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Globally, the presence of non-urgent patients in emergency departments (EDs) is considered one of the main reasons for creating excessive waiting times and overcrowding in units. This paper aims to understand the impact of non-urgent patients in EDs' operations.

This study is based on qualitative case studies conducted within two Brazilian EDs, and uses interviews and observations to access the data.

From a thematic analysis, three key themes emerged: characteristics of non-urgent demands in EDs, negative aspects of non-urgent patients in EDs, and the impact of the healthcare system model on EDs. These themes bring to light the impact that non-urgent patients have in EDs' operations, and provide theoretical and practical implications.

The limitation of this work is bound by the understanding of the non-urgent demands in EDs. Therefore, a benchmarking approach (investigating state-of-the-art practices to avoid such impact) was not applied but was suggested for future research instead.

The research provides significant contributions to practitioners and policymakers, aiding future discussions to improve healthcare coverage and performance.

The research provides significant contributions for managers and policymakers, aiding future discussions to improve healthcare. For instance, the use of well-known techniques (e.g. lean, six sigma) are discussed and suggested to enhance healthcare capacity and performance. Furthermore, the policymakers are called upon to evaluate the healthcare access and provide regulations that involve innovative approaches to widen healthcare access.

Based upon empirical data, this research extends the discussions related to non-urgent patient in EDs and is not limited merely to descriptive analysis, but by providing practical propositions and discussions related to the impact of these patients' presence in EDs' operations. Finally, the research provides a range of suggestions for future research related to the EDs' operational performance.

This study investigates the effect of user fees on access and waiting time in Nigeria. For access, the effect of user fees on both preventive and curative care; and the effect of user fees on waiting time at public healthcare facilities were examined. User fees are vital for the fiscal sustainability of healthcare provision for most African economies. Its imposition could debar healthcare access by the poor while its removal can reduce quality of care and induce longer waiting time.

The wave 3 of the Nigerian General Household Survey (2015/16) data was used for users of public health facilities. Access to healthcare was modelled using utilization data in a logistic regression model while waiting time was through the Negative Binomial Regression Model (NBRM).

The analyses showed significant effects of user fees on access to both preventive and curative care and on time spent waiting to make use of healthcare services. Individuals were able to access healthcare services regardless of amounts paid. Also, there was a non-negative effect of user fee imposition on waiting time.

Nigeria should improve healthcare facilities to address the enormous demand for healthcare services when designing policy for health sector.

This paper shows that even with the imposition of user fees, healthcare facilities could still not cater for the rising healthcare needs of the populace but cautioned that its abolition may not be a preferred option.

China launched a comprehensive health reform in 2009 to improve healthcare quality. Because preventive care utilization in China has not been frequently discussed, the purpose of this paper is to focus on the association between education level and preventive care before and after the initiation of the reform. Education has been referred to as the best health outcome indicator and China’s educational reform has been progressive, such as the health reform.

The authors analyzed data from four China Health and Nutrition Surveys (CHNS): 2004 (n=9,617); 2006 (n=9,527); 2009 (n=9,873); and 2011 (n=9,430). Variables were selected based on Andersen’s healthcare utilization model (predisposing, enabling and need factors). Multivariable logistic regression models, odds ratios (ORs) and 95 percent confidence intervals (95 percent CI) were conducted and reported.

In the adjusted multivariable logistic regression models, the authors found that general education was associated (p<0.05) with access to preventive care in 2004, 2009 and 2011, but not in 2006. Individuals with higher education had higher ORs for utilizing preventive care, compared with lower education (primary school education or none).

Policy implications include providing educational protocols regarding preventive care’s significance to residents educated at lower level schools, especially younger individuals.

To the authors’ knowledge, this is the first comparative assessment on education level and preventive care utilization before and after the implementation of the Chinese health reform.

The access to high quality, a reliable and affordable basic healthcare service is one of the key challenges facing the rural and semi‐urban population lying at base of the pyramid (BoP) in India. Realizing this as a social challenge and an economic opportunity (shared value), there has been an emergence of healthcare service providers who have bundled entrepreneurial attitude and passion with available scarce resources to design and implement cost‐effective, reliable and scalable market solutions for the BoP. The purpose of this research paper is to understand the underlying operating principles of these self‐sustainable business models aimed at providing healthcare services to the BoP segment in India.

The empirical context involves the use of case study research methodology, where the source of data is published case studies and the company websites of four healthcare organizations who have made a socio‐economic difference in the lives of the rural and semi‐urban population lying at the BoP in India.

The analysis and findings reflect the key operating principles for sustainable healthcare business ventures at the BoP. These include focus on 4A's (accessible, affordable, acceptable and awareness), local engagement, local skills building, learning by experiment, flexible organizational structure, dynamic leadership, technology integration and scalability.

This research study has focused mainly on the published case studies as source of data.

The intent is to understand and bring forth the learning and guiding principles, which act as a catalyst for the future researchers and business ventures engaged in BoP context.

The utilization of artificial intelligence (AI) in the solution of many problems encountered in healthcare in recent years is rapidly becoming widespread. Understanding of the use and importance of efficiency, security and accessible healthcare to everyone and providing value-based services for healthcare decision-makers is essential. The special uses of machine learning, natural language processing and smart voice assistants, which have developed as sub-branches of AI, for healthcare services, the contributions of these techniques to the digital transformation of healthcare services and how all these will help decision-making processes in healthcare services, will be discussed in this chapter. And also, FDA-approved algorithms that are a kind of AI tool will be explained.

The purpose of this paper is to identify factors, within a framework for integration, associated with healthcare utilization (primary care use, dental care, and insurance coverage) for Colorado refugees, by gender.

The Refugee Integration Survey and Evaluation project was a four-year longitudinal study of refugees that resettled in Colorado beginning in 2011. Refugees from Burma and Bhutan were used in this secondary data analysis. Various integration domains were explored as predictors, across gender groups, of the healthcare utilization outcome variables (physical exam in the past 12 months, dental exam in the past 12 months, and current healthcare coverage) using bivariate and multivariate logistic regression analyses.

In 2015, 73.1 percent of the sample reported accessing primary health care in the past year, and only 13.2 percent used dental care services. Nearly three-quarters reported having health insurance at the time of survey. In the adjusted models, there was a strong positive association between the outcome variable “physical exam” and the predictor variables “employment and economic self-sufficiency” (OR=0.70, p<0.001), “social bonding” (OR=3.73, p<0.001), and “safety and stability” (OR=2.23, p<0.001). Additionally, education and training predicted dental visit (OR=2.06, p<0.01). None of the integration domains were statistically significant predictors of dental visits in the adjusted models.

This study offers insights about facilitators and barriers to healthcare utilization uptake after resettling in a major US city. These findings can be used by agencies and governmental organizations to best tailor healthcare services and promotion of those services for this vulnerable population.