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Understanding of Maternal Health Status in Different Social Groups in India Using NFHS Data. 利用 NFHS 数据了解印度不同社会群体的孕产妇健康状况。
IF 2.4 Q2 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-09-18 eCollection Date: 2024-01-01 DOI: 10.1177/11786329241254206
Santosh Tamang, Uttam Kumar Sikder

Maternal health is a major public health concern in India. MMR of India has declined significantly but maternal health status has not much improved. The prevalence of anemia and low Body Mass Index (BMI) is more severe among the women belonging to the Scheduled Caste (SC) and Scheduled Tribe (ST) categories. In this paper, attempts have been made to examine the maternal health status and to identify the factors responsible for poor health status among SC and ST women. The study is purely based on secondary data taken from latest 3 rounds of NFHS (2005-6, 2015-16 & 2019-21). Multivariate analysis have been carried out using panel regression model to understand the impact of determinants on maternal healthcare. The study found that the SC and ST women are more prone to anemia than others (GENERAL category women). Maternal health status is mostly controlled by per capita health expenditure and health infrastructure variables like no. of hospitals and nurses, irrespective of social class. Thus poor maternal health status in India, especially among socially disadvantaged groups of society, have been major concern. The government should be more focused on existing policies related to maternal healthcare.

孕产妇健康是印度的一个主要公共卫生问题。印度的孕产妇死亡率已大幅下降,但孕产妇健康状况却没有多大改善。在册种姓(SC)和在册部落(ST)妇女中,贫血和身体质量指数(BMI)偏低的情况更为严重。本文试图研究在册种姓和在册部落妇女的孕产妇健康状况,并找出导致其健康状况不良的因素。本研究完全基于最新三轮 NFHS(2005-6 年、2015-16 年和 2019-21 年)的二手数据。使用面板回归模型进行了多变量分析,以了解决定因素对孕产妇保健的影响。研究发现,在册种姓和在册部落妇女比其他妇女(普通类别妇女)更容易贫血。孕产妇健康状况主要受人均医疗支出以及医院和护士数量等医疗基础设施变量的控制,与社会阶层无关。因此,印度孕产妇健康状况不佳,尤其是社会弱势群体的孕产妇健康状况不佳,一直备受关注。政府应更加重视与孕产妇保健有关的现行政策。
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引用次数: 0
The Use of Antibiotics at the End of Life: A Cross-Sectional Study. 生命末期抗生素的使用:一项横断面研究。
IF 2.4 Q2 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-09-15 eCollection Date: 2024-01-01 DOI: 10.1177/11786329241280812
Brayan Miranda-Chavez, Andre Fuentes-Yufra, Miguel Hueda-Zavaleta, Cesar Copaja-Corzo, Javier A Flores-Cohaila, Marco Rivarola-Hidalgo

Objective: To identify and analyze antibiotics' prescription patterns and associated factors among terminally ill patients at a hospital in southern Peru.

Methodology: A cross-sectional analytical study was conducted on adult patients who died in Hospital III Daniel Alcides Carrion in Tacna, Peru, 2023. Data were collected from electronic medical records, focusing on antibiotic use during the last hospitalization. Univariate, bivariate, and multivariate analyses were performed using Poisson regression to adjust for potential confounders.

Results: The study included 239 patients with an average age of 76. Antibiotics were administered to 93.72% of patients, with 42.46% lacking an identified infectious focus. Ceftriaxone, Meropenem, and Vancomycin were the most used antibiotics. A lower use of antibiotics within 72 hours prior to death was associated with hospitalizations longer than 18 days and having 2 or more comorbidities.

Conclusion: The high prevalence of antibiotic use at the end of life, often without an infectious focus, suggests a need for better guidelines and education on palliative care to avoid inappropriate antibiotic prescribing. Improved communication between healthcare providers, patients, and families is essential for optimizing end-of-life care.

