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Article
Publication date: 1 July 2018

Saligrama Agnihothri and Raghav Agnihothri

The purpose of this paper is to develop a framework for the application of evidence-based management to chronic disease healthcare.

Abstract

Purpose

The purpose of this paper is to develop a framework for the application of evidence-based management to chronic disease healthcare.

Design/methodology/approach

Chronic healthcare is specially characterized by recursive patient-physician interactions in which evidence-based medicine (EBM) is applied. However, implementing evidence-based solutions to improve healthcare quality requires managers to effect changes in many different areas: organizational structure, procedures, technology and in physician/provider behaviors. To complicate matters further, they must achieve these changes using the tools of resource allocation or incentives. The literature contains many systematic reviews evaluating the question of physician and patient behavior under various types and structures of incentives. Similarly, systematic reviews have also been done regarding specific changes to the healthcare process and their effectiveness in improving patient outcomes. Yet, these reviews uniformly lament a lack of appropriate data from well-organized studies on the question of “Why?” solutions may work in one instance while not in another. The authors present a new theoretical framework that aids in answering this question.

Findings

This paper presents a new theoretical framework (Influence Model of Chronic Healthcare) that identifies: the critical areas in which managers can effect changes that improve patient outcomes; the influence these areas can have on each other, as well as on patient and physician behavior; and the mechanisms by which these influences are exerted. For each, the authors draw upon, and present the evidence in the literature. Ultimately, the authors recognize that this is a complex question that has not yet been fully researched. The contribution of this model is twofold: first, the authors hope to focus future research efforts, and second, provide a useful heuristic to managers who must make decisions with only the lesser-quality evidence the literature contains today.

Originality/value

This model can be used by managers as a heuristic either ex ante or ex post to determine the effectiveness of their decisions and strategies in improving healthcare quality. In addition, it can be used to analyze why actions or decisions taken achieved a given outcome, and how best to proceed to effect further improvements on patient outcomes. Last, the model serves to focus attention on specific questions for further research.

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Article
Publication date: 28 February 2019

Shwadhin Sharma and Anita Khadka

Drawing on the taxonomy of patient empowerment and a sense of community (SoC), the purpose of this paper is to analyze the factors that impact the intention of the…

Abstract

Purpose

Drawing on the taxonomy of patient empowerment and a sense of community (SoC), the purpose of this paper is to analyze the factors that impact the intention of the individual to continue using online social health support community for their chronic disease management.

Design/methodology/approach

A survey design was used to collect the data from multiple online social health support groups related to chronic disease management. The survey yielded a total of 246 usable responses.

Findings

The primary findings from this study indicate that the informational support – not the nurturant support such as emotional, network, and esteem support – are the major types of support people are seeking from an online social health support community. This research also found that patient empowerment and SoC would positively impact their intention to continue using the online health community.

Research limitations/implications

This study utilized a survey design method may limit precision and realism. Also, there is the self-selection bias as the respondents self-selected themselves to take the survey.

Practical implications

The findings can help the community managers or webmasters to design strategies for the promotion and diffusion of online social health group among patient of chronic disease. Those strategies should focus on patient’s empowerment through action facilitating and social support and through creating a SoC.

Originality/value

An innovative research model integrates patient empowerment and a SoC to study patient’s chronic disease management through online social health groups to fill the existing research gap.

Details

Information Technology & People, vol. 32 no. 6
Type: Research Article
ISSN: 0959-3845

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Article
Publication date: 2 May 2017

Lynette Mei Lim Goh, Agnes Xiao Yan Wong, Gary Yee Ang and Audrey Siok Ling Tan

The purpose of this paper is to evaluate the impact of delivering healthy eating messages through an interactive health corner (HC) on improving healthy dietary habits in…

Abstract

Purpose

The purpose of this paper is to evaluate the impact of delivering healthy eating messages through an interactive health corner (HC) on improving healthy dietary habits in participants.

Design/methodology/approach

Self-administered questionnaires were administered to participants after the education session. In total, 5,292 valid questionnaires were obtained, yielding a response rate of 93.3 per cent. In the last three months of the pilot study, a random sample of 305 from 1,493 participants was chosen and followed up six months later. Bivariate analysis was used to study the association of knowledge gained and attitude. Behavioural change was measured in terms of whether participants had reported an increase in their consumption of healthier food.

Findings

Majority (>98 per cent) of participants reported that the HC corner was useful, and had helped increase their awareness and knowledge of creating healthier meals and making healthier food choices. 95.7 per cent were willing to make changes after visiting the HC. At six months follow-up, 84 per cent of the participants reported positive changes in their dietary habits. Those who made positive changes were younger (mean age: 58.0 years) compared with those who did not (mean age 61.0 years, p=0.035).

