scholarly journals Compassionate Healthcare for Parents of Children with Life-limiting Illnesses: A Qualitative Study

2021 ◽  
Vol 0 ◽  
pp. 1-6
Author(s):  
Leeai Chong ◽  
Farah Khalid ◽  
Adina Abdullah
Keyword(s):  
Burden Of Illness ◽  
Financial Burden ◽  
Quality Care ◽  
Premature Death ◽  
Spiritual Support ◽  
Clinical Experiences ◽  
Clinical Communication ◽  
Quality Healthcare ◽  
Bereaved Parents ◽  
Family Friendly

Objectives: Premature death of a child from a serious illness is probably one of the most painful experiences for a parent. This study examined the clinical experiences of bereaved parents of children with a life-limiting illness to provide recommendations for quality care. Materials and Methods: Data were collected using semi-structured in-depth interviews with bereaved parents whose children had died at least 3 months before the interview. Parents were purposively sampled from two institutions offering end-of-life care to children with life-limiting illnesses. Data were analysed using thematic analysis. Results: Data analysis revealed three main themes: (1) Clinical communication, (2) Healthcare infrastructure and (3) Non-physical aspects of healthcare. The seven subthemes uncovered were as follows: (1) Honesty and clarity, (2) empathy, (3) interdisciplinary communication, (4) inconveniences in hospital, (5) home palliative care, (6) financial burden of illness and (7) psychosocial and spiritual support. Conclusion: Strategies to improve healthcare for children and their families are multifold. Underlying the provision of quality care is compassion; a child and family-friendly healthcare system with compassionate providers and compassionate institutional policies are vital components to achieving quality healthcare. Culturally sensitive psychosocial, emotional and spiritual support will need to be integrated as standard care.

Evaluation of medical care for Diabetic and Hypertensive patients in primary care in Mexico: Observational retrospective study (Preprint)

2020 ◽  
Author(s):  
Agustin Lara-Esqueda ◽  
Sergio A Zaizar-Fregoso ◽  
Violeta M Madrigal-Perez ◽  
Mario Ramirez-Flores ◽  
Daniel A Montes-Galindo ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Medical Care ◽  
Serum Lipids ◽  
Quality Care ◽  
Premature Death ◽  
Current Standard ◽  
Anonymized Data ◽  
Quality Of Medical Care

BACKGROUND Diabetes Mellitus is a worldwide health problem and the leading cause of premature death with increasing prevalence over time. Usually, along with it, Hypertension presents and acts as another risk factor that increases mortality risk. Both diseases impact the country's health while also producing an economic burden for society, causing billions of dollars to be invested in their management. OBJECTIVE The present study evaluated the quality of medical care for patients diagnosed with diabetes mellitus (DM), hypertension (HBP), and both pathologies (DM+HBP) within a public health system in Mexico, according to the official Mexican standard for each pathology. METHODS 45,498 patients were included from 2012 to 2015. All information was taken from the electronic medical records database, exported as anonymized data for research purposes. Each patient record was compared against the standard to test the quality of medical care. RESULTS Glycemia with hypertension goals reached 29.6% in DM+HBP, 48.6% in DM, and 53.2% in HBP. The goals of serum lipids were reached by 3% in DM+HBP, 5% in DM, and 0.2% in HBP. Glycemia, hypertension, and LDL cholesterol reached 0.04%. 15% of patients had an undiagnosed disease of diabetes or hypertension. Clinical follow-up examinations reached 20% for foot examination and clinical eye examination in the whole population. Specialty referral reached 1% in angiology or cardiology in the whole population. CONCLUSIONS Goals for glycemic and hypertension reached 50% in the overall population, while serum lipids, clinical follow-up examinations, and referral to a specialist were deficient. Patients who had both diseases had more consultations, better control for hypertension and lipids, but inferior glycemic control. Overall, quality care for DM and/or HBP has not been met according to the standards. While patients with DM and HBP do not have a current standard to evaluate their own needs.

