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Determinants of Health Expenditure Among the Informal Workers of India: Is It Always Catastrophic? 印度非正规工人医疗支出的决定因素:是否总是灾难性的?
IF 2.3 Q4 HEALTH POLICY & SERVICES Pub Date : 2023-12-09 DOI: 10.1177/09720634231196935
R. Roy, Amit Kundu
The Indian labour market is dominated by informal workers. Out-of-pocket healthcare payments are the principal source of healthcare financing for those workers. This article will try to investigate the determinants of health expenditures across heterogeneous groups of informal workers in India based on the 68th round of National Sample Survey data on Employment and Unemployment for 2011–2012. Across different types of informal workers, mean health expenditure has been highest among ‘employees of informal sectors’. The determining factors for the health expenditure are social group, household head and the number of dependencies. It is also found that health expenditure is not always catastrophic among informal workers. The result obtained is that health expenditure has been catastrophic for almost 30% of informal workers across various heterogeneous groups. Using the probit model, the influencing factors responsible for the incidence of catastrophic health expenditure are age and sex of the household head, the number of senior citizens in the family, possession of assets and expenditure on fuel and electricity.
印度劳动力市场由非正式工人主导。自付医疗费用是这些工人医疗保健资金的主要来源。本文将根据2011-2012年第68轮全国就业和失业抽样调查数据,试图调查印度异质性非正规工人群体卫生支出的决定因素。在不同类型的非正规工人中,"非正规部门雇员"的平均保健支出最高。保健支出的决定因素是社会群体、户主和受抚养人的数目。研究还发现,在非正规工人中,卫生支出并不总是灾难性的。所获得的结果是,卫生支出对各种异质群体中近30%的非正式工人来说是灾难性的。使用probit模型,对灾难性卫生支出发生率负责的影响因素是户主的年龄和性别、家庭中老年人的人数、资产的拥有情况以及燃料和电力支出。
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引用次数: 0
Enhancing Accessibility, Functionality and Meditation Design in a Suburban Activity Centre: A Case Study at Mawson Lakes Campus 增强郊区活动中心的可达性、功能性和冥想设计:莫森湖校园案例研究
IF 2.3 Q4 HEALTH POLICY & SERVICES Pub Date : 2023-12-03 DOI: 10.1177/09720634231205656
Li Luo, Li Meng, Ziyue Yan, Simon Millcock, Rita Yi Man Li, Christopher Chow
Incorporating the user’s and the broader community’s values in the built environment design for placemaking is becoming essential. The proposed method applies a quality function deployment framework to assess campus accessibility and functionality to meet the users’ needs. The results showed the improvements required to the current campus design, including quiet places, more meditation places, improved public transport from home to and on campus and increased social activities and accessibility. We concluded that access to meditation places was essential for enhancing people’s well-being. The study results could be extended from suburban campuses to suburban town centres and prominent industrial places. There is a significant need to connect with the built environment by ensuring that people’s desires and needs are integrated into a place-making approach.
