Management Of Health Care Services Research Articles

The impact of a disaster medicine clinical training program on medical students' disaster literacy.

This study was conducted to assess how students' disaster literacy was affected by the Disaster Medicine Clinical Training Program at the Izmir Democracy University Faculty of Medicine (IDUFM) during the academic year 2022-2023. Using an experimental method involving experimental and control groups, measurements were made at different times. The sample consisted of 5th-year students at IDUFM for the experimental group, while the control group was composed of 3rd- and 4th-year students from different buildings with limited interaction with the experimental group. The clinical training program was organized to improve the clinical practice skills of students in the field of disaster medicine and provide theoretical information. Throughout their internship, the students were provided with a program including information on types of disasters, preparation, response, relief, emergency surgical procedures, hospital disaster plans, national and international organizations and institutions working in disasters, and other relevant topics. The Disaster Literacy Scale (DLS) was used to collect data. This scale is a self-report scale that was developed to evaluate knowledge levels about disasters. In this study, the scale was applied as a pretest and a posttest, and the obtained data were analyzed using independent samples and paired-sample t-tests. The DLS scores of the experimental group showed significant improvement after the training program compared to their pretest scores (Total Scale: p<0.001, Damage Mitigation: p=0.002, Preparation: p<0.001, Response: p<0.001, and Relief: p=0.004). When comparing the posttest results of the experimental group with the control group, the experimental group demonstrated significantly higher scores in Total Scale (p=0.01), Damage Mitigation (p=0.02), Response (p=0.03), and Relief (p<0.001). However, no significant differences were observed between the experimental group's pretest (T1) scores and the control group's posttest (T3) scores (p>0.05p>0.05p>0.05), indicating that the knowledge levels of the experimental and control groups were homogeneous prior to the training intervention. These findings confirm the effectiveness of the Disaster Medicine Training Program in improving disaster literacy and response skills among medical students. This study, which aimed to determine the effects of the Disaster Medicine Clinical Training Program on the disaster literacy of medical students, revealed that the program increased the literacy levels of the students and contributed to their responsible decision-making. It is thought that such education programs can make significant contributions to the effective management of healthcare services in disaster situations.

Developing a framework for community childcare doctors to support community-based parental health education in preventing unintentional injuries among children aged below 6 years: a grounded theory exploration in eastern China

ObjectiveUnintentional injuries are a major threat to children’s health. Community-based health management services, which include the prevention of unintentional injuries among children aged 0–6 years, are important basic national public...

Social Return on Investment of Musculoskeletal Physiotherapy in the National Health Service.

Social return on investment (SROI) may present a method for demonstrating the social value of healthcare interventions. It has not previously been measured in musculoskeletal (MSK) physiotherapy but is being used in the procurement and performance management of healthcare services. The aim of the study was to measure SROI in one provider of MSK physiotherapy in the United Kingdom's National Health Service (NHS). A retrospective single arm online survey-based service evaluation was carried out to calculate the SROI of an NHS adult MSK physiotherapy service using the Housing Association's Charitable Trust Social Value Calculator. 237 respondents (35.6%) completed the survey and a mean SROI of £4.13 for every £1 invested was demonstrated. There were sub-group variations based on symptom location and discharge location. This is the first time SROI has been calculated in an MSK physiotherapy setting. This service evaluation raises new questions about the variations observed in subgroups and the applicability of this methodology in individuals with MSK conditions who receive physiotherapy. MSK physiotherapy is an intervention which offers a positive SROI across a range of MSK conditions and contributes towards improved wellbeing. This is the first study to use the HACT Social Value Calculator when evaluating a physiotherapy service and further research is required to validate the results.

Evaluate the Differential Effectiveness of the Case Management and Primary Nursing Models in the Implementation of Discharge Planning.

