Service Planning Research Articles

Geospatial Assessment of Healthcare Accessibility and Equity in Qatar in Preparation for the 2022 FIFA World Cup

Accessibility to healthcare is one of the significant components of social determinants of public healthcare and is integral to societies’ overall well-being and economic prosperity. This study intends to assess changes in spatial distributions and accessibility of healthcare services within Qatar for 2010–2020, specifically concerning preparation for the 2022 FIFA World Cup. Assessment of the healthcare infrastructure is made using various techniques within a Geographic Information Systems (GIS) framework, like kernel density estimation, network analysis, and proximity analysis. The results show that access to healthcare has significantly improved, especially in urban centers such as Doha, besides a significant reduction in the length one travels to access healthcare facilities. However, despite improvements, many areas outside Doha still lag, requiring further investment in strategic planning. This study underscores how effective the health policies in Qatar and the Qatar National Master Plan (QNMP) have been in furthering principles of equity in access to healthcare services. The policy implications are that healthcare service planning should be integrated with urban development and transport networks for sustainable improvement in healthcare access. Thus, investment in infrastructure, strategic planning of locations, and addressing residual disparities are crucial for the long-term healthcare equity and system resilience of Qatar’s healthcare system.

Continuous Improvement in State Vocational Rehabilitation: A Demonstration and Call to Action

Background State Vocational Rehabilitation Agencies (SVRAs) are the leading provider of employment services for disabled adults in the United States, with achievement of competitive integrated employment as their main outcome. Objective Current data collection policies and practices require counselors to record extensive information for case documentation purposes, however, these data offer limited utility for service planning or for determinations of whether services are having the intended impact. Available data is not structured to support continuous improvement for individual providers or to establish evidence of best practices in day-to-day service provision. Method In this article, we present the many potential benefits of including pre-post assessment of services in measuring the impact of SVRA services. Results The Transition Readiness Toolkit offers a concrete example of the advantages associated with pre-post assessment and continuous use of data to guide services and quality improvement in SVRAs. Conclusion Recommendations and implications for implementing pre-post assessment for other SVRA services are provided.

Self-harm-related mental health presentations to emergency departments by children and young people from culturally and linguistically diverse groups in South Western Sydney.

Rates of self-harm among children and young people (CYP) have been on the rise, presenting major public health concerns in Australia and worldwide. However, there is a scarcity of evidence relating to self-harm among CYP from culturally and linguistically diverse (CALD) backgrounds. To analyse the relationship between self-harm-related mental health presentations of CYP to emergency departments and CALD status in South Western Sydney (SWS), Australia. We analysed electronic medical records of mental health-related emergency department presentations by CYP aged between 10 and up to 18 years in six public hospitals in the SWS region from January 2016 to March 2022. A multilevel logistic regression model was used on these data to assess the association between self-harm-related presentations and CALD status while adjusting for covariates and individual-level clustering. Self-harm accounted for 2457 (31.5%) of the 7789 mental health-related emergency department presentations by CYP; CYP from a CALD background accounted for only 8% (n = 198) of the self-harm-related presentations. CYP from the lowest two most socioeconomic disadvantaged areas made 63% (n = 1544) of the total self-harm-related presentations. Findings of the regression models showed that CYP from a CALD background (compared with those from non-CALD backgrounds) had 19% lower odds of self-harm (adjusted odds ratio 0.81, 95% CI 0.66-0.99). Findings of this study provide insights into the self-harm-related mental health presentations and other critical clinical features related to CYP from CALD backgrounds that could better inform health service planning and policy to manage self-harm presentations and mental health problems among CYP.

Health care costs and service utilization in the first year following moderate to severe traumatic injury.

