scholarly journals Proposta de modelo assistencial para uma operadora de saúde suplementar em expansão na cidade de São Paulo

2021 ◽  
Vol 21 (83) ◽  
Author(s):  
Lais De Sá Fonseca ◽  
Alberto José Niituma Ogata
Keyword(s):  
New Technologies ◽  
Health Management ◽  
Health Planning ◽  
Health Sector ◽  
Care Model ◽  
Patient Centered ◽  
Health Market ◽  
Health Products ◽  
New Guidelines ◽  
Number Of Customers

Proposal for an assistance model for an expanding supplementary health company in the city of São PauloIntrodução: O sistema de saúde suplementar enfrenta atualmente, assim como o setor público, os efeitos do aumento dos custos assistenciais. O setor saúde é influenciado pelo cenário econômico e sua atividade contribui com a geração de empregos e renda, e estimula o crescimento em investimentos e capital. O incremento das despesas neste segmento, está associado ao envelhecimento da população, às mudanças no perfil de consumo dos produtos de saúde, à incorporação de novas tecnologias, à falta de eficiência das ações preventivas e aos modelos de remuneração. Dessa forma, as operadoras passam a transformar as maneiras de ofertar cuidados através de novas diretrizes que buscam otimizar recursos e obter melhores resultados assistenciais, e assim, sustentabilidade no mercado de saúde privado. Objetivos: O presente trabalho visa propor a uma operadora de saúde privada em expansão de atividades um modelo assistencial baseado em referenciais teóricos e nas práticas do mercado de saúde suplementar atual. Método: Trata-se de pesquisa qualitativa com estratégia de estudo de caso. A análise descreve a operadora e suas características e detalha opções de modelo assistencial a serem aplicados em função da expansão do número de beneficiários. Resultados: A proposta de modelo para abordagem assistencial incluiu o foco em estrutura de atenção primária, a implantação de unidades de transição e cuidados paliativos e a prática de saúde integrativa. Conclusões: O estudo propõe alternativas para inserir o paciente no centro do cuidado e buscar melhor experiência, valor e fidelidade do cliente. A proximidade de equipe multidisciplinar exclusiva aos pacientes favorece, aliada ao segmento de diretrizes clínicas de indicadores processuais, o monitoramento sobre a utilização dos serviços disponíveis no sistema e a avaliação dos resultados operacionais.Palavras-chaves: Saúde Suplementar, Gestão em Saúde, Governança Clínica, Planejamento em Saúde, Sistemas de Saúde, Doenças Crônicas. ABSTRACTIntroduction: The supplementary health system is currently facing, as well as the public system, the effects of rising health care costs. The health sector is affected by the economic scenario and its activity contributes to generation of jobs, income, and stimulates growth in investments and capital. The increase in expenses in this segment is associated with ageing of population, changes in the consumption profile of health products, the incorporation of new technologies, the lack of efficiency in preventive actions and payment models. Thus, health companies begin to transform the ways of offering care through new guidelines that seek to optimize resources and obtain better care results, and thus, sustainability in the private health market. Objectives: The present study aims to propose to a private health operator in expansion of activities a care model based on theoretical references and on the practices of the current supplementary health market. Method: It is a qualitative research with a case study strategy. The analysis describes the company and its characteristics and details care model options to be applied due to the expansion in the number of customers. Results: The proposed model for the care approach included the focus on primary care structure, the implementation of transition units and palliative care and the practice of integrative health. Conclusions: The study proposes alternatives to insert patient centered care and seek better experience, value and customer loyalty. The proximity of an exclusive multidisciplinary team to patients favors, together with the segment of clinical guidelines for procedural indicators, the monitoring of the use of services available in the system and the evaluation of operational results.Keywords: Supplemental Health. Health management. Clinical Governance. Health Planning. Health Systems. Chronic Diseases.

scholarly journals Volunteer responsibilities, motivations and challenges in implementation of the community-based health planning and services (CHPS) initiative in Ghana: qualitative evidence from two systems learning districts of the CHPS+ project

