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1 – 10 of 847Clair Reynolds Kueny, Alex Price and Casey Canfield
Barriers to adequate healthcare in rural areas remain a grand challenge for local healthcare systems. In addition to patients' travel burdens, lack of health insurance, and lower…
Abstract
Barriers to adequate healthcare in rural areas remain a grand challenge for local healthcare systems. In addition to patients' travel burdens, lack of health insurance, and lower health literacy, rural healthcare systems also experience significant resource shortages, as well as issues with recruitment and retention of healthcare providers, particularly specialists. These factors combined result in complex change management-focused challenges for rural healthcare systems. Change management initiatives are often resource intensive, and in rural health organizations already strapped for resources, it may be particularly risky to embark on change initiatives. One way to address these change management concerns is by leveraging socio-technical simulation models to estimate techno-economic feasibility (e.g., is it technologically feasible, and is it economical?) as well as socio-utility feasibility (e.g., how will the changes be utilized?). We present a framework for how healthcare systems can integrate modeling and simulation techniques from systems engineering into a change management process. Modeling and simulation are particularly useful for investigating the amount of uncertainty about potential outcomes, guiding decision-making that considers different scenarios, and validating theories to determine if they accurately reflect real-life processes. The results of these simulations can be integrated into critical change management recommendations related to developing readiness for change and addressing resistance to change. As part of our integration, we present a case study showcasing how simulation modeling has been used to determine feasibility and potential resistance to change considerations for implementing a mobile radiation oncology unit. Recommendations and implications are discussed.
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Ashok Dalwai, Ritambhara Singh, Vishita Khanna and S. Rutuparna
According to Global Healthcare Security Index 2021, India ranked 66 out of 195 countries, indicating the need and scope for improvement. The Cooperative healthcare system which…
Abstract
According to Global Healthcare Security Index 2021, India ranked 66 out of 195 countries, indicating the need and scope for improvement. The Cooperative healthcare system which has been rendering exemplary services is yet to gain visible recognition in India. Given the need for upgrading the health infrastructure in India and providing more affordable health services to the country’s growing population, it would help appreciate the large role that cooperative healthcare can play along with others. This study explores the structure, conduct, and performance of healthcare co-operatives in India, the factors contributing to their success and failure, and the challenges they face. The Health Cooperatives have a strong presence in Kerala and Karnataka and are also coming up in other parts of the country. However, a detailed database of them for public awareness is very limited. The cooperative hospitals can meet the basic requirements of curative treatment in rural and poorly-endowed urban areas. The democratic way in which they function makes them a destination for a financially weaker section. They must retain this feature. The study covers two successful cases which reveal that India needs a more dense healthcare cooperative network. Since cooperative hospitals in tune with the spirit of service run on the principle of being ‘Not-for-Profit’ they need to be supported by the governments more liberally, without however interfering with their governance and administration.
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Samuel Sekyi, Philip Kofi Adom and Emmanuel Agyapong Wiafe
This study examined the influence of income and health insurance on the health-seeking behaviour of rural residents, addressing the concerns of endogeneity and heterogeneity bias.
Abstract
Purpose
This study examined the influence of income and health insurance on the health-seeking behaviour of rural residents, addressing the concerns of endogeneity and heterogeneity bias.
Design/methodology/approach
A two-stage residual inclusion was utilised to correct self-selection-based endogeneity problems arising from health insurance membership.
Findings
This study provides support for Andersen's behavioural model (ABM). Income and health insurance positively stimulate rural residents' use of modern healthcare services, but the effect of insurance risks a downward bias if treated as exogenous. Further, the effect of health insurance differs between males and females and between adults and the elderly.
Originality/value
This study advances the literature, arguing that, within the ABM framework, enabling (i.e. income and insurance) and predisposing factors (i.e. age and gender) complement each other in explaining rural residents' use of modern health services.
Peer review
The peer review history for this article is available at: https://publons.com/publon/10.1108/IJSE-03-2023-0223
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Samaya Pillai, Manik Kadam, Madhavi Damle and Pankaj Pathak
Healthcare is indispensable for any civilisation to attain a good quality of life and well-being on both mental and physical levels. The healthcare domain primarily falls under…
Abstract
Healthcare is indispensable for any civilisation to attain a good quality of life and well-being on both mental and physical levels. The healthcare domain primarily falls under pharma, medical, biotechnology, and nursing. Also, other fields may be aligned with these primary fields. Healthcare amasses the contemporary trends and knowledge of upcoming techniques to improve healthcare processes. The practitioners are primarily doctors, nurses, specialists and health professionals, hospital administrators, and health insurance.
