scholarly journals Contracting Out of Health Services for Province-level Integration of Healthcare System: Effect on Equity

2020 ◽  
Vol 54 (6) ◽  
Author(s):  
Theo Prudencio Juhani Z. Capeding ◽  
Ma-Ann M. Zarsuelo ◽  
Hilton Y. Lam ◽  
Ma. Esmeralda C. Silva ◽  
Michael Antonio F. Mendoza
Keyword(s):  
Health Services ◽  
Health Outcomes ◽  
Underserved Populations ◽  
Inclusive Development ◽  
System Effect ◽  
Public And Private ◽  
Policy Makers ◽  
Contracting Out ◽  
Patient Groups ◽  
The Impact

Background. The recently enacted Universal Health Care (UHC) Act prioritizes the provision of a comprehensive set of quality and accessible services. However, the devolution of health services has led to inequitable investments in healthcare resulting to disparities in health outcomes between areas. One of the strategies considered that could minimize these differences is the contracting out of health services to the private sector. This review focuses on mapping equity-related issues and concerns with regard to contracting out health services. Methods. A modified systematic search of literature using published journal articles through PubMed and Google Scholar and other pertinent reports and manuals was conducted on issues of equity and health service contracting. Results and Discussion. There is currently a dearth of literature on the effect of contracting services on health equity outcomes, particularly on the impact of contracting out on equity. Limited studies showed that contracting out can potentially improve equity by increasing service utilization. Mechanisms on how contracting out could potentially affect equity were also found. Results mainly suggest that concrete steps should be taken to ensure equitable access and improvement in health outcomes among population subgroups. To provide a framework in applying possible insights from the review, discussion of the literature review was framed in the context of establishing performance-based contracting. It was emphasized that including representatives from the underserved populations and patient groups during stakeholder consultations were crucial to provide localized context for the inclusive development of contracting arrangements. Other strategies that were highlighted included: establishing monitoring systems that disaggregate data between groups, selecting contractors that have the capacity to reach and provide services to the underserved, and making sure that these contractors are also open to data sharing for economic evaluation of services. Conclusion and Recommendations. Despite the paucity of data on the impact of contracting out services on equity, mechanisms explaining the effect of contracting on equity were put forward and illustrated. These findings can be considered by policy makers and program developers in the operationalization of service agreements between the public and private sectors.

The Impact of Social Mobilization on Health Service Delivery and Health Outcomes

2018 ◽  
Author(s):  
Xavier Giné ◽  
Salma Khalid ◽  
Mansuri Ghazala
Keyword(s):  
Health Services ◽  
Service Delivery ◽  
Health Outcomes ◽  
Health Workers ◽  
Health Service Delivery ◽  
Health Providers ◽  
Child Health Outcomes ◽  
Rural Pakistan ◽  
Post Natal Care ◽  
The Impact

This chapter uses a randomized community development programme in rural Pakistan to assess the impact of citizen engagement on public service delivery and maternal and child health outcomes. The programme had a strong emphasis on organizing women, who also identified health services as a development priority at baseline. At midline, we find that the mobilization effort alone had a significant impact on the performance of village-based health providers. We detect economically large improvements in pregnancy and well-baby visits by female health workers, as well as increased utilization of pre- and post-natal care by pregnant women. In contrast, the quality of supra-village health services did not improve, underscoring the importance of community enforcement and monitoring capacity for improving service delivery.

Measuring the globalization of health services: a possible index of openness of country health sectors to trade

2006 ◽  
Vol 1 (4) ◽  
pp. 323-342 ◽  
Author(s):  
RICHARD SMITH
Keyword(s):  
Health Policy ◽  
Health Services ◽  
Health Sector ◽  
Specific Aspect ◽  
Policy Makers ◽  
Significant Aspect ◽  
National Economies ◽  
The Impact

Globalization is a key challenge facing health policy-makers. A significant aspect of this is trade in health services. However, little is currently known about how trade in health services will affect the health of populations and national economies. A key determinant of the impact of trade in health services will be the general economic and trade context of the country concerned. One specific aspect of this is the ‘openness’ of a country’s health sector to trade; yet there is little, if anything, currently known about the most appropriate methods to assess openness of the health sector.

scholarly journals Understanding and evaluating new models of Child and Adolescent Mental Health Services in South-East England: a study protocol for an observational mixed-methods study

