scholarly journals Assessing a national policy on strengthening chronic care in primary care settings of a middle-income country using patients’ perspectives.

2020 ◽  
Author(s):  
Wichai Aekplakorn ◽  
Paibul Suriyawongpaisal ◽  
Samrit Srithamrongsaw ◽  
Phanuwich kaewkamjonchai
Keyword(s):  
Primary Care ◽  
Structural Equation ◽  
Health Care Services ◽  
Chronic Care ◽  
Care Quality ◽  
Equation Modeling ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Mixed Effect ◽  
Validated Questionnaire

Abstract Background To improve care for patients with chronic diseases, a recent policy initiative in Thailand focuses on strengthening primary care including training of the team to deliver healthcare based on the concept of Chronic Care Model (CCM). This study aimed to assess the perception of patients on the health care services after the implementation. Methods We conducted a cross-sectional survey of 4,071 patients with hypertension and/or diabetes registered to 27 primary care units and 11 hospital Non-communicable diseases (NCDs) clinics in 11 provinces.The patients were interviewed at home using a validated questionnaire of the Patient Assessment of Chronic Illness Care (PACIC+). It contains 20 items from the original PACIC, which measure different parts of the CCM, and an additional 6 items assess the 5A Model including assess, advise, agree, assist, and arrange subscales. Upgraded primary care unit (PCUs) were ordinary PCUs with the multi-professional team including a physician. Trained upgraded PCUs were upgraded PCUs with the training input. Structural equation modeling was used to create subscale scores for CCM and 5 A model characteristics. Mixed effect models were employed to compare subscale of patient perception of the care quality between trained upgraded PCUs, upgraded PCUs, ordinary PCUs and NCD clinics.Results There was an independent association between every PACIC subscale (as a measure of CCM) and facility type with the maximum likelihood for patients of ordinary PCU reporting high to highest scores (ORs: 1.46-1.85; p<0.05) compared to hospital NCD clinics. This is also the case for patients: seeing the same doctor on repeated visits (ORs: 1.82-2.17; p<0.05) or having phone contacts of the providers (ORs:1.53-1.99; p<0.05). Similarly, across all of the 5A model subscales, ORs for patients attending ordinary PCU responded with high to highest scores were 1.48-2.10 times compared to those for patients attending hospital NCD clinics (p<0.05). Conclusions The training and allocation of family physician approach in PCU may not satisfy the patients’ perception on quality of chronic care. Further studies might focus on other factors such as mismatch between health workforce and workload as a key factor influencing the success of the policy implementation.

scholarly journals Assessing a national policy on strengthening chronic care in primary care settings of a middle-income country using patients’ perspectives.

2021 ◽  
Author(s):  
Wichai Aekplakorn ◽  
Paibul Suriyawongpaisal ◽  
Samrit Srithamrongsaw ◽  
Phanuwich kaewkamjonchai
Keyword(s):  
Primary Care ◽  
Structural Equation ◽  
Chronic Care ◽  
Care Quality ◽  
Equation Modeling ◽  
Patient Assessment ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Mixed Effect ◽  
Validated Questionnaire