Most of the previous studies on costs following trauma have focused solely on in-hospital costs and costs associated with the acute treatment and early rehabilitation. As a result, post-hospital costs are often neglected in the estimation of total costs. We aimed to describe service utilization and total costs for health care services, rehabilitation services, and social support in the periods 0-6 months and 7-12 months after moderate-to-severe traumatic injury. Further, we explored costs and their associations with sociodemographic, clinical and injury-related variables. Data were obtained from a prospective, 12 months follow-up study of patients in all ages with moderate-to-severe traumatic injury determined by a New Injury Severity Score (NISS) > 9, admitted directly or within 72h to the trauma referral centres in year 2020. Data on utilization of health care and rehabilitation services from the Norwegian Patient Register (NPR), the Municipal patient and user register (KPR), and the Norwegian Control and Payment of Health Reimbursements Database (KUHR) were used. A total of 601 patients were included, 24% with moderate and 76% with severe injuries. The overall mean total health care cost per patient in the first year after traumatic injury was 846,877 (SD 1,042,649) Norwegian Kroner (NOK). The mean total cost of rehabilitation per patient was 251,487 (SD 317,050) NOK. Most costs were attributable to secondary care in the first six months post-injury. Severely injured patients had a higher health care utilization and average cost compared to those with moderate injury. Injury severity factors were the most prominent cost drivers, and number of injuries, severe head, spine, and extremity injuries were significantly associated with higher costs during the first year following trauma. The findings give a holistic insight into health care utilization and costs for patients across all ages with complex needs following trauma and can contribute to the planning and provision of services for this patient group.

Route Planning for Flexible Bus Services in Regional Cities and Rural Areas: Combining User Preferences with Spatial Analysis

Route Planning for Flexible Bus Services in Regional Cities and Rural Areas: Combining User Preferences with Spatial Analysis

Patient and Public Involvement Work With Parents of Children With Life-Limiting Conditions and Bereaved Parents: A Rapid Systematic Review.

Guidance and principles for involving the public in research or service planning exist but are not specific to the needs of parents of children with life-limiting conditions or bereaved parents. Review the evidence on involving parents of children with life-limiting conditions and bereaved parents in research, service planning and advocacy, and use this to develop best practice guidance. Rapid review following the Cochrane Rapid Reviews Methods Group Guidance. MEDLINE and EMBASE were searched for primary studies of any design and literature/systematic reviews, and grey literature searching was conducted. Sources reporting on involving parents of children with life-limiting conditions or bereaved parents in healthcare, research, or charity work in any setting, were included. Data were charted using the UK standards for public involvement in research (PPI). Two PPI consultation workshops were conducted with parents (n = 13) and healthcare professionals/charity representatives (n = 7). Six sources were included. Four reported benefits of parental involvement and two reported burdens. In relation to best practice, two reported on the importance of inclusive opportunities, three on working together, four on support and learning, three on communications, one on impact, and one on governance. PPI consultation workshops highlighted new factors which were not present in the literature around communication and understanding the impact of involvement. Organisations working with this group should consider offering inclusive approaches to improve diversity, levelling power imbalances, ensuring flexibility of approach, and appropriate communication and impact. The study was conducted in collaboration with 13 parents of children with life-limiting conditions and bereaved parents, and seven palliative care professionals. The group were involved at key stages of the review and contributed to the development of the findings and conduct of the review.

Identification of Priority Supply Areas for Carbon Sinks Based on Ecosystem Service Flow: A Case Study for the Hexi Region in Northwestern China

The development and implementation of regional protection plans for ecosystem carbon storage services have been recognized as crucial actions for mitigating global climate change. However, the supply areas of carbon sequestration in terms of ecosystem service flows in inland regions are still less evaluated. The goal of this study is to identify the priority-ranked supply areas for carbon sinks. Here, we conducted a case study in the Hexi Region of northwestern China and proposed a framework to quantify the priority supply areas for carbon sinks from the perspective of ecosystem service flows. Firstly, we quantified the carbon service supply and demand areas by combining carbon models (i.e., the Carnegie–Ames–Stanford Approach model and soil respiration models) with socioeconomic and natural factors. Then, we introduced a breaking point formula to estimate ecosystem service flow, specifically focusing on distance or range. Finally, we determined priority supply areas for carbon sinks based on the Zonation model. The results showed that significantly higher carbon sequestration values were detected in the Qilian Mountains, ranging from 2.0 to 3.0 t hm−2, in comparison with desert oasis areas, where the supply values ranged from 0 to 0.01 t hm−2. The urban areas and rural settlements within the study area are characterized by higher values of carbon emissions compared to those in the Qilian Mountains and deserts. The carbon flow analysis demonstrated that the middle and northern parts of the study area, being characterized by lower precipitation and sandy landscapes, were identified as locations with low carbon sequestration fluxes (<1.0 t hm−2). In addition, the mountainous regions were identified as the main highest priority area for ecosystem carbon sequestration, covering 8.33% of total area of the Hexi Region. Our findings highlighted the importance of the Qilian Mountains in terms of sustaining carbon sequestration service supply in the Hexi Region and targeted ecological protection practices to be implemented going forward.