It is a fundamental attribute needed for any society to attain good quality of life and well-being in mental and physical health. It is a fundamental right of people to receive good healthcare where drug treatment and hospitalization are available at a nominal cost, as a requirement of today’s modern era. There appears to be a significant disparity in the availability of good healthcare in rural areas compared to urban in India. Even though we enter the digital era with the facilities offered in Industry 4.0 and other advanced technologies brings about a significant change of overall processing within healthcare systems. During the pandemic of COVID-19, there has been digital transformation with success globally. Healthcare cooperatives are a new norm to support the healthcare systems globally. The chapter discusses Gampaha healthcare cooperative and reviews Ayushman Sahakar scheme in India. The reforms require time to evolve.
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Raj Krishna and Kumar Mukul Choudhary
Post COVID-19 crisis, healthcare has become a priority for every government. Furthermore, the pandemic has also made us realise why do we need an affordable healthcare delivery…
Abstract
Post COVID-19 crisis, healthcare has become a priority for every government. Furthermore, the pandemic has also made us realise why do we need an affordable healthcare delivery service at the grassroots level. As a result, the Government of India has come out with the Ayushman Sahakar scheme. This scheme has been launched by the Union Government with an aim to assist the cooperatives in the creation of healthcare infrastructure in this country. It is pertinent to note that the cooperatives in the last few years have transformed rural areas and have pushed them out of poverty. As a result, it will be interesting to see the impact cooperatives will have in the field of healthcare.
The authors in this work have discussed the history of healthcare cooperatives in India. After this, the authors have analysed the government schemes and legal provisions which regulate the functioning of healthcare cooperatives in this country. In the next part, the authors studied the Ayushman Sahakar scheme. The authors have discussed the features of the scheme and the impact it has generated in the field of healthcare. Lastly, the author has discussed the challenges which healthcare cooperatives face in this country and how we can overcome those challenges.
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Jeffersson Santos, Amanda Acevedo-Morales, Lillian Jones, Tara Bautista, Carolyn Camplain, Chesleigh N. Keene and Julie Baldwin
Advancing behavioral health and primary care integration is a priority for helping clients overcome the complex health challenges impacting healthcare deserts like those in…
Abstract
Purpose
Advancing behavioral health and primary care integration is a priority for helping clients overcome the complex health challenges impacting healthcare deserts like those in Arizona, United States of America (USA). This study aimed to explore the perspectives of people with a substance use disorder (SUD) on accessing integrated primary care (IPC) services in a rural-serving behavioral healthcare organization in Arizona.
Design/methodology/approach
Clients from a behavioral health facility in Arizona (n = 10) diagnosed with SUDs who also accessed IPC participated in a 45-min semi-structured interview.
Findings
The authors identified six overarching themes: (1) importance of IPC for clients being treated for SUDs, (2) client low level of awareness of IPC availability at the facility, (3) strategies to increase awareness of IPC availability at the behavioral health facility, (4) cultural practices providers should consider in care integration, (5) attitudes and perceptions about the experience of accessing IPC and (6) challenges to attending IPC appointments. The authors also identified subthemes for most of the main themes.
Originality/value
This is the first study in rural Arizona to identify valuable insights into the experiences of people with SUDs accessing IPC, providing a foundation for future research in the region on care integration.
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Samuel Sekyi, Senia Nhamo and Edinah Mudimu
This paper aims to evaluate Ghana's National Health Insurance Scheme (NHIS) on healthcare utilisation by exploring its heterogeneous effects based on residential status and wealth.
Abstract
Purpose
This paper aims to evaluate Ghana's National Health Insurance Scheme (NHIS) on healthcare utilisation by exploring its heterogeneous effects based on residential status and wealth.
Design/methodology/approach
The study used the Ghana Socioeconomic Panel Survey (GSPS) datasets. An instrumental variable strategy, specifically the two-stage residual inclusion (2SRI), was employed to control endogenous NHIS membership.
Findings
Generally, the results show that NHIS improves healthcare utilisation (i.e. visits to a health facility and formal care). Concerning the heterogeneous effects of health insurance on healthcare utilisation, the results revealed that NHIS members are more likely to seek care, irrespective of their residence status. The results further indicate that the probability of visiting a health facility and utilising formal care increases for the poorest NHIS participants. Based on these, the authors conclude that NHIS provides equitable healthcare access and utilisation for its vulnerable populations, who are beneficiaries.
