scholarly journals Comparing Service Delivery Models for Children with Developmental Delays in Canada: Adaptive and Maladaptive Behaviours, Parental Perceptions of Stress and of Care

2017 ◽  
Vol 27 (1) ◽  
Author(s):  
Ingrid E. Sladeczek ◽  
Laura Fontil ◽  
Nancy Miodrag ◽  
Anastasia Karagiannakis ◽  
Daniel Amar ◽  
...  
Keyword(s):  
Service Delivery ◽  
Parental Stress ◽  
Developmental Delays ◽  
Service Providers ◽  
Parental Perceptions ◽  
Community Based ◽  
Service Delivery Models ◽  
Maladaptive Behaviours ◽  
Delivery Models ◽  
Perceptions Of Care

This study compares two service delivery models (community-based and centre-based), examining them in light of children’s adaptive and maladaptive behaviours, and parental perceptions of stress and of care. More specifically, parents of 96 children with developmental delays assessed their children’s adaptive and maladaptive behaviours and rated their own perceived levels of stress as well as their perceptions of care from service providers. Findings indicated that children from the community-based sites were perceived as having less severe social skill deficits than those from centre-based sites. Regarding parental stress, mothers from community-based settings reported more challenges with their child’s father than did the mothers from centre-based settings; and fathers from the community-based settings reported more challenges related to their health than did the fathers from the centre-based settings. Regarding care, parents from the centre-based settings had more positive perceptions of care than did parents from the community-based settings. Therefore, in general, parents receiving services within community-based settings reported fewer positive perceptions of care and more challenges than those from centre-based settings. Overall, the results of this investigation can inform future programming for community- and centre-based service delivery systems. More specifically, the findings highlight the important role that family-centred care can play in supporting the needs of children with developmental delays and their families; particularly for families using community-based services.

Architectures for multichannel front-office service delivery models

2018 ◽  
Vol 38 (3) ◽  
pp. 828-851 ◽  
Author(s):  
Rui Sousa ◽  
Marlene Amorim
Keyword(s):  
Service Delivery ◽  
Operations Management ◽  
Service Providers ◽  
Design Principles ◽  
Empirical Measures ◽  
Service Strategy ◽  
Content Type ◽  
Service Delivery Models ◽  
Front Office ◽  
Delivery Models

Purpose Multichannel (MC) service providers have been adopting a wide diversity of front-office service delivery models, i.e. different ways of employing channels to support the delivery of the service activities that involve customer interaction. Despite this, we are still faced with a paucity of concepts to understand the myriad of possible choices. The purpose of this paper is to develop a theoretical framework and basic design architectures to provide a structured understanding of the diversity of operational design choices for MC front-office service delivery models, their efficacy implications, and how they fit with the provider’s service strategy. Design/methodology/approach The study employs the analytical conceptual approach. The authors logically develop the architectures based on the operations management theory and provide corresponding empirical illustrations based on secondary sources, direct observation, and case studies. Findings The authors propose two theoretically meaningful dimensions to characterize and distinguish between delivery models (channel redundancy and channel span) and put forward four anchor architectures for such models: generalist, parallel, constricted, and centralized. The authors identify the operational efficacy implications (effectiveness and efficiency) of the different architectures, and develop a set of propositions and design principles for selecting appropriate architectures. Research limitations/implications Future research should develop empirical measures for the dimensions underlying the architectures. Originality/value The study extends existing service process classifications by capturing the MC traits of front-office processes. The authors offer design principles to assist firms in selecting architectures that are aligned with their service strategy. The framework and architectures provide seminal concepts to support a wealth of future empirical studies.

scholarly journals Similar costs and outcomes for differentiated service delivery models for HIV treatment in Uganda

2021 ◽  
Author(s):  
Teresa Guthrie ◽  
Charlotte Muheki ◽  
Sydney Rosen ◽  
Shiba Kanoowe ◽  
Stephen Lagony ◽  
...  
Keyword(s):  
Service Delivery ◽  
Viral Suppression ◽  
Standard Of Care ◽  
Hiv Treatment ◽  
Sub Saharan Africa ◽  
Total Annual Cost ◽  
Differentiated Service ◽  
Community Based ◽  
Service Delivery Models ◽  
Delivery Models

