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1 – 10 of 345Camilla Michaëlis, Johanna Falby Falby Lindell, Cæcilie Hansen, Allan Krasnik, Susanne Reventlow, Marie Nørredam, Melissa Lutterodt and Annette Sofie Davidsen
Following the introduction of user fee for interpreting in Danish health care, a considerable decrease in interpreter services has been shown. This study aims to explore the…
Abstract
Purpose
Following the introduction of user fee for interpreting in Danish health care, a considerable decrease in interpreter services has been shown. This study aims to explore the experiences of language minority patients with health-care encounters when an interpreter was needed but not present.
Design/methodology/approach
Semistructured, in-depth interviews were conducted with 13 language minority patients with limited Danish proficiency. All interviews were conducted with interpreters in the participants’ native language. Data were analyzed using an inductive thematic approach.
Findings
Most participants experienced communication difficulties and difficulties participating actively in their own health care. The experience of unresolved language barriers led to a high degree of uncertainty and left the participants with unanswered health concerns. Participants expressed a reluctance to seek health care, which consequently limited the utilization of health care services.
Research limitations/implications
Although the findings only represent a small sample of patients, the results still reveal major challenges that minority-language patients encounter when seeking health care. Future studies should explore, if the intention of the law is met through the user fees.
Practical implications
Despite having the same entitlements as native Danish-speaking patients, minority-language patients experienced difficulties accessing and using health care services due to the user fee and unresolved language barriers. The study elucidates patient perspectives and points to important ways of improving the quality of health care.
Originality/value
To the best of the authors’ knowledge, no investigation into the communicative consequences of the introduction of the user fee for interpreting services exists. Thus, this study seeks to address that gap.
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Laura Curran and Jennifer Manuel
This study aims to examine the relationship between medication for opioid use disorder (MOUD) among pregnant individuals, referral source, mental health, political affiliation and…
Abstract
Purpose
This study aims to examine the relationship between medication for opioid use disorder (MOUD) among pregnant individuals, referral source, mental health, political affiliation and substance use policies in all 50 states in the USA.
Design/methodology/approach
This study describes MOUD receipt among pregnant people with an opioid use disorder (OUD) in 2018. The authors explored sociodemographic differences in MOUD receipt, referrals and co-occurring mental health disorders. The authors included a comparison of MOUD receipt among states that have varying substance use policies and examined the impact of these policies and the political affiliation on MOUD. The authors used multilevel binary logistic regression to examine effects of individual and state-level characteristics on MOUD.
Findings
Among 8,790 pregnant admissions with OUD, the majority who received MOUD occurred in the Northeast region (71.52%), and 14.99% were referred by the criminal justice system (n = 1,318). Of those who were self-referred, 66.39% received MOUD, while only 30.8% of referrals from the criminal justice system received MOUD. Those referred from the criminal justice system or who had a co-occurring mental health disorder were least likely to receive MOUD. The multilevel model showed that while policies were not a significant predictor, a state’s political affiliation was a significant predictor of MOUD.
Research limitations/implications
The study has some methodological limitations; a state-level analysis, even when considering the individual factors, may not provide sufficient description of community-level or other social factors that may influence MOUD receipt. This study adds to the growing literature on the ineffectiveness of prenatal substance use policies designed specifically to increase the use of MOUD. If such policies are consistently assessed as not contributing to substantial increase in MOUD among pregnant women over time, it is imperative to investigate potential mechanisms in these policies that may not facilitate MOUD access the way they are intended to.
Practical implications
Findings from this study aid in understanding the impact that a political affiliation may have on treatment access; states that leaned more Democratic were more likely to have higher rates of MOUD, and this finding can lead to research that focuses on how and why this contributes to greater treatment utilization. This study provides estimates of underutilization at a state level and the mechanisms that act as barriers, which is a stronger assessment of how state-specific policies and practices are performing in addressing prenatal substance use and a necessary step in implementing changes that can improve the links between pregnant women and MOUD.
