scholarly journals Innovation in healthcare services: notes on the limits of field research

2016 ◽  
Vol 32 (suppl 2) ◽  
Author(s):  
Laís Silveira Costa
Keyword(s):  
Population Aging ◽  
Field Research ◽  
Healthcare Services ◽  
Healthcare Systems ◽  
Public Healthcare ◽  
Social Changes ◽  
Public And Private ◽  
Disease Characteristics ◽  
Health And Disease ◽  
Current Article

Abstract: The contemporary context of population aging, itsthe population's different health and disease characteristics, and the growing incorporation of technologies by healthcare systems have highlighted the need to adjust the healthcare structure as a whole. The defense of a democratic and sustainable system reveals the importance of understanding how changes in healthcare take place. The current article aims to contribute to the understanding of innovation in healthcare services. The study's results indicate that the existence of certain knowledge gaps means that public policies tend to overlook a whole rangeseries of innovations normally associated with social changes, with a consequentwith an impact on human development, social cohesion, equality, and equity, allcentral issues that are central toin the field of collective public healthcare field. The article concludes that the lack of a mature theoretical framework negatively impacts the formulation of such policies, further aggravated in Brazil by growing differences in quality and access between population segments that depend on the public and private healthcare systems.

scholarly journals Public versus Private Healthcare Systems following Discharge from the ICU: A Propensity Score-Matched Comparison of Outcomes

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Felippe Leopoldo Dexheimer Neto ◽  
Regis Goulart Rosa ◽  
Bruno Achutti Duso ◽  
Jaqueline Sanguiogo Haas ◽  
Augusto Savi ◽  
...  
Keyword(s):  
Propensity Score ◽  
Healthcare System ◽  
Healthcare Systems ◽  
Public Healthcare ◽  
Public And Private ◽  
The Public ◽  
Private Healthcare ◽  
All Cause Mortality ◽  
Public Versus Private ◽  
Matched Comparison

Purpose.The long-term outcomes of patients after discharge from tertiary ICUs as they relate to the public versus private healthcare systems in Brazil have not yet been evaluated.Materials and Methods.A multicenter prospective cohort study was conducted to compare the all-cause mortality and the physical functional status (PFS) 24 months after discharge from the ICU between adult patients treated in the public and private healthcare systems. A propensity score- (PS-) matched comparison of all causes of mortality and PFS 24 months after discharge from the ICU was performed.Results.In total, 928 patients were discharged from the ICU including 172 (18.6%) patients in the public and 756 (81.4%) patients in the private healthcare system. The results of the PS-matched comparison of all-cause mortality revealed higher mortality rates among the patients of the public healthcare system compared to those of the private healthcare system (47.3% versus 27.6%,P=0.003). The comparison of the PS-matched Karnofsky performance and Lawton activities of daily living scores between the ICU survivors of the public and private healthcare systems revealed no significant differences.Conclusions.The patients of private healthcare system exhibited significantly greater survival rates than the patients of the public healthcare system with similar PFS following ICU discharge.

scholarly journals Public Healthcare: Citizen’s Preferences in Spain

Healthcare ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. 467
Author(s):  
Silvia Prieto-Herraez ◽  
Teresa González-Arteaga ◽  
Rocío de Andrés Calle
Keyword(s):  
Healthcare System ◽  
Healthcare Services ◽  
Healthcare Systems ◽  
Public Healthcare ◽  
Private Hospitals ◽  
The Public ◽  
The Stability ◽  
Spanish Health ◽  
Rapid Emergence ◽  
Over Time

This paper analyzes the stability of citizens’ preferences on public healthcare services in Spain. Nowadays, the increasing privatization of some healthcare services and the rapid emergence of private hospitals have caused changes in people’s preferences on public healthcare systems. This paper focuses on analyzing the preferences of Spaniards on their healthcare system over time under the assumption that citizens’ preferences are represented by complete pre-orders. Data for this study were collected from the Spanish Health Barometer survey, and they were searched from 1995 until 2018. The results show that preferences on the public healthcare system are very stable along time.

Seven lessons from the field: Research on transformation of health systems for older adults

2020 ◽  
Vol 33 (5) ◽  
pp. 220-227
Author(s):  
Paul Stolee ◽  
Maggie MacNeil ◽  
Jacobi Elliott ◽  
Catherine Tong ◽  
Alison Kernoghan
Keyword(s):  
Older Adults ◽  
Health Systems ◽  
Family Caregiver ◽  
Field Research ◽  
Healthcare Services ◽  
Healthcare Systems ◽  
System Transformation ◽  
Systems Research ◽  
Research Findings ◽  
Conducting Research

Research can play a key role in efforts to transform healthcare systems. Our group’s long-standing research program has been aimed at understanding how to support greater integration and coordination of healthcare services for older adults with complex conditions. Drawing on this experience, we outline seven “lessons from the field” that highlight research-related challenges that may hinder health system transformation. These challenges relate to conducting research in a complex and constantly changing system; co-design approaches that are simultaneously deemed essential yet too ambiguous to fund; patient, family caregiver, and citizen engagement; limited funding for health systems research; and lack of use of research findings. We hope that these reflections will help to inform an ongoing conversation about how these challenges might be overcome.

