scholarly journals Case Study for Stroke: National Stroke Data Linkage Program

2020 ◽  
Vol 5 (5) ◽  
Author(s):  
Monique F Kilkenny ◽  
Joosup Kim ◽  
Lachlan Dalli ◽  
Amminadab Eliakundu ◽  
Muideen Olaiya
Keyword(s):  
Linked Data ◽  
Data Linkage ◽  
Stroke Care ◽  
Aged Care ◽  
Public Hospitals ◽  
Economic Evaluations ◽  
Care Services ◽  
Linkage Program ◽  
The Impact

IntroductionStroke is a leading cause of death and disability. Since 2012, our innovative national data linkage program, has enabled the successful linkage of data from the Australian Stroke Clinical Registry (AuSCR) with national and state-based datasets to investigate the continuum of stroke care and associated outcomes. Objectives and ApproachUsing stroke as a case study, in this symposium we will describe the use of linked data to undertake clinical and economic evaluations and contribute new knowledge for policy and practice. We have undertaken a range of iterative and innovative projects linking the AuSCR (used now in >80 public hospitals across Australia with follow-up survey of patients between 90-180 days) with various administrative datasets. Linkages with the National Death Index, inpatient admissions and emergency presentations, Pharmaceutical Benefits Scheme (PBS), Medicare Benefits Schedule (MBS), Aged Care services; Ambulance Victoria, Australian Rehabilitation Outcomes Centre and general practice network datasets (POLAR) have been achieved. ResultsThe symposium will provide case studies and results from four data linkage projects involving the AuSCR: 1) Stroke123 (NHMRC: #1034415), a study to investigate the impact of quality of acute care on admission/emergency presentations and survival; 2) PRECISE (NHMRC:#1141848), a study to evaluate models of primary care involving linkages with PBS/MBS, aged care services and admissions/emergency data; 3) AMBULANCE: a study to investigate how pre-hospital care affects acute stroke care involving linkages with the ambulance and admissions/emergency datasets; and 4) POLAR: a study to understand the long-term management of stroke involving linkages with primary health data. Conclusion / ImplicationsThe National Stroke Data Linkage Program has been visionary and remains highly contemporary in the field of linked data. A unique feature of this program is the active participation of clinicians and policy-makers to ensure the evidence generated have direct benefits for accelerating change in practice and informing policy.

scholarly journals Assessing the Distribution of Elderly Requiring Care: A Case Study on the Residents in Barcelona and the Impact of COVID-19

2020 ◽  
Vol 17 (20) ◽  
pp. 7486
Author(s):  
Enrique Arvelo ◽  
Jesica de Armas ◽  
Monserrat Guillen
Keyword(s):  
Assisted Living ◽  
Negative Impact ◽  
Elderly Care ◽  
Principal Component ◽  
The Public ◽  
Care Services ◽  
Choropleth Maps ◽  
The Impact ◽  
The City

In this work, we establish a methodological framework to analyze the care demand for elderly citizens in any area with a large proportion of elderly population, and to find connections to the cumulative incidence of COVID-19. Thanks to this analysis, it is possible to detect deficiencies in the public elderly care system, identify the most disadvantaged areas in this sense, and reveal convenient information to improve the system. The methods used in each step of the framework belong to data analytics: choropleth maps, clustering analysis, principal component analysis, or linear regression. We applied this methodology to Barcelona to analyze the distribution of the demand for elderly care services. Thus, we obtained a deeper understanding of how the demand for elderly care is dispersed throughout the city. Considering the characteristics that were likely to impact the demand for homecare in the neighborhoods, we clearly identified five groups of neighborhoods with different profiles and needs. Additionally, we found that the number of cases in each neighborhood was more correlated to the number of elderly people in the neighborhood than it was to the number of beds in assisted living or day care facilities in the neighborhood, despite the negative impact of COVID-19 cases on the reputation of this kind of center.

