scholarly journals The Patient’s Will – Why and for Whom? Forms, Formalisation, and Implementation Issues

2018 ◽  
Vol 27 ◽  
pp. 158-169
Author(s):  
Maret Kruus ◽  
Rainis Int ◽  
Ants Nõmper
Keyword(s):  
Health Care ◽  
Health Care Services ◽  
Personal Autonomy ◽  
Effective Means ◽  
Living Will ◽  
Living Wills ◽  
Future Health ◽  
Care Services ◽  
Patient’S Will ◽  
To Receive

If a patient decides they do not wish to receive health care services and would prefer to die, the healthcare service provider is not allowed to provide health care services to the patient under the principle of personal autonomy. In this case, the patient’s will needs to be taken into consideration even when they are currently unable to express it themselves, for instance when the patient is unconscious. In the situations where the patient is unable to express their will on their own, many countries have introduced the use of living wills that are also often called advance directives. A living will is a declaration (usually in writing) on what kind of treatment a person wishes or does not wish to receive in a situation in which they are unable to make decisions on their own, for instance, in the case of unconsciousness or dementia. In addition to preparing a living will, people can also provide future health care directives by assigning a substitute decision maker who can express the person’s presumed will in case of the person being unable to express their decision. The most effective means for ensuring one’s personal autonomy is using a living will, since it is compiled by the person themselves. Although living wills are not common in Estonia, the legislation of the country makes no obstacles for its use. The people of Estonia are also becoming increasingly aware of their rights. People have already turned to notaries with a wish of providing notarial future directives on the provision of health care services or maintenance of their property in the case that they no longer have the capacity to exercise their will themselves. The article discusses the role of a living will near the end of life and also discusses the issues related to its formation and implementation. The last part of the article briefly addresses the instructions related to maintenance of the patient’s assets in the case of incapacity to exercise the will. 

Measuring reopening readiness: a universal COVID-19 index for US states

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Eunju Suh ◽  
Mahdi Alhaery
Keyword(s):  
Health Care ◽  
Health Care Services ◽  
Future Health ◽  
Content Type ◽  
Counter Measures ◽  
Care Services ◽  
Future Health Care ◽  
Pandemic Severity ◽  
Occupancy Rates ◽  
Bed Occupancy Rates

PurposeWhile United States is among countries with the world’s highest coronavirus infections, its approaches and policies to reopen the economy vary by state. A lack of objective criteria and monitoring toward satisfying the criteria can lead to another COVID-19 outbreak and business closures. Considering the pressing need to return to normalcy without a rebound of COVID-19 infections and deaths, an index that provides a data-driven and objective insight is urgently needed. Hence, a method was devised to assess the severity of the COVID-19 pandemic and determine the degree of progress any state has made in containing the spread of COVID-19.Design/methodology/approachUsing measures such as the weekly averages of daily new deaths, ICU bed occupancy rates, positive cases and test positivity rates, two indexes were developed: COVID-19 reopening readiness and severity.FindingsA clear difference in the pandemic severity trends can be observed between states, which is possibly due to the disparity in the state’s response to coronavirus. A sharp upward trend in index values requires caution prior to moving to the next phase of reopening.Originality/valueThe composite indexes advanced in this study will provide a universal, standardized and unbiased view of each state’s readiness to reopen and allow comparisons between states. This in turn can help governments and health-care agencies take counter measures if needed as to the anticipated demand for future health-care services and minimize adverse consequences of opening.

scholarly journals Legal Framework for the Training of Health Care Specialists in the Health Care System of Lithuania to Work with the Disabled

2020 ◽  
Vol 10 (2) ◽  
pp. 150-161
Author(s):  
Milda Ratkevičienė
Keyword(s):  
Health Care ◽  
Health Care Services ◽  
People With Disabilities ◽  
Legal Framework ◽  
Equal Rights ◽  
Future Health ◽  
Global Trends ◽  
Care Services ◽  
The World ◽  
The Disabled