Research limitations/implications

Incorporating cooking demonstrations as part of nutrition education is effective in inculcating healthy eating practices and changing self-reported eating habits in the short term. Further research is needed to verify actual change in eating habits and to determine if this change is sustainable in the long run.

Originality/value

Currently, no similar initiative has been implemented and studied to evaluate the effectiveness of this mode of health promotion in a primary care setting. This study will help the authors to evaluate if the intervention was effective in changing attitudes and behaviours after an education session at the HC.

Details

British Food Journal, vol. 119 no. 5
Type: Research Article
ISSN: 0007-070X

Keywords

Content available

Abstract

Details

International Journal of Health Care Quality Assurance, vol. 23 no. 8
Type: Research Article
ISSN: 0952-6862

Keywords

Content available
Article
Publication date: 13 June 2008

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281

Abstract

Details

International Journal of Health Care Quality Assurance, vol. 21 no. 4
Type: Research Article
ISSN: 0952-6862

Keywords

Content available
Article
Publication date: 16 March 2021

Yiyan Li and Siyu Ru

To compare chronic health status, utilization of healthcare services and life satisfaction among immigrant women and their Canadian counterparts.

Abstract

Purpose

To compare chronic health status, utilization of healthcare services and life satisfaction among immigrant women and their Canadian counterparts.

Design/methodology/approach

A secondary analysis of national data from the Canadian Community Health Survey (CCHS), 2015–2016 was conducted. The survey data included 109,659 cases. Given the research question, only female cases were selected, which resulted in a final sample of 52,560 cases. Data analysis was conducted using multiple methods, including logistic regression and linear regression.

Findings

Recent and established immigrant women were healthier than native-born Canadian women. While the Healthy Immigrant Effect (HIE) was evident among immigrant women, some characteristics related to ethnic origin and/or unhealthy dietary habits may deteriorate immigrant women's health in the long term. Immigrant women and non-immigrant women with chronic illnesses were both more likely to increase their use of the healthcare system. Notably, the present study did not find evidence that immigrant women under-utilized Canada's healthcare system. However, the findings showed that chronic health issues were more likely to decrease women's life satisfaction.

Originality/value

This analysis contributes to the understanding of immigrant women's acculturation by comparing types of chronic illnesses, healthcare visits, and life satisfaction between immigrant women and their Canadian counterparts.

Details

Journal of Health Research, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 0857-4421

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Article
Publication date: 1 April 2011

Dindial Ramrattan

Purpose: To present a descriptive framework that will provide the foundation for future exploratory research on the socioeconomic impact of Chronic Non‐Communicable…

Abstract

Purpose: To present a descriptive framework that will provide the foundation for future exploratory research on the socioeconomic impact of Chronic Non‐Communicable Diseases (CNCDs) in Trinidad and Tobago. The paper also attempts to initiate discussions regarding the placement of greater emphasis on preventative health care. Methodology: Time series data was used to paint a picture of the changing epidemiological profile within the country. Secondary data was also utilised to illustrate changes in policy within the country. Data was obtained from various key stakeholders inclusive of Government Ministries and the Central Statistical Office of Trinidad and Tobago. Findings: CNCDs are the leading cause of death in Trinidad and Tobago and attempts have been made to address these issues. Recurrent expenditure continues to constitute the majority of health sector spending with programmes like the Chronic Disease Assistance Programme (CDAP) directly targeting the rise of CNCDs. However, at the time of writing, there appeared to be very few linkages between the various relevant stakeholders to facilitate the combination of their expertise which would undoubtedly aid in reducing the impact of CNCDs on the economic earning potential and social fabric of Trinidad and Tobago.

Details

World Journal of Science, Technology and Sustainable Development, vol. 8 no. 4
Type: Research Article
ISSN: 2042-5945

Keywords

Content available
Article
Publication date: 23 June 2020

Aneka Khilnani, Jeremy Schulz and Laura Robinson

Telemedicine has been advancing for decades and is more indispensable than ever in this unprecedented time of the COVID-19 pandemic. As shown, eHealth appears to be…

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1655

Abstract

Purpose

Telemedicine has been advancing for decades and is more indispensable than ever in this unprecedented time of the COVID-19 pandemic. As shown, eHealth appears to be effective for routine management of chronic conditions that require extensive and repeated interactions with healthcare professionals, as well as the monitoring of symptoms and diagnostics. Yet much needs to be done to alleviate digital inequalities that stand in the way of making the benefits of eHealth accessible to all. The purpose of this paper is to explore the recent shift in healthcare delivery in response to the COVID-19 pandemic towards telemedicine in healthcare delivery and show how this rapid shift is leaving behind those without digital resources and exacerbating inequalities along many axes.

