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https://www.readbyqxmd.com/read/29899885/iran-s-struggling-health-system-an-increase-in-natural-childbirth-a-case-study
#1
Alireza Jabbari, Mohammad Hossein Yarmohamadian, Marziye Hadian
Background: The 7th package of health reform in Iran has been implemented in May 15, 1393, is concerned with the "promotion of natural childbirth." It has been focusing on reducing cesarean section (CS) and promoting normal vaginal delivery (NVD) as broadly as possible. This study evaluated the changes in the vaginal delivery and cesarean before and after implementation of the 7th package of health reform in public and private hospitals of Isfahan Province in 2014. Methods: This was a quasi-experimental research...
2018: International Journal of Preventive Medicine
https://www.readbyqxmd.com/read/29895263/uk-medical-education-on-human-trafficking-assessing-uptake-of-the-opportunity-to-shape-awareness-safeguarding-and-referral-in-the-curriculum
#2
Poojani Arulrajah, Sarah Steele
BACKGROUND: Human trafficking is a serious violation of human rights, with numerous consequences for health and wellbeing. Recent law and policy reforms mean that clinicians now hold a crucial role in national strategies. 2015 research, however, indicates a serious shortfall in knowledge and confidence among healthcare professionals in the UK, leading potentially to failures in safeguarding and appropriate referral. Medical education is a central point for trafficking training. We ascertain the extent of such training in UK Medical Schools, and current curricular design...
June 13, 2018: BMC Medical Education
https://www.readbyqxmd.com/read/29895206/transforming-improving-access-to-psychological-therapies
#3
Michael J Scott
The three commentaries on my paper 'IAPT - The Need for Radical Reform' are agreed that Improving Access to Psychological Therapies cannot be regarded as the 'gold standard' for the delivery of psychological therapy services. Furthermore, they agreed that Improving Access to Psychological Therapies should not continue to mark its 'own homework' and should be subjected to rigorous independent evaluation scrutiny. It is a matter for a public enquiry to ascertain why £1 billion has been spent on Improving Access to Psychological Therapies without any such an independent evaluation...
June 1, 2018: Journal of Health Psychology
https://www.readbyqxmd.com/read/29894233/value-based-surgical-care-a-view-from-the-surgeon-s-knife
#4
Alice Ca Murray
NHS trusts across the country are facing unprecedented financial pressures, along with rising levels of demand and widespread variation in surgical quality and cost. There is a moral and financial imperative to provide the most efficient use of resources in order to ensure sustainability of a system that is free at the point of use, and provide consistently high-value care for patients across the country. Delivering 'value' does not mean any reduction in the quality of care - it means achieving the same or higher quality at the same or lower cost...
June 2, 2018: British Journal of Hospital Medicine
https://www.readbyqxmd.com/read/29871691/assessing-the-reliability-and-validity-of-the-danish-version-of-organizational-readiness-for-implementing-change-oric
#5
Marie Höjriis Storkholm, Pamela Mazzocato, Mesfin Kassaye Tessma, Carl Savage
BACKGROUND: Organizational change initiatives in health care frequently achieve only partial implementation success. Understanding an organizational readiness for change (ORC) may be a way to develop more effective and efficient change strategies. Denmark, like many countries, has begun a major system-wide structural reform which involves considerable changes in service delivery. Due to the lack of a validated Danish instrument, we aimed to translate and validate a Danish version of the Organizational Readiness for Implementing Change (ORIC) questionnaire...
June 5, 2018: Implementation Science: IS
https://www.readbyqxmd.com/read/29870116/does-decentralization-improve-health-system-performance-and-outcomes-in-low-and-middle-income-countries-a-systematic-review-of-evidence-from-quantitative-studies
#6
Adenantera Dwicaksono, Ashley M Fox
Policy Points: For more than 3 decades, international development agencies have advocated health system decentralization to improve health system performance in low- and middle-income countries. We found little rigorous evidence documenting the impact of decentralization processes on health system performance or outcomes in part due to challenges in measuring such far-reaching and multifaceted system-level changes. We propose a renewed research agenda that focuses on discrete definitions of decentralization and how institutional factors and mechanisms affect health system performance and outcomes within the general context of decentralized governance structures...
June 2018: Milbank Quarterly
https://www.readbyqxmd.com/read/29863941/the-effects-of-medicaid-expansion-under-the-aca-a-systematic-review
#7
Olena Mazurenko, Casey P Balio, Rajender Agarwal, Aaron E Carroll, Nir Menachemi
Expanding eligibility for Medicaid was a central goal of the Affordable Care Act (ACA), which continues to be debated and discussed at the state and federal levels as further reforms are considered. In an effort to provide a synthesis of the available research, we systematically reviewed the peer-reviewed scientific literature on the effects of Medicaid expansion on the original goals of the ACA. After analyzing seventy-seven published studies, we found that expansion was associated with increases in coverage, service use, quality of care, and Medicaid spending...