Mobility as a Service: insights from pilot studies across different Italian settings

Mobility as a Service (MaaS) has been tested in numerous cities and enables users to travel within an integrated system of collective and shared transport services, with a single travel package or bundle, giving them the ability to plan, book and pay for a trip using a unique technological platform. At this stage of the MaaS system experimentation, a detailed analysis on a small scale enables, through the understanding of the mechanisms governing travel choices, the planning of a MaaS service on a large scale that has the right flexibility to adapt to different territorial contexts. The paper reports the main findings of a study carried out as part of a national research project funded by the Italian Ministry of University and Research. Within this project, evaluation methodologies were developed (Technology Acceptance Model, Revealed Preferences and Intended Preference surveys), pilot surveys were conducted on samples of potential users, and the results were analysed and compared to assess the potential activation of a MaaS and to estimate its impacts on mobility.Two pilot experiments and an extended test, with a sample of almost 200 users, were carried out in different territorial contexts in Italy: the metropolitan areas of Reggio Calabria and Messina, the extra-urban area of Gioia Tauro and the urban area of the metropolitan city of Cagliari. The activities should be regarded as preliminary and indispensable stage for the design of more extensive investigations, as well as for the planning of a possible MaaS system in the areas examined.

Voluntary self-disclosed Indigenous identity of patients in four Canadian health care settings: A multiple-site qualitative case study.

The lack of Indigenous health care data in Canada makes it challenging to plan health care services and inform Indigenous leadership on the health care needs of their respective Nations and communities. Several Canadian health care organizations have implemented a voluntary Indigenous identifier of patients within their electronic medical records. This study examines facilitators and barriers to implementing such a voluntary self-reported Indigenous identifier, from the perspective of key stakeholders who work at four Canadian health providers where an Indigenous identifier has been implemented. The four Canadian sites comprise three hospitals and one health authority. At each site, key stakeholders participated in semi-structured qualitative interviews. Interviews were transcribed and coded. Relevant documents that were publicly available or provided by each site were reviewed. There were four primary findings. First, for the introduction of an Indigenous identifier to be successful there must be pre-existing strong and trusting relationships between Indigenous communities and health care organizations. Second, health care organizations must provide training for those who ask clientele to self-identify as Indigenous, to overcome issues such as any patient backlash. Third, for the relationship between Indigenous people and health organizations to flourish, data governance must be Indigenous-led. Finally, the collection of Indigenous identifier data can enhance Indigenous health care services and health care service planning and delivery. Due to the ongoing distrust of government and health care services among Indigenous peoples and communities, special considerations are required prior to the implementation of an Indigenous identifier. Of primary importance is how health care organizations can contribute to Indigenous data governance and minimize potential harms associated with the collection of such data. The findings of this study can be used to guide other health care sites and Indigenous leaders aspiring for more robust health data by implementing voluntary Indigenous identity data collection.

Incidence of avoidant/restrictive food intake disorder in children and adolescents across the UK and Ireland: a BPSU and CAPSS surveillance study

ObjectiveWe aimed to estimate the incidence of avoidant/restrictive food intake disorder (ARFID) in children and adolescents (CA) presenting to secondary care in the UK and Republic of Ireland (ROI).DesignThis observational...

Defining a good death: Perspectives of patients, relatives, and health care professionals in the Catalan context-A qualitative study.

