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why healthcare is failing

Phillip Sundin, Jonathan Callan, Khanjan Mehta
Telemedicine is an increasingly common approach to improve healthcare access in developing countries with fledgling healthcare systems. Despite the strong financial, logistical and clinical support from non-governmental organisations (NGOs), government ministries and private actors alike, the majority of telemedicine projects do not survive beyond the initial pilot phase and achieve their full potential. Based on a review of 35 entrepreneurial telemedicine and mHealth ventures, and 17 reports that analyse their operations and challenges, this article provides a narrative review of recurring failure modes, i...
August 9, 2016: Journal of Medical Engineering & Technology
Rohena Duncombe
Objective The present study looked at the views of people directly involved in the entry process for community health counselling using the frame of the health access literature. The concurrence of system participants' views with the access literature highlights access issues, particularly for people who are vulnerable or disadvantaged. The paper privileges the voices of the system participants, inviting local health services to consider using participatory design to improve access at the entry point.Methods People involved in the entry process for community health counselling explored the question, 'What, for you, are the features of a good intake system?' They also commented on themes identified during pilot interviews...
August 29, 2016: Australian Health Review: a Publication of the Australian Hospital Association
Pietro Ghezzi, Vincent Jaquet, Fabrizio Marcucci, Harald H H W Schmidt
The theory stating that oxidative stress (OS) is at the root of several diseases is extremely popular. However, so far, no antioxidant is recommended or offered by healthcare systems neither approved as therapy by regulatory agencies that base their decisions on evidence-based medicine (EBM). This is simply because, so far, despite many preclinical and clinical studies indicating a beneficial effect of antioxidants in many disease conditions, randomised clinical trials have failed to provide the evidence of efficacy required for drug approval...
July 18, 2016: British Journal of Pharmacology
James Waldie, Tina Day, Stephen Tee
This article provides a critical discussion examining why adult patients continue to unnecessarily deteriorate and die despite repeated healthcare policy initiatives. After considering the policy background and reviewing current trends in the data, it proposes some solutions that, if enacted, would, the authors believe, have a direct impact on survival rates. Health professionals working in hospitals are failing to recognise signs of physiological deterioration. As a result, adult patients are dying unnecessarily, estimated to be in the region of 1000 a month...
July 14, 2016: British Journal of Nursing: BJN
Natasha Alligood-Percoco, Joshua P Kesterson
OBJECTIVE: Cervical cancer in the USA has transformed from a leading cause of cancer death, to a now largely preventable disease. Despite these advances, however, certain segments of the population, including Hispanic women, continue to be at increased risk. METHODS: A literature review was performed to summarize epidemiologic trends and barriers to care affecting Hispanic women. RESULTS: Hispanic women suffer a disproportionate burden of cervical cancer in the USA...
September 2016: Journal of Racial and Ethnic Health Disparities
Emilie Green, Sara E Shaw, Tim Harris
INTRODUCTION: Across the developed world, there are concerns about 'inappropriate' use of the emergency department (ED). Patients with palliative care needs frequently attend the ED. Previous studies define the 'reason' for presentation as the 'presenting symptom', which ignores the perspectives of service users. This paper addresses an acknowledged gap in the literature, which fails to examine the decision-making process that brings patients to the ED. METHODS: In-depth narrative interviews were conducted with 7 patients (known to a specialist palliative care service and presenting to the ED during a 10-week period) and 2 informal caregivers...
May 12, 2016: BMJ Supportive & Palliative Care
Hugh Lafollette
A number of healthcare professionals assert a right to be exempt from performing some actions currently designated as part of their standard professional responsibilities. Most advocates claim that they should be excused from these duties simply by averring that they are conscientiously opposed to performing them. They believe that they need not explain or justify their decisions to anyone, nor should they suffer any undesirable consequences of such refusal. Those who claim this right err by blurring or conflating three issues about the nature and role of conscience, and its significance in determining what other people should permit them to do (or not do)...
April 5, 2016: Cambridge Quarterly of Healthcare Ethics: CQ: the International Journal of Healthcare Ethics Committees
Josephine Ocloo, Rachel Matthews
BACKGROUND: There have been repeated calls to better involve patients and the public and to place them at the centre of healthcare. Serious clinical and service failings in the UK and internationally increase the urgency and importance of addressing this problem. Despite this supportive policy context, progress to achieve greater involvement is patchy and slow and often concentrated at the lowest levels of involvement. METHODS: A selective narrative literature search was guided by the authors' broad expertise, covering a range of disciplines across health and social care, policy and research...
August 2016: BMJ Quality & Safety
Helen Dickinson, Jon Pierre
PURPOSE: Many developed countries have seen significant reforms of their health systems for the last few decades. Despite extensive investment in these changes, health systems still face a range of challenges which reform efforts do not seem to have overcome. The purpose of this paper is to argue that there are two particular reasons, which go beyond the standard explanations of changing demographics and disease profiles. DESIGN/METHODOLOGY/APPROACH: The paper is a commentary based on the literature...
2016: Journal of Health Organization and Management
Srichand Devarakonda
CONTEXT: Quality health care should be within everyone's reach, especially in a developing country. While India has the largest private health sector in the world, only one-fifth of healthcare expenditure is publically financed; it is mostly an out-of-pocket expense. About 70% of Indians live in rural areas making about $3 per day, and a major portion of that goes towards food and shelter and, thus, not towards health care. Transportation facilities in rural India are poor, making access to medical facilities difficult, and infrastructure facilities are minimal, making the available medical care insufficient...
January 2016: Rural and Remote Health
Aloisia Shemdoe, Godfrey Mbaruku, Angel Dillip, Susan Bradley, JeJe William, Deborah Wason, Zoe Jane-Lara Hildon
BACKGROUND: In the United Republic of Tanzania, as in many regions of Sub-Saharan Africa, staff shortages in the healthcare system are a persistent problem, particularly in rural areas. To explore staff shortages and ways of keeping workers in post, we ask, (a) Which cadres are most problematic to recruit and keep in post? (b) How and for what related reasons do health workers leave? (c) What critical incidents do those who stay face? (d) And why do they stay and cope? METHODS: This is a multi-method paper based on analysis of data collected as part of a cross-sectional health facility study supporting maternal and reproductive health services in the United Republic of Tanzania...
2016: Human Resources for Health
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