scholarly journals Service utilization and impact on quality care of sick young infants in the primary healthcare units, West Gojjam, Amhara, Ethiopia

2021 ◽  
Vol 3 ◽  
Author(s):  
Bizuhan Gelaw Birhanu ◽  
Johanna Mmabojalwa Mathibe-Neke
Keyword(s):  
Service Utilization ◽  
Primary Healthcare ◽  
Quality Care ◽  
Young Infants ◽  
West Gojjam

scholarly journals ‘The nurse did not even greet me’: how informed versus non-informed patients evaluate health systems responsiveness in South Africa

2021 ◽  
Vol 6 (4) ◽  
pp. e004360
Author(s):  
Dumisani MacDonald Hompashe ◽  
Ulf-G Gerdtham ◽  
Carmen S Christian ◽  
Anja Smith ◽  
Ronelle Burger
Keyword(s):  
Health Systems ◽  
Primary Healthcare ◽  
Healthcare Workers ◽  
Quality Care ◽  
Public Healthcare ◽  
Health Coverage ◽  
Access To Health Services ◽  
Healthcare Provision ◽  
Healthcare Facilities ◽  
Patients Experience

Introduction Universal Health Coverage is not only about access to health services but also about access to high-quality care, since poor experiences may deter patients from accessing care. Evidence shows that quality of care drives health outcomes, yet little is known about non-clinical dimensions of care, and patients’ experience thereof relative to satisfaction with visits. This paper investigates the role of non-clinical dimensions of care in patient satisfaction. Methods Our study describes the interactions of informed and non-informed patients with primary healthcare workers at 39 public healthcare facilities in two metropolitan centres in two South African provinces. Our analysis included 1357 interactions using standardised patients (for informed patients) and patients’ exit interviews (for non-informed patients). The data were combined for three types of visits: contraception, hypertension and tuberculosis. We describe how satisfaction with care was related to patients’ experiences of non-clinical dimensions. Results We show that when real patients (RPs) reported being satisfied (vs dissatisfied) with a visit, it was associated with a 30% increase in the probability that a patient is greeted at the facilities. Likewise, when the RPs reported being satisfied (vs dissatisfied) with the visit, it was correlated with a 15% increase in the prospect that patients are pleased with healthcare workers’ explanations of health conditions. Conclusion Informed patients are better equipped to assess health-systems responsiveness in healthcare provision. Insights into responsiveness could guide broader efforts aimed at targeted education and empowerment of primary healthcare users to strengthen health systems and shape expectations for appropriate care and conduct.

scholarly journals Patient-Reported Experiences in Accessing Primary Healthcare among Immigrant Population in Canada: A Rapid Literature Review

2020 ◽  
Vol 17 (23) ◽  
pp. 8724
Author(s):  
Bishnu Bahadur Bajgain ◽  
Kalpana Thapa Bajgain ◽  
Sujan Badal ◽  
Fariba Aghajafari ◽  
Jeanette Jackson ◽  
...  
Keyword(s):  
Literature Review ◽  
Primary Healthcare ◽  
English Language ◽  
Quality Care ◽  
Healthcare Providers ◽  
Strong Support ◽  
Active Role ◽  
Healthcare Services ◽  
Patient Experiences ◽  
Patient Reported

(1) Background: Immigrants represent around 21.9% of the total population in Canada and encounter multifaceted obstacles in accessing and receiving primary healthcare. This literature review explores patient experiences in primary care from the perspective of immigrants and identifies areas for further research and improvement. (2) Methods: A comprehensive search was performed on PubMed, MEDLINE, Embase, SCOPUS, and Google scholar to identify studies published from 2010 to July 2020. Relevant articles were peer-reviewed, in English language, and reported patient experiences in primary healthcare in Canada. (3) Results: Of the 1566 searched articles, 19 articles were included in this review. Overall, the finding from articles were summarized into four major themes: cultural and linguistic differences; socioeconomic challenges; health system factors; patient–provider relationship. (4) Conclusion: Understanding the gaps to accessing and receiving appropriate healthcare is important to shape policies, enhance the quality of services, and deliver more equitable healthcare services. It is therefore pertinent that primary healthcare providers play an active role in bridging these gaps with strong support from policymakers. Understanding and respecting diversity in culture, language, experiences, and systems is crucial in reducing health inequalities and improving access to quality care in a respectful and responsive manner.

