scholarly journals Bad to All? A Novel Way to Analyze the Effects of Fee-for-Service on Multiple Grades Hospitals Operation Outcomes

2021 ◽  
Vol 18 (23) ◽  
pp. 12723
Author(s):  
Yiting Wang ◽  
Wenhui Hou ◽  
Xiaokang Wang ◽  
Hongyu Zhang ◽  
Jianqiang Wang
Keyword(s):  
Medical Service ◽  
Evaluation Framework ◽  
Public Hospitals ◽  
Central China ◽  
Fee For Service ◽  
Service Capacity ◽  
New Findings ◽  
Grade Ii ◽  
Financial Income ◽  
The Impact

It is a consensus that Fee-for-Service (FFS) is a traditional medical insurance payment scheme with significant disadvantages, namely the waste of health care resources. However, the majority of the prior works that draw such conclusions from the perspective of social welfare while analyzing the impacts of FFS on operation outcomes of hospitals still lack attention from the existing literature, considering the fact that the majority of public hospitals are self-founding. Under this motivation, we collected operation data of 301 public hospitals with different grades (grade II and III) in central China. Here, we present a novel statistical evaluation framework on the impact of FFS on hospital operation outcomes from four dimensions (financial income, efficiency, medical service capacity, and sustainability) using fixed-effects multivariate regression. With verification by the robustness test, our results indicate that: (i) The classification of the hospital (COH) significantly affected the impacts of FFS on hospitals’ operations. (ii) For grade III hospitals, FFS leads to higher financial income, medical service capacity (MSC) and longer length-of-stay (LOS). (iii) However, as for grade II hospitals, hospitals with FFS adoptions achieve lower financial income, lower MSC and shorter LOS, which violates the common sense from previous works. (iv) FFS has a significant negative impact on public hospital’s sustainable development; however, there is lack of evidence showing that sustainability would be affected by the interaction effects between FFS and COH. We believe these new findings from the perspective of hospital operation provide insights and could serve as a reference for the healthcare payment hierarchical reform by COH in low and middle-income countries (LMICs), which are going through the primary stage of the healthcare reform.

Gendered Impact of Corruption in Healthcare Service Delivery in Nigeria

2013 ◽  
Vol 11 (1) ◽  
Author(s):  
Yetunde A. Aluko
Keyword(s):  
Service Delivery ◽  
Public Hospitals ◽  
Public Health Care ◽  
Women's Voices ◽  
Medical Supplies ◽  
Poor Women ◽  
Level Information ◽  
Life Threatening ◽  
Threatening Situation ◽  
The Impact

This paper supports the hypothesis that corruption and non-delivery of services in key sectors such as health have gender-specific poverty consequences. The study utilized qualitative micro-level information about the structures of corruption and its impact on poor women. Respondents expressed their perceptions on the occurrence of corrupt practices in public health care system and its wider impact on society. The findings revealed that the impact of corruption is felt disproportionately by women and the poor, who are most dependent on public services, and have no alternative even when facing corrupt practices in a life threatening situation, such as complicated birth delivery. Pregnant women denied access to doctors tended to deliver at home, which increased the likelihood of complications and maternal and child mortality. Medical supplies meant for public hospitals are sold to private clinics who charge more for drugs and supplies. There is need to strengthen sectoral oversight mechanisms and transparency as well as increase women’s voices in service delivery.

scholarly journals Effect of COVID-19 on Thoracic Oncology Surgery in Spain: A Spanish Thoracic Surgery Society (SECT) Survey

Cancers ◽  
2021 ◽  
Vol 13 (12) ◽  
pp. 2897
Author(s):  
Néstor Martínez-Hernández ◽  
Usue Caballero Silva ◽  
Alberto Cabañero Sánchez ◽  
José Luis Campo-Cañaveral de la Cruz ◽  
Andrés Obeso Carillo ◽  
...  
Keyword(s):  
Overall Response Rate ◽  
Early Stage ◽  
Care Delivery ◽  
Public Hospitals ◽  
Clinical Activity ◽  
Spanish Society ◽  
Lung Cancer Patients ◽  
Oncological Patients ◽  
Multiple Choice Questionnaire ◽  
The Impact