Health systems often lack integrated, person-centered end-of-life care. Improving this care is a key priority for decision-makers in the Catalan context. This study aimed to understand how key stakeholders in the healthcare sector-patients, family members, and healthcare professionals-define the concept of a 'good death' and identify their key common elements in Catalonia, Spain. The research team conducted twenty-three semi-structured, in-depth qualitative interviews with patients receiving palliative care or suffering from complex or advanced chronic conditions, older adults over 65 with chronic illnesses, and their relatives. Three-focus discussion groups were also conducted which involved 31 professionals representing care, management, and planning at a local/regional level as well as representatives from patient and family associations involved in end-of-life care. All discussions and interviews followed a predefined guideline, and we recorded and transcribed them for later thematic content and discourse analysis. Overall, participants did not reach a single, universal definition of a 'good death.' Instead, it appears that a 'good death' involves dying in the way each person desires. In our effort to identify common elements, we found that participants consistently mentioned eight: comfort, placidity, safety, warmth, harmony, intimacy, respect, peacefulness and fulfilment. The study provides valuable insights for service planning and enhances the understanding of the needs of individuals at the end of life, including those with chronic conditions and their relatives, as well as the professionals who care for them and manage services or policies at the local and regional levels in Catalonia. The study highlights participants' preferences for their end-of-life care and their views on death, contributing to a broader understanding of what defines a 'good death.'

Assessment of prevalence and motivators for family planning utilisation among youth students in higher learning institutions in Dodoma, Tanzania: A cross sectional study.

Sub-Sahara Africa (SSA) has the greatest unmet need for family planning use, but young people are reported to under-utilise family planning services compared to other groups of women of the reproductive age in the region. Thus, promoting contraceptive services use among adolescents is vital in achieving universal access to sexual and reproductive health services. The main objective of this study was to assess the prevalence and motivators for family planning services utilization among youth students in higher learning institutions in Dodoma, Tanzania. An analytical cross-sectional study was conducted among 421 randomly selected youths in higher learning institutions in Dodoma. A self-administered structured questionnaire adopted from previous studies was used to collect data. Bivariate and multivariate logistic regression analysis using SPSS version 25 established association between variables. Statistical significance was declared at 95% confidence interval with α<0.05 and strength of association was reported by Odds Ratio (OR) and Adjusted Odds Ratio (AOR). Majority of the participants 221 (52.5%) were females, and most of them 320 (76.0%) were aged between 21 to 24 years. Of all participants, bachelor's degree scholar were 257 (61.0%). About 305, (72.4%) participants reported to have had sexual intercourse in the past 12 month. Of these 50.5% had their first intercourse at the age between 15 to 19 years. Most participants 239 (56.8%) reported to have used contraceptive method in the past 12 months. After adjusting for confounders (participants' socio-demographic characteristics), the motivators for family planning use among youth students were: living with relatives (AOR = 2.904, p 0.006), adequate FP knowledge (AOR = 2.230 p 0.003), positive perception (AOR = 1.772, p 0.025) and discussing FP matters with sexual partners (AOR = 6.045, p <0. 001). This study highlights a significant unmet need for family planning services among youth students in higher learning institutions in Dodoma, Tanzania, reflecting broader trends in Sub-Saharan Africa. Despite high sexual activity, family planning utilization remains suboptimal. Key motivators for using family planning services include living with relatives, having adequate knowledge, positive perceptions, and discussing family planning with sexual partners. These findings emphasize the need for targeted interventions focusing on education, fostering positive perceptions, and encouraging open partner discussions to enhance family planning utilization among adolescents, contributing to universal access to sexual and reproductive health services.

Effective Coverage of Modern Contraceptive Use in Ethiopia: An Ecological Linking Analysis of Service Provision Assessment and National Health Equity Surveys

The increase in contraceptive prevalence rate (crude coverage) in Ethiopia over the past two decades does not necessarily reflect service quality, and although the proportion of women with unmet needs has decreased, it remains unacceptably high. Hence, this study aimed to estimate the effective coverage (EC) of modern contraceptive methods in Ethiopia, considering the quality of care. We used nationally representative surveys, such as health facility surveys (Ethiopia Service Provision Assessment, 2021/22) and household surveys (National Health Equity Survey, 2022/2023). The descriptive analysis and ecological linking of the two surveys were used to assess the relationship between service quality and utilization among married/in union women in need of limiting or spacing children. In 2022, about 78% of health facilities in Ethiopia were ready to provide Family Planning (FP) services using modern contraceptive methods. Met FP need was 48%, with the quality of services assessed at 36%. After accounting for both service quality and readiness, Ethiopia’s effective coverage of family planning services using modern methods was estimated at 16%, with the highest coverage in the Sidama region (21%) and the lowest in the Somali region (2%). The EC of FP services in Ethiopia was low, largely attributed to the poor overall quality of the FP services provided. It is therefore important to ameliorate the quality of FP services in the country.