Abstract Background To improve care for patients with chronic diseases, a recent policy initiative in Thailand focused on strengthening primary care based on the concept of Chronic Care Model (CCM). This study aimed to assess the perception of patients about the health care services after the implementation. Methods We conducted a cross-sectional survey of 4,071 patients with hypertension and/or diabetes registered with 27 primary care units and 11 hospital non-communicable diseases (NCDs) clinics in 11 provinces.The patients were interviewed using a validated questionnaire of the Patient Assessment of Chronic Illness Care. Upgraded primary care units (PCUs) were ordinary PCUs with the multi-professional team including a physician. Trained upgraded PCUs were upgraded PCUs with the training input. Structural equation modeling was used to create subscale scores for CCM and 5 A model characteristics. Mixed effect logistic models were employed to examine the association of subscales (high vs low score) of patient perception of the care quality with type of PCUs.Results Compared to hospital NCD clinics, ordinary PCUs were the best in the odds of receiving high score for every CCM subscale (ORs: 1.46-1.85; p<0.05), whereas the trained upgraded PCUs were better in terms of follow-up (ORs:1.37; p <0.05), and the upgraded PCU did not differ in all domains. According to the 5 A model subscales, patient assessment also revealed better performance of ordinary PCUs in all domains compared to hospital NCD clinics whereas upgraded PCUs and trained upgraded PCUs did so in some domains. Seeing the same doctor on repeated visits (ORs: 1.82-2.17; p<0.05) or having phone contacts with the providers (ORs:1.53-1.99; p<0.05) were found beneficial using CCM subscales and the 5A model subscales. However, patient assessment by both subscales did not demonstrate a statistically significant association across health insurance status.Conclusions The policy implementation might not satisfy the patients’ perception on quality of chronic care according to the CCM and the 5A model subscale. However, the arrangement of chronic care with patients seeing the same doctors or patients having telephone contact with healthcare providers may satisfy the patients’ perceived needs.

scholarly journals Assessing a national policy on strengthening chronic care in primary care settings of a middle-income country using patients’ perspectives

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Wichai Aekplakorn ◽  
Paibul Suriyawongpaisal ◽  
Samrit Srithamrongsawadi ◽  
Phanuwich Kaewkamjonchai
Keyword(s):  
Primary Care ◽  
Structural Equation ◽  
Chronic Care ◽  
Care Quality ◽  
Equation Modeling ◽  
Patient Assessment ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Mixed Effect ◽  
Validated Questionnaire

Abstract Background To improve care for patients with chronic diseases, a recent policy initiative in Thailand focused on strengthening primary care based on the concept of Chronic Care Model (CCM). This study aimed to assess the perception of patients about the health care services after the implementation. Methods We conducted a cross-sectional survey of 4071 patients with hypertension and/or diabetes registered with 27 primary care units and 11 hospital non-communicable diseases (NCDs) clinics in 11 provinces. The patients were interviewed using a validated questionnaire of the Patient Assessment of Chronic Illness Care. Upgraded primary care units (PCUs) were ordinary PCUs with the multi-professional team including a physician. Trained upgraded PCUs were upgraded PCUs with the training input. Structural equation modeling was used to create subscale scores for CCM and 5 A model characteristics. Mixed effect logistic models were employed to examine the association of subscales (high vs low score) of patient perception of the care quality with type of PCUs. Results Compared to hospital NCD clinics, ordinary PCUs were the best in the odds of receiving high score for every CCM subscale (ORs: 1.46–1.85; p < 0.05), whereas the trained upgraded PCUs were better in terms of follow-up (ORs:1.37; p < 0.05), and the upgraded PCU did not differ in all domains. According to the 5 A model subscales, patient assessment also revealed better performance of ordinary PCUs in all domains compared to hospital NCD clinics whereas upgraded PCUs and trained upgraded PCUs did so in some domains. Seeing the same doctor on repeated visits (ORs: 1.82–2.17; p < 0.05) or having phone contacts with the providers (ORs:1.53–1.99; p < 0.05) were found beneficial using CCM subscales and the 5A model subscales. However, patient assessment by both subscales did not demonstrate a statistically significant association across health insurance status. Conclusions The policy implementation might not satisfy the patients’ perception on quality of chronic care according to the CCM and the 5A model subscale. However, the arrangement of chronic care with patients seeing the same doctors or patients having telephone contact with healthcare providers may satisfy the patients’ perceived needs.

scholarly journals Assessing a national policy on strengthening chronic care in primary care settings of a low-resource country using patients' perspectives.

