scholarly journals Contracts to Coordinate Healthcare Providers in the Telemedicine Referral System

2021 ◽  
Vol 13 (18) ◽  
pp. 10299
Author(s):  
Xianyi Wang ◽  
Xiaofang Wang ◽  
Hui He
Keyword(s):  
Treatment Cost ◽  
Local Community ◽  
Service Providers ◽  
Healthcare Providers ◽  
Medical Expenditure ◽  
Social Optimum ◽  
Bundled Payment ◽  
Online Treatment ◽  
Tertiary Hospitals ◽  
The Impact

With the help of telemedicine, healthcare providers can increase patients’ access to high-quality services while reducing the medical expenditure, especially for patients in remote areas. Once advanced care is needed, local patients will first be referred to an online health service and then be referred to the offline hospital if the online healthcare fails. In practice, local community hospitals and the advanced tertiary hospitals generally lack financial incentives to exert costly, but non-reimbursable, effort to avoid poor patient outcomes. Therefore, we build a new model to analyze the interaction between these two service providers, promoting them to exert the right effort by designing payment contracts. Our results show that neither fee-for-service nor bundled payment contracts can achieve the social optimum. Tertiary hospitals always exert less effort than the socially-optimal effort while the community hospital may exert less or more effort depending on the online treatment cost. Then, we propose a performance-based bundled payment contract that can coordinate both hospitals’ decisions to achieve socially optimal outcomes. Finally, we numerically show the impact of the referral service fee and the online treatment cost on the efficiency of these contracts.

scholarly journals ‘Putting salt on the wound’: a qualitative study of the impact of FGM-safeguarding in healthcare settings on people with a British Somali heritage living in Bristol, UK

BMJ Open ◽  
2020 ◽  
Vol 10 (6) ◽  
pp. e035039 ◽  
Author(s):  
Saffron Karlsen ◽  
Natasha Carver ◽  
Magda Mogilnicka ◽  
Christina Pantazis
Keyword(s):  
At Risk ◽  
Service Providers ◽  
Healthcare Providers ◽  
Female Genital Cutting ◽  
Snowball Sampling ◽  
Genital Mutilation ◽  
Healthcare Settings ◽  
Alternative Sources ◽  
The Impact ◽  
Female Genital

ObjectivesThis research documents the experiences of people with Somali heritage with female genital mutilation (FGM)-safeguarding services in healthcare and whether such services are considered appropriate by the people who encounter them.DesignSix focus groups conducted with ethnic Somalis living in Bristol, during the summer of 2018, divided by gender and whether people had experienced FGM-safeguarding as adults or children.SettingParticipants experienced FGM-safeguarding in primary and secondary care.Participants30 people (21 women and 9 men), identified through local organisations or snowball sampling. All participants were of Somali heritage and aged over 18.ResultsGovernment priorities to support those who have experienced female genital cutting/mutilation (FGC/M) are being undermined by their own approaches to protect those considered at risk. Participants argued that approaches to FGM-safeguarding were based on outdated stereotypes and inaccurate evidence which encouraged health and other service providers to see every Somali parent as a potential perpetrator of FGC/M. Female participants described providers in a range of healthcare settings, including Accident and Emergency Departments (A&E), antenatal care and general practice, as ‘fixated’ with FGC/M, who ignored both their health needs and their experience as victims. Participants felt stigmatised and traumatised by their experience. This undermined their trust in health services, producing a reticence to seek care, treatment delays and reliance on alternative sources of care. Associated recommendations include developing more accurate evidence of risk, more appropriate education for healthcare providers and more collaborative approaches to FGM-safeguarding.ConclusionAll the participants involved in this study are committed to the eradication of FGC/M. But the statutory approaches currently adopted to enable this are considered ill-conceived, unnecessarily heavy-handed and ultimately detrimental to this. Recognising these common aims can enable the development of services better able to protect and support those at risk of FGC/M in ways which are culturally competent and sensitive.

