scholarly journals Screening for psychiatric morbidity in the population - a comparison of the GHQ-12 and self-reported medication use

2018 ◽  
Vol 3 (1) ◽  
Author(s):  
Foteini Tseliou ◽  
Michael Donnelly ◽  
Dermot O'Reilly
Keyword(s):  
Health Care ◽  
Older People ◽  
Health Care Services ◽  
Economic Status ◽  
Health Care Systems ◽  
Psychiatric Morbidity ◽  
Medication Use ◽  
Screening Tools ◽  
Care Systems ◽  
Population Mental Health

IntroductionUptake of psychotropic medication has been previously used as a proxy for assessing the prevalence of population mental health morbidity. However, it is not known how this compares with estimates derived from population screening tools. ObjectivesTo compare estimates of psychiatric morbidity derived by a validated screening instrument of psychiatric morbidity and a self-reported medication uptake measure. MethodsThis study used data from two recent population-wide health surveys in Northern Ireland, a country (UK) with free health services and no prescription charges. The psychiatric morbidity of 7,489 respondents was assessed using the GHQ-12 and self-reported use of medication for stress, anxiety and depression (sDAS medication). ResultsOverall, 19% of respondents were defined as ‘cases’ and 14.3% were taking sDAS medication. Generally, the two methods identified the same population distributions of characteristics that were associated with psychiatric morbidity though nearly as many non-cases as cases received sDAS medication (46.4% vs. 53.6%). A greater proportion of women and older people were identified as cases according to sDAS medication use, while no such variation was observed between socio-economic status and method of assessment. ConclusionsThis study indicates that these two methods of assessing population psychiatric morbidity provide similar estimates, despite potentially identifying different individuals as cases. It is important to note that different health care systems might be linked to variations in obstacles when accessing and using health care services. Highlights There was a reasonable correspondence between the different methods of assessment. A greater proportion of women and older people were identified as cases through the self-reported use of medication. An almost equal amount of GHQ-12 cases and non-cases reported being in receipt of medication.

scholarly journals Future Perspectives of Health Care: Closing Remarks

2021 ◽  
pp. 375-380
Author(s):  
Gørill Haugan ◽  
Monica Eriksson
Keyword(s):  
Health Care ◽  
Health Promotion ◽  
Health Care Services ◽  
Health Care Systems ◽  
Health Sector ◽  
Care Services ◽  
Care Systems ◽  
Health Promoting ◽  
Professional Leadership ◽  
Salutogenic Model

AbstractThe Covid-19 pandemic has demonstrated the vulnerability of our health care systems as well as our societies. During the year of 2020, we have witnessed how whole societies globally have been in a turbulent state of transformation finding strategies to manage the difficulties caused by the pandemic. At first glance, the health promotion perspective might seem far away from handling the serious impacts caused by the Covid-19 pandemic. However, as health promotion is about enabling people to increase control over their health and its determinants, paradoxically health promotion seems to be ever more important in times of crisis and pandemics. Probably, in the future, pandemics will be a part of the global picture along with the non-communicable diseases. These facts strongly demand the health care services to reorient in a health promoting direction.The IUHPE Global Working Group on Salutogenesis suggests that health promotion competencies along with a reorientation of professional leadership towards salutogenesis, empowerment and participation are required. More specifically, the IUHPE Group recommends that the overall salutogenic model of health and the concept of SOC should be further advanced and applied beyond the health sector, followed by the design of salutogenic interventions and change processes in complex systems.

scholarly journals Interventions to Reduce Adult Nursing Turnover: A Systematic Review of Systematic Reviews

2017 ◽  
Vol 11 (1) ◽  
pp. 108-123 ◽  
Author(s):  
Mary Halter ◽  
Ferruccio Pelone ◽  
Olga Boiko ◽  
Carole Beighton ◽  
Ruth Harris ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Systematic Reviews ◽  
Health Care Services ◽  
Health Care Systems ◽  
Large Body ◽  
Review Literature ◽  
Adult Health ◽  
Turnover Rates ◽  
Care Systems