Background: Like many countries in sub-Saharan Africa, Uganda has scaled up differentiated service delivery models (DSDMs) for HIV treatment, but little information is available about the relative costs of the models. We estimated the total annual cost per patient and total cost per patient virally suppressed in five DSDMs, including facility- and community-based models and the standard of care. Methods: We conducted a cost/outcome study from the perspective of the service provider, using retrospective patient record review of a cohort of patients over a two-year period, with bottom-up collection of patient resource utilization data, top-down collection of above-delivery level and delivery-level provider fixed operational costs, and local unit costs. We enrolled adults on ART (>18 years old) enrolled in 47 DSDMs located at facilities or community-based service points in four regions of Uganda with at least 24 months of follow-up data. DSDMs assessed included facility-based groups (FBG); fast-track drug refills (FDR); community client-led ART delivery (CCLAD); community drug distribution points (CDDP); and facility-based individual management (FBIM), which is the standard of care model for new, complex, and virally unsuppressed patients. Viral suppression was defined as <1000 copies/ml. Results: Retention in care was 98% for the sample as a whole [96-100%]. Over viral suppression was 91%, which varied from 86% among patients in FBIM (with the largest share of complex / virally unsuppressed patients) to 93% among CDDP patients. The mean cost to the provider (Ministry of Health or NGO implementers) was $152 per annum per patient treated, ranging from $141 for FBG to $166 for FDR. Differences among the costs of the models were largely due to ARV regimens and proportions of patients on second line regimens. Service delivery costs, excluding ARVs, other medicines and laboratory tests, were modest, ranging from $9.66-16.43 per patient. Conclusions: Differentiated ART service delivery in Uganda achieved excellent treatment outcomes at a cost similar to the standard of care (FBIM). While large budgetary savings might not be immediately realized, the reallocation of saved staff time could improve health system efficiency as facilities and patients gain more experience with DSD models.

scholarly journals Preference and uptake of different community-based HIV testing service delivery models among female sex workers along Malaba-Kampala highway, Uganda, 2017

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Gerald Pande ◽  
Lilian Bulage ◽  
Steven Kabwama ◽  
Fred Nsubuga ◽  
Peter Kyambadde ◽  
...  
Keyword(s):  
Service Delivery ◽  
Hiv Testing ◽  
Sex Workers ◽  
Female Sex Workers ◽  
Community Based ◽  
Testing Service ◽  
Service Delivery Models ◽  
Female Sex ◽  
Hiv Testing Services ◽  
Delivery Models

Abstract Introduction Female Sex workers (FSW) and their clients accounted for 18% of the new HIV infections in 2015/2016. Special community-based HIV testing service delivery models (static facilities, outreaches, and peer to peer mechanism) were designed in 2012 under the Most At Risk Populations Frame work and implemented to increase access and utilization of HIV care services for key populations like female sex workers. However, to date there is no study that has been done to access the preference and uptake of different community-based HIV testing service delivery models used to reach FSW. We assessed preference and uptake of the current community-based HIV testing services delivery models that are used to reach FSW and identified challenges faced during the implementation of the models. Methods We conducted a cross-sectional study design using quantitative (interview with the health workers in facilities providing services to female sex workers and interviews with FSWs) and qualitative (interviews with Ministry of Health staff, health workers, district health team members, program staff at different levels involved in delivery of HIV care services, FSWs and political leaders to assess for the enabling environment created to deliver the different community-based HIV testing services to FSWs along the Malaba-Kampala highway. Malaba – Kampala high way is one of the major high ways with many different hot spots where the actual buying and selling of sex takes place. We defined FSWs as any female, who undertakes sexual activity after consenting with a man for money or other items/benefits as an occupation or as a primary source of livelihood irrespective of site of operation within the past six months. We assessed the preference and uptake of different community based HIV testing services delivery model among FSWs based on two indicators, i.e., the proportion of FSWs who had an HIV Counseling and Testing (HCT) in the last 12 months and the proportion of FSWs who were positive and linked to care. Results Overall, 86% (390/456) of the FSWs had taken an HIV test in the last 12 months. Of the 390 FSWs, 72% (279/390) had used static facilities, 25% (98/390) had used outreaches, and 3.3% (13/390) used peer to peer mechanisms to have an HIV test. Overall, 35% (159/390) of the FSWs who had taken an HIV test were HIV positive. Of the 159, 83% (132/159) were successfully linked into care. Ninety one percent (120/132) reported to have been linked into care by static facilities. Challenges experienced included; lack of trust in the results given during outreaches, failure to offer other testing services including hepatitis B and syphilis during outreaches, inconsistent supply of testing kits, condoms, STI drugs, and unfriendly health services due to the infrastructure and non-trained health workers delivering KP HIV testing services. Conclusions Most of the FSWs had HCT services and were linked to care through static facilities. Community-based HIV testing service delivery models are challenged with inconsistent supply of HIV testing commodities and unfriendly services.. We recommended strengthening of all HIV testing community-based HIV testing service deliverymodels by ensuring constant supply of HIV testing/AIDS care commoditiesoffering FSW friendly services, and provision of comprehensive HIV/AIDS health care package.

