scholarly journals Health management at the regional level: multivariable performance assessment

2020 ◽  
Vol 1 (2) ◽  
pp. 8-16
Author(s):  
Andrii Shipko ◽  
Nadiia Demikhova ◽  
Krzysztof Pajak ◽  
Vira Motrechko
Keyword(s):  
Health Care ◽  
Medical Care ◽  
Health Care Systems ◽  
Functional Model ◽  
Regional Health ◽  
Health Technologies ◽  
Regional Health Care ◽  
Study Results ◽  
Care Systems ◽  
Legislative Initiative

This article provides an analysis of areas for improving the state policy bases in public health services. The purpose of the research is to substantiate and develop systematized regulatory support for the structural-functional care model for children in particular regions. The authors systematized the legislative acts on the health technologies introduction in the structural-functional model. To achieve the study goal, the authors used a systematic approach to provide quantitative and qualitative analysis of the organization and optimization of medical-social justification of the structural-functional model; bibliosemantic – for the analysis of national and international experience in providing medical care to patients; epidemiological – to determine the levels, structure and dynamics of morbidity and prevalence of pathology in childhood; statistical – for collecting, processing and analyzing received information. The article presented the authors’ development on regulatory support for the structural-functional medical model components for children. Besides, special attention was paid to the improvement of health technologies in regional health care systems. The authors identified areas for implementing the legislative initiative to improve the regulatory support for medical care provision. This paper provides the author’s regulatory support of structural-functional medical model’s components toward children with bronchopulmonary dysplasia and dysplastic pathology of the bronchopulmonary system. The authors emphasized the improvement of health technologies in regional health care systems. To improve the area of legislative and regulatory support, the study identified the directions for implementing the legislative initiative. Based on the study results, the authors proposed considering 7 legislative acts of Ukraine on improving the normative-legal provision of components of the structural-functional model. The obtained results could further assess their impact on implementing health technologies at the regional, municipal and family levels.

scholarly journals Financing of Health Care in the Conditions of Pandemic Threats

Federalism ◽  
2020 ◽  
pp. 110-116
Author(s):  
A. G. Kolomiets
Keyword(s):  
Health Care ◽  
Health Care Systems ◽  
Social Groups ◽  
Regional Health ◽  
Free Riders ◽  
Regional Health Care ◽  
Care Systems ◽  
The Usa ◽  
Using Data ◽  
Excess Profit

The author, using data of health care systems and COVID in the USA, Italy and other countries makes a conclusion that effective parrying of pandemic threats demands correction of a health care system and its financing. In particular, expansion of access for «marginal» social groups to services of out-patient and polyclinic institutions including non-payable services on a constant basis is necessary. Situation when involvement of the low-paid migrants who are actually excluded from regional health care systems allows to get excess profit for employers, creates for society not only additional expenses, but also risks of catastrophic development of epidemiological situations. Such employers are a kind of «free-riders» too expensive for society.

scholarly journals The National Practice Benchmark for Oncology: 2015 Report for 2014 Data

2016 ◽  
Vol 12 (4) ◽  
pp. e437-e475 ◽  
Author(s):  
Carla Balch ◽  
John D. Ogle ◽  
James L. Senese
Keyword(s):  
Health Care ◽  
Health Care Systems ◽  
Business Practices ◽  
Competitive Advantages ◽  
Regional Health ◽  
Regional Health Care ◽  
Community Oncology ◽  
Care Systems ◽  
National Practice ◽  
Business Structure

The National Practice Benchmark (NPB) is a unique tool used to measure oncology practices against others across the country in a meaningful way despite variations in practice demographics, size, and setting. In today’s challenging economic environment, each practice positions service offerings and competitive advantages to attract patients. Although the data in the NPB report are primarily reported by community oncology practices, the business structure and arrangements with regional health care systems are also reflected in the benchmark report. The ability to produce detailed metrics is an accomplishment of excellence in business and clinical management. With these metrics, a practice should be able to measure and analyze its current business practices and make appropriate changes, if necessary. In this report, we build on the foundation initially established by Oncology Metrics (acquired by Flatiron Health in 2014) over years of data collection and refine definitions to deliver the NPB, which is uniquely meaningful in the oncology market.

