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1 – 10 of over 128000Francesco Taroni, Daniel Z. Louis and Elaine J. Yuen
The European Community is currently experimenting with the use ofDiagnosis Related Groups (DRGs) and other patient classificationsystems. Disease Staging is a clinically based…
Abstract
The European Community is currently experimenting with the use of Diagnosis Related Groups (DRGs) and other patient classification systems. Disease Staging is a clinically based classification system which focuses on the dimensions of severity of illness and can be implemented using the same data required for the DRGs. Reports a pilot study in the Emilia‐Romagna region of Italy, where data were analysed from three hospitals for patients hospitalized in 1988 with four diseases: coronary artery disease/acute myocardial infarction, cholecystitis, appendicitis, and diabetes mellitus. The same patients were classified using DRGs and Disease Staging, and the Disease Staging methodology was used to analyse issues of timeliness of hospital admission, length of stay patterns, and in‐hospital mortality rates.
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Unlike other health professions, there has historically been no licensing, registration, or certification of public health practitioners to demonstrate their qualification to the…
Abstract
Purpose
Unlike other health professions, there has historically been no licensing, registration, or certification of public health practitioners to demonstrate their qualification to the public and employers. The purpose of this paper is to outline the rationale for developing public health workforce certification, describes the certification process developed by the National Board of Public Health Examiners (NBPHE), and explains how it is affecting public health education and practice.
Design/methodology/approach
This paper is a narrative review from records of NBPHE.
Findings
The Association of Schools and Programs of Public Health commissioned a formal study of health worker credentialing in 1989 and created a task force in 1999 to determine the need for public health credentialing. Based on input from public health leaders and stakeholders, the NBPHE was formed in 2005 to offer the Certified in Public Health (CPH) examination. The first CPH examination was administered in 2008. Uptake of the CPH was strong the first year (693 examinees), dropped by nearly half (369 examinees) in the second year, and then increased each year through 2015. Part of the increase may be due to eligibility revisions for taking the CPH examination. Eligibility for taking the CPH examination was revised in 2010 to include graduate students in public health and in 2015 to include candidates with a bachelor degree from any field and at least five years of work experience in public health. The NBPHE is piloting open professional eligibility for candidates with no formal education in public health and at least five year’s public health work experience. Schools and programs of public health accredited by the Council on Education for Public Health (CEPH) view the CPH examination as a useful tool in curriculum assessment and improvement and for maintaining CEPH accreditation. Several schools and programs of public health have begun requiring all graduate students to take the CPH examination. The CPH credential is also increasingly being used as a hiring factor among employers.
Originality/value
NBPHE’s CPH credential is unique in the world. Foreign students graduating with American public health degrees have been taking the exam before returning to leadership roles in their own country. The CPH program described can serve as a model for other nations.
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This paper seeks to describe the public health guidance development activity of the new National Institute for Health and Clinical Excellence (NICE).
Abstract
Purpose
This paper seeks to describe the public health guidance development activity of the new National Institute for Health and Clinical Excellence (NICE).
Design/methodology/approach
The paper outlines the origins of the public health guidance development work, the types of guidance in public health which NICE will produce, the methodological approach which will be used, the advisory body structure, the health economics which will inform judgements about cost‐effectiveness, the audiences for the guidance and the approach to health inequalities which will be taken.
Findings
The future recommendations which NICE will make in public health are signalled.
Originality/value
The paper provides a summary of the key processes which will be used in the production of public health guidance.
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From the symposium keynote address, this paper aims to explore how healthcare‐associated infections (HAIs) have been transformed from being only a hospital concern to a much…
Abstract
Purpose
From the symposium keynote address, this paper aims to explore how healthcare‐associated infections (HAIs) have been transformed from being only a hospital concern to a much broader public health concern.
Design/ methodology/ approach
The paper is a narrative review.
Findings
HAIs have the characteristics that define issues as public health problems. As a result, public health departments can become important partners in the evolving hospital infection control field. However, whether all state health departments can afford to add HAI experts and whether current public health department HAI activities will be effective in preventing HAIs remain important questions.
Practical implications
Public health agencies must be selective about focusing limited resources into areas where they can protect and improve the public's health; whether HAIs are such an area remains to be seen. Although HAIs have historically been the focus of hospitals and hospital‐based services, public health involvement has been mandated through state and federal legislation. In theory, the new mandate is appropriate; in practice, its impact and value need to be comprehensively assessed.
Originality/value
The interdisciplinary team required to evaluate HAI mandatory public reporting comprehensively needs to start from an understanding of the history and concepts underlying public health practice.