After the first wave of COVID-19, the Spanish Society of Thoracic Surgeons (SECT) surveyed its members to assess the impact of the pandemic on thoracic oncology surgery in Spain. In May 2020, all SECT members were invited to complete an online, 40-item, multiple choice questionnaire. The questionnaire was developed by the SECT Scientific Committee and sent via email. The overall response rate was 19.2%. The respondents answered at least 91.5% of the items, with only one exception (a question about residents). Most respondents (89.3%) worked in public hospitals. The reported impact of the pandemic on routine clinical activity was considered extreme or severe by 75.5% of respondents (25.5% and 50%, respectively). Multidisciplinary tumour boards were held either with fewer members attending or through electronic platforms (44.6% and 35.9%, respectively). Surgical activity decreased by 95.7%, with 41.5% of centers performing surgery only on oncological patients and 11.7% only in emergencies. Nearly 60% of respondents reported modifying standard protocols for early-stage cancer and in the preoperative workup. Most centers (≈80%) reported using full personal protective equipment when operating on COVID-19 positive patients. The COVID-19 pandemic severely affected thoracic oncology surgery in Spain. The lack of common protocols led to a variable care delivery to lung cancer patients.

scholarly journals Rural-Spatial Restructuring Promoted by Land-Use Transitions: A Case Study of Zhulin Town in Central China

Land ◽  
2021 ◽  
Vol 10 (3) ◽  
pp. 234
Author(s):  
Dong Han ◽  
Jiajun Qiao ◽  
Qiankun Zhu
Keyword(s):  
Land Use ◽  
Rural Development ◽  
Structural Changes ◽  
Land Use Changes ◽  
Central China ◽  
Rural Space ◽  
Spatial Restructuring ◽  
Local Actors ◽  
The Impact

Rural-spatial restructuring involves the spatial mapping of the current rural development process. The transformation of land-use morphologies, directly or indirectly, affects the practice of rural restructuring. Analyzing this process in terms of the dominant morphology and recessive morphology is helpful for better grasping the overall picture of rural-spatial restructuring. Accordingly, this paper took Zhulin Town in Central China as a case study area. We propose a method for studying rural-spatial restructuring based on changes in the dominant and recessive morphologies of land use. This process was realized by analyzing the distribution and functional suitability of ecological-production-living (EPL) spaces based on land-use types, data on land-use changes obtained over a 30-year observation period, and in-depth research. We found that examining rural-spatial restructuring by matching the distribution of EPL spaces with their functional suitability can help to avoid the misjudgment of the restructuring mode caused by the consideration of the distribution and structural changes in quantity, facilitating greater understanding of the process of rural-spatial restructuring. Although the distribution and quantitative structure of Zhulin’s EPL spaces have changed to differing degrees, ecological- and agricultural-production spaces still predominate, and their functional suitability has gradually increased. The spatial distribution and functional suitability of Zhulin are generally well matched, with 62.5% of the matched types being high-quality growth, and the positive effect of Zhulin’s spatial restructuring over the past 30 years has been significant. We found that combining changes in EPL spatial area and quantity as well as changes in functional suitability is helpful in better understanding the impact of the national macro-policy shift regarding rural development. Sustaining the positive spatial restructuring of rural space requires the timely adjustment of local actors in accordance with the needs of macroeconomic and social development, and a good rural-governance model is essential.

scholarly journals Improving the experience of facility-based delivery for vulnerable women through obstetric care navigation: a qualitative evaluation

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kirsten Austad ◽  
Michel Juarez ◽  
Hannah Shryer ◽  
Patricia L. Hibberd ◽  
Mari-Lynn Drainoni ◽  
...  
Keyword(s):  
Health Workers ◽  
Positive Impact ◽  
Qualitative Evaluation ◽  
Obstetric Care ◽  
Hospital Staff ◽  
Public Hospitals ◽  
Future Research ◽  
Care Seeking ◽  
Structured Interviews ◽  
The Impact

