scholarly journals Countering the Tragedy of the Health Care Commons by Exnovation: Bringing Unexpected Problems and Solutions into View

2021 ◽  
Vol 13 (23) ◽  
pp. 13082
Author(s):  
Willemine Willems
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Health Care Costs ◽  
Health Care Professionals ◽  
Care Delivery ◽  
Health Care Systems ◽  
Ethnographic Study ◽  
Triple Aim ◽  
Care Systems ◽  
Care Costs

In the health sciences and policy, it is common to view rising health care costs as a tragedy of the commons, i.e., a situation in which the unhampered use of a resource by rational individuals leads to its depletion. By monitoring a set of outcomes, not only the costs but also patient experience and population health, simultaneously, it is claimed that the “triple aim” approach changes what is rational for health care stakeholders and, thus, can counter the rapidly rising health care costs. This approach has an important limitation: it reduces the monitored innovations to merely their outcomes; yet, how health care professionals and patients give shape to care delivery remains invisible. To get a more in-depth understanding of the consequences of adopting such an approach, in this article I use the method of exnovation instead. Exnovation foregrounds the everyday accomplishments of health care practices to enable reflection and learning. I draw on an ethnographic study into an innovation in care delivery aimed at rendering it more sustainable: Primary Care Plus. I reflected with both professionals and patients on what happened during 40 Primary Care Plus consultations. By presenting and analyzing three of these consultations, I foreground what is rendered invisible with the triple aim: improvisations, surprises and habits unfolding in practice. With exnovation, health care innovations can provide fertile soil for creating new forms of sustainable care that can help prevent the impending exhaustion of health care systems.

scholarly journals Overcoming fragmentation and waste in health care systems in Africa: Collaboration of health care professionals with pastoral caregivers

2014 ◽  
Vol 70 (2) ◽  
Author(s):  
Emem Agbiji ◽  
Christina Landman
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Hospital Care ◽  
Care Delivery ◽  
Health Care Systems ◽  
Medical Model ◽  
World Health ◽  
African Countries ◽  
Care Systems ◽  
Health Care Delivery Systems

This article explores the possibility and limits of collaboration between medical professionals and pastoral caregivers with a view to overcoming fragmentation and waste in the African hospital care sector. It argues that the quality of health and health care in many African countries is poor. Therefore, a purposeful reform of health care delivery systems in Africa is necessary. Building on the World Health Organization’s statement that the medical model that focuses on medicine and surgery and ignores the factors of belief and faith in healing is no longer satisfactory, it further argues that the medical model (including the bio-psychosocial model) is not sufficient for holistic hospital care; it therefore needs to accommodate complementary approaches (such as pastoral care) and include these as collaborative treatments. The connection of collaboration with quality, value, relationships and the ending of life implies that collaboration is an ethical process of reflection – which could have a legal implication.

scholarly journals Primary Care Networks and Eritrean Immigrants’ Experiences with Health Care Professionals in Switzerland: A Qualitative Approach

2019 ◽  
Vol 16 (14) ◽  
pp. 2614 ◽  
Author(s):  
Carla Wallimann ◽  
Andreas Balthasar
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Health Professionals ◽  
Health Care Professionals ◽  
Access To Health Care ◽  
Health Care Systems ◽  
European Countries ◽  
Care Providers ◽  
Swiss Health ◽  
Care Systems

Growing migration in European countries has simultaneously increased cultural diversity in health care. Migrants’ equal access to health care systems and migrant friendly health care have therefore become relevant topics. Findings gathered in recent years have mainly focussed on the perspective of care providers, whereas this study includes migrant perspectives. It explores the primary care network of Eritrean immigrants in Switzerland as well as their experiences of interacting with health professionals. Semi-structured face-to-face interviews with intercultural interpreters from Eritrea were conducted. On the basis of a thematic analysis, the study identified the important informal and formal contacts in these Eritrean immigrants’ primary care networks and the specific forms of support each actor provides. In this network, encounters with health professionals were predominately expressed positively. The main barriers reported were language difficulties and intercultural understanding. On the basis of the participants’ statements, six key lessons for practice have been derived. These lessons are specifically important for facilitating Eritrean immigrants’ access to the Swiss health care system. Nevertheless, they are also relevant for other groups of migrants in European countries.

scholarly journals Microbiome Imbalances: An Overlooked Potential Mechanism in Chronic Nonhealing Wounds

2019 ◽  
Vol 18 (1) ◽  
pp. 31-41
Author(s):  
Mengru Pang ◽  
Meishu Zhu ◽  
Xiaoxuan Lei ◽  
Pengcheng Xu ◽  
Biao Cheng
Keyword(s):  
Quality Of Life ◽  
Health Care ◽  
Health Care Costs ◽  
Chronic Wounds ◽  
Health Care Systems ◽  
Potential Mechanism ◽  
Care Systems ◽  
Hospital Stays ◽  
Care Costs