Originality/value
To the best of the authors’ knowledge, this is the first study to explore individual-level factors that include mental health and referral sources to treatment that lead to MOUD use in the context of state-level policy and political environments. Most studies estimate national-level rates of treatment use only, which can be useful, but what is necessary is to understand what mechanisms are at work that vary by state. This study also found that while substance use policies were designed to increase MOUD for pregnant women, this was not as prominent a predictor as other factors, like mental health, being referred from the criminal justice system, and living in a state with more Democratic-leaning affiliations.
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P. Padma Sri Lekha, E.P. Abdul Azeez and Ronald R. O'Donnell
Contextual to the recognition of the complex interplay between health and behavioral aspects, integrated behavioral health (IBH) has emerged. Although this model is becoming…
Abstract
Purpose
Contextual to the recognition of the complex interplay between health and behavioral aspects, integrated behavioral health (IBH) has emerged. Although this model is becoming popular in the Western world, its presence in the global context is not promising. This paper aims to explore the need for IBH in India and address its barriers to implementation and possible solutions.
Design/methodology/approach
We analyzed the case of IBH and its potential implications for India using the current evidence base, authors' reflections and experience of implementing similar programs.
Findings
This paper identifies contextual factors, including increased instances of non-communicable diseases and psychosocial and cultural determinants of health, that necessitate the implementation of IBH programs in India. The key features of different IBH models and their applicability are outlined. The current status of IBH and potential challenges in implementation in India in terms of human resources and other factors are delineated. We also discuss the potential models for implementing IBH in India.
Originality/value
Integrating behavioral health in primary care is considered an effective and sustainable model to promote health and well-being across various target populations. Towards this end, this paper is the first to discuss the contextual factors of IBH in India. It is a significant addition to the knowledge base on IBH and its possible implementation barriers and strategies in low- and middle-income countries.
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Bonnie Poksinska and Malin Wiger
Providing high-quality and cost-efficient care of older people is an important development priority for many health and social care systems in the world. This paper suggests a…
Abstract
Purpose
Providing high-quality and cost-efficient care of older people is an important development priority for many health and social care systems in the world. This paper suggests a shift from acute, episodic and reactive hospital-centered care toward longitudinal, person-centered and proactive home-centered care. The purpose of this paper is to contribute to the knowledge of a comprehensive development strategy for designing and providing home-centered care of older people.
Design/methodology/approach
The study design is based on qualitative research with an inductive approach. The authors study development initiatives at the national, regional and local levels of the Swedish health and social care system. The data collection methods included interviews (n = 54), meeting observations (n = 25) and document studies (n = 59).
Findings
The authors describe findings related to policy actions and system changes, attempts to achieve collaboration, integration and coordination, new forms of care offerings, characteristics of work settings at home and differences in patients' roles and participation at home and in the hospital.
Practical implications
The authors suggest home-centered care as a solution for providing person-centered and integrated care of older people and give examples of how this can be achieved.
Originality/value
The authors outline five propositions for research and development related to national policies, service modularity as a solution for customized and coordinated care, developing human resources and infrastructure for home settings, expanding services that enable older people living at home and patient co-creation.
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Yunwei Gai, Alia Crocker, Candida Brush and Wiljeana Jackson Glover
Research has examined how new ventures strengthen local economic outcomes; however, limited research examines health-oriented ventures and their impact on social outcomes…
Abstract
Purpose
Research has examined how new ventures strengthen local economic outcomes; however, limited research examines health-oriented ventures and their impact on social outcomes, including health outcomes. Increased VC investment in healthcare service start-ups signals more activity toward this end, and the need for further academic inquiry. We examine the relationship between these start-ups and county-level health outcomes, health factors, and hospital utilization.
