scholarly journals Patients’ Perceptions of Barriers and Facilitators to the Adoption of E-Hospitals: Cross-Sectional Study in Western China (Preprint)

2019 ◽  
Author(s):  
Peiyi Li ◽  
Yunmei Luo ◽  
Xuexin Yu ◽  
Jin Wen ◽  
Elizabeth Mason ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Services ◽  
Age Groups ◽  
Barriers And Facilitators ◽  
Western China ◽  
Cross Sectional ◽  
Web Based ◽  
Care Services ◽  
Facilitators And Barriers ◽  
Willingness To Use

BACKGROUND As an innovative approach to providing web-based health care services from physical hospitals to patients at a distance, e-hospitals (ie, extended care hospitals through the internet) have been extensively developed in China. This closed health care delivery chain was developed by combining e-hospitals with physical hospitals; treatment begins with web-based consultation and registration, and then, patients are diagnosed and treated in a physical hospital. This approach is promising in its ability to improve accessibility, efficiency, and quality of health care. However, there is limited research on end users’ acceptance of e-hospitals and the effectiveness of strategies aimed to prompt the adoption of e-hospitals in China. OBJECTIVE This study aimed to provide insights regarding the adoption of e-hospitals by investigating patients’ willingness to use e-hospitals and analyzing the barriers and facilitators to the adoption of this technology. METHODS We used a pretested self-administered questionnaire and performed a cross-sectional analysis in 1032 patients across three hierarchical hospitals in West China from June to August 2019. Patients’ sociodemographic characteristics, medical history, current disease status, proficiency with electronic devices, previous experience with web-based health services, willingness to use e-hospitals, and perceived facilitators and barriers were surveyed. Multiple significance tests were employed to examine disparities across four age groups, as well as those between patients who were willing to use e-hospitals and those who were not. Multivariate logistic regression was also performed to identify the potential predictors of willingness to use e-hospitals. RESULTS Overall, it was found that 65.6% (677/1032) of participants were willing to use e-hospitals. The significant predictors of willingness to use e-hospitals were employment status (<i>P</i>=.02), living with children (<i>P</i>&lt;.001), education level (<i>P</i>=.046), information technology skills (<i>P</i>&lt;.001), and prior experience with web-based health care services (<i>P</i>&lt;.001), whereas age, income, medical insurance, and familiarity with e-hospitals were not predictors. Additionally, the prominent facilitators of e-hospitals were convenience (641/677, 94.7%) and accessibility to skilled medical experts (489/677, 72.2%). The most frequently perceived barrier varied among age groups; seniors most often reported their inability to operate technological devices as a barrier (144/166, 86.7%), whereas young participants most often reported that they avoided e-hospital services because they were accustomed to face-to-face consultation (39/52, 75%). CONCLUSIONS We identified the variables, facilitators, and barriers that play essential roles in the adoption of e-hospitals. Based on our findings, we suggest that efforts to increase the adoption of e-hospitals should focus on making target populations accustomed to web-based health care services while maximizing ease of use and providing assistance for technological inquiries.

scholarly journals Patients’ Perceptions of Barriers and Facilitators to the Adoption of E-Hospitals: Cross-Sectional Study in Western China

10.2196/17221 ◽  
2020 ◽  
Vol 22 (6) ◽  
pp. e17221 ◽  
Author(s):  
Peiyi Li ◽  
Yunmei Luo ◽  
Xuexin Yu ◽  
Jin Wen ◽  
Elizabeth Mason ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Services ◽  
Age Groups ◽  
Barriers And Facilitators ◽  
Western China ◽  
Cross Sectional ◽  
Web Based ◽  
Care Services ◽  
Facilitators And Barriers ◽  
Willingness To Use

