Health Care Management Processes Research Articles

Determinants of Patient-Perceived Primary Healthcare Quality in Lithuania.

Patient-centered care is considered to be one of the essential pillars of a modern healthcare system. Thus, quality assessment based on patients' perceptions, views and experiences in their journey through the healthcare system is recognized as one of the key principles for quality improvement initiatives. Measuring patient satisfaction can be confounded by expectations and prior experiences, which can be at least partly overcome by evaluating patient-perceived healthcare quality (PPHQ). Understanding the principal constituents of PPHQ may aid healthcare professionals and decision makers in the healthcare management process and help in creating instruments to meaningfully measure patient feedback. Herein, we aimed to analyze the primary determinants of PPHQ and their interactions, with a focus on patient experiences and healthcare accessibility, using the example of Lithuanian primary healthcare. For this purpose, we conducted a cross-sectional representative telephone survey that included a total of 1033 respondents (48% male) who had encountered primary healthcare during last 3 years. Survey questions consisted of sociodemographic characteristics, patient perceptions of healthcare service provision, patient experiences, self-reported health status and overall PPHQ ranked with a 5-point Likert scale as the primary outcome. The classification-regression tree (CRT) technique was used to analyze the relationship between different explanatory variables and PPHQ, as well as their relative importance and interactions. The majority of respondents (89%) evaluated PPHQ as acceptable or good. CRT analysis identified staff behavior, organizational accessibility and financial accessibility as the most important factors affecting PPHQ. Importantly, the latter factors surpassed the effect of other known PPHQ determinants, such as sociodemographic characteristics or health status. Further analysis has revealed that the relative importance of staff behavior, including understanding, attention and empathy, increased when more problems with organizational accessibility were encountered. In conclusion, our study suggests that PPHQ in primary healthcare may primarily be determined by organizational and financial accessibility and staff behavior, which may also act as an important mediating factor.

A Blockchain Framework to Secure Personal Health Record (PHR) in IBM Cloud-Based Data Lake.

The health system in today's real world is significant but difficult and overcrowded. These hurdles can be diminished using improved health record management and blockchain technology. These technologies can handle medical data to provide security by monitoring and maintaining patient records. The processing of medical data and patient records is essential to analyze the earlier prescribed medicines and to understand the severity of diseases. Blockchain technology can improve the security, performance, and transparency of sharing the medical records of the current healthcare system. This paper proposed a novel framework for personal health record (PHR) management using IBM cloud data lake and blockchain platform for an effective healthcare management process. The problem in the blockchain-based healthcare management system can be minimized with the utilization of the proposed technique. Significantly, the traditional blockchain system usually decreases the latency. Therefore, the proposed technique focuses on improving latency and throughput. The result of the proposed system is calculated based on various matrices, such as F1 Score, Recall, and Confusion matrices. Therefore, the proposed work scored high accuracy and provided better results than existing techniques.

Mobile Health Technologies for Diabetes Mellitus: Current State and Future Challenges

The prevalence of diabetes is rising globally. Diabetes patients need continuous monitoring, and to achieve this objective, they have to be engaged in their healthcare management process. Mobile health (MH) is an information and communications technology trend to empower chronically ill patients in a smart environment. Discussing the current state of MH technologies is required in order to address their limitations. Existing review articles have evaluated the MH literature based on applicability and level of adoption by patients and healthcare providers. Most of these reviews asserted that MH apps and research have not reached a stable level yet. To the best of our knowledge, there is no clear description of solutions to these problems. In addition, no one has investigated and analyzed MH in its contextual environment in a detailed way. We conducted a comprehensive survey of MH research on diabetes management articles published between 2011 and September 27, 2017. In this survey, we discuss current challenges in MH, along with research gaps, opportunities, and trends. Our literature review searched three academic databases (ScienceDirect, IEEE Xplore, and SpringerLink). A total of 60 articles were analyzed, with 30% from ScienceDirect, 38% from IEEE Xplore, and 32% from SpringerLink. MH was analyzed in the context of the electronic health record (EHR) ecosystem. We consider dimensions such as clinical decision support systems, EHRs, cloud computing, semantic interoperability, wireless body area networks, and big data analytics. We propose specific metrics to analyze and evaluate MH from each of these dimensions. A comprehensive analysis of the literature from this viewpoint is valuable for both theoretical and developmental progress. This paper provides a critical analysis of challenges that have not been fully met and highlights directions for future research that could improve MH applicability.