Design/methodology/approach
Data on start-ups funded via institutional venture capital from PitchBook were merged with US county-level outcomes from the County Health Rankings and Area Health Resources Files for 2010 to 2019. We investigated how the number of VC-funded healthcare service start-ups, as well as a subset defined as innovative, were associated with county-level health measures. We used panel models with two-way fixed effects and Propensity Score Matched (PSM), controlling for demographics and socioeconomic factors.
Findings
Each additional VC-funded healthcare service start-up was related to a significant 0.01 percentage point decrease in diabetes prevalence (p < 0.01), a decrease of 1.54 HIV cases per 100,000 population (p < 0.1), a 0.02 percentage point decrease in obesity rates (p < 0.01), and a 0.03 percentage point decrease in binge drinking (p < 0.01). VC-funded healthcare service start-ups were not related to hospital utilization.
Originality/value
This work expands our understanding of how industry-specific start-ups, in this case healthcare start-ups, relate to positive social outcomes. The results underscore the importance of evidence-based evaluation, the need for expanded outcome measures for VC investment, and the possibilities for integration of healthcare services and entrepreneurship ecosystems.
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Jinwei Zhao, Shuolei Feng, Xiaodong Cao and Haopei Zheng
This paper aims to concentrate on recent innovations in flexible wearable sensor technology tailored for monitoring vital signals within the contexts of wearable sensors and…
Abstract
Purpose
This paper aims to concentrate on recent innovations in flexible wearable sensor technology tailored for monitoring vital signals within the contexts of wearable sensors and systems developed specifically for monitoring health and fitness metrics.
Design/methodology/approach
In recent decades, wearable sensors for monitoring vital signals in sports and health have advanced greatly. Vital signals include electrocardiogram, electroencephalogram, electromyography, inertial data, body motions, cardiac rate and bodily fluids like blood and sweating, making them a good choice for sensing devices.
Findings
This report reviewed reputable journal articles on wearable sensors for vital signal monitoring, focusing on multimode and integrated multi-dimensional capabilities like structure, accuracy and nature of the devices, which may offer a more versatile and comprehensive solution.
Originality/value
The paper provides essential information on the present obstacles and challenges in this domain and provide a glimpse into the future directions of wearable sensors for the detection of these crucial signals. Importantly, it is evident that the integration of modern fabricating techniques, stretchable electronic devices, the Internet of Things and the application of artificial intelligence algorithms has significantly improved the capacity to efficiently monitor and leverage these signals for human health monitoring, including disease prediction.
Sydney Austin, Ahad Bandealy and Elizabeth Cawley
The purpose of this paper is to highlight current utilizations of advanced technology within the digital mental health platform Keel Mind.
Abstract
Purpose
The purpose of this paper is to highlight current utilizations of advanced technology within the digital mental health platform Keel Mind.
Design/methodology/approach
Keel Mind, based out of Ontario, Canada is a therapeutic delivery platform that dually functions to train clinicians and deliver virtual therapy to clients.
Findings
From personalizing client and therapist matching to using natural language processing (NLP) and artificial intelligence (AI)-driven features Keel Mind supports clinician decision-making to meet the growing mental health needs of the population. Keel Mind functions to provide accessible service, efficiently train high-quality clinicians and enhance clinical outcomes for clients. In a preliminary study within post-secondary students from Ontario, Canada, 90.1% of clients reported liking the platform, and 83.4% reported that they experienced positive mental health outcomes as a result of using Keel Mind.
Practical implications
Keel Mind is a leader within the rapidly developing field of telepsychology and aims to promote positive mental health outcomes worldwide.
Originality/value
This digital showcase is the first published piece of work highlighting the technological capabilities of Keel Mind as a digital therapeutic platform. The intention of this work is to highlight current uses of digital technology within the field of therapeutic practice and to promote technological growth within the field.
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Liisa Lee, Mira Hammarén and Outi Kanste
To explore Finnish experts' perceptions of the forms of digital healthcare that are anticipated to be the most utilised in healthcare in the medium-term future (year 2035) and…
Abstract
Purpose
To explore Finnish experts' perceptions of the forms of digital healthcare that are anticipated to be the most utilised in healthcare in the medium-term future (year 2035) and anticipated healthcare workforce impacts those forms will have.