Building the Field: The Case for Community Service Learning

2017 ◽  
Vol 41 (4) ◽  
pp. 308-320
Author(s):  
Janelle E. Lawson ◽  
Allison R. Firestone
Keyword(s):  
Special Education ◽  
Service Learning ◽  
Community Service ◽  
Undergraduate Students ◽  
Local Community ◽  
Service Providers ◽  
Community Service Learning ◽  
Persons With Disabilities ◽  
Related Service ◽  
The Impact

In this study, the authors examine the impact of a community service learning course on undergraduate students’ decisions to pursue careers as special education teachers or related service providers. Participants ( N = 134) completed a course involving volunteer service with persons with disabilities in the local community and were surveyed as to whether they were interested in pursuing a career in special education upon graduation. Findings indicated that contact with a person with a disability through community service learning was a factor in influencing participants’ willingness to enter the field of special education.

scholarly journals The Impact of China’s Zero Markup Drug Policy on Hospitalization Expenses for Inpatients in Tertiary Public Hospitals: Evidence Based on Quantile Difference-in-Difference Models

Healthcare ◽  
2021 ◽  
Vol 9 (7) ◽  
pp. 908
Author(s):  
Ziling Ni ◽  
Jie Jia ◽  
Lu Cui ◽  
Siyu Zhou ◽  
Xiaohe Wang
Keyword(s):  
Service Providers ◽  
Hospital Costs ◽  
Treated Group ◽  
Public Hospitals ◽  
Hospital Charges ◽  
Control Group ◽  
Health Administration ◽  
Tertiary Hospitals ◽  
Lower Drug ◽  
The Impact

Objectives: The aim of this study was to determine the impact of the Zero Markup drug (ZMD) policy on hospitalization expenses for inpatients in tertiary Chinese hospitals. Methods: Using the administrative data from hospital electronic health records (EHRs) between 2015 and 2017, we implemented the quantile difference-in-differences (QDID) estimators to evaluate the impact of the ZMD policy on hospitalization expenses while controlling for patient-level and hospital-level characteristics. Results: According to the QDID models, the introduction of ZMD policy significantly induced lower drug costs for all inpatients especially at the 50th (-USD 507.84 (SE = USD 90.91), 75th (-USD 844.77 (SE = USD 149.70), and 90th (-USD 1400.00 (SE = USD 209.97)) percentiles of the overall distributions. However, the total hospitalization, diagnostic, treatment, material and services expenses for inpatients were significantly higher for the treated group than the control group. This tendency was more pronounced for inpatients in tertiary hospitals with lower expenses (in the 10th, 25th and 50th percentiles). Conclusion: The implementation of ZMD policy alone may not be enough to change the medical service providers’ profit-driven behavior. The targeted supervision of hospital costs by the Chinese health administration department should be strengthened to avoid unreasonable hospital charges.

scholarly journals Dampak Wisata Bahari bagi Kondisi Ekonomi Masyarakat Desa Kolorai, Kecamatan Morotai Selatan, Kabupaten Pulau Morotai

2021 ◽  
Vol 2 (2) ◽  
pp. 7
Author(s):  
Muhamad Adhiyaksa ◽  
Annisa Mu'awanah Sukmawati
Keyword(s):  
Data Collection ◽  
Local Community ◽  
Service Providers ◽  
Positive Impact ◽  
Secondary Data ◽  
Local People ◽  
Primary Data ◽  
Tourist Attractions ◽  
Marine Tourism ◽  
The Impact

Kolorai Village has a variety of tourism potentials, they are cultural tourism, nature tourism, and marine tourism. Marine tourism is a type of tourism that has become the mainstay of Kolorai Village and has the opportunity to have a positive impact on the economic development of coastal communities. The research is located in Kolorai Village, South Morotai District, Morotai Island Regency. This study aims to analyze the impact of marine tourism on the economic conditions of the local people in Kolorai Village, South Morotai District, Morotai Island Regency. The research method conducted by using a quantitative method with Crosstab analysis techniques to exam the correlation between the existence of marine tourism and changes in income levels. Data collection was carried out by collecting primary data through questionnaires, interviews, and field observations as well as secondary data collection from document review. The results showed that the presence of marine tourism in Kolorai Village had a significant impact on the economy of the local community. This can be seen from the existence of new livelihood opportunities for local people who are not only as fishermen but also as marine tourism business actors and tourism accommodation service providers. The existence of accessibility and diversification of tourist attractions also affects the dynamics of community income in the marine tourism sector.