目的确定并分析秘鲁南部一家医院临终病人的抗生素处方模式及相关因素:对秘鲁塔克纳市丹尼尔-阿尔西德斯-卡里翁第三医院(Hospital III Daniel Alcides Carrion)2023年死亡的成年患者进行了横断面分析研究。数据来自电子病历,重点是最后一次住院期间抗生素的使用情况。使用泊松回归法进行了单变量、双变量和多变量分析,以调整潜在的混杂因素:研究共纳入 239 名患者,平均年龄为 76 岁。93.72%的患者使用了抗生素,42.46%的患者未发现感染病灶。头孢曲松、美罗培南和万古霉素是使用最多的抗生素。死亡前72小时内抗生素使用率较低与住院时间超过18天和患有2种或2种以上合并症有关:生命末期抗生素使用率较高,且通常没有感染病灶,这表明需要更好的姑息治疗指南和教育,以避免不适当的抗生素处方。加强医疗服务提供者、患者和家属之间的沟通对于优化临终关怀至关重要。
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引用次数: 0
Multi-Dimensional Analysis of Japanese Telemedicine Patient Satisfaction. 日本远程医疗患者满意度的多维分析。
IF 2.4 Q2 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-09-15 eCollection Date: 2024-01-01 DOI: 10.1177/11786329241280864
Andrew N Mason, Toshio Naito, Shinichi Fukushima, Keiko Asano, Ken Yamaji, Ryohei Kuwatsuru

Introduction: Telemedicine is a growing segment of the healthcare industry. As telemedicine gains prominence in Japan, the importance of telemedicine patient satisfaction research will also grow. This study examines whether Japanese patients are equally impacted by the same latent dimensions discovered in the multi-dimensional service satisfaction model used by a United States (U.S.) study.

Methods: The subjects (n = 110) were patients who received telemedicine service between January and December 2023 at Juntendo University Hospital, Tokyo, Japan. Patient satisfaction perceptions were collected using a questionnaire composed of Likert scale items. Overall patient satisfaction served as the dependent variable, and patient perceptions of various aspects of the service were the independent variables. LASSO regression analysis was used to test the impact of the independent variables on overall patient satisfaction along with cluster analysis to examine the satisfaction ratings based upon patient characteristics.

Results: Japanese patient perceptions of telemedicine health benefits were the most impactful driver of overall satisfaction. Cluster analysis indicated that males were generally more satisfied than females. The least satisfied patients were predominately female and those experiencing telemedicine for the first time. Patients receiving service from a specialist physician were least satisfied with the telemedicine financial costs.

Discussion: Patient satisfaction levels were found to be highly impacted by perceptions of the health benefits received and the non-financial costs of service. These benefits could be highlighted by Japanese telemedicine providers to increase utilization of telemedicine services. Patient satisfaction was also found to be influenced by patient-centered care (ie, the "soft skills" of providers) to a lesser degree. Therefore, Japanese telemedicine providers may benefit from developing patient-centered communication skills.

Conclusion: The model used provides nuanced understandings of telemedicine patient satisfaction, which highlights where targeted improvements in Japanese telemedicine patient satisfaction are likely to be most impactful.

