicidal tendency of elderly persons were identified: the need to self-actualize, the need to belong, and the need to feel safe. The results also show that the people who make up the social and personal environment of elderly persons have a limited role in the prevention of suicide. This is due to their unfamiliarity with the problems surrounding the fulfilment of the basic needs of the suicidal elderly. Furthermore, as revealed in the cases studied here, the intervention of the health care system has centred mainly on the use of medication as a treatment for symptoms of psychological distress. The health care system pays little attention to the dissonance associated with the frustration suicidal elderly persons experience on account of their inability to satisfy their basic needs. Finally, the outcome of this qualitative study suggests that understanding the basic needs of the elderly can be very useful in understanding geriatric suicide.

Climate change and Australia's healthcare system - risks, research and responses

2010 ◽  
Vol 34 (4) ◽  
pp. 441 ◽  
Author(s):  
Haylee J. Weaver ◽  
Grant A. Blashki ◽  
Anthony G. Capon ◽  
Anthony J. McMichael
Keyword(s):  
Climate Change ◽  
Health Care ◽  
Health Care System ◽  
Health Care Professionals ◽  
Disaster Preparedness ◽  
Research Capacity ◽  
Service Planning ◽  
Ageing Population ◽  
Promotion Policy ◽  
Care System

Climate change will affect human health, mostly adversely, resulting in a greater burden on the health care system, in addition to any other coexistent increases in demand (e.g. from Australia’s increasingly ageing population). Understanding the extent to which health is likely to be affected by climate change will enable policy makers and practitioners to prepare for changing demands on the health care system. This will require prioritisation of key research questions and building research capacity in the field. There is an urgent need to better understand the implications of climate change for the distribution and prevalence of diseases, disaster preparedness and multidisciplinary service planning. Research is needed to understand the relationship of climate change to health promotion, policy evaluation and strategic financing of health services. Training of health care professionals about climate change and its effects will also be important in meeting long-term workforce demands.

Limitations in Health-Care System Resources Affecting Adherence of Patient With Psoriasis to Topical Drugs: A Focus Group Study

2020 ◽  
Vol 5 (2) ◽  
pp. 54-60
Author(s):  
Mathias Tiedemann Svendsen ◽  
Steven R. Feldman ◽  
Sylvia Naiga Tiedemann ◽  
Anne Sofie Stochholm Sørensen ◽  
Cecilie Marie Ringgaard Rivas ◽  
...  
Keyword(s):  
Health Care ◽  
Focus Group ◽  
Health Care System ◽  
Continuity Of Care ◽  
Health Care Professionals ◽  
Topical Therapy ◽  
Focus Group Study ◽  
Topical Drugs ◽  
System Resources ◽  
Care System

Background: Topical therapy is first-line treatment for patients with mild-to-moderate psoriasis, but low adherence to topical drugs is a barrier to treatment success. Health-care system resources are considered to have an impact on adherence of patient with psoriasis to topical drugs. Objective: To investigate dermatology nurses’ perception of the impact of health-care system resources on topical therapy adherence in patients with psoriasis. Methods: A semistructured focus group study was performed with 6 dermatology nurses and 2 student nurses. Participants were recruited from a dermatology outpatient hospital clinic. The study focused on the dermatology nurses’ perception of the effect health-care system resources (including health-care services provided to patients, how clinics are organized, and how the health-care personnel communicate) have on adherence of patients with psoriasis to topical treatment. The focus group discussion was divided into 3 areas: communication with patients and intercollegial communication, follow-up visits and admissions to consultations by other health-care professions, and how to establish consultations to support adherence of patients with psoriasis to topical drugs. Data were analyzed by a systematic text condensation method based on a phenomenological–hermeneutic approach. Results: Nurses identified a number of health-care system resources that may affect adherence of patients with psoriasis, primarily professional collaboration and communication, continuity of care, and the establishment of nurse consultations. Conclusion: Adherence may by negatively affected by contradictory information about topical drugs due to inadequate interprofessional collaboration among health-care professionals. Improving communication between health-care professionals and patients, ensuring continuity of care, and establishing nurse consultations may improve topical therapy outcomes.

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