Service Model Research Articles

LITERATURE REVIEW: MODEL CONTINUITY OF CARE PELAYANAN KEBIDANAN DEPRESI POSTPARTUM

During the postpartum period, midwives not only assess the physical examination and breastfeeding process, but also must assess the emotional well being and social support of the postpartum mother. The Continuity of Care (CoC) midwifery care model makes mothers get to know their caregivers better, this is one of the midwifery care models that provides services to help women build relationships with their caregivers. Postpartum depression is a major health problem, having a dangerous impact on postpartum mothers, their babies, and their families. The prevalence of depression in the Southeast Asia region is 27%, while in Indonesia the prevalence of depression is 3.7% and ranks second after India at 4.5%. This study aims to determine the Continuity of Care model for midwifery services with postpartum depression. The type of research used in this research is literature review research using 5 journals from the sources used in the form of journal search studies in electronic databases such as the Directory of Open Access Journals (DOAJ), ScienceDirect and EBSCO in full text form. So it can be concluded that a strong relationship between mothers and midwives who are known for providing continuous care, results in increased trust, more personal and loving care, and better sharing of information will reduce postpartum depression. To address knowledge gaps and methodological deficiencies in the existing literature, articles on postpartum depression in Asian countries need to further explore the role of physical, biological and cultural factors.

Coconstructing a Flexible At-Home Respite Model For and With Caregivers of Older Adults: A Living Lab Approach

At-home respite services seem too rigid to meet the needs of older adults and their caregivers. It is critical to develop service flexibility, as it allows for personalized care, adapted to health conditions, preferences, and evolving needs. While no prior studies used coconstruction methods to increase flexibility, this study could offer a better understanding of flexible respite for stakeholders. Using a living lab approach, this article aimed to (1) empirically determine the characteristics of this type of respite model and (2) document the levers and obstacles to consider for its implementation. Starting from a pre-existing flexible respite model named ANAAIS, the research team led workshops and interviews. First, the team carried out 2 workshops (TRIAGE and persona-scenario) with a total of 3 caregivers and 8 homecare professionals or managers. Second, a team member conducted interviews with 3 caregivers and 6 homecare professionals or managers. Content analysis was used on the data. The stakeholders coconstructed a Québec version of ANAAIS, a web application allowing caregivers to request an affordable respite, at the time wanted, and offered by a qualified care worker, through a simple application. Levers and barriers to its deployment are linked to the model’s characteristics as well as its internal and external context. For example, relations and connexions were perceived as a lever to deployment, while the lack of resources was considered an obstacle. This living lab project showed the feasibility and pragmatism of coconstructing a flexible and applicable respite service model.

Utilization of Kombucha Tea to Improve Children's Health and Reduce Stunting Rates in Patempuran Village, Jember Regency

In order to overcome the problem of stunting in children, a team of Jember University lecturers collaborated with the Patempuran Village community and posyandu cadres to carry out community service activities. The main focus of this activity is the mass use and dissemination of Kombucha Tea, chosen because of its important nutritional content and potential to improve intestinal health and nutrient absorption in children. This activity includes outreach to increase understanding of the benefits of Kombucha Tea, training for posyandu cadres and village mothers on how to produce Kombucha Tea, as well as the distribution process to families with children under five. Apart from that, counseling regarding healthy eating patterns and the importance of nutrition was also provided in this activity. The impact evaluation was carried out after the activity was carried out to measure the extent to which Kombucha Tea made a positive contribution in reducing stunting rates in Patempuran Village. Close collaboration between the lecturer team, the community and the local government forms a sustainable community service model, which is expected to have a positive impact in improving the welfare of children in Patempuran Village.