scholarly journals Effectiveness and cost-effectiveness of TeleStroke consultations to support the care of patients who had a stroke presenting to regional emergency departments in Western Australia: an economic evaluation case study protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e043836
Author(s):  
Christina Tsou ◽  
Suzanne Robinson ◽  
James Boyd ◽  
Shruthi Kamath ◽  
Justin Yeung ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Western Australia ◽  
Statistical Power ◽  
Stroke Care ◽  
Service Development ◽  
Tree Model ◽  
Human Research ◽  
Human Research Ethics ◽  
The Impact

IntroductionThe Western Australia (WA) Acute TeleStroke Programme commenced incrementally across regional WA during 2016–2017. Since the introduction of the TeleStroke Programme, there has been monitoring of service outputs, including regional patient access to tertiary stroke specialist advice and reperfusion treatment; however, the impact of consultation with a stroke specialist via telehealth (videoconferencing or telephone) on the effectiveness and cost-effectiveness of stroke care and the drivers of cost-effectiveness has not been systematically evaluated.Methods and analysisThe aim of the case study was to examine the impact of consultation with a stroke specialist via telehealth on the effectiveness and cost-effectiveness of stroke and transient ischaemic attack care using a mixed methods approach. A categorical decision tree model will be constructed in collaboration with clinicians and programme managers. A before and after comparison using state-wide administrative datasets will be used to run the base model. If sample size and statistical power permits, the cases and comparators will be matched by stroke type and presence of CT scan at the initial site of presentation, age category and presenting hospital. The drivers of cost-effectiveness will be explored through stakeholder interviews. Data from the qualitative analysis will be cross-referenced with trends emerging from the quantitative dataset and used to guide the factors to be involved in subgroup and sensitivity analysis.Ethics and disseminationEthics approval for this case study has been granted from the Western Australian Country Health Service Human Research and Ethics Committee (RGS3076). Reciprocal approval has been granted from Curtin University Human Research Ethics Office (HRE2019-0740). Findings will be disseminated publicly through conference presentation and peer-review publications. Interim findings will be released as internal reports to inform the service development.

Performance of CEmONC Centres in Public Hospitals of Tamil Nadu

2018 ◽  
Vol 20 (3) ◽  
pp. 363-377
Author(s):  
S. Rajasulochana ◽  
Umakant Dash
Keyword(s):  
Health Care ◽  
Tamil Nadu ◽  
Newborn Care ◽  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
Public Hospitals ◽  
Primary Study ◽  
Structured Interviews ◽  
Care Services

This case study examines the performance of public hospitals in Tamil Nadu in delivering emergency obstetric care services over a period of 8 years as well as to investigate from provider’s perspective the issues and constraints that affect performance. A mixed method approach has been adopted, integrating the descriptive analysis of administrative data on performance reports (2006–2007 to 2013–2014) of emergency obstetric and newborn care services in 46 public hospitals, along with primary study comprising of semi-structured interviews of 27 health personnel across selected public hospitals. Examination of trends in selected performance indicators shows that utilization of public hospitals for emergency obstetric and newborn care services has improved; a number of complicated and critical cases revived in the comprehensive emergency obstetric and newborn care (CEmONC) centres of public hospitals have gone up. The capability to treat complicated maternal and neonatal cases, however, is limited by inadequacy of specialist doctors, equipment maintenance issue and lack of hospital management. This case study is of interest to both public hospital administrators and health care policymakers who want to improve and develop strategies for better management in public hospitals. Specifically, there is an urgent need to (a) readdress human resource policy for health care personnel, (b) devise appropriate mechanisms for periodic inspection and preventive maintenance of hospital equipment and (c) develop management capabilities and leadership skills within public health system.

scholarly journals Impact of COVID-19 on Mental Health of Palliative Care Professionals and Services: A Mixed Method Survey Study

