scholarly journals Developing a Departmental Accreditation Model for Primary Healthcare in Iran

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Jafar Sadegh Tabrizi ◽  
Farid Gharibi ◽  
Elham Dadgar
Keyword(s):  
Primary Healthcare ◽  
School Health ◽  
Family Health ◽  
Cost Effective ◽  
Communicable Diseases ◽  
Quality And Safety ◽  
Final Model ◽  
Healthy Nutrition ◽  
Primary Standards ◽  
Health Education And Promotion

Background: Recently, the healthcare systems have turned towards cost-effective services such as primary healthcare (PHC) due to the increasing costs of health services. Objectives: This study aimed to develop a departmental accreditation model for primary healthcare in Iran. Methods: Initially, primary standards were obtained by making use of available scientific documents in service delivery units in the realm of primary healthcare in Iran as well as by obtaining feedback from their specialists. Then, all primary standards were entered into Delphi questionnaire and evaluated on a 9 point Likert scale by 15 - 20 experts based on two criteria of significance and feasibility. Finally, the final standards were specified based on the qualitative points obtained from the experts. Data were analyzed using SPSS version 18. Results: The final model obtained had 231 standards and 3065 measures in the twelve defined units. The total mean score was 8.38 and 7.65 for the sum of model measures in two criteria of significance and feasibility, respectively. The twelve standard domains were developed for accreditation of service provider units, including specialized realms of communicable diseases, non-communicable diseases, population and family health, mental-social health and addition, teenage, youth, and school health, disaster management, environmental health, occupational health, oral health, healthy nutrition, health education, and promotion, as well as medication and laboratory. Conclusions: Given that the developed model encompasses all PHC domains, its implementing will result in continuous enhancement in the quality and safety of PHC in Iran.

scholarly journals OP0198-HPR A STRUCTURED MODEL FOR OA CARE IN PRIMARY HEALTHCARE IS A COST-EFFECTIVE ALTERNATIVE COMPARED TO USUAL CARE FOR PEOPLE WITH HIP AND KNEE OA

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 119-120
Author(s):  
N. Østerås ◽  
E. Aas ◽  
T. Moseng ◽  
L. Van Bodegom-Vos ◽  
K. Dziedzic ◽  
...  
Keyword(s):  
Usual Care ◽  
Primary Healthcare ◽  
Intervention Group ◽  
Cost Effective ◽  
Cost Utility ◽  
Control Group ◽  
Structured Model ◽  
Knee Oa ◽  
Cost Effective Alternative ◽  
The Cost

