scholarly journals Effect of health promotion programs and home visits on chronic diseases

2021 ◽  
Vol 8 (12) ◽  
pp. 6170
Author(s):  
Shada Omar Baoum ◽  
Salman Ali Binladin ◽  
Mohammed Fahad Althobaiti ◽  
Mohammed Mousa Almousa ◽  
Taghreed Mahdi Awaji ◽  
...  
Keyword(s):  
Health Promotion ◽  
Quality Of Care ◽  
Hospital Admissions ◽  
Healthcare Providers ◽  
Home Visits ◽  
Current Evidence ◽  
Healthcare Resources ◽  
Health Promotion Programs ◽  
Chronic Disorders

Evidence shows that the management of chronic disorders is associated with massive expenditure and increased utilization of healthcare resources. Therefore, innovative management approaches to these conditions are encouraged to overcome these burdens and enhance the quality of care for the affected patients. Home visits and health promotion programs have been described in this context with favorable outcomes over individuals and communities. We have discussed the efficacy of home visits and health promotion programs on the outcomes of patients suffering from chronic disorders. Our findings indicated the validity of these approaches in enhancing the quality of care for patients with chronic conditions. Adequately applying these outcomes can be associated with enhanced quality of life for patients. Besides, estimates also showed that they can reduce the number of visits to the emergency department and the frequency of hospital admissions. Health promotion programs can also reduce the utilization of the different healthcare resources including medication use and the availability of healthcare providers. However, the current evidence lacks validation by proper investigations. Accordingly, we encourage further studies to be conducted to enhance the current findings adequately.

scholarly journals Satisfaction With Health Care by Dual Sensory Impairment Status

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 798-798
Author(s):  
Lama Assi ◽  
Ahmed Shakarchi ◽  
Bonnielin Swenor ◽  
Nicholas Reed
Keyword(s):  
Quality Of Care ◽  
Healthcare Providers ◽  
Health Determinants ◽  
Sensory Impairment ◽  
Medicare Beneficiaries ◽  
The Past ◽  
Patient Provider Communication ◽  
Care Satisfaction ◽  
Dual Sensory Impairment

Abstract Sensory impairment is a barrier to patient-provider communication and access to care, which may impact satisfaction with care. Satisfaction with the quality of care received in the past year was assessed in the 2017 Medicare Current Beneficiary Survey (weighted sample=53,905,182 Medicare beneficiaries). Self-reported sensory impairment was categorized as no sensory impairment, hearing impairment (HI)-only, vision impairment (VI)-only, and dual sensory impairment (DSI) – concurrent HI and VI. In a model adjusted for sociodemographic characteristics and health determinants, having DSI was associated with higher odds of dissatisfaction with the quality of care received (Odds Ratio [OR]=1.53, 95%Confidence Interval [CI]=1.14-2.06) relative to no sensory impairment; however, having HI-only or VI-only were not (OR=1.33, 95%CI=1.94-1.89, and OR=1.32, 95%CI=0.95-1.93, respectively). These findings have implications for healthcare providers as Medicare shifts to value-based reimbursement. Moreover, previous work that singularly focused on HI or VI alone may have failed to recognize the compounded effect of DSI.

scholarly journals Quality of care in the free maternal healthcare era in sub-Saharan Africa: a scoping review of providers’ and managers’ perceptions

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Monica Ansu-Mensah ◽  
Frederick Inkum Danquah ◽  
Vitalis Bawontuo ◽  
Peter Ansu-Mensah ◽  
Tahiru Mohammed ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Research Question ◽  
Healthcare Providers ◽  
Poor Quality ◽  
Sub Saharan Africa ◽  
Healthcare Financing ◽  
Maternal Healthcare ◽  
Sub Saharan ◽  
The Impact

