scholarly journals Modelling Potential Geographical Access of the Population to Public Hospitals and Quality Health Care in Romania

2020 ◽  
Vol 17 (22) ◽  
pp. 8487
Author(s):  
Liliana Dumitrache ◽  
Mariana Nae ◽  
Gabriel Simion ◽  
Ana-Maria Taloș
Keyword(s):  
Health Care ◽  
Health Services ◽  
Travel Time ◽  
Population Distribution ◽  
Care Delivery ◽  
Public Hospitals ◽  
Spatial Accessibility ◽  
Quality Health Care ◽  
Geographical Access ◽  
Quality Health

The geographical accessibility to hospitals relies on the configuration of the hospital network, spatial impedance and population distribution. This paper explores the potential geographic accessibility of the population to public hospitals in Romania by using the Distance Application Program Interface (API) Matrix service from Google Maps and open data sources. Based on real-time traffic navigation data, we examined the potential accessibility of hospitals through a weighted model that took into account the hospital competency level and travel time while using personal car transportation mode. Two scenarios were generated that depend on hospitals’ level of competency (I–V). When considering all categories of hospitals, access is relatively good with over 80% of the population reaching hospitals in less than 30 min. This is much lower in the case of hospitals that provide complex care, with 34% of the population travelling between 90 to 120 min to the nearest hospital classed in the first or second category of competence. The index of spatial accessibility (ISA), calculated as a function of real travel time and level of competency of the hospitals, shows spatial patterns of services access that highlight regional disparities or critical areas. The high concentration of infrastructure and specialised medical personnel in particular regions and large cities limits the access of a large part of the population to quality health services with travel time and distances exceeding optimal European level values. The results can help decision-makers to optimise the location of health services and improve health care delivery.

Consumer-Driven Health Care

2000 ◽  
Vol 35 (5) ◽  
pp. 477-478
Author(s):  
F. Randy Vogenberg
Keyword(s):  
Health Care ◽  
Managed Care ◽  
Health Services ◽  
Health Systems ◽  
Quality Health Care ◽  
Managed Health Care ◽  
The Future ◽  
Quality Health ◽  
The Many ◽  
The Impact

Managed health care has changed the way health services are provided and paid for. It is still evolving. Many pharmacists have already felt the impact of these changes. This continuing feature illuminates the many facets of managed care with special emphasis placed on how these changes may affect pharmacists working in health systems. The expertise provided by pharmacists will be needed to fulfill the potential of affordable, comprehensive, and quality health care as promised by managed care. Pharmacists must understand what is happening, why it is happening, and what is likely to happen in the future. To be an active and effective player, you must understand what is happening on the field.

scholarly journals The potential role of patent and proprietary medicine vendors’ associations in improving the quality of services in Nigeria’s drug shops

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Abisoye S. Oyeyemi ◽  
Oladimeji Oladepo ◽  
Adedayo O. Adeyemi ◽  
Musibau A. Titiloye ◽  
Sarah M. Burnett ◽  
...  
Keyword(s):  
Health Care ◽  
Care Delivery ◽  
Good Practice ◽  
Regulatory Agencies ◽  
Regulatory Environment ◽  
Quality Health Care ◽  
Main Challenge ◽  
Drug Shops ◽  
Quality Health ◽  
Basic Quality