Background: Nurse turnover is an issue of concern in health care systems internationally. Understanding which interventions are effective to reduce turnover rates is important to managers and health care organisations. Despite a plethora of reviews of such interventions, strength of evidence is hard to determine. Objective: We aimed to review literature on interventions to reduce turnover in nurses working in the adult health care services in developed economies. Method: We conducted an overview (systematic review of systematic reviews) using the Cochrane Database of Systematic Reviews, MEDLINE, EMBASE, Applied Social Sciences Index and Abstracts, CINAHL plus and SCOPUS and forward searching. We included reviews published between 1990 and January 2015 in English. We carried out parallel blinded selection, extraction of data and assessment of bias, using the Assessment of Multiple Systematic Reviews. We carried out a narrative synthesis. Results: Despite the large body of published reviews, only seven reviews met the inclusion criteria. These provide moderate quality review evidence, albeit from poorly controlled primary studies. They provide evidence of effect of a small number of interventions which decrease turnover or increase retention of nurses, these being preceptorship of new graduates and leadership for group cohesion. Conclusion: We highlight that a large body of reviews does not equate with a large body of high quality evidence. Agreement as to the measures and terminology to be used together with well-designed, funded primary research to provide robust evidence for nurse and human resource managers to base their nurse retention strategies on is urgently required.

Preventing Medication Errors with Antineoplastic Agents, Part 1

2000 ◽  
Vol 35 (5) ◽  
pp. 511-526 ◽  
Author(s):  
M. Christina Beckwith ◽  
Linda S. Tyler
Keyword(s):  
Health Care ◽  
Medication Error ◽  
Medication Errors ◽  
Antineoplastic Agents ◽  
Health Care Systems ◽  
Medication Use ◽  
Prescribing Errors ◽  
Care Systems

Goal — The goal of this program is to present practical ways to prevent medication errors with antineoplastic agents, identify common types of medication errors, and describe a system for reducing the incidence of medication errors and responding appropriately to antineoplastic medication errors. Objectives — At the completion of this program, the participant will be able to: 1. Describe the scope and impact of medication errors 2. Define common terms used in medication error literature. 3. List four common types of prescribing errors made with anti-neoplastic agents. 4. Identify steps where medication errors may occur during the drug ordering, preparation, and administration process. 5. Describe ways to prevent errors at each step of the medication use process. 6. Recommend a procedure for reporting and monitoring antineoplastic medication errors within the institution. 7. Describe a system for the non-punitive management of antineoplastic medication errors in health care systems.

scholarly journals UNDERSTANDING NON-MEDICAL COSTS FOR HEALTH CARE: EVIDENCE FROM INPATIENT CARE FOR OLDER PEOPLE IN CHINA

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S733-S733
Author(s):  
Wei Yang
Keyword(s):  
Health Care ◽  
Older People ◽  
Health Care Systems ◽  
Significant Proportion ◽  
Medical Costs ◽  
Urban China ◽  
Substantial Part ◽  
Rural And Urban ◽  
Care Systems ◽  
Health Payment

Abstract Non-medical costs can constitute a substantial part of total health care costs, especially for older people. Costs associated with carers, travel, food and accommodation for family members accompanying and caring for older people during their medical visits can be hefty. This study seeks to examine the effects of non-medical costs on catastrophic health payments and health payment-induced poverty among older people in rural and urban China. Using data from the China Health and Retirement Longitudinal Survey 2015, this study finds that inpatient costs account for a significant proportion of household expenditure, and non-medical costs can account for approximately 18% of total costs. That share is highest for those who belong to the lowest wealth groups. Non-medical costs increase the chances of older people incurring catastrophic health payments and suffering from health payment-induced poverty. Such effects are more concentrated among the poor than the rich. The results also show that the rural population are more likely to incur catastrophic health payments and suffer from health payment induced poverty compared to the urban population. This paper urges policy makers to consider reimbursing the non-medical costs of patient care, improving health care systems in general and for the rural populations specifically.

scholarly journals Older multimorbid patients’ experiences on integration of services: a systematic review

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Lilian Keene Boye ◽  
Christian Backer Mogensen ◽  
Tine Mechlenborg ◽  
Frans Boch Waldorff ◽  
Pernille Tanggaard Andersen
Keyword(s):  
Health Care ◽  
Continuity Of Care ◽  
Health Care Services ◽  
Health Care Systems ◽  
Easy Access ◽  
Ageing Population ◽  
Health Providers ◽  
Care Coordinator ◽  
Care Services ◽  
Care Systems