2020 ◽  
Author(s):  
Paibul Suriyawongpaisal ◽  
Wichai Aekplakorn ◽  
Samrit Srithamrongsaw ◽  
Phanuwich Kaewkamjonchai
Keyword(s):  
Primary Care ◽  
Chronic Care ◽  
Care Quality ◽  
Local Health ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Mixed Effect ◽  
Multiprofessional Team ◽  
Primary Care Settings ◽  
Healthcare Needs

Abstract Background To improve care for patients with chronic diseases, a recent policy initiative in Thailand focuses on strengthening primary care including training of the team to deliver healthcare based on the concept of Chronic Care Model(CCM). This study conducted a cross-sectional survey of 4,071 patients with hypertension and/or diabetes registered to 25 primary care units and 16 hospital NCD clinics in 11 provinces (76 in total) to examine the effects of provider training and local health systems settings on patients’ perception of the chronic care quality.Methods A home-based interview with questionnaire was conducted on the patients in primary care settings. The questionnaire was adopted from the Thai version of the Patient Assessment of Chronic Illness Care (PACIC+) developed by the MacColl Institute for Healthcare Innovation. The questionnaire contains 20 items from the original PACIC, which measure different parts of the CCM, and an additional 6 items assess the 5A Model.Mixed effect models were employed to compare subscale of patient perception of the care quality between trained upgraded PCUs, upgraded PCUs, ordinary PCUs and NCD clinics. Upgraded PCUs were ordinary PCUs with the multiprofessional team including a physician. Trained upgraded PCUs were upgraded PCUs with the training input.Results Mixed effect models depicted an independent association between every PACIC subscale (as a measure of CCM) and facility type with the maximum likelihood for patients of ordinary PCU reporting high to highest scores (ORs: 1.52-1.76; p<0.05) compared to hospital NCD clinics. This is also the case for patients: seeing the same doctor on repeated visits (ORs: 1.66-1.87; p<0.05) or having phone contacts of the providers (ORs:1.42-1.63; p<0.05). Similarly, across all of the 5A model subscales, ORs for patients attending ordinary PCU responded with high to highest scores were 1.4-2.0 times compared to those for patients attending hospital NCD clinics(p<0.05). Conclusions We could not find evidence to support effectiveness of the training approach. The training failure might indicate a need to address mismatch between health workforce and workload. It also indicates a need to incorporate fidelity check into any training program for chronic care addressing the complex healthcare needs.

scholarly journals Stress and Its Impact on Academic and Social Life of Undergraduate University Students in Ghana: A Structural Equation Modeling Approach

2020 ◽  
Vol 2 (1) ◽  
pp. 37-44
Author(s):  
Koawo Edjah ◽  
Francis Ankomah ◽  
Ebenezer Domey ◽  
John Ekow Laryea
Keyword(s):  
Structural Equation Modeling ◽  
Undergraduate Students ◽  
Social Life ◽  
Structural Equation ◽  
Positive Impact ◽  
Survey Design ◽  
Equation Modeling ◽  
Cross Sectional Survey ◽  
Satisfaction Scale ◽  
Cross Sectional

AbstractStress is concomitant with students’ life and can have a significant impact on their lives, and even how they go about their academic work. Globally, in every five visits by patients to the doctor, three are stress-related problems. This study examined stress and its impact on the academic and social life among students of a university in Ghana. The descriptive cross-sectional survey design was employed. Using the stratified and simple random (random numbers) sampling methods, 500 regular undergraduate students were engaged in the study. A questionnaire made up of Perceived Stress Scale and Students’ Life Satisfaction Scale was used to gather data for the study. Frequencies, percentages, means and standard deviation, and Structural Equation Modeling (SEM), with AMOS were used for the analyses. It was found that majority of the students were moderately stressed. Paramount among the stressors were academic stressors, followed by institutional stressors, and external stressors. Stress had a significant positive impact on the academic and social life of students. It was concluded that undergraduate students, in one way or the other, go through some kind of stress during the course of their study. It was recommended that the university, through its Students’ Affairs, and Counselling Sections, continue to empower students on how to manage and deal with stress in order to enhance their academic life.

scholarly journals Efeito da gamificação na intenção de uso de treinamentos on-line: uma adaptação do modelo UTAUT aplicado no TRT-2

