scholarly journals Creating the Framework for Cross-Sector Health Analysis for Local Communities

2018 ◽  
Vol 3 (4) ◽  
Author(s):  
Heather Richards ◽  
Kim Varas ◽  
Samantha Magnus ◽  
Jinhwa Oh ◽  
Christine Voggenreiter
Keyword(s):  
Health Services ◽  
Health System ◽  
First Nations ◽  
Administrative Data ◽  
Health Authority ◽  
Access To Health Care ◽  
Local Level ◽  
Health Administrative Data ◽  
Urban Rural ◽  
Statistics Canada

IntroductionA newly developed BC Ministry of Health geography classification has enabled a standardized approach for community-level analysis of health needs and service provision. An innovative methodology was developed and applied to health administrative data, creating more opportunities to identify variations in health status and utilization across the health system. Objectives and ApproachTwo design principles informed the development of the new geographies. Firstly, they reflect where people live and the communities with which they identify, and secondly, they will assist with identifying where health services are needed for local populations. The objective was to provide the Ministry and health authorities with a framework to identify and work towards providing the optimal delivery of services at the local level. A working group was established for this project and included representatives from the Ministry, each regional health authority, Provincial Health Services Authority, First Nations Health Authority, and BC Stats. ResultsThe building block for the geography classification is the Census Dissemination Block, the lowest unit of geography available in the Standard Geography Classification maintained by Statistics Canada. The geographies were assigned urban-rural designations based on an algorithm that considered the presence of a population centre, the size of the population centre, and the proportion of the population living in it, among other aspects. One of the main goals of the urban-rural designations was to provide meaningful peer groups for cross-jurisdictional studies. The project also reengineered the methods to geocode addresses to improve accuracy to use street addresses (over past method that used postal codes) so that assignment to Census Dissemination Block would be precise. The end result was 218 community geographies with urban-rural designations. Conclusion/ImplicationsThis geography standard allows health system stakeholders to better understand of geographic variation in utilization and access to health care. The ability to link and share information to profile community health between health administrative data and Census data available from Statistics Canada is better due to improved geocoding of addresses.

scholarly journals Increasing Incidence and Prevalence of Pathologic Hemoglobinopathies Among Children in Ontario, Canada from 1991-2013

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 4698-4698
Author(s):  
Ewurabena Simpson ◽  
Robert J Klaassen ◽  
Pranesh Chakraborty ◽  
Beth Potter ◽  
Melanie Ann Kirby-Allen ◽  
...  
Keyword(s):  
Health Services ◽  
Chronic Diseases ◽  
Administrative Data ◽  
Research Funding ◽  
Population Based ◽  
Advisory Board ◽  
Crude Incidence ◽  
Health Administrative Data ◽  
The Impact ◽  
Reference Cohort