Abstract Background Free maternal healthcare financing schemes play an essential role in the quality of services rendered to clients during antenatal care in sub-Saharan Africa (SSA). However, healthcare managers’ and providers’ perceptions of the healthcare financing scheme may influence the quality of care. This scoping review mapped evidence on managers’ and providers’ perspectives of free maternal healthcare and the quality of care in SSA. Methods We used Askey and O’Malley’s framework as a guide to conduct this review. To address the research question, we searched PubMed, CINAHL through EBSCOhost, ScienceDirect, Web of Science, and Google Scholar with no date limitation to May 2019 using keywords, Boolean terms, and Medical Subject Heading terms to retrieve relevant articles. Both abstract and full articles screening were conducted independently by two reviewers using the inclusion and exclusion criteria as a guide. All significant data were extracted, organized into themes, and a summary of the findings reported narratively. Results In all, 15 out of 390 articles met the inclusion criteria. These 15 studies were conducted in nine countries. That is, Ghana (4), Kenya (3), and Nigeria (2), Burkina Faso (1), Burundi (1), Niger (1), Sierra Leone (1), Tanzania (1), and Uganda (1). Of the 15 included studies, 14 reported poor quality of maternal healthcare from managers’ and providers’ perspectives. Factors contributing to the perception of poor maternal healthcare included: late reimbursement of funds, heavy workload of providers, lack of essential drugs and stock-out of medical supplies, lack of policy definition, out-of-pocket payment, and inequitable distribution of staff. Conclusion This study established evidence of existing literature on the quality of care based on healthcare providers’ and managers’ perspectives though very limited. This study indicates healthcare providers and managers perceive the quality of maternal healthcare under the free financing policy as poor. Nonetheless, the free maternal care policy is very much needed towards achieving universal health, and all efforts to sustain and improve the quality of care under it must be encouraged. Therefore, more research is needed to better understand the impact of their perceived poor quality of care on maternal health outcomes.

scholarly journals Quality of Care in Long-Term Hemodialysis Patients in Mexico

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Torres-Díaz JA ◽  
◽  
Gonzalez-Gonzalez JG ◽  
Zúniga-Hernández JA ◽  
Olivo-Gutiérrez MC ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Quality Of Care ◽  
Linear Regression ◽  
Regression Model ◽  
Linear Regression Model ◽  
World Literature ◽  
Logistic Regression Model ◽  
Hospital Admissions ◽  
Cross Sectional

Introduction: The End Stage Renal Disease (ESRD) is one of the leading causes of mortality in Mexico. The quality of care these patients receive remains uncertain. Methods: This is a descriptive, single-center and cross-sectional cohort study. The KDOQI performance measures, hemoglobin level >11 g/dL, blood pressure <140/90 mmHg, serum albumin >4 g/dL and use of arteriovenous fistula of patients with ESRD on hemodialysis were analyzed in a period of a year. The association between mortality and the KDOQI objectives was evaluated with a logistic regression model. A linear regression model was also performed with the number of readmissions. Results: A total of 124 participants were included. Participants were categorized by the number of measures completed. Fourteen (11.3%) of the participants did not meet any of the goals, 51 (41.1%) met one, 43 (34.7%) met two, 11 (8.9%) met three, and 5 (4%) met the four clinical goals analyzed. A mortality of 11.2% was registered. In the logistic regression model, the number of goals met had an OR for mortality of 1.1 (95% CI 0.5-2.8). In the linear regression model, for the number of readmissions, a beta correlation with the number of KDOQI goals met was 0.246 (95% CI -0.872-1.365). Conclusion: The attainment of clinical goals and the mortality rate in our center is similar to that reported in the world literature. Our study did not find a significant association between compliance with clinical guidelines and mortality or the number of hospital admissions in CKD patients on hemodialysis.

Haste or Waste? Peer Pressure and Productivity in the Emergency Department

2020 ◽  
Author(s):  
David Silver
Keyword(s):  
Quality Of Care ◽  
Peer Group ◽  
Healthcare Providers ◽  
Peer Groups ◽  
Peer Pressure ◽  
Cross Sectional ◽  
Discharge Data ◽  
Intensity Of Care ◽  
Group Environments

Abstract Motivated by wide cross-sectional variations in intensity of care that are unrelated to quality of care, researchers and policymakers commonly claim that healthcare providers waste considerable resources, engaging in so-called “flat-of-the-curve” medicine. A key yet elusive prediction of this hypothesis is that providers ought to be able to cut back on care without sacrificing quality. This article examines the effects of a particular form of provider cutbacks—those generated by physicians working in high-pressure peer group environments. Using expansive, time-stamped discharge data from 137 hospital-based emergency departments, I document that physicians systematically alter their pace and intensity of care across frequently shuffled peer groups. Peer groups that induce a physician to work faster also induce her to order fewer tests and spend less money. Contrary to the flat-of-the-curve hypothesis, these cutbacks lead to large reductions in quality of care. This evidence, paired with the fact that slower physicians do not produce better average outcomes, suggests that cross-physician differences in resource utilization reflect substantial differences in physician productivity within a hospital.