2021 ◽  
Author(s):  
Wallace Chi Ho Chan ◽  
Raymond Kam Wing Woo ◽  
Denis Ka-Shaw Kwok ◽  
Clare Tsz Kiu Yu ◽  
Lawrence Man-Hon Chiu
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Palliative Care ◽  
Health Care Professionals ◽  
Public Hospitals ◽  
Survey Study ◽  
Post Traumatic Stress ◽  
Care Services ◽  
Palliative Care Services ◽  
The Impact

Abstract Background: The impact of the COVID-19 pandemic on the mental health of health care professionals is profound, but few studies have examined this phenomenon. The way palliative care services have been affected during the pandemic remains underexplored. This study aimed to 1. examine the mental health of palliative care professionals during the pandemic and the relationship of mental health with socio-demographic factors; and 2. explore the impact of the pandemic on palliative care services. Methods: A cross-sectional survey study was conducted, and 142 palliative care professionals from public hospitals in Hong Kong completed an online questionnaire, which includes measurements on depression, anxiety, perceived stress, post-traumatic stress, professional quality of life, and 15 questions on the effect of COVID-19 on palliative care services. Descriptive and multivariate regression analyses were conducted. Quantitative and qualitative data about the impact of COVID-19 on palliative care services were analyzed and triangulated using a mixed-methods approach. Results: Our findings indicated that 82%, 43% and 42% of the participants felt moderately to highly stressed, anxious, and depressed during the pandemic. Female professionals who are younger or have no religious belief tended to have poorer mental health. Qualitative findings identified three themes which affected the provision of palliative care: 1. the tightening of restrictions on visitors; 2. The limited provision of services; and 3. staff deployment. Conclusions: This study suggests the need for concern about the mental health of palliative care professionals and for developing strategies of coping with the challenges during the pandemic.Trial registration: N/A (This paper does not involve a health care intervention)

Navigating the marketisation of community aged care services in rural Australia

2020 ◽  
Vol 4 (3) ◽  
pp. 377-393
Author(s):  
Suzanne Hodgkin ◽  
Pauline Savy ◽  
Samantha Clune ◽  
Anne-Marie Mahoney
Keyword(s):  
Free Market ◽  
Aged Care ◽  
Care Programme ◽  
For Profit ◽  
Care Services ◽  
Not For Profit ◽  
Service Organisation ◽  
Rural Australia ◽  
Community Aged Care

The aged care policies of many Organisation for Economic Co-operation and Development countries reflect free-market principles. In Australia, the recently introduced Consumer Directed Care programme centres on markets in which a range of organisations compete to provide services to community-living elders. As consumers, older people are allocated government funding with which they select and purchase items from their chosen service organisation. This article presents findings from a case study that explored the impacts of this programme on a group of rurally based, not-for-profit providers and consumers. The findings portray the challenges and advantages associated with providing and accessing services in limited rural markets.

scholarly journals Kaizen–Kata, a Problem-Solving Approach to Public Service Health Care in Mexico. A Multiple-Case Study

2020 ◽  
Vol 17 (9) ◽  
pp. 3297 ◽  
Author(s):  
Manuel F. Suárez-Barraza ◽  
José A. Miguel-Davila
Keyword(s):  
Health Care ◽  
Public Hospitals ◽  
Care Process ◽  
Customer Complaints ◽  
Study Approach ◽  
Operational Problem ◽  
Multiple Case ◽  
The Impact ◽  
Practical Implications

