scholarly journals Rationalizing Health Personnel Financing Schemes for Evidence-informed Policy Reforms: Policy Analysis

2020 ◽  
Vol 54 (6) ◽  
Author(s):  
Hilton Y. Lam ◽  
Katrina Loren R. Rey ◽  
Ma-Ann M. Zarsuelo ◽  
Ma. Esmeralda C. Silva ◽  
Michael Antonio F. Mendoza ◽  
...  
Keyword(s):  
Health Care ◽  
Health Personnel ◽  
Health Financing ◽  
Cost Effective ◽  
Position Statement ◽  
Health Care Facilities ◽  
Public Healthcare ◽  
Care Providers ◽  
Government Hospitals ◽  
Part Time

Background. The Universal Health Care Law seeks to optimize financing of personnel costs without compromising quality and equitable health care among the health care facilities. This position statement aimed to identify strategies and policy recommendations for the cost-effective financing of health personnel in public healthcare facilities. Methods. A systematic review of literature was done to generate policy brief and key points for roundtable discussion in collaboration with the Department of Health (DOH). The discussion was guided by the three health financing options of DOH: (a) retain Personnel Services (PS) as DOH budget but shift Maintenance and Other Operating Expenses (MOOE) to PhilHealth; (b) shift PS and MOOE to PhilHealth, and (c) rationalize part-time status in government hospitals. Results. The pros and cons of financing options were cross-examined. In Option 1, physicians in government hospitals would receive fixed salaries from DOH / Local Government Units. In Option 2, there would be a monopsony between PhilHealth and provincial power. Payment will be performance-driven, and balance billing will be eliminated. Option 3 would be a set up of retaining part-time positions for physicians. Conclusion and Recommendation. Participants deduced that for Option 1, provision of salary augmentation sources and ensuring adequate plantilla items and level of remuneration in government hospitals should be considered, in order to sufficiently compete with physicians’ income from private practice. For Option 2, the PhilHealth reimbursement system should ensure timely reimbursement so as not to subject care providers to financial instabilities. For Option 3, rationalizing part-time status should be flexible and can be applied regardless of how physicians are paid, as this would incentivize caregivers to work harder and smarter.

scholarly journals Assessment of Facility based newborn care at various health care facilities in Rajkot district

2017 ◽  
Vol 4 (4) ◽  
pp. 1125
Author(s):  
Jasmin R. Oza ◽  
Ashutosh D. Jogia ◽  
Bhavesh R. Kanabar ◽  
Dhara V. Thakrar
Keyword(s):  
Health Care ◽  
Health Personnel ◽  
Newborn Care ◽  
Health Care Facilities ◽  
Health Facilities ◽  
Health Centers ◽  
Care Providers ◽  
Digital Thermometer ◽  
Neonatal Deaths ◽  
District Hospitals

Background: India carries the single largest share (around 25-30%) of neonatal deaths in the world. It has been estimated that about 70% of neonatal deaths could be prevented if proven interventions are implemented effectively with high coverage.Methods: A cross-sectional observational study was conducted at various health facilities of Rajkot district where facility based newborn care are created as per the guidelines under NRHM. It was conducted during August 2013 to October, 2013. The data entry was done in Microsoft Office Excel 2007 and analyzed in Epi info software from CDC Atlanta. Results: This study included total 32 health facilities including 10 Primary Health Centers (PHC) (24X7), 15 Community Health Centers (CHC), 5 Sub District Hospitals (SDH), one District Hospital (DH) and one Medical College (MC). There are a total of 36 facilities of different level available in government set up for newborn care starting from NBCC to SNCU. All (100%) of the health centers visited were equipped with NBCC for newborn care, while NBSU and SNCU for newborn care were created at only 2 (6.2%) centers respectively. Only 2 out of 10 PHC had all required equipments for NBCC. All the required equipments were available at 3 CHCs out of total 15 CHCs. All the SDH were having adequate equipment for NBCC except resuscitator & separate Digital Thermometer were not available at 2 SDH. At DH, except for Digital thermometer, all equipments were adequate. Only 1 SDH has been established for NBSU and it did not have adequate no. of radiant warmer and resuscitator. DH is lacking in all the required equipment for SNCU except for resuscitator (250 ml) and refrigerator. Out of total 101 health personnel, 68 (67.3%) have been trained for NSSK.  From total 68 trained health personnel, 12 (17.7%) got the score above the cut off for resuscitation skill. Out of the trained respondents, 29 (42.7%) acquired score above cut off for routine care.Conclusion: All the PHCs, CHCs, SDHs and DH were deficient in equipments. NBSU was created in only one SDH. SNBU was created at DH and MC, but equipments were not sufficient at both centers. Health care providers involved in facility based newborn care units had poor knowledge regarding routine newborn care and also not properly trained in resuscitation.