Abstract Background: In Ontario, Canada's largest province, population-based health administrative data represents an accessible and useful tool for population surveillance of people with chronic diseases. While hemoglobinopathies can be identified using data from universal hemoglobinopathy screening, which was implemented in November 2006, these data would not contain information on affected immigrants (21.9% of the population). We validated algorithms using provincial health administrative data and newborn screening data to identify children with hemoglobinopathies whether or not they were born in Ontario, thereby creating a population-based surveillance cohort. Objectives: (1) Validate algorithms to identify children with sickle cell disease, thalassemia and other hemoglobinopathies from within health administrative data; and (2) Determine incidence and prevalence of hemoglobinopathies in Ontario children. Methods: For the validation study, a positive reference cohort was established using lists of known hemoglobinopathy patients who were followed at five pediatric hemoglobinopathy treatment sites in Ontario and born between November 24, 2006 and March 31, 2013. Health card numbers of these patients were linked deterministically to unique identification numbers in administrative data, which included data on hospitalizations, physician claims, sociodemographic characteristics, immigration records and cause of death. The negative reference cohort included all children residing in Ontario cities who had never been seen at a hemoglobinopathy centre, and therefore assumed not to have disease. Various combinations of administrative data codes were tested for their ability to identify children <18 years of age with hemoglobinopathies from within the databases, and we selected the algorithms with the highest positive predictive value, while maintaining sensitivity >80%. Using two validated algorithms, we identified all children with hemoglobinopathies born between April 1, 1991 and March 31, 2013. We described the crude incidence and prevalence per 100,000 patient-years (PYs). Results: Two algorithms functioned best to identify incident and prevalent hemoglobinopathy cases (see Table). Among children born between April 1, 1991 to March 31, 2013, 1526 incident hemoglobinopathy patients were identified using Algorithm 1 (crude incidence of 4.85 per 100,000 PYs) and 1660 new hemoglobinopathy patients were identified using Algorithm 2 (crude incidence 5.28 per 100,000 PYs, 95% CI 3.51 to 3.92). In 2013, the overall prevalence of children <18 years living with hemoglobinopathies was 1215-1325 cases. Conclusion: Through an innovative approach using provincial health administrative, immigration and demographic data, this study identified a rising incidence and prevalence of hemoglobinopathies among Ontario children <18 years of age between April 1, 1991 and March 31, 2013, potentially due to increased immigration rates. These findings could be used to inform health services distribution. This surveillance cohort will be used to understand the impact of immigration status on health care inequality for hemoglobinopathy-related health services delivery, as well as to assess outcomes in this important group of chronic diseases. Disclosures Klaassen: Amgen Inc.: Membership on an entity's Board of Directors or advisory committees; Octapharma AG: Consultancy, Honoraria; Agios Pharmaceuticals Inc.: Consultancy; Novartis: Research Funding; Hoffman-La Roche: Consultancy; Shire: Consultancy; Cangene: Research Funding. Jardine:Pfizer: Other: Advisory board; Bayer: Other: Advisory board; Baxalta: Other: Advisory board.

scholarly journals Main Health Issue In Haiti: A Brief Review

2020 ◽  
Author(s):  
Axler Jean Paul ◽  
Marlorie Petit ◽  
Lesly Ed Archer
Keyword(s):  
Health Care ◽  
Health Services ◽  
Health System ◽  
Access To Health Care ◽  
Organizational Crisis ◽  
Health Crisis ◽  
Basic Health ◽  
Geographic Coverage ◽  
Access To Health ◽  
And Training

Haiti reports a chronic structural and organizational crisis dating back more than 30 years. It is described 3 main tracks missing in the Haitian health system: geographic coverage, pointing to the problem of access to health care; financial coverage, and the inadequacy of basic health services. The problem of infrastructure, organization and training leads to disparities in the population where the most vulnerable are the ones who pay the consequences. This document presents a few statistical lines that will help to better understand the health crisis in the country both structurally and organizationally. Through the results of published work, we present the main points of weakness in the Haitian health system, which will help identify avenues for intervention with a view to change and improvement.

scholarly journals Experts’ point of view on migrants’ health and Bulgarian health system performance

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M Kamburova ◽  
S Georgieva ◽  
D Tsanova ◽  
E Mineva
Keyword(s):  
Health Care ◽  
Health System ◽  
System Performance ◽  
Access To Health Care ◽  
Local Level ◽  
Health Problems ◽  
Host Population ◽  
Point Of View ◽  
Health System Performance ◽  
Care Needs