Abstract Background Patent and Proprietary Medicine Vendors (PPMVs) play a major role in Nigeria’s health care delivery but regulation and monitoring of their practice needs appreciable improvement to ensure they deliver quality services. Most PPMVs belong to associations which may be useful in improving their regulation. However, little is known about how the PPMV associations function and how they can partner with relevant regulatory agencies to ensure members’ compliance and observance of good practice. This study sought to describe the PPMV associations’ structure and operations and the regulatory environment in which PPMVs function. With this information we explore ways in which the associations could help improve the coverage of Nigeria’s population with basic quality health care services. Methods A mixed methods study was conducted across four rural local government areas (LGAs) (districts) in two Nigerian states of Bayelsa and Oyo. The study comprises a quantitative data collection of 160 randomly selected PPMVs and their shops, eight PPMV focus group discussions, in-depth interviews with 26 PPMV association executives and eight regulatory agency representatives overseeing PPMVs’ practice. Results The majority of the PPMVs in the four LGAs belonged to the local chapters of National Association of Patent and Proprietary Medicine Dealers (NAPPMED). The associations were led by executive members and had regular monthly meetings. NAPPMED monitored members’ activities, provided professional and social support, and offered protection from regulatory agencies. More than 80% of PPMVs received at least one monitoring visit in the previous 6 months and local NAPPMED was the organization that monitored PPMVs the most, having visited 68.8% of respondents. The three major regulators, who reached 30.0–36.3% of PPMVs reported lack of human and financial resources as the main challenge they faced in regulation. Conclusions Quality services at drug shops would benefit from stronger monitoring and regulation. The PPMV associations already play a role in monitoring their members. Regulatory agencies and other organizations could partner with the PPMV associations to strengthen the regulatory environment and expand access to basic quality health services at PPMV shops in Nigeria.

Reining in the Pharmacy Budget

2000 ◽  
Vol 35 (4) ◽  
pp. 354-356
Author(s):  
F. Randy Vogenberg
Keyword(s):  
Health Care ◽  
Managed Care ◽  
Health Services ◽  
Health Systems ◽  
Quality Health Care ◽  
Managed Health Care ◽  
The Future ◽  
Quality Health ◽  
The Many ◽  
The Impact

Managed health care has changed the way health services are provided and paid for. It is still evolving. Many pharmacists have already felt the impact of these changes. This continuing feature illuminates the many facets of managed care with special emphasis placed on how these changes may affect pharmacists working in health systems. The expertise provided by pharmacists will be needed to fulfill the potential of affordable, comprehensive, and quality health care as promised by managed care. Pharmacists must understand what is happening, why it is happening, and what is likely to happen in the future. To be an active and effective player, you must understand what is happening on the field.

Talking about and Using Pharmacoeconomics Properly

2001 ◽  
Vol 36 (7) ◽  
pp. 717-722
Author(s):  
F. Randy Vogenberg
Keyword(s):  
Health Care ◽  
Managed Care ◽  
Health Services ◽  
Health Systems ◽  
Quality Health Care ◽  
Managed Health Care ◽  
The Future ◽  
Quality Health ◽  
The Many ◽  
The Impact

Managed health care has changed the way health services are provided and paid for. It is still evolving. Many pharmacists have already felt the impact of these changes. This continuing feature illuminates the many facets of managed care with special emphasis placed on how these changes may affect pharmacists working in health systems. The expertise provided by pharmacists will be needed to fulfill the potential of affordable, comprehensive, and quality health care as promised by managed care. Pharmacists must understand what is happening, why it is happening, and what is likely to happen in the future. To be an active and effective player, you must understand what is happening on the field.

scholarly journals Teleophthalmology: A Model for Eye Care Delivery in Rural and Underserved Areas of India

2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
Vijayaraghavan Prathiba ◽  
Mohan Rema
Keyword(s):  
Health Care ◽  
Local Community ◽  
Care Delivery ◽  
National Level ◽  
Community Outreach ◽  
Community Empowerment ◽  
Eye Care ◽  
Quality Health Care ◽  
Related Data ◽  
Quality Health

Objectives. To describe the application of teleophthalmology in rural and underserved areas of India. Study Design. This paper describes the major teleophthalmology projects in India and its benefits. Results. Teleophthalmology is the use of telecommunication for electronic transfer of health-related data from rural and underserved areas of India to specialities in urban cities. The MDRF/WDF Rural Diabetes Project has proved to be very beneficial for improvement of quality health care in Tamilnadu and can be replicated at the national level. This community outreach programme using telemedicine facilities has increased awareness of eye diseases, improved access to specialized health care, helped in local community empowerment, and provided employment opportunities. Early detection of sight threatening disorders by teleophthalmology and prompt treatment can help decrease visual impairment. Conclusion. Teleophthalmology can be a very effective model for improving eye care delivery system in rural and underserved areas of India.