scholarly journals Economic Life of Coastal Communities: A Study of Meleura Beach Tourism Objects

2020 ◽  
Vol 1 (2) ◽  
pp. 17-22
Author(s):  
Widya Astuti ◽  
Abdul Manan ◽  
Amar Ma’ruf
Keyword(s):  
Local Community ◽  
Service Providers ◽  
Positive Impact ◽  
Economic Life ◽  
Coastal Communities ◽  
Community Institutions ◽  
Increasing Trend ◽  
Beach Tourism ◽  
The Impact ◽  
To Receive

This study aims to determine the impact of the Meleura Beach attraction for the economic life of the Lakarinta Coastal community, Lohia District, Muna Regency. This research was conducted using qualitative methods or purposive sampling techniques. The results showed that the local community felt a positive impact on the existence of this beach area, especially those directly involved with the development of Meleura beach tourism objects both economically. The development of Maleura Beach also has an economic impact, in the form of changes or shifts in the livelihoods of most Lakarinta villagers, from farmers to traders and service providers. Changes and/or transitions like this are followed by changes in community income which also shows an increasing trend. If before the beach was developed, the majority of residents who had jobs as farmers were only able to receive between Rp 1,000,000-5,000,000 per year, now on average they are able to receive more than Rp 10,000,000 per year, even some of them can receive more than Rp 100,000,000 per year. The need for solid government funding and community institutions to help improve the economic life of the community and help provide solutions that benefit the community.

Treatment patterns in pancreatic cancer: Differences between expert and community practitioners.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e19207-e19207
Author(s):  
Ryan P. Topping ◽  
E. Gabriela Chiorean ◽  
Dan Laheru ◽  
Michael J. Pishvaian ◽  
Andrea Wang-Gillam ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Decision Support ◽  
Healthcare Providers ◽  
Decision Support Tool ◽  
Support Tool ◽  
Community Healthcare ◽  
Online Treatment ◽  
Full Analysis ◽  
The Impact ◽  
Expert Recommendations

e19207 Background: Expanding systemic therapy options continue to improve outcomes for patients (pts) with pancreatic cancer (PCa) in both the unresectable and resectable disease settings. We developed an online treatment (Tx) decision support tool designed to provide community healthcare providers (HCPs) with case-specific recommendations from 5 PCa experts. Here, we report an analysis of cases entered into the tool by HCPs, comparing their planned Tx with expert recommendations and assessing the impact of those recommendations on intended HCP Tx decisions. Methods: In July 2019, 5 expert panelists provided Tx recommendations for numerous distinct PCa cases. To use the tool, HCPs entered specific pt/disease factors along with their intended Tx plan for the case, after which they received expert Tx recommendations followed by a survey asking if the recommendations had changed their planned Tx course. Results: 251 HCPs entered 347 pt cases into the tool (83% by physicians). 68% of respondents reported treating < 15 pts with PCa per yr, and 60% sought recommendations for a specific pt. Variance was observed between experts and HCPs for cases in several Tx settings (Table); eg, although FOLFIRINOX was the primary panel recommendation for many younger, healthier pts requiring neoadjuvant or adjuvant therapy or first-line Tx for unresectable disease, most HCPs did not select this therapy for these pts at baseline. Among HCPs whose planned Tx differed from the experts, 51% indicated that they would change their Tx based on panel recommendations. Conclusions: Analysis of data from an online Tx decision support tool for PCa revealed variance between expert recommendations and the intended Tx of HCPs for numerous scenarios, with education provided by the tool potentially increasing the number of clinicians who made optimal Tx decisions. A full analysis of Tx trends will be presented. [Table: see text]

scholarly journals Randomized trial shows healthcare payment reform has equal-sized spillover effects on patients not targeted by reform

2020 ◽  
Vol 117 (32) ◽  
pp. 18939-18947 ◽  
Author(s):  
Liran Einav ◽  
Amy Finkelstein ◽  
Yunan Ji ◽  
Neale Mahoney
Keyword(s):  
Healthcare Providers ◽  
Spillover Effects ◽  
Similar Magnitude ◽  
Medicare Advantage ◽  
Random Assignment ◽  
Payment Reform ◽  
Bundled Payment ◽  
Healthcare Experience ◽  
Medicare Patients ◽  
The Impact

Changes in the way health insurers pay healthcare providers may not only directly affect the insurer’s patients but may also affect patients covered by other insurers. We provide evidence of such spillovers in the context of a nationwide Medicare bundled payment reform that was implemented in some areas of the country but not in others, via random assignment. We estimate that the payment reform—which targeted traditional Medicare patients—had effects of similar magnitude on the healthcare experience of nontargeted, privately insured Medicare Advantage patients. We discuss the implications of these findings for estimates of the impact of healthcare payment reforms and more generally for the design of healthcare policy.