Purpose: Mexico’s public hospitals are experiencing major operational problems which seriously affect the care of Mexican citizens. Some hospitals have initiated efforts to apply the Kaizen philosophy to improve this situation. Therefore, the purpose of this article is to analyze the methodological impact of Kaizen–Kata implementation in Mexican public hospitals that have tried to solve operational problems using this improvement approach. Design/Methodology/Approach: The service organization implemented Kaizen–Kata methodology in order to improve one operational problem-process in health care. A case-study approach was used in this research in order to understand the effects of the Kaizen–Kata methodology in solving problems in their operational procedures. Findings: Six specific drivers were identified when applying the Kaizen–Kata methodology. Furthermore, the impact on the levels of implementation of the Kaizen–Kata methodology in each of the improvement teams studied was also identified. Research Limitations: The main limitation of the research is that only three case-studies are presented thus it is not possible to generalize its results. Practical Implications (Where Possible): Other public hospitals can use this specific example as a working guide to solve the operational problems of health systems. Originality/Value: A methodology of continuous improvement in manufacturing was imported from the industry sector for application in an operational health care process. The Kaizen–Kata methodology contributed significantly to improving issues involving delays, customer complaints, process reworks and extra-cost, among other effects of operational problems.

Challenges in Clinical Data Linkage in Australia

2016 ◽  
Vol 1 (1) ◽  
pp. 18-29
Author(s):  
Jane Dominique Moon ◽  
Megan Bohensky ◽  
Mary Galea
Keyword(s):  
Data Linkage ◽  
Medical Intervention ◽  
Public Hospitals ◽  
Record System ◽  
Australian Health ◽  
Comprehensive Management ◽  
Multiple Data ◽  
Cord Injury ◽  
Private And Public ◽  
Linkage Program

Long term and comprehensive management of patients with Spinal Cord Injury (SCI) within the Australian health system suffers from ineffective patient data co-ordination between state and federal levels, between private and public hospitals, and among the allied health sectors, all of which form multiple data custodians. Patients with SCI may require medical intervention over an average of 30-40 years thus it is challenging to keep all the information that belongs to the same person accessible over a prolonged period of time. Although Australia is leading in the data linkage program (e.g. the West Australian Data Linkage Systems, WADLS), it has a long way to go as far as SCI patients are concerned. Here, the authors present findings based on interviews with a range of data custodians for patients with SCI, showing that data are kept in different silos which are not coordinated, hence duplication exists and patient information that exists on many different databases is inconsistently updated. This paper presents information generated by SCI patients and considers the range of data custodians and issues involved in data linkage in Australia, as well as reviewing the WADLS and a new Australian Government initiative called My Health Record system.

scholarly journals The Equity of Health Care Spending in South Korea: Testing the Impact of Publicness

2020 ◽  
Vol 17 (5) ◽  
pp. 1775
Author(s):  
Youngju Kang ◽  
Minyoung Kim ◽  
Kwangho Jung
Keyword(s):  
Health Care ◽  
Health Care Services ◽  
Hospital Performance ◽  
Public Hospitals ◽  
Future Research ◽  
Health Care Spending ◽  
Government Ownership ◽  
Care Services ◽  
Sectoral Differences ◽  
The Impact

This paper examined the important organizational and managerial factors of publicness for the equity of health care. The extent of organizational publicness was measured with key independent variables such as ownership, evaluation, and accreditation. The dependent variable was measured by three equity indicators for patients under medical care and veterans care: financial inequity, social equity, and overall equity. We analyzed unbalanced panel data with 328 general hospitals between 2008 and 2012. We performed panel analysis with fixed and random effects. Our findings illustrate that government ownership is significantly associated with differences in equity indicators. Government owned hospitals show the better performance for equity than nonprofit and individually owned hospitals do. Compared to nonprofit and individually owned hospitals, government owned hospitals have a higher share of medical payment bills and health care spending for the disadvantaged but a lower proportion of out-of-pocket payment. Government evaluation is also significantly related to better equity performance. There are, however, significantly negative interactions between hospital government ownership and the size of medical payment bills. We found a significant tendency that the more medical payments, the less responsiveness to the equity of health care in government owned hospitals. Future research in hospital performance is required to consider not only sectoral differences but also the negative proclivity of public hospitals that shrink health care services for the poor. Further research is also expected to explore what sectoral identities and behaviors across public, nonprofit, and private hospitals influence the level of equity or inequity in health care.

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