Originality/value
To the best of the authors' knowledge, this paper is the first to explore the heterogeneous effects of NHIS on healthcare utilisation across residential and income subpopulations. Splitting the dataset by residential status to examine healthcare utilisation inequality is worthwhile. In addition, analysing utilisation in terms of health care type would show whether Ghana's NHIS may be viewed as welfare-enhancing through increased formal health care utilisation.
Peer review
The peer review history for this article is available at: https://publons.com/publon/10.1108/IJSE-05-2023-0330
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R. Leelavathi, Arun Prakash and Rakhi Mohan
Human evolution has witnessed the highest level of metamorphism overages. COVID-19 alarmed us when we were unceasingly running toward monetary benefits and money, the significance…
Abstract
Human evolution has witnessed the highest level of metamorphism overages. COVID-19 alarmed us when we were unceasingly running toward monetary benefits and money, the significance of health. That initiated the thought process of improvising the health and healthcare infrastructure, leading to the birth of the health cooperative as a reform. During the state of COVID services, operations of the hospital were unreachable due to the unavailability of doctors, facilities, hiked charges, and lack of insurance coverage made people disbelieve in the system. Many social activists propose the idea of healthcare cooperatives to foster healthcare needs. The study guides us to understand the roles of healthcare cooperatives like the establishment of service facilities, modernisation of existing facilities, expansion to various topographical locations, and healthcare education to the general public, repair, and renovate the instrumentation in the medical field. The study also finds the ways and means of self-sustainability of health cooperatives with dependency on government financial support during the initial take-off. The benefits of cooperatives contributing to the NDHM and supporting the development of healthcare infrastructure in rural areas. The study enables us to find the factors that healthcare cooperatives need to consider for providing the right benefit to the citizens and factors for the self-sustained and self-resilient mode of seamless operation. The study has two different data collecting instruments, one to collect the data from the public and other from healthcare professionals. The result of the study reveals the mechanisms through which healthcare cooperatives can provide well-structured healthcare support to the nation.
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Rachel King, Clare Carolan and Steve Robertson
The purpose of this study is to explore the sustainability of innovations introduced during the coronavirus disease 2019 (Covid-19) pandemic in remote and rural primary care…
Abstract
Purpose
The purpose of this study is to explore the sustainability of innovations introduced during the coronavirus disease 2019 (Covid-19) pandemic in remote and rural primary care advanced clinical practice.
Design/methodology/approach
The methodology includes an exploratory qualitative study of eight key stakeholders from Scottish remote and rural primary care advanced practice (three policymakers and five advanced practitioners). Data were collected using semi-structured interviews during 2022 and analysed thematically.
Findings
Advanced practice in remote and rural primary care is characterised by a shortage of doctors, close-knit communities and a broad scope of practice. Covid-19 catalysed changes in the delivery of healthcare. Innovations which participants wanted to sustain include hybrid working, triage, online training and development, and increased inter-professional support networks.
Practical implications
Findings provide valuable insights into how best to support remote and rural advanced practice which may have implications for retaining healthcare professionals. They also identified useful innovations which could benefit from further investment.
Originality/value
Given current healthcare workforce pressures, identifying and sustaining innovations which will support and retain staff are imperative. Hybrid consultations and online access to training, development and support should be sustained to support the remote and rural advanced practice workforce. Further research should explore the sustainability of innovations introduced during the Covid-19 pandemic in other care contexts.
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Siu Mee Cheng and Cristina Catallo
Rural regions in Canada are aging faster than urban centers, but access to health and social care is limited. Integrated health and social care (IHSC) through collaboration across…
Abstract
Purpose
Rural regions in Canada are aging faster than urban centers, but access to health and social care is limited. Integrated health and social care (IHSC) through collaboration across different health and social care organizations can support enhanced care for older adults living in rural regions. However, IHSC is not well understood within a rural Canadian context.
Design/methodology/approach
A case study of a Canadian IHSC initiative, Geriatric Assessment Program Collaboratory (GAPC), in northern Alberta was undertaken to understand how successful IHSC can occur in an urban/rural region. The study used key informant interviews and a focus group of representatives from the GAPC organizations.
Findings
Nine factors were identified that support GAPC: communications, information sharing, shared vision and goals, inter-organizational culture, diffused leadership, team-based approaches, dedicated resources, role clarity, champions and pre-existing relationships. Eight external influence factors were identified as influencing partnership including geography, strong sense of community, inter-sectoral work, public policy, governance authorities and structures, funding models, aging communities and operating within a not-for-profit (NFP) setting.
Originality/value
The study reveals insights into how IHSC can occur within a rural Canadian context. This study demonstrates that IHSC occurs at the local level and that primary care providers can drive IHSC successfully.
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