Abstract Background Global disparities in maternal mortality could be reduced by universal facility delivery. Yet, deficiencies in the quality of care prevent some mothers from seeking facility-based obstetric care. Obstetric care navigators (OCNs) are a new form of lay health workers that combine elements of continuous labor support and care navigation to promote obstetric referrals. Here we report qualitative results from the pilot OCN project implemented in Indigenous villages in the Guatemalan central highlands. Methods We conducted semi-structured interviews with 17 mothers who received OCN accompaniment and 13 staff—namely physicians, nurses, and social workers—of the main public hospital in the pilot’s catchment area (Chimaltenango). Interviews queried OCN’s impact on patient and hospital staff experience and understanding of intended OCN roles. Audiorecorded interviews were transcribed, coded, and underwent content analysis. Results Maternal fear of surgical intervention, disrespectful and abusive treatment, and linguistic barriers were principal deterrents of care seeking. Physicians and nurses reported cultural barriers, opposition from family, and inadequate hospital resources as challenges to providing care to Indigenous mothers. Patient and hospital staff identified four valuable services offered by OCNs: emotional support, patient advocacy, facilitation of patient-provider communication, and care coordination. While patients and most physicians felt that OCNs had an overwhelmingly positive impact, nurses felt their effort would be better directed toward traditional nursing tasks. Conclusions Many barriers to maternity care exist for Indigenous mothers in Guatemala. OCNs can improve mothers’ experiences in public hospitals and reduce limitations faced by providers. However, broader buy-in from hospital staff—especially nurses—appears critical to program success. Future research should focus on measuring the impact of obstetric care navigation on key clinical outcomes (cesarean delivery) and mothers’ future care seeking behavior.

scholarly journals Impact of Climate Change on Potential Distribution of Chinese White Pine Beetle Dendroctonus armandi in China

Forests ◽  
2021 ◽  
Vol 12 (5) ◽  
pp. 544
Author(s):  
Hang Ning ◽  
Ming Tang ◽  
Hui Chen
Keyword(s):  
Climate Change ◽  
Potential Distribution ◽  
Greenhouse Gas Emission ◽  
Central China ◽  
Qinling Mountains ◽  
Climate Scenarios ◽  
Impact Of Climate Change ◽  
Precipitation Seasonality ◽  
Suitable Area ◽  
The Impact

Dendroctonus armandi (Coleoptera: Curculionidae: Scolytidae) is a bark beetle native to China and is the most destructive forest pest in the Pinus armandii woodlands of central China. Due to ongoing climate warming, D. armandi outbreaks have become more frequent and severe. Here, we used Maxent to model its current and future potential distribution in China. Minimum temperature of the coldest month and precipitation seasonality are the two major factors constraining the current distribution of D. armandi. Currently, the suitable area of D. armandi falls within the Qinling Mountains and Daba Mountains. The total suitable area is 15.83 × 104 km2. Under future climate scenarios, the total suitable area is projected to increase slightly, while remaining within the Qinling Mountains and Daba Mountains. Among the climate scenarios, the distribution expanded the most under the maximum greenhouse gas emission scenario (representative concentration pathway (RCP) 8.5). Under all assumptions, the highly suitable area is expected to increase over time; the increase will occur in southern Shaanxi, northwest Hubei, and northeast Sichuan Provinces. By the 2050s, the highly suitable area is projected to increase by 0.82 × 104 km2. By the 2050s, the suitable climatic niche for D. armandi will increase along the Qinling Mountains and Daba Mountains, posing a major challenge for forest managers. Our findings provide information that can be used to monitor D. armandi populations, host health, and the impact of climate change, shedding light on the effectiveness of management responses.

scholarly journals New findings on iron absorption conditioning factors

2004 ◽  
Vol 4 (3) ◽  
pp. 241-248 ◽  
Author(s):  
Rute Cândida Pereira ◽  
Alcides da Silva Diniz ◽  
Luiz Oscar Cardoso Ferreira
Keyword(s):  
Iron Absorption ◽  
The Body ◽  
Vulnerable Groups ◽  
Deficiency Anemia ◽  
Public Health Issue ◽  
Conditioning Factors ◽  
Risk Increase ◽  
New Findings ◽  
Intake Regulation ◽  
The Impact

