Development Of Health Care Services Research Articles

Patient engagement in the development and delivery of healthcare services: a systematic scoping review

BackgroundPatient engagement (PE) is required to improve future healthcare services. PE in the development and delivery of healthcare services is likely to be complex but is scarcely described.ObjectivesThe objective of...

Sexual healthcare and at-home STI test collection: attitudes and preferences of transgender women in the Southeastern United States.

HIV and sexually transmitted infections (STIs) disproportionally affect transgender women in the United States, particularly in the Southeast where rates of HIV and bacterial STIs are especially high. Despite the high HIV/STI burden among transgender women, their engagement in sexual healthcare services, including HIV/STI testing, is low. Understanding reasons for this disconnect is essential in developing HIV/STI prevention efforts for this population, especially in the Southeastern US, where access to affirming sexual healthcare providers and resources is limited. We aimed to perform an exploratory qualitative study to describe the attitudes and preferences of transgender women living in Alabama with regards to sexual healthcare and at-home STI test collection. Transgender women ≥18 years old residing in Alabama were invited to participate in virtual individual in-depth interviews via Zoom. The interview guide explored participant experiences engaging with sexual healthcare services as well as preferences related to extragenital (i.e., rectal, pharyngeal) and at-home STI testing for gonorrhea and chlamydia. A trained qualitative researcher coded transcripts after each interview and iteratively amended the interview guide as themes emerged. Data were coded and thematically analyzed using NVivo qualitative software. Between June 2021-April 2022, 22 transgender women were screened and 14 eligible women enrolled. Eight participants were white (57%), and six were black (43%). Five participants (36%) were living with HIV and engaged with HIV care services. Interview themes included preference for sexual healthcare environments specializing in LGBTQ+ care, enthusiasm toward at-home STI testing, an emphasis on affirming patient-provider interactions in sexual healthcare settings, a preference for sexual healthcare providers involved in STI testing who were not cisgender men, and gender dysphoria around sexual health discussions and testing. Transgender women in the Southeastern US prioritize affirming provider-patient interactions, however resources in the region are limited. Participants were enthusiastic about at-home STI testing options, which have the potential to mitigate gender dysphoria. Further investigation into development of remote sexual healthcare services for transgender women should be performed.

Lived experience of persons with multiple sclerosis: A qualitative interview study.

Multiple sclerosis (MS) is a chronic autoimmune disease with a substantial impact on quality of life and functional capability. The prognosis of MS has changed over time due to the development of increasingly effective therapies. As the knowledge and perceptions of persons living with chronic conditions increasingly have been acknowledged, it has become important to understand lived experiences with a focus on everyday events and experiences as a way of knowing and interpreting the world. Exploring context-specific lived experiences as a source of knowledge about the disease and care may contribute to more precision in designing care services. The aim of this study was to explore the lived experience of persons living with MS in a Swedish context. A qualitative interview study was conducted with both purposeful and random sampling strategies, resulting in 10 interviews. Data were analyzed using inductive thematic content analysis. The analysis generated 4 overarching themes with 12 subthemes, the 4 themes were: perspectives on life and health, influence on everyday life, relations with healthcare, and shared healthcare processes. The themes are concerned with the patients' own perspectives and context as well as medical and healthcare-related perspectives. Patterns of shared experiences were found, for example, in the diagnosis confirmation, future perspectives, and planning and coordination. More diverse experiences appeared concerning relations with others, one's individual requirements, symptoms and consequences, and knowledge building. The findings suggest a need for a more diverse and coproduced development of healthcare services to meet diverse needs in the population with greater acknowledgement of the person's lived experience, including consideration of the complexity of the disease, personal integrity, and different ways of knowing. Findings from this study will be further explored together with other quantitative and qualitative data.

A Conceptual Framework for Evaluating National Organ Donation and Transplantation Programs.

