Provision Of Health Care Services Research Articles

Investigation toward the economic feasibility of personalized medicine for healthcare service providers: the case of bladder cancer

Investigation toward the economic feasibility of personalized medicine for healthcare service providers: the case of bladder cancer

The role of health insurance in developing the health sector in Iraq

Ignoring easily accessible information, facts, and expertise is a contributing factor in numerous problems in the healthcare system that lead to poor-quality healthcare services. It makes no sense to manage healthcare systems without the required data since doing so would prohibit the provision of high-quality medical care. An updated description of the Iraqi healthcare system is what this essay seeks to do. On the Iraqi healthcare system, we identified and assessed both published and unpublished data. Within the informational materials, both published and unpublished, are books, journal articles, and official reports and records of the Iraqi Ministry of Health. Also examined was the useful data that can be discovered on websites. The data that were retrieved were all related to healthcare, including information on the organisational structure of the healthcare system, information on national healthcare policies, including the purpose, objective, and beneficial goals, information on the financing of the healthcare system, information on the provision of healthcare services, information on the workforce in the Iraqi healthcare system, information on the health of mothers and kids they have, as well as details on the state of the healthcare system in Iraq.

Complete Blood Count Reference Intervals for Children Aged Less Than 1 to 12 Years in the Northern Region of Ghana

Reliable laboratory diagnostic results are key for evaluating and improving children’s health. To interpret these results, child-specific reference intervals (RIs), which account for constant biological changes and physiological development with sex and age, are required, as recommended by the Clinical and Laboratory Standards Institute (CLSI). This study presents age- and sex-specific reference intervals for complete blood count (CBC) parameters in children (<1–12 years old) in the Northern Region of Ghana. In this cross-sectional study, 600 healthy children from randomly sampled schools in Tamale (the Northern Region) were recruited and screened. Data from 388 eligible children were used to nonparametrically determine the reference intervals of CBC parameters at the 2.5th and 97.5th percentiles. The CBC reference intervals were compared for variations in sex and age groups using the Wilcoxon rank-sum test. There were no statistically significant differences in most CBC parameters by sex (RBC, Hb, HCT, MCH, RDW (CV/SD), WBC, LYM#, MON#(%) NEU#(%), EOS#(%), and BAS#(%); p>0.05) and age group (RBC, MCV, RDW (CV/SD), WBC, LYM#, MON#(%) NEU#(%), EOS#(%), and BAS%; p>0.05). However, there were observable differences between this locally established CBC reference interval and that used for children at Tamale Teaching Hospital (manufacturer’s RIs). This study emphasises the importance of determining reference intervals representative of the local child population and incorporating them into the current reporting system of laboratories in the Northern Region to ensure the provision of effective and efficient healthcare services.

Electronic prescription systems in Greece: a large-scale survey of healthcare professionals’ perceptions

BackgroundThe national e-prescription system in Greece is one of the most important achievements in the e-health sector. Healthcare professionals’ feedback is essential to ensure the introduced system tends to their needs and reduces their everyday workload. The number of surveys collecting the users’ views is limited, while the existing studies include only a small number of participants.MethodsIn this study, healthcare professionals’ perceptions on e-prescription are explored. For this, a questionnaire was distributed online, containing closed- and open-ended questions aiming to address strengths and identify drawbacks in e-prescription. Answers were collected from primary health care physicians, specialized medical doctors and pharmacists.ResultsIn total, 430 answers were collected (129 from primary health care physicians, 164 responses from specialized medical doctors and 137 pharmacists). Analysis of the collected answers reveals that the views of the three groups of healthcare professionals mostly converge. The positive impact e-prescribing systems have on the overall prescribing procedure in preventing errors and providing automation is commented. Among gaps identified and proposed improvements, health care professionals note the need for access to information on adverse drug reactions, side effects, drug-to-drug interactions and allergies. Flexible interaction with Therapeutic Prescription Protocols is desired to ameliorate monitoring and decision-making, while drug dosing features, and simplified procedures for copying, repeating, canceling a prescription, are perceived as useful to incorporate.ConclusionsCollecting healthcare professionals’ feedback is important, as their views can be transcribed to system requirements, to further promote e-prescribing and improve the provided health care services by facilitating decision making through safer and more efficient e-prescription. Introduction of the identified improvements can simplify the everyday workflow of healthcare professionals. To the best of our knowledge, a survey with more than 400 answered questionnaires on the use of e-prescription systems by healthcare professionals has never been conducted in Greece before.

