Search results
1 – 10 of over 2000Martin McShane and Karen Kirkham
Changes in demographics and disease patterns are challenging health and care systems across the world. In England, national policies have reset the direction of travel for the…
Abstract
Purpose
Changes in demographics and disease patterns are challenging health and care systems across the world. In England, national policies have reset the direction of travel for the NHS. Collaboration, integration and personalisation are intended to become prime principles and drivers for new models of care. Central to this is the concept of population health management. This has emerged, internationally, as a method to improve population health. Fundamental for population health management to succeed is the use of integrated data, analytics combined with professional insight and the adoption of a learning health system culture. This agenda reaches beyond the NHS in England and the public health profession to embrace a broad range of stakeholders. By drawing on international experience and early experience of implementation in the United Kingdom, the potential for health and care systems in England to become world leading in population health management is explored.
Design/methodology/approach
A viewpoint paper.
Findings
Population health management is a major change in the way health and care systems look at the challenges they are facing. It makes what is happening to individuals, across the continuum of care, the essence for insight and action. The NHS has the components for success and the potential to become world leading in delivery of population health management as part of its integrated care agenda.
Originality/value
This is the first viewpoint paper to set out how population health management contributes to the integrated care agenda in the NHS.
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
Betty Steenkamer, Caroline Baan, Kim Putters, Hans van Oers and Hanneke Drewes
A range of strategies to improve pharmaceutical care has been implemented by population health management (PHM) initiatives. However, which strategies generate the desired…
Abstract
Purpose
A range of strategies to improve pharmaceutical care has been implemented by population health management (PHM) initiatives. However, which strategies generate the desired outcomes is largely unknown. The purpose of this paper is to identify guiding principles underlying collaborative strategies to improve pharmaceutical care and the contextual factors and mechanisms through which these principles operate.
Design/methodology/approach
The evaluation was informed by a realist methodology examining the links between PHM strategies, their outcomes and the contexts and mechanisms by which these strategies operate. Guiding principles were identified by grouping context-specific strategies with specific outcomes.
Findings
In total, ten guiding principles were identified: create agreement and commitment based on a long-term vision; foster cooperation and representation at the board level; use layered governance structures; create awareness at all levels; enable interpersonal links at all levels; create learning environments; organize shared responsibility; adjust financial strategies to market contexts; organize mutual gains; and align regional agreements with national policies and regulations. Contextual factors such as shared savings influenced the effectiveness of the guiding principles. Mechanisms by which these guiding principles operate were, for instance, fostering trust and creating a shared sense of the problem.
Practical implications
The guiding principles highlight how collaboration can be stimulated to improve pharmaceutical care while taking into account local constraints and possibilities. The interdependency of these principles necessitates effectuating them together in order to realize the best possible improvements and outcomes.
Originality/value
This is the first study using a realist approach to understand the guiding principles underlying collaboration to improve pharmaceutical care.
Details
Keywords
Bita A. Kash, Paul Ogden, Elizabeth Popp, Melissa Shaffer and Jane Bolin
The purpose of this study is to identify best practices for innovative primary care models and to describe a potential future primary care (PC) model for Texas to address the…
Abstract
Purpose
The purpose of this study is to identify best practices for innovative primary care models and to describe a potential future primary care (PC) model for Texas to address the burden of chronic disease in a population-based approach.
Design/methodology/approach
A systematic literature review was conducted and identified 1,880 published records through PubMed using 26 search terms. After abstract and full-text review, 70 articles remained as potential models.
Findings
Although there is already a severe shortage of physicians in Texas, emerging practice patterns and choices among physicians are likely to erode access to primary care services in the state. Health-care leaders are encouraged to consider models such as complex adaptive systems for team-based care, pharmacist hypertension care management program and combined nurse-led care management with group visit structure.
Research limitations/implications
As with any study, this research has its limitations; for example, models that might work in one state, or under a unique state-funded academic medical center, might not be “do-able” in another state within the nuances of a different funding mechanism.
Practical implications
Results of this research provide a model for implementing IPCM for the state of Texas first and will guide IPCM planning and implementation in other states.
Originality/value
This study is “land grant-centric” and focused on carrying out the mission of a major, top-tier research university with an emerging college of medicine at an academic medical center.
Details
Keywords
Arianna Maever Loreche, Veincent Christian F. Pepito and Manuel M. Dayrit
This review aimed to identify and map published studies on self-care practices to manage common acute health conditions in the Philippines.
Abstract
Purpose
This review aimed to identify and map published studies on self-care practices to manage common acute health conditions in the Philippines.