Conceptual frameworks are valuable resources that can be used to guide the planning, evaluation, and development of healthcare services. However, there are currently no comprehensive frameworks focused on organ donation and transplantation that identify the critical factors underlying a successful national program. To address this knowledge gap, we developed a conceptual framework that takes into account all major domains of influence, including political and societal aspects as well as clinical implementation. The framework was initially constructed based on a targeted review of the relevant medical literature. Feedback provided by a panel of international experts was incorporated into the framework via an iterative process. The final framework features 16 essential domains that are critical for initiating and maintaining a successful program and improving the health of patients with organ failure. Of particular note, these domains are subject to three overarching health system principles: responsiveness, efficiency, and equity. This framework represents a first attempt to develop a whole-system view of the various factors that contribute to the success of a national program. These findings provide a useful tool that can be adapted to any jurisdiction and used to plan, evaluate, and improve organ donation and transplantation programs.

Dawr al-ṣukūk al-murtabiṭah bi al-waqf al-naqdī fī taṭwīr mu'assasat al-ri‘āyah al-ṣiḥḥīyah bi Banten

This article aims to analyze the role of Cash Waqf Linked Sukuk (CWLS) in the development of healthcare services, particularly eye health, during the Covid-19 pandemic in Indonesia. The study adopts a descriptive qualitative approach, utilizing field research that involves analyzing social facts, expert opinions, and theoretical debates. The study findings indicate that the proceeds from CWLS, managed by the Indonesian Waqf Board (BWI) as the nāẓir (trustee), were used to purchase equipment for the retina and glaucoma center and provide patient transportation at Achmad Wardi Hospital. The utilization of CWLS proceeds significantly benefited 2,162 patients with retinal and glaucoma conditions, who faced challenges in accessing medical treatment and were at risk of blindness due to regional and social mobility restrictions during the pandemic. The model of utilizing CWLS proceeds for healthcare facility development at Achmad Wardi Hospital, implemented by BWI, can be replicated by other cash waqf trustees through collaboration with healthcare entities that cater to the community's needs.

What women want: A mixed-methods study of women's health priorities, preferences, and experiences in care in three Rwandan rural districts.

To explore Rwandan women's experiences, priorities, and preferences in accessing health care for non-pregnancy-related conditions and inform development of healthcare services related to these conditions among women of reproductive age at district hospitals and health centers in Rwanda. We used a mixed-methods, exploratory sequential design. Semi-structured qualitative interviews were conducted with Rwandan women and coded thematically. A cross-sectional quantitative survey based on the qualitative data was administered to women attending health centers. Seventeen interviews and 150 surveys were conducted. Women identified conditions including back pain, gynecologic cancers, and abnormal vaginal bleeding as concerns. They generally reported positive experiences while accessing health care and knowledge of accessing health care. Barriers to care were identified, including transportation costs and inability to miss work. Women expressed a desire for more control over their care and the importance of maintaining their dignity while accessing health care. These findings provide useful insights to inform development of non-pregnancy-related healthcare services for women in Rwanda according to their priorities and preferences. The reported end-user health concerns, barriers to care, and diminished control over their care point to a need to evolve health systems around user-tailored needs and design interventions optimizing access whilst promoting dignified care.

Evaluation of the Usage Requirements of Hospital Signage Systems Based on the Kano Model

This study aimed to determine the quality type and importance ranking of hospital signage systems’ usage requirements using the Kano model. This study collected data from 300 users in three hospitals in Guangzhou and evaluated 32 metrics of hospital signage systems. The Kano model questionnaire was used to analyze the quality type of each demand indicator, and the better–worse coefficient was used to calculate the sensitivity and importance ranking of the demand. Of the 32 attributes evaluated by participants, 4 are must-be quality (M), 4 are one-dimensional quality (O), 12 are attractive quality (A), and 12 are indifferent quality (I). The results of this study suggest that the presence of most of the evaluated attributes is associated with maintaining a level of user satisfaction, and the lack of these attributes causes user dissatisfaction. There is a strong demand for basic usage functions and an easy-to-use hospital signage system. In addition, users often wish to add and improve signage functions and have greater expectations for the inclusion of features such as digital intelligence and regional culture in this study. The results of this study show that the Kano model can better derive the user requirements for hospital signage systems and can promote the improvement of hospital signage systems in a more targeted manner, according to the quality type and importance of requirements, providing a research basis for the sustainable development of healthcare services.