This study aims to compare the effectiveness of the case management model and the primary nursing care model by focusing on hospital stay length, readmission, follow-up resource utilisation and survival. To improve patient continuity of care, a discharge planning team has been established at the hospital to implement the service concept of long-term medical care. The team works with a multidisciplinary medical team to provide case management, which ensures high-quality patient care. Retrospective case-control study. This study collected data from the medical record information system database and the Ministry of Health and Welfare's care service management information system to explore medical and follow-up care utilisation of patients discharged between 2017 and 2018. This study followed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines, with the checklist used to ensure transparent and complete reporting of the methodology and results. To ensure comparability between the case management model group and the primary nursing model group, propensity score matching was used. After matching, 660 individuals from the case management model group and 2876 individuals from the primary nursing model group were selected for further analysis. In this study, patients were primarily involved in the research as participants, providing data through their medical records for analysis. However, no direct involvement from the public or patients was used in the planning or design stages of the research. The study found that factors such as activities of daily living (ADL) score ≤ 60 points, catheterisation, poor chronic disease control and inadequate primary caregiver capacity can lead to longer hospitalisations. Males and patients with catheters have a higher risk of readmission within 30 days, and men, those aged ≥ 75 years, those with ADL score ≤ 60, catheterisation, pressure sores or unclean wounds, financial problems, insufficient primary caregiver capacity and those readmitted within 14 days after discharge had significantly increased mortality after discharge. Although the case management model group had higher hospitalisation days, they had lower readmission rates and higher survival rates than the primary nursing model group. Early consultation with the case manager for discharge planning can help patients to continue to receive care and utilise relevant resources after returning home. Identifying and addressing patient-specific factors can significantly improve patient outcomes by reducing hospitalizations and readmissions, and lowering mortality rates. The case management model is more effective than the primary nursing care model in reducing readmission rates and increasing survival rates. Early consultation with case managers for discharge planning is crucial to ensuring patient care continuity and resource utilization.

Research Hotspots and Knowledge Framework of Digital Healthcare Service Management from the Perspective of the Silver Economy

Over the next three decades, it is anticipated that China’s aging population will propel steady growth in elderly healthcare and senior care technologies. With its broad consumer base, long industrial chain, and variety of needs, the silver economy will provide the digital healthcare sector with a lot of prospects and enhance the well-being of the elderly while also promoting the sustainable development of the socio-economic environment. Research on digital healthcare services for the elderly is gaining traction in the digital economy era, although thorough studies in this area are still very uncommon. Therefore, in order to investigate potential future trends in digital healthcare services from the perspective of the silver economy, this research uses the visualization tool CiteSpace6.3.R1 to perform descriptive statistics, clustering analysis, and co-occurrence analysis on 639 relevant papers. The findings indicate that although China’s research in this field began later than that of other nations, it offers distinct benefits and enormous potential. Due to the irreversibility of population aging, digital health management in the context of the silver economy is likely to become a focal point of future digital society research. Innovation in the field of digital healthcare is being driven by the proper integration of advanced digital technologies like artificial intelligence and big data. In conclusion, this paper develops a research paradigm for the administration of digital healthcare services from the standpoint of the silver economy. This study offers cutting-edge insights and theoretical references, giving academics insightful advice on current research trends and possible future approaches.

Visualizing Scholarly Trends in Electronic Health (eHealth) Business Models: A Bibliometric Analysis.

The integration of digital health technologies with innovative business models became a crucial driver in the transformation of healthcare service delivery and management worldwide. As the adoption of electronic health (eHealth) solutions grows, there is increasing scholarly interest in understanding and optimizing these models. This paper reviewed the literature on eHealth business models from 1991 to 2024 through a bibliometric analysis of 1,118 documents published across 711 sources. The analysis primarily focused on journal articles and conference papers, utilizing VOSviewer (Centre for Science and Technology Studies, Leiden University, NLD) and Biblioshiny (Bibliometrix, Naples, ITA) to explore emerging trends, influential authors, and prominent sources. The results revealed a significant rise in research output, especially post-2007, with a peak during the COVID-19 pandemic. Key emerging themes included telemedicine, digital health, and information management, with a strong emphasis on international collaborations, particularly among countries in Europe, North America, and Asia. This study provided valuable insights into the evolution of eHealth business models, highlighting the importance of international and multidisciplinary approaches in this rapidly evolving field.