将用户和更广泛的社区的价值观纳入建筑环境设计中,以进行场所制作变得至关重要。该方法采用一个质量功能部署框架来评估校园的可达性和功能,以满足用户的需求。结果显示,当前的校园设计需要改进,包括安静的地方,更多的冥想场所,改善从家到校园的公共交通,增加社会活动和可达性。我们的结论是,进入冥想场所对提高人们的幸福感至关重要。研究结果可以从郊区校园扩展到郊区城镇中心和著名的工业场所。通过确保将人们的愿望和需求融入到场所制作方法中,与建筑环境联系起来是一个重要的需求。
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引用次数: 0
The Industrial Front and the Pandemic Crisis in Brazil: The Missing Agenda 工业阵线与巴西的流行病危机:缺失的议程
IF 2.3 Q4 HEALTH POLICY & SERVICES Pub Date : 2023-12-01 DOI: 10.1177/09720634221128709
Anapatricia Morales Vilha, Luis Paulo Bresciani, Guilherme Arevalo
The article seeks to identify the government initiatives to mobilise the Brazilian industry during the pandemic crisis. The motivation for the work stems from evidence showing the omissions at the federal level, with relevant implications for the death figures in Brazil. Public policies agenda and a conceptual review was carried out on industrial reconversion in severe emergency conditions, including international experiences in the current scenario. A documental survey was conducted with the federal government and selected state governments. The survey was carried out on the official portals of governments, related agencies and business entities representing the industrial sector. Lack of industry-coordinated mobilisation is given by the combination of intrinsic and extrinsic factors concerning the pandemic crisis, industrial reconversion is another relevant absence at the public agenda. Weak answers of Brazilian government regarding the industrial mobilisation for fighting the pandemic crisis, leading to further hypotheses on the structured agenda of possible effects. The study shows weakness of federal measures coming from the Brazilian government also in the economic front, adding the industrial reconversion absence in the policies agenda as another remarkable feature on the health impacts of COVID-19 pandemics.
文章旨在确定政府在大流行病危机期间动员巴西产业的举措。这项工作的动机源于有证据表明联邦一级存在疏漏,这对巴西的死亡数字产生了相关影响。对公共政策议程和严重紧急情况下的工业再转化进行了概念审查,包括当前情况下的国际经验。对联邦政府和部分州政府进行了文件调查。调查在政府、相关机构和代表工业部门的商业实体的官方门户网站上进行。大流行病危机的内在和外在因素共同造成了缺乏工业协调动员,工业再转化是公共议程上的另一个相关缺失。巴西政府对动员工业界抗击大流行病危机的答复不力,导致对可能产生影响的结构化议程提出进一步假设。研究表明,巴西政府在经济方面采取的联邦措施也很薄弱,政策议程中缺乏工业再转化是 COVID-19 大流行病对健康影响的另一个显著特点。
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引用次数: 0
The Mediating Role of Burnout in the Anxiety and Work Engagement Relationship 职业倦怠在焦虑与工作投入关系中的中介作用
IF 2.3 Q4 HEALTH POLICY & SERVICES Pub Date : 2023-12-01 DOI: 10.1177/09720634231215143
J. Perepelkin, Grant Alexander Wilson
Pandemic-related pressures and responsibilities increase the likelihood of burnout for all health care professionals. The consequences of burnout are significant, as it has been linked to high anxiety, increased turnover, decreased employee morale, higher absenteeism, and lower quality of service. To date, most research explores burnout’s relationship with these variables in isolation. This study explores the anxiety, burnout, and employee engagement relationships among community pharmacists during the global pandemic. Pharmacists in the Canadian province of Saskatchewan completed an online questionnaire that asked questions related to their levels of anxiety, burnout, and work engagement among other control variables. The relationships among the variables were explored via SPSS and the moderation and mediation PROCESS macro. The findings suggest that burnout fully mediates the anxiety and employee engagement relationship, suggesting that anxiety alone is not enough to reduce employee engagement. The results confirm burnout’s relationship with anxiety and lack of engagement and provide a more specific understanding of burnout’s antecedents and consequences, offering important insight for academics and practitioners. Due to the positive implications of eliminating burnout and the importance of employee engagement to organisational performance, managers should seek to reduce workplace stress to avoid burnout and disengagement.
