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
2020 ◽  
Vol 10 (1) ◽  
pp. 11-24
Author(s):  
Agustinus Hermino

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 


Author(s):  
Jayita Poduval

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.


1998 ◽  
Vol 44 (3) ◽  
pp. 400-415 ◽  
Author(s):  
Emre Berk ◽  
Kamran Moinzadeh

2017 ◽  
Vol 42 ◽  
pp. 401
Author(s):  
Andreza Werli-Alvarenga ◽  
Fernando Antônio Botoni ◽  
Daniela Mascarenhas de Paula ◽  
Edna Marileia Meireles Leite

1996 ◽  
Vol 22 (2-3) ◽  
pp. 331-360 ◽  
Author(s):  
Michael J. Malinowski

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.


2005 ◽  
Vol 10 (2_suppl) ◽  
pp. 22-30 ◽  
Author(s):  
Christine Way ◽  
Deborah Gregory ◽  
Norma Baker ◽  
Sandra Lefort ◽  
Brendan Barrett ◽  
...  

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.


2021 ◽  
Author(s):  
Hermann Badolo ◽  
Aristide Romaric Bado ◽  
Hervé Hien ◽  
Nicolas Méda ◽  
Appunni Sathiya Susuman

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.


2019 ◽  
Author(s):  
Ingvild Lilleheie ◽  
Jonas Debesay ◽  
Asta Bye ◽  
Astrid Bergland

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.


2005 ◽  
Vol 10 (2_suppl) ◽  
pp. 48-57 ◽  
Author(s):  
Deborah Gregory ◽  
Christine Way ◽  
Brendan Barrett ◽  
Patrick Parfrey

Objectives To monitor changes in providers' perceptions of health care quality and the importance of health reform, and in patients' satisfaction with services during and two years after restructuring, comparing the region of the province that was restructured (StJohn's) with those regions in which hospitals were not aggregated. Methods The Employee Attitude Survey questionnaire was sent to acute care providers (n=5353) to assess personal characteristics and perceptions of the impact of reform on workplace conditions, work-related attitudes and turnover intentions. The response rate for 2000 and 2002 was 42% (n=1222 and1034, respectively). Only respondents in both surveys (n=589) were used in the analysis because study results were the same for both the repeat sample and total samples. A Patient Satisfaction Survey questionnaire was administered to patients discharged from acute care facilities in 2000 (n=1741) and 2002 (n=704). Response rates were 82.5% and 90.2%, respectively. Results Most providers felt, at both time periods, that restructuring of the health care system was a positive step, but felt that health care quality was low. In the StJohn's region, perceptions of quality and standards of care improved over time. Patients were extremely satisfied with the admission process and hospital stay at both time periods in StJohn's. However, satisfaction declined in 2002 in regions outside StJohn's. Conclusions Aggregation of acute care hospitals is possible without adverse effects on providers' perceptions of health care quality or on patient satisfaction.


Author(s):  
Hugo Carradinha

The provision of affordable, high-quality health care is a political priority in Europe, and expenditure on pharmaceutical products is an important component of total health-care costs. The search by governments and health insurers to reduce health-care budgets has shown the importance of generic medicines, which are acquiring greater relevance. Generic medicines signify clear long-term savings to national health-care budgets.1 In this context, generic medicines are an essential part of the equation to the sustainability of the EU health-care system. Although the short-term results and price-cutting policies are only recent additions to the retail pharmaceutical market, the latest evidence shows that tendering and similar procurement systems play a negative role in patient health-care quality, government budgets and generic medicines industry sustainability and the capacity to continue to supply affordable prices.


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