Overlooked by the obstetric gaze – how women with persistent health problems due to severe perineal trauma experience encounters with healthcare services: a qualitative study

BackgroundDuring the first year postpartum, about 25 per cent of Swedish women with severe perineal trauma (SPT), i.e., a third- or fourth-degree perineal laceration at childbirth, are unsatisfied with their healthcare contacts. Further, there is a lack of research on the more long-term experiences of healthcare encounters among women with persistent SPT-related health problems. This study explores how women with self-reported persistent SPT-related health problems experience their contact with healthcare services 18 months to five years after childbirth when the SPT occurred.MethodsIn this descriptive qualitative study, a purposive sample of twelve women with self-reported persistent health problems after SPT were individually interviewed from November 2020 – February 2022. The data was analysed using inductive qualitative content analysis.ResultsOur results showed a paradoxical situation for women with persistent health problems due to SPT. They struggled with their traumatised body, but healthcare professionals rejected their health problems as postpartum normalities. This paradox highlighted the women’s difficulties in accessing postpartum healthcare, rehabilitation, and sick leave, which left them with neglected healthcare needs, diminished emotional well-being, and loss of financial and social status. Our results indicated that these health problems did not diminish over time. Consequently, the women had to search relentlessly for a ‘key person’ in healthcare who acknowledged their persistent problems as legitimate to access needed care, rehabilitation, and sick leave, thus feeling empowered.ConclusionsOur study revealed that women with persistent SPT-related health problems experienced complex health challenges. Additionally, their needs for medical care, rehabilitation, and sick leave were largely neglected. Thus, the study highlights an inequitable provision of SPT-related healthcare services in Sweden, including regional disparities in access to care. Hence, the authors suggest that Swedish national guidelines for SPT-related care need to be developed and implemented, applying a woman-centered approach, to ensure equitable, effective, and accessible healthcare.

Reporting on Health Care and Social Service Provider Approaches to Promoting Alcohol Abstinence During Pregnancy

ABSTRACT Despite the known detrimental health effects of alcohol use during pregnancy, there are still health care (HCP) and social service providers (SSP) who do not promote complete abstinence. The purpose of this study was to explore the current practices of HCPs and SSPs when discussing alcohol use during pregnancy, and to understand their rationale for their specific recommendations. An online survey was completed by 1123 HCPs (n = 588) and SSPs (n = 535) that asked them to identify their approach to discussing alcohol and pregnancy. Participants had the option to further explain their current recommendations regarding alcohol use during pregnancy in an open-ended format. Open-ended responses were analyzed using a content analysis approach (n = 156). The majority of respondents recommend abstinence (83.9% of HCPs, n = 493; 78.4% of SSPs, n = 419), while 9.8% of HCPs (n = 57) and 2.2% of SSPs (n = 12) responded that low levels of consumption may be acceptable. HCPs may recommend low levels of consumption based on other international guidelines, limited evidence to suggest that one unit of alcohol is harmful, and as a harm reduction strategy. SSPs stated that they refer clients to HCPs for recommendations related to alcohol consumption, and that they prefer to provide information based on public health guidelines. This exploratory work may inform the development of resources to support HCPs and SSPs to recommend abstinence from alcohol throughout gestation.

Certificate‐of‐Need laws in healthcare: A comprehensive review of the literature

AbstractCertificate‐of‐Need (CON) laws limit the supply of healthcare services in about two‐thirds of U.S. states. The regulations require those who wish to open or expand their facilities to first prove that their services are needed. Once encouraged by the federal government, Congress eliminated the inducement in the 1980s and since then several states have either pared their CON programs back or eliminated them altogether. To date, there have been 128 academic assessments of CON laws and together these papers contain over 450 tests. In this paper, I review this literature, organizing the results around the most common rationales for CON laws. The accumulated evidence is overwhelming that CON laws do not achieve their purpose. Instead, the balance of evidence suggests that these regulations increase spending, reduce access to care, undermine quality, and fail to ensure care for underserved populations.