与大流行病相关的压力和责任增加了所有医护专业人员出现职业倦怠的可能性。职业倦怠的后果非常严重,因为它与高度焦虑、人员流动增加、员工士气下降、缺勤率升高和服务质量下降有关。迄今为止,大多数研究都是孤立地探讨职业倦怠与这些变量之间的关系。本研究探讨了全球大流行期间社区药剂师的焦虑、职业倦怠和员工敬业度之间的关系。加拿大萨斯喀彻温省的药剂师们填写了一份在线问卷,问卷中的问题涉及他们的焦虑水平、职业倦怠和工作投入程度以及其他控制变量。研究人员通过 SPSS 和调节与调解 PROCESS 宏探讨了各变量之间的关系。研究结果表明,职业倦怠完全调节了焦虑与员工敬业度之间的关系,这表明仅靠焦虑不足以降低员工敬业度。研究结果证实了职业倦怠与焦虑和缺乏敬业度之间的关系,并对职业倦怠的前因后果有了更具体的了解,为学术界和实践者提供了重要的启示。鉴于消除职业倦怠的积极意义以及员工敬业度对组织绩效的重要性,管理者应设法减轻工作场所的压力,以避免职业倦怠和敬业度降低。
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引用次数: 0
Providing Home Healthcare Services for Patients during Pandemics: Applicability in Developing Countries 在大流行病期间为患者提供家庭医疗保健服务:发展中国家的适用性
IF 2.3 Q4 HEALTH POLICY & SERVICES Pub Date : 2023-12-01 DOI: 10.1177/09720634231215162
Rana Yousef, Khalid Al Zubi
The need for a systematic way to provide routine healthcare services for patients during pandemics is one of the priorities of the healthcare sector, especially when the country is in lockdown. In this article, we study the possibility of providing healthcare services for patients at their homes during pandemics in developing countries where such a system is not available. We present a technology-based solution and examine the possibility of its adaptation through a number of theoretical perspectives that examine changes in healthcare systems in general. Examining the theories of change revealed that providing healthcare services at home is a must during pandemics, and it has a significant role in improving the healthcare sector and in providing valuable services to patients, especially when the county is on lockdown. However, a number of challenges do exist for 0its adaptation in developing countries. These challenges are concerned with the costs of developing and maintaining the new system, as well as ensuring a precise and accurate healthcare service to be delivered on time and without any faults or errors. Having a well-studied plan by the health sector, an efficient scheduling mechanism for the healthcare services’ requests, and a service monitoring system can overcome all challenges and ensure a better quality of life for patients.
在大流行病期间,尤其是在国家处于封锁状态时,需要有系统地为病人提供常规医疗服务,这是医疗保健部门的优先事项之一。在这篇文章中,我们研究了在没有此类系统的发展中国家,在大流行病期间为病人提供上门医疗服务的可能性。我们提出了一种以技术为基础的解决方案,并通过研究一般医疗保健系统变化的一些理论视角来探讨其适应性的可能性。对变革理论的研究表明,在大流行病期间,在家中提供医疗保健服务是必须的,它在改善医疗保健行业和为患者提供有价值的服务方面具有重要作用,尤其是在县城处于封锁状态时。然而,发展中国家在适应 0its 方面确实存在一些挑战。这些挑战主要涉及开发和维护新系统的成本,以及确保准确无误地按时提供医疗服务。卫生部门制定周密的计划、有效的医疗服务申请调度机制和服务监测系统可以克服所有挑战,确保提高患者的生活质量。
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引用次数: 0
Validation of Employee Job Performance (EJP) Scale in an Arab Working Environment: The Case of Healthcare Providers in Emergency Departments in Jordan 阿拉伯工作环境中员工工作绩效(EJP)量表的验证:约旦急诊科医护人员案例
IF 2.3 Q4 HEALTH POLICY & SERVICES Pub Date : 2023-12-01 DOI: 10.1177/09720634231213919
Audai Naji Khaled Al Smadi, Safiya Amaran, Najib Majdi bin Yaacob
Job performance is an essential contributing factor to hospital success because it appraises healthcare providers’ (HCPs) job performance. Achieving the purpose of measuring HCP’s job performance in the emergency department requires a valid, reliable, satisfying psychometric properties scale. This study aims to verify the validity and reliability of the employee job performance (EJP) scale developed by Na-Nan et al. (2018). Two steps were followed to verify the validity and reliability of the EJP scale, namely, instrument validation and statistical testing, including exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). A survey questionnaire was distributed to the HCPs in two phases to collect the data in the period of April–July 2020. The findings failed to replicate the Na-Nan et al. (2018) EJP scale. Two items were dropped from the scale based on the content validity ratio results. The EFA yielded 11 items and two dimensions, and CFA yielded 9 items and two dimensions. The two dimensions name job quality (five items) and job time (five items). The goodness of fit of the model was defined as satisfactory with a value of Chi-square/df 2.63 and RMSEA < 0.08, TLI, GFI and CFI ≥ 0.90. The results of this study failed to replicate Na-Nan et al. (2018) findings. The final results indicated a two dimensions scale consisting of job quality and job time construct. In general, the two dimensions EJP scales meet the goodness of fit, and the results confirm the reliability and validity of the two dimensions EJP scale.