2019 ◽  
Author(s):  
MMargaret Kweku ◽  
Emmanuel Manu ◽  
Hubert Amu ◽  
Fortress Yayra Aku ◽  
Martin Adjuik ◽  
...  
Keyword(s):  
Community Health ◽  
Health Management ◽  
Telecommunication Network ◽  
Health Planning ◽  
Health Sector ◽  
Community Members ◽  
Community Based ◽  
Community Health Volunteers ◽  
Systems Learning ◽  
Training Programmes

Abstract Background Community volunteerism is essential in the implementation of Community-based Health Planning and Services (CHPS) concept in Ghana. We explored the motivations, responsibilities and challenges of Community Health Management Committees (CHMC) in two CHPS+ project districts in Ghana.Methods We used a qualitative approach to collect data through 4 focus group discussions among a purposive sample of Community Health Volunteers in December 2018 and analysed them thematically.Results The value, self-enrichment and protective functions were found to be the key motivations for serving on CHMCs. The committees provide support in running the CHPS programme through resource mobilisation, monitoring of logistics, assisting the Community Health Officers (CHO) in the planning of CHPS activities, and resolution of conflicts between the CHOs and community members. Financial challenges, inadequate logistics, lack of support from community members, lack of motivation, poor telecommunication network and lack of frequent skill development training programmes for CHMC members who serve as traditional birth attendants (TBAs) were major challenges in CHMC volunteerism.Conclusion Community health volunteerism needs to be prioritised by the Ghana Health Service and other health sector stakeholders to make it attractive for members to give off their best in the discharge of their responsibilities.

scholarly journals Veterans Health Administration’s Whole Health System of Care: Supporting the Health, Well-Being, and Resiliency of Employees

2021 ◽  
Vol 10 ◽  
pp. 216495612110226
Author(s):  
Kavitha P Reddy ◽  
Tamara M Schult ◽  
Alison M Whitehead ◽  
Barbara G Bokhour
Keyword(s):  
Health System ◽  
Care Delivery ◽  
Health Planning ◽  
Well Being ◽  
Employee Health ◽  
Veterans Health ◽  
Health Administration ◽  
Patient Centered ◽  
Foundational Work ◽  
Health And Well Being

The Veterans Health Administration (VHA) is implementing a Whole Health System (WHS) of care that empowers and equips Veterans to take charge of their health and well-being and live their lives to the fullest, and increasingly leaders recognize the need and value in implementing a similar approach to support the health and well-being of employees. The purpose of this paper is to do the following: 1) provide an overview of the WHS of care in VHA and applicability in addressing employee resiliency; 2) provide a brief history of employee well-being efforts in VHA to date; 3) share new priorities from VHA leadership as they relate to Employee Whole Health strategy and implementation; and 4) provide a summary of the impacts of WHS of care delivery on employees. The WHS of care utilizes all therapeutic, evidence-based approaches to support self-care goals and personal health planning. Extending these approaches to employees builds upon 10 years of foundational work supporting employee health and well-being in VHA. In 2017, one facility in each of the 18 Veterans Integrated Service Networks (VISNs) in VHA was selected to participate in piloting the WHS of care with subsequent evaluation by VA’s Center for Evaluating Patient-Centered Care (EPCC). Early outcomes, from an employee perspective, suggest involvement in the delivery of the WHS of care and personal use of the whole health approach have a meaningful impact on the well-being of employees and how they experience the workplace. During the COVID-19 pandemic, VHA has continued to support employees through virtual resources to support well-being and resiliency. VHA's shift to this patient-centered model is supporting not only Veteran care but also employee health and well-being at a time when increased support is needed.

scholarly journals Benchmarking European Home Care Models for Older Persons on Societal Costs: The IBenC Study

2021 ◽  
Vol 14 ◽  
pp. 117863292110224
Author(s):  
Lisanne I van Lier ◽  
Henriëtte G van der Roest ◽  
Vjenka Garms-Homolová ◽  
Graziano Onder ◽  
Pálmi V Jónsson ◽  
...  
Keyword(s):  
Home Care ◽  
Patient Centered Care ◽  
Mean Difference ◽  
Care Model ◽  
Patient Centered ◽  
Societal Costs ◽  
Centered Care ◽  
Care Models ◽  
Prospective Longitudinal ◽  
Care Performance