COVID-19 Pandemic and Its Global Impact on the Accessibility and Provision of Maternal and Child Health Care Services.

COVID-19 Pandemic and Its Global Impact on the Accessibility and Provision of Maternal and Child Health Care Services.

Infection prevention and control compliance during COVID-19 pandemic era: assessment of 26 regional referral hospitals in Tanzania

BackgroundInfection prevention and control (IPC) implementation at referral hospitals (RHs) in Tanzania is still inadequate, regardless of ongoing IPC capacity-building initiatives. This continues to challenge the quality of healthcare service provision as poor IPC implementation fuels healthcare-associated infections (HAIs) and antimicrobial resistance (AMR) problems. The study aimed to describe the implementation of IPC practices in 26 Regional RHs’ functional units in 2021.MethodsThe study involved secondary data from an assessment conducted using the National IPC Standard checklist for hospitals to all functional units at 26 regional RHs in 2021. Data were analysed in STATA version 15.0 to compute the weighted median with interquartile range (IQR) for each functional unit score.ResultsThe overall weighted median IPC compliance with 26 regional RHs in 2021 was 50 (41–60), whereby the lowest and highest scores were 24 and 72%, respectively. The highest-performing unit was the intensive care unit (ICU) for adults 71.4% (46.4–78.6), and lowest performing functional units were the mortuary, Central Sterilization and Supply Department, and blood transfusion [47.4% (36.8–57.9), 47.4% (40–50), and 47.6% (38.1–61.9)], respectively.ConclusionImplementation of IPC practices in 26 RHs in Tanzania is inadequate. We recommend that RHs need to strengthen IPC practices implementation in each functional unit in order to reach the required target of at least 80% score. This will enhance the reduction of the burden of HAIs and AMR, and increase the energy and morale of healthcare workers in preparedness and response to emerging and remerging diseases.

Examining the Factors Influencing Teleconsultation Adoption During the Pandemic Using the TAM Model

Purpose: The purpose of this study is to understand patients' behavior in adopting teleconsultation services during the pandemic which has accelerated technology adoption in various sectors and regions in unnatural ways through experimentation in the wide-spread adoption of telemedicine specifically in teleconsultation. Design/methodology/approach: The study is cross-sectional quantitative research with purposive sampling that was analyzed using the partial least squares structural equation model (PLS-SEM) with data gathered from 100 patients who used tele-consultation services during the pandemic. The technology adoption model (TAM) was used to frame the phenomenon as previous study revealed that TAM is most suitable to understand technology adoption in the healthcare industry. Findings: The analysis revealed that trust, ease of use, and privacy are significant latent variables that influence the intention and actual use of the tele-consultation services, while the usefulness of the services insignificantly influences the intention to use. The study revealed that trust is the dominant factor despite the emergency and experimentation state of patients to get healthcare services during the pandemic. Self-preservation, and the patients accumulated experience they had with the healthcare services provider are the determinants of this behavior based on theory and confirmative interview. Research limitations/implications: The implication of this research opens interdisciplinary future research and practical action on the relationship between healthcare provider, patient experience, self-preservation, and technology adoption during the emergency and pandemic era. Research Limitation: Early system usage and adopter focused, limited system quality and reliability, and generalization are the limitation of this research. Originality/value: The study provides insight into factors that influence the adoption and usage of tele-consultation experimentation health services during a pandemic.

