scholarly journals Status of Quality in Strategic Purchasing in the Health System: A Systematic Review

2020 ◽  
Vol 13 (3) ◽  
pp. 271-277
Author(s):  
Zahra Zarei ◽  
Somayeh Hesam ◽  
Shaghayegh Vahdat ◽  
Alireza Oliaei Manesh
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Health System ◽  
Health Care Services ◽  
Health Care Quality ◽  
Care Delivery ◽  
Care Quality ◽  
Quality Health Care ◽  
Health Care Quality Assurance ◽  
Strategic Purchasing

Introducction. Strategic purchasing is an important component of financing in the health system. It can enhance productivity, justice, and accountability in the health care delivery in case of considering the quality. This study, which was conducted as a systematic review, was aimed at investigating the status of quality in five domains of strategic purchasing in the health system to answer what, for whom, from whom, how to buy, and how much to buy. Material and Methods: This study systematically reviewed the articles published in the databases of Web of Sciences (WOS), Scopus, PubMed, Medline via Ovid, Embase from 2000 to October 2019. The keywords used to search the databases included the following: Health Care Sector, Delivery of Health Care, Quality Assurance, Quality Improvement, and Strategic Purchasing. A total of 182 articles were selected and reviewed by four researchers. Articles with irrelevant content were excluded. Data of the selected articles were analyzed using the content analysis method. Results: Of the 182 articles collected through searching the selected databases, 16 articles were analyzed. Based on the results of this study, strategic purchasing in the health system results in the delivery of services with higher quality. Conclusion: Strategic purchasing can enhance the performance of the health system through choosing the most appropriate provider and the most appropriate payment method, along with equity in providing quality health care services.

scholarly journals Quality indicators of dental health care in Serbia

2019 ◽  
Vol 66 (1) ◽  
pp. 36-42
Author(s):  
Svetlana Jovanović ◽  
Maja Milošević ◽  
Irena Aleksić-Hajduković ◽  
Jelena Mandić
Keyword(s):  
Health Care ◽  
Quality Improvement ◽  
Health System ◽  
Quality Indicators ◽  
Health Care Quality ◽  
Care Quality ◽  
System Quality ◽  
Quality Health Care ◽  
Quality Health

Summary Health care has witnessed considerable progresses toward quality improvement over the past two decades. More precisely, there have been global efforts aimed to improve this aspect of health care along with experts and decision-makers reaching the consensus that quality is one of the most significant dimensions and features of health system. Quality health care implies highly efficient resource use in order to meet patient’s needs in terms of prevention and treatment. Quality health care is provided in a safe way while meeting patients’ expectations and avoiding unnecessary losses. The mission of continuous improvement in quality of care is to achieve safe and reliable health care through mutual efforts of all the key supporters of health system to protect patients’ interests. A systematic approach to measuring the process of care through quality indicators (QIs) poses the greatest challenge to continuous quality improvement in health care. Quality indicators are quantitative indicators used for monitoring and evaluating quality of patient care and treatment, continuous professional development (CPD), maintaining waiting lists, patients and staff satisfaction, and patient safety.

scholarly journals Quality of health care in Nigeria: a myth or a reality

2018 ◽  
Vol 6 (9) ◽  
pp. 2875
Author(s):  
Benson Chukwunweike Ephraim-Emmanuel ◽  
Adetutu Adigwe ◽  
Roland Oyeghe ◽  
Daprim S. T. Ogaji
Keyword(s):  
Health Care ◽  
Health Care Delivery ◽  
Health Care Quality ◽  
Care Delivery ◽  
Care Quality ◽  
Quality Systems ◽  
Quality Health Care ◽  
The Poor ◽  
Quality Health

The delivery of high quality health care is crucial to achieving enhanced health benefits, patient safety and a positive patient experience of health care. This article provides insight on the quality of the health care delivery in Nigeria and aim to uncover if quality health care in Nigeria is a reality or a myth. Relevant information was abstracted from included articles and used to provide both descriptive and analytical discourse on the subject. Discussions and reflections were carried out along an established quality framework of treatment effectiveness, acceptability, efficiency, the appropriateness of the means of delivery as well as equity. The slow pace of development of quality systems in health service delivery in Nigeria is evidenced by the poor quality of health services as well as the poor health status of the population. The pace of developing quality systems in health care delivery in Nigeria is unsatisfactory. There is a need to galvanise the efforts of relevant stakeholders including the patient in charting a new agenda for health care quality improvement in Nigeria.

scholarly journals Analysis of Facilitators and Barriers to the Delivery of Routine Care during the COVID-19 Global Pandemic: A Systematic Review

Healthcare ◽  
2021 ◽  
Vol 9 (5) ◽  
pp. 528
Author(s):  
Cristian Lieneck ◽  
Brooke Herzog ◽  
Raven Krips
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Health Care Services ◽  
Care Delivery ◽  
Routine Care ◽  
Future Research ◽  
Healthcare Organizations ◽  
Care Services ◽  
Global Pandemic ◽  
Facilitators And Barriers

