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Healthcare reform

Anthony C Waddimba, Melissa Scribani, Nicole Krupa, John J May, Paul Jenkins
BACKGROUND: Widespread dissatisfaction among United States (U.S.) clinicians could endanger ongoing reforms. Practitioners in rural/underserved areas withstand stressors that are unique to or accentuated in those settings. Medical professionals employed by integrating delivery systems are often distressed by the cacophony of organizational change(s) that such consolidation portends. We investigated the factors associated with dis/satisfaction with rural practice among doctors/non-physician practitioners employed by an integrated healthcare delivery network serving 9 counties of upstate New York, during a time of organizational transition...
October 22, 2016: BMC Health Services Research
Robert Battat, Marc Jhonson, Lorne Wiseblatt, Cruff Renard, Laura Habib, Manouchka Normil, Brian Remillard, Timothy F Brewer, Galit Sacajiu
BACKGROUND: Recent calls for reform in healthcare training emphasize using competency-based curricula and information technology-empowered learning. Continuing Medical Education programs are essential in maintaining physician accreditation. Haitian physicians have expressed a lack access to these activities. The Haiti Medical Education Project works in alliance with Haitian medical leadership, faculty and students to support the Country's medical education system. We present the creation, delivery and evaluation of a competency-based continuing medical education curriculum for physicians in rural Haiti...
October 19, 2016: BMC Medical Education
Melinda Wolboldt, Barbara Saltzman, Patrick Tenbrink, Khaled Shahrour, Samay Jain
INTRODUCTION: With healthcare reform, cost and patient satisfaction will directly affect hospital reimbursement. We present data on same day discharge (SDD) for patients who underwent robot assisted laparoscopic radical prostatectomy (RALP). METHODS: Patient data were gathered in an IRB approved database. In April 2015, surgeon (SJ) began SDD. The SDD protocol for RALP includes multimodal anesthesia/analgesia and extended recovery. Interim analysis revealed that government insurance (CMS) refused hospital reimbursement for SDD...
October 19, 2016: Journal of Endourology
Rouhollah Zaboli, Shahram Tofighi, Ali Aghighi, Seyyed Javad Hosaini Shokouh, Nader Naraghi, Hassan Goodarzi
INTRODUCTION: Clinical practice guidelines are structured recommendations that help physicians and patients to make proper decisions when dealing with a specific clinical condition. Because blunt abdominal trauma causes a various range of mild, single-system, and multisystem injuries, early detection will help to reduce mortality and resulting disability. Emergency treatment should be initiated based on CPGs. This study aimed to determine the variables affecting implementing blunt abdominal trauma CPGs in an Iranian hospital...
August 2016: Electronic Physician
Marie-Josée Fleury, Guy Grenier, Catherine Vallée, Denise Aubé, Lambert Farand, Jean-Marie Bamvita, Geneviève Cyr
BACKGROUND: This study evaluates implementation of the Quebec Mental Health (MH) Reform (2005-2015) which aimed to improve accessibility, quality and continuity of care by developing primary care and optimizing integrated service networks. Implementation of MH primary care teams, clinical strategies for consolidating primary care, integration strategies to improve collaboration between primary care and specialized services, and facilitators and barriers related to these measures were examined...
October 18, 2016: BMC Health Services Research
Rosalía Cascón-Pereira, Ian Kirkpatrick, Mark Exworthy
This article aims to assess if the status of the medical profession has been reinforced or weakened with the new public management. With this purpose, it collects the opinion of two international experts regarding situation in the United Kingdom, in order to apply some lessons to the Spanish case. Both agree that, far from losing status and power with the healthcare reform, the medical profession has protected its status and autonomy against other social agents such as managers, politicians and patients. However, the maintenance of the status quo has been at the expense of an intra-professional stratification that has caused status inequalities linked to social class within the medical profession...
October 14, 2016: Gaceta Sanitaria
Jay Pan, Hanqing Zhao, Xiuli Wang, Xun Shi
In 2009, the Chinese government launched a new round of healthcare reform, which encourages development of private hospitals. Meanwhile, many public hospitals in China also became increasingly profit-oriented. These trends have led to concerns about social justice and regional disparity. However, there is a lack of empirical scientific analysis to support the debate. We started to fill this gap by conducting a regional-level analysis of spatial variation in spatial access to hospitals in the Sichuan Province...
October 1, 2016: Social Science & Medicine
Mariam F Eskander, Lindsay A Bliss, Ellen P McCarthy, Susanna W L de Geus, Sing Chau Ng, Deborah Nagle, James R Rodrigue, Jennifer F Tseng
BACKGROUND: Insurance impacts access to therapeutic options, yet little is known about how healthcare reform might change the pattern of surgical admissions. OBJECTIVE: We compared rates of emergent admissions and outcomes after colectomy before and after reform in Massachusetts with a nationwide control group. DESIGN: This study is a retrospective cohort analysis in a natural experiment. Prereform was defined as hospital discharge from 2002 through the second quarter of 2006 and postreform from the third quarter of 2006 through 2012...
November 2016: Diseases of the Colon and Rectum
Steven G Morgan, Katherine Boothe
Canada's universal public healthcare system is unique among developed countries insofar as it does not include universal coverage of prescription drugs. Universal, public coverage of prescription drugs has been recommended by major national commissions in Canada dating back to the 1960s. It has not, however, been implemented. In this article, we extend research on the failure of early proposals for universal drug coverage in Canada to explain failures of calls for reform over the past 20 years. We describe the confluence of barriers to reform stemming from Canadian policy institutions, ideas held by federal policy-makers, and electoral incentives for necessary reforms...
