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1 – 10 of over 3000This research paper aimed to study the legal structure of top-performing health governance systems and compare them with the Indonesian health social security system to identify…
Abstract
Purpose
This research paper aimed to study the legal structure of top-performing health governance systems and compare them with the Indonesian health social security system to identify the main differences and provide recommendations for Indonesian and other developing countries’ health policymakers and administrators.
Design/methodology/approach
Using formative research with a conceptual approach and statute approach as method in this study. Data was gathered using the document study technique, which studies various documents, especially legal documents related to health law, linked to legal purpose theories. Moreover, the World Health Organization ranking was considered to choose the two countries (France and Singapore) with a high social health security system for comparative analysis. All data collected has been analyzed using a qualitative and theoretical basis. Content analysis was performed by analyzing the legal documents, and the regulatory framework of all three countries was deeply analyzed to draw conclusions and recommendations.
Findings
Indonesia has specific laws to implement a social security system in the health sector. However, the lack of the best medical facilities and infrastructure and weak implementation of existing laws were identified as major reasons behind the poor health security system compared to comparative countries. Also, as a developing nation Indonesian Government face budgetary pressures and huge population challenges to meet required standards. Thus, the financing approaches used by Singapore and France may help developing countries meet these challenges effectively. Therefore, there is a dire need to strengthen the social health security system all over the country with amendments to laws and ensure the implementation of prevailing laws and regulations.
Practical implications
Providing understanding related to the social security health system in Indonesia along with a detailed description of the sound social health security system in France and Singapore will further provide an avenue for the researchers to critically analyze this line of study to devise some valuable suggestions further and to draw loopholes in the system.
Originality/value
A comparative approach for legal studies in the health sector is rare. So, this research advanced the social security health system-related literature and legal studies on the health sector by using this comparative approach to develop policy insights and future research directions, which will further help the field to grow.
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Siu Mee Cheng and Cristina Catallo
The Healthy at Home (H@H) is an older adult day program that is in Toronto in Ontario, Canada. This is an integrated health and social care (IHSC) program that seeks to address…
Abstract
Purpose
The Healthy at Home (H@H) is an older adult day program that is in Toronto in Ontario, Canada. This is an integrated health and social care (IHSC) program that seeks to address the social isolation and health needs of a highly vulnerable older adult population living in the north Toronto communities. These are Russian-speaking Jewish older adult immigrants. The case provides a detailed description of the factors that enabled a diverse group of health and social care organizations to integrate their respective services to address the health and social care needs of their clients using a culturally appropriate and trauma-informed lens.
Design/methodology/approach
A case description comprised of key informant interviews, and a focus group was undertaken of representatives from health and social care organizations serving clients in the north Toronto area.
Findings
This case description identified eleven integration factors that enabled organizations to provide integrated care using a culturally appropriate and trauma-informed lens, and they include developing an aligned vision and goals, communications, an inter-organization culture of inter-dependence, champions, pre-existing relationships, and champions. In addition, operating in the not-for-profit sector, sector differences, enabling public policies and a strong sense of community have influenced integration of services across the organizational partners to serve its high-risk client group.
Originality/value
This case description lends insights into how IHSC can be leveraged to provide culturally appropriate and trauma-informed care for highly vulnerable client/patient populations. A lesson learnt is that social care partners can engage in successful integration leadership in joint health and social care integration efforts.
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Washiraporn Wannachot, Pimporn Phukrongpet, Kanokporn Rattanasuteerakul and Hanvedes Daovisan
This study aims to explore how social support has reshaped the care of older adults living alone in northeast Thailand during the COVID-19 pandemic.
Abstract
Purpose
This study aims to explore how social support has reshaped the care of older adults living alone in northeast Thailand during the COVID-19 pandemic.
Design/methodology/approach
This study used a qualitative method using a narrative gerontological perspective with a descriptive design. Purposive sampling was conducted from 20 in-depth narrative interviews between November 2021 and February 2022 in Maha Sarakham province, northeast Thailand. Data transcriptions were performed using a narrative analytical process.
