scholarly journals Community Health Center Efficiency. The Impact of Organization Design and Local Context: The Case of Indonesia

2021 ◽  
Author(s):  
Suwatin Miharti ◽  
Rafael Wittek ◽  
Bart Los ◽  
Liesbet Heyse
Keyword(s):  
Community Health ◽  
Community Health Centers ◽  
Organizational Design ◽  
Local Community ◽  
Organization Design ◽  
Local Context ◽  
Poor People ◽  
Tobit Regression ◽  
Community Characteristics ◽  
The Impact

Background: The decentralization of the Indonesian healthcare system, launched in the year 2000, allowed the authorities of local community health centers (CHCs) to tailor their services to the needs of their clients. Many observers see this as an opportunity to increase CHC efficiency. Building on the Context Design Performance Framework, this paper assesses the extent to which efficiency variations between CHCs can be explained by the degree of fit between their organizational design characteristics and aspects of the communities in which they are embedded. Methods: Data envelopment analysis (DEA) was applied to construct a measure of CHC efficiency for a sample of 598 CHCs in 2011, drawn from a publicly available Ministry of Health (MoH) dataset. Tobit regression analysis was applied to assess the impact of organization design and community characteristics and their interplay on efficiency. Results: Large variations in CHC efficiency were discovered, suggesting that not all CHCs are equally capable of finding the optimal design to operate most efficiently. A significant inverted U-shape relationship was found for the organization design-efficiency link: efficiency is highest for CHCs with 1-2 horizontal units and decreases for CHCs exceeding or not reaching this number. No significant association was found between community characteristics (proportion of poor people, remote location of CHC) and CHC efficiency. Conclusion: Organizational design matters for CHC efficiency, but no evidence was found for the hypothesis that a better fit between community characteristics and CHC design increases efficiency. A potential reason for this might be that CHC management’s main design challenge is how to cope with the scarce availability of well-trained health personnel.

Impact of dermoscopy-aided pediatric teledermatology program on the accessibility and efficiency of dermatology care at community health centers

2021 ◽  
pp. 1357633X2110682
Author(s):  
Rebecca Calafiore ◽  
Aziz Khan ◽  
Daren Anderson ◽  
Zhao Helen Wu ◽  
Jun Lu
Keyword(s):  
Community Health ◽  
Community Health Centers ◽  
Large Scale ◽  
Pediatric Population ◽  
Adult Population ◽  
Health Centers ◽  
Referral System ◽  
Pediatric Dermatology ◽  
Store And Forward ◽  
The Impact

Background There are few studies focusing on pediatric teledermatology, and the impact of a large-scale pediatric teledermatology program on the accessibility and efficiency of dermatology care remains unclear. This study evaluated the impact of a state-wide implementation of a store-and-forward teledermatology program augmented by the incorporation of dermoscopy in pediatric patients visiting community health centers. Methods It was a descriptive, retrospective cohort study of 876 pediatric dermatology referrals. Results In the traditional referral system, only 60 patients (17.6%) were seen by dermatologists with average waiting times of 75 days due to limited access. In comparison, with an implementation of dermoscopy-aided teledermatology, all 536 teledermatology referrals received dermatological care within 24 h, of which only 64 (12%) patients requires face-to-face (F2F) consultation. Patients referred for F2F consultation via eConsults had a much lower no-show rate as compared to the traditional referral system (39% vs. 71%). Side by side comparison between general population and pediatric population has demonstrated shared features in efficiency and access improvement but revealed specific characteristics of pediatric teledermatology in terms of diagnosis and treatment. Conclusion Coordinated store-and-forward teledermatology platform with incorporation of dermoscopy between large community care network and dermatology provider can greatly improve access to pediatric dermatology care especially in underserved population. The efficiency of teledermatology in access improvement for pediatric population is comparable with adult population in eConsults. There are also unique features and challenges in pediatric teledermatology that require further research.

scholarly journals Measuring Local Well-being

2019 ◽  
Vol 15 (2) ◽  
Author(s):  
Philip S. Morrison
Keyword(s):  
Quality Of Life ◽  
Local Government ◽  
Local Community ◽  
Well Being ◽  
Local Context ◽  
Local Authorities ◽  
Short Article ◽  
The Impact