AbstractIntroduction:Health care is one of the most important fields not only in individual countries, but globally as well, yet it remains one of the most sensitive topics, too. Global organisations have calculated that one out of seven residents around the world has some sort of disability. It is very likely that due to various processes, the number of people with disabilities will increase. Therefore, the world in general and each country in particular, Lithuania included, faces a great challenge: to ensure suitable and high-quality accessibility to health care services for the disabled. Each country must have clear political guidelines and strategies how to ensure training of health care specialists qualified and able to carry out their tasks when working with the disabled. Therefore, this article analyses global trends of training specialists to work with the disabled and legal basis of such specialist training in Lithuania.Methods:This article features analysis of scientific literary sources and legal documents.Results:International and national Lithuanian documents have clearly established that people with disabilities have equal rights to health care services like the rest of the population without any reservations, so this norm must be established adhering to the principles of accessibility, suitability and universality, and which basically should be ensured by health care specialists. However, document analysis has revealed that documents governing the training of health care specialists in Lithuania and processes related to it pay little attention to the training of future health care specialists to work with the disabled, while descriptions of some specific areas of studies, e.g. dentistry, pharmacy, etc. designed to train health care specialists do no address the work with the disabled at all.Discussion and conclusions:Analysis has revealed that institutions of higher education in Lithuania that train health care specialists are not legally entitled to, other requirements aside, to focus the study process on the work with the disabled. Therefore, it begs the question whether such specialists are actually ready to implement the requirements guiding the provision of health care services and ensure top-quality and proper provision of services to all members of the society, irrespective of their special needs, disabilities, etc. Therefore, this article can serve as a basis for further research related to the training of health care specialists to work with the disabled in order to identify what practice is applied in this area in other countries, as well as to ensure it internationally, what are the options and means required to implement it and how to improve the training of health care specialists as much as possible to work with the disabled ensuring the quality of health care in particular and their life in general.

scholarly journals Socioeconomic inequalities in the access to and quality of health care services

2014 ◽  
Vol 48 (6) ◽  
pp. 968-976 ◽  
Author(s):  
Bruno Pereira Nunes ◽  
Elaine Thumé ◽  
Elaine Tomasi ◽  
Suele Manjourany Silva Duro ◽  
Luiz Augusto Facchini
Keyword(s):  
Health Care ◽  
Socioeconomic Status ◽  
Health Care Services ◽  
Access To Health Services ◽  
Socioeconomic Groups ◽  
Care Services ◽  
Access To Health ◽  
To Receive ◽  
Use Of Health Care

OBJECTIVE To assess the inequalities in access, utilization, and quality of health care services according to the socioeconomic status. METHODS This population-based cross-sectional study evaluated 2,927 individuals aged ≥ 20 years living in Pelotas, RS, Southern Brazil, in 2012. The associations between socioeconomic indicators and the following outcomes were evaluated: lack of access to health services, utilization of services, waiting period (in days) for assistance, and waiting time (in hours) in lines. We used Poisson regression for the crude and adjusted analyses. RESULTS The lack of access to health services was reported by 6.5% of the individuals who sought health care. The prevalence of use of health care services in the 30 days prior to the interview was 29.3%. Of these, 26.4% waited five days or more to receive care and 32.1% waited at least an hour in lines. Approximately 50.0% of the health care services were funded through the Unified Health System. The use of health care services was similar across socioeconomic groups. The lack of access to health care services and waiting time in lines were higher among individuals of lower economic status, even after adjusting for health care needs. The waiting period to receive care was higher among those with higher socioeconomic status. CONCLUSIONS Although no differences were observed in the use of health care services across socioeconomic groups, inequalities were evident in the access to and quality of these services.

scholarly journals Health and healthcare in the year 2040 – Facts for planning a complex and uncertain future

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
T Funk ◽  
B Forsberg
Keyword(s):  
Health Care ◽  
Burden Of Disease ◽  
Health Care Services ◽  
Disease Burden ◽  
Health Planning ◽  
Health Care Planning ◽  
Care Needs ◽  
Future Health ◽  
Care Services ◽  
Future Health Care