Pharmaceutical sector: Packaging requirement in serialization

Access to healthcare is a fundamental right for every individual, and it is the responsibility of governments to ensure the provision of quality healthcare services and infrastructure to their citizens. Over the past few decades, both governments and the healthcare industry have been grappling with the challenge of minimizing the adverse effects on public health caused by counterfeit medicines. According to the World Health Organization, approximately four out of ten medicines in developing and impoverished countries are either fake or potentially adulterated, leading to significant economic losses and reducing funds allocated for research and development (R&D) by organizations. Preventing counterfeit medicines from entering the supply chain poses a significant challenge for governments and regulatory authorities. Consequently, there is a concerted effort to establish stringent guidelines aimed at thwarting criminals and counterfeiters from infiltrating markets with fake medications. The healthcare industry recognizes the necessity for strict regulations and secure technologies to ensure the provision of safe and authentic drugs to patients. In the United States, the FDA has outlined a ten-year roadmap to implement drug traceability measures. Additionally, the Healthcare Distribution Alliance (HDA) has mandated the inclusion of multiple barcodes and human-readable data in product packaging hierarchy. Furthermore, the FDA is actively engaged in a pilot project with leading pharmaceutical manufacturers and wholesalers to explore the utilization of blockchain technology within an interoperable digital network for securing the transfer of digital traceability data among authorized trading partners.

Conflict Dynamics in Indian Healthcare: An Exploratory Study on Primers of Conflict in Private Clinical Establishments of Kolkata

Healthcare conflicts are complicated and often dysfunctional in nature. The Indian healthcare system, with its thinning workforce, finds it increasingly difficult to meet the demands and expectations of its healthcare service recipients. Healthcare service providers like physicians, nurses, technical and administrative personnel work in a dynamic and stressful environment with resource and manpower limitations. Healthcare service recipients like patients and their families often face challenges regarding access to care, associated costs, time issues and other situational dynamics. These underlying situations often result in different types of conflicts in the workplace. The purpose of this exploratory study is to understand the factors that serve as primers for healthcare conflicts in the Indian scenario. Data were collected from hospital feedback forms for patients/patient families. The top 10 threads indicating the patient satisfaction factors and conflicting grounds were identified through content analysis, and that formed the basis of the semi-structured questionnaire schedules. Fifty semi-structured interviews were done with healthcare service recipients and healthcare service providers (25 in each set) in private clinical establishments of Kolkata, West Bengal. Four main themes and nine subthemes were identified that illustrated the grounds for healthcare conflicts in Indian settings. The identification of the causes of dissatisfaction and understanding their relationship with healthcare conflicts will go a long way in conflict management.

Country image and medical tourist’s trust impact on intention to revisit India

Purpose This study aims to investigate the influence of cognitive and affective trust on the revisit intention of medical tourists to a developing country like India, focusing on the role of country image as a moderator. Design/methodology/approach This study used partial least square-based structural equation modelling to test the hypotheses using data from 297 medical tourists visiting India from abroad for treatment. Findings The findings of this study confirmed that all the dimensions of cognitive trust, namely, perceived expertise, performance and reputation of the health-care service providers, have a positive and significant impact on the revisit intention of medical tourists to India. In contrast, none of the two dimensions of affective trust have a significant effect on the revisit intention of medical tourists to India. This study also confirmed that country image significantly moderates the relationship between performance dimensions of cognitive trust and medical tourists’ revisit intention to India. Originality/value The study’s findings have significant theoretical and managerial implications as they explore the effect of cognitive and affective trust on medical tourists’ the revisit intention to visit an emerging economy, considering the country’s image as a moderator.

Effects of banditry on primary health care delivery in north-western Nigeria

This study investigated the effects of banditry on primary health care delivery in north-western Nigeria. Banditry has emerged as a critical concern in recent years in the region, affecting many sectors including healthcare systems. We examined how the escalating violence and insecurity have disrupted the provision of essential health services, leading to a range of adverse consequences, including the displacement of healthcare workers, the closure of health facilities, and the hindrance of medical supply chains in north-western Nigeria. The secondary sources of data reviewed show the detrimental effects of banditry on healthcare delivery in north-western Nigeria, particularly in rural communities. These effects included instilling fear among health workers, of which there are already insufficient numbers, hence forcing them away from healthcare centres and contributing to a malnutrition crisis. Thus, it is recommended that there should be robust security measures to safeguard healthcare facilities and workers, community outreach programs to educate local populations, telemedicine services and mobile clinics to provide healthcare services in areas with limited access due to security concerns, training of healthcare workers in conflict-prone areas in emergency response and conflict resolution to deal with security threats effectively, and collaboration with local non-governmental organisations (NGOs), community leaders, and traditional healers to bridge gaps in healthcare delivery.