scholarly journals Case-management for nursing care of patient with stroke: a cross-cultural critical reflective analysis

2016 ◽  
Vol 2 (3) ◽  
pp. 178
Author(s):  
Dimitrios Theofanidis
Keyword(s):  
Health Care ◽  
Case Management ◽  
Health Care Professionals ◽  
Health Care Systems ◽  
Financial Burden ◽  
Quality Care ◽  
Stroke Care ◽  
Discussion Paper ◽  
Health Care Reforms ◽  
The Usa

Introduction: Stroke remains a heavy financial burden on health care systems around the world. Yet, health care reforms have called for sophisticated management systems in order to provide high-quality care on equal terms for the entire population within a cost-conscious environment. Aim: The main aim of this discussion paper is to define and reflect cross-culturally on the merits of the Case-Management (CM) approach for contemporary stroke care delivery.Methods: Critical reflective analysis was used for this paper’s needs, whereby readers are gradually introduced to skills of critical and reflective thinking. This can then be applied into a clinical context which may assist nurses to achieve a better understanding of their professional role within the complexities of contemporary health care delivery.Discussion: An overview for stroke care differences between Greece and USA is provided using the following critical analysis components: Situation, Experience evaluated, Personal Reflections and Opportunities for Change.Conclusions: CM in the USA aims to meet the urgent challenges of stroke care. CMs are health care professionals whose role is to serve as client advocates and to coordinate services whilst assuring financial and gate keeping functions as required. As these services are currently unavailable in Greece, despite adverse financial circumstances, efforts should be made to introduce a culturally adopted CM initiative for stroke care.

scholarly journals SCREENING FOR MILD COGNITIVE IMPAIRMENT: THERE IS THE WILL BUT IS THERE A WAY?

2020 ◽  
pp. 1-2
Author(s):  
J.E. Galvin
Keyword(s):  
Primary Care ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Burden Of Illness ◽  
Financial Burden ◽  
Fold Increase ◽  
Primary Care Providers ◽  
Care Providers ◽  
Eligibility Determination ◽  
The Will

Alzheimer’s disease (AD) currently affect over 5.8 million Americans and over 35 million people worldwide (1). The number of AD cases is expected to increase as the number of people over age 65 grow by 62% and the number over age 85 is expected to grow by 84% (1, 2). More than one in eight adults over age 65 has dementia, and current projections indicate a three-fold increase by 2050. Thus, the prevalence, incidence, morbidity, and mortality for AD (3) and its prodromal state of Mild Cognitive Impairment due to AD (MCI-AD) (4) will increase dramatically and the societal financial burden of illness and dependency will expand exponentially. Primary care providers are often responsible for the detection, diagnosis, and treatment of AD as the number of dementia specialists (neurologists, psychiatrists, and geriatricians) and specialty centers is not sufficient to meet the growing demands (2, 5). The inability to detect MCI and ADRD may affect eligibility determination for care and services and impede case ascertainment and recruitment in clinical research.

scholarly journals Impacts on employment, finances, and lifestyle for working age people facing an expected premature death: A systematic review

2017 ◽  
Vol 16 (3) ◽  
pp. 347-364 ◽  
Author(s):  
Slavica Kochovska ◽  
Tim Luckett ◽  
Meera Agar ◽  
Jane L. Phillips
Keyword(s):  
Systematic Review ◽  
English Language ◽  
Financial Burden ◽  
Premature Death ◽  
Well Being ◽  
Family Responsibilities ◽  
Language Studies ◽  
Working Age ◽  
Nonmalignant Disease ◽  
The Impact