This study aims to benchmark mean societal costs per client in different home care models and to describe characteristics of home care models with the lowest societal costs. In this prospective longitudinal study in 6 European countries, 6-month societal costs of resource utilization of 2060 older home care clients were estimated. Three care models were identified and compared based on level of patient-centered care (PCC), availability of specialized professionals (ASP) and level of monitoring of care performance (MCP). Differences in costs between care models were analyzed using linear regression while adjusting for case mix differences. Societal costs incurred in care model 2 (low ASP; high PCC & MCP) were significantly higher than in care model 1 (high ASP, PCC & MCP, mean difference €2230 (10%)) and in care model 3 (low ASP & PCC; high MCP, mean difference €2552 (12%)). Organizations within both models with the lowest societal costs, systematically monitor their care performance. However, organizations within one model arranged their care with a low focus on patient-centered care, and employed mainly generalist care professionals, while organizations in the other model arranged their care delivery with a strong focus on patient-centered care combined with a high availability of specialized care professionals.

scholarly journals Delivering Personalized Care at a Distance: How Telemedicine Can Foster Getting to Know the Patient as a Person

2021 ◽  
Vol 11 (2) ◽  
pp. 137
Author(s):  
Janet Record ◽  
Roy Ziegelstein ◽  
Colleen Christmas ◽  
Cynthia Rand ◽  
Laura Hanyok
Keyword(s):  
New Technologies ◽  
Office Visit ◽  
Modern Technology ◽  
Office Visits ◽  
Patient Centeredness ◽  
Patient Centered ◽  
Personalized Care ◽  
High Satisfaction

The promise of precision medicine is based on the use of new technologies to better characterize patients by defining individuals in the areas of genomics, proteomics, metabolomics and other aspects of biologic variability. Wise application of modern technology can similarly transform health visits with patients, allowing for better characterization of the patient’s individual life circumstances than possible in a traditional office visit. The use of, and experience with, telemedicine have increased significantly during the COVID-19 pandemic. Patients and clinicians report high satisfaction with telemedicine, and the quality of communication and patient-centeredness experienced in this setting are both rated highly. In this article, we explore the benefits offered by telemedicine in facilitating personalized care with particular focus on telemedicine delivered by video platforms. We propose strategies and skills specific to the effective implementation of personalized telemedicine, drawing on literature in patient-centered communication and home visits. While traditional in-person office visits continue to offer important opportunities such as thorough physical examination and the potential for enhanced non-verbal communication, telemedicine offers many important advantages that can facilitate the process of getting to know the patient as a person.

scholarly journals COVIDIAGNOSTIX: health technology assessment of serological tests for SARS-CoV-2 infection

2021 ◽  
Vol 37 (1) ◽  
Author(s):  
Rossella Tomaiuolo ◽  
Pietro Derrico ◽  
Matteo Ritrovato ◽  
Massimo Locatelli ◽  
Frida Milella ◽  
...  
Keyword(s):  
Health Technology Assessment ◽  
Technology Assessment ◽  
Evaluation Method ◽  
New Technologies ◽  
Health Management ◽  
Health Technology ◽  
Innovative Technology ◽  
Serological Tests ◽  
Antibody Tests

Abstract Objective In vitro diagnostic tests for SARS-COV-2, also known as serological tests, have rapidly spread. However, to date, mostly single-center technical and diagnostic performance's assessments have been carried out without an intralaboratory validation process and a health technology assessment (HTA) systematic approach. Therefore, the rapid HTA for evaluating antibody tests for SARS-COV-2 was applied. Methods The use of rapid HTA is an opportunity to test innovative technology. Unlike traditional HTA (which evaluates the benefits of new technologies after being tested in clinical trials or have been applied in practice for some time), the rapid HTA is performed during the early stages of developing new technology. A multidisciplinary team conducted the rapid HTA following the HTA Core Model® (version 3.0) developed by the European Network for Health Technology Assessment. Results The three methodological and analytical steps used in the HTA applied to the evaluation of antibody tests for SARS-COV-2 are reported: the selection of the tests to be evaluated; the research and collection of information to support the adoption and appropriateness of the technology; and the preparation of the final reports and their dissemination. Finally, the rapid HTA of serological tests for SARS-CoV-2 is summarized in a report that allows its dissemination and communication. Conclusions The rapid-HTA evaluation method, in addition to highlighting the characteristics that differentiate the tests from each other, guarantees a timely and appropriate evaluation, becoming a tool to create a direct link between science and health management.