工作绩效是医院成功的一个重要因素,因为它是对医疗服务提供者(HCPs)工作绩效的评价。要达到衡量急诊科医护人员工作绩效的目的,需要一个有效、可靠、心理测量学特性满意的量表。本研究旨在验证那楠等(2018)编制的员工工作绩效(EJP)量表的效度和信度。验证员工工作绩效量表的效度和信度遵循两个步骤,即工具验证和统计检验,包括探索性因子分析(EFA)和确认性因子分析(CFA)。在 2020 年 4 月至 7 月期间,研究人员分两期向卫生保健人员发放了调查问卷,以收集数据。研究结果未能复制那楠等(2018 年)的 EJP 量表。根据内容效度比对结果,量表中删除了两个项目。EFA 得到 11 个项目和两个维度,CFA 得到 9 个项目和两个维度。这两个维度分别为工作质量(5 个条目)和工作时间(5 个条目)。模型的拟合优度被定义为令人满意,Chi-square/df 值为 2.63,RMSEA < 0.08,TLI、GFI 和 CFI ≥ 0.90。本研究结果未能复制那楠等(2018)的研究结果。最终结果表明,量表由工作质量和工作时间两个维度构成。总体而言,两个维度的EJP量表符合拟合优度,结果证实了两个维度EJP量表的信度和效度。
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引用次数: 0
The Information on Decision-making in Health: From Predictable to Unpredictable 健康决策信息:从可预测到不可预测
IF 2.3 Q4 HEALTH POLICY & SERVICES Pub Date : 2023-12-01 DOI: 10.1177/09720634231215393
Vanessa de Lima e Souza, Maria Manuel Borges
This study’s aim is to identify the information needs, sources, seeking behaviour and uses of information by health managers involved with decision-making in public health. An exploratory, qualitative and comparative study was performed to analyse the municipal and state spheres of public health administration in Brazil and the Department of Informatics of the National Health System at the federal level. Nine health managers were interviewed at different hierarchy levels. It was verified that the decision is subsidised by technical, scientific information and appropriation of experiences from different sources. The flow of information is bottom-up, associated with the flow of documents that feed the health information systems. There is a need for predictable and unpredictable information, originating mainly from the press and the Public Ministry. The municipal sphere is better structured to handle information than the state sphere. Unpredictable information needs to interfere with the routine of health management work activities and impact health managers’ decision-making. Information is seldom used in this decision-making process, with the weakness of the health information systems being pointed out as the main cause. The production of information for decision-making needs to be systematised to support decisions, making a synthesis of the different sources of existing information systems.