Findings
The in-depth narrative interviews indicated that older adults living alone during the coronavirus pandemic valued a comfortable life, a sense of place, favourable living arrangements, self-reliance, life goals and meaningful life. The gerontological analysis showed that social support for older adults living alone included a social safety net, networking, supporting needs, physical care and mental health responses to the COVID-19 pandemic.
Originality/value
To the best of the authors’ knowledge, this is the first qualitative narrative gerontological study to explore how social support reshaped the care of older adults living alone during the COVID-19 pandemic in northeast Thailand.
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The purpose of this research is to identify novel ways of tackling health inequalities of underserved populations. It explores the opportunities presented by the changes in health…
Abstract
Purpose
The purpose of this research is to identify novel ways of tackling health inequalities of underserved populations. It explores the opportunities presented by the changes in health and social care legislation to employ historically underused services, such as police custody healthcare providers, in addressing health inequalities.
Design/methodology/approach
This research analyses the policy approaches to tackling health inequalities in the UK in the past 40 years with an emphasis on those experienced by the people detained in English police custodies. It analyses the current model of healthcare in police custody and proposes a novel integrated model of care and joint commissioning opportunities in funding it.
Findings
Policies to tackle health inequalities have largely failed, as they became entrenched. But recent changes in the health and social care legislation in England offer opportunities to address them by employing historically underused healthcare services, such as those operating in police custodies.
Research limitations/implications
The research does not touch upon ethical considerations related to the patient privacy aspect of integrated care. Interventions by and interactions with police custody healthcare providers would be visible to all professionals with access to the patient’s health record. As with all novel interventions or innovative models of care, the effectiveness of such clinical interventions remains to be established by further research. It opens a new line of research on quality improvement through integration of care and explores understudied aspects of joint commissioning of integrated care.
Practical implications
It offers health commissioners and public health leaders the opportunity to employ police custody healthcare services in reaching their population health management objectives and meeting their health inequalities objectives at local level. It also gives police and crime commissioners the opportunity to address the health drivers of criminal behaviour that overlap with health inequalities. It offers funding opportunities presented by jointly commissioning services at lower costs to both police and health commissioners alike. It improves the health outcomes of historically underserved populations by facilitating access to health and social care services and facilities.
Social implications
Reducing health inequalities and disparities in health outcomes can decrease the costs of the healthcare services over the long term and might contribute to reducing criminality by addressing inequities and some health drivers of criminal behaviour.
Originality/value
The paper explores understudied opportunities offered by the recent changes in health and social care legislation in England and includes underused resources to tackle health inequalities.
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Anya Ahmed, Lorna Chesterton and Matthew J. Ford
The purpose of this paper is twofold: to explore the existing evidence around dementia services and interrogate the overarching UK policy development relating to service inclusion…
Abstract
Purpose
The purpose of this paper is twofold: to explore the existing evidence around dementia services and interrogate the overarching UK policy development relating to service inclusion of black and minoritised groups. The paper will go on to identify the implications for the dementia wellness pathway and make recommendations regarding how services can be more inclusive.
Design/methodology/approach
This paper examines the policy/practice landscape around dementia care provision and observes if lessons can be learnt to improve health outcomes for people living with dementia from black and minoritised communities.
Findings
A review of dementia policy demonstrates how opportunities to improve the awareness, diagnosis and post-diagnostic support for minoritised communities are being missed. The outcomes of this mean that individuals are denied vital treatment and support, which could enhance quality of life and delay the progression of dementia.
Practical implications
The authors’ premise is that not meeting the dementia support needs of less-heard communities has negative financial as well as social and health-related outcomes and has wider resonance and implications for all stages of the dementia wellness pathway. Moreover, there is a legal responsibility for public services to provide culturally sensitive, responsive, appropriate and available care, to all people, without discrimination.