ABSTRACTObjective:The working ages (25–65 years) are a period when most people have significant work, financial, and family responsibilities. A small proportion of working age people will face an expected premature death from cancer or other life-limiting illness. Understanding the impact an expected premature death has on this population is important for informing support. The current study set out to summarize research describing the effects that facing an expected premature death has on employment, financial, and lifestyle of working age people and their families.Method:A systematic review using narrative synthesis approach. Four electronic databases were searched in July 2016 for peer-reviewed, English language studies focusing on the financial, employment, and lifestyle concerns of working age adults living with an advanced life-limiting illness and/or their carers and/or children.Results:Fifteen quantitative and 12 qualitative studies were included. Two-thirds (n = 18) were focused on cancer. All studies identified adverse effects on workforce participation, finances, and lifestyle. Many patients were forced to work less or give up work/retire early because of symptoms and reduced functioning. In addition to treatment costs, patients and families were also faced with child care, travel, and home/car modification costs. Being younger was associated with greater employment and financial burden, whereas having children was associated with lower functional well-being. Changes in family roles were identified as challenging regardless of diagnosis, whereas maintaining normalcy and creating stability was seen as a priority by parents with advanced cancer. This review is limited by the smaller number of studies focussing on the needs of working age people with nonmalignant disease.Significance of results:Working age people facing an expected premature death and their families have significant unmet financial, employment, and lifestyle needs. Comparing and contrasting their severity, timing, and priority for people with nonmalignant conditions is required to better understand their unique needs.

Novel Spanish Translators for Acute Care Nurses and Physicians: Usefulness and Effect on Practitioners’ Stress

2005 ◽  
Vol 14 (6) ◽  
pp. 545-550 ◽  
Author(s):  
Andrew C. Bernard ◽  
Audra Summers ◽  
Jennifer Thomas ◽  
Myrna Ray ◽  
Anna Rockich ◽  
...  
Keyword(s):  
Critical Care ◽  
Stress Reduction ◽  
Quality Care ◽  
Healthcare Providers ◽  
Critical Care Nurses ◽  
Survey Period ◽  
Acute Care Nurses ◽  
Quality Healthcare ◽  
Stress Levels ◽  
Nurses And Physicians

• Background Language barriers are significant impediments to providing quality healthcare, and increased stress levels among nurses and physicians are associated with these barriers. However, little evidence supports the usefulness of a translation tool specific to healthcare. • Objectives To evaluate the effectiveness of a novel English-Spanish translator designed specifically for nurses and physicians. The hypothesis was that the translator would be useful and that use of the translator would decrease stress levels among nurses and physicians caring for Spanish-speaking patients. • Methods Novel English-Spanish translators were developed entirely on the basis of input from critical care nurses and physicians. After 7 months of use, users completed surveys. Usefulness of the translator and stress levels among users were reported. • Results A total of 60% of nurses (n = 32) and 71% (n = 25) of physicians responded to the survey. A total of 96% of physicians and 97% of nurses considered the language barrier an impediment to delivering quality care. Nurses reported significantly more stress reduction than did physicians (P = .01). Most nurses and physicians had used the translator during the survey period. Overall, 91% of nurses and 72% of physicians found that the translator met their needs at the bedside some, most, or all of the time. All nurses thought that they most likely would use the translator in the future. • Conclusions The translator was useful for most critical care nurses and physicians surveyed. Healthcare providers, especially nurses, experienced decreased stress levels when they used the translator.

scholarly journals Breast Cancer: Reimbursement Policies and Adoption of New Therapeutic Agents by National Health Systems

Breast Care ◽  
2019 ◽  
Vol 14 (6) ◽  
pp. 373-381 ◽  
Author(s):  
Dario Trapani ◽  
Giuseppe Curigliano ◽  
Alexandru Eniu
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Priority Setting ◽  
Financial Distress ◽  
Quality Care ◽  
Premature Death ◽  
Health Coverage ◽  
Breast Cancer Patients ◽  
Middle Income ◽  
Timely Access

