scholarly journals Health Service Needs From a Household Perspective: an Empirical Study in Rural Empty Nest Households in China

2021 ◽  
Author(s):  
Xueyan Cheng ◽  
Liang Zhang
Keyword(s):  
Health Service ◽  
Rural China ◽  
Family Doctor ◽  
Mental Healthcare ◽  
Service Needs ◽  
Empty Nest ◽  
Multi Stage ◽  
Medicine Service ◽  
Family Based ◽  
Relationship Of

Abstract Objective: Household is a fundamental unit in many fields. This study was to analyse consistency degree and people’s health service needs from the perspective of household.Methods: A multi-stage random sampling was conducted. A total of 7293 individuals in 2715 households were interviewed, and 1606 individuals in 803 empty-nest households were enrolled in this study. A questionnaire was used to ask each individual about their health service needs in empty nest households. The consistency degree was calculated based on their consistent answers to the questionnaire, and a correlation analyse was used to study the relationship of individuals’ health service needs in the same empty nest households. A family collective model was used to analyse household-based health service needs.Results: Individual’s needs consistency rates in empty nest households, such as diagnosis and treatment service(H1), follow-up service for chronic disease(H2), telemedicine care(H3), physical examination service(H4), health education service(H5), mental healthcare(H6), and Chinese traditional medicine service(H7) were 40.30%, 89.13%, 98.85%, 58.93%, 57.95%, 72.84%, and 63.40%, respectively. Service needs of H1, H3, H4, H5, H7 for individuals in the same empty nest households had significant correlations with each other (r=0.404, 0.177, 0.286, 0.265, 0.220, P<0.001). Health service needs from a perspective of household in rural China mainly included H1 (12.4%), H4 (44.2%), H5 (26.9%) and H7(18.9%). Conclusions: Individuals in the same household are highly consistent with each other in health service needs. Individuals could affect other members’ health service needs in their households, when one of them get illness, their spouse would likely to have same health service needs to avoid getting disease or to keep health. In this study, health service needs in empty nest households are mainly concerned with health promotion and maintenance services, which could be an indicator for primary care to improve the effectiveness of service delivery, such as family doctor and family-based health insurance system. Also, more focus should be paid on households that need great help on different health services.

scholarly journals Health Service Needs from a Household Perspective: An Empirical Study in Rural Empty Nest Families in Sinan and Dangyang, China

2022 ◽  
Vol 19 (2) ◽  
pp. 628
Author(s):  
Xueyan Cheng ◽  
Liang Zhang
Keyword(s):  
Primary Care ◽  
Health Education ◽  
Health Service ◽  
Physical Examination ◽  
Sampling Strategy ◽  
Service Needs ◽  
Management Service ◽  
Empty Nest ◽  
The Family ◽  
Family Level

This study aimed to explore the health service needs of empty nest families from a household perspective. A multistage random sampling strategy was conducted to select 1606 individuals in 803 empty nest households in this study. A questionnaire was used to ask each individual about their health service needs in each household. The consistency rate was calculated based on their consistent answers to the questionnaire. We used a collective household model to analyze individuals’ public health service needs on the family level. According to the results, individuals’ consistency rates of health service needs in empty nest households, such as diagnosis and treatment service (H1), chronic disease management service (H2), telemedicine care (H3), physical examination service (H4), health education service (H5), mental healthcare (H6), and traditional Chinese medicine service (H7) were 40.30%, 89.13%, 98.85%, 58.93%, 57.95%, 72.84%, and 63.40%, respectively. Therefore, family-level health service needs could be studied from a family level. Health service needs of H1, H3, H4, H5, and H7 for individuals in empty nest households have significant correlations with each other (r = 0.404, 0.177, 0.286, 0.265, 0.220, p < 0.001). This will be helpful for health management in primary care in rural China; the concordance will alleviate the pressure of primary care and increase the effectiveness of doctor–patient communication. Health service needs in empty nest households who took individuals’ public needs as household needs (n = 746) included the H4 (43.3%) and H5 (24.9%) and were always with a male householder (94.0%) or at least one had chronic diseases (82.4%). Health service needs in empty nest households that considered one member’s needs as household needs (n = 46) included the H1 (56.5%), H4 (65.2%), H5 (63.0%), and H7 (45.7%), and the member would be the householder of the family (90.5%) or had a disease within two weeks (100.0%). In conclusion, family members’ roles and health status play an important role in health service needs in empty nest households. Additionally, physical examination and health education services are the two health services that are most needed by empty nest households, and are suitable for delivering within a household unit.

scholarly journals Remote care for mental health: qualitative study with service users, carers and staff during the COVID-19 pandemic