The Impact of Internal Work Environment on the Retention of Healthcare Providers at Turaif General Hospital

2019 ◽  
Vol 10 (12) ◽  
pp. 1183-1199
Author(s):  
Mohammed Alrouili ◽  
Keyword(s):  
Work Environment ◽  
General Hospital ◽  
Professional Growth ◽  
Healthcare Providers ◽  
Entire Study ◽  
Internal Work ◽  
Research Findings ◽  
Study Population ◽  
The Right ◽  
The Impact

This study attempted to identify the impact of internal work environment on the retention of healthcare providers at Turaif General Hospital in the Kingdom of Saudi Arabia. In particular, the study aimed to identify the dimensions of work circumstances, compensation, and relationship with colleagues, professional growth, and the level of healthcare providers’ retention. In order to achieve the study goals, the researcher used the descriptive analytical approach. The researcher used the questionnaire as the study tool. The study population comprised all the healthcare providers at Turaif General Hospital. Questionnaires were distributed to the entire study sample that consisted of 220 individuals. The number of questionnaires valid for study was 183 questionnaires. The research findings were as follows: the participants’ estimate of the work circumstances dimension was high (3.64), the participants’ estimate of the compensation dimension was moderate (3.32), the participants’ estimate of the relationship with colleagues dimension was high (3.62), the participants’ estimate of the professional growth dimension was weak (2.39), and the participants’ estimate of healthcare providers’ retention level was intermediate (2.75). Accordingly, the researcher’s major recommendations are: the need to create the right atmosphere for personnel in hospitals, the interest of the hospital to provide the appropriate conditions for the staff in terms of the physical and moral aspects for building the work adjustment in the staff, and conducting training courses and educational lectures for personnel in hospitals on how to cope with the work pressures.

THE IMPACT OF DECENTRALIZATION ON THE DEVELOPMENT OF ENTREPRENEURSHIP IN UKRAINE

2017 ◽  
Author(s):  
Lyudmyla Mishchenko ◽  
◽  
Dmytro Mishchenko ◽  
Keyword(s):  
Social Entrepreneurship ◽  
Local Governments ◽  
Poverty Reduction ◽  
Social Protection ◽  
Local Community ◽  
Well Being ◽  
Economic Incentives ◽  
Social Enterprises ◽  
Infrastructural Support ◽  
The Impact

The actualization of the results of financial decentralization in Ukraine as part of the reform of decentralization of power and the development of proposals for its improvement is explained by the fact that a clear division of functions, powers and financial resources between national and regional levels is the basis for the well-being of our citizens. opportunities for its sustainable socio- economic development on a democratic basis. It is noted that financial decentralization is a process of giving authority to mobilize revenues and expenditures of local governments in order to increase the effectiveness of the implementation of these powers and better management of community budgets. It is established that unlike traditional entrepreneurship, which focuses on profit generation, the purpose of social entrepreneurship is to create and accumulate social capital. Abroad, social enterprises operate successfully in the fields of education, the environment, human rights, poverty reduction and health care, and their development and dissemination is one way to improve the living conditions of citizens. A similar mission is entrusted to local governments, which allows us to consider the revival of social entrepreneurship as an important element in improving self-government policy. It is determined that in modern conditions social entrepreneurship is one of the tools to ensure the ability of the local community to provide its members with an appropriate level of education, culture, health, housing and communal services, social protection, etc., as well as plan and implement programs efficient use of available natural and human resources, investment and infrastructural support of territorial communities. Due to financial decentralization, local governments have received additional resources that can be used to create economic incentives to promote social entrepreneurship in small and medium-sized businesses at the community level.

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