Prediction of acute care service utilization for patients with hematologic malignancies.

2019 ◽  
Vol 37 (27_suppl) ◽  
pp. 312-312
Author(s):  
Kai Zu ◽  
Kristina Greenwood ◽  
Joyce Lamori ◽  
Besa Smith ◽  
Tyler C Smith ◽  
...  
Keyword(s):  
Acute Care ◽  
Service Utilization ◽  
Quality Care ◽  
Hematologic Malignancies ◽  
Risk Models ◽  
Quality Reporting ◽  
Care Services ◽  
Increased Risk ◽  
Acute Care Services ◽  
The Impact

312 Background: Improving the ability to predict which patients are at increased risk for acute care services subsequent to hospitalization can lead to more effective interventions and quality care. This study evaluated the performance of risk models to predict 30-day acute service utilization among adult inpatients with newly diagnosed hematologic malignancies. The study explored the impact of medical complications on potentially preventable service utilization, aligned with specifications for proposed measure OP-35 from the CMS Hospital Outpatient Quality Reporting Program. Methods: The study included 933 unique adult patients admitted to four acute care inpatient facilities within a non-profit community based healthcare system during calendar years 2012 to 2017. Risk models integrated a comprehensive set of data elements using clinical information from electronic medical records and facility oncology registries. Predictive models were constructed using a multivariable logistic regression, with calculation of standardized coefficients to rank order variables with the greatest impact on unplanned readmissions. Exploratory data mining techniques were conducted to augment classification of at-risk patients. Results: The mean age of study participants was 65 years and 55.1% were male. In order of prevalence, the types of hematologic malignancy were lymphoma (48.7%), leukemia (35.2%), myeloma (14.0%), and mixed types (2.1%). Approximately one fifth of patients received unplanned acute care services within 30 days after the index hospitalization (lymphoma = 23.1%, myeloma = 22.1%, leukemia = 18.6%). Among the risk models, the most influential predictors included initial length of stay, severity of illness, and consult for social work. Overall, 56.6% of patients who were readmitted within 30 days of hospitalization presented with one or more symptoms associated with the CMS medical complication measure, including cytopenia, infection, negative hydration, and/or pain. Conclusions: Optimizing quality care in a value-based health care environment requires proactive approaches such as risk prediction models for identifying patients who can benefit most from care transition interventions.

scholarly journals Women’s retention on the Continuum of Maternal Care Pathway in West Gojjam Zone, Ethiopia: Multilevel Analysis

2020 ◽  
Author(s):  
Amanu Aragaw Emiru ◽  
Getu Degu Alene ◽  
Gurmesa Tura Debelew
Keyword(s):  
Maternal Health ◽  
Health Service ◽  
Antenatal Care ◽  
Service Utilization ◽  
Maternal Care ◽  
Health Service Utilization ◽  
Continuum Of Care ◽  
Maternal Health Service ◽  
West Gojjam ◽  
The Continuum