Background:To improve quality of care for patients with hip and knee osteoarthritis (OA), a structured model for integrated OA care was developed based on international treatment recommendations. A previous analysis of a cluster RCT (cRCT) showed that compared to usual care, the intervention group reported higher quality of care and greater satisfaction with care. Also, more patients were treated according to international guidelines and fulfilled recommendations for physical activity at the 6-month follow-up.Objectives:To assess the cost-utility of a structured model for hip or knee OA care.Methods:A cRCT with stepped-wedge cohort design was conducted in 6 Norwegian municipalities (clusters) in 2015-17. The OA care model was implemented in one cluster at the time by switching from “usual care” to the structured model. The implementation of the model was facilitated by interactive workshops for general practitioners (GPs) and physiotherapists (PTs) with an update on OA treatment recommendations. The GPs explained the OA diagnosis and treatment alternatives, provided pharmacological treatment when appropriate, and suggested referral to physiotherapy. The PT-led patient OA education programme was group-based and lasted 3 hours followed by an 8–12-week individually tailored resistance exercise programme with twice weekly 1-hour supervised group sessions (5–10 patients per PT). An optional 10-hours Healthy Eating Program was available. Participants were ≥45 years with symptomatic hip or knee OA.Costs were measured from the healthcare perspective and collected from several sources. Patients self-reported visits in primary healthcare at 3, 6, 9 and 12 months. Secondary healthcare visits and joint surgery data were extracted from the Norwegian Patient Register. The health outcome, quality-adjusted life-year (QALY), was estimated based on the EQ-5D-5L scores at baseline, 3, 6, 9 and 12 months. The result of the cost-utility analysis was reported using the incremental cost-effectiveness ratio (ICER), defined as the incremental costs relative to incremental QALYs (QALYs gained). Based on Norwegian guidelines, the threshold is €27500. Sensitivity analyses were performed using bootstrapping to assess the robustness of reported results and presented in a cost-effectiveness plane (Figure 1).Results:The 393 patients’ mean age was 63 years (SD 9.6) and 74% were women. 109 patients were recruited during control periods (control group), and 284 patients were recruited during interventions periods (intervention group). Only the intervention group had a significant increase in EQ-5D-5L utility scores from baseline to 12 months follow-up (mean change 0.03; 95% CI 0.01, 0.05) with QALYs gained: 0.02 (95% CI -0.08, 0.12). The structured OA model cost approx. €301 p.p. with an additional €50 for the Healthy Eating Program. Total 12 months healthcare cost p.p. was €1281 in the intervention and €3147 in the control group, resulting in an incremental cost of -€1866 (95% CI -3147, -584) p.p. Costs related to surgical procedures had the largest impact on total healthcare costs in both groups. During the 12-months follow-up period, 5% (n=14) in the intervention compared to 12% (n=13) in the control group underwent joint surgery; resulting in a mean surgical procedure cost of €553 p.p. in the intervention as compared to €1624 p.p. in the control group. The ICER was -€93300, indicating that the OA care model resulted in QALYs gained and cost-savings. At a threshold of €27500, it is 99% likely that the OA care model is a cost-effective alternative.Conclusion:The results of the cost-utility analysis show that implementing a structured model for OA care in primary healthcare based on international guidelines is highly likely a cost-effective alternative compared to usual care for people with hip and knee OA. More studies are needed to confirm this finding, but this study results indicate that implementing structured OA care models in primary healthcare may be beneficial for the individual as well as for the society.Disclosure of Interests:None declared

scholarly journals Early detection and management of major non-communicable diseases in urban primary healthcare facilities in Ethiopia: a study protocol for a type-3 hybrid implementation-effectiveness design

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e040564
Author(s):  
Helen Yifter ◽  
Afrah Omer ◽  
Seid Gugsa ◽  
Abebaw Fekadu ◽  
Abraham Kebede ◽  
...  
Keyword(s):  
Early Detection ◽  
Primary Healthcare ◽  
Addis Ababa ◽  
Communicable Diseases ◽  
Barriers And Facilitators ◽  
Non Communicable Diseases ◽  
Implementation Effectiveness ◽  
Evaluation Phase ◽  
Intervention Protocol ◽  
Type 3

IntroductionIntegrating early detection and management of non-communicable diseases in primary healthcare has an unprecedented role in making healthcare more accessible particularly in low- and middle-income countries such as Ethiopia. This study aims to design, implement and evaluate an evidence-based intervention guided by the HEARTS technical package and implementation guide to address barriers and facilitators of integrating early detection and management of hypertension, diabetes mellitus and cardiovascular diseases in primary healthcare settings of Addis Ababa.MethodologyWe will employ a type-3 hybrid implementation-effectiveness study from November 2020 to May 2022. This study will target patients ≥40 years of age. Ten health centres will be randomly selected from each subcity of Addis Ababa. The study will have four phases: (1) Baseline situational analysis (PEN facility-capacity assessment, 150 observations of patient healthcare provider interactions and 697 patient medical record reviews), (2) Consolidated Framework for Implementation Research (CFIR) inspired qualitative assessment of barriers and facilitators (20 in-depth interviews of key stakeholders), (3) Design of intervention protocol. The intervention will have capacity enhancement components including training of non-communicabledisease (NCDservice providers, provision of essential equipment/supporting materials and monthly monitoring and feedback and (4) Implementation monitoring and evaluation phase using the RE-AIM (reach, efficacy, adoption, implementation and maintenance) framework. Outcomes on early detection and management of NCDs will be assessed to examine the effectiveness of the study.Ethics and dissemination planEthical clearance was obtained from the Addis Ababa University, College of Health Sciences Institutional Review Board and Addis Ababa Health Bureau. We plan to present the findings from this research in conferences and publish them in peer-reviewed journals.