Satisfaction among lung cancer (LCa) patients (pts) in multidisciplinary (MDC) vs. serial care (SC) settings.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e18254-e18254
Author(s):  
Kenneth Daniel Ward ◽  
Nana Boateng ◽  
Fedoria Elaine Rugless Stewart ◽  
Matthew Smeltzer ◽  
Bianca Jackson ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Healthcare Providers ◽  
Satisfaction With Care ◽  
Provider Communication ◽  
Linear Regression Models ◽  
Care Satisfaction ◽  
Treatment Onset ◽  
Consumer Assessment ◽  
Clinical Trial Information

e18254 Background: Coordinated MDC, in which all key specialists concurrently provide early input, develop and execute a consensus plan of care in collaboration with pts and their caregivers, may improve satisfaction with care. We rigorously evaluated this premise. Methods: Prospective clinical cohort study comparing newly-diagnosed LCa pts receiving MDC (n=156) or SC (n=307) in the same healthcare system. Pts were enrolled before treatment onset. At baseline (study entry) and 3 months later, pts and caregivers completed treatment-related measures from the Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey, including perceptions of quality of care, satisfaction with care, and extent of involvement in decision making. Satisfaction indices at 3 months will be compared in multiple linear regression models, adjusting for baseline scores and demographic and treatment-related characteristics. Results: Pt characteristics were similar, except for age and stage (Table). At baseline, MDC pts rated their care more positively than SC pts, but satisfaction with provider communication was similar. Three month data are currently being analyzed. Conclusions: MDC provided greater pt satisfaction in the diagnostic phase of LCa care. Further prospective analyses will test the hypothesis that MDC pts experience greater satisfaction with quality of care and provider communication compared to SC pts. Clinical trial information: NCT02123797. [Table: see text]

scholarly journals Perceived Consequences of Healthcare Service Decentralization on Access, Affordability and Quality of Care in Khartoum Locality, Sudan

2020 ◽  
Author(s):  
Bandar Noory ◽  
Sara Hassanein ◽  
Jeffrey Edwards ◽  
Benedikte Victoria Lindskog
Keyword(s):  
Quality Of Care ◽  
Healthcare Providers ◽  
Quality Of Healthcare ◽  
Healthcare Services ◽  
System Capacity ◽  
Cross Sectional ◽  
Study Results ◽  
Catchment Areas ◽  
The Impact

Abstract Background: Decentralization of healthcare services have been widely utilized, especially in developing countries, to improve the performance of healthcare systems by increasing the access and efficiency of service delivery. Experiences have been variable secondary to disparities in financial and human resources, system capacity and community engagement. Sudan is no exception and understanding the perceived effect of decentralization on access, affordability, and quality of care among stakeholders is crucial.Methods: This was a mixed method, cross-sectional, explorative study that involved 418 household members among catchment areas and 40 healthcare providers of Ibrahim Malik Hospital (IBMH) and Khartoum Teaching Hospital (KTH). Data were collected through a structured survey and in-depth interviews from July-December 2015.Results: Access, affordability and quality of healthcare services were all perceived as worse, compared to before decentralization was implemented. Reported affordability was found to be 53% and 55% before decentralization compared to 24% to 16% after decentralization, within KTH and IBMH catchment areas respectively, (p= 0.01). The quality of healthcare services were reported to have declined from 47% and 38% before decentralization to 38% and 28% after, in KTH and IBMH respectively (p=0.02). Accessibility was found to be more limited, with services being accessible before decentralization approximately 59% and 52% of the time, compared to 41% and 30% after, in KTH and IBMH catchment areas respectively, (p=0.01).Accessibility to healthcare was reported to have decreased secondary to facility closures, reverse transference of services, and low capacity of devolved facilities. Lastly, privatized services were reported as strengthened in response to this decentralization of healthcare. Conclusions: The deterioration of access, affordability and quality of health services was experienced as the predominant perception among stakeholders after decentralization implementation. Our study results suggest there is an urgent need for a review of the current healthcare policies, structure and management within Sudan in order to provide evidence and insights regarding the impact of decentralization.

scholarly journals Feasibility testing of a community dialogue approach for promoting the uptake of family planning and contraceptive services in Zambia

2020 ◽  
Author(s):  
Margarate Nzala Munakampe ◽  
Theresa Nkole ◽  
Adam Silumbwe ◽  
Joseph Mumba Zulu ◽  
Joanna Paula Cordero ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Family Planning ◽  
Healthcare Providers ◽  
Unmet Need ◽  
Community Members ◽  
Community Dialogue ◽  
Awareness Programs ◽  
Key Issues ◽  
Feasibility Testing

