scholarly journals Antibiotic Prescribing in Outpatient Before and After Implementation of the Urban Family Physician and Referral System

2021 ◽  
Vol 15 (6) ◽  
pp. 1749-1755
Author(s):  
Ehsan Nabovati ◽  
Hamed Mahmoudi ◽  
Reza Abbasi ◽  
Saeed Barzegari ◽  
Hossein Akbari ◽  
...  
Keyword(s):  
Health Services ◽  
Family Physician ◽  
Positive Impact ◽  
Referral System ◽  
Antibiotic Prescribing ◽  
Mazandaran Province ◽  
Medication Prescription ◽  
The Family ◽  
Before And After ◽  
Urban Family

Background The Family Physician and Referral System was piloted in Mazandaran and Fars provinces, Iran in 2012. The goal of this program was to improve the provision of health services including medication prescription. Objective This study aimed to determine the trends in antibiotic prescribing in outpatient before and after implementation of the Family Physician and Referral System in Babol, Iran from 2010 to 2018. Methods In this retrospective study, all prescriptions of urban family physicians in Babol, which were registered in the database of the Health Services Insurance Organization of Mazandaran province, were included. The trends of average number of items per prescription, percentage of antibiotics per prescription, frequency of antibiotic groups, and cost of antibiotics were calculated using SQL Server and IBM SPSS version 22. Results The average number of items per prescription was found to be 3.4±1.82, and 2.8±1.60, and percentage of antibiotics per prescription was 49% and 32% in 2010 and 2018, respectively. The most prescribed antibiotic groups were penicillin (54.8%) and cephalosporin (39.9%). Amoxicillin 500mg capsules (13.1%), metronidazole 250 mg (10.2%), and ciprofloxacin 500 mg (8.2%) were the most prescribed antibiotics. Also, the mean cost of prescriptions containing antibiotics compared to the total prescriptions had decreased from 22% in 2010 to 5.5% in 2018. Conclusion The pattern of medication prescription especially antibiotics, improved after the implementation of the Family Physician and Referral System. Due to the positive impact of the Family Physician and Referral System on medication prescription by physicians, we recommend the implementation of this program in low and middle-income countries. Keywords: Antibiotic, medication prescribing, Health system reform plan, Family physician, Trend

scholarly journals Underlying factors and challenges of implementing the urban family physician program in Iran

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mohammad Hossein Mehrolhassani ◽  
Vahid Kohpeima Jahromi ◽  
Reza Dehnavieh ◽  
Mahla Iranmanesh
Keyword(s):  
Family Physician ◽  
Program Implementation ◽  
Rural Areas ◽  
Health Coverage ◽  
Policy Makers ◽  
International Pressure ◽  
Electronic File ◽  
The Family ◽  
Urban Family ◽  
Management Changes

Abstract Background The family physician program was launched in 2005 in rural areas of Iran and then piloted in 2012 in the cities of Fars and Mazandaran provinces due to insufficient health coverage in these cities. However, despite its pivotal role in the health system, this program has not progressed according to the policies. This study aimed to explain the underlying factors and challenges of implementing the urban family physician program in Iran. Methods This qualitative study was conducted on 44 policy-makers and managers at national and provincial levels selected via snowball and purposive sampling with maximum variation. The data were managed in MAXQDA 2020 and analyzed by directed content analysis. A triangulation method was adopted for this purpose. Results A total of 10 categories, 18 sub-categories, and 29 codes were formed. Most challenges related to underlying factors included precipitancy, economic sanctions, belief in traditional medicine, belief in the expertise of previous physicians, and global ranking of countries. For program implementation, most challenges included a diversity of insurance organizations, budget allocation, referral system, electronic file, educational system, and culture building. Conclusions The major challenges pertaining to underlying factors included international pressure for reforms and precipitancy in program implementation due to management changes. The challenges associated with program implementation included budget provision and interaction with insurance organizations. Therefore, to expand this program to other provinces in Iran, the identified factors should be carefully considered so that sufficient confidence and commitment can be guaranteed for all stakeholders.