Abstract Background Half of the older persons in high-income counties are affected with multimorbidity and the prevalence increases with older age. To cope with both the complexity of multimorbidity and the ageing population health care systems needs to adapt to the aging population and improve the coordination of long-term services. The objectives of this review were to synthezise how older people with multimorbidity experiences integrations of health care services and to identify barriers towards continuity of care when multimorbid. Methods A systematic literature search was conducted in February 2018 by in Scopus, Embase, Cinahl, and Medline using the PRISMA guidelines. Inclusion criteria: studies exploring patients’ point of view, ≥65 and multi-morbid. Quality assessment was conducted using COREQ. Thematic synthesis was done. Results Two thousand thirty studies were identified, with 75 studies eligible for full text, resulting in 9 included articles, of generally accepted quality. Integration of health care services was successful when the patients felt listened to on all the aspects of being individuals with multimorbidity and when they obtained help from a care coordinator to prioritize their appointments. However, they felt frustrated when they did not have easy access to their health providers, when they were not listened to, and when they felt they were discharged too early. These frustrations were also identified as barriers to continuity of care. Conclusions Health care systems needs to adapt to people with multimorbidity and find solutions on ways to create flexible systems that are able to help older patients with multimorbidity, meet their individual needs and their desire to be involved in decisions regarding their care. A Care coordinator may be a solution.

The making and sustaining of leaders in health care

2019 ◽  
Vol 33 (2) ◽  
pp. 241-262 ◽  
Author(s):  
Terry J. Boyle ◽  
Kieran Mervyn
Keyword(s):  
Health Care ◽  
Community Health ◽  
Health Care Services ◽  
Health Care Systems ◽  
Structured Interviews ◽  
Healthcare Provision ◽  
Triple Aim ◽  
Content Type ◽  
Care Services ◽  
Care Systems

Purpose Many nations are focussing on health care’s Triple Aim (quality, overall community health and reduced cost) with only moderate success. Traditional leadership learning programmes have been based on a taught curriculum, but the purpose of this paper is to demonstrate more modern approaches through procedures and tools. Design/methodology/approach This study evolved from grounded and activity theory foundations (using semi-structured interviews with ten senior healthcare executives and qualitative analysis) which describe obstructions to progress. The study began with the premise that quality and affordable health care are dependent upon collaborative innovation. The growth of new leaders goes from skills to procedures and tools, and from training to development. Findings This paper makes “frugal innovation” recommendations which while not costly in a financial sense, do have practical and social implications relating to the Triple Aim. The research also revealed largely externally driven health care systems under duress suffering from leadership shortages. Research limitations/implications The study centred primarily on one Canadian community health care services’ organisation. Since healthcare provision is place-based (contextual), the findings may not be universally applicable, maybe not even to an adjacent community. Practical implications The paper dismisses outdated views of the synonymity of leadership and management, while encouraging clinicians to assume leadership roles. Originality/value This paper demonstrates how health care leadership can be developed and sustained.

scholarly journals How to assess the value of low-value care

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
José Antonio Sacristán
Keyword(s):  
Health Care ◽  
Cost Effectiveness ◽  
Health Care Services ◽  
Health Care Systems ◽  
Effective Intervention ◽  
Use Of Resources ◽  
True Value ◽  
Care Systems ◽  
Definition Of ◽  
The Cost

Abstract Background Many of the strategies designed to reduce “low-value care” have been implemented without a consensus on the definition of the term “value”. Most “low value care” lists are based on the comparative effectiveness of the interventions. Main text Defining the value of an intervention based on its effectiveness may generate an inefficient use of resources, as a very effective intervention is not necessarily an efficient intervention, and a low effective intervention is not always an inefficient intervention. The cost-effectiveness plane may help to differentiate between high and low value care interventions. Reducing low value care should include three complementary strategies: eliminating ineffective interventions that entail a cost; eliminating interventions whose cost is higher and whose effectiveness is lower than that of other options (quadrant IV); and eliminating interventions whose incremental or decremental cost-effectiveness is unacceptable in quadrants I and III, respectively. Defining low-value care according to the efficiency of the interventions, ideally at the level of subgroups and individuals, will contribute to develop true value-based health care systems. Conclusion Cost-effectiveness rather than effectiveness should be the main criterion to assess the value of health care services and interventions. Payment-for-value strategies should be based on the definition of high and low value provided by the cost-effectiveness plane.

scholarly journals Equity, Efficiency, and Accessibility in Urban and Regional Health-Care Systems

1982 ◽  
Vol 14 (11) ◽  
pp. 1479-1507 ◽  
Author(s):  
L D Mayhew ◽  
G Leonardi
Keyword(s):  
Health Care ◽  
Resource Allocation ◽  
Health Care Services ◽  
Spatial Interaction ◽  
Health Care Systems ◽  
Interaction Model ◽  
Health Care Planning ◽  
Regional Health Care ◽  
Allocation Criteria ◽  
Care Systems