Abstract Background: The continuum of maternal care has been one of the effective approaches for improving the health of mothers and newborns. Although large numbers of Ethiopian women do not use maternal health services, points of drop out along the continuum are not understood well. Understanding of a particular point of maternal care dropout on the continuum, however, helps governments make effective interventions. This study aimed to assess the extent of women’s service utilization and the factors affecting retention on the continuum of care in West Gojjam Zone, Ethiopia. Methods: A community-based study linked to health facility data was conducted in June 2018. Data were obtained from 1281 mothers who gave birth to their last baby within the preceding 12 months from a two-stage cluster sampling. Data were collected via face-to-face interviews using a pretested questionnaire. Multilevel logistic regression models were used to examine the effects of individual and cluster-level factors on key elements of the continuum of care. The measure of fixed effects was expressed as Odds Ratio with 95 % confidence interval. Results: The study revealed that only 12.1% of women completed the continuum of care (ANC4+, SBA, PNC within 48 hours after birth); while 25.1% reported not having care at any stage for their most recent birth. There were commonalities and differences in the predictors of the three indicators of maternal health service utilization. Variables related to services received during antenatal care such as early initiation of ANC (AOR=7.53, 95%CI, 2.94, 19.29) and receiving proper contents (AOR=3.31, 95%CI, 1.08, 10.16) were among the predictors significantly associated with the completion of the continuum of care. Conclusions: The continuum of maternal care completion rate was extremely low, indicating that women were not getting the maximum possible health benefit from existing health services. The results also revealed that maternal health service utilization was influenced by factors operating at various levels-individual, household, community, and health facility. Since antenatal care is considered an entry point for the subsequent use of maternal services, strategies that aimed to improve maternal health service utilization should target early initiation and antenatal care quality

scholarly journals Family and provider perceptions of quality of care in the management of sick young infants in primary healthcare settings in four counties of Kenya

2021 ◽  
Vol 10 (3) ◽  
pp. e001125
Author(s):  
Samuel Mbugua ◽  
Jesse Gitaka ◽  
Tabither Gitau ◽  
George Odwe ◽  
Peter Mwaura ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Primary Healthcare ◽  
Young Infant ◽  
Infant Care ◽  
Health Providers ◽  
Provider Attitudes ◽  
Healthcare Facilities ◽  
Healthcare Settings ◽  
Young Infants

BackgroundUnderstanding the perceptions of quality of care given to sick young infants in primary healthcare settings is key for developing strategies for effective uptake and utilisation of possible severe bacterial infection guidelines. The purpose of this study is to assess families and providers’ perceptions of care given to sick young infants at primary healthcare facilities in four diverse counties in Kenya.MethodsA cross-sectional qualitative design involving 37 in-depth interviews and 39 focus group discussions with very young (15–18 years), young (19–24 years) and older (25–45 years) caregivers of young infants aged 0–59 days; and key informant interviews with community-based and facility-based front-line health providers (14) in primary healthcare facilities. Qualitative data were captured using audio tapes and field notes, transcribed, translated and exported into QSR NVivo V.12 for analysis. A thematic framework approach was adopted to classify and analyse data.ResultsPerceived care given to sick young infants was described around six domains of the WHO framework for the quality of maternal and newborn healthcare: evidence-based practices for routine and emergency care; functional referral systems; effective communication; respect and preservation of dignity; availability of competent, motivated human resources; and availability of physical resources. Views of caregivers and providers regarding sick young infant care in primary healthcare settings were similar across the four sites. Main hindrance to sick young infant care includes stockout of essential drugs, limited infrastructure, lack of functional referral system, inadequate providers which led to delays in receiving treatment, inadequate provider skills and poor provider attitudes. Despite these challenges, motivation and teamwork of health providers were key tenets in care provision.ConclusionThe findings underscore the need to prioritise improving quality of sick young infant services at primary healthcare settings by building capacity of providers through training, ensuring continuous supply of essential medicines and equipment and improving infrastructure including referral.

scholarly journals Impact assessment of accreditation in primary and secondary public Healthcare Institutions in the State of Kerala, India

2020 ◽  
Author(s):  
Sindhu Joseph
Keyword(s):  
Patient Satisfaction ◽  
Primary Healthcare ◽  
Positive Impact ◽  
Quality Care ◽  
Healthcare Delivery ◽  
Public Healthcare ◽  
Healthcare Facilities ◽  
Medical Quality ◽  
Quality Dimensions ◽  
The Impact