Design/methodology/approach

Because the digitally disadvantaged are less likely to use eHealth services, they bear greater risks during the pandemic to meet ongoing medical care needs. This holds true for both medical conditions necessitating lifelong care and conditions of particular urgency such as pregnancy. For this reason, the authors examine two case studies that exemplify the implications of differential access to eHealth: the case of chronic care diseases such as diabetes requiring ongoing care and the case of time-sensitive health conditions such as pregnancy that may be compromised by gaps in continuous care.

Findings

Not only are the digitally disadvantaged more likely to belong to populations experiencing greater risk – including age and economic class – but they are less likely to use eHealth services and thereby bear greater risks during the pandemic to meet ongoing medical care needs during the pandemic.

Social implications

At the time of writing, almost 20% of Americans have been unable to obtain medical prescriptions or needed medical care unrelated to the virus. In light of the potential of telemedicine, this does not need to be the case. These social inequalities take on particular significance in light of the COVID-19 pandemic.

Originality/value

In light of the COVID-19 virus, ongoing medical care requires exposure to risks that can be successfully managed by digital communications and eHealth advances. However, the benefits of eHealth are far less likely to accrue to the digitally disadvantaged.

Details

Journal of Information, Communication and Ethics in Society, vol. 18 no. 3
Type: Research Article
ISSN: 1477-996X

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Article
Publication date: 7 March 2016

Bernadette Ludwig and Holly Reed

– The purpose of this paper is to examine health issues among Liberian refugees living in Staten Island and access potential barriers to accessing healthcare.

Abstract

Purpose

The purpose of this paper is to examine health issues among Liberian refugees living in Staten Island and access potential barriers to accessing healthcare.

Design/methodology/approach

Qualitative methods including interviews (n=68) with West African immigrants, predominantly Liberian refugees, and long-term ethnography were employed to elicit West Africans’ views on health, acculturation, and access to service providers. Framework analysis was employed to analyze the data thematically.

Findings

Chronic health diseases, depression, isolation, and inadequate access to healthcare were the main concerns of the population studied. The findings are in contrast to the public health experts’ concentration on infectious diseases.

Practical implications

The barriers to access proper healthcare have implications for healthcare providers and government institutions and information about these barriers can help them to refocus their health efforts to better address the needs of West African refugees.

Originality/value

Africans are among the newest immigrants in the USA and are considerably understudied compared to other groups such as Latin Americans and Asians. Additionally, there is an abundance research about refugees’ health status when they first arrive in the USA, but there is little data on their health after their resettlement.

Details

International Journal of Migration, Health and Social Care, vol. 12 no. 1
Type: Research Article
ISSN: 1747-9894

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Article
Publication date: 18 April 2017

Vidya Dalvi and Nandakumar Mekoth

While interpretative phenomenological analysis (IPA) has been used in health psychology research, it has so far not been applied to seek deeper insights into the patients…

Abstract

Purpose

While interpretative phenomenological analysis (IPA) has been used in health psychology research, it has so far not been applied to seek deeper insights into the patients’ experiences about treatment. The purpose of this paper is to address this gap by using IPA to understand patient non-adherence.

Design/methodology/approach

In total, 18 patients with chronic conditions seeking healthcare services in Goa and Karnataka, India, were selected by using the snowball sampling method. In-depth interviews were conducted face to face. A semi-structured questionnaire developed by the researchers was used to collect the data. IPA was used to explore the themes to predict patient non-adherence.

Findings

The study results indicate that economic factors, health system related factors, social factors and psychological factors impact patient non-adherence. Patient non-adherence includes medication non-adherence and lifestyle modification non-adherence.

Research limitations/implications

Being cross sectional in design, the results may not be as appropriate as the results derived from a longitudinal study given that non-adherence occurs over time.

Practical implications

Patient non-adherence is a global health issue. Multidisciplinary approach to enhance patient adherence to treatment should form part of public healthcare policy.

Social implications

Exploring the factors influencing patient non-adherence will help the health-care industry stakeholders to reduce healthcare cost and improve patient’s quality of life.

Originality/value

Although there is extensive quantitative research on the prevalence of non-adherence, qualitative research is limited. This paper addresses this gap by using IPA to understand patient non-adherence and its factors and dimensions.

Details

International Journal of Health Care Quality Assurance, vol. 30 no. 3
Type: Research Article
ISSN: 0952-6862

Keywords

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