The Intersection of Health Rehabilitation Services with Quality of Life in Saudi Arabia: Current Status and Future Needs.

Quality of life (QoL) is essential for maintaining a healthy, balanced lifestyle, especially among individuals with chronic diseases. Saudi Arabia (SA) launched a health sector transformation program as part of the nationwide Vision 2030 initiative to ensure the sustainable development of efficient healthcare services, aiming to improve health by increasing well-being and QoL. More investigation into the current status of health rehabilitation services provided to individuals with chronic diseases and future needs to optimize services and improve QoL is needed. This was narratively discussed by experts from different health rehabilitation services in SA. Comprehensive health rehabilitation services including orthopedic, occupational, cardiac, pulmonary, critical care, perioperative, hearing and speech, substance use disorders, and vocational rehabilitation services were addressed. Health rehabilitation services in SA, as in other countries, are suboptimal for individuals in health rehabilitation programs. To optimize the QoL of individuals with chronic diseases, health rehabilitation services should be tailored based on the unique requirements of each service and its serving patients. The shared need to improve health rehabilitation services includes the adoption of home-based and telehealth services, the integration of multi-governmental sectors, the empowerment and allocation of health rehabilitation specialists, public awareness campaigns, policy legislation and guideline development, and the implementation of a long-term follow-up system. This review is one of the first to address the intersection of health rehabilitation services and QoL in SA; urgent and holistic actions are paramount to address the pressing need to optimize SA's health rehabilitation services. The experts' recommendations in this study may be applicable to other countries' health systems, as health rehabilitation services are not well optimized globally.

Machine Learning-Based Detection of Dengue from Blood Smear Images Utilizing Platelet and Lymphocyte Characteristics.

Dengue fever, also known as break-bone fever, can be life-threatening. Caused by DENV, an RNA virus from the Flaviviridae family, dengue is currently a globally important public health problem. The clinical methods available for dengue diagnosis require skilled supervision. They are manual, time-consuming, labor-intensive, and not affordable to common people. This paper describes a method that can support clinicians during dengue diagnosis. It is proposed to automate the peripheral blood smear (PBS) examination using Artificial Intelligence (AI) to aid dengue diagnosis. Nowadays, AI, especially Machine Learning (ML), is increasingly being explored for successful analyses in the biomedical field. Digital pathology coupled with AI holds great potential in developing healthcare services. The automation system developed incorporates a blob detection method to detect platelets and thrombocytopenia from the PBS images. The results achieved are clinically acceptable. Moreover, an ML-based technique is proposed to detect dengue from the images of PBS based on the lymphocyte nucleus. Ten features are extracted, including six morphological and four Gray Level Spatial Dependance Matrix (GLSDM) features, out of the lymphocyte nucleus of normal and dengue cases. Features are then subjected to various popular supervised classifiers built using a ten-fold cross-validation policy for automated dengue detection. Among all the classifiers, the best performance was achieved by Support Vector Machine (SVM) and Decision Tree (DT), each with an accuracy of 93.62%. Furthermore, 1000 deep features extracted using pre-trained MobileNetV2 and 177 textural features extracted using Local binary pattern (LBP) from the lymphocyte nucleus are subjected to feature selection. The ReliefF selected 100 most significant features are then fed to the classifiers. The best performance was attained using an SVM classifier with 95.74% accuracy. With the obtained results, it is evident that this proposed approach can efficiently contribute as an adjuvant tool for diagnosing dengue from the digital microscopic images of PBS.

Portfolio of Services for the Manager Assistance Network Healthcare in Chile

Objective: Identify the difficulties that Health Services administrators face when defining their clinical and administrative environments and identifying specific activities of Network Managers. Method: An exploratory qualitative study was carried out involving 32 health services managers and four former post-reform undersecretaries in Chile, where a legal reform was implemented that redefined their role in a new context. The category "Health Network Administrator" was created to evaluate the impact of the reform on the Development of healthcare services, considering five key categories: Health Network Management, Clinical-care coordination of providers, Economic management of the health network, Development of human resources for the health network and Investment management in the health network. Results: They indicate that eighteen differentiated services are the responsibility of the Network Manager. Some of these services require flexibility in the exchange, redistribution, and transaction of resources between members of the networks, which may require review in the current legal framework, especially in the financial and human resources areas. Conclusion: It postpones the discussion on the administrative reform of providers in Chile, emphasising the need to define specific objectives for managers that distinguish them from other actors in the health productive chain.

