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https://www.readbyqxmd.com/read/28630544/pregnancies-and-fetal-anomalies-incompatible-with-life-in-chile-arguments-and-experiences-in-advocating-for-legal-reform
#1
Lidia Casas, Lieta Vivaldi
Chile allows abortion under no circumstances. Whether it's fetal anomaly incompatible with life or congenital malformation resulting in little or no life expectancy, all Chilean women are expected to carry their pregnancies to term. In this context, in January 2015 the Chilean Congress began debating a bill to legalize abortion on three grounds, including fatal congenital malformation. The medical community, including midwives, has presented its views for and against, especially on how the law may affect clinical practices; in addition, women, many of whom have experienced a fatal congenital malformation diagnosis, have weighed in...
June 2017: Health and Human Rights
https://www.readbyqxmd.com/read/28612498/china-s-health-care-system-reform-progress-and-prospects
#2
Ling Li, Hongqiao Fu
This paper discusses the progress and prospects of China's complex health care reform beginning in 2009. The Chinese government's undertaking of systemic reform has achieved laudable achievements, including the expansion of social health insurance, the reform of public hospitals, and the strengthening of primary care. An innovative policy tool in China, policy experimentation under hierarchy, played an important role in facilitating these achievements. However, China still faces gaps and challenges in creating a single payer system, restructuring the public hospitals, and establishing an integrated delivery system...
June 14, 2017: International Journal of Health Planning and Management
https://www.readbyqxmd.com/read/28609187/integrating-social-services-and-home-based-primary-care-for-high-risk-patients
#3
Joe Feinglass, Greg Norman, Robyn L Golden, Naoko Muramatsu, Michael Gelder, Thomas Cornwell
There is a consensus that our current hospital-intensive approach to care is deeply flawed. This review article describes the research evidence for developing a better system of care for high-cost, high-risk patients. It reviews the evidence that home-centered care and integration of health care with social services are the cornerstones of a more humane and efficient system. The article describes the strengths and weaknesses of research evaluating the effects of social services in addressing social determinants of health, and how social support is critical to successful acute care transition programs...
June 13, 2017: Population Health Management
https://www.readbyqxmd.com/read/28595429/expanding-palliative-care-s-reach-in-the-community-via-the-elder-service-agency-network
#4
M Carrington Reid, Angela Ghesquiere, Cara Kenien, Elizabeth Capezuti, Daniel Gardner
Over the past two decades, palliative care has established itself as a promising approach to address the complex needs of individuals with advanced illness. Palliative care is well-established in US hospitals and has recently begun to expand outside of the hospital setting to meet the needs of non-hospitalized individuals. Experts have called for the development of innovative community-based models that facilitate delivery of palliative care to this target population. Elder service agencies are important partners that researchers should collaborate with to develop new and promising models...
April 17, 2017: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/28589685/efficiency-performance-of-china-s-health-care-delivery-system
#5
Luyu Zhang, Gang Cheng, Suhang Song, Beibei Yuan, Weiming Zhu, Li He, Xiaochen Ma, Qingyue Meng
Improving efficiency performance of the health care delivery system has been on the agenda for the health system reform that China initiated in 2009. This study examines the changes in efficiency performance and determinants of efficiency after the reform to provide evidence to assess the progress of the reform from the perspective of efficiency. Descriptive analysis, Data Envelopment Analysis, the Malmquist Index, and multilevel regressions are used with data from multiple sources, including the World Bank, the China Health Statistical Yearbook, and routine reports...
June 7, 2017: International Journal of Health Planning and Management
https://www.readbyqxmd.com/read/28583973/solving-disparities-through-payment-and-delivery-system-reform-a-program-to-achieve-health-equity
#6
Rachel H DeMeester, Lucy J Xu, Robert S Nocon, Scott C Cook, Andrea M Ducas, Marshall H Chin
Payment systems generally do not directly encourage or support the reduction of health disparities. In 2013 the Finding Answers: Solving Disparities through Payment and Delivery System Reform program of the Robert Wood Johnson Foundation sought to understand how alternative payment models might intentionally incorporate a disparities-reduction component to promote health equity. A qualitative analysis of forty proposals to the program revealed that applicants generally did not link payment reform tightly to disparities reduction...
June 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28582655/coopetition-in-health-care-a-multi-level-analysis-of-its-individual-and-organizational-determinants
#7
Daan Westra, Federica Angeli, Martin Carree, Dirk Ruwaard
Cooperative inter-organizational relations are salient to healthcare delivery. However, they do not match with the pro-competitive healthcare reforms implemented in several countries. Healthcare organizations thus need to balance competition and cooperation in a situation of 'coopetition'. In this paper we study the individual and organizational determinants of coopetition versus those of cooperation in the price-competitive specialized care sector of the Netherlands. We use shared medical specialists as a proxy of collaboration between healthcare organizations...
May 26, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28580650/maternal-near-misses-at-a-provincial-hospital-in-papua-new-guinea-a-prospective-observational-study
#8
John W Bolnga, Marilyn Morris, Catherine Totona, Moses Laman
BACKGROUND: Maternal near-miss indices are World Health Organisation (WHO) recognised indicators that may improve our understanding of factors associated with maternal morbidity and mortality. In Papua New Guinea (PNG) where maternal mortality is among the highest in the world, only one study has documented near-miss indices in a tertiary-level hospital, but none from provincial hospitals where the majority of under-privileged women access healthcare services. AIMS: To determine the near-miss ratio, maternal mortality index (MMI), and associated maternal indices for Modilon Hospital in Madang Province of PNG...
June 5, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28570110/the-challenges-of-upskilling-health-care-assistants-in-community-nursing
#9
Shelley Anne Pringle
Community care is at the forefront of the National Health Service reforms. Role redistribution from registered nurses to health care assistants is growing. This paper examines the challenges of upskilling community health care assistants to undertake catheterisation for uncomplicated patients in the community. Social constructivist methods facilitated reflective practice. Challenges included fears around delegation, accountability and the responsibilities involved in supporting the development of health care assistants...
June 2, 2017: British Journal of Community Nursing
https://www.readbyqxmd.com/read/28554880/diversity-in-emental-health-practice-an-exploratory-qualitative-study-of-aboriginal-and-torres-strait-islander-service-providers
#10
Jennifer Bird, Darlene Rotumah, James Bennett-Levy, Judy Singer
BACKGROUND: In Australia, mental health services are undergoing major systemic reform with eMental Health (eMH) embedded in proposed service models for all but those with severe mental illness. Aboriginal and Torres Strait Islander service providers have been targeted as a national priority for training and implementation of eMH into service delivery. Implementation studies on technology uptake in health workforces identify complex and interconnected variables that influence how individual practitioners integrate new technologies into their practice...
May 29, 2017: JMIR Mental Health
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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