BMJ Open ◽  
2018 ◽  
Vol 8 (12) ◽  
pp. e024230 ◽  
Author(s):  
Stephen Rocks ◽  
Melissa Stepney ◽  
Margaret Glogowska ◽  
Mina Fazel ◽  
Apostolos Tsiachristas
Keyword(s):  
Mental Health ◽  
Mixed Methods ◽  
Mental Health Services ◽  
Health Services ◽  
Health Outcomes ◽  
Adolescent Mental Health ◽  
Child And Adolescent ◽  
Resource Utilisation ◽  
South East England ◽  
The Impact

IntroductionIncreased demand for Child and Adolescent Mental Health Services (CAMHS), alongside concerns that services should be better commissioned to meet the needs of the most vulnerable, has contributed to a requirement to transform services to improve accessibility, quality of care and health outcomes. Following the submission of government-mandated transformation plans for CAMHS, services in England are changing in how, where and by whom they are delivered. This protocol describes the research methods to be applied to understand CAMHS transformations and evaluate the impact on the use of mental health services, patient care, satisfaction, health outcomes and health resource utilisation costs.Methods and analysisA mixed-methods approach will be taken in an observational retrospective study of CAMHS provided by a large National Health Service (NHS) mental health trust in South-East England (Oxford Health NHS Foundation Trust). Quantitative research will include descriptive analysis of routinely collected data, with difference-in-differences analysis supplemented with propensity score matching performed to assess the impact of CAMHS transformations from 2015 onwards. An economic evaluation will be conducted from a healthcare perspective to provide commissioners with indications of value for money. Qualitative research will include observations of services and interviews with key stakeholders including CAMHS staff, service users and guardians, to help identify mechanisms leading to changes in service delivery, as well as barriers and enabling factors in this phase of transformation.Ethics and disseminationThis project has been registered with NHS Oxford Health Foundation Trust as a service evaluation. Informed consent will be sought from all stakeholders partaking in interviews according to good clinical practice. A local data sharing protocol will govern the transfer of quantitative data. Study findings will be published in professional journals for NHS managers and peer-reviewed scientific journals. They will be discussed in seminars targeting CAMHS providers, managers and commissioners and presented at scientific conferences.

scholarly journals New and Emerging Mobile Technologies for Healthcare (mHealth): A Horizon Scanning Study

2019 ◽  
Vol 8 (1) ◽  
pp. 17
Author(s):  
Azar Kazemi ◽  
Hosna Salmani ◽  
Alireza Shakibafard ◽  
Farhad Fatehi
Keyword(s):  
Health Services ◽  
Mobile Apps ◽  
Preventive Health Services ◽  
Target Population ◽  
Mobile Technologies ◽  
Full Potential ◽  
Public And Private ◽  
Innovative Technologies ◽  
Horizon Scanning ◽  
The Impact

Introduction: The popularity of mobile phone applications (Apps) and wearable devices for medical and health purposes is on the rise, but not all the mobile health (mHealth) innovative solutions that hit the news every day will sustain and have an impact on the health of people. The aim of this news-based horizon scanning study was to explore and identify new and emerging mobile technologies that are likely to impact the future of health and medical care.Methods: We conducted a systematic search on top ranking technology websites, according to Alexa Ranking, to identify health-related mobile-based technologies. We followed the EuroScan guide for horizon scanning, which recommends four steps: identification, filtering, prioritization, evaluation and conclusion. Technologies of interest were mHealth technologies regardless of their maturity level. The impact of technologies was assessed and scored in four areas: user, technology, safety, and cost.Results: Five hundred news articles were identified through the electronic search. After screening, 106 mHealth innovative technologies were included in this study. We categorized the included technologies into three groups: mobile apps (n=37), smart-connected devices (n=19), and wearables (n=50). mHealth technologies were most frequently developed for preventive health services, mental health services and rehabilitation services. There was no remarkable difference between the technology groups in terms of safety and adverse effects, but the groups were significantly different in terms of the target population, technology, and cost.Conclusion: An increasing number of solutions based on mobile technology is being developed by both public and private sectors but a low proportion of them undergo proper scientific evaluations. Despite the commercial availability of many innovative mobile apps, wearables, and smart connected devices, few of them have been actually used in clinics, hospitals, and health centers. There is a clear need for changes in healthcare service models to unlock the full potential of these innovative technologies.