Enabling primary healthcare service development with patient participation: a qualitative study of the internal facilitator role in Norway.

To explore how primary healthcare professionals (HCPs) tasked with facilitating primary healthcare service development with patient participation perceived their role. Patient participation in health service development is a recognized means of ensuring that health services fit the public's needs. However, HCPs are often uncertain about how to involve patient representatives (PRs), and patient participation is poorly implemented. Inspired by the Promoting Action on Research Implementation in Health Services framework, we address the innovation (patient participation), its recipients (PRs, HCPs, supervisors, and senior managers), and its context (primary healthcare at a local and organizational level). We conducted semi-structured individual interviews with six HCPs working as internal facilitators in primary healthcare in four Norwegian municipalities. The data were analyzed by applying Braun and Clarke's reflexive thematic analysis. The themes show that to develop primary healthcare services with patient participation, facilitators must establish a network of PRs with relevant skills, promote involvement within their organization, engage HCPs favorable toward patient participation, and demonstrate to supervisors and senior managers its usefulness to win their support. Implementing patient participation must be a shared, collective responsibility of facilitators, supervisors, and senior management. However, supervisors and senior management appear not to fully understand the potential of involvement or how to support the facilitators. The facilitator role requires continuous and systematic work on multiple organizational levels to enable the development of health services with patient participation. It entails maintaining a network of persons with experiential knowledge, engaging HCPs, and having senior management's understanding and support.

Employee perceptions of non-communicable diseases health risks, absenteeism and the role of organisational support in a South African pharmaceutical manufacturing company.

The growing prevalence of non-communicable diseases (NCDs) in South African workers has been shown to be associated with absenteeism and increased risk of morbidity. Low-income workers living in urban settings are particularly vulnerable. Consultation with workers is crucial for understanding risks and identifying opportunities for intervention to promote health in the workplace. The purpose of this study was to examine South African pharmaceutical manufacturing workers' perspectives of health risk factors and absenteeism, and to identify how they perceived a role for the organisation to initiate interventions to improve their health. Five focus groups were conducted to capture 27 employees' perspectives. The semi-structured focus group discussions were recorded and analysed using a thematic content analysis approach. Participants indicated that they were aware of behavioural health risks such as prolonged sitting. They showed insight into strategies to prevent injuries and stay healthy, but also expressed dissatisfaction about the lack of organisational support, leading to stress and consequently absenteeism. Participants emphasized the responsibility of the organisation to support a range of health promoting strategies. The findings of this study are important for cultivating a tailored workplace intervention to reduce NCD risk factors in the pharmaceutical manufacturing workforce. It is vital that these be supported by leadership of the company through the provision of funding and the development of internal healthcare services.

Constructing healthcare services markets: networks, brokers and the China-England engagement