Developmental Stages and Spiritual Coping Responses among Economically Impoverished Women Living with HIV Disease

1998 ◽  
Vol 52 (3) ◽  
pp. 227-240 ◽  
Author(s):  
Anton M. Somlai ◽  
Timothy G. Heckman ◽  
Kristin Hackl ◽  
Michael Morgan ◽  
Dana Welsh
Keyword(s):  
Health Care ◽  
Developmental Stages ◽  
Health Care Systems ◽  
Early Adulthood ◽  
Religion And Spirituality ◽  
Care Clinic ◽  
Coping Responses ◽  
Women Living With Hiv ◽  
Regional Health Care ◽  
Care Systems

Identifies environmental markers, situational appraisals, perceived ability to mediate situations and outcomes, primary coping strategies, and purposes served by religion and spirituality in 10 HIV-positive women recruited from a regional health care clinic. Findings indicated that the women experienced a disintegration of family during their early developmental years, yielding feelings of hopelessness and isolation; that their sexual development was marked by rape and incest, and their early adulthood was characterized by failed relationships, pregnancies, drugs, and alcohol. Reports that the women's religious influences were predominantly maternal and provided a model for intercessory prayer. Notes that prior to their diagnosis of HIV, participants described their coping as escapist, while after diagnosis they believed there was a divine intercession renewing their spiritual growth and connectedness with others. Reports that the women's personal spirituality was greatly influenced by prayer, television ministries, and reading the Bible. Suggests that interventions that actively recruit women into social support services, health care systems, and faith congregations are needed and that television ministries may serve as access points for connecting women with necessary services.

scholarly journals Equity, Efficiency, and Accessibility in Urban and Regional Health-Care Systems

1982 ◽  
Vol 14 (11) ◽  
pp. 1479-1507 ◽  
Author(s):  
L D Mayhew ◽  
G Leonardi
Keyword(s):  
Health Care ◽  
Resource Allocation ◽  
Health Care Services ◽  
Spatial Interaction ◽  
Health Care Systems ◽  
Interaction Model ◽  
Health Care Planning ◽  
Regional Health Care ◽  
Allocation Criteria ◽  
Care Systems

This paper explores four different criteria of health-care resource allocation at the urban and regional level. The criteria are linked by a common spatial-interaction model. This model is based on the hypothesis that the number of hospital patients generated in a residential zone i is proportional to the relative morbidity of i, and to the availability of resources in treatment zone j, but is in inverse proportion to the accessibility costs of getting from i to j. The resource-allocation criteria are based on objectives on which there is broad agreement among planners and other actors in a health-care system. These objectives are concerned with allocations that conform to notions of equity, efficiency, and two definitions of accessibility. The allocation criteria give mainly aggregate-level information, and are designed with the long-term regional planning of health-care services in mind. The paper starts by defining the criteria, and describes how they are intended to be employed in a planning context. The allocation rules are then formally derived and linked together mathematically. They are then applied to a region, London, England, which is known to have very complex health-care planning problems. As a result of this application, two of the criteria—equity and efficiency—are selected for further analysis. A new model is built and applied that specifically enables the user to trade off one of these criteria against the other.

Revisiting Health Regionalization in Canada

2016 ◽  
Vol 47 (2) ◽  
pp. 333-351 ◽  
Author(s):  
Paul Barker ◽  
John Church
Keyword(s):  
Health Care ◽  
Health Services ◽  
Health Care Systems ◽  
Health Care Expenditures ◽  
Regional Health ◽  
Health Authorities ◽  
Care Systems ◽  
Physician Care ◽  
Regional Health Authorities ◽  
Regional Authorities

Twenty years ago, many of Canada’s provinces began to introduce regional health authorities to address problems with their health care systems. With this action, the provinces sought to achieve advances in community decision-making, the integration of health services, and the provision of care in the home and community. The authorities were also to help restrict health care costs. An assessment of the authorities indicates, however, that over the past two decades they have been unable to meet their objectives. Community representatives continue to play little role in determining the appropriate health services for their regions. Gains have been made towards integrating health services, but the plan for a near seamless set of health services has not been realized. Funding for health services remains focused on hospital and physician care, and health care expenditures have until very recently been little affected by regional authorities. This disappointing performance has caused some provinces to abandon their regional authorities, but this article argues that the provision of greater autonomy and a better public appreciation of their role and potential may lead to more successful regional authorities. Accordingly, the objective of this article is to reveal the shortcomings of regional health authorities in Canada while at the same time arguing that changes can be made to increase the chances of more workable authorities.

scholarly journals Bottom-Up Approach to Establish Coordination Mechanisms for Disaster Preparedness Among Largely Private Health-Care Providers in Central Tokyo

2021 ◽  
pp. 1-9
Author(s):  
Keyword(s):  
Health Care ◽  
Medical Care ◽  
Disaster Preparedness ◽  
Health Care Systems ◽  
Health Care Personnel ◽  
Coordination Mechanisms ◽  
Care Providers ◽  
Bottom Up ◽  
Care Systems ◽  
The City