The Effect of Education on Administrators and Service Providers′ Knowledge of the Family Physician Plan and Referral System in Urban Areas

2015 ◽  
Vol 1 (2) ◽  
pp. 47
Author(s):  
Maryam Azarnoosh ◽  
Hamed Asgari ◽  
Maryam Kheirmand ◽  
Mansour Shiri ◽  
Mohsen Rohani ◽  
...  
Keyword(s):  
Family Physician ◽  
Urban Areas ◽  
Service Providers ◽  
Referral System ◽  
The Family

scholarly journals Urban Mental Health Initiative: Developing Interdisciplinary Collaboration, the Role of the Family Physician in Management of Severe Mentally Ill Patients

2021 ◽  
Vol 27 (1) ◽  
pp. 104-119
Author(s):  
Seyed Kazem Malakouti ◽  
◽  
Amirabbas Keshavarz Akhlaghi ◽  
Fatemeh Shirzad ◽  
Vahid Rashedi ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Family Physician ◽  
Urban Areas ◽  
Psychiatric Patients ◽  
Community Based ◽  
Urban Mental Health ◽  
The Family ◽  
Community Based Services

Introduction: Mental health in Iran was approved in 1988. However, and then this program was integrated into the primary care system in our country and was implemented within the villagers' family physician program with great success. In urban areas, there is no structured health network. However, regarding the demographic changes in the country's population, huge sprawling of cities, and the changes in urban-rural population proportion, demands for a coherent plan to provide mental health services to the urban population are felt more than ever. This study aimed to investigate the feasibility and establishment of a model of urban mental health network for severe psychiatric patients. Methods: This plan is based on resource reviews, Use the experiences of other countries, Model World Health Organization, The services available in the country currently run by the beneficiary organizations, Description of the responsibilities of the responsible organizations, Collaboration between the Ministry of Health and various organizations responsible for mental health, Having the views of national expert and international constant in this field from other countries cooperated with the aim of examining how to compile a coherent and integrated urban health service plan. This model is estimated by community-based services for 100,000 people. Results: The proposed model for providing immediate psychiatric services with greater cohesion and increasing training and skills capacity among staff 110, 115, 1480, and 123 services, as well as a space for hospitalization of 3 to 5 emergency patients next to the public hospital, is recommended. Depending on the number of patients in a population of 100,000, we will need community-based services, including 2 to 3 home visit teams to cover 80 patients per team, and 3 daily centers to provide services to 40 patients. If community-based services are provided, we will need 12 acute psychiatric beds and 5 beds for mid-term rehabilitation to provide inpatient services. In terms of employment and accommodation, 50 patients will need supported employment, respectively, and two apartments with an area of about 60 meters will be needed to accommodate about eight people. The provision of the above services requires the equal participation of the interested organizations. The family physician will play an essential role in continuing medical care for severe and mild psychiatric patients under the constant supervision of specialists Discussion and Conclusion: To achieve a better model of mental health services in cities that can cover a wide range of people in urban areas and at various levels from prevention and care to treatment and rehabilitation, we need the coordination between the organizations providing these services for the accurate planning of the interests of each organization, elimination of duplicate services, and saving human capital and resources of the country.

scholarly journals Intrahousehold Power in Russia and the Maternal Capital Law

2018 ◽  
Vol 16 (2) ◽  
pp. 371-386
Author(s):  
Natalya Shelkova
Keyword(s):  
Positive Impact ◽  
Associate Professor ◽  
The Family ◽  
Before And After ◽  
Monitoring Survey ◽  
Economics Department ◽  
Policy Shift ◽  
The Difference ◽  
The Uk ◽  
College Educated

Natalya Y. Shelkova – Ph.D., Associate Professor, Economics Department, Guilford College, Greensboro, USA. Email: [email protected] It has been documented that the introduction of market economy institutions in Russia has disadvantaged Russian women, weakening their economic position and their power within the family. This paper investigates whether the introduction of the 2007 the Maternal Capital Law, which aims to promote fertility by granting Russian women a non-cash subsidy for having more than one child, affected the intrahousehold balance of power in Russian families. In order to investigate this hypothesis, the paper looks at changes in the ratio of family expenditure on children to spending on alcohol and tobacco before and after passing of the law. Data from the Russia Longitudinal Monitoring Survey (RLMS-HSE), 2002 to 2010, is used. The estimated regression models employ the difference-in-difference methodology and are based on Lundberg, Pollack and Wales, who researched a similar policy shift in the UK in 1970s. The results demonstrate that the year 2008 was a critical turning point: starting with 2008 the ratio of family expenditure on children to spending on alcohol and tobacco increased for families with two or more children (the results are statistically significant). After 2007, on average, expenditure on children increased by fifty-nine roubles per every ruble of alcohol and tobacco expenditures (mesearured in 2002 roubles), nearly doubling. The effect in families with a husband not holding a college degree was shown to be larger and more siginifcant than in families with college-educated husbands. It is concluded that the 2007 Law has had a positive impact on the bargaining power of Russian women.