June 2018: Health Affairs
https://www.readbyqxmd.com/read/29794522/medicaid-innovations-and-the-role-of-academic-health-centers
#8
Sheldon M Retchin, Wendy Yi Xu
Although they represent less than 8% of all U.S. hospitals, academic health centers (AHCs) deliver almost 40% of the inpatient care for Medicaid beneficiaries. However, because of low Medicaid reimbursement rates, AHCs have had to rely on supplemental funding sources, such as disproportionate share hospital (DSH) payments and upper payment limit (UPL) payments. Recent legislative efforts and changes to payment structures have made these sources vulnerable to severe reductions. For instance, DSH payments are scheduled to be cut by $8 billion by 2021, and UPL payments are a diminishing resource for many states because the program is based on a fee-for-service model and most states are moving to managed care...
May 22, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/29792191/cost-of-provision-of-opioid-substitution-therapy-provision-in-tijuana-mexico
#9
Jose Luis Burgos, Javier A Cepeda, James G Kahn, Maria Luisa Mittal, Emilio Meza, Raúl Rafael Palacios Lazos, Psyché Calderón Vargas, Peter Vickerman, Steffanie A Strathdee, Natasha K Martin
BACKGROUND: Mexico recently enacted drug policy reform to decriminalize possession of small amounts of illicit drugs and mandated that police refer identified substance users to drug treatment. However, the economic implications of drug treatment expansion are uncertain. We estimated the costs of opioid substitution therapy (OST) provision in Tijuana, Mexico, where opioid use and HIV are major public health concerns. METHODS: We adopted an economic health care provider perspective and applied an ingredients-based micro-costing approach to quantify the average monthly cost of OST (methadone maintenance) provision at two providers (one private and one public) in Tijuana, Mexico...
May 23, 2018: Harm Reduction Journal
https://www.readbyqxmd.com/read/29754969/pathways-to-drg-based-hospital-payment-systems-in-japan-korea-and-thailand
#10
Peter Leslie Annear, Soonman Kwon, Luca Lorenzoni, Stephen Duckett, Dale Huntington, John C Langenbrunner, Yuki Murakami, Changwoo Shon, Ke Xu
Countries in Asia are working towards achieving universal health coverage while ensuring improved quality of care. One element is controlling hospital costs through payment reforms. In this paper we review experiences in using Diagnosis Related Groups (DRG) based hospital payments in three Asian countries and ask if there is an "Asian way to DRGs". We focus first on technical issues and follow with a discussion of implementation challenges and policy questions. We reviewed the literature and worked as an expert team to investigate existing documentation from Japan, Republic of Korea, and Thailand...
May 7, 2018: Health Policy
https://www.readbyqxmd.com/read/29714595/pharma-opportunities-and-risks-multiply-as-regulatory-reform-remakes-apac-expanded-accelerated-pathways-challenge-developer-value-story-evidence-collection-and-market-access-strategies
#11
Alberto Grignolo, Zhang Mingping
Sweeping reforms in the largest markets of the Asia-Pacific region are transforming the regulatory and commercial landscape for foreign pharmaceutical companies. Japan, South Korea, and China are leading the charge, establishing mechanisms and infrastructure that both reflect and help drive international regulatory convergence and accelerate delivery of needed, innovative products to patients. In this rapidly evolving regulatory and commercial environment, drug developers can benefit from reforms and proliferating accelerated pathway (AP) frameworks, but only with regulatory and evidence-generation strategies tailored to the region...
January 1, 2018: Therapeutic Innovation & Regulatory Science
https://www.readbyqxmd.com/read/29712711/medical-nutrition-education-training-and-competencies-to-advance-guideline-based-diet-counseling-by-physicians-a-science-advisory-from-the-american-heart-association
#12
REVIEW
Karen E Aspry, Linda Van Horn, Jo Ann S Carson, Judith Wylie-Rosett, Robert F Kushner, Alice H Lichtenstein, Stephen Devries, Andrew M Freeman, Allison Crawford, Penny Kris-Etherton
Growing scientific evidence of the benefits of heart-healthy dietary patterns and of the massive public health and economic burdens attributed to obesity and poor diet quality have triggered national calls to increase diet counseling in outpatients with atherosclerotic cardiovascular disease or risk factors. However, despite evidence that physicians are willing to undertake this task and are viewed as credible sources of diet information, they engage patients in diet counseling at less than desirable rates and cite insufficient knowledge and training as barriers...
April 30, 2018: Circulation
https://www.readbyqxmd.com/read/29697433/ensuring-access-to-quality-health-care-in-vulnerable-communities
#13
Jay Bhatt, Priya Bathija
For millions of Americans living in vulnerable rural and urban communities, their hospital is an important, and often their only, source of health care. As transformation in the hospital and health care field continues, some communities may be at risk of losing access to health care services and the opportunities and resources they need to improve and maintain their health. Integrated, comprehensive strategies to reform health care delivery and payment, within which vulnerable communities can make individual choices based on their needs, support structures, and preferences, are needed...