Healthcare services is an expanding international market with which national healthcare systems engage, and from which they benefit, to greater and lesser degrees. This study examines the case of the China-England engagement in healthcare services as a vehicle for illuminating the way in which such market relationships are constructed. China and England have different approaches to the international healthcare services market. Aware of the knowledge and technology gaps between itself and the leading capitalist nations of the West in healthcare, as in other sectors, the Chinese leadership has encouraged a variety of international engagements to facilitate the bridging of these gaps including accessing new supply and demand relationships in international markets. These engagements are situated within an approach to health system development based on establishing broad policy directions, allowing a degree of local innovation, initiating and evaluating pilot studies, and promulgating new programmatic frameworks at central and local levels. The assumption is that the new knowledge and technologies are integrated into this approach and implemented under the guidance of Chinese experts and leaders. England's healthcare system has the knowledge resources to provide the supply to meet at least some of the China demand but has yet to develop fully the means to enable an efficient market response, though such economic engagement is supported by the UK's trade related departments of state. As a result, the development of China-England commercial relationships in patient care, professional education and hospital and healthcare service development has been led largely by high status NHS Trusts and private sector organisations with the entrepreneurial capacity to exploit their market position. Drawing on their established international clinicians and commercial teams with experience of domestic private sector provision, these institutions have built trust-based collaborations sufficiently robust to facilitate demand-supply relationships in the international healthcare services market. Often key to the development of relations required to make commercial exchange feasible and practicable are a range of international brokers with the skills and capacity to provide the necessary linkage with individual healthcare consumers and institutional clients in China. Integral to the broker role, and often supplied by the broker itself, are the communication technologies of telemedicine to enable the interaction between consumer and healthcare provider, be this in patient care, professional education or healthcare service development. Although England's healthcare system has the knowledge required to respond to China's market demand and such economic engagement is supported and actively encouraged by the UK's trade related departments of state, the response is constrained by multiple domestic demands on its resources and by the limits of the NHS approach to marketisation in healthcare.

Managers’ Perceptions of Barriers to Using IT for Organizational Development: Case of a Hospital Chain in Riyadh, Saudi Arabia

BackgroundInformation technology is widely used by managers in healthcare settings in Saudi Arabia and has positive effects on healthcare systems. This study focuses on mangers’ perspectives on barriers, as healthcare system users and leaders.MethodThis work was conducted as a qualitative exploratory case study based on semi-structured audio-recorded interviews conducted at a hospital chain in Riyadh, Saudi Arabia, using open-ended questions to provide in-depth information.ResultsThe use of IT in healthcare settings has had positive effects, but many barriers can cause delays or problems in using IT, including hacking, human resistance to new technology and the need for experts in the field of IT in healthcare. Training and support of employees are leading solutions to the many problems encountered in implementing and using IT in healthcare.ConclusionThe study identified the problems in using IT for the development of healthcare services and the positive effects on the services provided to patients, and indicated a need for further development and support.

Primary healthcare professionals' experience with patient participation in healthcare service development: A qualitative study.

How healthcare professionals experience patient participation in health service development impacts its use. This participatory study explores primary healthcare professionals' perceptions of developing health services with patient representatives. Four focus group interviews with primary healthcare professionals (n = 26) were conducted. We analyzed data by applying Braun and Clarke's reflexive thematic analysis. The healthcare professionals perceived having a complementary interprofessional relationship with the patient representatives and regarded them as colleagues. However, the professionals navigated between a position of authority and collaboration, reconciling the need for participation with its challenges, e.g., to identify the representatives' collective representation among their personal experience, to ensure a more evidence-informed result that they and their colleagues would endorse. Regarding patient representatives as colleagues can blur the line between professionals and representatives' positions and functions and further complicate health service development. Our results indicate a need for skilled facilitators to lead the process. This study identifies issues that professionals are uncertain about when collaborating with representatives to develop primary healthcare services; difficulties that professionals must overcome to collaborate constructively with representatives. Our findings can inform healthcare professionals' education about patient participation on all levels. We have suggested topics to address.

Digital Twin-assisted Blockchain-inspired irregular event analysis for eldercare

Since the development of smart healthcare services, different solutions have been developed in the field of healthcare to increase the life expectancy of the patient by reducing the cost of healthcare. Digital Twin (DT) is considered one of the most promising technologies and a game changer in the field of healthcare. DT is generating a virtual imitation of a physical object that mimics the status of an event by changing the information in real time. In this article, a smart context-aware physical activity monitoring framework is developed by combining different advanced techniques such as IoT, DT, FoT, CoT, and Blockchain to maintain the sensitiveness of the healthcare domain. In the proposed study, the physical movements of an elder are analyzed by utilizing the sequential data processing capability of deep learning to detect irregular physical events. In addition, the proposed framework can keep the data of an individual secured by applying progressed security highlights of blockchain. The proposed solution effectively analyzed an irregular event of an individual with considerable accuracy in real time. The calculated outcomes have shown the effectiveness of DT with smart healthcare solutions that would help to develop effective medical services by bringing patients and medical care experts together. Furthermore, the performance of the proposed solution is measured with respect to irregular event recognition, model training and testing, rate of latency, and data processing cost. In this manner, a case study defines the effectiveness of the proposed methodology in the smart healthcare industry.