Low selection of HIV PrEP refills at private pharmacies among clients who initiated PrEP at public clinics: findings from a mixed-methods study in Kenya

BackgroundIn Africa, the delivery of HIV pre-exposure prophylaxis (PrEP) at public healthcare clinics is challenged by understaffing, overcrowding, and HIV-associated stigma, often resulting in low PrEP uptake and continuation among clients. Giving clients the option to refill PrEP at nearby private pharmacies, which are often more convenient and have shorter wait times, may address these challenges and improve PrEP continuation.MethodsThis mixed methods study used an explanatory sequential design. At two public clinics in Kiambu County, Kenya, clients ≥ 18 years initiating PrEP were given the option to refill PrEP at the clinic where they initiated for free or at one of three nearby private pharmacies for 300 Kenyan Shillings (~ $3 US Dollars). The providers at these pharmacies (pharmacists and pharmaceutical technologists) were trained in PrEP service delivery using a prescribing checklist and provider-assisted HIV self-testing, both with remote clinician oversight. Clients were followed up to seven months, with scheduled refill visits at one, four, and seven months. The primary outcomes were selection of pharmacy-based PrEP refills and PrEP continuation. Following pilot completion, 15 in-depth interviews (IDIs) with clients who refilled PrEP were completed. We used descriptive statistics and thematic analysis to assess study outcomes.ResultsFrom November 2020 to November 2021, 125 PrEP clients were screened and 106 enrolled. The majority (59%, 63/106) of clients were women and the median age was 31 years (IQR 26–38 years). Over 292 client-months of follow-up, 41 clients (39%) refilled PrEP; only three (3%) at a participating pharmacy. All clients who completed IDIs refilled PrEP at clinics. The reasons why clients did not refill PrEP at pharmacies included: a preference for clinic-delivered PrEP services (i.e., pre-existing relationships, access to other services), concerns about pharmacy-delivered PrEP services (i.e., mistrust, lower quality care, costs), and lack of knowledge of this refill location.ConclusionsThese findings suggest that clients who initiate PrEP at public clinics in Kenya may have already overcome barriers to clinic-delivered PrEP services and prefer PrEP access there. To reach new populations that could benefit from PrEP, a stand-alone model of pharmacy-delivered PrEP services may be needed.Trial registrationClinicalTrials.gov: NCT04558554 [registered: June 5, 2020].

Establishing a telehealth model addressing paediatric sleep health in remote and rural Northern Territory Australia: Overcoming the distance barrier.

This study examined the outcomes of a telehealth model for sleep health assessment among Indigenous and non-Indigenous children residing in remote and regional communities at the Top End Northern Territory (NT) of Australia. Video telehealth consultation, that included clinical history and relevant physical findings assessed virtually with an interstate paediatric sleep physician was conducted remotely. Polysomnography (PSG) and therapeutic interventions were carried out locally at Darwin, NT. The study participants were children referred between 2015 and 2020. Of the total 812 children referred for sleep assessment, 699 underwent a diagnostic PSG. The majority of patients were female (63%), non-Indigenous (81%) and resided in outer regional areas (88%). Indigenous children were significantly older and resided in remote or very remote locations (22% vs. 10%). Referral patterns differed according to locality and Indigenous status - (non-Indigenous via private (53%), Indigenous via public system (35%)). Receipt of referrals to initial consultation was a median of 16 days and 4 weeks from consult to PSG. Remote children had slightly longer time delay between the referral and initial consult (32 vs. 15 days). Fifty one percent were diagnosed to have OSA, 27% underwent adenotonsillectomy and 2% were prescribed with CPAP therapy. This study has demonstrated that a telehealth model can be an effective way in overcoming logistical barriers and in providing sleep health services to children in remote and regional Australia. Further innovative efforts are needed to improve the service model and expand the reach for vulnerable children in very remote communities.

A pre-post study design: evaluating the effectiveness of a new community-based integrated service model on patient outcomes

This study aimed to evaluate a new service model, Specialists Together In the Community (STIC), in terms of patient outcomes. This model integrates Flexible Assertive Community Treatment (FACT)-principles with expertise of specialized teams that offer diagnosis-related outpatient treatment. In a pre-post design, symptoms and quality of life of 930 former FACT-patients were measured repeatedly pre- and post-STIC. Regarding patients in former specialized teams, pre- and post-treatment social functioning and symptoms were measured for the pre- (n = 944) and post-STIC (n = 544) groups. Against expectation, symptoms of former FACT-patients remained stable post-STIC compared to a slight decrease pre-STIC. According to expectation, pre- and post-STIC groups had an equal symptom reduction. Unexpectedly, the post-STIC group did not improve more on social functioning than the pre-STIC group. Explorative analysis showed less treatment contacts in the post-STIC group. The highly similar patient outcomes post-STIC could be improved by monitoring process outcomes and prolonging study duration.