Normalizing Cross-Border Healthcare in Europe via New E-Prescription Paradigms

2013 ◽  
pp. 168-208
Author(s):  
Alexander Berler ◽  
Ioannis Apostolakis
Keyword(s):  
Cloud Computing ◽  
New Technologies ◽  
Health Sector ◽  
Healthcare Services ◽  
Ageing Population ◽  
Strategic Decisions ◽  
Demographic Shift ◽  
Electronic Prescription ◽  
Cross Border ◽  
The Right

The 21st century started with some significant efforts globally in the e-health sector. This was mainly pushed as a generic strategy from many nations and international organizations in order to cope with issues such as ageing population, demographic shift, social security limitations, and financial instability. A second reason was the introduction of new technologies such as cloud computing, Web interoperability standards, mobile health, and social media that are steadily changing the way healthcare has been seen in the last decades. In addition to that, globalization, commuting, immigration, and increased mobility raised the issue of cross-border healthcare and the right to access normalized healthcare services anywhere, anytime. In that context, the authors analyze the technological offerings and result of the epSOS (European Patient Smart Open Services) framework and how it has affected strategic decisions in electronic prescription in Greece, thus creating a new useful e-health national application. They prove that by rethinking healthcare, reusing established standards such as HL7 CDA (Health Level Seven Clinical Document Architecture) and IHE (Integrating the Healthcare Enterprise) profiles, it is possible to propose a new innovative system that is in fact based upon new technological propositions such as REST (Representational State Transfer) architecture and cloud computing.

The Healthcare Strategic Practice in Abu Dhabi, United Arab Emirates

2019 ◽  
pp. 75-91
Author(s):  
Ahmad Al Balkhi
Keyword(s):  
United Arab Emirates ◽  
Health Planning ◽  
Health Sector ◽  
Theoretical Background ◽  
Abu Dhabi ◽  
Healthcare Sector ◽  
Special Focus ◽  
Health Issues ◽  
Strategic Option ◽  
Critical Issues

This chapter aims to review the healthcare strategies in the United Arab Emirates (UAE) with a special focus on the Emirate of Abu Dhabi. The chapter starts with an introduction to the adopted strategic planning of health sector in the UAE. Then it provides the theoretical background to the subject, outlines the persisting health issues and concerns, in addition to the main challenges of health planning in the United Arab Emirates. This will be followed by an overview of the current health system and regulations in the UAE, and will elaborate on the adopted health strategies, and upon that will suggest solutions and tips that can help in overcoming challenges and resolving critical issues. The review concludes with recommendation for future researches that could expand the scope of this review to be more comprehensive and focused on the strategic option for achieving excellence in the healthcare sector.

mHealth R&D Activities in Europe

2016 ◽  
pp. 758-789 ◽  
Author(s):  
Yiannis Koumpouros ◽  
Aggelos Georgoulas
Keyword(s):  
Health Sector ◽  
Real Life ◽  
Patient Centered Care ◽  
The European Union ◽  
Patient Centered ◽  
Current Trends ◽  
Health Innovations ◽  
Potential Market ◽  
Centered Care ◽  
Pros And Cons

The scope of the chapter is to present a thorough review on the most up to date research and development activities funded by the European Union in the m-health sector and more specifically in the domain of m-Health Innovations for Patient-Centered Care. This review brings to light the latest research directions and trends that are taking place around Europe and the world. The mhealth market is analyzed along with the focusing on the main apps and their classification. Moreover, it presents the trends of the research topics addressed and what are the plans and future activities pushed. The obstacles faced, the pros and cons and the proposed actions, and their match to real life situations are also discussed. The chapter concludes on the current trends and the potential market on m-health solutions and innovations and how they are trying to address the global need for patient-centered care.

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