Children as change agents for family health

2017 ◽  
Vol 117 (5) ◽  
pp. 498-510 ◽  
Author(s):  
Lisette Burrows
Keyword(s):  
Health Promotion ◽  
New Zealand ◽  
School Health ◽  
Health Knowledge ◽  
Change Agents ◽  
Family Health ◽  
School Health Promotion ◽  
Theoretical Frameworks ◽  
Content Type ◽  
Agents Of Change

Purpose The purpose of this paper is to explore ways in which children and young people are being positioned as change agents for families through school health promotion initiatives in New Zealand. Design/methodology/approach The paper maps and describes the kinds of policies and initiatives that directly or indirectly regard children as conduits of healthy eating and exercise messages/practices for families. Drawing on post-structural theoretical frameworks, it explores what these resources suggest in terms of how healthy families should live. Findings Families are positioned as central to school health promotion initiatives in New Zealand, especially in relation to obesity prevention policies and strategies. Children are further positioned as agents of change for families in many of the resources/policies/initiatives reviewed. They are represented as key transmitters and translators of school-based health knowledge and as capable of, and responsible for, helping their families eat well and exercise more. Social implications While recognising children’s agency and capacity to translate health messages is a powerful and welcome message at one level, the author need to consider the implications of requiring children to convey health information, to judge their family practices and, at times, to be expected to change these. This may create anxiety, family division and expect too much of children. Originality/value The paper takes a novel post-structural perspective on a familiar health promotion issue. Given the proliferation of family-focussed health initiatives in New Zealand and elsewhere, this perspective may help us to explore, critique and understand more fully how children are expected to be engaged in these initiatives, and the potentially harmful implications of these expectations.

scholarly journals Biosensors and nanomaterials and their application for mycotoxin determination

2011 ◽  
Vol 4 (4) ◽  
pp. 361-374 ◽  
Author(s):  
I. Tothill
Keyword(s):  
Food Quality ◽  
Quantitative Methods ◽  
Scientific Literature ◽  
Cost Effective ◽  
Screening Tools ◽  
Field Analysis ◽  
Quality And Safety ◽  
Site Testing ◽  
Food Quality And Safety ◽  
Mycotoxin Analysis

Mycotoxin analysis and detection in food and drinks is vital for ensuring food quality and safety, eliminating and controlling the risk of consuming contaminated foods, and complying with the legislative limits set by food authorities worldwide. Most analysis of these toxins is still conducted using conventional methods; however, biosensor methods are currently being developed as screening tools for use in field analysis. Biosensors have demonstrated their ability to provide rapid, sensitive, robust and cost-effective quantitative methods for on-site testing. The development of biosensor devices for different mycotoxins has attracted much research interest in recent years with a range of devices being designed and reported in the scientific literature. However, with the advent of nanotechnology and its impact on the evolution of ultrasensitive devices, mycotoxin analysis is also benefiting from the advances taking place in applying nanomaterials in sensors development. This paper reviews the developments in the area of biosensors and their applications for mycotoxin analysis, as well as the development of micro/nanoarray transducers and nanoparticles and their use in the development of new rapid devices.

scholarly journals Experience and professional training in the School Health Program

2018 ◽  
Vol 52 (0) ◽  
Author(s):  
Eliabe Rodrigues de Medeiros ◽  
Erika Simone Galvão Pinto
Keyword(s):  
Professional Training ◽  
School Health ◽  
Health Program ◽  
Family Health ◽  
Statistical Association ◽  
Normative Study ◽  
School Health Program ◽  
Health Strategy ◽  
The Family ◽  
Family Health Strategy