介绍:远程医疗是医疗保健行业中一个不断增长的细分市场。随着远程医疗在日本的日益突出,远程医疗患者满意度研究的重要性也将与日俱增。本研究探讨了日本患者是否同样受到美国一项研究使用的多维服务满意度模型中发现的潜在维度的影响:研究对象(n = 110)为 2023 年 1 月至 12 月期间在日本东京顺天堂大学医院接受远程医疗服务的患者。使用由李克特量表项目组成的问卷收集患者的满意度。患者总体满意度为因变量,患者对服务各方面的感知为自变量。我们使用 LASSO 回归分析来检验自变量对患者总体满意度的影响,同时使用聚类分析来检验基于患者特征的满意度评分:结果:日本患者对远程医疗健康益处的看法是对总体满意度影响最大的驱动因素。聚类分析显示,男性的满意度普遍高于女性。最不满意的患者主要是女性和首次使用远程医疗的患者。接受专科医生服务的患者对远程医疗的经济成本最不满意:讨论:研究发现,患者的满意度受其对所获健康益处和服务非经济成本的看法影响很大。日本远程医疗服务提供商可强调这些益处,以提高远程医疗服务的利用率。研究还发现,患者满意度受以患者为中心的护理(即提供者的 "软技能")的影响较小。因此,日本远程医疗提供者可能会从发展以患者为中心的沟通技能中受益:结论:所使用的模型提供了对远程医疗患者满意度的细微理解,突出了有针对性地提高日本远程医疗患者满意度最有可能产生影响的方面。
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引用次数: 0
Factors Associated With Willingness to Pay for Primary Health Care Services in South Africa: A Cross-Sectional Survey of Medical Schemes Members. 南非愿意为初级保健服务付费的相关因素:对医疗计划成员的横断面调查。
IF 2.4 Q2 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-09-11 eCollection Date: 2024-01-01 DOI: 10.1177/11786329241274479
Evelyn Thsehla, Charles Hongoro, Jacqui Miot, Kate Kgasi, Edmore Marinda, Esnath Maramba, Alister Chabi, Barry Childs, Olurotimi Modupe, Olufunke Alaba

The cost of healthcare is an issue of concern for both consumers and funders of healthcare in South Africa. The country spends approximately 8% of GDP on health care. Health care is financed through the public sector which covers 86% of the population and the private sector which covers 14% of the population. Medical schemes are the main source of healthcare financing in the private sector. Services covered by medical schemes include chronic diseases, emergencies, diagnosis, and treatment of a selected number of diseases. Primary health care services such as screening are limited. The aim of this study was to assess factors associated with members of medical schemes' willingness to pay for a primary health care package in the private sector. A cross-sectional survey was conducted amongst principal members of medical schemes between July and September 2020. All principal members with access to an online questionnaire were eligible to participate in this study. Logistic regression was used to identify factors associated with willingness to pay for primary health care services. A total of 6512 members of medical schemes participated in the study. Thirty-five percent of the participants were willing to pay for the primary health care package. Factors influencing willingness to pay included marital status, employment status, income and household size. The study highlights the need for policymakers to consider socioeconomic factors when designing health care policies.

医疗费用是南非医疗消费者和资助者都关心的问题。南非的医疗费用约占国内生产总值的 8%。医疗保健的资金来源是覆盖 86% 人口的公共部门和覆盖 14% 人口的私营部门。医疗计划是私营部门医疗保健资金的主要来源。医疗计划所涵盖的服务包括慢性病、急诊、诊断和治疗部分疾病。筛查等初级医疗保健服务有限。本研究旨在评估与医疗计划成员是否愿意支付私立部门初级保健套餐费用相关的因素。我们在 2020 年 7 月至 9 月期间对医疗计划的主要成员进行了横断面调查。所有可访问在线问卷的主要成员均有资格参与本研究。研究采用逻辑回归法来确定与基层医疗服务付费意愿相关的因素。共有 6512 名医疗计划成员参与了研究。35%的参与者愿意为初级保健套餐付费。影响支付意愿的因素包括婚姻状况、就业状况、收入和家庭规模。这项研究强调了政策制定者在制定医疗保健政策时考虑社会经济因素的必要性。
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引用次数: 0
The Influencing Factors of Psychosocial Adaptation of Cancer Patients: A Systematic Review and Meta-Analysis. 癌症患者社会心理适应的影响因素:系统回顾与元分析》。
IF 2.4 Q2 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-09-11 eCollection Date: 2024-01-01 DOI: 10.1177/11786329241278814
Hanjing Zhu, Linning Yang, Hongfan Yin, Xia Yuan, Jia Gu, Yan Yang

Purpose: The psycho-social adaptation of cancer patients is very important, which affects the treatment, rehabilitation process and prognosis of patients, and is closely related to the subjective well-being and quality of life of patients. However, the key factors affecting the psycho-social adjustment of cancer patients are not clear yet. This study aims to evaluate the psycho-social adaptation of cancer patients and its influencing factors based on a meta-analysis.