The impact of health insurance on health services utilization and health outcomes in Vietnam

2014 ◽  
Vol 9 (4) ◽  
pp. 359-382 ◽  
Author(s):  
G. Emmanuel Guindon
Keyword(s):  
Health Insurance ◽  
Health Services ◽  
Health Outcomes ◽  
Health Services Utilization ◽  
Living Standard ◽  
Outpatient Services ◽  
Services Utilization ◽  
The Poor ◽  
Inpatient Services ◽  
The Impact

AbstractIn recent years, a number of low- and middle-income country governments have introduced health insurance schemes. Yet not a great deal is known about the impact of such policy shifts. Vietnam’s recent health insurance experience including a health insurance scheme for the poor in 2003 and a compulsory scheme that provides health insurance to all children under six years of age combined with Vietnam’s commitment to universal coverage calls for research that examines the impact of health insurance. Taking advantage of Vietnam’s unique policy environment, data from the 2002, 2004 and 2006 waves of the Vietnam Household Living Standard Survey and single-difference and difference-in-differences approaches are used to assess whether access to health insurance – for the poor, for children and for students – impacts on health services utilization and health outcomes in Vietnam. For the poor and for students, results suggest health insurance increased the use of inpatient services but not of outpatient services or health outcomes. For young children, results suggest health insurance increased the use of outpatient services (including the use of preventive health services such as vaccination and check-up) but not of inpatient services.

scholarly journals Psychiatric intensive care and low secure units: where are we now?

2008 ◽  
Vol 32 (12) ◽  
pp. 441-443 ◽  
Author(s):  
M. Dominic Beer
Keyword(s):  
Mental Health ◽  
Intensive Care ◽  
Health Services ◽  
Intensive Care Units ◽  
Short Term ◽  
Term Care ◽  
Policy Makers ◽  
General Mental Health ◽  
Department Of Health ◽  
Patient Groups

SummaryThe last decade has seen clinicians and policy makers develop psychiatric intensive care units and low secure units from the so-called ‘special care wards’ of the 1980s and 1990s. Psychiatric intensive care units are for short-term care, while low secure units are for care for up to about 2 years. Department of Health standards have been set for these units. A national survey has shown that there are two main patient groups in the low secure units: patients on forensic sections coming down from medium secure units and those on civil sections who are transferred from general psychiatric facilities. Recent clinical opinion has emphasised the important role both psychiatric intensive care units and low secure units play in providing a bridge between forensic and general mental health services.

The association between Internet use and health outcomes in the population of older adults

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
K Szulc ◽  
M Duplaga
Keyword(s):  
Older Adults ◽  
Health Status ◽  
Health Services ◽  
Health Outcomes ◽  
Internet Use ◽  
Health Behaviours ◽  
The Internet ◽  
Internet Users ◽  
Health Related ◽  
The Impact

Abstract Background The Internet has become one of the primary sources of health-related information. Less is known about the impact of Internet access and use on health-related outcomes in the older population, which frequently suffer from a digital divide. The main objective of this study was the assessment of the associations between Internet use and variables reflecting health status, the use of health services and health behaviours in the population at least 50 years old. Methods The analysis was carried out on the data set from the telephone-based survey in a sample of 1000 respondents representative for targeted age strata of Polish society. The effects of Internet use were assessed with logistic regression models after adjusting for key socioeconomic variables. Results Mean age (standard deviation) of respondents was 64.2 (9.6). In the study group, 51.1% respondents were Internet users, 19.4% - persons with disabilities, 21.2% were hospitalised at least once, and 51.0% visited health care facilities at least six times in preceding 12 months. The respondents being Internet users less frequently reported chronic diseases (OR, 95%CI: 0.21, 0.16-0.30), disability status (0.52, 0.37-0.72) and higher self-assessed health status (1.64, 1.24-2.16). They also less often used health services in the preceding 12 months (0.77, 0.60-0.99. Internet use was not associated with hospital admission in the preceding year (1.04, 0.76-1.41) and most of the health behaviours (smoking: 1.06, 0.77-1.45, physical activity: 0.85, 0.63-1.15, the consumption of fruits and vegetables: 0.73, 0.50-1.07). Interestingly, Internet users drunk more alcohol (1.52, 1.14-2.02). Conclusions In the population of older adults, the use of the Internet is associated with variables reflecting health status and the utilisation of health services. Higher health status and lower prevalence of chronic conditions among Internet users were found after adjusting for age and other socioeconomic factors. Key messages It was shown that Internet use may be related with more favourable health outcomes. The reported association should trigger further research on the impact of Internet in elderly persons.