HEALTH FINANCING POLICIES

1999 ◽  
Vol 15 (4) ◽  
pp. 686-698 ◽  
Author(s):  
Hengjin Dong ◽  
Lennart Bogg ◽  
Clas Rehnberg ◽  
Vinod Diwan
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Health Financing ◽  
Health Care Facilities ◽  
Central China ◽  
Care Providers ◽  
Prescribing Behavior ◽  
Care Facilities ◽  
Insured Patients ◽  
Village Health

Objectives: To describe effects of health financing on providers' opinions and prescribing behavior in rural China.Methods: A multi-stage sampling procedure was used to select county, township, and village health care facilities. A total of 1,064 health care providers in county, township, and village health care facilities in six counties in central China were randomly selected and surveyed during one week by written questionnaire.Results: Patient's health financing systems (insurance or out-of-pocket payment), financing methods for health facilities (general budget or fee for service), and payment methods for providers (salary or bonus) influenced provider prescribing. Bonuses could improve the quality of health care, but could also be an incentive to prescribe more drugs or more expensive drugs and other services. The providers were of the view that patients' health financing and ability to pay were the main determinants of the type of treatment. Insured patients could have more access to expensive drugs, referred to specialized health care facilities, and have a higher cure rate (according to the doctor's opinion) for tuberculosis. Most of the clinical doctors said that they prescribed more expensive antibiotics for insured patients and changed prescriptions according to patients' demands, financial ability, and health financing systems in the treatment of some diseases, such as chronic bronchitis, tuberculosis, and hypertension.Conclusion: The empirical data suggest that the main factor influencing provider prescribing behavior is the economic incentives in relation to health care financing for both health care providers and consumers.

Knowledge of HIV post exposure prophylaxis among public healthcare providers in Ilala District, Dar es Salaam

2019 ◽  
Author(s):  
Victor Kinigwa ◽  
Manase Kilonzi ◽  
Wigilya P. Mikomangwa ◽  
George M. Bwire ◽  
Hamu J. Mlyuka ◽  
...  
Keyword(s):  
Health Care ◽  
Dar Es Salaam ◽  
Health Care Facilities ◽  
Public Healthcare ◽  
Post Exposure Prophylaxis ◽  
Care Providers ◽  
Post Exposure ◽  
Level Of Knowledge ◽  
Exposure Prophylaxis ◽  
Study Participants

Abstract Background Post-exposure prophylaxis (PEP) using highly active antiretroviral therapy (HAART) significantly reduces the risk of HIV infection to the victims. Evidence based practice has brought dynamicity in HAART regimens necessitating continual updates on knowledge of health care providers (HCPs) regarding PEP. Therefore, this study aimed to assess contemporary knowledge of HCPs on PEP three years after the introduction of Tenofovir based HAART regimens as a default for PEP in Tanzania.Methods A health care facilities based cross-sectional study was conducted between April and June 2018 in Ilala municipal Dar es Salaam, Tanzania. A consecutive sampling method was deployed and 233 HCPs were enrolled. Data were collected using a self-administered questionnaire with closed-ended questions. The level of knowledge was graded using Bloom’s cut off point. Chi-square and multinomial logistic regression tests were used to check for association at significance level of p<0.05.Results A total of 13 health facilities were visited and 233 HCPs were interviewed among them 30.9%, 5.6%, 58.4%, and 5.2% were medical doctors, pharmaceutical personnel, nurses and laboratory technician respectively. The majority 72.1% (168) of the participants were female and the majority 47.2% (110) of the HCPs were aged ≥55 years. Diploma (43.8% (102)) education level constituted the largest proportion of the participants and the majority 50.2% (117) were nurses. About 70% of the respondents had low to moderate knowledge. The majority 87.6%(204) of the study participants were knowledgeable on dosage duration for PEP. However, only 41.2% (96) knew the recommended ARV regimen for PEP in Tanzania and 48.9% (114) knew how soon PEP should be initiated to prevent HIV acquisition. Certificate holders were more likely to have low knowledge on PEP compared to diploma and degree holders aOR (95% CI) 14(3.9 – 50.8), p=<0.01. The main source of PEP information to study participants was HIV treatment guideline (29%) followed by seminars (22%).Conclusion The majority of the assessed HCPs had low to moderate knowledge on PEP. The level of knowledge on PEP among HCPs increased with the level of education whereby those with a degree are more knowledgeable.

