Health & Social Care in the Community最新文献

This article examines the implementation of a social innovation designed to improve access to end-of-life care in depopulating rural areas of Eastern Poland. The initiative tested an integrated model of home-based support for chronically and terminally ill individuals, combining an interdisciplinary home hospice care team, locally embedded support networks, and a newly introduced role: the Dependent Care Coordinator (KOOZ). The study draws on multimethod field research conducted over several years, including staff surveys, semistructured interviews, sociometric analysis, and secondary data from patient needs assessments. Findings show that the model substantially expanded the scope and flexibility of home hospice services, strengthened coordination between health and social care actors, and reduced the burden on medical staff through the involvement of caregivers and the KOOZ. At the same time, the implementation revealed systemic barriers, including workforce shortages, institutional fragmentation, and cultural resistance to palliative and psychological support. The article contributes to the evidence base on integrated rural care, demonstrating both the potential of community-based social innovation and the structural constraints that limit its scalability and long-term sustainability.

Inadequate interprofessional collaboration presents a challenge when older adults transition from hospital to home care, as this process involves multiple health and social care professionals. To address this, the Swedish Care Coordination Act (CCA) was introduced in 2018, which altered the procedures for care planning and redistributed responsibilities among health and social care actors. This article explores how hospital discharge policies shape the landscape of collaborative care planning for older adults by studying the framing of problems and solutions related to the CCA. Policy documents related to the legislation were analysed by drawing on concepts developed in framing theory, specifically the sense-making of different policy interests and the overall policy storytelling. The analysis shows one main problem description, named ‘waiting time’ for patients, and three frames defining causes, blame and solutions: the outdated legislation frame, the healthcare involvement frame and the bureaucracy frame. The main problem and the outdated legislation frame unified the political ambitions with the interests of local and regional policy actors, while the healthcare involvement frame and the bureaucracy frame were based on interests deriving from the municipalities and the regional councils, respectively. The policy storytelling was based on taking the policy actors’ interests and perceptions of blame into account, making it possible to merge the different objectives. In conclusion, the frames were largely derived from the professional actors’ interests, assigning interprofessional collaboration difficulties to professional deficits rather than working conditions and resource allocation. The patient perspective was essentially absent from all three frames, which may contribute to upholding professional control of the discharge process. The findings suggest that it is vital to consider the neglected aspects of patient participation and working conditions when creating hospital discharge policy.

To examine the impact of China’s 2016 maternity leave extension on mothers’ health, this study uses difference-in-differences models and five waves of the China Family Panel Studies (2012–2020). We find that extended maternity leave significantly improves mothers’ physical health and reduces depression. An extension of 10 days is associated with a 0.013-unit decrease in self-rated health and a 0.098-point decrease in depression scores. Notably, the beneficial effects are more pronounced for those residing in rural areas and with a spouse; moreover, early childbearing benefits in physical health, and late childbearing benefits in mental health. Mechanistic analyses further reveal that extended maternity leave improves mothers’ health outcomes through improving life satisfaction. These findings provide new evidence from China on the health benefits of maternity leave and underscore the need for multidimensional postnatal health support and stronger family support policies as integral components of maternity leave reforms.

This study examines the impact of digital transformation on public health using global panel data for 94 countries from 2003 to 2021, applying feasible generalized least squares (FGLS) estimation with country–time clustered standard errors. It also investigates the mechanisms through which digital transformation affects public health from the perspectives of human capital and health expenditure efficiency. The results demonstrate that digital transformation has a significant positive impact on public health, and the findings remain valid after robustness tests. Income-level heterogeneity analyses suggest that digital transformation has the greatest positive impact on public health in low- and low-middle-income nations, while the effect is limited in upper-middle-income countries. Further mediation analyses indicate that digital transformation can indirectly improve public health by increasing human capital and health expenditure efficiency. This study extends the boundaries of research on the relationship between digital transformation and public health, offering insights into the broader possibilities for employing digital technology to improve public health.

This study investigates the influence of social determinants of health (SDH) on the self-care practices of older adults in Ghana using data from the 2021 Ghana Population and Housing Census. Structural equation modelling (SEM) was used to assess both direct and indirect effects on self-care practices among individuals aged 60 years and older. Results indicate that healthcare access (β = 0.93), education (β = 0.75), economic stability (β = 0.74) and social and community context (β = 0.74) are the strongest predictors of self-care, directly and indirectly mediated by social and environmental factors. Findings highlight the interplay between these determinants and their critical roles in shaping the self-care of older adults. Findings highlight the need for targeted interventions to enhance support systems, healthcare and socioenvironmental conditions. These findings contribute to global ageing discussions, especially in resource-limited contexts such as Ghana.