Basic procedures: The Systematic review was conducted following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) checklist and guided by the society-to-cell model framework. Literature retrieval was conducted from the construction of the library to December 2023.

Main findings: Fourteen pieces of literature were included in this study, with a total sample size of 2922 cases. Among the 14 literatures included, 9 were in English and 5 were in Chinese, published between 1991 and 2021. All of the 14 literatures were cross-sectional studies. According to the society-to-cells model framework, the influencing factors are divided into 5 levels: society, community, family, individual, and physiology. However, studies related to the cellular level are lacking.

Principal conclusions: The psychosocial adaptation of cancer patients is affected by physiology, individual, family, community and society, among which age, education level, disease uncertainty, hope level, psychological pain, self-efficacy, social support, coping styles (facing, avoidance, submission, and emotion-oriented) are the main factors affecting the psychosocial adaptation of cancer patients. However, studies related to the cellular level are lacking. This may be due to the fact that most of the factors from the individual to the society level are intervenable, and most studies focus more on the mining of these levels of factors. However, the biological basis is crucial to the occurrence and development of diseases, and needs to be paid attention to by nursing staff, and further research on this level needs to be strengthened in the future.

目的:癌症患者的社会心理适应非常重要,它影响着患者的治疗、康复过程和预后,与患者的主观幸福感和生活质量密切相关。然而,影响癌症患者社会心理适应的关键因素尚不明确。本研究旨在基于荟萃分析评估癌症患者的社会心理适应及其影响因素:系统综述按照系统综述和荟萃分析首选报告项目(PRISMA)清单进行,并以社会到细胞模型框架为指导。文献检索从建库开始至 2023 年 12 月结束:本研究共纳入 14 篇文献,样本量共计 2922 例。在这 14 篇文献中,有 9 篇英文文献和 5 篇中文文献,发表于 1991 年至 2021 年之间。14 篇文献均为横断面研究。根据社会到细胞模型框架,影响因素分为 5 个层面:社会、社区、家庭、个人和生理。主要结论:主要结论:癌症患者的社会心理适应受生理、个体、家庭、社区和社会的影响,其中年龄、受教育程度、疾病的不确定性、希望程度、心理痛苦、自我效能感、社会支持、应对方式(面对、回避、顺从和情绪导向)是影响癌症患者社会心理适应的主要因素。然而,与细胞水平相关的研究却很缺乏。这可能是由于从个人到社会层面的大多数因素都是可以干预的,而且大多数研究更侧重于挖掘这些层面的因素。然而,生物学基础对疾病的发生和发展至关重要,需要护理人员予以重视,今后还需进一步加强对这一层面的研究。
{"title":"The Influencing Factors of Psychosocial Adaptation of Cancer Patients: A Systematic Review and Meta-Analysis.","authors":"Hanjing Zhu, Linning Yang, Hongfan Yin, Xia Yuan, Jia Gu, Yan Yang","doi":"10.1177/11786329241278814","DOIUrl":"https://doi.org/10.1177/11786329241278814","url":null,"abstract":"<p><strong>Purpose: </strong>The psycho-social adaptation of cancer patients is very important, which affects the treatment, rehabilitation process and prognosis of patients, and is closely related to the subjective well-being and quality of life of patients. However, the key factors affecting the psycho-social adjustment of cancer patients are not clear yet. This study aims to evaluate the psycho-social adaptation of cancer patients and its influencing factors based on a meta-analysis.</p><p><strong>Basic procedures: </strong>The Systematic review was conducted following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) checklist and guided by the society-to-cell model framework. Literature retrieval was conducted from the construction of the library to December 2023.</p><p><strong>Main findings: </strong>Fourteen pieces of literature were included in this study, with a total sample size of 2922 cases. Among the 14 literatures included, 9 were in English and 5 were in Chinese, published between 1991 and 2021. All of the 14 literatures were cross-sectional studies. According to the society-to-cells model framework, the influencing factors are divided into 5 levels: society, community, family, individual, and physiology. However, studies related to the cellular level are lacking.</p><p><strong>Principal conclusions: </strong>The psychosocial adaptation of cancer patients is affected by physiology, individual, family, community and society, among which age, education level, disease uncertainty, hope level, psychological pain, self-efficacy, social support, coping styles (facing, avoidance, submission, and emotion-oriented) are the main factors affecting the psychosocial adaptation of cancer patients. However, studies related to the cellular level are lacking. This may be due to the fact that most of the factors from the individual to the society level are intervenable, and most studies focus more on the mining of these levels of factors. However, the biological basis is crucial to the occurrence and development of diseases, and needs to be paid attention to by nursing staff, and further research on this level needs to be strengthened in the future.</p>","PeriodicalId":12876,"journal":{"name":"Health Services Insights","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11406651/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142284465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Identifying Patient Subpopulations with Significant Race-Sex Differences in Emergency Department Disposition Decisions. 识别急诊科处置决定中存在显著种族-性别差异的患者亚群。
IF 2.4 Q2 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-09-05 eCollection Date: 2024-01-01 DOI: 10.1177/11786329241277724
Peter Lin, Nilay T Argon, Qian Cheng, Christopher S Evans, Benjamin Linthicum, Yufeng Liu, Abhishek Mehrotra, Laura Murphy, Mehul D Patel, Serhan Ziya