The delivery of routine health care during the COVID-19 global pandemic continues to be challenged as public health guidelines and other local/regional/state and other policies are enforced to help prevent the spread of the virus. The objective of this systematic review is to identify the facilitators and barriers affecting the delivery of routine health care services during the pandemic to provide a framework for future research. In total, 32 articles were identified for common themes surrounding facilitators of routine care during COVID-19. Identified constructed in the literature include enhanced education initiatives for parents/patients regarding routine vaccinations, an importance of routine vaccinations as compared to the risk of COVID-19 infection, an enhanced use of telehealth resources (including diagnostic imagery) and identified patient throughput/PPE initiatives. Reviewers identified the following barriers to the delivery of routine care: conservation of medical providers and PPE for non-routine (acute) care delivery needs, specific routine care services incongruent the telehealth care delivery methods, and job-loss/food insecurity. Review results can assist healthcare organizations with process-related challenges related to current and/or future delivery of routine care and support future research initiatives as the global pandemic continues.

scholarly journals Primary health care quality in Iran: a systematic review and meta-analysis

2019 ◽  
Vol 21 (1) ◽  
pp. 71-77
Author(s):  
Hasan Abolghasem Gorji ◽  
Sanaz Royani ◽  
Mohammad Mohseni ◽  
Saber Azami-Aghdash ◽  
Ahmad Moosavi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Primary Health Care ◽  
Health Care Quality ◽  
Meta Analysis ◽  
Care Quality ◽  
Primary Health

Incidence of Complicated Appendicitis as a Metric of Health Care Delivery

2020 ◽  
pp. 000313482095376
Author(s):  
Fawaz Araim ◽  
Artem Shmelev ◽  
Gopal C. Kowdley
Keyword(s):  
Health Care ◽  
Acute Appendicitis ◽  
Health Care Delivery ◽  
Health Care Quality ◽  
Care Delivery ◽  
State Level ◽  
Care Quality ◽  
Physician Density ◽  
Multivariable Logistic Regression Model ◽  
Modifiable Factors

Background Complicated acute appendicitis (CAA) has been linked to extremes of age, racial and socioeconomic disparities, public insurance, and remote residency. CAA rate has been used from 2005 to 2018 as a health care quality metric, with the assumption that delay in treatment was a main cause of perforation. We studied factors that could contribute to CAA focusing on modifiable factors which could be altered as part of a health care delivery system. Materials and Methods All primary admissions for acute appendicitis (AA) from the 2010 Nationwide Inpatient Sample were linked to 2010 state-level physician density data. CAA was distinguished by codes for perforation, generalized peritonitis, or intra-abdominal abscess. A multivariable logistic regression model for CAA prediction was built. Results A total of 288 556 patients were admitted with AA and 86 272 (29.9%) had CAA. Independent factors, linked to CAA, included age outside the 10-39 range (odds ratio (OR) = 2.1-2.4 and all P < .001), male gender (OR = 1.2), malnutrition (OR = 6.2), diabetes mellitus (OR = 2.1), chronic anemias (OR = 1.9), nonprivate insurances (OR 1.2-1.5), nonmetropolitan patient’s residence (OR = 1.15), and Midwest region (OR = 1.2). Patient income and physician coverage were not significant factors after adjustment for all other covariates. Highest CAA fraction of 39.6% was noted in rural patients admitted to urban teaching facilities. Discussion Although provider coverage at the state level may seem adequate and not related to increased CAA rates, the distance patients traveled for their definitive surgical care correlated with higher rates of CAA. Adjusting physician distribution into nonurban settings closer to patients could decrease rates of CAA by diminishing time to definitive care.

scholarly journals Use of EHR-Based Pediatric Quality Measures: Views of Health System Leaders and Parents

2019 ◽  
Vol 35 (2) ◽  
pp. 177-185
Author(s):  
David M. Hartley ◽  
Susannah Jonas ◽  
Daniel Grossoehme ◽  
Amy Kelly ◽  
Cassandra Dodds ◽  
...  
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Health System ◽  
Health Care Quality ◽  
Quality Measures ◽  
Care Quality ◽  
Quality Data ◽  
High Confidence ◽  
System Leaders ◽  
Using Data

Measures of health care quality are produced from a variety of data sources, but often, physicians do not believe these measures reflect the quality of provided care. The aim was to assess the value to health system leaders (HSLs) and parents of benchmarking on health care quality measures using data mined from the electronic health record (EHR). Using in-context interviews with HSLs and parents, the authors investigated what new decisions and actions benchmarking using data mined from the EHR may enable and how benchmarking information should be presented to be most informative. Results demonstrate that although parents may have little experience using data on health care quality for decision making, they affirmed its potential value. HSLs expressed the need for high-confidence, validated metrics. They also perceived barriers to achieving meaningful metrics but recognized that mining data directly from the EHR could overcome those barriers. Parents and HSLs need high-confidence health care quality data to support decision making.

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