October 15, 2016: Healthcare Management Forum
Karsten Vrangbaek
Denmark is a small Northern European country with an extensive welfare state and a strong commitment to maintaining a universal healthcare system. Like the other countries in the Nordic region, Denmark has a long tradition of democratically governed local and regional governments with extensive responsibilities in organizing welfare state services. The Danish healthcare system has demonstrated an ability to increase productivity, while at the same time maintaining a high level of patient satisfaction. Ongoing reforms have contributed to these results, as well as a firm commitment to innovation and coordination...
2016: HealthcarePapers
Toshita Kalkana, Saibal Moitra, Surinder K Jindal, Subhabrata Moitra
Battle against COPD: time to reinforce the primary healthcare units of rural areas of India to combat lung diseases
April 2016: ERJ Open Research
Grainne Lowe, Virginia Plummer, Leanne Boyd
Objective The aim of the present study was to investigate and describe the application of a change management theoretical framework in relation to nurse practitioner (NP) role integration.Methods A survey formed Phase 1 of a broader mixed-methods study to explore perceptions of the change process involved with integrating NPs into Australian health care settings. The stakeholder participants were NPs, nurse managers and nurse policy advisers.Results Key themes were identified adding information about how NPs, nurse managers and nurse policy advisers perceive the integration of NPs into Australian healthcare...
October 7, 2016: Australian Health Review: a Publication of the Australian Hospital Association
Jesse D Schold, Michael P Phelan, Laura D Buccini
There is substantial evidence across different healthcare contexts that social determinants of health are strongly associated with morbidity and mortality in the US. These factors, including socioeconomic status, behavior and environmental risks, education, social support, healthy food and access to healthcare also vary widely by region and individual communities. One of the implications of heterogeneity in these risks is the potential impact on measured quality of healthcare providers. In particular, there is concern that providers treating disproportionally vulnerable communities may be disadvantaged by lack of risk adjustment for these factors that affect health but not indicators of quality of care...
October 3, 2016: American Journal of Transplantation
Elham Rafighi, Shoba Poduval, Helena Legido-Quigley, Natasha Howard
BACKGROUND: Recent British National Health Service (NHS) reforms, in response to austerity and alleged 'health tourism,' could impose additional barriers to healthcare access for non-European Economic Area (EEA) migrants. This study explores policy reform challenges and implications, using excerpts from the perspectives of non-EEA migrants and health advocates in London. METHODS: A qualitative study design was selected. Data were collected through document review and 22 in-depth interviews with non-EEA migrants and civil-society organisation representatives...
May 8, 2016: International Journal of Health Policy and Management
Lindsay E Jubelt, Amy I Elitzer, Jonathan P Kyriacou, David L Reich
No abstract text is available yet for this article.
July 7, 2016: Journal of Cardiothoracic and Vascular Anesthesia
A Santoro, N Abu-Rmeileh, A Khader, A Seita, M McKee
Palestinian refugees served by the United Nation Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) are experiencing increasing rates of diagnosis of non-communicable diseases. In response, in 2011 UNRWA initiated an Agency-wide programme of primary healthcare reform, informed by the Chronic Care Model framework. Health services were reorganized following a family-centred approach, with delivery by multidisciplinary family health teams supported by updated technical advice. An inclusive clinical information system, termed e-Health, was implemented to collect a wide range of health information, with a focus on continuity of treatment...
2016: Eastern Mediterranean Health Journal, la Revue de Santé de la Méditerranée Orientale
Sirirat Anutrakulchai, Pisaln Mairiang, Cholatip Pongskul, Kaewjai Thepsuthammarat, Chitranon Chan-On, Bandit Thinkhamrop
BACKGROUND: Thailand has reformed its healthcare to ensure fairness and universality. Previous reports comparing the fairness among the 3 main healthcare schemes, including the Universal Coverage Scheme (UCS), the Civil Servant Medical Benefit Scheme (CSMBS) and the Social Health Insurance (SHI) have been published. They focused mainly on provision of medication for cancers and human immunodeficiency virus infection. Since chronic kidney disease (CKD) patients have a high rate of hospitalization and high risk of death, they also require special care and need more than access to medicine...
September 29, 2016: BMC Health Services Research
(no author information available yet)
'This autumn, the US will choose a new president and, with this, a change in healthcare. But how will these changes affect US citizens? Considering that the goal of healthcare reform is to improve quality and access to care, does either presidential candidate completely support this goal?'
September 28, 2016: Nursing Standard
Chinyere Mbachu, Obinna Onwujekwe, Nkoli Ezumah, Olayinka Ajayi, Olusola Sanwo, Benjamin Uzochukwu
Decentralisation is defined as the dispersion, distribution or transfer of resources, functions and decision-making power from a central authority to regional and local authorities. It is usually accompanied by assignment of accountability and responsibility for results. Fundamental to understanding decentralisation is learning what motivates central governments to give up power and resources to local governments, and the practical significance of this on their positions regarding decentralisation. This study examined key political and institutional influences on role-players' capacity to support decentralisation of HIV and AIDS treatment services to primary healthcare facilities, and implications for sustainability...
September 2016: African Journal of AIDS Research: AJAR
Thomas Czypionka, Gerald Röhrling, Susanne Mayer
BACKGROUND: Coordinated health service utilisation in the ambulatory care sector is of major interest from a health policy perspective. This ecological study investigates the interplay between medical care utilisation in hospital outpatient departments and in freestanding physician practices by drawing on the example of the Austrian healthcare system, which is standing out due to three features: ambulatory care is provided by both free-standing public (contract) and private (non-contract) practitioners; medical specialists operate in free-standing physician practices and in hospital outpatient departments; essentially, no gatekeeping is in place...
September 27, 2016: European Journal of Public Health
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