scholarly journals Opportunities and challenges in providing health care for International Retirement Migrants: a qualitative case study of Canadians travelling to Yuma, Arizona

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
John Pickering ◽  
Valorie A. Crooks ◽  
Jeremy Snyder ◽  
Trudie Milner
Keyword(s):  
Health Care ◽  
Qualitative Case Study

scholarly journals A household perspective on access to health care in the context of HIV and disability: a qualitative case study from Malawi

2016 ◽  
Vol 16 (1) ◽  
Author(s):  
Stine Hellum Braathen ◽  
Lifah Sanudi ◽  
Leslie Swartz ◽  
Thomas Jürgens ◽  
Hastings T Banda ◽  
...  
Keyword(s):  
Health Care ◽  
Access To Health Care ◽  
Qualitative Case Study ◽  
Access To Health

scholarly journals Timely referral saves the lives of mothers and newborns: Midwifery led continuum of care in marginalized teagarden communities – A qualitative case study in Bangladesh

F1000Research ◽  
2018 ◽  
Vol 7 ◽  
pp. 365 ◽  
Author(s):  
Animesh Biswas ◽  
Rondi Anderson ◽  
Sathyanarayanan Doraiswamy ◽  
Abu Sayeed Md. Abdullah ◽  
Nabila Purno ◽  
...  
Keyword(s):  
Health Care ◽  
Qualitative Case Study ◽  
Post Partum ◽  
Primary Health Care Centre ◽  
Health Facilities ◽  
Health Care Centre ◽  
Access Barrier ◽  
Reproductive Healthcare ◽  
Timely Referral

Background: Prompt and efficient identification, referral of pregnancy related complications and emergencies are key factors to the reduction of maternal and newborn morbidity and mortality. As a response to this critical need, a midwifery led continuum of reproductive health care was introduced in five teagardens in the Sylhet division, Bangladesh during 2016. Within this intervention, professional midwives provided reproductive healthcare to pregnant teagarden women in the community.  This study evaluates the effect of the referral of pregnancy related complications. Methods: A qualitative case study design by reviewing records retrospectively was used to explore the effect of deploying midwives on referrals of pregnancy related complications from the selected teagardens to the referral health facilities in Moulvibazar district of the Sylhet division during 2016.  In depth analyses was also performed on 15 randomly selected cases to understand the facts behind the referral. Results: Out of a total population of 450 pregnant women identified by the midwives, 72 complicated mothers were referred from the five teagardens to the facilities. 76.4% of mothers were referred to conduct delivery at facilities, and 31.1% of them were referred with the complication of prolonged labour. Other major complications were pre-eclampsia (17.8%), retention of the placenta with post-partum hemorrhage (11.1%) and premature rupture of the membrane (8.9%). About 60% of complicated mothers were referred to the primary health care centre, and among them 14% of mothers were delivered by caesarean section. 94% deliveries resulted in livebirths and only 6% were stillbirths. Conclusions: This study reveals that early detection of pregnancy complications by skilled professionals and timely referral to a facility is beneficial in saving the majority of baby’s as well as mother’s lives in resource-poor teagardens with a considerable access barrier to health facilities.

scholarly journals Bridge Over Troubled Waters: End-of-Life (EOL) Decisions, A Qualitative Case Study

2015 ◽  
Author(s):  
Kate Callahan ◽  
Nancy Maldonado ◽  
Joan Efinger
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Qualitative Case Study ◽  
Advanced Directives ◽  
Loved One ◽  
Group Settings ◽  
The Social ◽  
Eol Care ◽  
Share Information

This case study investigated the psychological and emotional experiences of nine health care professionals who attended a Five Wishes seminar, designed to acquaint participants with thinking holistically about death. All the self-selected participants had experienced the death of a loved one and indicated they were able to discuss death issues. Data collection included interviews, observations, physical artifacts, and the Five Wishes documents. Content analysis was the central technique used to identify themes. Findings indicated participants attended the EOL seminar to share information with their colleagues and patients; the information also interested them personally. However, facing death and making EOL care decisions were difficult for the participants. The EOL seminars educated them regarding some of the mysteries and problem s of EOL care and offered them some solutions and insights bot h professionally and personally. This study has implications for educators and health care professionals: 1) EOL decisions are facilitated by the social support of group settings . 2) Reluctance about facing death can be reduced by comprehensive, lifelong education beginning in the early childhood years and culminating with holistic advanced directives such as the Five Wishes.