Background As an innovative approach to providing web-based health care services from physical hospitals to patients at a distance, e-hospitals (ie, extended care hospitals through the internet) have been extensively developed in China. This closed health care delivery chain was developed by combining e-hospitals with physical hospitals; treatment begins with web-based consultation and registration, and then, patients are diagnosed and treated in a physical hospital. This approach is promising in its ability to improve accessibility, efficiency, and quality of health care. However, there is limited research on end users’ acceptance of e-hospitals and the effectiveness of strategies aimed to prompt the adoption of e-hospitals in China. Objective This study aimed to provide insights regarding the adoption of e-hospitals by investigating patients’ willingness to use e-hospitals and analyzing the barriers and facilitators to the adoption of this technology. Methods We used a pretested self-administered questionnaire and performed a cross-sectional analysis in 1032 patients across three hierarchical hospitals in West China from June to August 2019. Patients’ sociodemographic characteristics, medical history, current disease status, proficiency with electronic devices, previous experience with web-based health services, willingness to use e-hospitals, and perceived facilitators and barriers were surveyed. Multiple significance tests were employed to examine disparities across four age groups, as well as those between patients who were willing to use e-hospitals and those who were not. Multivariate logistic regression was also performed to identify the potential predictors of willingness to use e-hospitals. Results Overall, it was found that 65.6% (677/1032) of participants were willing to use e-hospitals. The significant predictors of willingness to use e-hospitals were employment status (P=.02), living with children (P<.001), education level (P=.046), information technology skills (P<.001), and prior experience with web-based health care services (P<.001), whereas age, income, medical insurance, and familiarity with e-hospitals were not predictors. Additionally, the prominent facilitators of e-hospitals were convenience (641/677, 94.7%) and accessibility to skilled medical experts (489/677, 72.2%). The most frequently perceived barrier varied among age groups; seniors most often reported their inability to operate technological devices as a barrier (144/166, 86.7%), whereas young participants most often reported that they avoided e-hospital services because they were accustomed to face-to-face consultation (39/52, 75%). Conclusions We identified the variables, facilitators, and barriers that play essential roles in the adoption of e-hospitals. Based on our findings, we suggest that efforts to increase the adoption of e-hospitals should focus on making target populations accustomed to web-based health care services while maximizing ease of use and providing assistance for technological inquiries.

scholarly journals Facilitators and barriers to the clinical administration of herbal medicine in Ghana: a qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Comfort Asare ◽  
Lydia Aziato ◽  
Daniel Boamah
Keyword(s):  
Health Care ◽  
Herbal Medicine ◽  
Health Professionals ◽  
Health Care Services ◽  
Clinical Use ◽  
Care Services ◽  
Herbal Medications ◽  
Facilitators And Barriers ◽  
Medicine Administration ◽  
Willingness To Use

Abstract Background Herbal medicine administration in conventional health care services is gaining popularity lately. Much has not been documented on the perceived enhancers and challenges to herbal medicine administration at the hospital. The study sought to explore the facilitators and barriers to the clinical administration of herbal medicine in Ghana. Method Qualitative descriptive exploratory design was employed. Fourteen participants among the consented and purposively sampled nurses were interviewed. Data was transcribed and analysed using content analysis. Results The participants disclosed that facilitators to the clinical administration of herbal medicine include doctors’ prescription, affordability of herbal medications by patients, patients’ willingness to use herbal medicine and availability of herbal medicine. Barriers to the clinical administration of herbal medicine were inadequate knowledge on herbal medicine, lack of publicity, unclear integration, lack of collaboration and policies on herbal medicine administration at the hospital. Other barriers were negative mindset of patients and lack of national health insurance scheme (NHIS) coverage. Conclusion Clinical administration of herbal medicine is faced with an array of challenges. Doctor’s prescription, nursing education on herbal medicine and NHIS coverage of herbal medicine are imperative to improve herbal medicine administration in hospitals. Plain English summary Herbal medicine addition into mainstream health care services is surging high in many countries. This study aimed at finding out what nurses consider as the issues that make it easy or difficult to serve herbal medicine in the hospital. Qualitative method was employed, in-depth face-to-face interviews were conducted and data collected was typed verbatim. The typed data was content analysed and findings supported with the nurses’ statements. The findings of the study showed that facilitators to the clinical use of herbal medicine include doctors’ prescription, affordability of the herbal drug, patient’s willingness to use the herbal medication, patient’s belief about herbal medicine and availability of herbal medicine. Challenges to the clinical use of herbal medicine disclosed were lack of knowledge on herbal medicine, lack of publicity, unclear integration, lack of collaboration between health professionals and herbal medicine providers. Other barriers include negative mindset of patients and lack of national health insurance (NHIS) coverage. The researchers came to a consensus that nurses need further training on herbal medicine to enhance herbal medicine use at the hospital. Health professionals need to collaborate with herbal medicine service providers and NHIS must be reviewed to cover herbal medications.

scholarly journals Analysis of Facilitators and Barriers to the Delivery of Routine Care during the COVID-19 Global Pandemic: A Systematic Review

Healthcare ◽  
2021 ◽  
Vol 9 (5) ◽  
pp. 528
Author(s):  
Cristian Lieneck ◽  
Brooke Herzog ◽  
Raven Krips
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Health Care Services ◽  
Care Delivery ◽  
Routine Care ◽  
Future Research ◽  
Healthcare Organizations ◽  
Care Services ◽  
Global Pandemic ◽  
Facilitators And Barriers