Assessment of the global healthcare industry during COVID-19 pandemic: A content analysis approach

Background Content analysis (CA) is an investigative research tool used in healthcare studies to identify imminent challenges while providing lead time for preparedness measures. The objective of this study is to report on the challenges confronting the global healthcare industry. Methods This study used the conventional CA “bottom-up” approach to a quantitative data. CA is a research technique that uses the qualitative research method and word counts to evaluate communication outcomes. A group of executive master’s in business administration (EMBA) and medical students championed the study. Using 13 periodicals as the data sources, researchers conducted online keyword searches for all articles, titles, and abstracts containing the word “healthcare”. The collected data was gathered from five international, four Middle Eastern, and four Lebanese periodicals from January 1, 2021 to December 31, 2021. Results CA results indicate remarkable domination of keywords “COVID-19 health impact” as a major worldwide theme. Significant differences were noticeable among subcategories but remained related to COVID-19 in particular, social responsibilities, and research and development. Topics such as comorbid illnesses, social responsibility, healthcare logistics, and the well-being of healthcare service providers were among the least covered topics. Conclusion Our findings emphasize the importance of global media and their coverage of healthcare issues on the types of healthcare topics (e.g., vaccines, drugs…) covered in the Lebanese periodicals in our study. Thus, global healthcare media are the main source for Lebanese periodicals reporting healthcare issues rather than the Lebanese healthcare authorities. Therefore, there is need for the development of a more efficient technology-driven healthcare management system. At the global level, there is a need to develop a step-by-step action-oriented strategic initiative to respond to emerging pandemics.

Factors Influencing the impact of nurse practitioners' clinical autonomy: a self determining perspective.

To explore factors that influence the impact of nurse practitioners' clinical autonomy with a self-determining perspective. Worldwide, there is a significant demand for healthcare professionals such as the nurse practitioner in meeting some healthcare needs across patients' lifespans. Factors influencing nurse practitioners clinical autonomy can impact the full utilisation of the role in practice. Limited evidence exists that describes or researches nurse practitioner clinical autonomy. Instead, there is a focus in the literature on strategic debates, role confusion and nurse practitioners reporting the straddling between nursing, allied heath professionals and medicine in the provision of healthcare services. A cross-sectional study design was used in a purposive sample in a national sample of nurse practitioners in Ireland across a full range of healthcare settings. Additionally, the survey included open comments sections to capture qualitative comments by the nurse practitioners themselves. Self-determination theory is rooted in an organismic dialectical stance. This study used a convenience sample of n = 148 from a total sample of n = 448 (33%) of the population. The Dempster Practice Behavioural Scale and an initially validated advanced nursing practice clinical autonomy scale were used. Open comments were analysed by thematic analysis. STROBE Standards guidelines for cross-sectional studies were followed, and COREQ guidelines were followed for writing qualitative research. The study findings demonstrated that the more clinical experience the nurse practitioner had, the higher their levels of clinical autonomy. The previous length of nursing experience did not impact nurse practitioner clinical autonomy levels. However, average experience of nurse practitioner' in this study was 3-10 years. No significant differences existed between the reported gender, nurse practitioners' clinical autonomy and decision-making. 1:40 female and 1:9 male nurse practitioners undertook a doctorate or PhD-level education. No advanced nurse practitioner identified as non-binary. Gender and organisational culture considerations can influence nurse practitioners clinical autonomy. This study highlights intrinsic motivators that support nurse practitioners in providing innovative healthcare: competence, relatedness and clinical autonomy. Countries credentialing, regulations professional standards and healthcare policy positively influence nurse practitioner clinical autonomy. Nurse practitioners' clinical autonomy is championed when health policy and organisational stakeholders intrinsically collaborate. A disconnect between health policy organisational culture extrinsically influences lower levels of nurse practitioners' clinical autonomy. The findings underline the positive impact of nurse practitioner clinical autonomy. A recommendation of this study is to continue to measure impact of clinical autonomy anddevelop nurse practitioners' self-determination strategies around the role and integrity of their levels of intrinsic clinical autonomy.