Deploying Cloud-Based Healthcare Services

2020 ◽  
Vol 11 (4) ◽  
pp. 87-100
Author(s):  
Vikas Kumar ◽  
Aashish Bhardwaj
Keyword(s):  
Cloud Computing ◽  
Healthcare System ◽  
Population Aging ◽  
Holistic Approach ◽  
Healthcare Services ◽  
Healthcare Systems ◽  
Healthcare Organizations ◽  
Healthcare Data ◽  
The People ◽  
Different Levels

Healthcare of individuals is very important; hence, the healthcare data needs to be managed very professionally. These requirements have become more stringent with the population aging and the growing attention to healthcare by the people. Cloud computing has emerged as a prominent solution to the computing demands of healthcare organizations, and a number of cloud-based solutions are available in the market. However, different users of the healthcare systems have different expectations from the cloud, and these must be taken into account while migrating to cloud. This article presents the implications of cloud computing solutions for the present day healthcare scenario. Prominent cloud-based healthcare services have been presented along with their specific applications. Considering the different users of healthcare systems, a holistic approach has been presented for the deployment of a cloud-based healthcare system. The deployment approach is suitable for all different levels of the healthcare organizations.

scholarly journals Introduction. A mixed model of hospital services: Catalonia, 1870s-2010s

2021 ◽  
Vol 6 (1) ◽  
pp. 1-29
Author(s):  
Paloma Fernández Pérez ◽  
Alfons Zarzoso
Keyword(s):  
Mixed Model ◽  
Current Knowledge ◽  
Healthcare Services ◽  
Public Healthcare ◽  
Special Issue ◽  
Public And Private ◽  
Hospital System ◽  
History Of ◽  
Hospital Systems ◽  
The Rich

This special issue aims to contribute to current knowledge held on mixed hospital systems from a historical perspective, as there is nowadays much debate on the sustainability and efficiency of public and private healthcare systems in the world in the COVID-19 pandemic. By focusing on the evolution of mixed hospital systems through the case study of the history of such systems in Catalonia in the last century, the authors of this special issue show that mixed hospital systems take a long period of time to be used, and trusted, by the population. It is also considered how public healthcare regulators can create a diversity of mechanisms that facilitate access by the population to healthcare services in times of external shocks such as pandemics. This introductory text begins with a section about the international context which explains the relevance of mixed hospital systems, which is followed by a summary of the main historical points regarding the Catalan model of mixed hospital provision since the 19th century. It also highlights the most significant contributions of the seven articles of this special issue, which consider how the Catalan society confronted social, economic, and political changes and how those actions led to configure a distinctive mixed model of hospital system. Finally, this text also sheds light on areas of research regarding the rich history of hospital healthcare that still need to be addressed.

scholarly journals Long-term effectiveness of elderly health care voucher scheme strategies: a system dynamics simulation analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ka Chun Chong ◽  
Hong Fung ◽  
Carrie Ho Kwan Yam ◽  
Patsy Yuen Kwan Chau ◽  
Tsz Yu Chow ◽  
...  
Keyword(s):  
Primary Care ◽  
Chronic Disease ◽  
Public Sector ◽  
System Dynamics ◽  
The Elderly ◽  
Healthcare Services ◽  
Dynamics Simulation ◽  
Public And Private ◽  
The Public ◽  
The Impact

Abstract Background The elderly healthcare voucher (EHCV) scheme is expected to lead to an increase in the number of elderly people selecting private primary healthcare services and reduce reliance on the public sector in Hong Kong. However, studies thus far have reported that this scheme has not received satisfactory responses. In this study, we examined changes in the ratio of visits between public and private doctors in primary care (to measure reliance on the public sector) for different strategic scenarios in the EHCV scheme. Methods Based on comments from an expert panel, a system dynamics model was formulated to simulate the impact of various enhanced strategies in the scheme: increasing voucher amounts, lowering the age eligibility, and designating vouchers for chronic conditions follow-up. Data and statistics for the model calibration were collected from various sources. Results The simulation results show that the current EHCV scheme is unable to reduce the utilization of public healthcare services, as well as the ratio of visits between public and private primary care among the local aging population. When comparing three different tested scenarios, even if the increase in the annual voucher amount could be maintained at the current pace or the age eligibility can be lowered to include those aged 60 years, the impact on shifts from public-to-private utilization were insignificant. The public-to-private ratio could only be marginally reduced from 0.74 to 0.64 in the first several years. Nevertheless, introducing a chronic disease-oriented voucher could result in a significant drop of 0.50 in the public-to-private ratio during the early implementation phase. However, the effect could not be maintained for an extended period. Conclusions Our findings will assist officials in improving the design of the EHCV scheme, within the wider context of promoting primary care among the elderly. We suggest that an additional chronic disease-oriented voucher can serve as an alternative strategy. The scheme must be redesigned to address more specific objectives or provide a separate voucher that promotes under-utilized healthcare services (e.g., preventive care), instead of services designed for unspecified reasons, which may lead to concerns regarding exploitation.