Design/methodology/approach
The authors conducted a scoping review in PubMed, Scopus, Cumulative Index of Nursing and Allied Health Literature (CINAHL), ProQuest Central, Journal Storage (JSTOR) and the Philippine Council for Health Research and Development – Health Research and Development Information Network (HERDIN). The authors included all studies on self-care practices to manage common acute conditions, namely low back pain, allergic rhinitis, general acute pain, cough, cold, diarrhea, constipation and stress, published up to 2021 in the Philippines. Information on the article type, aim of the study, study design and setting, population characteristics and size, and self-practices employed for the conditions were extracted and synthesized.
Findings
The authors identified various self-care practices for acute conditions among the general population and indigenous peoples in the Philippines from 26 studies included in the review: the use of medicines with and without a prescription, appropriate and inappropriate antibiotic use, use of medicinal plants and other traditional and alternative therapies and products, recreational activities and healthy habits and behaviors, and self-management or seeking care from traditional healers (albularyo or manggagamot) or health professionals. A number of considerations influenced their decision on how to manage symptoms, including perceived severity of the condition, availability and perceived effectiveness of treatment, cost, and advice from trusted sources of health information.
Research limitations/implications
The authors searched five major databases and a local research database, but some studies may still have been missed in the review. The review also excluded intervention studies on the outcomes of self-care, which limits the authors' ability to make conclusions on the effectiveness of the different modalities of self-care.
Social implications
Filipinos engage in a variety of “safe” (or evidence-informed) and “unsafe” (or harmful) self-care practices. While the term “self-care” is not routinely used by the general population and health providers, it is widely enculturated and practiced in the Philippines. Self-care benefits individuals and the health system, but there are also practices that increase risk of adverse outcomes and death including inappropriate antibiotic use, prescription sharing and reuse, and delays in seeking adequate treatment from a health professional. To leverage on self-care in advancing Universal Health Coverage (UHC) goals, the authors recommend a national strategy that provides guidance on how to practice responsible self-care, further research on the effectiveness and safety of alternative medicine and other priority areas, and better integration of self-care in the formal education and health systems. The authors also propose that the research agenda on self-care include acute health conditions, given their impact and burden on health and the economy.
Originality/value
This is the first published review of self-care practices for managing common acute health conditions, which captured practices of various groups and populations including indigenous peoples.
Details
Keywords
Owolabi Lateef Kuye and Olusegun Emmanuel Akinwale
Bureaucracy to a large extent entrenches orderliness and productive means of achieving goals in both public and private organisations across the world. However, bureaucracy is not…
Abstract
Purpose
Bureaucracy to a large extent entrenches orderliness and productive means of achieving goals in both public and private organisations across the world. However, bureaucracy is not suitable in the management of hospitals due to its peculiar nature of operations. This study investigates the conundrum of bureaucratic processes and health-care service delivery in government hospitals in Nigeria.
Design/methodology/approach
The study surveyed 600 outpatients and attendees visiting tertiary and government hospitals in Nigeria using descriptive design to obtained data from the respondents. A research instrument, questionnaire, was used to gather data. Out of the 600 outpatients visiting the 20 hospitals in government and tertiary hospitals, 494 responses were returned from the attendees. The study employed random sampling strategy to collect the information.
Findings
The findings of this study were that service delivery in government hospitals were in adverse position on all the four constructs of bureaucratic dimensions as against quality of service delivery in hospitals in Nigeria. It discovered that bureaucratic impersonality cannot impact on the quality of service delivery in government hospitals in Nigeria. Separation and division of labour among health workers have no significant effect on quality service delivery in government hospitals. Formal rules and regulations (administrative procedure, rules, and policies) prevent quality service delivery in government hospitals in Nigeria. Also, patient’s waiting time was not significant to the quality of service delivery in government hospitals.
Research limitations/implications
The results are constrained with dimensions of bureaucratic processes. Thus, the implication of this study is that bureaucracy in the Nigerian public hospitals is an unnecessary marriage which should be carefully separated and de-emphasised for quality service delivery in the hospitals to thrive.
Practical implications
Largely, this study is practical essential as it unearths the irrelevant operations procedure that hinder progress in Nigerian hospitals.
Originality/value
The study accomplishes recognised importance to survey how bureaucracy impedes quality service delivery in government hospitals. This study has provided a vital clue to elements that will bring rapid attention to patients’outcome in Nigerian hospitals and health-care facilities which hitherto has not been emphasised. The study has contributed to the existing body of knowledge associated to healthcare service quality in developing country.
