Quantity Of Health Care Research Articles

Perceptions of nursing students regarding their Discipline at Kabul University of Medical Science in 2021

Abstract Background and Aim: Students' perspectives regarding their Discipline directly affect the quality and quantity of health care and ultimately the health of individuals and society. This study aimed to determine the perspective of Nursing Students at Kabul University of Medical Sciences “Abo Ali ibn Sina” about their Discipline. Methodology: A cross-sectional descriptive study was conducted among 249 nursing students at Kabul University of Medical Sciences “Abo Ali ibn Sina” by census sampling method. The data collection tool was the University of Minnesota Questionnaire based on the Likert scale. Data were coded and analyzed using Statistical Package for Social Science (SPSS25) software. Results: The mean and standard deviation of the student's perspectives regarding their Discipline were 15.85 ± 4.777 respectively, which was higher than the mean exam score. In total, 143 (57.4%) participants had positive perspectives regarding their Discipline, 78 (31.3%) had negative perspectives And 28 (11.2%) were neutral. According to the results of the Kruskal-Wallis test, Perceptions of Nursing students regarding their Discipline had a statistically significant difference between marital status (P=0.005), Accommodation type (P = 0.028), and classes (P=0.001). Conclusion: The mean score for the perspectives of the population under investigation toward their Discipline was higher than the acceptable level which demonstrates a desirable perspective toward their Discipline among the majority of students.

Does free hospitalization insurance change health care consumption of the poor? Short-term evidence from Pakistan

We analyze short-term effects of free hospitalization insurance for the poorest quintile of the population in the province of Khyber Pakhtunkhwa, Pakistan. First, we exploit that eligibility is based on an exogenous poverty score threshold and apply a regression discontinuity design. Second, we exploit imperfect rollout and compare insured and uninsured households using propensity score matching. With both methods we fail to detect significant effects on the incidence of hospitalization. Whereas the program did not meaningfully increase the quantity of health care consumed, insured households more often choose private hospitals, indicating a shift towards higher perceived quality of care.

Place-Based Drivers of Mortality: Evidence from Migration.

We estimate the effect of current location on elderly mortality by analyzing outcomes of movers in the Medicare population. We control for movers' origin locations as well as a rich vector of pre-move health measures. We also develop a novel strategy to adjust for remaining unobservables, using the correlation of residual mortality with movers' origins to gauge the importance of omitted variables. We estimate substantial effects of current location. Moving from a 10th to a 90th percentile location would increase life expectancy at age 65 by 1.1 years, and equalizing location effects would reduce cross-sectional variation in life expectancy by 15 percent. Places with favorable life expectancy effects tend to have higher quality and quantity of health care, less extreme climates, lower crime rates, and higher socioeconomic status.

A new challenge for midwives and medical doctors in time of the threat of a mass terrorist attack and a life threatening mass disaster

Purpose:To present the results of research and evaluation study of the legal regulations and rules directly linked and connected to midwives' scope of practice and provide a response on how the professional population of midwives can act as adequate and independent medical providers in the threat of a mass terrorist attack and/or a life-threatening mass disaster event. Materials and methods: The data derives from the Supreme Chamber of Nurses and Midwives in Poland; National Council of Nurses and Midwives in Poland; Gazette of the Republic of Poland, Journal of Laws; curriculum outlines for professional midwifery higher education in Poland; scientific literature, scientific recommendations. The qualitative research method to the data sources in 2018 were used. Results: In the event of a mass terrorist attack and/or a life-threatening mass disaster, the possibility of a pregnant, birthing or postpartum woman and her newborn obtaining proper medical attention from a midwife is questionable. Conclusions:The threat of terrorism in the European Union has grown. A new implications are necessary for policy and practice to keep midwives in their profession to provide adequate quality and quantity of health care in event of a mass terrorist attack and/or a life-threatening mass disaster. In our study we found: a terrorist threat as a gap in the teaching of obstetrics and midwifery; restricted availability of pharmacological agents for use by non-military midwives in event of a terrorist attack and/or a life-threatening mass disaster; lack of authorizations under a midwife license to perform PCD and /or PMCD.

Optimal Health Care Contract under Physician Agency

We model asymmetric information arising from physician agency and its effect on the design of payment and health care quantity. The physician aims to maximize a combination of physician profit and patient benefit. The degree of substitution between profit and patient benefit in the physician agency is the physician's private information, as is the patient's intrinsic valuation of treatment quantity. The equilibrium mechanism depends only on the physician agency parameter, and exhibits extensive pooling, with prescribed quantity and payment being insensitive to the agency characteristic or patient's actual benefit. The optimal mechanism is interpreted as managed care where strict approval protocols are placed on treatments.