scholarly journals Nurse practitioner led model of after-hours emergency care in an Australian rural urgent care Centre: health service stakeholder perceptions

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Elena Wilson ◽  
Lisa C. Hanson ◽  
Kathleen E. Tori ◽  
Byron M. Perrin
Keyword(s):  
Health Care ◽  
Health Service ◽  
Rural Health ◽  
Nurse Practitioner ◽  
Care Delivery ◽  
Urgent Care ◽  
Quality Health Care ◽  
Quality Health ◽  
After Hours ◽  
Urgent Care Centre

Abstract Background The challenges of providing and accessing quality health care in rural regions have long been identified. Innovative solutions are not only required but are also vital if effective, timely and equitable access to sustainable health care in rural communities is to be realised. Despite trial implementation of some alternative models of health care delivery, not all have been evaluated and their impacts are not well understood. The aim of this study was to explore the views of staff and stakeholders of a rural health service in relation to the implementation of an after-hours nurse practitioner model of health care delivery in its Urgent Care Centre. Methods This qualitative study included semi-structured individual and group interviews with professional stakeholders of a rural health service in Victoria, Australia and included hospital managers and hospital staff who worked directly or indirectly with the after-hours NPs in addition to local GPs, GP practice nurses, and paramedics. Thematic analysis was used to generate key themes from the data. Results Four themes emerged from the data analysis: transition to change; acceptance of the after-hours nurse practitioner role; workforce sustainability; and rural context. Conclusions This study suggests that the nurse practitioner-led model is valued by rural health practitioners and could reduce the burden of excessive after-hour on-call duties for rural GPs while improving access to quality health care for community members. As pressure on rural urgent care centres further intensifies with the presence of the COVID-19 pandemic, serious consideration of the nurse practitioner-led model is recommended as a desirable and effective alternative.

scholarly journals Strengthening Capacities of Ward Development Committees to Promote Health in Nigeria: A Case Study of Osun State

2021 ◽  
Vol 9 (3) ◽  
pp. 149-158
Author(s):  
Helen U. Ekpo
Keyword(s):  
Health Care ◽  
Quality Improvement ◽  
Health Services ◽  
Capacity Building ◽  
Health Care Facilities ◽  
Health Facilities ◽  
Quality Health Care ◽  
Roles And Responsibilities ◽  
Quality Health ◽  
Quality Health Services

Unsatisfactory health indices characterize Osun State Nigeria Primary Health Care facilities and poor operational conditions. Residents patronize private health facilities with attendant payment of huge out-of-pocket medical bills. Implementation of the Basic Health Care Provision Fund (BHCPF), a mechanism to increase access to quality health care for all its citizens initiated by the state government, commenced in 2018. The study sought to determine the extent to which capacity building/training of Ward development committees (WDC) in BHCPF supported PHCs has contributed to the provision of quality health services in the BHCPF supported facilities. The study was qualitative in design and used three focus group discussions held in three BHCPF implementing LGAs with thirty-five (27males, 8 females) consenting trained WDC members. Prior to the BHCPF training, the majority of the WDCs were not actively involved in the management of their PHCs, as political appointees and were unclear about their roles and responsibilities to the health facilities in their wards. After the training, most of the trained WDCs engaged with their PHC staff to debrief, review the quality improvement plans for their health facilities, identified immediate needs to address, approached influential people in the community, and mobilized local resources to address identified gaps. Electricity and water supply were restored in most of the facilities, hospital beds and basic equipment for were procured for PHCs, building, and equipping of the laboratory were completed. Building the capacity of the WDC on their roles and responsibilities strengthened them to contribute to the provision of quality health services in their communities. Keywords: Access, capacity building, quality improvement, Universal Health Coverage, Ward development committees.