Details
Keywords
Phudit Tejativaddhana, Nalinee Nakittipha Chuakhamfoo and Man Thi Hue Vo
This paper aims to explore the aging society situation, long-term care (LTC) policy preparation, COVID-19’s impact on older people, and post-pandemic preparations in Thailand and…
Abstract
Purpose
This paper aims to explore the aging society situation, long-term care (LTC) policy preparation, COVID-19’s impact on older people, and post-pandemic preparations in Thailand and the implications for The Association of Southeast Asian Nations (ASEAN) countries.
Design/methodology/approach
Online databases from international, national, academic agencies and SCOPUS database from January 2019 to July 2021 were utilized for analysis. Relevant literature and data were selected for review.
Findings
The evidence suggests that the proportion of the aging population is increasing due to declined fertility and rising life expectancy. Current and future demand for effective healthcare in ASEAN will be better achieved with policies like the Universal Health Coverage and Primary Health Care system. While some countries, specifically Thailand, are developing and expanding their LTC policies, some concerns regarding the active aging policy remain. Most ASEAN countries are using public domain for LTC policies. However, the COVID-19 pandemic has posed a major challenge in implementing LTC and affected the vulnerable aging population in many aspects, including social protection issues in Thailand.
Originality/value
With the support from international organizations, ASEAN countries have framed several policy strategies in response to the increasing aging population, such as providing more LTC in the community. The unexpected challenges from the COVID-19 pandemic compel policymakers to consider resource allocations and community-based services. On the positive side, as the pandemic has made the vulnerable group exposed, social protection issues have been brought to the forefront of the political debate and called for an appropriate policy response.
Details
Keywords
Jessica H. Williams, Geoffrey A. Silvera and Christy Harris Lemak
In the US, a growing number of organizations and industries are seeking to affirm their commitment to and efforts around diversity, equity, and inclusion (DEI) as recent events…
Abstract
In the US, a growing number of organizations and industries are seeking to affirm their commitment to and efforts around diversity, equity, and inclusion (DEI) as recent events have increased attention to social inequities. As health care organizations are considering new ways to incorporate DEI initiatives within their workforce, the anticipated result of these efforts is a reduction in health inequities that have plagued our country for centuries. Unfortunately, there are few frameworks to guide these efforts because few successfully link organizational DEI initiatives with health equity outcomes. The purpose of this chapter is to review existing scholarship and evidence using an organizational lens to examine how health care organizations can advance DEI initiatives in the pursuit of reducing or eliminating health inequities. First, this chapter defines important terms of DEI and health equity in health care. Next, we describe the methods for our narrative review. We propose a model for understanding health care organizational activity and its impact on health inequities based in organizational learning that includes four interrelated parts: intention, action, outcomes, and learning. We summarize the existing scholarship in each of these areas and provide recommendations for enhancing future research. Across the body of knowledge in these areas, disciplinary and other silos may be the biggest barrier to knowledge creation and knowledge transfer. Moving forward, scholars and practitioners should seek to collaborate further in their respective efforts to achieve health equity by creating formalized initiatives with linkages between practice and research communities.
Details
Keywords
Song Ying, Daniele Leone, Antonella Francesca Cicchiello, Antonella Francesca Cicchiello and Amirreza Kazemikhasragh
The economic shock posed by the current COVID-19 outbreak brought out a worldwide public health emergency with a close relationship between the industrial marketing practices, the…
Abstract
Purpose
The economic shock posed by the current COVID-19 outbreak brought out a worldwide public health emergency with a close relationship between the industrial marketing practices, the health level of society and its economic development. The purpose of this study is to analyse the industrial dynamics in health care and their impact on economic growth and health status.
Design/methodology/approach
To empirically investigate the relationship between growth and health, the authors use a data set drawn from 29 selected Organisation for Economic Co-operation and Development (OECD) countries over the period 2000 and 2019. Using panel regressions, the authors investigate the impact of the health-care industry measured in terms of health status, health expenditure, sales on pharmaceutical products, the number of persons working in health care and the coverage by private health insurances. Fixed effect and random effect regressions are used to estimate this model.
Findings
Overall, the results are suggestive of a nexus between the industrial marketing dynamics of health-care context and economic growth – both interacting and improving each other. As the quality of the health-care market enhances, the economy grows richer and the health status of the population improves considerably.
Practical implications
To support health-care markets in OECD countries, health policymakers need to formulate a long-term industrial health policy that addresses all the social and individual determinants of health.
Originality/value
To the best of the knowledge, this is the first study to provide a better understanding of the relationship between health-care industrial dynamics and economic growth in OECD countries along different dimensions.
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