A robust algorithm for authenticated health data access via blockchain and cloud computing.

In modern healthcare, providers increasingly use cloud services to store and share electronic medical records. However, traditional cloud hosting, which depends on intermediaries, poses risks to privacy and security, including inadequate control over access, data auditing, and tracking data origins. Additionally, current schemes face significant limitations such as scalability concerns, high computational overhead, practical implementation challenges, and issues with interoperability and data standardization. Unauthorized data access by cloud providers further exacerbates these concerns. Blockchain technology, known for its secure and decentralized nature, offers a solution by enabling secure data auditing in sharing systems. This research integrates blockchain into healthcare for efficient record management. We proposed a blockchain-based method for secure EHR management and integrated Ciphertext-Policy Attribute-Based Encryption (CP-ABE) for fine-grained access control. The proposed algorithm combines blockchain and smart contracts with a cloud-based healthcare Service Management System (SMS) to ensure secure and accessible EHRs. Smart contracts automate key management, encryption, and decryption processes, enhancing data security and integrity. The blockchain ledger authenticates data transactions, while the cloud provides scalability. The SMS manages access requests, enhancing resource allocation and response times. A dual authentication system confirms patient keys before granting data access, with failed attempts leading to access revocation and incident logging. Our analyses show that this algorithm significantly improves the security and efficiency of health data exchanges. By combining blockchain's decentralized structure with the cloud's scalability, this approach significantly improves EHR security protocols in modern healthcare setting.

ICT Effect on India's Healthcare Management Services Development

In today's healthcare services, information and communication technology is no longer only employed to automate procedures. Rather, Information Communication Technology is being utilized as a significant system for offering kinds of help to individuals. The execution of ICT in the clinical benefits region enjoys accomplished different benefits, such as enhanced revenue, effectiveness, efficacy, faster service, customer satisfaction, ease for customers, flexibility in operation, continuously operations, capacity money saved, and expense benefits. ICT has been used in the healthcare industry in many creative ways that have improved communication between physicians, patients, and other stakeholders. This can be accomplished by enlisting the aid of social entrepreneurs to help create a wealth opportunity. The researcher's goal in this study is to evaluate how widely ICT is being used in India's various health fields. It is additionally considered critical to identify and evaluate the technology in the medical services area to recommend appropriate proactive, protecting, and advancing methodologies that would improve the authenticity and viability of medical services offices in India

Factors affecting Implementation of Primary Health Care Services among Nurses in Level 3 Health Facilities in Kiambu County, Kenya

Primary health care is instrumental to delivery of quality basic health care services in communities. Its significance lies in ensuring that appropriate basic healthcare services are offered to all who need them competently, fairly and efficiently based on a people-centered approach. The study therefore sought to assess the factors affecting implementation of primary health care services among nurses in level 3 health facilities in Kiambu County, Kenya. This was an analytical cross-sectional study conducted among 141 nurses who worked in level 3 health facilities in Kiambu County and recruited using simple random sampling technique. They responded to a self-administered questionnaire. Data was probed descriptively with measures including proportions along with counts utilizing SPSS version 25.0. Relationships in study attributes were probed with chi-square test at 95% CI with outcomes shown in tables and figures. From the findings, majority (91.5%, n = 129) of the nurses rated the level of implementation of primary health care services in their work stations as sub-optimal. The factors found to strongly correlate with the poor implementation of the primary health care services were inadequate number of available healthcare personnel (p = 0.002); poor or low remuneration of health care providers (p = &lt; 0.000); poor supply of essential medicine/drugs (p = 0.011); unavailability of essential medical equipment (p = 0.000); poor planning of the PHC programs (p = 0.024); lack of or inadequate support to HCPs from the hospital management (p = 0.013) and significant underfunding of the primary health care services (p = 0.001). Efforts are therefore required on the part of relevant stakeholders in Kiambu County to address the various factors that impede effective delivery of primary health care services

