Search results

Health care services are typically viewed as institutions or agencies offering professional care or care supervised by professionals. The concept of availability of health care services involves the degree to which persons can readily find professional care. Few scholars have considered the relevance of these notions to life-circumstances of older homebound women who experience emergent situations (ES) at home such as falls, unintentional injuries, or health problems. During a larger descriptive phenomenological study of the experience of reaching help quickly, 33 of 40 homebound women, aged 85–98 years, who were living alone, reported 57 situations of interest during open-ended interviews over 18 months. The purposes of this facet of the study were (a) to describe the life-world of women who had fortuitous help with ES at home, (b) to categorize helpers involved, and (c) to elaborate the reported influence of such situations on recognizing the risk of being unable to reach help quickly in the future. Life-world was featured by having help right now from someone on the scene. We categorized involved helpers into six types, including four previously identified types of home care helpers as well as (a) “on-the-spot” helpers, acquaintances not among the woman's home care helpers and (b) “at-this-scene-only” helpers, who were not likely to encounter the woman afterwards. In these ES, the home – not the health care institution – was the setting. On-the-scene helpers served as critical health care resources. In contrast to the typical focus on availability of health care services in a public space, availability of on-the-scene helpers in the home, a private space, was critical to the well-being of these old homebound women. This work raises new notions about availability of health care services for older homebound women and offers new perspectives on the key support network concepts of proximity and frequency of contact.

This chapter assesses the effects of two rural community residential advantages – economic growth and availability of health services – upon residents’ health and emotional well-being.

A de facto experimental design divided communities into four analytical types based on their economic growth and health services. Household survey data were gathered via a drop-off/pickup procedure and 400 randomly selected households were surveyed in each location. Physical health was measured with a subset of items from the Medical Outcomes Study’s 36-item short form. A 10-item emotional well-being index was used. Beyond sociodemographic items, questions concerned household assets, medical problems, social supports, and community ties. Nested regression analyses were used to assess the effects of residential advantage upon health, net of potentially confounding factors.

Contrary to expectations, both residential advantages were necessary for improved health. The most important negative net effect on health was aging. Beyond household assets and community economic expansion, miles commuted to work was the next most important factor enhancing physical health. In all types of communities, residents’ emotional well-being scores were independent of age, but positively related to household income and religious involvement.

Obviously the study is limited by geography and by the small number of communities in each residential type. While we could measure the effects of household members not being able to address all health needs, we could not assess the effects of such problems on anyone else in the households beyond the respondents. Our survey approach is also unable to address the effects of rural residents being unable to meet their health needs over time.

Ours is the first study that we know of applying a de facto natural experimental design to assess community residential effects. The interrelated effects of residential community resources for residents’ health suggests that more studies like this one should be done.

The study assesses public health programs to shed light on the experiences of low-income and minority women with children seeking health services. Thirteen focus groups were conducted with 111 pregnant women or women with children. Women consumers of public health services experience difficulties accessing health services due to a lack of insurance, information and language barriers about programs and eligibility, a shortage of Medicaid providers and specialist services, long waits, bureaucratic barriers, and dismissive treatment. Accessibility and information barriers were more prominent in rural regions whereas bureaucratic barriers were more pronounced in urban areas. Lower satisfaction with services was reported among ethnic minority women compared to whites.

This chapter covers four main concepts: (a) providing an understanding of service; (b) organizing hospitality decisions and processes; (c) defining strategic service visions; and (d) dissecting operations strategies for hospitality services. In the first section, the definition of service, the five service dimensions, and the service package are covered. In the second section, hospitality decisions and processes are framed by service concepts and the service-profit chain. A service concept is the starting point for developing hospitality operations strategies, while the service-profit chain explains the link from customer satisfaction and customer loyalty to a service firm’s growth and profitability. In the third section, the strategic service vision is explored. Successful service firms all have a strategic service vision, which includes a set of ideas and actions organized in a systematic way to maximize a firm’s performance. In the fourth and final section, the operations strategy for hospitality services is covered. Successful service operations occur when management defines and adheres to a competitive operations strategy.