Viewpoint:

It has been widely accepted and recommended that the needed improvements in the quality of health care require fundamental reforms in medical education. However, it is essential to recognize that there are significant problems not only with the quality but also with the quantity of health care in the United States. The medical profession has to confront the fundamental moral problem of unrealized rights and unattained justice in health care that has resulted in explicit harm to the health of a large portion of the population. Does this state of affairs have anything to do with the ways physicians have been educated about civic responsibilities, leadership, and professional integrity? What kind of education is to be provided for what kind of physicians and for what kind of medicine? Emphasis should be placed on the leadership role and on the underlying attitudes and values of physicians that reflect the morality of medicine. The doctor-patient and doctor-society relationships are part and parcel of the moral and professional responsibilities of physicians. Different moralities are involved when medicine is practiced as a job or business or vocation, because these entail different dispositions toward patients and society. The envisioned educational changes should challenge and prepare physicians not only with regard to their knowledge and skills but also with regard to their moral and professional integrity and leadership, so they may serve individuals and society in a health care system that ensures equal access to high-quality services for all.

Provider payments and patient charges as policy tools for cost-containment: How successful are they in high-income countries?

In this paper, we focus on those policy instruments with monetary incentives that are used to contain public health expenditure in high-income countries. First, a schematic view of the main cost-containment methods and the variables in the health system they intend to influence is presented. Two types of instruments to control the level and growth of public health expenditure are considered: (i) provider payment methods that influence the price and quantity of health care, and (ii) cost-containment measures that influence the behaviour of patients. Belonging to the first type of instruments, we have: fee-for-service, per diem payment, case payment, capitation, salaries and budgets. The second type of instruments consists of patient charges and reference price systems for pharmaceuticals. Secondly, we provide an overview of experience in high-income countries that use or have used these particular instruments. Finally, the paper assesses the overall potential of these instruments in cost-containment policies.

Competition and Containment in Health Care

In the United Kingdom and elsewhere, the preconditions for well-functioning internal markets (in relation to market structure, transaction costs, and information) may not exist in health care. Similar doubts exist about the impact of internal markets on cost-effectiveness. While the quantity of health care has increased, the effects on quality are ambiguous and costs have not been successfully restrained. With respect to equity of health care, fears have been raised that sections of the population may be discriminated against. In the United Kingdom, resources have been shifted away from deprived areas and toward the more affluent. Health care services are once again being reformed, by New Labour in the United Kingdom and similar administrations elsewhere. The rhetoric of competition has given way to talk of partnership. The imposition of new forms of rationing has been reshaped, not abandoned. Additional funding is required, along with an effective commitment to the pursuit of equity and quality in health care.

The health care needs of hospitalized patients with AIDS in Taiwan.

The purpose of this study was to investigate and highlight health care needs as perceived by hospitalized patients with AIDS (PWA) in Taiwan. Convenience sampling was used for this study. Subjects were chosen from one of the medical centers in metropolitan Taipei, Taiwan. Criteria for sampling were that subjects be diagnosed with AIDS, hospitalized without complications of neuropathy, psychosis, or dementia, 12 years old or older, and able to speak Mandarin. Sample size was determined by the saturation principle. Eight subjects were interviewed in depth using a semistructured interview guide. These interviews were tape recorded and transcribed. Content analysis was applied to analyze interview data. The double coding percentage agreement was 0.81, and the intercoder percentage agreement was 0.89. Results revealed the most important health care needs associated with these patients included obtaining information about AIDS, protecting privacy, improving the quality and quantity of health care, securing family members' safety and financial security, and accepting the grief process. These findings suggest that the needs of the PWAs must be identified before nursing care is provided. Furthermore, developing a health care need scale is recommended for patients with AIDS to more effectively assess their health care needs.

Health Against Wealth

Whether you are for or against managed care, this book is a must-read. George Anders, senior writer for the Wall Street Journal , has spent the last 4 years covering the health care marketplace. To write Health Against Wealth he took a year's sabbatical, researching the industry in depth and talking with every level of provider, payer, and consumer. The result is an outsider's critical, often provocative, but generally balanced view of managed care and managed care organizations. Although he still favors the philosophy of managed care, Anders acknowledges the inherent difficulties in balancing business performance promised to stockholders with quality and quantity of health care delivered to health maintenance organization (HMO) enrollees—especially as sicker and older people sign up with managed care plans. In the early part of the book, Anders outlines the economic and social pressures spurring the accelerated growth of the managed care revolution. He explains that the

Health Care Utilization and Outcomes Among Persons With Rheumatoid Arthritis in Fee-for-Service and Prepaid Group Practice Settings