Breastfeeding support during the Covid-19 pandemic in England: analysis of a national survey.

Breastfeeding support interventions are associated with longer breastfeeding duration. Contemporary nationally representative data on breastfeeding support as reported by women in England is lacking. Using English national maternity survey data, we describe sources and modes of breastfeeding support as reported by women who gave birth in 2020; sources of support are compared with earlier maternity surveys (2014, 2016, 2018). We also explore the characteristics associated with source/mode of support in 2020 (n = 4,611). Women who breastfed were asked about sources of breastfeeding support (midwife; other health professional; other formal breastfeeding support such as breastfeeding specialist, breastfeeding support group, peer supporter; and partner/friend/relative), how this help was given and whether they would have liked more help from a health professional with breastfeeding. Adjusted risk ratios (aRR) for the association between sociodemographic and pregnancy-related variables and each source/mode of support were estimated using modified Poisson regression. From 2014 to 2020 support from midwives and other health professionals declined (from 84.0% to 64.7%, and 61.6% to 15.5% respectively) whereas other formal breastfeeding support and informal support from partners/friends/relatives remained constant at 27-31% and 34-38% respectively. The proportion of women who wanted more help with breastfeeding increased from 30% in 2014-2018 to 46% in 2020. In 2020, women most likely to want more help with breastfeeding were nulliparous (aRR = 1.64, 95%CI:1.50-1.79), younger (aRR = 1.21, 95%CI:1.03-1.42) and of Pakistani ethnicity (aRR = 1.30, 95%CI:1.06-1.60). Receiving breastfeeding support over the phone (35%) was more common than via video call (13%) or text message (5%); these percentages varied according to socio-demographic and pregnancy-related factors. Breastfeeding support has declined in recent years, and did not meet the needs of many women during the pandemic. Planning for a future emergency should include adequate provision of breastfeeding support particularly if staff are redeployed into other roles. The characteristics associated with support can inform service planning and delivery. Future research should use these factors to develop novel ideas for intervention, such as directly targeting partners or other informal networks with educational or psychosocial interventions.

Framework for collaborative local climate adaptation scenario development- nexus between climate resilience, public health service and spatial planning

Framework for collaborative local climate adaptation scenario development- nexus between climate resilience, public health service and spatial planning

A Roadmap of Noninstitutional Living Options for People with Dementia: "Don't Fence Me In".

Canadians overwhelmingly do not want to live in long-term care institutions (LTCIs) when they age; yet many end up there for lack of home care, because family care partners burn out, or because they and their professional advisors are unaware of alternatives to institutions. Not only is institutional dementia care riven with problems, it segregates disabled people, thereby abrogating human rights. Because systemic ageism and ableism cloud seniors' care, institutions remain the default option for Canadians with dementia. Yet, decades of deinstitutionalization enabled younger disabled Canadians to live in the community with supports. Why not seniors? We describe a plethora of noninstitutional dementia-care alternatives. We then present a roadmap for considering all relevant care options in service plans, one that incorporates supported decision making by people with dementia. We propose a paradigm shift in how Canada serves its senior citizens - not just the current generation, but those to come, including ourselves.

Examining the mental health trajectories of children and adolescents: a cross-cohort analysis.