ANDROID HEALTHCARE APPLICATION

The healthcare systems is pivotal in improving the accessibility and management of healthcare services. This paper focuses on the creation of a comprehensive appointment management system to streamline various healthcare interactions. Modern healthcare challenges such as scheduling appointments, ordering medications, and accessing health information necessitate an integrated approach. The proposed system includes modules for user registration, lab test management, medication management, doctor search and appointment booking, health education articles, order tracking, and user logout functionalities. Utilizing user-friendly interfaces and robust backend infrastructure, the system ensures secure user registration, easy browsing of lab tests and medications, efficient search for specialist doctors, convenient appointment booking, access to health articles, and order tracking. Key features include personalized user profiles, real-time appointment scheduling, and secure data storage using a SQLite database. Keywords: Healthcare management, Mobile Applications, Software Engineering

Reflections of nurses and primary healthcare managers on integrating hospital at home into public primary healthcare services: a Norwegian focus group study

Background Hospital at home (HaH) is an innovative approach to healthcare delivery that brings specialized services to patients’ homes. HaH services are typically available in urban areas where hospitals can easily reach nearby patients. An integrated care model that utilizes the public primary healthcare system may extend HaH services to include patients residing further away from hospitals. However, there is limited evidence of primary healthcare employees’ views on integrating HaH care into primary healthcare services. This study aimed to explore the reflections of primary healthcare employees on integrating HaH care into primary healthcare services. Methods Ten focus group interviews were conducted with homecare nurses and managers of primary healthcare services in five municipalities in Mid-Norway. Reflexive thematic analysis was used to analyze the data. Results The analysis resulted in three key themes regarding the integration of HaH care into primary healthcare. Participants discussed how they capture the distinctiveness of HaH care within the primary healthcare landscape. Moreover, they identified that the introduction of HaH care reveals opportunities to address challenges. Lastly, the study uncovered a strong primary healthcare commitment and a sense of professional pride among the participants. This resilience and dedication among primary healthcare employees appeared as an incentive to make the integration of HaH work. Conclusions This study offers valuable insights into integrating HaH into primary healthcare services, highlighting opportunities to address challenges. The resilience and dedication of primary healthcare employees underscore their commitment to adapting to and thriving with HaH care. To establish a sustainable HaH care model, it is important to address geographical limitations, consider the strain on providers, maintain robust relationships, enhance funding, and formalize decision-making processes.

Social health organizations: an analysis of the specialties and exams contracted by the State of São Paulo, Brazil.

Social Health Organizations (SHOs) are private entities that receive resources from governments for the management of public healthcare services. With the history of market interest in public health and the high volume of resources transferred to SHOs, one must question if the market logic continues to be inserted in this management model. The understanding of the dynamics of providing healthcare services to the population in the different contracts may help to understand how possible changes in the contracted services may have an influence. This is a descriptive-exploratory study using quantitative and qualitative approaches. Documental research was conducted through the collection of data from management contracts and amendments. The State of São Paulo was chosen because of its economic representativeness and for being the pioneer state in the implementation of SUS services managed by SHO. Medical specialties were included in 184 renegotiations (6.14%) and excluded in 187 (6.24%), whereas non-medical services were included in 26 renegotiations (2.97%) and excluded in 144 (16.44%). Regarding examinations, 101 renegotiations (18.07%) had their goals increased and 60 (10.73%) reduced, while 6 renegotiations (1.07%) included exams and 12 (2.14%) excluded them.

