scholarly journals Paramedics' experiences of financial medicine practices in the pre-hospital environment. A pilot study

2016 ◽  
Vol 21 ◽  
pp. 103-109
Author(s):  
Craig Vincent-Lambert ◽  
Richard-Kyle Jackson
Keyword(s):  
South Africa ◽  
Health Care ◽  
Pilot Study ◽  
South African ◽  
Emergency Care ◽  
Health Care Professionals ◽  
Service Providers ◽  
Hospital Environment ◽  
Patient Treatment ◽  
Unethical Conduct

Background: The term “financial medicine” refers to the delivery of health-related services where the generation of financial gain or “profit” takes precedence over the provision of care that is reflective of evidence-based best practice. The practicing of financial medicine includes over-servicing and overbilling, both of which have led to a sharp rise in the cost of health care and medical insurance in South Africa. For this reason, the practicing of financial medicine has been widely condemned both internationally and locally by the Health Professions Council of South Africa (HPCSA) and allied Professional bodies.Objectives: This qualitative pilot study explored and described the experiences of South African Paramedics with regard to the practicing of financial medicine in the local pre-hospital emergency care environment.Method: A sample of South African Paramedics were interviewed either face-to-face or telephonically. The interviews were audio recorded and transcripts produced. Content analysis was conducted to explore, document and describe the participants' experiences with regard to financial medicine practices in the local pre-hospital environment.Results: It emerged that all of the participants had experienced a number of financial medicine practices and associated unethical conduct. Examples included Over-servicing, Selective Patient Treatment, Fraudulent Billing Practices, Eliciting of kickbacks, incentives or benefits and Deliberate Time Wasting.Conclusion: The results of this study are concerning as the actions of service providers described by the participants constitute gross violations of the ethical and professional guidelines for health care professionals. The authors recommend additional studies be conducted to further explore these findings and to establish the reasons for, and ways of, limiting financial medicine practices in the South African emergency care environment.

Decriminalized, Not Legalized: A Pilot Study of South African University Students’ Views on the Use, Impact, Legalization and Decriminalization of Marijuana

2020 ◽  
Vol 50 (4) ◽  
pp. 490-506
Author(s):  
Molewane Mametja ◽  
Eleanor Ross
Keyword(s):  
South Africa ◽  
Health Care ◽  
Pilot Study ◽  
University Students ◽  
South African ◽  
Health Care Professionals ◽  
Significant Others ◽  
Intervention Programs ◽  
Personal Use ◽  
Potential Impact

Given the 2018 decriminalization of marijuana in South Africa for personal use and medicinal consumption, the aim of this research was to explore the perceptions of university students regarding the use, impact, legalization, and decriminalization of marijuana. Key findings revealed that a fair number of participants acknowledged using marijuana. When asked about the potential impact of marijuana on users, their families and significant others, they seemed to have a good understanding of the effects of the drug. However, while some participants were aware of the addictive nature of marijuana, others were not aware of the risk of addiction from smoking or ingesting this substance. However, they were able to weigh up the risks as well as the benefits of legalization/decriminalization of marijuana. This study has implications for health care professionals working with youth who use illicit substances such as marijuana, and in developing prevention and intervention programs aimed at the youth.

scholarly journals Spatiotemporal modelling and mapping of cervical cancer incidence among HIV positive women in South Africa: a nationwide study

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Dhokotera Tafadzwa ◽  
Riou Julien ◽  
Bartels Lina ◽  
Rohner Eliane ◽  
Chammartin Frederique ◽  
...  
Keyword(s):  
South Africa ◽  
Health Care ◽  
Cervical Cancer ◽  
South African ◽  
Access To Health Care ◽  
Health Facilities ◽  
Hiv Positive ◽  
The South ◽  
Hiv Positive Women ◽  
Access To Health

