Bmc Health Serv Res
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Bmc Health Serv Res · Jul 2020
The state of emergency medical services and acute health facility care in Uganda: findings from a National Cross-Sectional Survey.
There is limited information on the state of emergency medical services (EMS) in Uganda. The available evidence is from studies that focused on either assessing EMS capacity and gaps at the national level especially in Kampala or identifying risk factors for specific emergency medical conditions (e.g., injuries). In this study, we sought to provide a snapshot of the state of EMS in Uganda by assessing the pre-hospital and hospital emergency care capacity at both national and sub-national (district) levels. ⋯ Our findings reveal weaknesses at every level of what should be a critical component in the health care system - one that deals with the ability to treat life-threatening conditions in a time sensitive manner. The Ministry of Health needs to speed up efforts to provide policies and guidelines, and to increase investments for the creation of a functional EMS in Uganda.
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Bmc Health Serv Res · Jul 2020
Diagnostic anticipation to reduce emergency department length of stay: a retrospective cohort study in Ferrara University hospital, Italy.
Emergency Department (ED) crowding reduces staff satisfaction and healthcare quality and safety, which in turn increase costs. Despite a number of proposed solutions, ED length of stay (LOS) - a main cause of overcrowding - remains a major issue worldwide. This retrospective cohort study was aimed at evaluating the effectiveness on ED LOS of a procedure called "Diagnostic Anticipation" (DA), which consisted in anticipating the ordering of blood tests by nurses, at triage, following a diagnostic algorithm approved by physicians. ⋯ The impact of DA varied by patients' condition, being significant for chest pain only. Further research is needed before the implementation, estimating the potential proportion of inappropriate blood tests and ED crowding status.
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Bmc Health Serv Res · Jul 2020
Observational StudyImpact of the CareWell integrated care model for older patients with multimorbidity: a quasi-experimental controlled study in the Basque Country.
Older patients with multimorbidity have complex health and social care needs, associated with elevated use of health care resources. The aim of this study is to evaluate the impact of CareWell integrated care model for older patients with multimorbidity in the Basque Country. ⋯ The implementation of CareWell integrated care model changed the profile of health resource utilization, strengthening the key role of primary care and reducing the number of emergency visits and hospitalizations. The satisfaction with this model of care was high.
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Bmc Health Serv Res · Jul 2020
Pharmacists' viewpoint towards their professional role in healthcare system: a survey of hospital settings of Pakistan.
Pharmacy service is an essential part of a healthcare system. The profession of pharmacy is well recognized and is practiced to its full potential in developed countries however, it is underutilized in developing countries such as Pakistan. The recognition of pharmacist's role as healthcare professional is limited. This study aimed to document pharmacists' attitude towards their role in Pakistan's healthcare system, their experience with doctors and their perceptions towards involvement in medicines management. ⋯ Pharmacists were willing to perform their duties and provide healthcare benefits to patients however, they seemed sceptical of advanced clinical pharmacy roles such as intervening in prescriptions and medication therapy, consultations and prescribing. There is a need to increase awareness regarding pharmacist's role. Therefore, it would be helpful if trainings and seminars are conducted on the importance of clinical pharmacy to improve the pharmacy services in Pakistan's healthcare system.
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Bmc Health Serv Res · Jul 2020
Observational StudyPatient perspectives on interventional pain management: thematic analysis of a qualitative interview study.
Chronic pain is a widespread problem that is usually approached by focusing on its psychological aspects or on trying to reduce the pain from the pain generator. Patients report that they feel responsible for their pain and that they are disempowered and stigmatized because of it. Here, we explored interventional pain management from the patient's perspective to understand the process better. ⋯ Many of the themes evolved in relation to the subjects' contact with the healthcare services they received, but when the themes were merged and structured into the model, a cohesive pattern of empowerment appeared. If empowerment is a major factor in the positive effects of interventional pain management, it is important to facilitate and not hinder empowerment.