Organizações sociais de saúde: análise sobre as especialidades e exames contratados pelo Estado de São Paulo, Brasil

Abstract Social Health Organizations (SHOs) are private entities that receive resources from governments for the management of public healthcare services. With the history of market interest in public health and the high volume of resources transferred to SHOs, one must question if the market logic continues to be inserted in this management model. The understanding of the dynamics of providing healthcare services to the population in the different contracts may help to understand how possible changes in the contracted services may have an influence. This is a descriptive-exploratory study using quantitative and qualitative approaches. Documental research was conducted through the collection of data from management contracts and amendments. The State of São Paulo was chosen because of its economic representativeness and for being the pioneer state in the implementation of SUS services managed by SHO. Medical specialties were included in 184 renegotiations (6.14%) and excluded in 187 (6.24%), whereas non-medical services were included in 26 renegotiations (2.97%) and excluded in 144 (16.44%). Regarding examinations, 101 renegotiations (18.07%) had their goals increased and 60 (10.73%) reduced, while 6 renegotiations (1.07%) included exams and 12 (2.14%) excluded them.

Lessons for tomorrow: The role of relationships and mindfulness in sustaining services during a crisis.

The COVID-19 pandemic placed unprecedented demands on hospitals around the globe, making timely crisis response critical for organizational success. One mechanism that has played an effective role in health care service management during large-scale crises is the Hospital Incident Command System. The aim of this article was to understand the role of HICS in the management of a large academic medical center and its impact on relationships and communication among providers in the delivery of services during a crisis. This mixed methods study was based on meeting observations, document reviews, semistructured interviews, and two measures of team performance within an academic medical center in the Northeast during the COVID-19 pandemic. Descriptive and bivariate analyses were applied, and qualitative data were coded and analyzed for themes. HICS provided a systematic information-sharing and decision-making process that increased communication and coordination among team members. Analyses indicate a correlation between dimensions of relational coordination and organizational mindfulness. Qualitative data revealed the importance of shared meetings and huddles and the evolution of HICS across multiple waves of the crisis. HICS facilitated organizational improvements during the crisis response and generated opportunities to maintain specific coordination practices beyond the crisis. The prolonged implementation of HICS during the COVID-19 pandemic created challenges, including the disruption of the routine leadership structure. Applying relational coordination and organizational mindfulness frameworks may allow hospitals to leverage communications and relationships within a high-stakes environment to improve service delivery.

Impact of Privatization on Healthcare System: A Systematic Review.

A notable shift in healthcare policy is healthcare privatization, which refers to the transfer of ownership, management, or provision of healthcare services from the public sector to private entities. To provide a narrative examination of the impact of privatization on various dimensions of healthcare, including quality, equity, accessibility, and cost-effectiveness. Policymakers can utilize the findings of this study to make well-informed decisions regarding privatization strategies. A systematic review was implemented using the following databases: PubMed, Scopus, and Google Scholar. Studies conducted from January 2000 to January 2023 in developing or developed countries that assessed the impact of healthcare privatization on population health within public sector institutions were included. Eleven studies were included. The findings revealed diverse perspectives on the impact of healthcare privatization, with four studies (36.4%) supporting privatization (two of these were conducted in Saudi Arabia), six studies (54.5%) opposing it (three of these were conducted in European countries), and one study (9.1%) taking a neutral stance. Two studies investigated the impact on healthcare quality, and both revealed that privatization negatively impacts uninsured patients and low-income populations. In addition, five studies investigated the healthcare access and equity dimensions following privatization: one was in favor, one was neutral, and three were opposing it. Four studies investigated the cost-effectiveness dimension, with three in favor and one study opposing it. This review highlights different perspectives on healthcare privatization. While studies, as those from Saudi Arabia, suggest benefits in terms of efficiency and innovation, others, particularly from European countries, emphasize negative consequences such as inequity and reduced quality. This emphasizes the need for more investigations to understand privatization's impact on healthcare.

Use of Health Care Services and Its Associated Factors Among People With Type 2 Diabetes in Nepal.