Abstract Background Disparities in invasive cervical cancer (ICC) incidence exist globally, particularly in HIV positive women who are at elevated risk compared to HIV negative women. We aimed to determine the spatial, temporal, and spatiotemporal incidence of ICC and the potential risk factors among HIV positive women in South Africa. Methods We included ICC cases in women diagnosed with HIV from the South African HIV cancer match study during 2004–2014. We used the Thembisa model, a mathematical model of the South African HIV epidemic to estimate women diagnosed with HIV per municipality, age group and calendar year. We fitted Bayesian hierarchical models, using a reparameterization of the Besag-York-Mollié to capture spatial autocorrelation, to estimate the spatiotemporal distribution of ICC incidence among women diagnosed with HIV. We also examined the association of deprivation, access to health (using the number of health facilities per municipality) and urbanicity with ICC incidence. We corrected our estimates to account for ICC case underascertainment, missing data and data errors. Results We included 17,821 ICC cases and demonstrated a decreasing trend in ICC incidence, from 306 to 312 in 2004 and from 160 to 191 in 2014 per 100,000 person-years across all municipalities and corrections. The spatial relative rate (RR) ranged from 0.27 to 4.43 in the model without any covariates. In the model adjusting for covariates, the most affluent municipalities had a RR of 3.18 (95% Credible Interval 1.82, 5.57) compared to the least affluent ones, and municipalities with better access to health care had a RR of 1.52 (1.03, 2.27) compared to municipalities with worse access to health. Conclusions The results show an increased incidence of cervical cancer in affluent municipalities and in those with more health facilities. This is likely driven by better access to health care in more affluent areas. More efforts should be made to ensure equitable access to health services, including mitigating physical barriers, such as transportation to health centres and strengthening of screening programmes.

scholarly journals In-Home Telerehabilitation for Post-Knee Arthroplasty: A Pilot Study

2009 ◽  
Vol 1 (1) ◽  
pp. 9-16 ◽  
Author(s):  
Michel Tousignant ◽  
Patrick Boissy ◽  
Hélène Corriveau ◽  
Hélène Moffet ◽  
François Cabana
Keyword(s):  
Health Care ◽  
Pilot Study ◽  
Acute Care ◽  
Knee Arthroplasty ◽  
Health Care Professionals ◽  
Acute Care Hospital ◽  
Rehabilitation Services ◽  
Control Group ◽  
Care Hospital ◽  
Post Discharge

The purpose of this study was to investigate the efficacy of in-home telerehabilitation as an alternative to conventional rehabilitation services following knee arthroplasty. Five community-living elders who had knee arthroplasty were recruited prior to discharge from an acute care hospital. A pre/post-test design without a control group was used for this pilot study. Telerehabilitation sessions (16) were conducted by two trained physiotherapists from a service center to the patient’s home using H264 videoconference CODECs (Tandberg 550 MXP) connected at 512 Kb\s. Disability (range of motion, balance and lower body strength) and function (locomotor performance in walking and functional autonomy) were measured in face-to-face evaluations prior to and at the end of the treatments by a neutral evaluator. The satisfaction of the health care professional and patient was measured by questionnaire. Results are as follows. One participant was lost during follow-up. Clinical outcomes improved for all subjects and improvements were sustained two months post-discharge from in-home telerehabilitation. The satisfaction of the participants with in-home telerehabilitation services was very high. The satisfaction of the health care professionals with the technology and the communication experience during the therapy sessions was similar or slightly lower. In conclusion, telerehabilitation for post-knee arthroplasty is a realistic alternative for dispensing rehabilitation services for patients discharged from an acute care hospital.Keywords: Telerehabilitation, Physical Therapy, Total Knee Arthroplasty, Videoconferencing

scholarly journals Are antiretrovirals prescribed according to the recommended prescribed daily doses in the private healthcare sector in South Africa

2011 ◽  
Vol 16 (1) ◽  
Author(s):  
Norah L. Katende-Kyenda ◽  
Martie Lubbe ◽  
Juan H.P. Serfontein ◽  
Ilse Truter
Keyword(s):  
South Africa ◽  
Health Care ◽  
Health Care Providers ◽  
Health Care Professionals ◽  
Health Care Sector ◽  
Hiv And Aids ◽  
Healthcare Sector ◽  
Private Health Care ◽  
Care Providers ◽  
Increased Risk