April 24, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/29690941/could-local-integration-of-health-and-social-care-finally-overcome-the-pull-to-the-centre
#14
Anna Dixon
There are several advantages of Bevan's design, such as progressive funding through taxation and equity of access regardless of income, that we must not lose sight of as we celebrate the NHS's (National Health Service) 70th birthday. However, there remain historical fault-lines dividing health and social care. The challenge is how to preserve equity if a more radical reform were implemented to fully integrate both the funding and delivery of health and social care. Funding from national taxation with defined entitlements could preserve both equity in funding and geographical equity...
April 25, 2018: Health Economics, Policy, and Law
https://www.readbyqxmd.com/read/29681079/abortion-law-reform-why-ethical-intractability-and-maternal-morbidity-are-grounds-for-decriminalisation
#15
Andrew McGee, Melanie Jansen, Sally Sheldon
In this paper, we present two grounds for arguing that abortion should be decriminalised. First, we consider the implications of the fact that the long-standing ethical debate concerning the morality of abortion has to date proven intractable. We maintain that because the philosophical literature has failed to demonstrate conclusively that views either for or against abortion's moral acceptability are false, the matter remains at a stalemate in terms of rational debate, contributing to the ongoing absence of political and popular consensus about the issue in our society...
April 22, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29677929/openehr-based-systems-and-the-general-data-protection-regulation-gdpr
#16
Mariana Sousa, Duarte Ferreira, Cátia Santos-Pereira, Gustavo Bacelar, Samuel Frade, Olívia Pestana, Ricardo Cruz-Correia
The concerns about privacy and personal data protection resulted in reforms of the existing legislation in European Union (EU). The General Data Protection Regulation (GDPR) aims to reform the existing measures on the topic of personal data protection of the European Union citizens, with a strong input on the rights and freedoms of people and in the establishment of rules for the processing of personal data. OpenEHR is a standard that embodies many principles of interoperable and secure software for electronic health records...
2018: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/29652822/taking-a-gamble-for-high-rewards-management-perspectives-on-the-value-of-mental-health-peer-workers
#17
Louise Byrne, Helena Roennfeldt, Peri O'Shea, Fiona Macdonald
Mental health peer work is attracting growing interest and provides a potentially impactful method of service user involvement in mental health design and delivery, contributing to mental health reform. The need to effectively support this emerging workforce is consequently increasing. This study aimed to better understand the views of management in relation to peer work and specifically explores the value of peer work from the perspective of management. This qualitative research employed grounded theory methods...
April 13, 2018: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/29650619/nursing-role-in-well-child-care-systematic-review-of-the-literature
#18
Jolanda Turley, Jaclyn Vanek, Sharon Johnston, Doug Archibald
OBJECTIVE: To describe and compare well-child care (WCC) in Australia, the Netherlands, and the United Kingdom (UK), focusing on the role of nurses and their interactions with other primary care providers in order to derive relevant lessons for Canada's interprofessional primary care teams. DATA SOURCES: Ovid MEDLINE, EMBASE, and CINAHL were searched broadly using the search terms well child care, nursing role, and delivery of care and other synonymous terms. In addition, Google Scholar was used to search for gray literature, and reference mining revealed a few other relevant articles...
April 2018: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/29629505/marijuana-promotion-online-an-investigation-of-dispensary-practices
#19
Patricia A Cavazos-Rehg, Melissa J Krauss, Elizabeth Cahn, Kiriam Escobar Lee, Erin Ferguson, Biva Rajbhandari, Shaina J Sowles, Glennon M Floyd, Carla Berg, Laura J Bierut
Marijuana product advertising will become more common, as the use of medical and/or recreational marijuana becomes increasingly legal in the USA. In this study, we investigate the marketing tactics being used on marijuana dispensary websites in the USA that could influence substance use behaviors. One hundred dispensary websites were randomly selected from 10 states that allowed the legal use of medical or recreational marijuana and had at least 10 operational dispensaries. Three dispensaries were excluded due to non-functioning websites, leaving a sample of 97 dispensaries...
April 9, 2018: Prevention Science: the Official Journal of the Society for Prevention Research
https://www.readbyqxmd.com/read/29627134/delivering-a-new-deal-of-kidney-health-opportunities-to-improve-outcomes-within-the-veterans-health-administration
#20
Susan T Crowley, Katherine Murphy
Just as the "New Deal" aimed to elevate the "forgotten man" of the Great Depression through governmental relief and reform, so does the Department of Veterans Affairs (VA) health care system aim to improve the health of veterans with the invisible illness of chronic kidney disease through a concerted series of health care delivery reforms. Augmenting its primary care platform with advances in informatics and health service delivery initiatives targeting kidney disease, the VA is changing how nephrology care is provided to veterans with the goal of optimized population kidney health...
April 4, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
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