Background/objectives: The race-sex differences in emergency department (ED) disposition decisions have been reported widely. Our objective is to identify demographic and clinical subgroups for which this difference is most pronounced, which will facilitate future targeted research on potential disparities and interventions.

Methods: We performed a retrospective analysis of 93 987 White and African-American adults assigned an Emergency Severity Index of 3 at 3 large EDs from January 2019 to February 2020. Using random forests, we identified the Elixhauser comorbidity score, age, and insurance status as important variables to divide data into subpopulations. Logistic regression models were then fitted to test race-sex differences within each subpopulation while controlling for other patient characteristics and ED conditions.

Results: In each subpopulation, African-American women were less likely to be admitted than White men with odds ratios as low as 0.304 (95% confidence interval (CI): [0.229, 0.404]). African-American men had smaller admission odds compared to White men in subpopulations of 41+ years of age or with very low/high Elixhauser scores, odds ratios being as low as 0.652 (CI: [0.590, 0.747]). White women were less likely to be admitted than White men in subpopulations of 18 to 40 or 41 to 64 years of age, with low Elixhauser scores, or with Self-Pay or Medicaid insurance status with odds ratios as low as 0.574 (CI: [0.421, 0.784]).

Conclusions: While differences in likelihood of admission were lessened by younger age for African-American men, and by older age, higher Elixhauser score, and Medicare or Commercial insurance for White women, they persisted in all subgroups for African-American women. In general, patients of age 64 years or younger, with low comorbidity scores, or with Medicaid or no insurance appeared most prone to potential disparities in admissions.