Current antiretroviral treatment (ART) guidelines recommend different combinations that have led to major improvements in the management of HIV and AIDS in the developed and developing world. With the rapid approval of many agents, health care providers may not be able to familiarise themselves with them all. This lack of knowledge leads to increased risk of dose- prescribing errors, especially by non-HIV and AIDS specialists. The purpose of this retrospective non-experimental, quantitative drug utilisation study was to evaluate if antiretrovirals (ARVs) are prescribed according to the recommended prescribed daily doses (PDDs) in a section of the private health care sector in South Africa (SA). Analysed ARV prescriptions (49995, 81096 and 88988) for HIV and AIDS patients were claimed from a national medicine claims database for the period 1 January 2005 through to 31 December 2007. ARV prescriptions prescribed by general practitioners (GPs) with PDDs not according to the recommended ARV dosing increased dramatically, from 12.33% in 2005 to 24.26% in 2007. Those prescribed by specialists (SPs) increased from 15.46% in 2005 to 35.20% in 2006 and decreased to 33.16% in 2007. The highest percentage of ARV prescriptions with PDDs not according to recommended ARV dosing guidelines was identified in ARV regimens with lopinavir−ritonavir at a PDD of 1066.4/264 mg and efavirenz at a PDD of 600 mg prescribed to patients in the age group of Group 3 (19 years > age ≤ 45 years). These regimens were mostly prescribed by GPs rather than SPs. There is a need for more education for all health care professionals and/or providers in the private health care sector in SA on recommended ARV doses, to avoid treatment failures, development of resistance, drug-related adverse effects and drug interactions.OpsommingHuidige riglyne vir behandeling met antiretrovirale middels beveel verskillende kombinasies aan wat tot groot verbetering in die beheer van MIV en VIGS in die ontwikkelde en ontwikkelende wêreld gelei het. Met die vinnige goedkeuring van talle nuwe middels kan dit gebeur dat verskaffers van gesondheidsorg nie kan bybly om hulle hiermee op hoogte te hou nie. Hierdie gebrek aan kennis lei tot ‘n hoër risiko vir foute in die voorgeskrewe dosis en veral deur persone wat nie spesialiste in MIV en VIGS is nie. Die doel van hierdie nie-eksperimentele, retrospektiewe, kwantitatiewe studie van die gebruik van geneesmiddels was om te bepaal of antiretrovirale middels in ‘n deel van die privaat gesondheidsorgsektor in Suid-Afrika (SA) volgens die aanbevole voorgeskrewe daaglikse dosisse (VDD) voorgeskryf word. Voorskrifte van antiretrovirale middels (49995, 81096 en 88988) aan pasiënte met MIV en VIGS wat in die periode van 1 Januarie 2005 tot 31 Desember 2007 van ‘n nasionale medisyne databasis geëis is, is ontleed. Voorskrifte van antiretrovirale middels deur algemene praktisyns (APs) met VDDs wat nie volgens die aanbevole dosisse vir antiretrovirale middels was nie, het dramaties van 12.33% in 2005 tot 24.26% in 2007 toegeneem. Die wat deur spesialiste (SPs) voorgeskryf is, het van 15.46% in 2005 tot 35.20% in 2006 toegeneem en in 2007 tot 33.16% gedaal. Die hoogste persentasie van voorskrifte vir antiretrovirale middels met VDDs wat nie volgens die riglyne was nie, was in die regimens met lopinavir−ritonavir met ‘n VDD van 1066.4/264 mg en efavirens met ‘n VDD van 600 mg wat aan pasiënte in die ouderdomsgroep van ouer as 19 tot en met 45 jaar voorgeskryf is. Hierdie regimens is meer deur APs as deur SPs voorgeskryf. Daar is ‘n behoefte aan nog opleiding van alle gesondheidsprofessies en/of voersieners in die privaat gesondheidsorgsektor in SA oor die aanbevole antiretrovirale middel-dosisse om mislukking van behandeling, ontwikkeling van weerstand, nadelige effekte vanweë geneesmiddels en geneesmiddel interaksies te voorkom.

scholarly journals Efficacy of a brief online mindfulness-based intervention on the psychological well-being of health care professionals and trainees during the COVID-19 pandemic: A mixed method design

2021 ◽  
Vol 26 ◽  
Author(s):  
Iram Osman ◽  
Shaista Hamid ◽  
Veena S. Singaram
Keyword(s):  
South Africa ◽  
Health Care ◽  
Mixed Method ◽  
Health Professionals ◽  
Health Care Professionals ◽  
Well Being ◽  
Personal Accomplishment ◽  
Intervention Analysis ◽  
Health Crisis ◽  
The Impact