scholarly journals Prescrição Antibiótica no Ambulatório em Doentes Pediátricos com Patologia Respiratória

2019 ◽  
Vol 32 (2) ◽  
pp. 101 ◽  
Author(s):  
Joana Verdelho Andrade ◽  
Pedro Vasconcelos ◽  
Joana Campos ◽  
Teresa Camurça
Keyword(s):  
Otitis Media ◽  
Family Physician ◽  
Clinical Guideline ◽  
Respiratory Infections ◽  
Acute Otitis Media ◽  
Antibiotic Prescribing ◽  
Acute Tonsillitis ◽  
The Family ◽  
Tract Infections ◽  
Clinical Records

Introduction: Respiratory tract infections represent the most frequent conditions in pediatric clinical practice that motivate antibiotic prescribing. The objective was to identify the frequency and pattern of antibacterial prescribing in respiratory diseases.Material and Methods: Over a period of two years (divided by the presentation of the clinical guideline standards) data was collected from clinical records of children with respiratory disease. Chi-square tests or Fisher’s exact test were used to test associations between variables, statistical significance p < 0.05.Results: There were 547 visits (mean age 6 years ± 5.3, 55% male gender). Analysis for Group A Streptococcus of the oropharynx was most frequently requested by pediatric residents (p = 0.005). Chest x-rays were more frequently requested by the Family Physician (p = 0.033). An antibiotic was prescribed in 87% of pneumonias, 84% acute otitis media, 68% acute tonsillitis, 25% laryngitis, 17% upper respiratory infections, 16% acute bronchiolitis. The Family Physician prescribed antibiotics more often than the Pediatrics resident in acute tonsillitis (p = 0.003) and in acute otitis media (p = 0.013). The most frequently prescribed antibiotic was amoxicillin (61%). There were no significant differences between the two periods studied regarding the number of prescriptions and antibiotic choice of the conditions studied.Discussion: Antibiotic prescribing in pediatric acute respiratory infections was high and the choice of antibiotic therapy could be adjusted. We found no difference in antibiotic prescribing after the presentation of the clinical guideline standards.Conclusion: An improvement in the antibiotic prescription in children and adolescents in the outpatient clinic is considered necessary.

scholarly journals Morbidity, utilization of curative care and service entry point preferences in metropolitan Centro Habana, Cuba

2016 ◽  
Vol 32 (10) ◽  
Author(s):  
Armando Rodríguez ◽  
Addys Díaz ◽  
Susana Balcindes ◽  
René García ◽  
Pol De Vos ◽  
...  
Keyword(s):  
Health Care ◽  
Chronic Disease ◽  
Health Services ◽  
Chronic Diseases ◽  
Family Physician ◽  
Health Problems ◽  
Entry Point ◽  
Adult Women ◽  
The Family ◽  
Formal Services

Abstract: First-line health services with a primary health care approach are a strong trigger for adequate health-care-seeking behavior. Research on the association between prevalence of chronic diseases and acute illnesses and use of health services emphasizes the importance of socioeconomic determinants in such patterns of utilization. In a cross-sectional study of 408 families in Centro Habana, Cuba, home interviews were conducted between April and June 2010 to analyze socio-demographic determinants of acute and chronic health problems and use of formal health services. Bivariate and logistic regression models were used. 529 persons reported a chronic disease. During the previous month, 155 of the latter reported an exacerbation and 50 experienced an unrelated acute health problem. 107 persons without chronic diseases reported acute health problems. Age was the strongest determinant of chronic disease prevalence. Adult women and the elderly were more likely to report acute problems. Acute patients with underlying chronic disease used formal services more often. No socio-demographic variable was associated with services use or consultation with the family physician. While the family physician is defined as the system's entry-point, this was the case for only 54% of patients that had used formal services, thus compromising the physician's role in counseling patients and summarizing their health issues. The importance of chronic diseases highlights the need to strengthen the family physician's pivotal role. New economic policies in Cuba, stimulating self-employment and private initiative, may increase the strain on the exclusively public health care system. Still, the Cuban health system has demonstrated its ability to adapt to new challenges, and the basic premises of Cuba's health policy are expected to be preserved.