scholarly journals Has Metal-On-Metal Resurfacing Been a Cost-Effective Intervention for Health Care Providers?—A Registry Based Study

PLoS ONE ◽  
2016 ◽  
Vol 11 (11) ◽  
pp. e0165021
Author(s):  
Ruth Pulikottil-Jacob ◽  
Martin Connock ◽  
Ngianga-Bakwin Kandala ◽  
Hema Mistry ◽  
Amy Grove ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Cost Effective ◽  
Effective Intervention ◽  
Care Providers ◽  
Metal On Metal

scholarly journals Experiences of homosexual patients’ access to primary health care services in Umlazi, KwaZulu-Natal

Curationis ◽  
2015 ◽  
Vol 38 (2) ◽  
Author(s):  
Nokulunga H. Cele ◽  
Maureen N. Sibiya ◽  
Dudu G. Sokhela
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Nursing Education ◽  
Health Care Providers ◽  
Health Care Services ◽  
Health Care Facilities ◽  
Easy Access ◽  
Care Providers ◽  
Care Services ◽  
Primary Health

Background: Homosexual patients are affected by social factors in their environment, and as a result may not have easy access to existing health care services. Prejudice against homosexuality and homosexual patients remains a barrier to them seeking appropriate healthcare. The concern is that lesbians and gays might delay or avoid seeking health care when they need it because of past discrimination or perceived homophobia within the health care thereby putting their health at risk.Aim of the study: The aim of the study was to explore and describe the experiences of homosexual patients utilising primary health care (PHC) services in Umlazi in the province ofKwaZulu-Natal (KZN).Method: A qualitative, exploratory, descriptive study was conducted which was contextual innature. Semi-structured interviews were conducted with 12 participants. The findings of this study were analysed using content analysis.Results: Two major themes emerged from the data analysis, namely, prejudice against homosexual patients by health care providers and other patients at the primary health care facilities, and, homophobic behaviour from primary health care personnel.Conclusion: Participants experienced prejudice and homophobic behaviour in the course of utilising PHC clinics in Umlazi, which created a barrier to their utilisation of health services located there. Nursing education institutions, in collaboration with the National Department of Health, should introduce homosexuality and anti-homophobia education programmes during the pre-service and in-service education period. Such programmes will help to familiarise health care providers with the health care needs of homosexual patients and may decrease homophobic attitudes.

Health Care, Medical Education and National Medical Commission Bill

LAW REVIEW ◽  
2018 ◽  
Vol 38 (1) ◽  
Author(s):  
Dr. R. K. Verma
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Medical Profession ◽  
Care Providers ◽  
Indian States ◽  
National Medical ◽  
Government Hospitals ◽  
Make Health Care ◽  
Care Development ◽  
Medical Colleges

Health and health care development has not been a priority of the Indian States and it is a wellknown fact that all these facilities, policies and systems of healthcare are an eyewash and restricted to sheer papers. The worst aspect of this situation is that private medical colleges and institutions have become money making machine and in turn they take admissions of even the incompetent and unworthy students in consideration of inordinate fees and donations and as a result the doctors who get their degrees from these incompetent and unethical institutions are authorized to practice who are mostly inept, unskilled and unworthy thereby putting to risk lives of many of their patients. Over the years, the IMA and the MCI have been alleged to be deviating from its motto, thereafter doing little to control the rampant corruption in medical profession and medical colleges/government hospitals etc. Moreover, there is no transparency in their working or accountability for deeds. Medical care is not just a matter of accessibility and affordability but also quality as India prepares to fight the emerging problems of health care. To provide best health care at the lowest possible cost and make health care providers accountable for cost and quality, it is a high time for critical analysis regarding views and perspective of National Medical Commission Bill, 2017.

scholarly journals Tomorrow's Challenges –Today's Realities Making the Leap: 2002 Ryley-Jeffs Memorial Lecture

2002 ◽  
Vol 63 (3) ◽  
pp. 134-139
Author(s):  
Kathleen M. Martin
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Health Care Services ◽  
Structural Changes ◽  
Health Care Facilities ◽  
Memorial Lecture ◽  
Institute Of Medicine ◽  
Care Providers ◽  
Quality Health Care ◽  
Canadian Health Care System

