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https://www.readbyqxmd.com/read/28544493/-it-s-a-fight-to-get-anything-you-need-accessing-care-in-the-community-from-the-perspectives-of-people-with-multimorbidity
#1
Julia W Ho, Kerry Kuluski, Jennifer Im
BACKGROUND: There is a growing interest in redesigning health-care systems to better manage the increasing numbers of people with multimorbidity. Knowing how patients experience health-care delivery and what they need from the health-care system are critical pieces of evidence that can be used to guide health system reforms. OBJECTIVE: The purpose of this study was to understand the challenges patients with multimorbidity face in accessing care in the community, and the implications for patients and their families...
May 24, 2017: Health Expectations: An International Journal of Public Participation in Health Care and Health Policy
https://www.readbyqxmd.com/read/28537961/the-affordable-care-act-and-cancer-care-delivery
#2
Gabriel A Brooks, J Russell Hoverman, Carrie H Colla
The Affordable Care Act (ACA) has reformed US health care delivery through insurance coverage expansion, experiments in payment design, and funding for patient-centered clinical and health care delivery research. The impact on cancer care specifically has been far reaching, with new ACA-related programs that encourage coordinated, patient-centered, cost-effective care. Insurance expansions through private exchanges and Medicaid, along with preexisting condition clauses, have helped more than 20 million Americans gain health care coverage...
May 2017: Cancer Journal
https://www.readbyqxmd.com/read/28532500/extending-access-to-essential-services-against-constraints-the-three-tier-health-service-delivery-system-in-rural-china-1949-1980
#3
Xing Lin Feng, Melisa Martinez-Alvarez, Jun Zhong, Jin Xu, Beibei Yuan, Qingyue Meng, Dina Balabanova
BACKGROUND: China has made remarkable progress in scaling up essential services during the last six decades, making health care increasingly available in rural areas. This was partly achieved through the building of a three-tier health system in the 1950s, established as a linked network with health service facilities at county, township and village level, to extend services to the whole population. METHODS: We developed a Theory of Change to chart the policy context, contents and mechanisms that may have facilitated the establishment of the three-tier health service delivery system in rural China...
May 23, 2017: International Journal for Equity in Health
https://www.readbyqxmd.com/read/28529119/call-for-shared-decision-making-in-china-challenges-and-opportunities
#4
Mi Yao, Samuel Finnikin, K K Cheng
China's healthcare system has undergone extensive changes over recent years and the most recent reforms are designed to shift the emphasis away from hospital based services towards a more primary care based system. There is an increasing recognition that shared decision making needs to play a central role in the delivery of healthcare in China, but there are several significant barriers to overcome before this aspiration becomes a reality. Doctor-patient relationships in China are poor, consultations are often brief transactions and levels of trust are low...
May 18, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/28525630/laboratory-integration-and-consolidation-in-a-regional-health-system
#5
Jim Cook
Health systems face intense pressure to decrease costs and improve services as the health care delivery system in the United States undergoes tremendous change due to health care reform. As health systems grow, like any business, they are forced to explore standardization to realize and maintain efficient practices. Clinical services, such as laboratory medicine, are more difficult to integrate due to wider variation in acceptable practice and culture, compared with other services. However, changes to laboratory service are imperative if health care professionals expect to survive and thrive in the new business environment...
May 19, 2017: Laboratory Medicine
https://www.readbyqxmd.com/read/28525558/electronic-clinical-quality-measure-reporting-challenges-findings-from-the-medicare-ehr-incentive-program-s-controlling-high-blood-pressure-measure
#6
Dawn M Heisey-Grove, Hilary K Wall, Janet S Wright
Objective: To identify physician and practice characteristics associated with high clinical and technical performance on the electronic clinical quality measure (eCQM) that calculates the proportion of patients with hypertension who have controlled blood pressure. Materials and Methods: The study included 268 602 physicians participating in the Medicare Electronic Health Record Incentive Program between 2011 and 2014. Independent variables included delivery reform participation and physician, practice level, and area characteristics...
May 19, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28499378/organisational-systems-approaches-to-improving-cultural-competence-in-healthcare-a-systematic-scoping-review-of-the-literature
#7
REVIEW
Janya McCalman, Crystal Jongen, Roxanne Bainbridge
INTRODUCTION: Healthcare organisations serve clients from diverse Indigenous and other ethnic and racial groups on a daily basis, and require appropriate client-centred systems and services for provision of optimal healthcare. Despite advocacy for systems-level approaches to cultural competence, the primary focus in the literature remains on competency strategies aimed at health promotion initiatives, workforce development and student education. This paper aims to bridge the gap in available evidence about systems approaches to cultural competence by systematically mapping key concepts, types of evidence, and gaps in research...