Strategic Role of Zakat in Multidimensional Quality of Life in Sijunjung, Indonesia

2018 ◽  
Vol 15 (1) ◽  
pp. 55-72
Author(s):  
Herlin Hamimi ◽  
Abdul Ghafar Ismail ◽  
Muhammad Hasbi Zaenal
Keyword(s):  
Quality Of Life ◽  
Positive Impact ◽  
Wealth Distribution ◽  
Absolute Poverty ◽  
Before And After ◽  
The Status ◽  
Being There ◽  
The Impact

Zakat is one of the five pillars of Islam which has a function of faith, social and economic functions. Muslims who can pay zakat are required to give at least 2.5 per cent of their wealth. The problem of poverty prevalent in disadvantaged regions because of the difficulty of access to information and communication led to a gap that is so high in wealth and resources. The instrument of zakat provides a paradigm in the achievement of equitable wealth distribution and healthy circulation. Zakat potentially offers a better life and improves the quality of human being. There is a human quality improvement not only in economic terms but also in spiritual terms such as improving religiousity. This study aims to examine the role of zakat to alleviate humanitarian issues in disadvantaged regions such as Sijunjung, one of zakat beneficiaries and impoverished areas in Indonesia. The researcher attempted a Cibest method to capture the impact of zakat beneficiaries before and after becoming a member of Zakat Community Development (ZCD) Program in material and spiritual value. The overall analysis shows that zakat has a positive impact on disadvantaged regions development and enhance the quality of life of the community. There is an improvement in the average of mustahik household incomes after becoming a member of ZCD Program. Cibest model demonstrates that material, spiritual, and absolute poverty index decreased by 10, 5, and 6 per cent. Meanwhile, the welfare index is increased by 21 per cent. These findings have significant implications for developing the quality of life in disadvantaged regions in Sijunjung. Therefore, zakat is one of the instruments to change the status of disadvantaged areas to be equivalent to other areas.

PENINGKATAN EKONOMI BAGI ANGGOTA KOPERASI WANITA PI TANAH ABANG JAKARTA

2019 ◽  
Vol 1 (2) ◽  
Author(s):  
Febri Rakhmawati Arsj
Keyword(s):  
Development Strategy ◽  
Significant Role ◽  
Positive Impact ◽  
Standard Of Living ◽  
Family Welfare ◽  
Knowledge And Skills ◽  
Family Economy ◽  
The Family ◽  
Real Forms ◽  
Productive Role

Wanita memiliki peran yang signifikan untuk ikut  berperan aktif dan produktif dalam perekonomian. Masyarakat menjadi produktif sehingga dapat meningkatkan derajat dan taraf hidup serta meningkatkan kesejahteraan keluarga.Berwirausaha menjadi pilihan perempuan untuk dapat bekerja membantu perekonomian keluarga dan koperasi merupakan salah satu perwujudannya.Koperasi merupakan salah satu bentuk nyata dari pengamalan pancasila.Untuk mendukung majunya koperasi perlu adanya sosialisasi kewirausahaan ke anggota koperasi khususnya wanita.Koperasi wanita mempunyai karakteristik khas yang berbeda dengan koperasi pada umumnya sehingga membutuhkan pendekatan strategi pengembangan yang berbeda pula. Hal ini tak bisa terlepas dari karakteristik anggotanya di dominasi oleh ibu rumah tangga yang menyebabkan keunggulan tersendiri dibandingkan koperasi lain.Adapun tujuannya untuk membuka dan  menumbuhkan jiwa usaha sehingga anggota dapat membantu mensejahterakan dirinya serta keluarga. Studi ini diawali dengan observasi kepada anggota koperasi yang bekerja hanya sebagai ibu rumah tangga.Sosialisasi diberikan dalam satu tahap mengenai motivasi usaha dan wirausaha.Pelatihan ini memberikan dampak positif bagi peningkatan motivasi, pengetahuan dan ketrampilan anggota koperasi wanita Tanah Abang. Women have a significant role to play an active and productive role in the economy. The community becomes productive so that it can improve the degree and standard of living and improve family welfare. Entrepreneurship is the choice of women to be able to work to help the family economy and cooperatives is one of its manifestations. Cooperatives are one of the real forms of Pancasila practice. To support the advancement of cooperatives, there needs to be entrepreneurial dissemination to cooperative members, especially women. Women's cooperatives have distinctive characteristics that are different from cooperatives in general so that they require a different development strategy approach. This cannot be separated from the characteristics of its members who are dominated by housewives which causes its own superiority compared to other cooperatives. The purpose is to open and grow the business spirit so that members can help the welfare of themselves and their families. This study begins with observations to cooperative members who work only as housewives. Socialization is given in one stage regarding business motivation and entrepreneurship. This training has a positive impact on increasing the motivation, knowledge and skills of members of the Tanah Abang women's cooperative.Keywords: Women; Cooperative; Entrepreneurship

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