scholarly journals As predicted by theory: choice and competition in a publicly funded and regulated regional health system yield improved access and cost control

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jonas Wohlin ◽  
Clara Fischer ◽  
Karin Solberg Carlsson ◽  
Sara Korlén ◽  
Pamela Mazzocato ◽  
...  
Keyword(s):  
Cost Control ◽  
Care Quality ◽  
Patient Choice ◽  
Public Healthcare ◽  
Successful Implementation ◽  
Publicly Funded ◽  
Public And Private ◽  
Bundled Payment ◽  
Private Providers ◽  
Number Of Patients

Abstract Background New Public Management (NPM) has been widely used to introduce competition into public healthcare. Results have been mixed, and there has been much controversy about the appropriateness of a private sector-mimicking governance model in a public service. One voice in the debate suggested that rather than discussing whether competition is “good” or “bad” the emphasis should be on exploring the conditions for a successful implementation. Methods We report a longitudinal case study of the introduction of patient choice and allowing private providers to enter a publicly funded market. Patients in need of hip or knee replacement surgery are allowed to choose provider, and those are paid a fixed reimbursement for the full care episode (bundled payment). Providers are financially accountable for complications. Data on number of patients, waiting lists and times, costs to the public purchaser, and complications were collected from public registries. Providers were interviewed at three points in time during a nine-year follow-up period. Time-series of the quantitative data were exhibited and the views of actors involved were explored in a thematic analysis of the interviews. Results The policy goals of improving access to care and care quality while controlling total costs were achieved in a sustained way. Six themes were identified among actors interviewed and those were consistent over time. The design of the patient choice model was accepted, although all providers were discontent with the level of reimbursement. Providers felt that quality, timeliness of service and staff satisfaction had improved. Public and private providers differed in terms of patient-mix and developed different strategies to adjust to the reimbursement system. Private providers were more active in marketing and improving operation room efficiency. All providers intensified cooperation with referring physicians. Close attention was paid to following the rules set by the purchaser. Discussion and conclusions The sustained cost control was an effect of bundled payment. What this study shows is that both public and private providers adhere long-term to regulations by a public purchaser that also controls entrance to the market. The compensation was fixed and led to competition on quality, as predicted by theory.

scholarly journals Public and private sectors collective response to combat COVID-19 in Malaysia

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Ching Siang Tan ◽  
Saim Lokman ◽  
Yao Rao ◽  
Szu Hua Kok ◽  
Long Chiau Ming
Keyword(s):  
Insurance Coverage ◽  
Healthcare Providers ◽  
Screening Tests ◽  
Public Healthcare ◽  
Private Hospitals ◽  
Public And Private ◽  
The Public ◽  
Private Healthcare ◽  
Care Services ◽  
Challenges And Opportunities

AbstractOver the last year, the dangerous severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread rapidly around the world. Malaysia has not been excluded from this COVID-19 pandemic. The resurgence of COVID-19 cases has overwhelmed the public healthcare system and overloaded the healthcare resources. Ministry of Health (MOH) Malaysia has adopted an Emergency Ordinance (EO) to instruct private hospitals to receive both COVID-19 and non-COVID-19 patients to reduce the strain on public facilities. The treatment of COVID-19 patients at private hospitals could help to boost the bed and critical care occupancy. However, with the absence of insurance coverage because COVID-19 is categorised as pandemic-related diseases, there are some challenges and opportunities posed by the treatment fees management. Another major issue in the collaboration between public and private hospitals is the willingness of private medical consultants to participate in the management of COVID-19 patients, because medical consultants in private hospitals in Malaysia are not hospital employees, but what are termed “private contractors” who provide patient care services to the hospitals. Other collaborative measures with private healthcare providers, e.g. tele-conferencing by private medical clinics to monitor COVID-19 patients and the rollout of national vaccination programme. The public and private healthcare partnership must be enhanced, and continue to find effective ways to collaborate further to combat the pandemic. The MOH, private healthcare sectors and insurance providers need to have a synergistic COVID-19 treatment plans to ensure public as well as insurance policy holders have equal opportunities for COVID-19 screening tests, vaccinations and treatment.

scholarly journals Surgical care in the public health agenda

2017 ◽  
Vol 33 (10) ◽  
Author(s):  
Mário Scheffer ◽  
Saurabh Saluja ◽  
Nivaldo Alonso
Keyword(s):  
Public Health ◽  
Universal Access ◽  
Surgical Care ◽  
Public Health Issue ◽  
Public And Private ◽  
The Public ◽  
Timely Fashion ◽  
Current Article ◽  
Clinical Conditions ◽  
Global Indicators

The current article examines surgical care as a public health issue and a challenge for health systems organization. When surgery fails to take place in timely fashion, treatable clinical conditions can evolve to disability and death. The Lancet Commission on Global Surgery defined indicators for monitoring sustainable universal access to surgical care. Applied to Brazil, the global indicators are satisfactory, but the supply of surgeries in the country is marked by regional and socioeconomic inequalities, as well as between the public and private healthcare sectors.

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