This study aimed to assess the utilization of health care services and its associated factors among people with type 2 diabetes mellitus (T2DM) in Nepal. Data on the utilization of health care services were assessed in 481 adults aged 30 to 70 years with T2DM in Nepal. Multiple logistic regression analysis was performed to determine the factors associated with the utilization of health care services. Over 6 months, 66.1% of participants visited health care facilities or health service providers, followed by specialist visits (3.5%), hospitalization (2.1%), and emergency department visits (1.9%). Visit to health care facilities was significantly higher among those aged 50 to 59 years old (ORA: 1.64), practicing Hinduism (ORA: 2.4), and earning NRs ≥30 000 (≥USD 226.10) (ORA: 1.82) as compared to those aged ≥60 years old, practicing other religions, and with monthly family income NRs ≤10 000 (≤USD 75.37), respectively. The utilization of health care services among people with T2DM in Nepal was reasonably low. Identifying the underlying causes of low use of health care services is of great importance to bridge the gap in using health care services for management of diabetes.

Measuring and Managing Healthcare Supply and Demand in Real-Time.

Measuring the supply and demand for access to and wait-times for healthcare is key to managing healthcare services and allocating resources appropriately. Yet, few jurisdictions in distributed, socialized medicine settings have any way to do so. In this paper, we propose the requirements for a jurisdictional patient scheduling system that can measure key metrics, such as supply of and demand for regulated health care professional care, access to and wait times for care, real-time health system utilization and provide the data to compute patient journeys. The system is also capable of tracking new supply of providers and who does not have access to a primary care provider. Benefits, limitations and risks of the model are discussed.

Hubungan Bauran Pemasaran dengan Loyalitas Pasien: Literature Review

Introduction: This research explores the relationship between the marketing mix (7Ps) and patient loyalty in the context of healthcare, particularly in outpatient units of hospitals in Indonesia. A deep understanding of factors influencing patient loyalty provides valuable insights for healthcare service managers. Objective: The main objective of this study is to identify and analyze the relationship between marketing mix elements, including product, price, promotion, place, process, people, and physical evidence, with patient loyalty in the hospital environment. The research also aims to provide insights into key factors influencing patients' decisions to revisit healthcare services Method: Using a systematic review approach following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, the study conducted searches on Scopus and Google Scholar databases, considering articles published between 2018 and 2023. Twelve articles meeting inclusion criteria were identified and analyzed Result: Research findings indicate a positive correlation between specific elements of the marketing mix and patient loyalty, emphasizing their significance in influencing patients' decisions to reuse healthcare services. Key influencing factors include service performance, responsiveness, adherence to standard timelines, and advertising. Conclusion: The study confirms the importance of specific marketing mix elements in shaping patient loyalty in hospitals. Location, promotion, personnel, and physical evidence emerge as key elements for hospitals to focus on in enhancing patient loyalty. Practical recommendations are provided as guidance for hospital managers to improve these aspects and enhance the overall patient experience.

Digital Healthcare: Requirements for a Successful Transformation

Digital transformation of healthcare is the dominating discussion topic for all healthcare stakeholders. Digital transformation encompasses all areas of healthcare and is far more than digital healthcare applications (DiGA), digital care applications (DiPA), telemedicine applications, telematics infrastructure activities, and applications from the fields of eHealth, mHealth, or Telehealth. All existing care processes and structures in the healthcare system are undergoing an inventory in order to transfer analog components of care into a digital context. The digital transformation is not taking place exclusively in economic sectors such as healthcare, but is a process of change throughout society in the collection, use, provision, linking and evaluation of information (=data). For the healthcare sector, it is clear that different technical concepts are used, while digital healthcare takes place in different places and at different times, may include different user (groups) and retains, expands or changes the healthcare context. Established healthcare functions such as diagnostics, therapy, documentation and the management of healthcare services are retained and transferred to a digital context. In addition, new application areas will emerge, such as the overarching access to health data by different actors, real-time-driven monitoring systems of holistic health data, (clinical) decision systems, or the provision of data for health services. Even if the majority of the digital transformation has not yet taken place, it is assumed that these functions and application areas of healthcare will serve to sustainably improve the quality of care and benefit the well-being of all (future) patients. For the transfer of existing processes into a digital context and the establishment of new application areas, there are prerequisites for healthcare institutions and the healthcare system itself.

Clinical Leadership in Managing Healthcare Services - A Surgeon’s View Point

Clinical Leadership in Managing Healthcare Services - A Surgeon’s View Point