Telehealth-delivered parent-based sleep-focused intervention for insomnia in preschool children with autism spectrum disorder: A randomized controlled study.

Sleep problems are common in children with autism spectrum disorder. Although the effects of parent-based sleep intervention were shown to be promising, previous research was limited to the face-to-face service model, which might limit accessibility. This study examined a sleep-focused parent training group delivered via telehealth for treating insomnia in preschool children with autism spectrum disorder, which allowed parents to join the intervention remotely. Results showed that children in the intervention group had greater improvements in sleep and insomnia symptoms after treatment, as compared to those who only received care as usual. This sleep-focused treatment also led to improved daytime behaviors, especially externalizing problems such as hyperactivity and conduct problems, in children with autism spectrum disorder. Parents who had attended the training also reported reduced parental stress level after treatment. The findings supported the feasibility and promising effects of a brief parent-based sleep intervention delivered via telehealth for preschooler with autism spectrum disorder.

Does Farmers’ Cognition Enhance Their Enthusiasm for Adopting Sustainable Digital Agricultural Extension Services? Evidence from Rural China

The service model of digital agricultural technology extension, as a novel and sustainable approach, plays a pivotal role in facilitating the digital transformation of farmers’ agricultural practices. Leveraging survey data from 1475 farmers in China, the study employed a multivariate ordered logit model to investigate the relationship between farmers’ cognition and enthusiasm to adopt digital agricultural extension services. The findings revealed that subjective and objective cognitions positively influence farmers’ enthusiasm for adopting digital agricultural extension services. Furthermore, policy incentives, as a significant regulatory factor, effectively influence farmers’ cognition levels and enthusiasm to adopt digital agricultural extension services. Additionally, female respondents, farmers with higher educational levels, and membership in agricultural cooperatives all facilitate the adoption of these services. This study not only enriches the theoretical framework for agricultural technology promotion, aiding in the understanding of farmers’ decision-making processes when adopting digital agricultural extension services, but also provides a deeper insight into the role of digital agricultural technologies in promoting sustainable agricultural development, offering scientific evidence for relevant policy formulation and implementation.

Using PLS-SEM to test the relationship model of corporate social performance across the product/service continuum: When do shared values matter?

Is it as simple as do good and keep customers? Does the principle operate similarly across the product-service continuum? To better understand the complex consumer relationship with corporate social performance (CSP), the moderation of shared values in an established trust mediating relationship model including both corporate functional performance (CFP) and CSP as antecedents was tested. PLS-SEM was used to explore how the model holds up along three points of the product service continuum: pure good (shoes), good with retail service (fast-food restaurants), and pure service (tax services). The one size fits all approach to relationship development and CSP strategy does not bear true. The shared values congruence effect is greater in the fast-food model, and the trust effect is greater in the shoe and tax service models.

Supportive and palliative care needs in advanced non-malignant liver disease: systematic review

Advanced cirrhosis confers a significant symptom burden and has a 50% 2-year mortality rate in those with decompensated disease. There is increasing demand for supportive and palliative care (SAPC) for...

