Search results
1 – 10 of over 10000At the beginning of the 21st century, multiple and diverse social entities, including the public (consumers), private and nonprofit healthcare institutions, government (public…
Abstract
At the beginning of the 21st century, multiple and diverse social entities, including the public (consumers), private and nonprofit healthcare institutions, government (public health) and other industry sectors, began to recognize the limitations of the current fragmented healthcare system paradigm. Primary stakeholders, including employers, insurance companies, and healthcare professional organizations, also voiced dissatisfaction with unacceptable health outcomes and rising costs. Grand challenges and wicked problems threatened the viability of the health sector. American health systems responded with innovations and advances in healthcare delivery frameworks that encouraged shifts from intra- and inter-sector arrangements to multi-sector, lasting relationships that emphasized patient centrality along with long-term commitments to sustainability and accountability. This pathway, leading to a population health approach, also generated the need for transformative business models. The coproduction of health framework, with its emphasis on cross-sector alignments, nontraditional partner relationships, sustainable missions, and accountability capable of yielding return on investments, has emerged as a unique strategy for facing disruptive threats and challenges from nonhealth sector corporations. This chapter presents a coproduction of health framework, goals and criteria, examples of boundary spanning network alliance models, and operational (integrator, convener, aggregator) strategies. A comparison of important organizational science theories, including institutional theory, network/network analysis theory, and resource dependency theory, provides suggestions for future research directions necessary to validate the utility of the coproduction of health framework as a precursor for paradigm change.
Details
Keywords
Pooja Kansra and Amiya Abdul Khadar
Population ageing is a demographic transition and burdens every country’s health sector. A lack of social security combined with low government health-sector spending has made…
Abstract
Purpose
Population ageing is a demographic transition and burdens every country’s health sector. A lack of social security combined with low government health-sector spending has made health-care utilisation difficult among elderly in many developing countries like India. This makes population ageing a global phenomenon for policymakers, researchers and stakeholders to discuss and debate in 21st century. The purpose of this paper is to examine the behavioural determinants of health-care utilisation among elderly population in Punjab.
Design/methodology/approach
This study examines health-care utilisation among the elderly population in Punjab. A structured questionnaire was used to collect the data in the state of Punjab, with a multi-stage stratified random sample of 385 respondents. Logit regression was used to analyse the association between several behavioural factors like age, gender, place of residence, source of livelihood, education and frequency of visits with health-care utilisation among elderly aged 60 and above.
Findings
This study revealed that gender, age, place of residence, source of livelihood, education and frequency of visits were significant determinants of health-care utilisation among elderly population.
Originality/value
This study directs the need to improve health-care utilisation in a country, reducing inequalities that exist among the elderly population with respect to socio-economic and demographic differences.
Details
Keywords
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.
Details
Keywords
Matthew E. Archibald, Rachel N. Head, Jordan Yakoby and Pamela Behrman
This study examines chronic illness, disability and social inequality within an exposure-vulnerabilities theoretical framework.
Abstract
Purpose
This study examines chronic illness, disability and social inequality within an exposure-vulnerabilities theoretical framework.
Methodology/Approach
Using the National Survey of Drug Use and Health (NSDUH), a preeminent source of national behavioral health estimates of chronic medical illness, stress and disability, for selected sample years 2005–2014, we construct and analyze two foundational hypotheses underlying the exposure-vulnerabilities model: (1) greater exposure to stressors (i.e., chronic medical illness) among racial/ethnic minority populations yields higher levels of serious psychological distress, which in turn increases the likelihood of medical disability; (2) greater vulnerability among minority populations to stressors such as chronic medical illness exacerbates the impact of these conditions on mental health as well as the impact of mental health on medical disability.
Findings
Results of our analyses provided mixed support for the vulnerability (moderator) hypothesis, but not for the exposure (mediation) hypothesis. In the exposure models, while Blacks were more likely than Whites to have a long-term disability, the pathway to disability through chronic illness and serious psychological distress did not emerge. Rather, Whites were more likely than Blacks and Latinx to have a chronic illness and to have experienced severe psychological distress (both of which themselves were related to disability). In the vulnerability models, both Blacks and Latinx with chronic medical illness were more likely than Whites to experience serious psychological distress, although Whites with serious psychological distress were more likely than these groups to have a long-term disability.
Research Limitations
Several possibilities for understanding the failure to uncover an exposure dynamic in the model turn on the potential intersectional effects of age and gender, as well as several other covariates that seem to confound the linkages in the model (e.g., issues of stigma, social support, education).
Originality/Value
This study (1) extends the racial/ethnic disparities in exposure-vulnerability framework by including factors measuring chronic medical illness and disability which: (2) explicitly test exposure and vulnerability hypotheses in minority populations; (3) develop and test the causal linkages in the hypothesized processes, based on innovations in general structural equation models, and lastly; (4) use national population estimates of these conditions which are rarely, if ever, investigated in this kind of causal framework.