Abstract In Japan, despite its private-dominant and disjointed health-care system, national initiatives to coordinate various types of health-care facilities are lacking. Municipal governments manage this task with limited resources. This study describes a successful example of a bottom-up approach to create city-wide collaboration for disaster preparedness. In Minato City, located in central Tokyo, a group of physicians created a project involving a city-wide disaster medical care drill. The city Public Health Center, in charge of health-care systems including disaster medicine, helped the group to increase proponents of the project. The city-wide disaster drill started in November 2017; thereafter, the drills were held every year. Participation in drills by various health-care personnel helped establish a city-wide system for disaster medical care, coordination mechanisms among stakeholders, increased motivation among health-care personnel, and development of in-hospital systems. This approach is flexible and applicable to various forms of health-care systems in other areas.

scholarly journals Development and Implementation of a Person-Centered, Technology-Enhanced Care Model For Managing Chronic Conditions: Cohort Study (Preprint)

2018 ◽  
Author(s):  
Curtis L Petersen ◽  
William B Weeks ◽  
Olof Norin ◽  
James N Weinstein
Keyword(s):  
Health Care ◽  
Chronic Conditions ◽  
Chronic Condition ◽  
Health Care Systems ◽  
Health Care Expenditures ◽  
Health Behavior Change ◽  
Care Model ◽  
Health Technologies ◽  
Care Systems ◽  
Per Capita

BACKGROUND Caring for individuals with chronic conditions is labor intensive, requiring ongoing appointments, treatments, and support. The growing number of individuals with chronic conditions makes this support model unsustainably burdensome on health care systems globally. Mobile health technologies are increasingly being used throughout health care to facilitate communication, track disease, and provide educational support to patients. Such technologies show promise, yet they are not being used to their full extent within US health care systems. OBJECTIVE The purpose of this study was to examine the use of staff and costs of a remote monitoring care model in persons with and without a chronic condition. METHODS At Dartmouth-Hitchcock Health, 2894 employees volunteered to monitor their health, transmit data for analysis, and communicate digitally with a care team. Volunteers received Bluetooth-connected consumer-grade devices that were paired to a mobile phone app that facilitated digital communication with nursing and health behavior change staff. Health data were collected and automatically analyzed, and behavioral support communications were generated based on those analyses. Care support staff were automatically alerted according to purpose-developed algorithms. In a subgroup of participants and matched controls, we used difference-in-difference techniques to examine changes in per capita expenditures. RESULTS Participants averaged 41 years of age; 72.70% (2104/2894) were female and 12.99% (376/2894) had at least one chronic condition. On average each month, participants submitted 23 vital sign measurements, engaged in 1.96 conversations, and received 0.25 automated messages. Persons with chronic conditions accounted for 39.74% (8587/21,607) of all staff conversations, with higher per capita conversation rates for all shifts compared to those without chronic conditions (P<.001). Additionally, persons with chronic conditions engaged nursing staff more than those without chronic conditions (1.40 and 0.19 per capita conversations, respectively, P<.001). When compared to the same period in the prior year, per capita health care expenditures for persons with chronic conditions dropped by 15% (P=.06) more than did those for matched controls. CONCLUSIONS The technology-based chronic condition management care model was frequently used and demonstrated potential for cost savings among participants with chronic conditions. While further studies are necessary, this model appears to be a promising solution to efficiently provide patients with personalized care, when and where they need it.

scholarly journals Measuring Regional Performance in the Italian NHS: Are Disparities Decreasing?

2021 ◽  
Author(s):  
Silvia Bruzzi ◽  
Enrico Ivaldi ◽  
Marta Santagata
Keyword(s):  
Health Care ◽  
Health Systems ◽  
Health Care Quality ◽  
Health Care Systems ◽  
Care Quality ◽  
Regional Disparities ◽  
Future Research ◽  
Regional Health ◽  
Regional Health Care ◽  
Composite Indexes

AbstractGiven the regional disparities that historically characterize the Italian context, in this paper we propose a framework to evaluate the regional health care systems’ performance in order to contribute to the debate on the relationship between decentralisation of health care and equity. To investigate the regional health systems performance, we refer to the OECD Health Care Quality Indicators project to construct of a set of five composite indexes. The composite indexes are built on the basis of the non-compensatory Adjusted Mazziotta-Pareto Index, that allows comparability of the data across units and over time. We propose three indexes of health system performance, namely Quality Index, Accessibility Index and Cost-Expenditure Index, along with a Health Status Index and a Lifestyles Index. Our framework highlights that regional disparities still persist. Consistently with the evidence at the institutional level, there are regions, particularly in Southern Italy, which record lower levels of performance with high levels of expenditure. Continuous research is needed to provide policy makers with appropriate data and tools to build a cohesive health care system for the benefit of the whole population. Even if future research is needed to integrate our framework with new indicators for the calculation of the indexes and with the identification of new indexes, the study shows that a scientific reflection on decentralisation of health systems is necessary in order to reduce inequalities.

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