May 12, 2017: International Journal for Equity in Health
https://www.readbyqxmd.com/read/28494782/health-workforce-and-governance-the-crisis-in-nigeria
#8
Davies Adeloye, Rotimi Adedeji David, Adenike Ayobola Olaogun, Asa Auta, Adedapo Adesokan, Muktar Gadanya, Jacob Kehinde Opele, Oluwafemi Owagbemi, Alexander Iseolorunkanmi
BACKGROUND: In Nigeria, several challenges have been reported within the health sector, especially in training, funding, employment, and deployment of the health workforce. We aimed to review recent health workforce crises in the Nigerian health sector to identify key underlying causes and provide recommendations toward preventing and/or managing potential future crises in Nigeria. METHODS: We conducted a scoping literature search of PubMed to identify studies on health workforce and health governance in Nigeria...
May 12, 2017: Human Resources for Health
https://www.readbyqxmd.com/read/28493177/what-is-single-payer-health-care-a-review-of-definitions-and-proposals-in-the-u-s
#9
Jodi L Liu, Robert H Brook
BACKGROUND: Single-payer systems have been proposed as a health care reform alternative in the United States. However, there is no consensus on the definition of single-payer. Most definitions characterize single-payer as one entity that collects funds and pays for health care on behalf on an entire population. Increased flexibility for state health care reform may provide opportunities for state-based single-payer systems to be considered. OBJECTIVE: To explore the concept of single-payer and to describe the contents of single-payer health care proposals...
May 10, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28492452/the-changing-landscape-of-hiv-prevention-in-the-united-states-health-department-experiences-and-local-adaptations-in-response-to-the-national-hiv-aids-strategy-and-high-impact-prevention-approach
#10
Holly H Fisher, Aba Essuon, Tamika Hoyte, Ekaterine Shapatava, Gene Shelley, Aisha Rios, Stephanie Beane, Stacey Bourgeois, Erica Dunbar, Tobey Sapiano
OBJECTIVE: HIV prevention has changed substantially in recent years due to changes in national priorities, biomedical advances, and health care reform. Starting in 2010, motivated by the National HIV/AIDS Strategy (NHAS) and the Centers for Disease Control and Prevention's (CDC's) High-Impact Prevention (HIP), health departments realigned resources so that cost-effective, evidence-based interventions were targeted to groups at risk in areas most affected by HIV. This analysis describes how health departments in diverse settings were affected by NHAS and HIP...
May 10, 2017: Journal of Public Health Management and Practice: JPHMP
https://www.readbyqxmd.com/read/28492444/neuro-ophthalmology-transitioning-from-old-to-new-models-of-health-care-delivery
#11
Larry P Frohman
In contradiction to fundamental laws of supply and demand, 2 decades of payment policies have led to some medical specialties experiencing declines in both manpower and reimbursement. This paradox has resulted in increasingly long wait times to see some specialists, some specialties becoming less attractive to potential trainees, and a dearth of new trainees entering these fields. Evolving models of health care delivery hold the promise of increasing patient access to most providers and may diminish costs and improve outcomes for most patients/conditions...
June 2017: Journal of Neuro-ophthalmology: the Official Journal of the North American Neuro-Ophthalmology Society
https://www.readbyqxmd.com/read/28486280/payor-reform-opportunities-for-spine-surgery-part-iii-population-health-programs-and-converging-strategies
#12
Jason Scalise, David Jacofsky
As the cost of health care continues to rise, government and commercial payors are implementing strategies as a means of reducing the overall expenditure of health care dollars. The largest savings will be not just in more cost-effective treatments but in strategies that can avoid the need for treatments in the first place. Although the savings from popular payor reform strategies like bundled payments are tied to the initiation of the clinical episode, population health programs utilize a variety of tactics to decrease the need for health care utilization overall...
May 8, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28485716/the-former-yugoslav-republic-of-macedonia-health-system-review
#13
Neda Milevska Kostova, Snezhana Chichevalieva, Ninez A Ponce, Ewout van Ginneken, Juliane Winkelmann
This analysis of the health system of the former Yugoslav Republic of Macedonia reviews recent developments in organization and governance, health financing, health care provision, health reforms and health system performance. The country has made important progress during its transition from a socialist system to a market-based system, particularly in reforming the organization, financing and delivery of health care and establishing a mix of private and public providers. Though total health care expenditure has risen in absolute terms in recent decades, it has consistently fallen as share of GDP, and high levels of private health expenditure remain...
May 2017: Health Systems in Transition
https://www.readbyqxmd.com/read/28485714/portugal-health-system-review
#14
Jorge de Almeida Simoes, Goncalo Figueiredo Augusto, Ines Fronteira, Cristina Hernandez-Quevedo
This analysis of the Portuguese health system reviews recent developments in organization and governance, health financing, health care provision, health reforms and health system performance. Overall health indicators such as life expectancy at birth and at age 65 years have shown a notable improvement over the last decades. However, these improvements have not been followed at the same pace by other important dimensions of health: child poverty and its consequences, mental health and quality of life after 65...