Details
Keywords
Gerard W. Toh, Wee Ling Koh, Jack Ho, Jackson Chia, Ad Maulod, Irene Tirtajana, Peter Yang and Mathia Lee
Health disparities affecting lesbian, gay, bisexual, transgender and queer (LGBTQ) populations have been reported in many countries. For Singapore, no large quantitative studies…
Abstract
Purpose
Health disparities affecting lesbian, gay, bisexual, transgender and queer (LGBTQ) populations have been reported in many countries. For Singapore, no large quantitative studies on mental health and well-being in the local LGBTQ community have been published. The authors conducted a community-based survey (National LGBT Census Singapore, 2013; NLCS2013) that covered a comprehensive set of demographic, social and health indicators. Here, the authors investigated mental health status and its correlates in 2,350 LGBTQ individuals within the NLCS2013 sample.
Design/methodology/approach
The NLCS2013 was an anonymous online survey conducted amongst self-identified LGBTQ adults (aged ≥ 21 years) residing in Singapore. The survey included the World Health Organisation Well-being Index (WHO-5) as a measure of mental well-being, with low WHO 5 scores (<13/25) indicating poor mental well-being. The authors analysed relationships between low WHO-5 score and a range of respondent characteristics using multivariate logistic regression.
Findings
Strikingly, 40.9% of 2,350 respondents analysed had low WHO-5 scores, indicating poor mental well-being. Parental non-acceptance, experience of conflict at home and bullying/discrimination in the workplace or educational environments were all significantly associated with poor mental well-being. Conversely, community participation appeared protective for mental well-being, as respondents who participated in LGBTQ community organisations or events were less likely to have poor mental well-being than non-participants.
Originality/value
The NLCS2013 represents one of the first broad-based efforts to comprehensively and quantitatively capture the sociodemographic and health profile, including mental health status, within Singapore’s resident LGBTQ population. These findings affirm the need to address the mental health needs of LGBTQ individuals in Singapore and to foster safe spaces and allyship.
Details
Keywords
Yousef Moradi, Marzieh Mahboobi and Ghobad Moradi
Identifying the health-related needs in transgender (TG) people can help to formulate strategies for providing appropriate and accessible health services and promoting health and…
Abstract
Purpose
Identifying the health-related needs in transgender (TG) people can help to formulate strategies for providing appropriate and accessible health services and promoting health and social justice, as well as human rights in these populations. This systematic review aims to determine health-related needs, problems and barriers, as well as ways to solve them in TG people from the viewpoint of TG individuals and health policymakers.
Design/methodology/approach
All international electronic databases such as PubMed (Medline), Embase, CINAHL, Scopus, Web of Sciences, Cochrane, PsycInfo and Google Scholar (Gray Literature) were searched from December 1990 to December 2019. After the search, the articles were screened based on their title, abstract and full text. The quality of articles was assessed using the Strengthening the reporting of observational studies in epidemiology (STROBE), Consolidated Standards of Reporting Trials (CONSORT) and Standards for Reporting Qualitative Research (SRQR) checklists. The search strategy, data extraction and quality evaluation of articles were independently performed by two researchers.
Findings
The general health-related needs identified in TG individuals from the viewpoint of themselves included access to legal hormone therapy, psychological and psychiatric counseling, privacy, health and hygiene needs, equality and freedom of expression. General health-related needs in TG individuals from the viewpoint of health policymakers included screening tests to detect sexually transmitted diseases, especially HIV, cancers and other diseases, as well as training service providers (physicians, nurses, health workers, etc.).
Research limitations/implications
One of the limitations of this study was nonreporting of health-related needs in initial articles by different TG groups because these groups have had different needs and different barriers to accessing health-care services. In this study, health-related needs and barriers to satisfy them were categorized from the viewpoint of TG populations and health policymakers around the world, which may influence future decisions to provide services to TG populations. The results of this systematic review can help to develop different strategies by considering all TGs from individual, family and social aspects to better provide services for this group. However, given the dynamics and changes in the existing communities and the limited studies on gender minorities in developing countries, further research is required to comprehensively address the subject.
Originality/value
The findings can be used as an incentive to improve existing conditions and to address problems and shortcomings. The results of this systematic review formulate strategies for providing appropriate and accessible health services and better lives for TGs, planning for more effective participation of these individuals in local communities, improving their physical problems and mental health through counseling, as well as promoting health and social justice, and human rights for these populations.
Details
Keywords
Georgia Watson, Cassie Moore, Fiona Aspinal, Andrew Hutchings, Rosalind Raine and Jessica Sheringham
Many countries have a renewed focus on health inequalities since COVID-19. In England, integrated care systems (ICSs), formed in 2022 to promote integration, are required to…
Abstract
Purpose
Many countries have a renewed focus on health inequalities since COVID-19. In England, integrated care systems (ICSs), formed in 2022 to promote integration, are required to reduce health inequalities. Integration is supported by population health management (PHM) which links data across health and care organisations to inform service delivery. It is not well-understood how PHM can help ICSs reduce health inequalities. This paper describes development of a programme theory to advance this understanding.
Design/methodology/approach
This study was conducted as a mixed-methods process evaluation in a local ICS using PHM. The study used Framework to analyse interviews with health and care professionals about a PHM tool, the COVID-19 vaccination uptake Dashboard. Quantitative data on staff Dashboard usage were analysed descriptively. To develop a wider programme theory, local findings were discussed with national PHM stakeholders.