本研究旨在确定参与公共卫生决策的卫生管理人员的信息需求、信息来源、信息搜索行为和信息使用情况。我们进行了一项探索性、定性和比较研究,分析了巴西市级和州级公共卫生管理部门以及联邦一级的国家卫生系统信息部。九名不同级别的卫生管理人员接受了访谈。经核实,决策得到了技术、科学信息和不同来源经验的支持。信息流是自下而上的,与为卫生信息系统提供信息的文件流有关。需要可预测和不可预测的信息,这些信息主要来自新闻界和公共事务部。市政部门比国家部门更善于处理信息。不可预测的信息需要干扰日常的卫生管理工作,影响卫生管理人员的决策。在决策过程中很少使用信息,卫生信息系统的薄弱被认为是主要原因。决策信息的产生需要系统化,以支持决策,并对现有信息系统的不同来源进行综合。
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引用次数: 0
Adherence to Quality in District Hospitals of Haryana: A Recent Assessment as per Indian Public Health Standards (IPHS) 哈里亚纳邦地区医院对质量的坚持:根据印度公共卫生标准(IPHS)进行的最新评估
IF 2.3 Q4 HEALTH POLICY & SERVICES Pub Date : 2023-12-01 DOI: 10.1177/09720634231215161
Rajesh Kumar Aggarwal, Dalbir Singh
The article assesses the quality standards of available health care services as per the Indian Public Health Standards (IPHS) at all the 22 District Hospitals (DHs) in Haryana and also brings out a ranking of districts within the State based on these parameters. A structured schedule was prepared using IPHS norms and guidelines, and data was collected from all the DHs in the State on required components of quality standards. The article uses different statistical tools such as mean, standard deviation, coefficient of variation (CV) for analysis and attempts preparing a composite IPHS Index based on the type and number of services available. It found that the overall mean percentage score of observed quality standards was 66.5% across 22 DHs in Haryana (8 DHs>70%, 11 DHs between 60% and 70% and 3 DHs < 60%). Further, ranking across the State shows DH Panchkula on top with rank one whereas DH Charkhi Dadri appears at last with rank 22 based on the laid IPHS parameters. The article asserts that the observed quality standards are not fully matched with expected quality standards at DHs in Haryana and recommends the need for periodic reviews, perpetual monitoring of these standards and functioning, and emphasises on systemic management of the required IPHS parameters to ensure provisioning of optimal healthcare services at these hospitals.
文章按照印度公共卫生标准(IPHS),对哈里亚纳邦所有 22 家地区医院(DHs)的现有医疗服务质量标准进行了评估,并根据这些参数对该邦各地区进行了排名。文章采用 IPHS 规范和指南编制了一份结构化时间表,并从该邦所有县医院收集了有关质量标准所需组成部分的数据。文章使用了不同的统计工具,如平均值、标准偏差、变异系数 (CV) 进行分析,并尝试根据现有服务的类型和数量编制 IPHS 综合指数。研究发现,在哈里亚纳邦的 22 家 DH 中,观察到的质量标准的总体平均百分比得分为 66.5%(8 家 DH>70%,11 家 DH 在 60% 到 70% 之间,3 家 DH <60%)。此外,根据 IPHS 规定的参数,全邦排名显示,潘奇库拉县卫生院排名第一,而查克希-达德里县卫生院排名最后,为第 22 位。文章认为,哈里亚纳邦卫生院的观察质量标准与预期质量标准并不完全一致,建议有必要进行定期审查,对这些标准和功能进行长期监测,并强调对所需的 IPHS 参数进行系统管理,以确保在这些医院提供最佳的医疗保健服务。
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引用次数: 0
The Impact of COVID-19 on Dental Care Services and Practices in Jordan COVID-19 对约旦牙科保健服务和实践的影响
IF 2.3 Q4 HEALTH POLICY & SERVICES Pub Date : 2023-12-01 DOI: 10.1177/09720634231215156
Mohammad S. Alyahya, Sara R. Assaf, Majdi M Alzoubi, N. Al-sheyab, Ala F. Ashour
Dentists and their patients are highly exposed to COVID-19 due to the close contact nature of dental procedures. The primary aim of this study was to investigate the impact of COVID-19 on dental care practices and services in Jordan. A mixed-method design was used; data from dentists (N = 400) were collected using an online survey, and 15 semi-structured telephone interviews were conducted with dentists from public and private sectors. The findings revealed that the COVID-19 pandemic significantly impacted dental care practices and services. The majority of the participants reported a decline in their income and a decline in dental services demand, with a significant increase in costs for this profession. Additionally, this study showed that most participants were in a state of anxiety and fear about contracting the virus and transmitting it to their families while practising their profession that caused a change in their behaviours and attitudes. In conclusion, dental healthcare workers are at greater risk of being infected with COVID-19. There is a need to implement recommended protocols in dental clinics, it is also essential that decision makers develop appropriate interventions and measures to ensure continuity in the provision of dental services during the pandemic.