Originality/value
This paper offers a valuable review of policy and practice around dementia care in the UK and makes recommendations to improve health outcomes for people living with dementia from black and minoritised communities.
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Nadia A. Abdelmegeed Abdelwahed, Mohammed A. Al Doghan, Ummi Naiemah Saraih and Bahadur Ali Soomro
In the present era, digital technology can be used responsibly to provide developed and developing countries with high-quality health-care services to nations. This study aims to…
Abstract
Purpose
In the present era, digital technology can be used responsibly to provide developed and developing countries with high-quality health-care services to nations. This study aims to explore Saudi Arabia’s intentions to adopt digital health-care practices.
Design/methodology/approach
To be consistent with previous studies, this study used a quantitative methodology to collect the data from health-care professionals working in Saudi Arabia’s public and private health institutes. Consequently, this study’s findings are based on 306 valid samples.
Findings
On the one hand, the path analysis reveals that health-care professionals believe in perceptions relating to the use of e-health and technology (PEHT) and experiences regarding internet use (ERIU) and that these have positive and significant effects on attitudes toward the use of e-health and technology (ATEHT) and intentions to use e-health services (ITUES). On the other hand, barriers to using e-health (BUEH) negatively impact ATEHT and ITUES. Finally, ATEHT also has a positive and significant effect on ITUES.
Practical implications
This study’s findings will help Saudi Arabia’s policymakers and the country’s health ministry to develop policies to provide e-services that health-care professionals can use to improve the quality of the country’s health care, patients’ human rights and social care. Furthermore, this study’s findings are helpful in developing attitudes and intentions toward either e-health or digital health to provide better health facilities to serve Saudi Arabia’s citizens.
Originality/value
This study empirically confirms among Saudi Arabia’s health-care professionals the PEHT, ERIU and BUEH toward ATEHT and ITUES.
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Sundas Pervaiz, Usman Javed, Amir Rajput, Shoaib Shafique and Rabia Tasneem
Drawing upon the stimulus-organism-response model, this study aims to explore the impact of soft aspects of service quality on revisit intention through the mechanism of perceived…
Abstract
Purpose
Drawing upon the stimulus-organism-response model, this study aims to explore the impact of soft aspects of service quality on revisit intention through the mechanism of perceived empathy.
Design/methodology/approach
For the examination of the hypothesized relationships, the study adopts structural equation modelling to analyse the data of 562 respondents (i.e. 281 family members and 281 inpatients).
Findings
The empirical results suggest that service quality increased family member empathy perception, which, in turn, improved inpatients’ revisit intentions.
Originality/value
Past studies have focused on the roles of overall service quality. The authors have extended the literature by examining the specific but important aspect of service quality and its effects on emotional response. Importantly, the study explains that the affective reactions of a patient’s family, fastened with perceived empathy, have a central role in influencing the patients’ subsequent reactions. Moreover, the prior studies collected the data either from hospital employees or patients. However, in the present study, the authors used a unique sample (family members as well as patients) to have a deeper understanding. Thus, the study enhances the literature on the stimuli-response (i.e. service quality – revisit intentions) relationship in the context of service marketing in general and health care in specific. Important academic and managerial contributions and recommendations for future research are discussed.
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Athanasios Michalis, Demosthenes B. Panagiotakos, Apostolos Papadopoulos and Vassiliki Costarelli
The study aims to have adults discuss experiences, practices needs and feelings related to health management, diet and food security.
Abstract
Purpose
The study aims to have adults discuss experiences, practices needs and feelings related to health management, diet and food security.
Design/methodology/approach
A total of 22 immigrants were recruited from the Open School of Immigrants in Piraeus, Attica, Greece, to participate in focus group discussions. The discussions were audio recorded and thematically analyzed. Three major themes were developed: pathways to health care, nutrition management and experiences related to food shortages.