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e049210
Author(s):  
Elisa Liberati ◽  
Natalie Richards ◽  
Jennie Parker ◽  
Janet Willars ◽  
David Scott ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Service ◽  
Health Services ◽  
Mental Healthcare ◽  
Well Being ◽  
Comparison Method ◽  
Service Users ◽  
Qualitative Interview Study ◽  
Remote Care

ObjectivesTo explore the experiences of service users, carers and staff seeking or providing secondary mental health services during the COVID-19 pandemic.DesignQualitative interview study, codesigned with mental health service users and carers.MethodsWe conducted semistructured, telephone or online interviews with a purposively constructed sample; a lived experience researcher conducted and analysed interviews with service users. Analysis was based on the constant comparison method.SettingNational Health Service (NHS) secondary mental health services in England between June and August 2020.ParticipantsOf 65 participants, 20 had either accessed or needed to access English secondary mental healthcare during the pandemic; 10 were carers of people with mental health difficulties; 35 were members of staff working in NHS secondary mental health services during the pandemic.ResultsExperiences of remote care were mixed. Some service users valued the convenience of remote methods in the context of maintaining contact with familiar clinicians. Most participants commented that a lack of non-verbal cues and the loss of a therapeutic ‘safe space’ challenged therapeutic relationship building, assessments and identification of deteriorating mental well-being. Some carers felt excluded from remote meetings and concerned that assessments were incomplete without their input. Like service users, remote methods posed challenges for clinicians who reported uncertainty about technical options and a lack of training. All groups expressed concern about intersectionality exacerbating inequalities and the exclusion of some service user groups if alternatives to remote care are lost.ConclusionsThough remote mental healthcare is likely to become increasingly widespread in secondary mental health services, our findings highlight the continued importance of a tailored, personal approach to decision making in this area. Further research should focus on which types of consultations best suit face-to-face interaction, and for whom and why, and which can be provided remotely and by which medium.

scholarly journals Identification of sixteen novel candidate genes for late onset Parkinson’s disease

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Alessandro Gialluisi ◽  
Mafalda Giovanna Reccia ◽  
Nicola Modugno ◽  
Teresa Nutile ◽  
Alessia Lombardi ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Candidate Genes ◽  
Rare Variants ◽  
Late Onset ◽  
High Specificity ◽  
Diagnostic Tools ◽  
Multi Stage ◽  
Whole Exome ◽  
Family Based

Abstract Background Parkinson’s disease (PD) is a neurodegenerative movement disorder affecting 1–5% of the general population for which neither effective cure nor early diagnostic tools are available that could tackle the pathology in the early phase. Here we report a multi-stage procedure to identify candidate genes likely involved in the etiopathogenesis of PD. Methods The study includes a discovery stage based on the analysis of whole exome data from 26 dominant late onset PD families, a validation analysis performed on 1542 independent PD patients and 706 controls from different cohorts and the assessment of polygenic variants load in the Italian cohort (394 unrelated patients and 203 controls). Results Family-based approach identified 28 disrupting variants in 26 candidate genes for PD including PARK2, PINK1, DJ-1(PARK7), LRRK2, HTRA2, FBXO7, EIF4G1, DNAJC6, DNAJC13, SNCAIP, AIMP2, CHMP1A, GIPC1, HMOX2, HSPA8, IMMT, KIF21B, KIF24, MAN2C1, RHOT2, SLC25A39, SPTBN1, TMEM175, TOMM22, TVP23A and ZSCAN21. Sixteen of them have not been associated to PD before, were expressed in mesencephalon and were involved in pathways potentially deregulated in PD. Mutation analysis in independent cohorts disclosed a significant excess of highly deleterious variants in cases (p = 0.0001), supporting their role in PD. Moreover, we demonstrated that the co-inheritance of multiple rare variants (≥ 2) in the 26 genes may predict PD occurrence in about 20% of patients, both familial and sporadic cases, with high specificity (> 93%; p = 4.4 × 10− 5). Moreover, our data highlight the fact that the genetic landmarks of late onset PD does not systematically differ between sporadic and familial forms, especially in the case of small nuclear families and underline the importance of rare variants in the genetics of sporadic PD. Furthermore, patients carrying multiple rare variants showed higher risk of manifesting dyskinesia induced by levodopa treatment. Conclusions Besides confirming the extreme genetic heterogeneity of PD, these data provide novel insights into the genetic of the disease and may be relevant for its prediction, diagnosis and treatment.