由于牙科治疗过程具有密切接触的性质,牙医及其患者高度暴露于 COVID-19。本研究的主要目的是调查 COVID-19 对约旦牙科护理实践和服务的影响。研究采用了混合方法设计;通过在线调查收集了牙医(N = 400)的数据,并对来自公共和私营部门的牙医进行了 15 次半结构化电话访谈。调查结果显示,COVID-19 大流行严重影响了牙科保健实践和服务。大多数参与者报告说,他们的收入下降,牙科服务需求减少,这一行业的成本大幅增加。此外,本研究还表明,大多数参与者在从事本行业时都处于焦虑和恐惧状态,担心感染病毒并传染给家人,这导致了他们行为和态度的改变。总之,牙科医护人员感染 COVID-19 的风险较大。有必要在牙科诊所实施建议的规程,决策者还必须制定适当的干预措施,以确保大流行期间牙科服务的连续性。
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引用次数: 0
Inclusion of Sexual Health Education for the Wellbeing and Dignity of Secondary School Children: An Indian Rural Perspective 为中学生的福祉和尊严纳入性健康教育:印度农村的视角
IF 2.3 Q4 HEALTH POLICY & SERVICES Pub Date : 2023-12-01 DOI: 10.1177/09720634231217028
Sangeeta Mehrolia, A. Veena, Subburaj Alagarsamy
The study investigates students’ perspectives on incorporating sexual health education into the curriculum of secondary schools in rural Bangalore. Focused on assessing how such education impacts students’ physical and psychological well-being, confidence, and ability to make informed decisions, the research collected data from 981 students across 6th to 10th grades. A structured questionnaire, measured on a five-point Likert scale, explored students’ perceptions of sexual health education and its outcomes. After a meticulous data cleaning process, which included outlier removal, the study utilized a final sample of 900 students. IBM SPSS 25 and AMOS 25 facilitated the statistical analysis. The findings underscore the significant positive effect of sexual health education on students’ confidence levels. It highlights how this form of education aids in maintaining personal hygiene and fosters balanced decision-making skills among students. The study’s results advocate for the implementation of sexual health education in schools, emphasizing its role in enhancing student wellbeing and confidence. Additionally, it contributes to defining the scope and framework of a sexual health education curriculum from the students’ perspective in rural Bangalore schools, aligning educational objectives with the actual needs and perceptions of the student body.
本研究调查了学生对将性健康教育纳入班加罗尔农村中学课程的看法。研究重点是评估性健康教育如何影响学生的身心健康、自信心以及做出明智决定的能力,研究收集了 981 名六至十年级学生的数据。通过一份结构化问卷,以李克特五点量表为标准,探讨了学生对性健康教育及其结果的看法。经过细致的数据清理过程(包括去除离群值),研究最终使用了 900 个学生样本。IBM SPSS 25 和 AMOS 25 协助进行了统计分析。研究结果强调了性健康教育对学生自信水平的显著积极影响。它强调了这种形式的教育如何帮助学生保持个人卫生和培养平衡的决策技能。研究结果倡导在学校开展性健康教育,强调其在增进学生福祉和信心方面的作用。此外,研究还有助于从班加罗尔农村学校学生的角度出发,确定性健康教育课程的范围和框架,使教育目标与学生的实际需求和观念相一致。
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引用次数: 0
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Journal of Health Management
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