Search results

Secondary customers often experience secondary vulnerabilities that manifest in family-centred transformative services as other- and self-related customer needs. Yet, a relational perspective on primary and secondary customers’ needs is lacking. The study analyses secondary customers’ needs and their relationship to primary customers’ needs to enhance well-being in customer entities. The service inclusion lens is used to understand customers’ experiences of vulnerability.

The study uses an exploratory approach. The data consists of ethnographic observations and interviews of elderly residents (primary customers), their family members (secondary customers) and nurses in two nursing homes.

Primary and secondary customers’ needs are interrelated (or unrelated) in four ways: they are separate, congruent, intertwined or discrepant. The vulnerability experiences fluctuate in intensity and over time, individually reflecting on these need dimensions.

The study contributes to service research concerning customers’ experiences of vulnerability, secondary customers and their inclusion in services. Primary customers’ service inclusion may increase/decrease secondary customers’ service inclusion and their experience of vulnerability. Moreover, secondary customers’ inclusion is often necessary to foster primary customers’ inclusion and well-being.

Fostering service inclusion and well-being for primary and secondary customers requires balanced inclusion and acknowledging the needs of both groups. Service providers may need to act as moderators within customer entities if discrepant needs occur.

The study addresses the under-researched areas of family members’ customer needs, their relation to primary customers’ needs, experiences of secondary vulnerability and context-related vulnerability.

Integrated health and social care initiatives are increasing and health and social care systems are aiming to improve health and social outcomes in disadvantaged groups. There is a global dialogue surrounding improving services by shifting to an integrated health and social care approach. There is consensus of what is “health care”; however, the “social care” definition remains less explored. The authors describe the state of “social care” within the current integrated care literature and identify the depth of integration in current health and social care initiatives.

A narrative literature review, searching Medline, PsychINFO, CINAHL, PubMed, Scopus and Cochrane databases and grey literature (from 2016 to 2021), employing a search strategy, was conducted.

In total. 276 studies were eligible for full-text review, and 33 studies were included and categorised in types: “social care as community outreach dialogues”, “social care as addressing an ageing population”, “social care as targeting multimorbidity and corresponding social risks factors” and “social care as initiatives addressing the fragmentation of services”. Most initiatives were implemented in the United Kingdom. In total, 21 studies reported expanding integrated governance and partnerships; 27 studies reported having health and social care staff with clear integrated governance; 17 had dedicated funding and 11 used data-sharing and the integration of systems’ records.

The authors' demonstrate that social care approaches are expanding beyond the elderly, and these models have been used to respond to multimorbidity [including coronavirus disease 2019 (COVID-19)], targeting priority groups and individuals with complex presentations.

The substantial increase in non-communicable diseases (NCDs) is considered a major threat to developing countries. According to various international organizations and researchers, Kerala is reputed to have the best health system in India. However, many economists and health-care experts have discussed the risks embedded in the asymmetrical developmental pattern of the state, considering its high health-care and human development index and low economic growth. This study, a scoping review, aims to explore four major health economic issues related to the Kerala health system.

A systematic review of the literature was performed using PRISMA to facilitate selection, sampling and analysis. Qualitative data were collected for thematic content analysis.

Chronic diseases in a significant proportion of the population, low compliance with emergency medical systems, high health-care costs and poor health insurance coverage were observed in the Kerala community.

The present study was undertaken to determine the scope for future research on Kerala's health system. Based on the study findings, a structured health economic survey is being conducted and is scheduled to be completed by 2021. In addition, the scope for future research on Kerala's health system includes: (1) research on pathways to address root causes of NCDs in the state, (2) determine socio-economic and health system factors that shape health-seeking behavior of the Kerala community, (3) evaluation of regional differences in health system performance within the state, (4) causes of high out-of-pocket expenditure within the state.

Given the internationally recognized standard of Kerala's vital statistics and health system, this review paper highlights some of the challenges encountered to elicit future research that contributes to the continuous development of health systems in Kerala.

This systematic review paper aims to investigate seasonal ambient change’s impact on the incidence of falls among older adults.

The population, exposure, outcome (PEO) structured framework was used to frame the research question prior to using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis framework. Three databases were searched, and a total of 12 studies were found for inclusion, and quality appraisal was carried out. Data extraction was performed, and narrative analysis was carried out.

Of the 12 studies, 2 found no link between seasonality and fall incidence. One study found fall rates increased during warmer months, and 9 of the 12 studies found that winter months and their associated seasonal changes led to an increase in the incidence in falls. The overall result was that cooler temperatures typically seen during winter months carried an increased risk of falling for older adults.

Additional research is needed, most likely examining the climate one lives in. However, the findings are relevant and can be used to inform health-care providers and older adults of the increased risk of falling during the winter.

This study aims to examine the way in which elderly people, men and women, with a terminal illness use language to construct a narrative about their “living-with-dying” experience.

This investigation is a secondary analysis based on a corpus of health and illness narratives collected by the Health Experiences Research Group at the University of Oxford and published by the DIPEx charity (available at: http://healthtalk.org/home).

This study shows that there are qualitative differences in the way in which not only elderly people but also men and women report their experience with terminal illness and their relation to death.

Understanding the different perspectives from which elderly people narrate their experiences of how they live while dying from terminal illness can help health professionals to develop more effective all-inclusive health policies and practices in end-of-life care.

Heating, ventilating, air-conditioning and cooling (HVAC) systems are crucial in daily health-care facility services. Design-related defects can lead to maintenance issues, causing service disruptions and cost overruns. These defects can be avoided if a link between the early design stages and maintenance feedback is established. This study aims to use experts’ experience in HVAC maintenance in health-care facilities to list and evaluate the risk of each maintenance issue caused by a design defect, supported by the literature.

Following semistructured interviews with experts, 41 maintenance issues were identified as the most encountered issues. Subsequently, a survey was conducted in which 44 participants evaluated the probability and impact of each design-caused issue.

Chillers were identified as the HVAC components most prone to design defects and cost impact. However, air distribution ducts and air handling units are the most critical HVAC components for maintaining healthy conditions inside health-care facilities.

The unavailability of comprehensive data on the cost impacts of all design-related defects from multiple health-care facilities limits the ability of HVAC designers to furnish case studies and quantitative approaches.

This study helps HVAC designers acquire prior knowledge of decisions that may have led to unnecessary and avoidable maintenance. These design-related maintenance issues may cause unfavorable health and cost consequences.