Background: Breast cancer is a cause of morbidity for more than half a million of patients in Europe, resulting in broad societal impacts that affect patients, families, and societies from a human, emotional, economic, and financial perspective. Expenditure for cancer medicines represents one of the principal driving costs of healthcare. The aim of this review is to describe the European policy and regulatory landscape of innovation uptake in breast oncology – with emphasis on value in cancer healthcare. Summary: In Europe, several reimbursement models or policy tools have been developed by countries to compose their benefit packages. The most commonly applied scheme is the product-specific eligibility model, prioritizing selected medicines and their indications. Mixed models are commonly developed, addressing the protection of more vulnerable people, ensuring protection from impoverishment caused by cancer and containing disparities. However, the risk to incur significant out-of-pocket expenses for essential or newer medicines for cancer is still substantial in Europe, especially in low- and middle-income countries, determining greater financial distress and poorer outcome for patients. Value-based priority setting is an essential mechanism to ensure timely access to the most valuable medicines for breast cancer patients. Estimations of the value of medicines can be provided within health technology assessment services and networks and informed by benefit scales and tools. Key Messages: There is ample room for reciprocal support across the diverse cultural and legal realities in Europe. The aim is common: save cancer patients from premature death by ensuring the timely access to the best care, protecting from financial hardships and distress to leave no cancer patient behind in poverty. Steps are to be taken to promote value-based priority setting, paving the way toward universal health coverage in Europe, where health of people is protected, and affordable best quality care is the only standard pursued and acceptable.

Territorial Inequality in Health Service Delivery: Lessons from Latin America’s Federations

2020 ◽  
Vol 62 (3) ◽  
pp. 19-43
Author(s):  
Agustina Giraudy ◽  
Jennifer Pribble
Keyword(s):  
Latin American ◽  
Central Government ◽  
Quality Care ◽  
Health Service Delivery ◽  
Quality Healthcare ◽  
Increased Risk ◽  
Two Factors ◽  
Inequality In Health ◽  
Low Levels ◽  
Latin American Countries

ABSTRACTAccess to quality healthcare varies across the national territory inside Latin American countries, with some subnational units enjoying higher-quality care than others. Such territorial inequality is consequential, as residents of particular regions face shorter life spans and an increased risk of preventable disease. This article analyzes trajectories of territorial healthcare inequality across time in Argentina, Brazil, and Mexico. The data reveal a large decline in Brazil, a moderate decline in Mexico, and low levels of change followed by a moderate decline in Argentina. The article argues that two factors account for these distinct trajectories: the nature of the coalition that pushed health decentralization forward and the existence of mechanisms for central government oversight and management.

scholarly journals Was spricht gegen Zwei-Klassen-Medizin?

2018 ◽  
Vol 67 (1) ◽  
pp. 30-41
Author(s):  
Friedrich Breyer
Keyword(s):  
Health Insurance ◽  
Private Health Insurance ◽  
Burden Of Illness ◽  
Financial Burden ◽  
Sickness Fund ◽  
Health Insurance System ◽  
Average Income ◽  
Lively Debate ◽  
Leftist Parties ◽  
Adjustment Scheme

Abstract: In Germany, there is a lively debate on a so-called „two-class-medicine“, meaning that privately insured persons get better medical treatment than sickness fund members. As an economist, the author is not in a position to judge whether this is true. However, the co-existence of social and private health insurance (GKV and PKV) constitutes a „two-class-health insurance“, which leads to severe inequities in the distribution of the financial burden of illness. In this article it is shown that there are legal ways to address and eliminate these inequities without abolishing the private health insurance system altogether. The instruments are the inclusion of private health insurance in the risk adjustment scheme of the sickness funds and the transformation of the GKV contributions into flat per-person amounts, independent of earnings, accompanied by a tax-financed compensation for families with below-average income, as in Switzerland and the Netherlands. Interestingly, this second reform proposal has been vigorously opposed by all leftist parties ever since, who fight for the chimaera of a „people's insurance“, which sounds good but cannot be implemented in a legal way and, moreover, would not even eliminate „two-class-medicine“.

scholarly journals A STEEEP Hill to Climb: A Scoping Review of Assessments of Individual Hospitalist Performance