To compare health care utilization and outcomes over an 11-year period among persons with rheumatoid arthritis (RA) in fee-for-service and prepaid group practice settings. Cohort of persons with RA followed up for as long as 11 years. The principal measures were obtained from an annual structured telephone interview conducted by a trained survey worker. Persons with RA presenting to a random sample of community rheumatologists in northern California. Patients were enrolled in 2 cycles: in 1982 and 1983 and in 1989. Study rheumatologists listed all persons meeting criteria for RA presenting to their offices over a 1-month period. Of the 1062 so listed, we enrolled 1025, or 96.5%. Of the 1025 persons with RA, 227 (22.2%) reported receiving care in prepaid group practice settings. As of the end of 1994, 5295 person-years of observation were available for the analysis of the annual level of the utilization and outcome measures; 341 persons had been followed up for all 11 years of the study. The main utilization outcomes measured included office visits, outpatient surgeries, hospital admissions, and painful joints. The persons with RA in fee-for-service and prepaid group practice settings did not differ in the quantity of health care used in any 1 year for either RA or non-RA reasons. Among those followed up for all 11 years, the persons in fee-for-service and prepaid group practice settings did not differ in the cumulative quantity of health care used over the entire period of study. The 2 groups did not differ on any outcome measure on either an annual or long-term basis. The results of mortality analyses were inconsistent: using Kaplan-Meier estimates, the persons with RA in prepaid group practice settings survived significantly longer (P<.05 by long-rank test); using Cox proportional hazards methods, the proportion dying each year did not differ signficantly. We could find no evidence that persons with RA in fee-for-service and prepaid group practice settings received different quantities of health care or experienced different outcomes on either an annual or long-term basis.

Price and quantity in international comparisons of health care expenditure

An important omission from earlier cross-national comparisons of health care expenditure has been the failure to distinguish between price and quantity. Using recent data on purchasing power parities, the purpose of this article is to report some preliminary results regarding health care expenditure and quantity across 22 OECD countries. The article concludes that, contrary to what has been suggested in some recent articles, the relative price of health care is not correlated to the aggregate per capita income. The fraction of the national income that is devoted to health care provision increases with the per capita income regardless of whether health care is measured in terms of expenditure or quantity. The relative price of health care has a rationing effect on the quantity of health care that is offered, with a price alasticity close to minus one. The latter finding means that the health care expenditure is not greater in countries with higherprices. Furthermore, the differences in health care expendit...

What Does Quality Health Care Cost?

Achieving the best health care delivery involves a tension between quality and quantity of health care and its cost. Usually the latter ‐ the cost ‐ is debated in terms of its insufficiency. In addition, however, the amount of revenue tied up in “failure costs” or the cost of poor quality can, in any hospital or community service, be appreciable. A model of quality costing to address these issues is outlined.

NHS indemnity for medical negligence: its implications

From 1 January 1990 medical and dental practitioners employed by health authorities were no longer required under the terms of their contracts to subscribe to a medical defence organisation. The health department, however, advised practitioners (DHSS circular) to “maintain their defence body membership in order to ensure they are covered for any work which does not fall within the scope of the indemnity scheme”. The expediency with which the scheme was introduced enabled little discussion on the consequences of such change and surprised medical practitioners and defence organisations alike. This major change in medical indemnity since 1954 will have long-term implications for practitioners, medical defence organisations, local health authorities and most importantly, the quality and quantity of health care which can be delivered. A meeting held on 9 April 1990 at Charter Nightingale Hospital was convened to discuss the implications of the NHS indemnity scheme between senior registrars in psychiatry and representatives from the Medical Defence Union, Medical Protection Society, British Medical Association and the local health authority.

The arms race and health care.

The probable medical consequences of nuclear war have attrac? ted much attention recently.1 2 Less well recognised are the economic effects of preparations for war, both nuclear and conventional, which have vital implications for the quality and quantity of health care both at home and throughout the world. The data presented here are mainly from the Western world, where such information is more freely available than behind the Iron Curtain. Official USSR figures for their military expendi? ture are certainly too low, but Western estimates of Russian expenditure on arms are equally certainly too high.3 4 There can be little doubt that the Russian economy, and hence standards of health care in the USSR and its satellites, is considerably damaged by its high level of military spending. Defence budgets are presented in such a way that it is difficult or impossible to estimate how military resources are divided between preparations for nuclear and conventional war,5 though figures of 20% for nuclear war for the super-powers and 10% for world military spending are usually quoted. Electronic equipment, delivery systems such as planes and missiles, and personnel can all be used for either nuclear or conventional war.

What is the monetary value of a human life?

The resources available to the health service are limited and so the amount the NHS can spend on saving human life is also limited. Rational allocation of resources requires a decision theory model, which in turn demands some monetary valuation of human life. Each of three approaches discussed--basing value on productive capacity, the NHS's implied values, or individuals' values--rests on an underlying set of non-monetary values. Choice of the underlying value will determine the method to be used in placing a monetary value on life. As the Health Service implicitly places certain values on life already, a means of making this valuation more rational and explicity can only improve the quality and quantity of health care.

PSRO: friend or foe?

I was among those who opposed PSRO (Professional Standards Review Organization) throughout the Congressional debate. I believed that the objective —effective professional review of the quality and quantity of health care within a context of public accountability — could be achieved more easily, for more patients, at less cost, and with less danger of political manipulation, by strengthening existing hospital-based peer review, extending it to noninstitutional services in the area, and making its accountability more explicit.This would mean fixing responsibility on the hospital professional staff and clarifying its accountability to the public via the board of trustees, in line . . .