Humanized care as a Public Policy. The peruvian case

Resumen Es una experiencia de trasferencia de conocimientos que posibilito fortalecer el proceso de implementacion de una politica publica de cuidado humanizado en la Region La Libertad-Peru en el periodo 2007-2014 cuyo objetivo radica en redimensionar las relaciones de poder entre Estado y Sociedad Civil respecto al cuidado de la vida y la libertad, conceptos que dan sentido y fines a una politica socio-sanitaria. La experiencia se baso en desarrollar e implementar un modelo de cuidado, iniciando por cuestionar el actual modelo de atencion con visas a proponer un modelo orientado a preservar la salud y desarrollo de ciudadania. Para ello se implementaron procesos de modelamiento de la prestacion socio-sanitaria, se modificaron estructuras y se re-inventaron los procesos de gestion sanitaria. Sin duda esta experiencia requiere ser evaluada, fortalecida y mejorar, siendo necesario determinar su efectividad, eficacia y valorar el impacto en la salud y en el desarrollo de la poblacion libertena para garantizar sostenibilidad e inversion por parte de la clase tecnico-politica.

Healthcare-associated infections – on developing effective control systems under a renewed healthcare management debate

PurposeThe development of control systems to sustain the level of healthcare-associated infections (HAIs) is an emerging issue for healthcare management. This is partly due to the perception that HAI became a serious negative impact factor on the performance of healthcare organizations and on related public health dimensions. Throughout the decade of 1990 a significant number of international programmes were developed to understand and to promote effective HAIs prevention and control systems: Patient Safety and the quality improvement of healthcare organizations became common concepts in healthcare management. However, regardless of advances in infection control systems, the rates of incidence of HAIs remained relatively unchanged in the last decades. The purpose of this study is to point out barriers that recent international literature has identified as factors hindering the successful development of control systems to prevent HAIs. The international debate on possible alternatives to strengthen this common healthcare management issue, benefits form one such update.MethodsA literature review was conducted in a 3-month period by two investigators. The BioMed Central, Pubmed, Emerald, and B-on databases were searched for articles published between January 2006 and September 2011. A standard form was created for data extraction.FindingsA total of 49 articles met inclusion criteria. Within the analysed articles, 26 were developed in Europe, 15 were developed in North America; 6 were developed in Asia, and 2 in Australia. Thirty (30) different barriers to effective HAIs control systems were identified. The barriers were clustered by dimensions and sub-dimensions. The largest number of barriers clustered, are associated with structures and processes and also barriers associated with healthcare management processes.

Infrastructure for a clinical-decision-intelligence system

Clinical decision intelligence (CDI) is an emerging area in health care, covering a broad range of subjects, from clinical data integration and data analysis to knowledge management and application development. The goal of CDI systems is to improve health-care quality and reduce costs through the discovery, management, and application of clinical intelligence from heterogeneous and rapidly expanding data sources. These sources include data from clinical practice, nursing, health-care management, health-care administration, and medical research. In this paper, we discuss the functional requirements and reference architecture for CDI systems and their clinical applications. This architecture includes an integrated framework for managing the entire CDI process, a standardized enterprise ontology management system, and a clinical knowledge representation platform. The CDI approach has the potential to transform the health-care management process through the integration of business intelligence, business rule management, and business process management in a clinical setting, and to help health-care organizations move closer to an on demand model.

A Statistical Control Model for Utilization Management Programs

A new approach is proposed for monitoring health-care costs to help in cost containment efforts. This informative essay is intended to provide information on and stimulate discussion of ways of improving the health-care management process. Data that are being collected by insurers and providers could be used to analyze and improve the health-care process. New statistical techniques, and better, more consistent input of data, will be critical to successful utilization management programs. Necessary conditions for the success of the new methods are (1) diagnosis protocols that are “true gold standards,” (2) a satisfactory disease classification system, (3) meaningful and consistently coded data, and (4) statistical methodology that takes advantage of as much of the available data as possible. The hospital admissions process is illustrated to show the incorporation of an inexpensive statistical control process for reducing the incidence of unnecessary hospitalizations.

Business planning in Hong Kong hospitals: the emergence of a seamless health care management process.

This paper examines the progress made by public hospitals in Hong Kong in implementing a business planning approach. A review of available literature suggests two main exploratory themes. The first establishes the key features of business planning in the private sector. The second theme discusses the problems of adapting this approach to the distinctive requirements of the public sector. The literature also suggests three dimensions for evaluating planning: incremental-developmental; reactive-proactive; ends-means. Qualitative data were collected by scrutinizing relevant organizational documentation and by discussions with focus groups formed by participants in the planning process. The data were analyzed against eight key elements of a business plan identified from the literature and from panels of business experts. These elements were found to be present in the Hospital Authority's plans but were less evident in hospital level plans. Because of the unitary nature of hospital organization in Hong Kong, it has been difficult for hospitals to break out of a reactive, incremental and ends-based pattern to a more imaginative identification of the distinctive business and market that they may be in. This is, however, changing rapidly and it is clear that there is in place a robust and 'seamless' health care management process.