“INTERMED”: a method to assess health service needs

1999 ◽  
Vol 21 (1) ◽  
pp. 39-48 ◽  
Author(s):  
Frits J Huyse ◽  
John S Lyons ◽  
Friedrich C Stiefel ◽  
Joris P.J Slaets ◽  
Peter de Jonge ◽  
...  
Keyword(s):  
Health Service ◽  
Service Needs

A Blueprint for the Conduct of Large, Multi-Site Trials in Telemedicine (Preprint)

2021 ◽  
Author(s):  
Patricia Commiskey ◽  
April W Armstrong ◽  
Tumaini Rucker Coker ◽  
Earl Ray Dorsey ◽  
John Fortney ◽  
...  
Keyword(s):  
Skin Diseases ◽  
Care Delivery ◽  
Mental Healthcare ◽  
Stroke Care ◽  
Lessons Learned ◽  
Patient Centered ◽  
Implementation Challenges ◽  
Home Based ◽  
Family Based ◽  
Key Aspects

BACKGROUND Recent literature supports the efficacy and efficiency of telemedicine in improving various health outcomes, despite the wide variability in results. OBJECTIVE Understanding site-specific issues in the implementation of telemedicine trials for broader replication and generalizability of results is needed. Lessons can be learned from existing trials, and a blueprint can guide researchers to conduct these challenging studies using telemedicine more efficiently and effectively. METHODS This viewpoint presents relevant challenges and solutions for conducting multi-site telemedicine trials using seven ongoing and completed studies funded by the Patient Centered Outcomes Research Institute (PCORI) portfolio of large multi-site trials to highlight the challenges in implementing telemedicine trials. RESULTS Implementation challenges related to clinical, informatics, regulatory, legal, quality and billing were identified and described. CONCLUSIONS Lessons learned from these studies were used to create a blueprint of key aspects to consider for the design and implementation of multi-site telemedicine trials. CLINICALTRIAL NCT02358135: Improving Specialty-Care Delivery in Chronic Skin Diseases (PI: AWArmstrong) NCT02396576: Using Telehealth to Deliver Developmental, Behavioral, and Mental Health Services in Primary Care Settings for Children in Underserved Areas (PI: TRCoker) NCT02038959: Connect.Parkinson (PI: RDorsey) NCT04000971: C3FIT (Coordinated, Collaborative, Comprehensive, Family-based, Integrated, Technology-enabled Care) Stroke Care Trial (PI: KGaines) NCT03694431: Noninferiority Comparative Effectiveness Trial of Home-Based Palliative Care (HomePal) Trial (PI: HNguyen, KMularski) NCT04153864: SUMMIT (Scaling Up Maternal Mental healthcare by Increasing access to Treatments) Trial (PI: DRSingla) NCT03985800: Specialty Medical Homes to Improve Outcomes for Patients with Inflammatory Bowel Disease (IBD) and Behavioral Health Conditions Trial (PI: ESzigethy)

Assessing Health Service Needs: Tools for Health Planning

1996 ◽  
Vol 9 (1) ◽  
pp. 22-27 ◽  
Author(s):  
Kevin Brazil ◽  
Malcolm Anderson
Keyword(s):  
Decision Making ◽  
Information Systems ◽  
Geographic Information Systems ◽  
Health Service ◽  
Health Services ◽  
Survey Methods ◽  
Health Planning ◽  
Service Needs ◽  
Needs Assessments ◽  
Structured Groups

As fiscal pressures mount, health-planning and decision-making at smaller geographics scales must be more effective. Involving local constituents in needs assessments, it is believed, would lead to better identification and serving of regional demands and needs for health services. This article examines needs assessment as a tool to determine a community's service needs and establish priorities for the creation of programs. Various approaches used in needs assessments are described, including survey methods, structured groups and geographic information systems.

scholarly journals A Value-Based Steering Model for Healthcare

2021 ◽  
Vol 1 ◽  
Author(s):  
Laura J. Pitkänen ◽  
Riikka-Leena Leskelä ◽  
Helena Tolkki ◽  
Paulus Torkki
Keyword(s):  
Health Service ◽  
Health Services ◽  
Healthcare System ◽  
Public Service ◽  
Service Provider ◽  
Service System ◽  
Design Science ◽  
Service Needs ◽  
Science Study ◽  
A Value

This article aims to answer how a commissioning body can steer health services based on value in an environment where the commissioner is responsible for the health services of a population with varying health service needs. In this design science study, we constructed a value-based steering model consisting of three parts: (1) the principles of steering; (2) the steering process; and (3) Value Steering Canvas, a concrete tool for steering. The study is based on Finland, a tax-funded healthcare system, where healthcare is a public service. The results can be applied in any system where there is a commissioner and a service provider, whether they are two separate organizations or not. We conclude that steering can be done based on value. The commissioning body can start using value-based steering without changes in legislation or in the present service system. Further research is needed to test the model in practice.

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