The Characteristics of People with Serious Mental Illness Who are at High Risk for Hospitalization or Death.

Many individuals with serious mental illness are at high risk for hospitalization or death due to inadequate treatment of medical conditions or unhealthy behaviors. The authors describe demographic and clinical characteristics associated with increased risk in this population. Electronic data were obtained for individuals in treatment at a large Veterans' healthcare system who were at high risk according to a validated model. A random sample of these individuals was assessed in person. Multivariable regressions estimated the effect of numerous demographic, health, and clinical characteristics on risk. Emergency visits and hospitalizations were common. Greater risk was associated with being male, not married, and having more diagnoses. While risk varied by race, this effect was no longer significant after controlling for other factors. Health-related quality of life worsened with increasing risk. Routine data identify a large population of high-risk individuals who may benefit from outreach to provide healthcare services.

Shaping patient perceptions with healthcare supply chain transparency

AbstractHealthcare professionals continually face pressure for increased transparency in their supply chains (SCs). This research examines how healthcare SC information disclosures and physician operations influence patient perceptions (i.e., satisfaction with physicians and attitude toward healthcare service providers). Evidence from prior research might not be applicable in the healthcare context because of intense regulations and safety concerns. Moreover, previous studies have mostly adopted an internal, operational perspective. By contrast, we provide healthcare professionals with guidance on how to maximize patient perceptions. Anchoring on signaling theory and construal level theory of psychological distance, we examine whether and how the disclosed information in a healthcare context influences patients' perceptions with two vignette‐based studies. In contrast with literature on SC transparency, we do not find a main effect of SC disclosures in healthcare. Instead, the effects depend on the content disclosed. We find that spatial and temporal distances of the healthcare SC significantly influence patients' perceptions. Furthermore, a three‐way interaction shows that by strategically disclosing manufacturing and distribution information, especially when these occur close to the patient's home country, and incorporating service recovery actions, such as closer follow‐ups, professionals can maximize patient perception outcomes.

Hidden cost of hospital-based delivery and associated factors among postpartum women attending public hospitals in Gamo zone, southern Ethiopia

BackgroundSince 2005, the healthcare system in Ethiopia has implemented policies to promote the provision of free maternal healthcare services. The primary goal of these policies is to enhance the accessibility of maternity care for women from various socioeconomic backgrounds. Additionally, the aim is to increase the utilization of maternity services, such as institutional deliveries, by removing financial obstacles that pregnant women may face. Even though maternity services are free of charge. The hidden cost has unquestionably been a key obstacle in seeking and utilizing health care services. Significant payments due to delivery services could create a heavy economic burden on households.ObjectivesTo determine the hidden cost of hospital-based delivery and associated factors among postpartum women attending public hospitals in Gamo zone, southern Ethiopia 2023.MethodsA facility-based cross-sectional study was conducted on 411 postpartum women in Gamo Zone Public Health Hospitals from December 1, 2022, to January 30, 2023. The systematic sampling technique was applied to reach study units. Data was collected using the Kobo Toolbox Data Collection Tool and exported to SPSS statistical software version 27 for analysis. Simple linear regression and multiple linear regression were done to see the association of variables. The significance level was declared at a P-value < 0.05 in the final model.ResultThe median hidden cost of hospital-based delivery was 1142 Ethiopian birr (ETB), with a range (Q) of 2262 (504–2766) ETB. Monthly income of the family (β = 0.019), obstetrics complications (β = 0.033), distance from the health facility (β = 0.003), and mode of delivery (β = 0.072), were positively associated with the hidden cost of hospital-based delivery. While, rural residence (β = −0.041) was negatively associated with the outcome variable.ConclusionThis study showed the hidden cost of hospital based delivery was relatively high. Residence, monthly income of the family, obstetric complications, mode of delivery, and distance from the health facility were statistically significant. It is important to take these factors into account when designing health intervention programs and hospitals should prioritize the availability of essential drugs and medical supplies within their facilities to address direct medical costs in hospitals.

Analyze the Effectiveness of Telemedicine in Providing Healthcare Services in the United States

Analyze the Effectiveness of Telemedicine in Providing Healthcare Services in the United States