2019 ◽  
Vol 12 (3) ◽  
pp. 472
Author(s):  
Ludmilla Cavarzere de Oliveira ◽  
Luis Hernan Contreras Pinochet ◽  
Ricardo Luiz Pereira Bueno ◽  
Mauri Aparecido de Oliveira
Keyword(s):  
Structural Equation ◽  
Statistical Significance ◽  
Learning By Doing ◽  
Equation Modeling ◽  
Intention To Use ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Regional Labor ◽  
On Line ◽  
Facilitating Conditions

The objective of this research was to analyze the effect of gamification on intention to use online training from the partial validation of the UTAUT model for qualification of members and servers of the Regional Labor Court of the 2nd Region (TRT-2). The study analyzed the relationship between constructs performance expectancy, effort expectancy, facilitating conditions, and familiarity with the intention to use gaming in distance media.  This was conducted through an empirical application, which used the Structural Equation Modeling (SEM) for data analysis. The research was a single cross-sectional survey, carried out with TRT-2 members and servers who participated in the distance-feeding course ‘Healthy Living’ in 2015. Of the four hypotheses, only familiarity (F) was not significant as it did not serve as a behavioral intentions (BI) predictor of gamification for distance learning courses. Some explanations for such phenomenon may be career promotion and additional qualifications, learning by doing and sample size. The results confirmed that most hypotheses have a high statistical significance of the structural paths and have demonstrated that the model proposed in this study is consistent and can be applied in future studies with appropriate adjustments.

The Moderating Effect of Job Satisfaction on Physicians’ Motivation to Adhere to Financially Incentivized Clinical Practice Guidelines

2016 ◽  
Vol 74 (2) ◽  
pp. 148-177 ◽  
Author(s):  
Anthony C. Waddimba ◽  
Howard B. Beckman ◽  
Thomas L. Mahoney ◽  
James F. Burgess
Keyword(s):  
Structural Equation ◽  
Census Data ◽  
Pay For Performance ◽  
Population Characteristics ◽  
Equation Modeling ◽  
Moderating Effects ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Adherence To Guidelines ◽  
Primary Physicians

We examined moderating effects of professional satisfaction on physicians’ motivation to adhere to diabetes guidelines associated with pay-for-performance incentives. We merged cross-sectional survey data on attitudes, from 156 primary physicians, with prospective medical record-sourced data on guideline adherence and census data on ambulatory-care population characteristics. We examined moderating effects by testing theory-driven models for satisfied versus discontented physicians, using partial least squares structural equation modeling. Results show that attitudes motivated, while norms suppressed, adherence to guidelines among discontented physicians. Separate models for satisfied versus discontented physicians revealed motivational differences. Satisfied physicians disregarded intrinsic and extrinsic influences and biases. Discontented physicians, alienated by social pressure, favored personal inclinations. To improve adherence to guidelines among discontented physicians, incentives should align with personal attitudes and incorporate promotional campaigns countering resentment of peer and organizational pressure.

Dynamic capabilities: interrelations and distinct effects on performance in low and high competitive intensity environments

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Amiram Markovich ◽  
Kalanit Efrat ◽  
Daphne R. Raban
Keyword(s):  
Firm Performance ◽  
Structural Equation ◽  
Dynamic Capabilities ◽  
Equation Modeling ◽  
Company Performance ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Competitive Intensity ◽  
Content Type ◽  
Impact Performance

PurposeThis study aims to augment the understanding of dynamic capabilities (DCs) by exploring the interrelations among the DC categories (sensing, seizing, reconfiguring) and the distinct impact of each DC on firm performance under low and high levels of competitive intensity.Design/methodology/approachThe analysis is based on a cross-sectional survey of 139 managers in Israel. The data were collected through Web-based questionnaires using the Qualtrics software. A two-stage data analysis was performed using structural equation modeling (SEM).FindingsThe findings indicate that DCs follow a sequence in which sensing drives seizing, which, in turn, enhances reconfiguring. The effects of sensing are mainly manifested through its direct impact on seizing, with no evidence for an impact of sensing on company performance. Moreover, under low competitive intensity, only seizing appears to impact performance, while under high competitive intensity, reconfiguring joins seizing in improving firm performance.Originality/valueThe study's findings advance the debate on the direct vs sequential nature of DCs by indicating an internal DC sequence. Our research also advocates for a crucial role of sensing in enhancing DCs, regardless of the level of competitive intensity. Furthermore, this research expands the understanding of the consequences of DCs and enables the prioritization of DC categories under low and high competitive intensity.

