The International journal of health planning and management
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Int J Health Plann Manage · Jan 2019
ReviewConditional cash transfer policies in maternal health service utilization in Nepal: Analysis of safe delivery incentive program (Aama Surakshya Karyakram) using Kingdon's multiple streams framework.
Various factors limit access to and utilization of health services even when provided at subsidized cost. This results in poor utilization of services that contributes to further economic impoverishment and health care disparity. Many countries are experimenting with various approaches to tackle the poor utilization of health care services including demand-side financing policy. ⋯ Furthermore, there was commitment from external development partners (EDPs) for investment in maternal health. Together, these problem, policy, and politics opened Kingdon's "windows of opportunity" for formulation of conditional cash transfer policy. This paper presents evolution of Aama Surakshya Karyakram and uses Kingdon's multiple streams framework to explain how problem, policy, and politics streams converged together to allow this program to be introduced in Nepal.
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Int J Health Plann Manage · Jan 2019
Association between patient attachment to a regular doctor and self-perceived unmet health care needs in Canada: A population-based analysis of the 2013 to 2014 Canadian community health surveys.
Although Canada operates a universal health care insurance system, equitable access to required health care services when needed still poses a challenge for some. The aim of this study was to examine the relationship between patient attachment to a family physician and self-perceived unmet health care needs (UHN) in Canada, after adjusting for predisposing, enabling, and need factors of the behavioral model of health services use. ⋯ Ongoing public discourses on improving primary health care performance and reducing the burden of UHN in Canada should prioritize efforts that promote and facilitate the use of a regular family physician.
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Int J Health Plann Manage · Jan 2019
Low prioritization of latent tuberculosis infection-A systemic barrier to tuberculosis control: A qualitative study in Ontario, Canada.
Eliminating tuberculosis (TB) in low-incidence countries is an important global health priority, and Canada has committed to achieve this goal. The elimination of TB in low-incidence countries requires effective management and treatment of latent tuberculosis infection (LTBI). This study aimed to understand and describe the system-level barriers to LTBI treatment for immigrant populations in the Greater Toronto and Hamilton Area, Ontario, Canada. ⋯ This multiperspective study identified barriers beyond the typical socioeconomic determinants and highlighted important upstream factors that hinder treatment initiation and adherence. Addressing these factors is critical if Canada is to meet the WHO's global call to eradicate TB in all low incidence settings.
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Int J Health Plann Manage · Jan 2019
The effect of patient satisfaction with academic hospitals on their loyalty.
Patients' loyalty to a health care institution can lead to the aggregation of patients' medical history in an institution and facilitating access to records by health care providers. Considering the increase of the competition between providers, it is important to gain patients' satisfaction, which leads to their return and loyalty. Therefore, this study evaluated the effect of patients' satisfaction with service quality on their loyalty. ⋯ The results showed that patient satisfaction with service quality affects their hospital choices and increases loyalty. In order to increase patient loyalty to academic hospitals, improving the services quality along with delivering cost-effective cares, improving hospital environment, and providing useful information to patients are recommended.
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Int J Health Plann Manage · Jan 2019
The impact of health transformation plan on hospitalization rates in Iran: An interrupted time series.
The study aims to assess the impact of health transformation plan (HTP) as a major health system reform on hospitalization rate in Iran. Health transformation plan adopted different measures to increase the coverage of basic health insurance, increase the quality of outpatient visit care, improve and expand the family physician program, expand health services to suburban areas, reduce out-of-pocket (OOP) payments for inpatient services, and update tariffs to more realistic ones. ⋯ Health transformation plan has improved the utilization of hospitalization care services in a province that historically had been suffering from underutilized hospital services.