scholarly journals Study protocol for a longitudinal study evaluating the impact of rape on women’s health and their use of health services in South Africa

BMJ Open ◽  
2017 ◽  
Vol 7 (9) ◽  
pp. e017296 ◽  
Author(s):  
Naeemah Abrahams ◽  
Soraya Seedat ◽  
Carl Lombard ◽  
Andre P Kengne ◽  
Bronwyn Myers ◽  
...  
Keyword(s):  
Mental Health ◽  
South Africa ◽  
Longitudinal Study ◽  
Health Services ◽  
Health Outcomes ◽  
Service Providers ◽  
Adult Women ◽  
Gender Based Violence ◽  
Gender Based ◽  
The Impact

IntroductionSouth Africa is a country known for its high levels of HIV infection and sexual violence. Although the interface between gender-based violence, HIV and mental health has been described, there are substantial gaps in knowledge of the medium-term and long-term health impact. The 2010 Global Burden of Disease study excluded many health outcomes associated with rape and other forms of gender-based violence because systematic reviews revealed huge gaps in data and poor evidence of health effects. This study aims to describe the incidence and attributable burden of physical and mental health problems (including HIV acquisition) in adult women over a 2-year postrape period, through comparison with a cohort of women who have not been raped. The study will substantially advance our understanding of the impact of rape and will generate robust data to assist in the development of postrape health services and the delivery of evidence-based care.Methods and analysisThis longitudinal study seeks to recruit 1008 rape-exposed and 1008 rape non-exposed women. Women were recruited from health services, and assessments were carried out at baseline, 3, 6, 9, 12, 18 and 24 months. Outcome measures include exposure to risk factors; mental health status; cardio-metabolic risks; and biomarkers for HIV, sexually transmitted infections, pregnancy and stress. The primary analysis will be to compare HIV incidence in the two groups using log-rank tests. Appropriate models to predict health outcomes over time will also be applied.Ethics and disseminationThe South African Medical Research Council’s Ethics Committee approved the study. As rape is a key element of the study, the safety and protection of participants guides the research process. We will adopt a research uptake strategy to ensure dissemination to policy makers, service providers and advocacy groups. Peer-reviewed journal articles will be published.

scholarly journals Public-Private Partnership in Health Care and Its Impact on Health Outcomes: Evidence from Ruharo Mission Hospital in Uganda

2018 ◽  
Vol 6 (12) ◽  
pp. 79
Author(s):  
Justus Asasira ◽  
Frank Ahimbisibwe
Keyword(s):  
Health Care ◽  
Health Services ◽  
Health Outcomes ◽  
Public Private Partnership ◽  
Private Partnership ◽  
The Public ◽  
Public Facilities ◽  
Mission Hospital ◽  
Private Providers ◽  
The Impact

Background: Uganda’s government has embraced private provision of social services including health care. The involvement of private providers is an indicator that the public facilities are not sufficient enough to meet the high demands of the ever-increasing population. This has been done through partnership arrangements. This paper discusses the impact of Public-Private Partnership (PPP) in health care outcomes of the local population and opportunities for improving health outcomes, challenges facing private providers in a low income setting.Methodology: Data were collected using qualitative methods in January 2017 through interview (using semi-structured questions) at Ruharo Mission Hospital (RMH) administration, health workers, district health office and used a structured questionnaire for patients/clients. This was a nascent study, with a sample size of 22 respondents. The hospital has three departments; Organized Useful Rehabilitation Services (OURS), General Medical Services (GMS) and Eye Department (ED). All the departments of the hospital were represented in this study.Results: The hospital is a Church of Uganda project and runs a budget of 5 billion shillings ($ 1,351,351.4) annually, had multiple sources of funding including PHC funding annually and that, health services were delivered adequately to clients. Much as some services were accessed at no costs, other services like eye treatment were found expensive on the side of clients. The hospital’s hybrid mode of delivering health services through outreaches and facility-based services was cherished, however it had no ambulance and relied only on a hospital van.Conclusions and Recommendations: Our study concluded that if private providers are supported under the partnership arrangement, they can adequately deliver services to the clients and decongest the public facilities. We recommend that the government devote funds to support the hospital through employing more sub-seconded staff, procuring medicines, and ambulances to enable it to subsidize services especially eye treatment and other services not supported under the partnership.

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