GAIA-X as Enabler for Services and Business Models for Real-time Data in the Transportation Sector

GAIA-X as Enabler for Services and Business Models for Real-time Data in the Transportation Sector

Sensemaking and medical professional identity within the context of strategic change

Objective of the study: To identify how the physicians of a major Brazilian hospital perceive the proposed change in payment models for services provided and whether the proposed change affects elements of the professional identity of the physicians interviewed. Methodology / approach: This study draws on the sensemaking theory, medical professional identity and implementation of strategies in complex organizations. It was carried out a qualitative research through semi-structured interviews with a group of physicians who works in a large Brazilian hospital that was facing changes in the reimbursement model. Originality / Relevance: Research addressing the reasons why physicians tend to resist is important to help strategists to design an approach to obtain professional adherence. Main results: The research participants perceive threats to their autonomy in two attributes, Clinical Autonomy and Financial Autonomy. Regarding the change in the payment model for services rendered, some interviewees perceive their need, but demonstrate a desire for more active participation in the discussion and elaboration of new models, thus configuring the need to maintain their Political Autonomy. Theoretical / methodological contributions: This work contributes to the literature by advancing the process of understanding sensemaking triggers and demonstrating how and why threats to professional identity can hamper the process of implementing strategies in complex organizations. Social / management contributions: The implementation of strategies in hospital organizations is a topic of great relevance for the managers of the healthcare industry, due to its multiplicity of actors and interests, in addition to exponential technological evolution.

Innovation and practice in the service model of the nursing team in the 37°C comprehensive ward

Objective: To establish a nursing service model of 37°C “six-center” services and study the effect of this model on improving nursing services in the course of nursing work.Methods: The semi-structured interview method and group meeting method are used to establish the 37°C nursing service model and implement the “general health” concept of “benevolence-based and central enterprise quality.” The newly established 37°C “six-center service” (enthusiastic reception, patient explanation, careful observation, sincere help, warm-hearted delivery and heart-to-heart visit) nursing model in the comprehensive ward of Baogang Hospital (Inner Mongolia) runs through the three phases of patient admission, hospitalization and discharge, providing patients with warm care services, so that patients can truly enjoy the warmth of 37°C “six-center service” nursing and friendly family flair during the peri-hospitalization period.Results: (1) The established 37°C “six-heart service” nursing service model has been treated as a nursing service path and is widely used in the hospital; (2) After the implementation of the 37°C nursing service, patients, nurses, doctors, hospitals and the society show an effectively improved satisfaction; (3) The 37°C “six-heart service” nursing service model is established as a hospital nursing service brand; (4) The 37°C “six-heart service” nursing service brand has received enthusiastic responses in Baotou, Health Management Technology Co., Ltd. and GENERTEC.Conclusions: The established 37°C “six-heart service” nursing service model can effectively improve the quality of nursing service and establish a nursing service brand, which can be promoted across the country.

Access to early diagnosis for attention-deficit/hyperactivity disorder among children and adolescents in Mexico City at specialized mental health services

BackgroundIn Mexico, this pioneering research was undertaken to assess the accessibility of timely diagnosis of Dyads [Children and adolescents with Attention Deficit Hyperactivity Disorder (ADHD) and their primary caregivers] at specialized mental health services. The study was conducted in two phases. The first phase involved designing an “Access Pathway” aimed to identify barriers and facilitators for ADHD diagnosis; several barriers, with only the teacher being identified as a facilitator. In the second phase, the study aimed to determine the time taken for dyads, to obtain a timely diagnosis at each stage of the Access Pathway. As well as identify any disparities based on gender and socioeconomic factors that might affect the age at which children can access a timely diagnosis.MethodIn a retrospective cohort study, 177 dyads participated. To collect data, the Acceda Survey was used, based on the robust Conceptual Model Levesque, 2013. The survey consisted of 48 questions that were both dichotomous and polytomous allowing the creation of an Access Pathway that included five stages: the age of perception, the age of search, the age of first contact with a mental health professional, the age of arrival at the host hospital, and the age of diagnosis. The data was meticulously analyzed using a comprehensive descriptive approach and a nonparametric multivariate approach by sex, followed by post-hoc Mann-Whitney’s U tests. Demographic factors were evaluated using univariable and multivariable Cox regression analyses.Results71% of dyads experienced a late, significantly late, or highly late diagnosis of ADHD. Girls were detected one year later than boys. Both boys and girls took a year to seek specialized mental health care and an additional year to receive a formal specialized diagnosis. Children with more siblings had longer delays in diagnosis, while caregivers with formal employment were found to help obtain timely diagnoses.ConclusionsOur findings suggest starting the Access Pathway where signs and symptoms of ADHD are detected, particularly at school, to prevent children from suffering consequences. Mental health school-based service models have been successfully tested in other latitudes, making them a viable option to shorten the time to obtain a timely diagnosis.