Abstract Introduction Migrants often face serious inequities concerning their state of health and their access to good quality health services. The aim of the study is to analyze the experts' point of view on migrants' health and Bulgarian health system performance in this field. Methods Within the TRAIN4M&H project, founded by European Commission, work seminar was organized in Bulgaria in March 2019th. Focus group and facilitated discussion with experts intended to elicit information about significant migrants' health problems was performed. Quantitative and qualitative data were collected through an unstructured interview. Data processing was performed by SPSS v.24. Results All participants in the seminar: 22 frontline health professionals (5), law enforcement officers (13), social workers (2) and other professionals (2) were covered. According 60% of participants the health of migrants threatens the health of the host population. The leading health issues among migrants are: infectious and parasitic disorders as a result of bad hygiene (9), psychiatric problems and drug abuse (5), children and pregnant women health problems (3) etc. Most of the experts (77.3%) determine that there is no difference between health care needs of the migrants and Bulgarian population. None of the respondents said that migrants need hospital care mainly. On the opposite, according to experts' point of view they need emergency care (31.8%), primary health care (36.4%) and specialized care (22.7%). The Bulgarian health system provides adequate health care only in some specific cases, according to two thirds of the respondents. As positive results of the health system performance experts point “asylum seekers are fully health insured”, “the treatment of migrants in the centers is free of charge” etc. Conclusions In order to establish migrant friendly health system in Bulgaria and to improve the quality of services provided develop and enhance skills of professionals working at local level is crucial. Key messages Professionals working at local level with migrants have to be well qualified to face problems in relation to migrants’ health and their access to health care. According to the experts working at local level with migrants Bulgarian health system is not well prepared and provides adequate health care for migrants only in some specific cases.

scholarly journals The Effect of Health System Evolution Program on Out-of-pocket Payment in Hospitals Affiliated to Mashhad University of Medical Sciences

2019 ◽  
Author(s):  
Amin Adel ◽  
Akbar Javan Biparva ◽  
Hosein Ebrahimipour ◽  
Shapour Badiee Aval ◽  
Elaheh Askarzadeh
Keyword(s):  
Health Services ◽  
Health System ◽  
Access To Health Care ◽  
Health Indicators ◽  
Poor People ◽  
Medical Sciences ◽  
Macroeconomic Policies ◽  
System Evolution ◽  
Research Findings ◽  
The Government

Background: Providing financial resources for health services is the responsibility of the government, insurers and direct payments of individuals. Considering that health services are one of the most essential people's needsand impose a high cost on individuals, and may create catastrophic health costs for poor people. Therefore, the present study was conducted with the aim of analyzing the effect of health system evolution (HSE) program on out-of-pocket (OOP) payment in hospitals affiliated to Mashhad University of Medical Sciences. Methods: This descriptive-analytic study was conducted in 24 hospitals of Mashhad University of Medical Sciences from 2013 to 2017 in order to survey the effect of HSE Program. The sample of this study included all patients with basic insurance referring to hospitals. Data were collected based on a researcher-made checklist for urban and rural patients. The statistical analysis software SPSS19 was used to analyze the data. Results: According to the research findings, the total OOP payment percentage fell from about 20 % to 8 % at the end of the year. The percentage of the patient's spending on consumer use declined from 60 % to 6 %, for drugs from 30 % to 5.5 %, for services from 12 % to 4 %. Conclusion: Increasing people's financial access to health care will improve the health of the community, which is expected to improve community health indicators by lowering their OOP payments. The continuation of OOP payments reduces the need for macroeconomic policies and sustainable budgets.

scholarly journals ‘We have a plan for that’: a qualitative study of health system resilience through the perspective of health workers managing antenatal and childbirth services during floods in Cambodia

BMJ Open ◽  
2022 ◽  
Vol 12 (1) ◽  
pp. e054145
Author(s):  
Dell D Saulnier ◽  
Dawin Thol ◽  
Ir Por ◽  
Claudia Hanson ◽  
Johan von Schreeb ◽  
...  
Keyword(s):  
Public Sector ◽  
Qualitative Study ◽  
Health Services ◽  
Health System ◽  
Health Workers ◽  
Local Level ◽  
Structured Interviews ◽  
Healthcare Facilities ◽  
System Resilience ◽  
A Minor