The Local Government (Community Well-being) Amendment Bill is designed to provide local authorities with greater legal freedom to make investments that will raise the well-being of their local community. The legislation is predicated on the assumption that people’s well-being is influenced by their local context. In order to identify the influence of changes in context generated by local investments, it is necessary to recognise that individuals differ in many ways and that the impact of any given investment can vary substantially from one person to the next. Indicators based on collections of individuals miss much of that variation. It is also necessary to recognise the variety of ways well-being can be measured. This short article raises both these issues by exploring three measures of well-being currently available on the 2018 Quality of Life survey.

scholarly journals Climate Resilience with Traditional Wisdom in Asia

2021 ◽  
pp. 33-39
Author(s):  
Pallavi Tiwari ◽  
Archana Kushwaha ◽  
Yogesh Kumar Sharma
Keyword(s):  
Local Community ◽  
Fast Rate ◽  
Local Level ◽  
Local Context ◽  
Traditional Practices ◽  
Asian Countries ◽  
Climate Resilience ◽  
The World ◽  
The Impact

The climate is changing at a fast rate and the impact of the same can now be felt across all the world. The worst hit is the Asian countries which are the most vulnerable when it comes to extreme events. To cope with same, local level actions are the most effective if originated from local community and local context. Traditional wisdom originates from deep cultural and environmental considerations along with generations transformation that transcends these traditional practices to a much-suited action with respect to resiliency. The paper establishes the role of such traditional practices in the achievement of climate resilience in communities. The authors draw insights from the existing indigenous practices from various Asian countries and try to analyze the various challenges and potential in adoption of such practices on larger scale. The paper concludes with recommendations to overcome such challenges.

Learning-structure fit part I

2018 ◽  
Vol 25 (5) ◽  
pp. 294-304 ◽  
Author(s):  
Aleša Saša Sitar ◽  
Miha Škerlavaj
Keyword(s):  
Learning Styles ◽  
Organizational Design ◽  
Organization Design ◽  
Independent Learning ◽  
Learning Behavior ◽  
Learning Collaborative ◽  
Content Type ◽  
Double Loop Learning ◽  
The Impact ◽  
The Relationship

Purpose The purpose of this study, which consists of two parts, is to bring together literature on organizational design and learning of individuals in organizational settings. The literature suggests that learning takes place in organic and less-structured organizational designs, whereas empirical research provides conflicting evidence. This first part theorizes about the influence of mechanistic vs organic designs on three different aspects of employees’ learning behavior: knowledge sourcing, learning styles and learning loops. Design/methodology/approach This paper is built on previous research on the impact of structure on learning and theorizes about the relationship between mechanistic/organic design and specific learning behavior at work. Findings Four propositions are developed in this paper, regarding how a different structure leads to a different learning behavior. Mechanistic structure is associated with internal learning, independent learning and single-loop learning, whereas organic design leads to external learning, collaborative learning and double-loop learning. Research limitations/implications Because the paper is conceptual in nature, the propositions are in need of empirical validation. Some directions for empirical testing are proposed. Practical/implications For an organization design practice, managers should be aware of the distinct impact different structures have on individual learning at work. Furthermore, the appropriate organizational structure for learning must be considered in the broader context of contingencies. Originality/value This paper contributes to the organizational design literature and to the organizational learning theory by conceptualizing the relationship between structure and learning of individuals at work.

The Impact of Managed Care on the Mix of Vulnerable Populations Served by Community Health Centers

2001 ◽  
Vol 24 (1) ◽  
pp. 51-66 ◽  
Author(s):  
Leiyu Shi ◽  
Robert M. Politzer ◽  
Jerri Regan ◽  
Deborah Lewis-Idema ◽  
Marilyn Falik
Keyword(s):  
Managed Care ◽  
Community Health ◽  
Vulnerable Populations ◽  
Community Health Centers ◽  
Health Centers ◽  
The Impact
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