Design/methodology/approach
A total of 17 experts representing relevant interest groups participated in a biphasic online Delphi study. The results for each round were analysed using descriptive statistical methods and inductive content analysis.
Findings
The forms of digital healthcare that the experts perceived as most likely to be utilised were those enabling patient participation, efficient organisation of services and automated data collection and analysis. The main impacts on the healthcare workforce were seen as being the redirection of workforce needs within the healthcare sector and need for new skills and new professions. The decrease in the need for a healthcare workforce was seen as less likely. The impacts were perceived as being constructed through three means: impacts within healthcare organisations, impacts on healthcare professions and impacts via patients.
Research limitations/implications
The results are not necessarily transferable to other contexts because the experts anticipated local futures. Patients' views were also excluded from the study.
Originality/value
Healthcare organisations function in complex systems where drivers, such as regional demographics, legislation and financial constraints, dictate how digital healthcare is utilised. Anticipating the workforce effects of digital healthcare utilisation has received limited attention; the study adds to this discussion.
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Pimtong Tavitiyaman, Tin-Sing Vincent Law, Yuk-Fai Ben Fong and Tommy K.C. Ng
This study aims to explore the influence of health-care service quality on customers’ perceived value, satisfaction, effectiveness and behavioural intention concerning district…
Abstract
Purpose
This study aims to explore the influence of health-care service quality on customers’ perceived value, satisfaction, effectiveness and behavioural intention concerning district health centres (DHCs) in Hong Kong. This research also intends to assess customers’ perception of the subsidy scheme and its influence on the relationships amongst the aforementioned constructs.
Design/methodology/approach
The convenience and snowball sampling approaches were adopted, and the self-administered questionnaire was sent to 309 customers of DHCs.
Findings
Service quality attributes in terms of staffing and procedures positively increased customers’ perceived value and staffing, procedures and operations. Physical facilities positively promoted customers’ satisfaction, consequently improving DHCs’ effectiveness and behavioural intention. However, core treatments and services of DHCs did not impact customers’ perceived value and satisfaction. Furthermore, customers receiving subsidies exhibited a more positive perception than those without subsidies.
Practical implications
Health-care organisations are advised to strategically allocate resources (staffing, facilities and procedures and operations management) to optimise overall performance outcomes. DHC operators could reinforce the core services of DHCs and health-care voucher subsidies to local citizens so as to enhance the effectiveness of DHCs and behavioural intention of customers.
Originality/value
This study integrates the input–process–output approach in measuring the effectiveness of and customers’ behavioural intention towards newly established DHCs.
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Rosemarie Santa González, Marilène Cherkesly, Teodor Gabriel Crainic and Marie-Eve Rancourt
This study aims to deepen the understanding of the challenges and implications entailed by deploying mobile clinics in conflict zones to reach populations affected by violence and…
Abstract
Purpose
This study aims to deepen the understanding of the challenges and implications entailed by deploying mobile clinics in conflict zones to reach populations affected by violence and cut off from health-care services.
Design/methodology/approach
This research combines an integrated literature review and an instrumental case study. The literature review comprises two targeted reviews to provide insights: one on conflict zones and one on mobile clinics. The case study describes the process and challenges faced throughout a mobile clinic deployment during and after the Iraq War. The data was gathered using mixed methods over a two-year period (2017–2018).
Findings
Armed conflicts directly impact the populations’ health and access to health care. Mobile clinic deployments are often used and recommended to provide health-care access to vulnerable populations cut off from health-care services. However, there is a dearth of peer-reviewed literature documenting decision support tools for mobile clinic deployments.
Originality/value
This study highlights the gaps in the literature and provides direction for future research to support the development of valuable insights and decision support tools for practitioners.
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