scholarly journals Sociodemographic Factors Influencing the Use of eHealth in People with Chronic Diseases

2019 ◽  
Vol 16 (4) ◽  
pp. 645 ◽  
Author(s):  
Fabienne Reiners ◽  
Janienke Sturm ◽  
Lisette J.W. Bouw ◽  
Eveline J.M. Wouters
Keyword(s):  
Health Care ◽  
Chronic Disease ◽  
Chronic Diseases ◽  
Rural Areas ◽  
Health Care Services ◽  
Sociodemographic Factors ◽  
Care Services ◽  
Computing Machinery ◽  
Different Types ◽  
Lower Education

Alongside the growing number of older persons, the prevalence of chronic diseases is increasing, leading to higher pressure on health care services. eHealth is considered a solution for better and more efficient health care. However, not every patient is able to use eHealth, for several reasons. This study aims to provide an overview of: (1) sociodemographic factors that influence the use of eHealth; and (2) suggest directions for interventions that will improve the use of eHealth in patients with chronic disease. A structured literature review of PubMed, ScienceDirect, Association for Computing Machinery Digital Library (ACMDL), and Cumulative Index to Nursing and Allied Health Literature (CINAHL) was conducted using four sets of keywords: “chronic disease”, “eHealth”, “factors”, and “suggested interventions”. Qualitative, quantitative, and mixed-method studies were included. Four researchers each assessed quality and extracted data. Twenty-two out of 1639 articles were included. Higher age and lower income, lower education, living alone, and living in rural areas were found to be associated with lower eHealth use. Ethnicity revealed mixed outcomes. Suggested solutions were personalized support, social support, use of different types of Internet devices to deliver eHealth, and involvement of patients in the development of eHealth interventions. It is concluded that eHealth is least used by persons who need it most. Tailored delivery of eHealth is recommended.

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.

scholarly journals A Socio-ecological Framing of the Philippine Mental Health Act of 2017

Spectrum ◽  
2018 ◽  
Author(s):  
Josiah Michael Villareal De Los Santos ◽  
Sonya Jakubec
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Rural Areas ◽  
Health Care Services ◽  
Population Level ◽  
Case Review ◽  
Care Services ◽  
Barriers To Implementation ◽  
Sphere Of Influence

Filipinos experience numerous barriers to mental health care in their country, such as stigmatization ofillness and behaviours, lack of mental health care services, and resource deficits. The Philippine MentalHealth Act of 2017 was formed to resolve these issues and is in its early stages of implementation.Legislation and policy interventions of this nature are but one level of many interventions that can addresshealth care at a population level. The influence of this legislation for different levels of society is analyzed inorder to understand the different barriers and alternatives to its implementation. Solutions suggested in thelegislation, such as addressing lack of accessibility in rural areas, creating liaisons between different levelsof mental health care, and educating the population regarding mental health, are explored for their effects ondifferent spheres, or levels, of influence. The comprehensiveness of the legislation to address the needs ofmental health service users are highlighted, as are barriers to implementation that inhibit the realization ofpractical strategies. This policy case review and analysis informs program development by highlighting thestrengths and weaknesses aligned to the legislative articles’ target sphere of influence and the population.

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.

Innovation in ICT-Based Health Care Provision

2011 ◽  
Vol 6 (2) ◽  
pp. 14-27 ◽  
Author(s):  
Synnøve Thomassen Andersen ◽  
Arild Jansen
Keyword(s):  
Health Care ◽  
Rural Areas ◽  
Health Care Services ◽  
Innovation Process ◽  
Care Provision ◽  
Power Structures ◽  
Mobile Phone Technology ◽  
Existing Structures ◽  
Care Services ◽  
Decentralized Model

This paper describes a project redesigning psychiatric services for children and adolescents, introducing a new decentralized model into the ordinary structures of health care services in rural areas in Norway by using mobile phone technology. The authors apply a multilayer and dialectic perspective in the analysis of the innovation process that created the ICT solution that supports this treatment model. The salient challenges of the project were related to the contradictions between the existing, dominant power structures and the emergent structures in the different layers of the design structures. As a result of the development process, a new model emerged with a larger potential for creating a new innovation path than if it had been linked to existing structures. This paper contributes to the understanding of how user-driven innovation can break with existing power structures through focusing on different layers in the change processes.

Promoting Health in Rural India: Enhancing Job Performance of Lay Health Care Activists

2019 ◽  
Vol 9 (2) ◽  
pp. 226-242 ◽  
Author(s):  
Jatin Pandey ◽  
Manjari Singh ◽  
Biju Varkkey ◽  
Dileep Mavalankar
Keyword(s):  
Health Care ◽  
Job Performance ◽  
Community Health ◽  
Health Care Workers ◽  
Rural Areas ◽  
Health Care Services ◽  
Rural India ◽  
Community Health Care ◽  
Care Services ◽  
Care Workers

The health of people in a nation is a potential indicator of its development. Over and above that, the job performance of people involved in the delivery and facilitation of health care services within a nation reflects the actual health conditions in it. In developing countries, where a large chunk of the population lives in rural areas, the job performance of grass-roots health care workers gains significant importance in order to ensure effective and efficient delivery of health care services to the masses and marginalized communities. The present study takes the case of Accredited Social Health Activists (ASHAs) in difficult rural areas of India to identify factors that affect their job performance and suggests interventions through which it could be enhanced. Fifty-five ASHAs were interviewed and five focused group discussions (FGDs) were conducted. Additionally, triangulation was done by interviewing other stakeholders, while studying relevant documents. Through content analysis of these interviews and documents, this study identifies the demands, resources and stressors that affect the job performance of these important intermediaries in the health care supply chain (in the Indian context). The study also suggests policy-level decisions that could help in enhancing job performance of ASHAs by managing demands, increasing resources and reducing stressors. Key Messages We have developed a model that delineates the demands, resources and stressors that affect job performance of women workers in rural India. We have studied Accredited Social Health Activists (ASHAs) who are part of community health care sector. However, our findings are applicable to a wider set of similar job roles. We have studied the nuances of factors affecting job performance for a category of community health care workers who are not full-time employees, have received minimal training and work in close proximity of their residence in a closely knit society. We have looked at job performance of ASHAs who are women community health workers, with low educational qualifications, based in rural setting of a developing country. We have recommended policy implications that would aid in enhancing the performance of ASHAs and thus improve the health care situation in rural India.

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