背景/目的:急诊科(ED)处置决定中的种族性别差异已被广泛报道。我们的目的是找出这种差异最明显的人口和临床亚群,这将有助于今后对潜在的差异和干预措施进行有针对性的研究:我们对 2019 年 1 月至 2020 年 2 月期间在 3 家大型急诊室分配到急诊严重程度指数为 3 的 93 987 名白人和非裔美国成年人进行了回顾性分析。利用随机森林,我们确定了埃利克豪斯(Elixhauser)合并症评分、年龄和保险状况作为将数据划分为亚人群的重要变量。然后,在控制其他患者特征和急诊室条件的情况下,我们拟合了逻辑回归模型,以检验每个亚人群中的种族-性别差异:结果:在每个亚人群中,非裔美国女性入院的几率低于白人男性,几率比低至 0.304(95% 置信区间 (CI):[0.229, 0.404])。在 41 岁以上或 Elixhauser 评分极低/极高的亚人群中,非裔美国男性的入院几率小于白人男性,几率比低至 0.652(CI:[0.590, 0.747])。在年龄介于 18 至 40 岁或 41 至 64 岁、Elixhauser 分数较低、具有自费或医疗补助保险身份的亚人群中,白人女性比白人男性的入院几率更低,几率比低至 0.574(CI:[0.421, 0.784]):非裔美国男性入院可能性的差异因年龄较小而缩小,白人女性入院可能性的差异因年龄较大、Elixhauser 评分较高以及医疗保险或商业保险而缩小,但非裔美国女性入院可能性的差异在所有亚组中都持续存在。一般来说,64 岁或以下、合并症评分较低、有医疗补助或无保险的患者最容易出现潜在的入院差异。
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引用次数: 0
Exploring the Impact of COVID-19 on Cervical Cancer Screening Services: A Qualitative Study of Healthcare Providers' and Women's Perspectives and Experiences. 探索 COVID-19 对宫颈癌筛查服务的影响:医疗保健提供者和妇女的观点与经验定性研究》。
IF 2.4 Q2 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-09-03 eCollection Date: 2024-01-01 DOI: 10.1177/11786329241275883
Fennie Mantula, Yoesrie Toefy

A qualitative exploration was conducted to analyse the reasons behind the low utilisation of cervical cancer screening services in Gwanda district, Zimbabwe, focusing on the impact of the COVID-19 pandemic. The study involved 5 focus group discussions with 36 women, utilising maximum variation sampling to explore the effects of COVID-19 on screening coverage. Additionally, in-depth interviews were conducted with 25 health-care providers from primary health facilities and the provincial hospital offering screening services. The results suggest a decline in the progress of the cervical cancer screening programme due to the disruptions caused by COVID-19 which subsequently reduced women's access to screening and treatment services. It was anticipated that restoring women's confidence in adherence to screening would require time post-pandemic. Moreover, findings highlighted the potential progression of undetected precursor lesions to advanced cancer stages during non-screening periods, which may increase future cervical cancer morbidity and mortality. The findings underscore the importance of integrating cervical cancer screening messaging within broader health communication strategies to emphasise the significance of health interventions for overall well-being. This study recommends the adoption of more efficient screening methods, such as Human-Papillomavirus self-sampling to mitigate future disruptions in screening services, thereby guiding policymakers towards implementing best screening approaches.

我们进行了一项定性研究,分析了津巴布韦 Gwanda 地区宫颈癌筛查服务利用率低的原因,重点关注 COVID-19 大流行的影响。这项研究包括与 36 名妇女进行的 5 次焦点小组讨论,利用最大变异抽样来探讨 COVID-19 对筛查覆盖率的影响。此外,还对提供筛查服务的基层医疗机构和省级医院的 25 名医护人员进行了深入访谈。结果表明,由于 COVID-19 的干扰,宫颈癌筛查计划的进展有所下降,妇女获得筛查和治疗服务的机会也随之减少。预计大流行过后,恢复妇女坚持筛查的信心需要时间。此外,研究结果还强调,在未进行筛查期间,未被发现的前驱病变可能会发展到癌症晚期,这可能会增加未来宫颈癌的发病率和死亡率。研究结果强调了将宫颈癌筛查信息纳入更广泛的健康传播战略的重要性,以强调健康干预对整体健康的重要意义。本研究建议采用更有效的筛查方法,如人类乳头状瘤病毒自我采样,以减少未来筛查服务的中断,从而指导政策制定者实施最佳筛查方法。
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引用次数: 0
The Effects of Ghana's Free Maternal and Healthcare Policy on Maternal and Infant Healthcare: A Scoping Review. 加纳免费孕产妇保健政策对孕产妇和婴儿保健的影响:范围审查》。
IF 2.4 Q2 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-09-03 eCollection Date: 2024-01-01 DOI: 10.1177/11786329241274481
Emefa Awo Adawudu, Kizito Aidam, Elisha Oduro, Dennis Miezah, Allison Vorderstrasse