The premise of the presentation is a challenge to health care providers to examine the quality of services currently provided in health care facilities across the country. While the Canadian health care system is under scrutiny with numerous reviews and commissions, the underlying question is: are the structural changes making a difference? We need to consider the recommendations in the latest report from the Institute of Medicine, Crossing the Quality Chasm. The report calls for a sweeping redesign and suggests a set of ten new rules to guide patient/clinician relationships. Dietitians must take the lead on implementation of systematic changes, model the way and get involved in the necessary changes. As the report suggests, the gap between where we are and where we need to go in providing quality health care services is not just a crack; it is in fact a chasm.

Knowledge Based Commissioning: Can a National Clinical Effectiveness Policy Be Compatible with Seeking Local Professional Advice?

1996 ◽  
Vol 1 (1) ◽  
pp. 28-34 ◽  
Author(s):  
Peter Littlejohns ◽  
Carol Dumelow ◽  
Sian Griffiths
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Clinical Effectiveness ◽  
Cost Effective ◽  
Care Providers ◽  
Professional Advice ◽  
Knowledge Based ◽  
Artery Disease ◽  
Health Care Purchasing ◽  
The Right

Objectives: To help develop a means, based on the views of purchasers and providers of health care, of incorporating national research on clinical effectiveness into local professional advisory mechanisms in order to inform health care purchasing and contracting. Methods: Three geographically based multidisciplinary workshops attended by National Health Service (NHS) staff drawn from the principal purchaser and provider groups in one English region were organized around the discussion of three health care purchasing case studies: Coronary artery disease, diabetes and management of clinical depression in general practice. The proceedings were transcribed and analyzed using content analysis methods. Results: 95 people took part. There were major differences between the purchasers' and health care providers' views on the right balance between local and national information and advisory sources for purchasing. In general, providers wanted the provision of advice to purchasers to be local, in which their opinion was sought, either individually or collectively, acted on and the results fed back to them. In contrast, health authority purchasers considered that local professionals were only one source of professional advice, albeit an important one, to be utilized in coming to decisions. General practitioner fundholders as purchasers, however, preferred to rely on their own experiences and contacts with local providers in making purchasing decisions. Conclusions: Professional specialist advisory groups are necessary to inform the purchasing of health care, but should extend beyond advising on the placement of individual contracts. Involving health care providers in all short-term contracting is unlikely to be cost-effective given the time commitment required. The emphasis at purchaser/provider meetings should be on education: Providing an opportunity for purchasers and providers to develop closer relationships to discuss political imperatives and financial constraints; increasing communication and understanding of providers' and purchasers' roles; and providing an environment for professionals and purchasers to share their views on purchasing. As currently presented, elements of the national policies in the NHS advocating the use of both national evidence on clinical effectiveness and local professional advice are contradictory and should be clarified.

Direct-to-Consumer Genetic Testing

2012 ◽  
Vol 5 (1) ◽  
pp. 35-67 ◽  
Author(s):  
Richard A. Stein
Keyword(s):  
Health Care ◽  
Genetic Testing ◽  
Health Care Providers ◽  
Double Helix ◽  
Health Care Facilities ◽  
Past Century ◽  
Care Providers ◽  
Genetic Tests ◽  
Direct To Consumer ◽  
Dna Double Helix

Genetics has fascinated societies since ancient times, and references to traits or behaviors that appear to be shared or different among related individuals have permeated legends, literature, and popular culture. Biomedical advances from the past century, and particularly the discovery of the DNA double helix, the increasing numbers of links that were established between mutations and medical conditions or phenotypes, and technological advances that facilitated the sequencing of the human genome, catalyzed the development of genetic testing. Genetic tests were initially performed in health care facilities, interpreted by health care providers, and included the availability of counseling. Recent years have seen an increased availability of genetic tests that are offered by companies directly to consumers, a phenomenon that became known as direct-to-consumer genetic testing. Tests offered in this setting range from the ones that are also provided in health care establishments to tests known as ‘recreational genomics,’ and consumers directly receive the test results. In addition, testing in this context often does not involve the availability of counseling and, when this is provided, it frequently occurs on-line or over the phone. As a field situated at the interface between biotechnology, biomedical research, and social sciences, direct-to-consumer genetic testing opens multiple challenges that can be appropriately addressed only by developing a complex, inter-disciplinary framework.

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