The delivery of routine health care during the COVID-19 global pandemic continues to be challenged as public health guidelines and other local/regional/state and other policies are enforced to help prevent the spread of the virus. The objective of this systematic review is to identify the facilitators and barriers affecting the delivery of routine health care services during the pandemic to provide a framework for future research. In total, 32 articles were identified for common themes surrounding facilitators of routine care during COVID-19. Identified constructed in the literature include enhanced education initiatives for parents/patients regarding routine vaccinations, an importance of routine vaccinations as compared to the risk of COVID-19 infection, an enhanced use of telehealth resources (including diagnostic imagery) and identified patient throughput/PPE initiatives. Reviewers identified the following barriers to the delivery of routine care: conservation of medical providers and PPE for non-routine (acute) care delivery needs, specific routine care services incongruent the telehealth care delivery methods, and job-loss/food insecurity. Review results can assist healthcare organizations with process-related challenges related to current and/or future delivery of routine care and support future research initiatives as the global pandemic continues.

scholarly journals Structure and Distribution of Health Care Costs across Age Groups of Patients with Multimorbidity in Lithuania

2021 ◽  
Vol 18 (5) ◽  
pp. 2767
Author(s):  
Laura Nedzinskienė ◽  
Elena Jurevičienė ◽  
Žydrūnė Visockienė ◽  
Agnė Ulytė ◽  
Roma Puronaitė ◽  
...  
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Chronic Disease ◽  
National Health Insurance ◽  
Health Care Services ◽  
Age Groups ◽  
Age Group ◽  
Resource Usage ◽  
Care Services ◽  
Care Costs

Background. Patients with multimorbidity account for ever-increasing healthcare resource usage and are often summarised as big spenders. Comprehensive analysis of health care resource usage in different age groups in patients with at least two non-communicable diseases is still scarce, limiting the quality of health care management decisions, which are often backed by limited, small-scale database analysis. The health care system in Lithuania is based on mandatory social health insurance and is covered by the National Health Insurance Fund. Based on a national Health Insurance database. The study aimed to explore the distribution, change, and interrelationships of health care costs across the age groups of patients with multimorbidity, suggesting different priorities at different age groups. Method. The study identified all adults with at least one chronic disease when any health care services were used over a three-year period between 2012 and 2014. Further data analysis excluded patients with single chronic conditions and further analysed patients with multimorbidity, accounting for increasing resource usage. The costs of primary, outpatient health care services; hospitalizations; reimbursed and paid out-of-pocket medications were analysed in eight age groups starting at 18 and up to 85 years and over. Results. The study identified a total of 428,430 adults in Lithuania with at least two different chronic diseases from the 32 chronic disease list. Out of the total expenditure within the group, 51.54% of the expenses were consumed for inpatient treatment, 30.90% for reimbursed medications. Across different age groups of patients with multimorbidity in Lithuania, 60% of the total cost is attributed to the age group of 65–84 years. The share in the total spending was the highest in the 75–84 years age group amounting to 29.53% of the overall expenditure, with an increase in hospitalization and a decrease in outpatient services. A decrease in health care expenses per capita in patients with multimorbidity after 85 years of age was observed. Conclusions. The highest proportion of health care expenses in patients with multimorbidity relates to hospitalization and reimbursed medications, increasing with age, but varies through different services. The study identifies the need to personalise the care of patients with multimorbidity in the primary-outpatient setting, aiming to reduce hospitalizations with proactive disease management.

Impact of restricting access to health care services on Syrian refugees in Jordan: evidence from cross-sectional surveys

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Ibraheem Khaled Abu Siam ◽  
María Rubio Gómez
Keyword(s):  
Health Care ◽  
Health Care Access ◽  
Access To Health Care ◽  
Health Care Services ◽  
Health Care Cost ◽  
Syrian Refugees ◽  
Cross Sectional ◽  
Content Type ◽  
Care Access ◽  
Care Services

Purpose Access to health-care services for refugees are always impacted by many factors and strongly associated with population profile, nature of crisis and capacities of hosing countries. Throughout refugee’s crisis, the Jordanian Government has adopted several healthcare access policies to meet the health needs of Syrian refugees while maintaining the stability of the health-care system. The adopted health-care provision policies ranged from enabling to restricting and from affordable to unaffordable. The purpose of this paper is to identify the influence of restricted level of access to essential health services among Syrian refugees in Jordan. Design/methodology/approach This paper used findings of a cross-sectional surveys conducted over urban Syrian refugees in Jordan in 2017 and 2018 over two different health-care access policies. The first were inclusive and affordable, whereas the other considered very restricting policy owing to high inflation in health-care cost. Access indicators from four main thematic areas were selected including maternal health, family planning, child health and monthly access of household. A comparison between both years’ access indicators was conducted to understand access barriers and its impact. Findings The comparison between findings of both surveys shows a sudden shift in health-care access and utilization behaviors with increased barriers level thus increased health vulnerabilities. Additionally, the finding during implementation of restricted access policy proves the tendency among some refugees groups to adopt negative adaptation strategies to reduce health-care cost. The participants shifted to use a fragmented health-care, reduced or delayed care seeking and use drugs irrationally weather by self-medication or reduce drug intake. Originality/value Understanding access barriers to health services and its negative short-term and long-term impact on refugees’ health status as well as the extended risks to the host communities will help states that hosting refugees building rational access policy to protect whole community and save public health gains during and post crisis. Additionally, it will support donors to better mobilize resources according to the needs while the humanitarian actors and service providers will better contribute to the public health stability during refugee’s crisis.