2020 ◽  
Vol 15 (10) ◽  
pp. 599-605 ◽  
Author(s):  
Alan W Dow ◽  
Benjamin Chopski ◽  
John W Cyrus ◽  
Laura E Paletta-Hobbs ◽  
Rehan Qayyum
Keyword(s):  
Scoping Review ◽  
Quality Care ◽  
Transitions Of Care ◽  
Evidence Based ◽  
Consensus Guidelines ◽  
Patient Centered ◽  
Quality Healthcare ◽  
Current Assessment ◽  
Evidence Based Guidelines ◽  
Future Work

BACKGROUND: Although ensuring high-quality care requires assessment of individual hospitalist performance, current assessment approaches lack consistency and coherence. The Institute of Medicine’s STEEEP framework for quality healthcare conceptualizes quality through domains of “Safe,” “Timely,” “Effective,” “Efficient,” “Equitable,” and “Patient Centered.” This framework may be applicable to assessing individual hospitalists. OBJECTIVE: This scoping review sought to identify studies that describe variation in individual hospitalist performance and to code this data to the domains of the STEEEP framework. METHODS: Via a systematic search of peer-reviewed literature that assessed the performance of individual hospitalists in the Medline database, we identified studies that described measurement of individual hospitalist performance. Forty-two studies were included in the final review and coded into one or more domains of the STEEEP framework. RESULTS: Studies in the Safe domain focused on transitions of care, both at discharge and within the hospital. Many studies were coded to more than one domain, especially Timely, Effective, and Efficient. Examples include adherence to evidence-based guidelines or Choosing Wisely recommendations. The Patient Centered domain was most frequently coded, but approaches were heterogeneous. No included studies addressed the domain Equitable. CONCLUSIONS: Applying the STEEEP framework to the published literature on assessment of individual hospitalist performance revealed strengths and weaknesses. Areas of strength were assessments of transitions of care and application of consensus guidelines. Other areas, such as equity and some components of safe practice, need development. All domains would benefit from more practical approaches. These findings should stimulate future work on feasibility of multidimensional assessment approaches.

scholarly journals How Does ISO 15189 Laboratory Accreditation Support the Delivery of Healthcare in Ethiopia? A Systematic Review

1970 ◽  
Vol 29 (2) ◽  
Author(s):  
Kasaw Adane ◽  
Mekonnen Girma ◽  
Teshiwal Deress
Keyword(s):  
Quality Improvement ◽  
Quality Management System ◽  
Quality Care ◽  
Quality Of Healthcare ◽  
Healthcare Services ◽  
Improve Quality ◽  
Iso 15189 ◽  
Quality Healthcare ◽  
Quality Patient Care ◽  
Quality Improvement Interventions

BACKGROUND: Assessing quality by considering input, process and output level quality variables is important to ensure improved quality services. Designing and execution of an effective quality management system are aimed for the purpose of quality improvement, error reduction and associated risks. Therefore, this review is designed to assess the value of accreditation on the performance of healthcare institutions in ensuring quality improvement interventions. Moreover, this review presents important concepts of accreditation and the aspects of quality.METHODS: Published articles were downloaded using EndNote® application software program from PubMed (NML) database, Web of Sciences (TS) and Google Scholar. From a total of 883 downloaded full-text published materials, only 28 journals and 1 report issued from 2010 to 2017 were used for the development of this review.RESULT: The overall quality of healthcare services in developing countries was error-prone and suffered from limitations. These could be associated with wrong interventions and increased risks. Accreditation schemes have been implemented to provide quality care and ensure safety.CONCLUSION: Evaluation feedback induces interventions aimed at quality improvement and ensures better management systems, good process design, wise resource utilization, meeting patients’ need and increased satisfaction. Hence, stakeholders must be engaged in the provision of improve quality patient care and reduce associated risks. Hence, giving special quality improvement attention helps to improve quality healthcare services.

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