Background: During the coronavirus disease 2019 (COVID-19) pandemic, health professionals were pushed to the front line of a global health crisis unprepared and resource constrained, which affected their mental well-being.Aim: This study aimed to investigate the effectiveness of a brief online mindfulness-based intervention (MBI) on stress and burnout for health professionals training and working in South Africa during the COVID-19 crisis.Setting: The context of the study is the overburdened, under-resourced health care system in South Africa during a global pandemic.Methods: A mixed method framework was adopted for this study. The quantitative data was analysed using descriptive analysis and the participants’ qualitative experiences were interpreted using interpretative phenomenological analysis.Results: Forty-seven participants took part in this study. The study found a statistically significant (p 0.05) reduction in stress levels and emotional exhaustion as well as an increase in mindful awareness and feelings of personal accomplishment after the intervention. The participants’ shared experiences were analysed in two parts. The pre-intervention analysis presented with central themes of loss of control and a sense of powerlessness because of COVID-19. The post-intervention analysis comprised themes of a sense of acquired control and empowerment through increased mindfulness.Conclusions: The study found that a brief online MBI can be associated with reduced levels of stress and burnout as well as an increased sense of control and empowerment, felt both personally and professionally, during a global crisis.Contribution: The impact of an online MBI for health care professionals amidst a pandemic has not been previously documented.

scholarly journals The influence of bank employees on bank customer relationship management

2007 ◽  
Vol 7 (1) ◽  
Author(s):  
C. Rootman ◽  
M. Tait ◽  
J Bosch
Keyword(s):  
South Africa ◽  
South African ◽  
Customer Service ◽  
Customer Relationship Management ◽  
Service Providers ◽  
Relationship Management ◽  
Primary Objective ◽  
Customer Relationship ◽  
Positive Attitudes ◽  
Bank Employees

Purpose: Despite extensive research in services marketing, much is still unknown to specific service providers on the influence of their employees on their services. This paper attempts to address this limitation and investigates the influence of employees on the customer relationship management (CRM) of banks. The primary objective of this paper is to investigate the influence of selected independent variables, namely attitude and knowledgeability, on the CRM of banks.Design/Methodology/Approach: An empirical investigation was conducted with a structured questionnaire with items that related to banks' CRM in terms of attitude and knowledgeability. The sample consisted of 290 banking clients in the Nelson Mandela Metropolitan area and the response rate was 91.03%. Findings: Significant positive relationships exist between both the knowledgeability, and attitude of bank employees and a bank's CRM. These relationships imply that more extensive knowledgeability and more positive attitudes of bank employees lead to improved, maintained relationships between a bank and its clients. Employees play an important role in banks’ client relationships. Implications: Banks should focus on increasing their employees' knowledgeability and improving their attitude to ensure higher levels of CRM. This paper provides strategies for banks and could create greater awareness among South African banks of the advantages of CRM, how their employees influence their CRM, and ways to adapt to these influences. Originality/Value: No study has focused exclusively on CRM within banks in South Africa. Prior research focused on customer service and service quality; both possible results of superior CRM. However, this research differs, as it identifies the variables influencing CRM in banks in South Africa. It is proposed that this paper will be beneficial for South African banks, as the recommendations may be used to ensure higher levels of CRM in banks.

scholarly journals Sense (Scents) of South Africa

1999 ◽  
Vol 55 (1) ◽  
pp. 3-5
Author(s):  
Katherine F. Shepard
Keyword(s):  
South Africa ◽  
Health Care ◽  
South African ◽  
Health Care Facilities ◽  
Speech Pathology ◽  
African Society ◽  
South African Society ◽  
Care Facilities ◽  
The University ◽  
Physiotherapy Education

This paper presents a brief description of some of the author’s perceptions of the land, of physiotherapy education and practice and of the struggle of the nation of South Africa acquired during a 4 week visit in late spring 1997. One week was spent in Cape Town participating in several venues at the International Congress of the South African Society of Physiotherapy. Three weeks were spent at the University of the Witswatersrand in Johannesburg presenting a course in qualitative research to health care colleagues representing the disciplines of physical therapy, occupational therapy, speech pathology and occupational health. During the time in Johannesburg several health care facilities were visited including Baragwanath Hospital, Natal Hospital and the Wits Rural Facility and Tinswalo Hospital at Acornhoek.

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