scholarly journals Pharmaceutical care in Brazil’s primary health care

2017 ◽  
Vol 51 (suppl.2) ◽  
Author(s):  
Patricia Sodré Araújo ◽  
Ediná Alves Costa ◽  
Augusto Afonso Guerra Junior ◽  
Francisco de Assis Acurcio ◽  
Ione Aquemi Guibu ◽  
...  
Keyword(s):  
Health Care ◽  
Health Promotion ◽  
Primary Health Care ◽  
Pharmaceutical Care ◽  
Health Care Services ◽  
Cross Sectional ◽  
Educational Activities ◽  
Health Team ◽  
Care Services ◽  
Primary Health

OBJECTIVE: To characterize the activities of clinical nature developed by pharmacists in basic health units and their participation in educational activities aiming at health promotion. METHODS: This article is part of the Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos – Serviços, 2015 (PNAUM – National Survey on Access, Use and Promotion of Rational Use of Medicines – Services, 2015), a cross-sectional and exploratory study, of evaluative nature, consisting of a survey of information in a representative sample of cities, stratified by the Brazilian regions that constitute domains of study, and a subsample of primary health care services. The interviewed pharmacists (n=285) were responsible for the delivery of medicines and were interviewed in person with the use of a script. The characterization of the activities of clinical nature was based on information from pharmacists who declared to perform them, and on participation in educational activities aiming at health promotion, according to information from all pharmacists. The results are presented in frequency and their 95% confidence intervals. RESULTS: From the interviewed subjects, 21.3% said they perform activities of clinical nature. Of these, more than 80% considered them very important; the majority does not dispose of specific places to perform them, which hinders privacy and confidentiality in these activities. The main denominations were “pharmaceutical guidance” and “pharmaceutical care.” The registration of activities is mainly made in the users’ medical records, computerized system, and in a specific document filed at the pharmacy, impairing the circulation of information among professionals. Most pharmacists performed these activities mainly along with physicians and nurses; 24.7% rarely participated in meetings with the health team, and 19.7% have never participated. CONCLUSIONS: Activities of clinical nature performed by pharmacists in Brazil are still incipient. The difficulties found point out to the professionals’ improvisation and effort. The small participation in educational activities of health promotion indicates little integration of pharmacists with the health team and of pharmaceutical services with other health actions

scholarly journals Community Residents’ Awareness of Family Doctor Contract Services, Signing With Family Doctor, Willingness to Use Community Health Care Centers: A Community-Based Analysis in Shenzhen, China

2020 ◽  
Author(s):  
Qingming Zheng ◽  
Lu Shi ◽  
Tiantian Pang ◽  
Willie Leung
Keyword(s):  
Health Care ◽  
Chronic Disease ◽  
Health Care Services ◽  
Family Doctor ◽  
Disease Status ◽  
Care Services ◽  
Community Health Care Centers ◽  
Primary Health Care Services ◽  
Willingness To Use ◽  
The Impact

Abstract Background: Family doctor contracted services (FDCS) began in China in 2016. Shenzhen, one of the most developed cities in China, implemented a family doctor (FD) policy in 2017. The objectives of this study were to identify the impact of the awareness of the FD and signing with a FD on health care seeking behavior, as well as the impact of chronic disease status on the awareness of FDs and signing with a FD. Methods: Cross-sectional secondary data based on residents living in Luohu district was used for analysis. Linear probability models (LPM) were used to determine the relationship between willingness to use community health care centers (CHCs) and awareness of the FDCS, as well as the association between willingness to use CHCs and signing with a FD. LPM was also used to estimate the association between chronic disease status and awareness of the FDCS, as well as the association between chronic disease status and signing with a FD.Results: Among 1205 adults included in analysis, 27% of the participants knew the FDCS, 5% signed with FD, and 20% had chronic disease. Both awareness of the FDCS and signing with a FD significantly increased the probability of using CHCs. The results indicated that participants with chronic disease were more likely to be aware of the FDCS and sign with a FD.Conclusions: Consequently, this study provided evidence that awareness of FDCS and signing with a FD had positive impact on utilization of primary health care services in the at community level. Also, individuals with chronic disease tend to use FDCS. More interventions to improve awareness of FDCS can help to increase the utilization of primary health care services.

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