Abstract Background In the Stockholm region, a regional political assembly is responsible for health care services for a population of 2.3 million. In November 2017, the political leadership decided on a programme to project health and healthcare developments in the Stockholm region until 2040 as a basis for a longterm health plan. This presentation aims to describe the methodology used, share some results and raise some questions for further work. Through the presentation we also seek collaboration with European partners involved in similar health planning work. Methodology Six perspectives for analysis were defined and under each a set of areas for deeper analysis identified. It was agreed that the planning should be fact-driven. Under the constraint of availability, data covering the period 2000 to 2017 was collected for around 90 variables. Data was gathered from various publicly available databases and was analysed in Microsoft Excel. Results Stockholm’s population increased continuously since the millennial shift and could increase by another 28% until 2040. Since 2000, life expectancy increased by 2 years for women and 3 years for men. More than 85% of the burden of disease is caused by chronic diseases. However, the overall disease burden per 100 000 population has been decreasing over the years. In 2017, more than 21 million outpatient care visits were done. Extrapolations of these trends show that the disease burden per capita will continue to decrease, but the total burden of disease as well as demand for health care will continue to increase. Discussion A fact-based analysis of future health and healthcare proved to be an efficient base for planning and discussions of future health care services. Results confirmed some well-established perceptions of developments but also pointed to some misconceptions and established “facts” that proved to be false. New digital services make prediction of the future health service mix dynamic and challenging. Key messages To meet future health care needs, future health and health care trends should be planned for and considered in decision making processes. Forecasts and health care planning should be fact-based to have an as accurate picture of future health and health care trends as possible.

Following the Money

2020 ◽  
Vol 48 (3) ◽  
pp. 434-442 ◽  
Author(s):  
William M. Sage ◽  
Timothy M. Westmoreland
Keyword(s):  
Health Care ◽  
Health Policy ◽  
Health Insurance ◽  
Affordable Care Act ◽  
Health Care Services ◽  
Future Health ◽  
Care Services ◽  
Policies And Procedures ◽  
Future Health Care ◽  
Health Returns

It is no exaggeration to say that American health policy is frequently subordinated to budgetary policies and procedures. The Affordable Care Act (ACA) was undeniably ambitious, reaching health care services and underlying health as well as health insurance. Yet fiscal politics determined the ACA’s design and guided its implementation, as well as sometimes assisting and sometimes constraining efforts to repeal or replace it. In particular, the ACA’s vulnerability to litigation has been the price its drafters paid in exchange for fiscal-political acceptability. Future health care reformers should consider whether the nation is well served by perpetuating such an artificial relationship between financial commitments and health returns.

scholarly journals Barriers to Access Health Care Services among Rural Adolescent Girls in Raina I Block, Purba Bardhaman, West Bengal

2021 ◽  
Vol 9 (3) ◽  
pp. 61-72
Author(s):  
Mousumi Dholey ◽  
Sumana Sarkar
Keyword(s):  
Health Care ◽  
Adolescent Girls ◽  
Rural Areas ◽  
Access To Health Care ◽  
Health Care Services ◽  
Future Health ◽  
Quality Health Care ◽  
Cross Sectional ◽  
Care Services ◽  
Rural Adolescent

Adolescence in girls is a crucial transition phase during which they experience biological and psychological changes along with changes in social outlook. This phase provides an opportunity to lay the foundation for their future health. But, in rural areas, adolescent girls are often deprived of better nutrition and proper health care guide, resulting in serious health issues like malnutrition, stunting, wasting, and anaemia. Moreover, their access to health care services is subjected to various constraints as infrastructural and societal barriers such as regressive norms, social stigma, gendered family structure, etc. Thus, the present study attempts to explore the perceived barriers that prevent rural adolescent girls from accessing health care services at the micro-level. A community-based cross-sectional study was carried out after randomly selecting 120 adolescent girls in the age cohort of 10-19 years in the Raina-I block of Purba Bardhaman district. The results suggested that societal barriers have a significant influence over health-related decision-making. Besides, lack of quality health care services and economic burden are some of the other significant obstacles observed here.

scholarly journals A profile of professional nursing practice in the private sector in the R.S.A.