The authors focus iron intake regulation in the body and the probable mechanisms related to iron absorption. They analyze the impact of iron absorption deficiency resulting in iron deficiency anemia, a public health issue of great impact in the world influencing child and maternal health risk increase. This paper aims at highlighting the problems affecting the uptake or inhibiting processes of iron absorption in an attempt to correlate information on conditioning factors and current findings. This study is a document based descriptive study comprising literature review. In food, iron has different forms, such as the heme and non-heme forms following different absorption pathways with different efficiency rates, depending on conditioning factors, such as diet profile, physiological aspects, iron chemical state, absorption regulation, transportation, storing, excretion and the presence of disease, They also discuss the current difficulties in dealing with iron nutritional deficiency in vulnerable groups, children and pregnant women, and focus data on iron consumption, adhesion to breast feeding and the frequency of prenatal care visits.

scholarly journals An evaluation of the Victorian Salt Reduction Partnership’s advocacy strategy for policy change

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Emalie Rosewarne ◽  
Michael Moore ◽  
Wai-Kwan Chislett ◽  
Alexandra Jones ◽  
Kathy Trieu ◽  
...  
Keyword(s):  
Public Health ◽  
Policy Change ◽  
Action Plan ◽  
Evaluation Framework ◽  
Decision Makers ◽  
Health Advocacy ◽  
Salt Reduction ◽  
Public Health Advocacy ◽  
The Creation ◽  
The Impact

Abstract Background Public health advocacy strategies facilitate policy change by bringing key health issues to the forefront of public and political discourse, influencing decision-makers and public opinion, and increasing policy demand. The Victorian Salt Reduction Partnership (VSRP) was established in 2014 in response to inadequate government action to improve population diets in Australia. This study aimed to evaluate the success of the VSRP’s advocacy strategy in achieving policy change. Methods Documentation of VSRP activities and outputs were collected, and semi-structured interviews conducted as part of a comprehensive process evaluation. For this study, the Kotter Plus 10-step public health advocacy evaluation framework was used to guide data extraction, analysis, and synthesis. Results A sense of urgency for salt reduction was generated by producing evidence and outlining the potential impact of a state-based salt reduction programme. This enabled the creation of a coalition with diverse skills and expertise, which facilitated the development of an innovative and collaborative advocacy action plan. A clear change vision was established, but communication of the vision to decision-makers was lacking, which reduced the impact of the programme as decision-makers were not provided with a clear incentive for policy change. As a result, while programme outputs were achieved, these did not translate to achieving broader strategic goals during a limited-term intervention in a political climate unconcerned with salt. Conclusions The Kotter Plus 10-step framework was a useful tool for evaluating the success of the VSRP advocacy strategy. The framework enabled the identification of key strengths, including the creation of the guiding coalition, and areas where efforts could be improved in future similar strategies, such as effective communication within partnerships and to decision-makers, to better influence policy and improve public health impact.

scholarly journals Assessing the impact of case mobility: issues and recommendations from Greece

2021 ◽  
Vol 68 (1) ◽  
pp. 1-12
Author(s):  
Athanasios Thanos Giannopoulos
Keyword(s):  
Performance Indicators ◽  
Evaluation Framework ◽  
Transport Systems ◽  
Intelligent Transport Systems ◽  
Intelligent Transport ◽  
Before And After ◽  
Mobility Matrix ◽  
Living Labs ◽  
The Impact ◽  
The City

AbstractThis paper is concerned with the assessment of future applications of CASE (Co-operative, Autonomous, Shared, and Electric) mobility—a term that is also taken to include the more traditionally known applications of ITS (Intelligent Transport Systems). It sets the objective of making such assessments more holistic and horizontal in nature because future CASE mobility applications will include many technologies and service concepts as an integrated whole serving specific mobility objective. Traditional evaluation methodologies will therefore have to be modified to account for this situation, and to this end, the paper focuses on assessing and adapting such “traditional” methodologies. It draws from the experience gained in Greece in the last decade when a substantial number of ITS applications were implemented and assessed, especially in the second largest urban area of the country, the city of Thessaloniki (part of the EU’s European Network of Living Labs). Four basic methodologies are selected: the use of KPIs (Key Performance Indicators), focused interviews, the CMME (CASE Mobility Matrix Evaluation), and the use of safety audits before and after the CASE mobility application. For the first three, the paper suggests specific indicators and/or content. It also gives an example of the use of CMME based on a use case from Thessaloniki. The contents and recommendations of this paper provide a better understanding of the emerging situation as regards CASE mobility applications and point to the need for establishing a timely and comprehensive CASE mobility evaluation framework at both national and European levels, for future implementations.