[Does the Innovation Fund Improve Healthcare Provision? A Critical Assessment of the Status of Implementing Successful Innovation Fund Projects into Healthcare Practice].

Since 2015, the Federal Joint Committee (G-BA)'s Innovation Fund has been supporting projects in health services research and new health service models ("Neue Versorgungsformen", NVF). By the end of 2022, 211 projects in the NVF category had been funded. A key objective is the transfer of successful projects into standard care. This article analyzes previous projects regarding their incorporation into routine care based on transfer recommendations of the Innovation Fund Committee ("Innovationsausschuss" IA). Descriptive analysis of all projects completed by August 1, 2023 with transfer recommendations in the "NVF" funding stream. Presentation by topic, project duration, time until IA transfer decision, categorization, and number of institutions and organizations (recipients) addressed per project, their feedback published on the G-BA website, response rates per recipient group, and a content classification and interpretation of exemplary feedback. Recommendations based on the results and their discussion in an expert workshop. Out of 57 NVF projects, 17 had a transfer recommendation. A total of 57 feedback responses were received from a total of 431 recipients addressed by the IA across these projects. Response rates varied significantly. One-third of inquiries to the G-BA and its member organizations received a response (31%), while only every fifth inquiry to federal states (18%) and professional societies (18%) got a response. Less than one in ten inquiries to the Federal Ministry of Health (8%), administrative bodies (6%), and the German Medical Association (0%) received a response. Project-specific feedback within a recipient group was often contradictory or limited to regional scope. The transfer process reveals significant structural and procedural obstacles regarding the incorporation of projects evaluated as successful into routine health care. To ensure that funding from the innovation fund is most effectively used, there needs to be a realistic chance of successful transfer of positive project outcomes into routine care. The DNVF recommends stronger involvement of rule-competent institutions, mandatory publication of responses, structured moderation of the transfer process, expanding types of selective contracts, financing of implementation phases and of studies drawing on results across successful NVF projects.

One Day Service Model Towards Community Satisfaction in Peaceful Villages Watang Sidenreng District

This research is quantitative research with a descriptive approach. The population in this study were all people who received services at the Peace Village Office during the last two months. The sampling technique in this research is by using saturated samples. So the population in this study is the same as the sample size, namely 77 people. Data analysis uses multiple regression analysis to hypothesize the one day service model on community satisfaction. The results of multiple linear analysis show that the one day service model has a positive effect on the level of community satisfaction. The results of the research show that the implementation of the one day service model, in this case the one day service at the Peace Village Office, has gone well. Likewise with the level of community satisfaction with public services, where the people of Peace Village feel satisfied with the public services they receive.

What can we learn from service model analysis? An application in the government export finance sector

The service model approach, like business models in the private sector, is gaining increasing attention in public management literature. In line with this evolving discourse, our study analyzes service models in government export promotion. By exploring the use of service models and discussing key developments, we shed light on the diverse application of service models in the context of officially supported export credits – an under-researched field in which a lot of innovation is happening. We observe a limited number of traditional service models with significant relevance. In addition, our findings suggest a rising diversity that signifies innovation and the broadening scope of activities. We also uncover the underlying motivations and practical experiences associated with their implementation and provide valuable insights into the benefits they offer.

Study on One-Stop Student Community Education Management and Services in Higher Education Institutions

In the contemporary era of rapid advancements in information technology, the domain of higher education administration and services is also experiencing a new wave of transformation. Particularly concerning the management and provision of services to student communities, the limitations of traditional fragmented and departmentalized models are gradually becoming apparent. Against this backdrop, the emergence of a "one-stop" model for student community education management and services seeks to integrate a comprehensive range of support, encompassing academic guidance, psychological counseling, lifestyle amenities, and career planning, through a unified service platform. This model not only optimizes resource allocation and enhances service efficiency but, more importantly, significantly augments students' sense of attainment and satisfaction. Nevertheless, to realize this objective, universities must delve deeply into exploration and innovation across multiple dimensions, including administrative structures, information technology infrastructure, human resources, and student feedback.