Abstract Background Community dialogues have been used in various participatory approaches in various health prevention and awareness programs, including family planning interventions to increase understanding and alignment of particular issues from different peoples’ perspectives. The feasibility testing comprised of the implementation of a community dialogue intervention which generated discussion on key issues that needed to be addressed to decrease the unmet need for family planning- in this instance improving Quality of Care; and an evaluation thereof. The aim of this paper is to document the evaluation of the feasibility testing of a community dialogue approach, as part of formative phase research, in order to increase community and health care provider dialogue about family planning and contraceptives. Methods The operational and cultural feasibility of the community dialogue was evaluated through participant observations during the dialogue, using a standardised feasibility testing tick-list, and through focus group discussions with three different groups of stakeholders who participated in the community dialogue. Results Overall, 21 of the 30 invited participants attended the meeting. The approach created dialogue on family planning and QoC as per the objectives of the feasibility testing. There was a dialogue about how the quality of care could be achieved in family planning from the divergent stakeholders, guided by the agreed-upon ground rules. A need for more time for discussion and representation from the adolescents and other stakeholders in family planning such as the nutritionist was noted. Some participants were not comfortable with the language used, while others felt the other participants had more knowledge about the topics discussed. Conclusion Generally, the community dialogue was well received by the community members and the healthcare providers, as was seen from the positives sentiment expressed by both categories. Some key considerations for refining the approach included soliciting maximum participation from otherwise marginalized groups like the youths would provide stronger representation.

scholarly journals Evaluating equity in healthcare: pilot implementation of a self-assessment tool

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
A Chiarenza ◽  
D Domenig ◽  
S Cattacin
Keyword(s):  
Quality Of Care ◽  
Assessment Tool ◽  
Healthcare Providers ◽  
The Self ◽  
Vulnerable Groups ◽  
Service Users ◽  
Cross Sectional Survey ◽  
Self Assessment ◽  
Cross Sectional

Abstract Background Several sets of standards aiming at improving access and quality of care for service users have been published in recent years. Certain standards focused on improving healthcare providers’ responsiveness to specific target groups. The general goal of this research was to improve organisations’ awareness of equity standards that are not focused on specific groups, but on all contributing factors that put vulnerable groups at risk of exclusion. The specific objective was to evaluate the degree of compliance with a set of equity standards in 52 health care organisations from 16 countries. Methods A self-assessment tool (SAT) was developed to allow healthcare organisations to measure their capacity to provide equitable care for service users. The SAT indicates the main areas that should be addressed: equity in policy; equitable access and utilisation; equitable quality of care; equity in participation; promoting equity. A cross-sectional survey addressing participants from pilot-organisations was used for data collection, concerning both the self-reported compliance score with the standards, as well as the additional information provided to support the score assigned. Data were analysed quantitatively as well as qualitatively. Results The findings confirm that healthcare providers do invest in improving equity in the access and delivery of services to vulnerable groups. However, many health organisations have inadequate strategies to address inequities and are insufficiently engaged in improving equity in participation and promoting equity outside the organisation. Conclusions The participating organisations reported a significant impact from use of the self-assessment tool: some received the support from regional/national authorities to continue working on improving equity in healthcare; others linked the equity standards to existing performance-measurement strategies; others invested in new frameworks to improve service users engagement. Key messages The implementation of the SAT contributes to a self-reflective process, involving health professionals and managers, in which gaps and potential improvements are identified. Pilot organisations utilised the SAT as part of a process of increasing their awareness of equity issues and changing their organisational culture.

A System for Program Evaluation in Community Health

1999 ◽  
Vol 5 (4) ◽  
pp. 74
Author(s):  
Deborah Gleeson ◽  
Vera Boston
Keyword(s):  
Health Promotion ◽  
Program Evaluation ◽  
Community Health ◽  
Planning Process ◽  
Systematic Evaluation ◽  
Health Staff ◽  
Program Evaluations ◽  
Direct Benefits ◽  
Health Promotion Programs

There are many benefits to be gained from the systematic evaluation of health promotion programs in community health centres. Program evaluation and documentation encourages organisational learning as well as directly improving the quality of programs. The documentation of program evaluations also enables review of the range of programs provided, which can inform the overall organisational planning process. Busy, over-stretched community health staff, however, often see program evaluation as an unnecessary luxury. Organisational evaluation requirements are often perceived as adding to the paperwork burden without having direct benefits for clients, staff or the organisation. North Yarra Community Health has developed a systematic process for evaluating all health promotion programs undertaken by staff. The process consists of evaluation guidelines and forms, which are part of a health promotion resource kit, a process for reporting and accountability through a Programs and Services Committee with representatives from the Board of Management, and a system for filing of program documentation. This paper describes the process, some of the barriers encountered, and how these barriers were overcome.

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