Improvements in neonatal and paediatric care mean that many children with complex care needs (CCNs) now survive into adulthood. This cohort of children places great challenges on health and social care delivery in the community: they require dynamic and responsive health and social care over a long period of time; they require organisational and delivery coordination functions; and health issues such as minor illnesses, normally presented to primary care, must be addressed in the context of the complex health issues. Their clinical presentation may challenge local care management. The project explored the interface between primary care and specialised health services and found that it is not easily navigated by children with CCNs and their families across the European Union and the European Economic Area countries. We described the referral-discharge interface, the management of a child with CCNs at the acute–community interface, social care, nursing preparedness for practice and the experiences of the child and family in all Models of Child Health Appraised countries. We investigated data integration and the presence of validated standards of care, including governance and co-creation of care. A separate enquiry was conducted into how care is accessed for children with enduring mental health disorders. This included the level of parental involvement and the presence of multidisciplinary teams in their care. For all children with CCNs, we found wide variation in access to, and governance of, care. Effective communication between the child, family and health services remains challenging, often with fragmentation of care delivery across the health and social care sector and limited service availability.

Purpose — This chapter considers how transport policy and planning has been developing in Victoria in tandem with the research program described elsewhere in this book. Developments in policy and planning are discussed with particular regard to transport disadvantage and social inclusion.

Methodology — The chapter commences by providing a policy and planning context in terms of the geography and demography of travel needs, the relevant jurisdictional responsibilities in Australia and the policy history. It then describes the evolution of transport policy in the past decade and outlines the way in which the findings of this research are being incorporated into the development of programs and projects to support social inclusion. Additionally, some key policy challenges are outlined, at least some of which may provide fruitful areas for undertaking further research to support the development of future policies and programs.

Findings — The results show that applied research can be a highly successful endeavour, particularly when policy and planning perspectives are integrated into the development of the research design and strong collaboration is an ongoing feature of the research program.

Every citizen can be financially and economically active in certain circumstances if he or she has competencies, such as financial literacy. Current academic research suggests that financial literacy may be more important than income level and professional qualifications, as the decisive factor in the future will not be the amount of financial resources available to a person but the ability to manage them effectively and achieve their goals. Financial literacy competencies help different social groups to achieve private financial stability, acquire skills such as private financial planning, savings (including the third pillar of pensions), and their diversification, private capital multiplication, and openness to new business initiatives. The study aims to find out how financial literacy has developed in Estonia, Latvia, and Lithuania. Particular attention is paid to factors influencing the level of financial literacy. Research methods used are analysis of scientific publications and previously conducted research, analysis of surveys’ data on financial literacy and their factors, comparative time-scale analysis using regression trendline calculations of Estonia, Latvia, and Lithuania. The research results proved the impact and interconnection of main financial inclusion aspects such as account ownership, use of the Internet, availability of ATMs, and bank offices on financial literacy level. The main factor influencing the demand side of financial services is numeracy knowledge; a strong correlation has been found between PISA mathematics average scores for countries and their literacy level. The analyzed savings factor (voluntary savings for pension, life insurance, and investments in mutual funds) showed a heterogeneous situation – the ranks of countries differed from the financial literacy levels. It draws the attention of government policy-makers to attract citizens to these long-term investment and social security products by strengthening the supply side of the financial services.

This chapter addresses the grand challenge of an aging society and the subsequent growing demand for in-home care for the elderly – often referred to as homecare. It examines how emergent homecare models in England differ from the “time and task” model and how they are shaping the care market. These models offer new approaches regarding what, how, and when care is delivered at home. Homecare providers face rising demand driven not only by population aging but also by market demand for personalized care, choice, continuity of care, and real-time availability. The landscape presents an opportunity for innovative models to become established, by offering a more inducing service design and value propositions that respond to customers' needs. Using the “business model canvas” to guide data collection, this study presents an ethnographic case analysis of four homecare organizations with distinct emergent homecare models. The study includes 14 months of field observation and 33 in-depth interviews. It finds that providers are becoming increasingly aware of evolving customer needs, establishing models such as the “uberization,” “community-based,” “live-in,” and “preventative” described in the chapter. These models are becoming more pervasive and are mostly market-driven; however, some of their innovations are market shaping. The major innovations are in their value propositions, partnership arrangements, and customer segments. Their value propositions focus on well-being outcomes, including choice and personalization for care users; their workforces are perceived to be a major stakeholder segment, and their networks of partners offer access to complementary services, investments, and specialist knowledge.

This chapter examines the relationship between health service restructuring and the health care experiences of women from rural and remote areas of Canada. Data were collected from 34 focus groups (237 women), 15 telephone interviews and 346 responses from an online survey. Access to services, care quality and satisfaction are salient themes in these data. Problems include: travel, shortage of providers, turnover in personnel, delays associated in accessing care, lack of knowledge of women's health issues and patronizing attitudes of some health care providers. Health care service restructuring has led to deterioration in service availability and quality. Key areas for policy development need to address health care access and quality improvement issues, including increasing access to more (particularly female) providers who are sensitive to women's health issues.