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– The purpose of this paper is to describe a national framework for leadership and workforce development in public mental health, published by Public Health England in 2015.
Abstract
Purpose
The purpose of this paper is to describe a national framework for leadership and workforce development in public mental health, published by Public Health England in 2015.
Design/methodology/approach
It has been developed with national partners and the local public health workforce, responding to local need and national policy. It aims to build the capacity and capability of leaders and a workforce that is confident, competent and committed to: promoting good mental health across the population, preventing mental illness and suicide, and improving the quality and length of life of people living with mental illness.
Findings
The framework outlines six ambitions for change and suggests the core principles and competencies needed in the workforce, and in leaders, to make that change happen, alongside practical actions.
Practical implications
A call to action approach is used to gain commitment from strategic partners and key organisations. Planners and practitioners are encouraged to use the framework to inform the commissioning and delivery of workforce development.
Originality/value
This is the first time a national framework for workforce development in public mental health has been published and as such it sets direction for national and local bodies and provides a practical approach to inform and influence action.
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Janice Robinson and Siân Griffiths
New public health policies present social services with new opportunities and challenges. A shared public health and social care agenda is emerging around health improvement…
Abstract
New public health policies present social services with new opportunities and challenges. A shared public health and social care agenda is emerging around health improvement, social exclusion and regeneration. Early signs of synergy indicate that social services have a key role to play in shaping the public health agenda and in acting as a bridge between the NHS and the wider local authority.
The purpose of this paper is to show how the Turning Point Initiative to improve the health of populations by improving the USA public health system has many lessons on…
Abstract
Purpose
The purpose of this paper is to show how the Turning Point Initiative to improve the health of populations by improving the USA public health system has many lessons on collaboration for governance systems.
Design/methodology/approach
The article synthesizes published literature outlining the results of a Robert Wood Johnson Foundation/W.K. Kellogg Foundation grant program to 21 USA states and 43 communities and relationships to administrative practice.
Findings
Turning Point's creation of a formalized network of public health partners across the USA has led to innovations in collaboration, increased system capacity, and alternative structures for improving health.
Originality/value
Turning Point's efficacy in community health system improvement can be mirrored in clinical governance. A major potential for improvement in clinical delivery systems is available by re‐thinking key partners, organizational structures, and system administrative capacity.
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Suicide is primarily conceptualised as an event with causes relating to individual lives. However, we argue that it is impor tant not to lose sight of the fact that not all causes…
Abstract
Suicide is primarily conceptualised as an event with causes relating to individual lives. However, we argue that it is impor tant not to lose sight of the fact that not all causes of suicide are related simply to individual action and circumstances. Clear evidence exists for some risk factors for suicide being visable at the population level or related to membership of various social groups. Strategies to prevent suicide, therefore, ought to focus on such causes (eg. injustice, discrimination, mental illness in general), not just on causes relating to individuals. In turn, this means that suicide prevention should not merely focus on trying to reduce access to the means of suicide by individuals (eg. shotguns in rural areas, pesticides in India, means of strangulation in prisons etc) but should expand to include such things as socio‐economic determinants and other population influences on mental health. We argue that suicide ought to be thought of as being, in an impor tant sense, a public health problem, and that the resources of public health ethics are one impor tant element in seeking to address this impor tant issue.
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Evelien van der Schee, Peter P. Groenewegen and Roland D. Friele
If public trust in health care is to be used as a performance indicator for health care systems, its measurement has to be sensitive to changes in the health care system. For this…
Abstract
Purpose
If public trust in health care is to be used as a performance indicator for health care systems, its measurement has to be sensitive to changes in the health care system. For this purpose, this study has monitored public trust in health care in The Netherlands over an eight‐year period, from 1997 to 2004. The study expected to find a decrease in public trust, with a low point in 2002.
Design/methodology/approach
Since 1997, public trust in health care was measured through postal questionnaires to the “health care consumer panel”. This panel consists of approximately 1,500 households and forms a representative sample of the Dutch population.
Findings
Trust in health care and trust in hospitals did not show any significant trend. Trust in medical specialists displayed an upward trend. Trust in future health care, trust in five out of six dimensions of health care and trust in general practitioners actually did show a decrease. However, only for trust in macro level policies and trust in professional expertise this trend continued. For the remaining trust objects, after 1999 or 2000, an upward trend set in.
Research implications/limitations
No support was found for our overall assumption. Explanations for the fact that trust did increase after 1999 or 2000 are difficult to find. On the basis of these findings the study questions whether the measure of public trust is sensitive enough to provide information on the performance of the health care system.
Originality/value
The aim of this research is to study public trust in health care on its abilities to be used as a performance indicator for health care systems.
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