Ghana was the first sub-Saharan country to implement a National Health Insurance Scheme (NHIS). In furtherance of the nation's Universal Health Coverage (UHC) goals, in 2008, Ghana actualized plans for a Free Maternal Healthcare Policy (FMHCP) under the NHIS. The FMHCP was aimed at removing financial barriers to accessing maternal and neonatal health services. This scoping review was conducted to map out the literature on the effects of the FMHCP under the NHIS on the utilization of maternal and infant health care in Ghana. Six databases including CINAHL, PubMed, Sage Journals, Academic Search Premier, Science Direct, and Medline were searched in conducting this review with key terms. A total of 175 studies were retrieved after the search and finally, 23 articles were included in the study after various stages of elimination. The review followed the reporting guidelines stated in the Preferred Reporting Items for Systematic and Meta-analyses Extensions for Scoping Reviews (PRISMA-ScR). The results showed an overall increase in the utilization of antenatal care, facility-based delivery, and postnatal care services. However, certain systemic issues persist regarding access to maternal and infant healthcare. Socio-demographic inequalities such as maternal level of education, place of residence, and economic status likewise barriers such as the existence of out-of-pocket payments, long distance to health facilities, and poor distribution of resources in rural areas hindered the utilization of maternal and infant healthcare. The country faces significant work to eliminate existing barriers and inequalities to ensure that it achieves its UHC goals.

加纳是第一个实施国家健康保险计划(NHIS)的撒哈拉以南国家。为了推进国家的全民健康保险(UHC)目标,加纳于 2008 年在国家健康保险计划下实施了免费孕产妇保健政策(FMHCP)计划。免费孕产妇保健政策旨在消除获得孕产妇和新生儿保健服务的经济障碍。本范围审查旨在对有关加纳国家医疗保险计划下的免费孕产妇保健政策对利用孕产妇和婴儿保健服务的影响的文献进行梳理。本综述使用关键术语检索了六个数据库,包括 CINAHL、PubMed、Sage Journals、Academic Search Premier、Science Direct 和 Medline。搜索后共检索到 175 项研究,经过不同阶段的筛选,最终有 23 篇文章被纳入本研究。本综述遵循了《系统和元分析扩展范围综述的首选报告项目》(PRISMA-ScR)中规定的报告指南。结果显示,产前护理、设施内分娩和产后护理服务的利用率总体有所提高。然而,在获得母婴保健服务方面,某些系统性问题依然存在。社会人口方面的不平等,如孕产妇的教育水平、居住地和经济状况,同样阻碍了孕产妇和婴儿保健服务的利用,如存在自付费用、距离医疗机构较远以及农村地区资源分配不均等问题。该国面临着消除现有障碍和不平等现象的艰巨任务,以确保实现全民保健目标。
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引用次数: 0
Evaluating the Barriers and Facilitators to Implementing a Novel Referral System for Outpatient Geriatric Services: The Geri-Hub Quality Improvement Initiative. 评估实施新型老年病门诊转诊系统的障碍和促进因素:老年枢纽质量改进计划》。
IF 2.4 Q2 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-08-30 eCollection Date: 2024-01-01 DOI: 10.1177/11786329241274482
Guillaume Lim Fat, Kristina M Kokorelias, Erica Foronda, Bindhu Sadasivan, Lindy Romanovsky

Background: In healthcare systems prioritizing care of older adults, resource limitations and escalating demand often impede access to outpatient specialized geriatric services.

Objectives: This study, theoretically guided by the Consolidated Framework for Implementation Research (CFIR), aimed to explore barriers and facilitators in implementing a centralized "Geri-Hub." The Geri-Hub is a centralized intake system established within 2 hospital systems to coordinate outpatient and community-based services for older adults, aiming to connect them with the most appropriate care in a timely manner.

Methods: Qualitative insights were gathered from healthcare professionals at 2 academic institutions in the process of consolidating services. Through open-ended surveys and semi-structured interviews, we solicited feedback on referral management, waiting times, and overall work experiences.