ABSTRACT Objective: To analyze the association between experience and professional training in the School Health Program. Method: Descriptive, inferential, quantitative and normative study. The data were collected from May to July 2017 through a questionnaire based in the School Health Program, with the participation of professionals from the Family Health Strategy. Results: 105 professionals participated in the study. The average time working in the Family Health Strategy and in the School Health Program is 12.1 and 7.2 years, respectively. 94.3% of the professionals feel qualified to perform the activities of the School Health Program, although only 30.5% have participated in training. There is statistical association between experience and professional training. Conclusion: The professionals who conduct activities in the School Health Program undergo few training processes, but feel qualified to carry out the activities proposed.

scholarly journals Construction and Validation of an Instrument to Evaluate Knowledge on Healthy Eating in Schoolchildren

Aquichan ◽  
2019 ◽  
Vol 19 (2) ◽  
Author(s):  
Celia Maria Ribeiro de Vasconcelos ◽  
Eliane Maria Ribeiro de Vasconcelos ◽  
Maria Gorete Lucena de Vasconcelos ◽  
Viviane Cristina Fonseca Jardim ◽  
Maria Cristina Falcão Raposo ◽  
...  
Keyword(s):  
Content Validity ◽  
School Health ◽  
Health Program ◽  
Family Health ◽  
P Value ◽  
Validity Index ◽  
Significance Level ◽  
Content Validity Index ◽  
Family Health Program ◽  
School Health Program

Objective: To validate the content and appearance of an instrument to evaluate knowledge on healthy feeding. Materials and Methods: Methodological study of validation of content, appeareance with 22 judges, and semantic validation with 12 schoolchildren from 4th and 5th grades in primary school education, ranging in age between nine and ten years. The Scale-Level Content Validity Index (S-CVI) ≥ 0.90 and the Item-Level Content Validity Index (I-CVI) ≥ 0.80 were considered approved in the validation. The Binomial test was used through the p value of the proportion (rejecting the H0 if p ≤ 0.80) to select items that should be revised or modified (items validated at significance level ≤ 0.05). Results: The instrument was validated with S-CVI = 0.93 and I-CVI ≥ 0.80 in the 12 items evaluated, with the mean proportion of “non-discordance” among judges = 0.93. The instrument with the suggested modifications was submitted to the target audience and completely approved by all the participating students. Conclusion: This instrument can be used during the health education activities of the School Health Program and the Family Health Program to promote healthy feeding with children between nine and ten years of age.

scholarly journals Aiming for Health Equity: The role of Public Health Policy and Primary Healthcare Comment on "Universal Health Coverage for Non-Communicable Diseases and Health Equity: Lessons From Australian Primary Healthcare"

2021 ◽  
Author(s):  
Bo Burström
Keyword(s):  
Public Health ◽  
Social Determinants Of Health ◽  
Healthcare System ◽  
Health Equity ◽  
Social Determinants ◽  
Primary Healthcare ◽  
Communicable Diseases ◽  
Determinants Of Health ◽  
Non Communicable Diseases

This commentary refers to the article by Fisher et al on lessons from Australian primary healthcare (PHC), which highlights the role of PHC to reduce non-communicable diseases (NCDs) and promote health equity. This commentary discusses important elements and features when aiming for health equity, including going beyond the healthcare system and focusing on the social determinants of health in public health policies, in PHC and in the healthcare system as a whole, to reduce NCDs. A wider biopsychosocial view on health is needed, recognizing the importance of social determinants of health, and inequalities in health. Public funding and universal access to care are important prerequisites, but regulation is needed to ensure equitable access in practice. An example of a PHC reform in Sweden indicates that introducing market solutions in a publicly funded PHC system may not benefit those with greater needs and may reduce the impact of PHC on population health.

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