scholarly journals Financial Inclusion and Firms Growth in Manufacturing Sector: A Threshold Regression Analysis in Selected Asean Countries

Economies ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. 80
Author(s):  
Rosmah Nizam ◽  
Zulkefly Abdul Karim ◽  
Tamat Sarmidi ◽  
Aisyah Abdul Rahman
Keyword(s):  
Financial Services ◽  
Firm Growth ◽  
Manufacturing Sector ◽  
Threshold Level ◽  
Financial Inclusion ◽  
Manufacturing Firm ◽  
New Findings ◽  
Asean Countries ◽  
The Impact ◽  
Threshold Point

This paper examines the effect of financial inclusion on the firm growth of the manufacturing sector (513 firms) in selected ASEAN countries (Malaysia, Philippines, and Vietnam) using a cross-section threshold estimation technique. The levels of financial inclusion across firms were measured based on the distribution of financial services (access to credit). The main findings revealed that there is a non-monotonic effect of financial inclusion on the firm’s growth. These findings show that the impact of financial inclusion on firm growth in the manufacturing sector is significantly positive below a threshold point, and turns to significantly negative after a certain threshold point has been reached. These new findings suggest that manufacturing firm owners and banking institutions should deepen their financial inclusion efforts, and limit the distribution of credit access within the optimum value or threshold level in promoting the growth of the firm.

scholarly journals Improving the management and care of refugees in Australian hospitals: a descriptive study

2016 ◽  
Vol 40 (6) ◽  
pp. 679 ◽  
Author(s):  
Lindsey Ross ◽  
Catherine Harding ◽  
Alexa Seal ◽  
Geraldine Duncan
Keyword(s):  
Healthcare Professionals ◽  
Barriers To Care ◽  
Psychological Needs ◽  
Public Hospitals ◽  
Health Needs ◽  
Cultural Barriers ◽  
Rural Setting ◽  
Provider Perceptions ◽  
Additional Support ◽  
The Impact

Objectives The aim of the present study was to investigate healthcare provider perceptions of the impact of refugee patients at two public hospitals, one rural and one urban, in designated refugee resettlement areas. Healthcare professionals’ views regarding improvements that could be made in this area were also sought. Methods Two-page anonymous questionnaires containing demographic, quantitative and open-ended questions were distributed to 150 healthcare providers at each research site. Results Response rates at the rural and urban sites were 50% and 49%, respectively. Refugees were seen at least monthly by 40% of respondents. Additional support was requested by 70% of respondents. Confidence was associated with being born overseas (P = 0.029) and increased time working with refugees (rs = 0.418, P < 0.001). Only 47% of respondents felt confident managing social and psychological needs of refugees. Midwives saw refugees more than nursing and allied healthcare staff combined, and this was significant at the rural hospital (P < 0.001). Rural respondents reported that working with refugees enhanced their practice (P = 0.025), although felt significantly less confident (P < 0.001) than urban respondents. Themes that arose regarding barriers to care included language and cultural barriers, paucity of knowledge and issues accessing available services, including appropriate interpreters, Medicare eligibility and patient factors, including lack of patient trust in government systems. Desire for support was more pronounced in the rural setting (P = 0.001). Conclusions Refugees were seen frequently in both settings and most respondents requested additional support, highlighting that caring for refugees in Australian hospitals is a significant challenge. Additional support and education should be targeted to those caring for refugees most frequently, particularly midwifery services, to reduce barriers to care. What is known about the topic? Refugees are a vulnerable group, often with complex health needs. These needs are often unmet because of issues including language and cultural barriers. What does this paper add? Refugees were seen frequently in the two public hospital settings involved in the present study and most often by midwifery services. Healthcare professionals require more support, more information about available services and better access to interpreter services. These issues were more pronounced in the rural setting where very limited research exists. What are the implications for practitioners? Implementing additional support and education regarding refugee health needs could increase knowledge and confidence when managing refugees, reducing barriers to care and improving quality of care.

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