scholarly journals Sectoral evolution and shifting service delivery models in the sharing economy

2020 ◽  
Vol 13 (2) ◽  
pp. 663-684
Author(s):  
S. Mahmuda ◽  
T. Sigler ◽  
E. Knight ◽  
J. Corcoran
Keyword(s):  
Service Delivery ◽  
Growth Stage ◽  
Service Providers ◽  
Sharing Economy ◽  
Professional Services ◽  
Firm Level ◽  
Service Delivery Models ◽  
Level Data ◽  
Development Trajectory ◽  
Delivery Models

Abstract The rise of the sharing economy has had transformative impacts on extant service delivery models, with wide ranging implications for existing firms, regulators, and the workforce at large. This paper draws upon firm-level data to better understand how new forms of service delivery have accompanied the diffusion of the sharing economy. Unlike previous waves of technological innovation, sharing economy firms have emerged as digital intermediaries rather than direct service providers driven by shifting consumer practices and attitudes. We apply an innovation diffusion model to trace the development trajectory of the sharing economy across 1000 firms. Our model segments the evolution of the sharing economy into three distinct and overlapping phases, comprising an Embryonic Stage (1995–2008), an Early Growth Stage (2007–2015), and most recently a Late Growth Stage (2014–present). Analysis of the 1000 firms reveals that the sharing economy has rapidly gained momentum across all industry sectors, with its growth trajectory principally tied to the evolution of related financial and technological innovations paralleled by social adoption. We find that service delivery models differ considerably between sectors, with professional services favouring business-oriented models, and consumables oriented more towards peer sharing. Though peer-to-peer (P2P) has been the dominant model, this is changing as larger firms enter the market and existing firms become industry leaders. We argue that while the marginal cost of new transactions within a P2P structure is low, barriers to market entry become ever-higher as sharing economy service delivery models are increasingly embedded within the mainstream economy.

Reimbursement and Telepractice

2013 ◽  
Vol 3 (2) ◽  
pp. 35-40
Author(s):  
Carol Dudding
Keyword(s):  
Service Delivery ◽  
Healthcare Services ◽  
Speech Language Pathology ◽  
Delivery Method ◽  
Quality Healthcare ◽  
Service Delivery Models ◽  
Private Lives ◽  
Language Pathology ◽  
Delivery Models

Whether in our professional or private lives, we are all aware of the system wide efforts to provide quality healthcare services while containing the costs. Telemedicine as a method of service delivery has expanded as a result of changes in reimbursement and service delivery models. The growth and sustainability of telehealth within speech-language pathology and audiology, like any other service, depends on the ability to be reimbursed for services provided. Currently, reimbursement for services delivered via telehealth is variable and depends on numerous factors. An understanding of these factors and a willingness to advocate for increased reimbursement can bolster the success of practitioners interested in the telehealth as a service delivery method.

scholarly journals Service Delivery Models to Maximize Quality of Life for Older People at the End of Life: A Rapid Review

2019 ◽  
Vol 97 (1) ◽  
pp. 113-175 ◽  
Author(s):  
CATHERINE J. EVANS ◽  
LUCY ISON ◽  
CLARE ELLIS‐SMITH ◽  
CAROLINE NICHOLSON ◽  
ALESSIA COSTA ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Service Delivery ◽  
Older People ◽  
End Of Life ◽  
Rapid Review ◽  
Service Delivery Models ◽  
Delivery Models
Sign in / Sign up

Export Citation Format

Share Document