AbstractObjectivesThis study examines the impact of accreditation on the quality of public healthcare delivery in primary and secondary healthcare facilities in Kerala, India.Study DesignA cross-sectional study.SettingKerala State, IndiaParticipantsParticipants are the in-patients (621) who are admitted in medical wards at accredited (312) and non-accredited (309) public healthcare facilities.Main Outcome MeasuresTen constructs used in the study, overarching the quality healthcare delivery, adapting previous studies, SERVQUAL, and Donabedian’s SPO models, are Physical Facility, Admission Services, Patient centeredness, Accessibility of Medical Care, Financial Factors, Professionalism, Staff Services, Medical Quality, Diagnostic Services, and Patient Satisfaction.MethodsThe study employed a positivist approach using a survey questionnaire. The study was conducted from July 2017 to July 2018, using stratified random sampling consists of the four strata; GHs, W&C hospitals, THQHs/THs and CHCs.ResultsAccreditation has a positive impact on patient satisfaction and other quality dimensions, overarching structural and procedural quality in primary healthcare facilities under the public sector in Kerala. Conversely, accreditation has not improved the quality dimensions in secondary healthcare facilities and thereby, the satisfaction of patients.ConclusionsIt cannot be assumed that accreditation is always associated with quality care in primary healthcare facilities. The implementation process must be systematic and must be regularly monitored to make it useful. Mere structural transformation through accreditation alone cannot guarantee patient satisfaction. Secondary healthcare facilities must be transformed into quality care centres through rhetoric action of the authorities concerned through organized efforts.

scholarly journals Effects of Training Health Workers in Integrated Management of Childhood Illness on Quality of Care for Under-5 Children in Primary Healthcare Facilities in Afghanistan

2019 ◽  
Vol 9 (1) ◽  
pp. 17-26
Author(s):  
Essa Tawfiq ◽  
Sayed Ali Shah Alawi ◽  
Kayhan Natiq
Keyword(s):  
Quality Of Care ◽  
Physical Examination ◽  
Primary Healthcare ◽  
Health Workers ◽  
Integrated Management ◽  
Quality Care ◽  
Medical Advice ◽  
Healthcare Facilities ◽  
Training Courses

Background: Training courses in integrated management of childhood illness (IMCI) have been conducted for health workers for nearly one and half decades in Afghanistan. The objective of the training courses is to improve quality of care in terms of health workers communication skills and clinical performance when they provide health services for under-5 children in public healthcare facilities. This paper presents our findings on the effects of IMCI training courses on quality of care in public primary healthcare facilities in Afghanistan. Methods: We used a cross-sectional post-intervention design with regression-adjusted difference-in-differences (DiD) analysis, and included 2 groups of health workers (treatment and control). The treatment group were those who have received training in IMCI recently (in the last 12 months), and the control group were those who have never received training in IMCI. The assessment method was direct observation of health workers during patient-provider interaction. We used data, collected over a period of 3 years (2015–2017) from primary healthcare facilities, and investigated training effects on quality of care. The outcome variables were 4 indices of quality care related to history taking, information sharing, counseling/medical advice, and physical examination. Each index was formed as a composite score, composed of several inter-related tasks of quality of care carried out by health workers during patient-provider interaction for under-5 children. Results: Data were collected from 733 primary healthcare facilities with 5818 patients. Quality of care was assessed at the level of patient-provider interaction. Findings from the regression-adjusted DiD multivariate analysis showed significant effects of IMCI training on 2 indices of quality care in 2016, and on 4 indices of quality care in 2017. In 2016 two indices of quality care showed improvement. There was an increase of 8.1% in counseling/medical advice index, and 8.7% in physical examination index. In 2017, there was an increase of 5.7% in history taking index, 8.0% in information sharing index, 10.9% in counseling/medical advice index, and 17.2% in physical examination index. Conclusion: Conducting regular IMCI training courses for health workers can improve quality of care for under-5 children in primary healthcare facilities in Afghanistan. Findings from our study have the potential to influence policy and strategic decisions on IMCI programs in developing countries.

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