Patient experiences of codesigned rehabilitation interventions in hospitals: a rapid review

BackgroundCodesign strengthens partnerships between healthcare workers and patients. It also facilitates collaborations supporting the development, design and delivery of healthcare services. Prior rehabilitation reviews have focused mainly on the clinical...

ГЕНЕЗИС РОЗВИТКУ ПРАВОВОГО РЕГУЛЮВАННЯ У СФЕРІ ОХОРОНИ ЗДОРОВ’Я В УКРАЇНІ ЗА ЧАСИ НЕЗАЛЕЖНОСТІ

The article analyzes the genesis of the development of legal regulation in the field of health care in Ukraine in times of independence. Four stages of normative and legal base creation of system of medical care of the population as the leading link of the state social policy are considered. The first stage in 1991–2000 was the most difficult, on one hand it was necessary to preserve the health care system, that was left over from the old government, and on another hand - to start reforming the normative and legal framework to further ensuring of a minimum level of social guarantees for population on health care provision. At the second stage in the period 2000–2010 of the development of the health care system in Ukraine the implementation of the Concept started, activities were carried out to identify the main directions and approbation of key mechanisms for reforming of the medical sector. During the third period in 2010-2013, a large-scale reform of the health care system in some regions was launched as part of a pilot project. The fourth stage began in 2014 and continues till today. In August 2014 the Ministry of Health initiated the development of a National Strategy for Health Care Reform in Ukraine. By means of the new strategic approaches in improving of the quality and availability of aid and reducing financial risks for people a new impetus to industry reform was required. It is emphasized that the third and fourth stages, from the standpoint of reforming the medical system, were the most productive. It is emphasized that the provisions of the National Strategy for Health Care Reform in Ukraine are currently being implemented. The document has two main objectives: first of all to stimulate the proper reforms, but at the same time to demonstrate to the decision-makers that health and health care are powerful tools in politics. The strategy clarifies the horizon for reform, provides it with structures and demonstrates the potential of various measures aimed at the effective development of health care services. Based on the strategy, the Ministry of Health has also developed a Concept for reforming the financing of the health care system and bills that will launch a reform of Ukrainian medicine. The strategy should be the basis for creating a detailed action plan for reforming of Healthcare with proposals for the short, medium and long term perspective.

Can Patients Co-Create Value in an Online Healthcare Platform? An Examination of Value Co-Creation.

With the development of online healthcare services, patients could receive support and create value with other users on online healthcare platforms. However, little research has been conducted on the internal mechanisms of patient value co-creation from the perspective of online healthcare platforms. To analyze patient value co-creation in online healthcare platforms, this study explores the underlying mechanisms of patient value co-creation among patients. The results show that value co-creation includes patient citizenship behavior and participation behavior. Information quality, peer communication, and system quality influence functional experiences and emotional experiences. In addition, functional experiences and emotional experiences could influence patient value co-creation. This study clarifies the mechanism of value co-creation among patients and provides insight into value co-creation in online healthcare platforms.

Development of healthcare and social care services for the elderly population.

Background & aim: The percentage of older people has been growing in all economically developed countries over the past several decades. The purpose of this research was to optimize the healthcare and social care model based on the in-depth study of social, hygienic and clinical characteristics of elderlyindividuals. Materials & methods: The authors' study included individuals aged 65years and older. Results: The proportion of elderly and senile individuals increased from 15.3% in 2011 to 18.6% in 2020. The authors found that the existing healthcare system does not meet the needs of the aging population and thus developed a new organizational model for healthcare and social care services designed to integrate the activities of social welfare centers and local polyclinics. Conclusion: Implementation ofthe authors' model enables a range of healthcare and social care services and allows for management of a patient's health based on individual characteristics.