Epidemiological samples provide opportunity to understand the development of mental health trajectories to better understand whether such epidemiological data can help to plan and modify service delivery for youth mental health. Variation between countries is not well understood and thus applying evidence from other countries to national strategies limits support service policy and planning. We therefore examine developmental patterns of youth mental health across different countries using the Growing Up in Ireland (GUI) Cohorts, with comparison to existing UK longitudinal cohort data (Millennium Cohort Study, MCS; Growing up in Scotland, GUS). Youth mental health problems within each cohort across development (5-17/18 years) were assessed using parent reported Strengths and Difficulties Questionnaire (SDQ) scores. Using latent growth curve analyses, we examined trajectories of emotional, conduct, and hyperactivity problems for boys and girls, separately for each cohort. Across cohorts, we observed similar developmental patterns for emotional, conduct, and hyperactivity problems. However, the GUI emotional problems in Ireland emerged earlier than in the UK. By adolescence, GUI emotional scores were similar to the UK, suggesting that the differences in emotional problems between the ROI and UK had narrowed by adolescence. Covariates also had different associations with youth mental health trajectories across cohorts. Utilizing multiple nationally representative cohort longitudinal datasets can help inform clinically meaningful conclusions and potential recommendations on population level multi-tiered service needs and development in the area of child and adolescent mental health support and future provision.

Revisiting factors influencing consumer travel for purchasing goods and experiencing services in Shanghai, China

This paper revisits the relationships among the perceived built environment, travel attitude, perceived value, and consumer travel in the particular era of the changing retail landscape amid advances in information technology. This study thus uses consistent partial least squares structural equation modelling (PLSc-SEM) to estimate the focal parameters on the basis of data from 30 commercial centres in Shanghai, China. Additionally, this inquiry uses multigroup analysis structural equation modelling (MGA-SEM) to evaluate the disparities between two types of consumer travel: purchasing goods and experiencing services. The results show that consumers’ perceived values and travel attitude significantly influence their travel and that these effects are even more apparent for experience services. In addition, the perceived built environment plays a partially positive role in consumer travel. Notably, however, accessibility cannot directly influence consumer travel and only indirectly influences travel attitude, whereas commercial attractiveness positively influences both of these factors. Accordingly, this study offers valuable insights, enabling urban planning, transportation, and commercial services to better address the evolving retail landscape and emerging consumer travel demands.

Health Promotion and Health Literacy in the Legal Foundations of the Austrian Healthcare System

Health reform sees health promotion (HP) and health literacy (HL) as essential cornerstones for achieving health policy goals. This article examines the extent to which the legal foundation in the Austrian healthcare system provides a basis for orientation towards HP and HL. The focus of the analysis was set on medical professions, the health care and nursing professions, hospitals, and primary health care facilities. In a first step, legal and other relevant documents were reviewed. For this, a literature-based coding grid was created. In a second step, the legal bases were analyzed and interpreted using the coding grid. Recommendations were derived from the analysis of the legal basis and experts' assessments. Health promotion and health literacy are included in the general legal foundations. However, HP/HL is primarily conceived as a supplementary service with separate financing and is thus less understood as an integral part of any patient contact. The primary health care units and the nursing professions have a relatively clear mandate with regard to HP/HL compared to the hospitals and medical professions. Overall, it was recognized that terminology should be used more coherently and operationalized for the respective areas of cure and care. In particular, the legal bases relating to the medical professions do not build on one another in a coherent manner. Having adequate staff is the key to HP/HL. If these are in place, competencies in the field of HP/HL should be required, promoted, evaluated, and rewarded. HP/HL should be an integral part of any care setting. The concepts of health promotion and health literacy should be operationalized in the legal frameworks of health professions and organizations. This is especially true for the Physicians' Act and for hospitals. Furthermore, the role of patients should be strengthened and the involvement of users in the planning of health services should be further developed.

The Impact of COVID-19 on Fertility Rates in China: An Empirical Analysis Using ARIMA Modeling

Abstract: This paper conducts an in-depth empirical analysis of the impact of COVID-19 on fertility rates in China using ARIMA modeling and forecasting techniques. The study reveals a significant and fundamental decline in birth rates throughout the pandemic, indicating that the long-term downward trend is more pronounced than ever. This unprecedented drop underscores the severity and uniqueness of the COVID-19 crisis's influence on reproductive behavior. The findings align with prior research on the global economic and health challenges' effects, but the scale and speed of changes during the pandemic remain unparalleled. These dynamics highlight the necessity to reassess and strengthen population management strategies and healthcare systems, particularly in reproductive health and family planning services. Despite utilizing a comprehensive dataset, limitations regarding data scope and sample size persist. Future research should broaden data scope and sample size, analyze regional differences, undertake long-term longitudinal studies, and incorporate multivariable analysis to better understand the pandemic's impact on fertility decisions.