Findings
ICS staff used PHM in heterogeneous ways to influence programme delivery and reduce inequalities in vaccine uptake. PHM data was most influential where it highlighted action was needed for “targetable” populations. PHM is more likely to influence decisions on reducing inequalities where data are trusted and valued, data platforms are underpinned by positive inter-organisational relationships and where the health inequality is a shared priority.
Originality/value
The COVID-19 pandemic accelerated a shift toward use of digital health platforms and integrated working across ICSs. This paper used an evaluation of integrated data to reduce inequalities in COVID-19 vaccine delivery to propose a novel programme theory for how integrated data can support ICS staff to tackle health inequalities.
Details
Keywords
This paper aims to investigate research activity on barriers for minority and underserved groups to access and use mental health services.
Abstract
Purpose
This paper aims to investigate research activity on barriers for minority and underserved groups to access and use mental health services.
Design/methodology/approach
Using Scopus, relevant articles published from 1993 to 2022 were collected. The final list included 122 articles.
Findings
Research hotspots included cultural and ethnic barriers, obstacles encountered by LGBTQ+ individuals, challenges faced by refugees and immigrants, limited access in rural areas and barriers affecting special populations. The top 10 cited articles focused on language barriers, cultural stigma, gender-specific challenges and systemic obstacles. New research avenues included the role of technology in overcoming barriers to access mental health services.
Practical implications
Policymakers and practitioners can use this knowledge to develop targeted interventions, enhance cultural competence, reduce stigma, improve rural access and provide LGBTQ+-affirming care, ultimately promoting equitable mental health care.
Social implications
This research underscores the importance of addressing mental health service barriers for equity and social justice. Neglecting these disparities can worsen mental health, increase health-care costs, reduce productivity and lead to higher social welfare expenses, perpetuating disadvantages.
Originality/value
This paper's uniqueness lies in its comprehensive analysis of barriers and facilitators to mental health service utilization among minority and underserved groups. It serves as a basis for developing evidence-based strategies to improve service accessibility and enhance the well-being of marginalized communities.
Details
Keywords
Ada Kwan, Rachel Sklar, Drew B. Cameron, Robert C. Schell, Stefano M. Bertozzi, Sandra I. McCoy, Brie Williams and David A. Sears
This study aims to characterize the June 2020 COVID-19 outbreak at San Quentin California State Prison and to describe what made San Quentin so vulnerable to uncontrolled…
Abstract
Purpose
This study aims to characterize the June 2020 COVID-19 outbreak at San Quentin California State Prison and to describe what made San Quentin so vulnerable to uncontrolled transmission.
Design/methodology/approach
Since its onset, the COVID-19 pandemic has exposed and exacerbated the profound health harms of carceral settings, such that nearly half of state prisons reported COVID-19 infection rates that were four or more times (and up to 15 times) the rate found in the state’s general population. Thus, addressing the public health crises and inequities of carceral settings during a respiratory pandemic requires analyzing the myriad factors shaping them. In this study, we reported observations and findings from environmental risk assessments during visits to San Quentin California State Prison. We complemented our assessments with analyses of administrative data.
Findings
For future respiratory pathogens that cannot be prevented with effective vaccines, this study argues that outbreaks will no doubt occur again without robust implementation of additional levels of preparedness – improved ventilation, air filtration, decarceration with emergency evacuation planning – alongside addressing the vulnerabilities of carceral settings themselves.
Originality/value
This study addresses two critical aspects that are insufficiently covered in the literature: how to prepare processes to safely implement emergency epidemic measures when needed, such as potential evacuation, and how to address unique challenges throughout an evolving pandemic for each carceral setting.
Details
Keywords
Wafa Hammedi, Joy Parkinson and Lia Patrício
The purpose of this paper is to explore the challenges, interplay and potential directions for future service research to address the first three Sustainable Development Goals…
Abstract
Purpose
The purpose of this paper is to explore the challenges, interplay and potential directions for future service research to address the first three Sustainable Development Goals (SDGs) of no poverty, zero hunger and good health and well-being.
Design/methodology/approach
This commentary examines how service research has addressed these SDGs in the literature, and through the development of a theory of change, the authors propose an agenda for service research going beyond serving, to enabling and transforming service systems, expanding the current focus on individual to community and population well-being through promotion and prevention.
Findings
Service research has increasingly advocated human-centered approaches but requires a shift towards an all of humanity perspective. Individual and collective well-being have gained attention in service research, emphasizing the importance of considering collective well-being.
Research limitations/implications
The commentary underscores the need for a comprehensive approach to develop services that contribute to the well-being of the human species. It calls for research that transcends dyadic interactions, considers systemic dynamics and broadens the focus from individual to collective and population well-being.
Social implications
This paper discusses important societal issues of poverty, hunger and good health and well-being and the need for integrated and ecosystem approaches to develop equitable and sustainable solutions for collective well-being.
Originality/value
While SDGs 1, 2 and 3 address individual goals, they collectively underpin the well-being of communities and societies.
Details