Chronic nonhealing wounds are a severe burden to health care systems worldwide, causing millions of patients to have lengthy hospital stays, high health care costs, periods of unemployment, and reduced quality of life. Moreover, treating chronic nonhealing wounds effectively and reasonably in countries with limited medical resources can be extremely challenging. With many outstanding questions surrounding chronic nonhealing wounds, in this review, we offer changes to the microbiome as a potentially ignored mechanism important in the formation and treatment of chronic wounds. Our analysis helps bring a whole new understanding to wound formation and healing and provides a potential breakthrough in the treatment of chronic nonhealing wounds in the future.

scholarly journals Financial management within the health system

2013 ◽  
Vol 19 (2) ◽  
pp. 84-90
Author(s):  
M.F. Popa ◽  
Ionut Parlica
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Health Care System ◽  
Health Care Costs ◽  
Financial Management ◽  
Health Care Systems ◽  
State Budget ◽  
Care Systems ◽  
Care Costs ◽  
Care System

Abstract The financial management within the medical management plays a very important role considering the fact that health care costs a lot of money. The health care system is greatly influenced by the allocated funds so that there are types of health care systems depending on the allocation and collection of funds and depending on the payments of the services providers. There are several mechanisms for financing the health care system of which the most important are represented by the state budget funding and voluntary health insurance. In terms of financial management, is a reform within the Romanian health care system mainly focused on reducing the number of hospitals and restructuring the County Health Houses

scholarly journals Incorporating Medical Students into Primary Care Telehealth Visits: A Tutorial (Preprint)

2020 ◽  
Author(s):  
Aanika Balaji ◽  
Sarah Lou Clever
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Medical Students ◽  
Care Delivery ◽  
Health Care Systems ◽  
Continuity Clinic ◽  
Virtual Technology ◽  
Educational Value ◽  
Care Systems ◽  
Key Steps

UNSTRUCTURED Abstract With the of the COVID-19 pandemic, health care systems began using virtual technology to connect participants. Incorporating medical students into this new platform for health care delivery is challenging and not well described in the literature. This manuscript describes our experience with integrating a medical student in an Internal Medicine continuity clinic elective. We describe the technology used; key steps in preparing the student and patients; and maintenance of the educational value of the elective over four primary care telehealth sessions. Through this experience, we conclude that medical students can be integrated into virtual clinics can be done successfully. Telemedicine has a valuable role in health care, and medical students must be exposed to this.

Direct Primary Care: A Successful Financial Model for the Clinical Practice of Lifestyle Medicine

2021 ◽  
pp. 155982762110066
Author(s):  
Amy R. Mechley
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Care Delivery ◽  
Health Care Systems ◽  
Well Being ◽  
The United States ◽  
Fee For Service ◽  
Financial Model ◽  
Lifestyle Medicine ◽  
Direct Primary

Primary care has been shown to significantly decrease the overall cost of a population’s health care while improving the quality of each person’s well-being. Lifestyle medicine (LM) is ideally positioned to be delivered via primary care and has been shown to improve short- and long-term health outcomes of patients and populations. Direct primary care (DPC) represents a viable alternative to the fee-for-service reimbursement model. It has been shown to be economically and financially sustainable. Furthermore, it has the potential to fulfill the Quadruple Aim of health care in the United States. LM practiced in a DPC model has the potential to transform health care delivery. This article will discuss the need for health care systems change, provide an overview of the DPC model, demonstrate a basic understanding of the benefits, and review the steps needed to de-risk the investment of time, money, and resources for our future DPC providers.

The Future of Health Care in South Korea and the UK

2006 ◽  
Vol 5 (3) ◽  
pp. 375-385 ◽  
Author(s):  
Bob Matthews ◽  
Yoonsoon Jung
Keyword(s):  
Health Care ◽  
South Korea ◽  
Care Delivery ◽  
Health Care Systems ◽  
Public Provision ◽  
Capitalist System ◽  
Private Provision ◽  
Care Systems ◽  
Health Care Delivery Systems ◽  
The Uk

This paper discusses and compares the origin and development of the health care systems of South Korea and the UK from the end of WW2 and endeavours to compare outcomes. The paper emphasises the importance of war as a stimulus to the development of national health services in both countries and argues that there is convergence between the UK's nationalised NHS and South Korea's US-modelled capitalist system. Overall, we conclude that there is a possibility not only that the financing and nature of the Korean and UK health care delivery systems may show convergence, but it is not impossible that they will ‘change places’ with the UK system dominated by private provision and South Korea's by public provision.

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