A Regionalization Model to Increase Equity of Access to Perinatal Care Services

2020 ◽  
Author(s):  
Zahra Mohammadi Daniali ◽  
Mohammad Mehdi Sepehri ◽  
Farzad Movahedi Sobhani ◽  
Mohammad Heidarzadeh
Keyword(s):  
Health Care ◽  
Health Services ◽  
Travel Time ◽  
Neonatal Mortality ◽  
Perinatal Care ◽  
Spatial Accessibility ◽  
Allocation Model ◽  
Care Services ◽  
Birth Data ◽  
Level I

Abstract BackgroundReducing neonatal mortality is one of the most important issue in developing countries. One powerful method to reduce the neonatal mortality rate is increase equity in access to health services by regionalization. This study employs national hospitalized birth data from march 2018 to march 2019 to determine the optimal number and location of Perinatal Care Services (PCS) and to manage the referral network of the region.MethodsThis research has examined effective criteria regarding PCS network design. These criteria include the equipment (number of Neonatal Intensive Care Unit (NICU) and ventilator), experts (number of neonatal expert and fellowship), gravity (actual journey of expectant mothers to hospitals), and the type of university manages hospital. Moreover, distances between demands and PCS were transformed into vehicular travel time according to the maximum speed limit in the country road network. There have been annual 315,992 hospitalized birth data. These data provided separately for each city and three types of service requirements according to the gestational age and birth weight, i.e., under 32 weeks or 1500 gram, between 32-34 weeks or 1500-2000 gram, and over 34 weeks or 2000 gram, which receive services of level I, II, and III, respectively. A model builder tool of ARC GIS software was applied to develop a three-level hierarchical location-allocation model to respond to the maximal demand in 30 (level I), 60 (level II), and 120 (level III) minuts of travel time. The developed model was then applied to serve neonates from uncovered cities. Moreover, the alternative PCS were determined for level III services to present more reliable solutions.ResultsObtained results revealed that the total 130, 121, and 86 PCS are needed to respond to demands of level I, II, III, respectively, in 373 different cities. The service level III has not covered 39 cities; hence another model assigned nearest PCS to these cities so that the travel distances from which to allocated centers were determined 173 min on average. ConclusionsRegionalization is an approach to increase spatial accessibility to health services. Finding the optimal location to implement PCS would gradually decrease neonatal mortality and morbidity. It can also reduce expenses of under-used local health centers and give better health care regarding the access to experts. In this way, regional services should be considered as a sustainable health care solution at the policy and decision-making levels of the region, national and universal healthcare network.

scholarly journals Exploring Traditional Chinese Medicine in Alberta: Challenges and opportunities

2018 ◽  
Vol 01 (03) ◽  
pp. 181-192
Author(s):  
Vesna Nguyen ◽  
Janice Leung ◽  
Richard Lewanczuk ◽  
Sunita Vohra ◽  
Carl Amrhein
Keyword(s):  
Health Care ◽  
Chinese Medicine ◽  
Traditional Chinese Medicine ◽  
Care Delivery ◽  
Policy Framework ◽  
Maturity Model ◽  
Quality Health Care ◽  
Challenges And Opportunities ◽  
Quality Health ◽  
Canadian Provinces

Integrative medicine is commonplace across the world, but in North America, it is considered a complement, rather than a mainstay of health care delivery. In Canada, where conventional Western medicine dominates modern health practices, we explore the progress, challenges, and opportunities of complementary medical practices, in particular Traditional Chinese Medicine (TCM) in the province of Alberta. We provide a TCM policy framework and maturity model as tools to assess the overall state of TCM practices and apply them in an Albertan context. While Alberta has made significant progress in developing capacity, competence, and accountability within TCM practices, the maturity of its practices may be considered to be in their infancy compared to more developed Chinese jurisdictions and some other Canadian provinces. We highlight significant gaps and barriers that limit the potential for complementary medicine to become part of mainstream health care as safe, effective, and quality health care choices, and discuss possible next steps.

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