Study of factors affecting customer patronage: engagement model of health insurance

Purpose Improving health outcomes requires a robust health-care service model that delivers cost-efficient services and increase customer patronage. The purpose of this study is to examine how service quality and convenience influence perceived value, satisfaction and customer patronage of health insurance policyholders. Based on contemporary research, this study further investigates the moderating role of trust, inertia, insurer type and word-of-mouth (WOM) on relationship between satisfaction and customer patronage. Design/methodology/approach This study conceptualized the dimensions of SERVQUAL and SERVCON as drivers of perceived value leading to satisfaction and finally customer patronage in presence of four moderators. To test the hypotheses, data from 500 consumers who had a running health insurance policy was collected and analyzed using partial least square path modeling. Findings The results of this study showed service quality and convenience dimensions significantly affected perceived value. Perceived value strongly influenced satisfaction and customer patronage intentions. Satisfaction had a significant positive effect on patronage. WOM and trust moderated the satisfaction–patronage relationship for recommendation intention but not repurchase intention. The moderators had an indirect bearing on customer patronage. Social implications Such an engagement ecosystem can be considered to be a revolution, as it will change the way businesses are conducted and how stakeholders interact with one another. Originality/value This study adapts and integrates the SERVQUAL and SERVCON models to health insurance domain. Second, this study conceptualizes a modified view of post-benefit convenience relevant for health insurance as policy renewal intention rather than returns/exchanges. This addresses a gap in the SERVCON scale's applicability to insurance services. This study also makes a novel attempt of examining implication of WOM and trust in health insurance domain.

IT’S NEVER TOO LATE TO START: A CASE FOR PREVENTATIVE OUTPATIENT GERIATRIC SERVICES

INTRODUCTION & AIMS The population is ageing and the chronic disease burden growing, seeing more older adults present to hospital with preventable non-communicable diseases. Multidisciplinary outpatient teams are well placed to manage modifiable risk factors to prevent disease progression and hospitalisations. A preventative service was launched at Concord Hospital integrating geriatrician, exercise physiologist and dietitian care to optimise the physical and mental health of older adults with chronic disease and frailty. This evaluation aims to determine the success of service implementation and feasibility of the model. METHODS Between November 2022 and June 2023, 59 patients (mean age 80.2 years (SD 6.2), 47.5% female) completed 12-weeks of concurrent exercise and diet interventions with medical oversight. Patients were assessed pre- and post-interventions. Exercise was individualised and multimodal, performed twice weekly in a supervised group. Diet was individualised with a protein supplement prescribed as appropriate. The outcomes measured were Fried Frailty Phenotype (FFP), leg strength (one repetition maximum leg press), Short Physical Performance Battery (SPPB), Geriatric Depression Scale Short Form (GDS), and Mini Nutritional Assessment Long Form (MNA). Service activity was measured monthly via rate of referral and occasions of service (OOS). Data were analysed using JASP (v.0.18.1). RESULTS Monthly rate of referral and OOS increased from 18 to 51 patients and 49 to 479 occasions respectively, indicating service demand. After 12-weeks there were significant improvements in FFP (mean difference [95%CI] -0.4 [-0.7, -0.2] points), leg strength (34.0 [27.1, 40.8] kilograms), SPPB (1.1 [0.8, 1.5] points), GDS (-1.4 [-2.2, -0.6] points) and MNA (2.6 [1.6, 3.5] points), with no effect of sex observed. CONCLUSION Initial implementation of a preventative outpatient geriatric service was successful with increasing service demand and significant physical and mental health improvements. The service model is feasible; however, further evaluation is required to determine outcomes after continued service provision.