Results: Thirteen frequently referring providers and a cohort of 9 geriatricians, along with 4 administrators, contributed to the study. Geriatricians emphasized streamlined referrals, flexible scheduling for urgent cases, and a target wait time of 3 months. Administrators stressed standardized referral procedures, defined roles, and accessible referral information.

Discussion: The findings underscored the need for straightforward referral processes, enhanced communication on referral statuses, and reduced wait times. Optimizing these processes could potentially mitigate resource utilization issues and improve patient outcomes in healthcare systems. This research highlights the critical role of timely access to geriatric services during transformative phases in healthcare delivery.

背景:在优先照顾老年人的医疗保健系统中,资源限制和不断增长的需求往往阻碍了门诊老年病专科服务的获取:本研究以实施研究综合框架(CFIR)为理论指导,旨在探讨实施集中式 "老年病中心 "的障碍和促进因素。Geri-Hub 是在两家医院系统内建立的一个集中接收系统,旨在协调老年人的门诊和社区服务,及时为他们提供最合适的医疗服务:方法:在整合服务的过程中,从两家学术机构的医疗保健专业人员那里收集定性见解。通过开放式调查和半结构化访谈,我们征求了有关转诊管理、等待时间和整体工作经验的反馈意见:13 名经常转诊的医疗机构和 9 名老年病学专家以及 4 名管理人员参与了研究。老年病科医生强调要简化转诊程序、灵活安排紧急病例的时间以及 3 个月的目标等待时间。管理人员则强调标准化的转诊程序、明确的角色定位和便捷的转诊信息:讨论:研究结果表明,有必要制定简单明了的转诊流程、加强转诊状态的沟通并缩短等待时间。优化这些流程有可能缓解医疗系统中的资源利用问题,并改善患者的治疗效果。这项研究强调了在医疗服务转型阶段及时获得老年病服务的关键作用。
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引用次数: 0
Primary Healthcare Marketing: A Bibliometric Study and Research Agenda. 初级保健营销:文献计量学研究与研究议程》。
IF 2.4 Q2 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-08-28 eCollection Date: 2024-01-01 DOI: 10.1177/11786329241266648
Piotr Rościszewski, Mariusz Stępień, Justyna Berniak-Woźny

The evolution of our lives has forced changes to the healthcare system and consequently established healthcare marketing as an essential element of health services, including primary health care (PHC). This article aims to analyze the size, structure, and dynamics of research on primary healthcare marketing to identify the main topics and research trends in this area. The authors conducted a bibliographic analysis based on the methods of performance analysis and scientific mapping. The bibliographical analysis covered 1981 publications selected from the Scopus database and was carried out with the use of the MS Excel and VOSviewer applications. The results were supplemented with an in-depth analysis of 34 publications selected based on bibliographic coupling analysis to determine key research trends and results, which increased the understanding of the research area. The conducted research proves that the issue of marketing in primary health care is rarely addressed by researchers, which translates into very limited research results and little impact on the decision-making process in this area. This research field requires much greater commitment, especially in the areas indicated in the future research agenda recommendations.

我们生活的发展迫使医疗保健系统发生变化,从而使医疗保健营销成为包括初级医疗保健(PHC)在内的医疗保健服务的基本要素。本文旨在分析初级医疗保健营销研究的规模、结构和动态,以确定该领域的主要课题和研究趋势。作者根据绩效分析和科学绘图的方法进行了书目分析。书目分析涵盖了从 Scopus 数据库中选取的 1981 篇出版物,并使用 MS Excel 和 VOSviewer 应用程序进行了分析。此外,还对根据书目耦合分析选出的 34 篇出版物进行了深入分析,以确定主要研究趋势和成果,从而加深对研究领域的了解。所进行的研究证明,研究人员很少涉及初级卫生保健中的营销问题,这导致研究成果非常有限,对该领域的决策过程影响甚微。这一研究领域需要更大的投入,特别是在未来研究议程建议中指出的领域。
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引用次数: 0
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Health Services Insights
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