Can forensic accounting impact sustainable corporate governance?

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Ali Rehman ◽  
Fathyah Hashim
Keyword(s):  
Corporate Governance ◽  
Structural Equation ◽  
Survey Design ◽  
Equation Modeling ◽  
Governance System ◽  
Cross Sectional Survey ◽  
Design Data ◽  
Cross Sectional ◽  
Content Type ◽  
Organizational Policies

Purpose The purpose of this paper is the measurement of forensic accounting’s (FA) impact on sustainable corporate governance (SCG) within Omani public listed companies. Beyond merely cataloging the latest criminal innovations and SCG problems, this paper offers a path forward to overcome the myriad threats that can harm the organization and society. FA and SCG can achieve, anticipate and prevent tomorrow’s fraud today before organizations reach the point of no return. Design/methodology/approach For this study, FA is an independent variable and SCG is the dependent variable. This study used a descriptive cross-sectional survey design. Data are collected by internet-based tool and analyzed via partial least squares structural equation modeling and Statistical Package for Social Sciences. Findings Result suggests that FA has a significant direct impact over SCG; moreover, FA can become the part of governance management toward the elimination of fraud and achievement of SCG. Practical implications This study can assist regulators, professional bodies and organizations in amending their codes of corporate governance and organizational policies by introducing the SCG clauses and making FA as a compulsory part of governance system. Originality/value Up to the best of the knowledge of researchers, there is no study conducted before which verifies the FA impact on SCG; moreover, previous relevant studies verify only one constituent for SCG, whereas this study is identifying three constituents necessary for SCG.

scholarly journals Workaholism, Work Engagement and Child Well-Being: A Test of the Spillover-Crossover Model

2020 ◽  
Vol 17 (17) ◽  
pp. 6213 ◽  
Author(s):  
Akihito Shimazu ◽  
Arnold B. Bakker ◽  
Evangelia Demerouti ◽  
Takeo Fujiwara ◽  
Noboru Iwata ◽  
...  
Keyword(s):  
Work Engagement ◽  
Behavioral Problems ◽  
Family Conflict ◽  
Structural Equation ◽  
Well Being ◽  
Work Attitudes ◽  
Emotional And Behavioral Problems ◽  
Equation Modeling ◽  
Cross Sectional Survey ◽  
Cross Sectional

This study examines how working parents’ work attitudes (i.e., workaholism and work engagement) are associated with their child’s psychological well-being. Based on the Spillover-Crossover model (SCM), we hypothesize that (a) work-to-family spillover (i.e., work-to-family conflict and facilitation) and (b) employee happiness will sequentially mediate the relationship between parents’ work attitudes and their child’s emotional and behavioral problems. A cross-sectional survey was conducted among Japanese dual-earner couples with pre-school child(ren). On the basis of valid data from 208 families, the hypothesized model was tested using structural equation modeling. For both fathers and mothers simultaneously, workaholism was positively related to work-to-family conflict, which, in turn, was negatively related to happiness. In contrast, work engagement was positively related to work-to-family facilitation, which, in turn, was positively related to happiness. Fathers’ and mothers’ happiness, in turn, were negatively related to their child’s emotional and behavioral problems. Results suggest that parents’ workaholism and work engagement are related to their child’s emotional and behavioral problems in opposite ways, whereby parents’ spillover and happiness mediate this relationship. These findings support the SCM and suggest that decreasing workaholism and improving work engagement may not only improve employees’ happiness, but also decrease their child’s emotional and behavioral problems.

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