This paper explores four different criteria of health-care resource allocation at the urban and regional level. The criteria are linked by a common spatial-interaction model. This model is based on the hypothesis that the number of hospital patients generated in a residential zone i is proportional to the relative morbidity of i, and to the availability of resources in treatment zone j, but is in inverse proportion to the accessibility costs of getting from i to j. The resource-allocation criteria are based on objectives on which there is broad agreement among planners and other actors in a health-care system. These objectives are concerned with allocations that conform to notions of equity, efficiency, and two definitions of accessibility. The allocation criteria give mainly aggregate-level information, and are designed with the long-term regional planning of health-care services in mind. The paper starts by defining the criteria, and describes how they are intended to be employed in a planning context. The allocation rules are then formally derived and linked together mathematically. They are then applied to a region, London, England, which is known to have very complex health-care planning problems. As a result of this application, two of the criteria—equity and efficiency—are selected for further analysis. A new model is built and applied that specifically enables the user to trade off one of these criteria against the other.

scholarly journals How do socio-economic factors and distance predict access to prevention and rehabilitation services in a Danish municipality?

2016 ◽  
Vol 17 (06) ◽  
pp. 578-585 ◽  
Author(s):  
Anette L. Hindhede ◽  
Ane Bonde ◽  
Jasper Schipperijn ◽  
Stine H. Scheuer ◽  
Susanne M. Sørensen ◽  
...  
Keyword(s):  
Health Care ◽  
General Practitioners ◽  
Catchment Area ◽  
Access To Health Care ◽  
Health Care Services ◽  
Economic Status ◽  
Health Care Systems ◽  
Economic Vulnerability ◽  
Initial Appointment ◽  
Planned Activities

AimThe aim was to explore the extent to which a Danish prevention centre catered to marginalised groups within the catchment area. We determined whether the district’s socio-economic vulnerability status and distance from the citizens’ residential sector to the centre influenced referrals of citizens to the centre, their attendance at initial appointment, and completion of planned activities at the centre.BackgroundDisparities in access to health care services is one among many aspects of inequality in health. There are multiple determinants within populations (socio-economic status, ethnicity, and education) as well as the health care systems (resource availability and cultural acceptability).MethodsA total of 347 participants referred to the centre during a 10-month period were included. For each of 44 districts within the catchment area, the degree of socio-economic vulnerability was estimated based on the citizens’ educational level, ethnicity, income, and unemployment rate. A socio-economic vulnerability score (SE-score) was calculated. Logistic regression was used to calculate the probability that a person was referred to the centre, attended the initial appointment, and completed the planned activities, depending on sex, age, SE-score of district of residence, and distance to the centre.FindingsCitizens from locations with a high socio-economic vulnerability had increased probability of being referred by general practitioners, hospitals, and job centres. Citizens living further away from the prevention centre had a reduced probability of being referred by their general practitioners. After referral, there was no difference in probability of attendance or completion as a function of SE-score or distance between the citizens’ district and the centre. In conclusion, the centre is capable of attracting referrals from districts where the need is likely to be relatively high in terms of socio-economic vulnerability, whereas distance reduced the probability of referral. No differences were found in attendance or completion.

scholarly journals Roemer 20 Years Later: When a Classical Health-System Typology Meets Market-Oriented Reforms

2017 ◽  
Vol 9 (1) ◽  
Author(s):  
Melanie Bourque ◽  
Jean-Simon Farrah
Keyword(s):  
Health Care ◽  
Health System ◽  
Health Systems ◽  
Public Management ◽  
Health Care Services ◽  
New Public Management ◽  
Health Care Systems ◽  
Supply And Demand ◽  
Managed Competition ◽  
Care Systems

In 1990, Roemer came up with a very influential health system typology. From his vast study, emerged three types of health care systems: nationalized, mandated and entrepreneurial. Health care systems are not static; slow changes and reforms somewhat alter values and goals on which those systems were initially established. It is fair to say, then, that over the last two decades, health care reformers have adopted a market-oriented governance model that blends new public management (NPM) and managed competition reforms in the provision of health care services to transform supply- and demand-side actors into “responsibilized” customers, payers or providers. These transformations beg the question as to whether we are witnessing a radical redefinition of health care systems through the implementation of market-oriented governance. We propose to add the evolution of market-oriented health reforms in five case studies to Milton Roemer’s typology of health systems. In light of our findings, we will wrap up the analysis with an assessment of the usefulness of Roemer’s classification for social scientists to grasp the evolution of health systems over the past 20 years, and more importantly, to analyze the current state of these health care systems after years of market-oriented reforms.

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