Curationis ◽  
1988 ◽  
Vol 11 (2) ◽  
Author(s):  
S. Pera
Keyword(s):  
Health Care ◽  
Private Sector ◽  
Health Care Services ◽  
Registered Nurse ◽  
Nursing Practice ◽  
Future Health ◽  
Care Services ◽  
Professional Nursing Practice ◽  
Health Centres ◽  
Future Health Care

The purpose of this study was to develop a profile of professional nursing practice in private enterprise health care services in the Republic of South Africa. In the light of the future health care needs and the relationship between the private and public sector health care establishments, information about the role and task of the I professional nurse was needed. Information would provide a data base about the registered nurse and so facilitate future health care planning. An exploratory field study was undertaken to locate the various work environments of the registered nurse in four statistical urban regions. Questionnaires were handed out and collected from a proportional stratified sample of professional nurses who were working in thirteen types of health care environments in the period between I June 1983 and 30 September 1983. A return rate of 68 percent yielded 340 completed questionnaires from 501 registered nurses. The study revealed that the majority of nurses in the private sector were relatively young. White, female, English-speaking professionals who were practising in four broad areas of health care: • Custodial care environments such as residential homes for the aged, institutions for the chronic sick and frail aged, homes for children and homes for the adult handicapped. • Hospitals and related special health centres catering for drug addicts, alcoholics and patients suffering from psychiatric/nervous disorders. • Institutions for child and adult education which included crèches/nursery schools, primary and secondary hoarding schools, special schools for the handicapped, and university based student health centres. • Medical and dental consulting room practices. • Other entrepreneurial employment settings such as business and industrial occupational health care services, nursing service agencies, and mobile emergency care units.

“Why Should I Tell My Business?”: An Emerging Theory of Coping and Disclosure in Teens

2016 ◽  
Vol 30 (2) ◽  
pp. 124-142 ◽  
Author(s):  
Daniela T. DeFrino ◽  
Monika Marko-Holguin ◽  
Stephanie Cordel ◽  
Lauren Anker ◽  
Melishia Bansa ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Mental Health Care ◽  
Health Care Services ◽  
Primary Care Providers ◽  
Care Providers ◽  
Care Services ◽  
Constant Comparative Analysis ◽  
To Receive

Disclosing predepression feelings of sadness is difficult for teens. Primary care providers are a potential avenue for teens to disclose these feelings and a bridge to mental health care before becoming more seriously ill. To explore how to more effectively recruit teens into a primary care-based, online depression prevention study, we held 5 focus groups with African American and Latino teens (n = 43) from a large Midwestern city. We conducted constant comparative analysis of the data and a theoretical conceptualization of coping and disclosure emerged. Our analysis revealed an internal coping continuum in reaction to sadness and pivotal elements of trust and judgment that either lead teens to disclose or not disclose these feelings. The teens’ perspectives show the necessary characteristics of a relationship and comfortable community and virtual settings that can best allow for teens to take the step of disclosing to receive mental health care services.

scholarly journals Cost, Quality, and Access of Healthcare in Piura, Peru

2019 ◽  
Vol 16 (2) ◽  
pp. 17-30 ◽  
Author(s):  
Julia Griffin ◽  
Elaina Osterbur
Keyword(s):  
Health Care ◽  
Health Care Services ◽  
Small Sample Size ◽  
Healthcare Services ◽  
Small Sample ◽  
Medical Providers ◽  
Care Services ◽  
Care Workers ◽  
The Cost ◽  
To Receive

The aim of the study is to investigate the patient perceptions on the cost, quality, and access of health care services in Piura, Peru. Although one of the largest cities in Peru, Piura has one of the lowest densities of health care workers in the country which greatly impacts the population’s ability to receive medical treatment. Lack of financial resources and health literacy, among other health disparities exist. Modeled after CAHPS Health Plan Adult Commercial Survey 5.0 and the Patient Satisfaction Survey, a forty-four question English and Spanish survey was created with questions to study healthcare variables. As a correlational study with convenience sampling, the survey was administered to both patients and medical providers in eight city health centers. Over a period of twelve days, 107 surveys were collected. After eliminating subjects who did not meet the study criteria, 92 patients and 13 medical providers were included in the study. Findings from medical providers are not reported because of the small sample size. The results of this study suggests that 32% of subjects do not have health insurance, 24% of subjects rated their healthcare received as average, 18% of participants rated their healthcare as the best possible on a scale of zero to ten, and 29% of subjects had to wait an average of seven days for access to healthcare services when care is urgent. The results of this analysis can be used to better understand the Peruvian healthcare system and educate the Piura community and the Parish Santísimo Sacramento as they continue to improve and expand their health care services. KEYWORDS: Cost; Quality; Access; Healthcare; Piura; Peru; Satisfaction; Parroquia Santísimo Sacramento; EsSalud; SIS; MINSA

Sign in / Sign up

Export Citation Format

Share Document