Findings
Most of the participants identified internet as the most commonly used way to obtain health advice; they also stated that unexpected ill-health is usually accompanied by feelings of fear, anxiety and loneliness. Immigrants, who had visited a public hospital in Greece, identified the language barrier as the most challenging issue, followed by the long waiting lists. Fear and anxiety of hospital visits was an important factor in their decision to vaccinate against COVID-19. Lack of time, high cost of healthy food and lack of knowledge were the most common obstacles to a healthy diet. One in two immigrants reported that they have faced food insecurity issues in the past. Stress, psychological distress and irritation were reported, due to food shortages, especially during the first few years of arriving in Greece. The exclusion of some foods, reduced portion sizes and buying cheaper foods were among the coping strategies to address food shortages.
Originality/value
The study offers an insight into immigrant’s experiences, practices and feelings about managing health issues and could be useful for health-care practitioners, researchers and policymakers.
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Melanie Stephens, Lydia Hubbard, Siobhan Kelly, Andrew Clark and Lorna Chesterton
The purpose of this paper is to report on an interprofessional (IPE) student training scheme recently conducted in three care homes across the Northwest of England. The…
Abstract
Purpose
The purpose of this paper is to report on an interprofessional (IPE) student training scheme recently conducted in three care homes across the Northwest of England. The intervention was designed as a feasibility study to explore the impacts such schemes have on residents, students and care home staff. Additional lessons emerged that contribute to the design and direction of future IPE initiatives in other care homes and care settings.
Design/methodology/approach
This case study outlines how the intervention was designed and implemented and the findings from its evaluation. This paper uses Biggs’ (1993) presage–process–product framework to evaluate the process of setting up care homes as a site of collaborative learning.
Findings
Collaborative working between stakeholders is necessary for the successful implementation of IPE in care home settings. The process is complex and requires communication and commitment across all levels of engagement. For this model to grow and have a beneficial impact on older people’s lives, there are layered factors to consider, such as the socio-political context, the characteristics of the individuals who participate and diverse approaches to learning.
Research limitations/implications
This case study reports the subjective views of the research collaborators. While this raises the potential for bias, it presents an “insider” perspective of the research process and offers learning that might be beneficial in efforts to run future IPE training schemes.
Originality/value
To the best of the authors’ knowledge, no other research studies or published interventions have been identified that explicitly address the experiences of implementing an IPE training scheme in UK care home settings. This paper will therefore be useful to academic researchers, individuals managing student placements and to health and social care staff who wish to learn about of the value of IPE learning schemes.
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Lorna de Witt, Kathryn A. Pfaff, Roger Reka and Noeman Ahmad Mirza
Current and predicted continued dramatic increases in international migration and ethnocultural diversity of older adult cohorts pose challenges for health care services. Review…
Abstract
Purpose
Current and predicted continued dramatic increases in international migration and ethnocultural diversity of older adult cohorts pose challenges for health care services. Review studies on ethnoculturally diverse older adults and health care show a lack of focus on their service use experiences. This study aims to report a meta-ethnography that addresses this knowledge gap through answering the review question: How do ethnoculturally diverse older adults who are immigrants experience health careservices?
Design/methodology/approach
The authors applied a seven-phase method of meta-ethnography to guide the review. The authors conducted two literature searches (April 2018 and June 2020) in MEDLINE, CINAHL, Embase, Sociological Abstracts and Abstracts in Social Gerontology that yielded 17 papers eligible for review.
Findings
“There’s always something positive and something negative” is the overarching metaphor for answering the review question. Findings highlight positive and negative tensions within ethnoculturally diverse older adults’ health care use experiences of understanding and being understood, having trust in providers and the health care system, having needs, preferences and resources met and desire for self-care over dependency. The majority of experiences were negative. Tipping points towards negative experiences included language, fear, provider attitudes and behaviours, service flexibility, attitudes towards Western and traditional health care and having knowledge and resources.
Originality/value
The authors propose concrete actions to mitigate the tipping points. The authors discuss policy recommendations for health care system changes at the micro, meso and macro service levels to promote positive experiences and address mainstream service policy inequities.
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