March 2017: Health Systems in Transition
https://www.readbyqxmd.com/read/28483137/expanded-roles-of-registered-nurses-in-primary-care-delivery-of-the-future
#15
Laurie Bauer, Thomas Bodenheimer
BACKGROUND: Primary care in the United States is changing: practice size is increasing, there is a growing shortage of primary care practitioners, and there is a heightened prevalence of chronic disease. Given these trends, it is likely that registered nurses will become important members of the primary care team. PURPOSE: This paper explores the challenges and opportunities in primary care delivery in the 21st century and examines the likelihood of expanded roles for RNs to improve quality and add capacity to the primary care workforce...
April 7, 2017: Nursing Outlook
https://www.readbyqxmd.com/read/28479642/does-medical-malpractice-law-improve-health-care-quality
#16
Michael Frakes, Anupam B Jena
We assess the potential for medical liability forces to deter medical errors and improve health care treatment quality, identifying liability's influence by drawing on variations in the manner by which states formulate the negligence standard facing physicians. Using hospital discharge records from the National Hospital Discharge Survey and clinically-validated quality metrics inspired by the Agency for Health Care Research and Quality, we find evidence suggesting that treatment quality may improve upon reforms that expect physicians to adhere to higher quality clinical standards...
November 2016: Journal of Public Economics
https://www.readbyqxmd.com/read/28477295/do-tort-reforms-impact-the-incidence-of-birth-by-cesarean-section-a-reassessment
#17
Javier Cano-Urbina, Daniel Montanera
Investigations into the existence and impact of defensive medicine in obstetrics have produced mixed and often conflicting implications. The most widely-cited and accepted results in this literature find that less severe malpractice environments cause an increase in the use of cesarean section. This has been interpreted as "offensive medicine"; taking advantage of lenient malpractice environments by providing unnecessary services in order to raise revenue. In this article we show that an assumption concerning births with an unknown method of delivery, which is not explicitly stated in the literature, is pivotal in obtaining these results...
March 2017: International Journal of Health Economics and Management
https://www.readbyqxmd.com/read/28474049/transdiagnostic-stepped-care-in-mental-health
#18
Shane Pm Cross, Ian Hickie
A component of Australia's recent national reform agenda for mental health services is the directive to the Primary Health Networks to develop and implement stepped-care models of service delivery. The current guidance proposes that interventions are aligned to mild, moderate and severe illness categories. Other models in operation are tied to single disorders, such as depression. Both approaches have a number of limitations when applied to real-world, complex clinical practice, especially in primary care. This article outlines some limitations of these models and argues for the development of a transdiagnostic model, based on developments in our work in primary care youth services, which can be generalised to adult populations...
April 27, 2017: Public Health Research & Practice
https://www.readbyqxmd.com/read/28472460/did-contracting-effect-the-use-of-primary-health-care-units-in-pakistan
#19
Muhammad Ashar Malik, Ellen Van de Poel, Eddy Van Doorslaer
For many years, Pakistan has had a wide network of Basic Health Units spread across the country, but their utilization by the population in rural and peri-urban areas has remained low. As of 2004, in an attempt to improve the utilization and performance of these public primary healthcare facilities, the government has gradually started contracting-in intergovernmental organizations to manage these BHUs. Using five nationally representative household surveys conducted between 2001 and 2012, and exploiting the gradual roll-out of this reform to apply a difference-in-difference approach, we evaluate its impact on BHU utilization...
May 3, 2017: Health Policy and Planning
https://www.readbyqxmd.com/read/28471210/therapist-report-of-adaptations-to-delivery-of-evidence-based-practices-within-a-system-driven-reform-of-publicly-funded-children-s-mental-health-services
#20
Anna Lau, Miya Barnett, Nicole Stadnick, Dana Saifan, Jennifer Regan, Shannon Wiltsey Stirman, Scott Roesch, Lauren Brookman-Frazee
OBJECTIVE: This study examined clinical adaptations reported by community therapists to multiple evidence-based practices (EBPs) currently implemented in children's mental health services. Based on an item set informed by Stirman and colleagues' model (2015), 2 factors emerged describing Augmenting adaptations and Reducing/Reordering adaptations. We used multilevel modeling to examine therapist- and practice-level predictors of therapist reports of each type of adaptation. METHOD: Data were drawn from an online survey, including a novel therapist report measure of EBP adaptations, completed by 572 therapists (89...
May 4, 2017: Journal of Consulting and Clinical Psychology
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