Ethics and Incentives: An Evaluation and Development of Stakeholder Theory in the Health Care Industry

2002 ◽  
Vol 12 (4) ◽  
pp. 413-432 ◽  
Author(s):  
Heather Elms ◽  
Shawn Berman ◽  
Andrew C. Wicks
Keyword(s):  
Health Care ◽  
Stakeholder Theory ◽  
Qualitative Case Study ◽  
Health Care Industry ◽  
Interactive Effects ◽  
Managerial Behavior ◽  
Care Industry ◽  
Managerial Action ◽  
Legal Case

Abstract:This paper utilizes a qualitative case study of the health care industry and a recent legal case to demonstrate that stakeholder theory’s focus on ethics, without recognition of the effects of incentives, severely limits the theory’s ability to provide managerial direction and explain managerial behavior. While ethics provide a basis for stakeholder prioritization, incentives influence whether managerial action is consistent with that prioritization. Our health care examples highlight this and other limitations of stakeholder theory and demonstrate the explanatory and directive power added by the inclusion of the interactive effects of ethics and incentives in stakeholder ordering.

scholarly journals "It gets people through the door": a qualitative case study of the use of incentives in the care of people at risk or living with HIV in British Columbia, Canada

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Marilou Gagnon ◽  
Adrian Guta ◽  
Ross Upshur ◽  
Stuart J. Murray ◽  
Vicky Bungay
Keyword(s):  
Health Care ◽  
British Columbia ◽  
Service Providers ◽  
Qualitative Case Study ◽  
Population Level ◽  
Unintended Consequences ◽  
Structural Barriers ◽  
Structural Determinants ◽  
Hiv Cascade

Abstract Background There has been growing interest in the use of incentives to increase the uptake of health-related behaviours and achieve desired health outcomes at the individual and population level. However, the use of incentives remains controversial for ethical reasons. An area in which incentives have been not only proposed but used is HIV prevention, testing, treatment and care—each one representing an interconnecting step in the "HIV Cascade." Methods The main objective of this qualitative case study was to document the experiences of health care and service providers tasked with administrating incentivized HIV testing, treatment, and care in British Columbia, Canada. A second objective was to explore the ethical and professional tensions that arise from the use of incentives as well as strategies used by providers to mitigate them. We conducted interviews with 25 providers and 6 key informants, which were analyzed using applied thematic analysis. We also collected documents and took field notes. Results Our findings suggest that incentives target populations believed to pose the most risk to public health. As such, incentives are primarily used to close the gaps in the HIV Cascade by getting the "right populations" to test, start treatment, stay on treatment, and, most importantly, achieve (and sustain) viral suppression. Participants considered that incentives work because they "bring people through the door." However, they believed the effectiveness of incentives to be superficial, short-lived and one-dimensional—thus, failing to address underlying structural barriers to care and structural determinants of health. They also raised concerns about the unintended consequences of incentives and the strains they may put on the therapeutic relationship. They had developed strategies to mitigate the ensuing ethical and professional tensions and to make their work feel relational rather than transactional. Conclusions We identify an urgent need to problematize the use of incentives as a part of the "HIV Cascade" agenda and interrogate the ethics of engaging in this practice from the perspective of health care and service providers. More broadly, we question the introduction of market logic into the realm of health care—an area of life previously not subject to monetary exchanges.

scholarly journals Barriers and facilitators of adherence for cervical cancer prevention in low-income women in Colombia

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
Jaramillo PC Bermúdez ◽  
M Arrivillaga Quintero ◽  
K J Torres Poveda ◽  
D M Castrillón Libreros ◽  
D Neira Acevedo ◽  
...  
Keyword(s):  
Health Care ◽  
Cervical Cancer ◽  
Primary Health Care ◽  
Cancer Prevention ◽  
Low Income ◽  
Qualitative Case Study ◽  
Cervical Cancer Prevention ◽  
Public Network ◽  
Primary Health

Abstract Introduction In Colombian women, cervical cancer screening coverage in 2017, 48.2 % of women were able to pay and 34.3% were not able to. Objective To determine the barriers and facilitators of screening adherence to preventive program for cervical cancer prevention, in women were not able to pay affiliated to a public network of primary health care in Cali, Colombia, during the years 2014-2018. Methods Sequential mixed study, quantitative initial phase and second qualitative phase. We analyzed information from 32,001 insured women and 7,691 users of the program. The quantitative design was cross-cutting, observational and analytical; we also incorporate a qualitative case study; we conduct focus groups, in-depth interviews with users, health care services and administrative staff. Results 47.5% of women were adherents to the program; women over 50 (OR = 0,82; 95% CI = 0,73-0,92), who lived further away from the health care site, (OR = 0,78; 95% CI = 0,62-0,97), had worse adherence to the program; women most often from medical consultations had increased adherence (OR = 3; 95% CI = 2,66-3,42). The qualitative case study showed similar barriers to other populations, living conditions, shame and fears of the procedure itself. We found as facilitators, agile attention, the ease of consulting services, and having some social support. Conclusions Despite the efforts of the public network of primary health care, the personnel staff consider a great barrier, the lack of updated information of women, which prevents recruitment and monitoring. Key messages In low-income women, it is necessary to generate interventions in groups of poor non-adherent women, as well as women with low adherence. Adherence depends on women’s beliefs and knowledge. Lack of interaction with a healthcare provider, increasing age and living far away from the health care site continue to be barriers.

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