ObjectiveHealth system resilience can increase a system’s ability to deal with shocks like floods. Studying health systems that currently exhibit the capacity for resilience when shocked could enhance our understanding about what generates and influences resilience. This study aimed to generate empirical knowledge on health system resilience by exploring how public antenatal and childbirth health services in Cambodia have absorbed, adapted or transformed in response to seasonal and occasional floods.DesignA qualitative study using semi-structured interviews and thematic analysis and informed by the Dimensions of Resilience Governance framework.SettingPublic sector healthcare facilities and health departments in two districts exposed to flooding.ParticipantsTwenty-three public sector health professionals with experience providing or managing antenatal and birth services during recent flooding.ResultsThe theme ‘Collaboration across the system creates adaptability in the response’ reflects how collaboration and social relationships among providers, staff and the community have delineated boundaries for actions and decisions for services during floods. Floods were perceived as having a modest impact on health services. Knowing the boundaries on decision-making and having preparation and response plans let staff prepare and respond in a flexible yet stable way. The theme was derived from ideas of (1) seasonal floods as a minor strain on the system compared with persistent, system-wide organisational stresses the system already experiences, (2) the ability of the health services to adjust and adapt flood plans, (3) a shared purpose and working process during floods, (4) engagement at the local level to fulfil a professional duty to the community, and (5) creating relationships between health system levels and the community to enable flood response.ConclusionThe capacity to absorb and adapt to floods was seen among the public sector services. Strategies that enhance stability and flexibility may foster the capacity for health system resilience.

scholarly journals EXPERIENCES OF IMMIGRANT WOMEN ACCESSING HEALTH CARE IN PUNTA ARENAS, CHILE

2020 ◽  
Vol 29 (spe) ◽  
Author(s):  
Mackarena Alejandra Antilef Ojeda ◽  
Evangelia Kotzias Atherino dos Santos ◽  
Pattrícia da Rosa Damiani
Keyword(s):  
Health Care ◽  
Data Collection ◽  
Health Services ◽  
Health System ◽  
Thematic Analysis ◽  
Access To Health Care ◽  
Immigrant Women ◽  
Access To Health ◽  
Descriptive Approach ◽  
The City

ABSTRACT Objective: to understand the experience of immigrant women on access to health care in the city of Punta Arenas, Chile. Method: a qualitative, exploratory, and descriptive approach study, in which 13 immigrant women took part. Data collection was carried out between March and July 2019, through four different focus groups. A thematic analysis was carried out. Results: from the analysis of the participants' narratives, the following categories emerged, detailed and analyzed in the light of other studies related to the theme: Use of the health services; Satisfaction in using the health services, and Obstacles to the use of the health services. Conclusion: in general, the immigrant population is required to know about their rights and duties as users of the health system.

Multi-level Barriers for Utilization of Youth Friendly Reproductive Health Services (YFRHS) among Youths

2020 ◽  
Vol 8 ◽  
pp. 95-108
Author(s):  
Shanti Prasad Khanal
Keyword(s):  
Reproductive Health ◽  
Health Services ◽  
Health System ◽  
System Level ◽  
Mixed Method Research ◽  
Reproductive Health Services ◽  
Group Discussions ◽  
Personal Level ◽  
Multi Level ◽  
Youth Friendly

 The present study aims to examine the multi-level barriers to utilize by the youth-friendly reproductive health services (YFRHS) among the school-going youths of the Surkhet valley of Nepal. This study is based on the sequential explanatory research design under mixed-method research. The quantitative data were collected using the self- administered questionnaire from the 249 youths, aged between the 15-24 years, those selected by using random sampling. The qualitative data were collected using the Focus Group Discussions (FGDs) from the 12 participants who were selected purposively. The study confirmed that school-going youths do not have appropriate utilization of YFHS due to multi-layered barriers. However, the utilization of the service was higher among females, those the older age group, studying in the upper classes, the upper castes, and married youths. The key findings and themes are recognized as multi-layered barriers including personal-level, health system-level, community-level, and policy-level on the entire socio-ecological field. Among them, the existing health system is the foremost barrier. Multi-level interventions are, therefore, required to increase the YFRHS utilization and improve concerns for school-going-youths.  

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