Bmc Health Serv Res
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Bmc Health Serv Res · Oct 2015
An analysis of policy levers used to implement mental health reform in Australia 1992-2012.
Over the past two decades, mental health reform in Australia has received unprecedented government attention. This study explored how five policy levers (organisation, regulation, community education, finance and payment) were used by the Australian Federal Government to implement mental health reforms. ⋯ Patterns in the application of policy levers across the National Mental Health Strategy, as identified in this analysis, represent a novel way of conceptualising the history of mental health reform in Australia. An improved understanding of the strategic targeting and appropriate utilisation of policy levers may assist in the delivery and evaluation of evidence-based mental health reform in the future.
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Bmc Health Serv Res · Oct 2015
Multicenter StudyA cross-sectional survey of emergency and essential surgical care capacity among hospitals with high trauma burden in a Central African country.
As the overwhelming surgical burden of injury and disease steadily increases, disproportionately affecting low- and middle-income countries, adequate surgical and trauma care systems are essential. Yet, little is known about the emergency and essential surgical care (EESC) capacity of facilities in many African countries. The objective of this study was to assess the EESC capacity in different types of hospitals across Cameroon. ⋯ Severe shortages highlighted by this survey demonstrate the significant gaps in capacity of hospitals to deliver EESC and effectively address the increasing surgical burden of disease and injury in Cameroon. This data provides a foundation for evidence-based decision-making surrounding appropriate allocation and provision of resources for adequate EESC in the country.
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Bmc Health Serv Res · Oct 2015
Gender differences in the use of psychiatric outpatient specialist services in Tromsø, Norway are dependent on age: a population-based cross-sectional survey.
Overall, men are less likely than women to seek health care services for mental health problems, but differences between genders in higher age groups are equivocal. The aim of the current study was to investigate the association between gender and the use of psychiatric outpatient specialist services in Norway, both in a general population and in a subpopulation with self-reported anxiety and/or depression. ⋯ Most people with self-reported anxiety/depression did not visit specialist outpatient clinics. This applies in particular to men aged 30-49 years, older individuals, and individuals with lower education. Gender differences in the use of services in the general population were dependent on age, whereas in the subgroup with anxiety/depression gender differences were not confirmed.
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Bmc Health Serv Res · Oct 2015
Older patients' participation in hospital admissions through the emergency department: an interview study of healthcare professionals.
Patient participation is an important aspect of healthcare quality and may be one way to improve the quality of transitional care for older patients. Research reveals minimal awareness about patient participation in hospital admissions. Hospital admissions require attention to individuals' specific needs beyond patient frailty, and to involve patients and their families in shared decision-making. The aim of this study was to identify factors influencing patient participation by exploring healthcare professionals' views on patient participation during the hospital admission of older patients through the emergency department (ED). ⋯ Patient participation in hospital admissions of older patients is dependent on the way the service is organized, the patients' condition, hospital resources, healthcare professionals' attitudes, and support from patients' next of kin. Some of the participants had high expectations of themselves and actively involved patients, but others did not find patient participation relevant in the emergency department. Some used crowded wards as a reason not to engage older patients in their own care.
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Bmc Health Serv Res · Oct 2015
Cost of stroke: a controlled national study evaluating societal effects on patients and their partners.
To estimate the direct and indirect costs of stroke in patients and their partners. ⋯ Stroke has significant mortality, morbidity and socioeconomic consequences for patients, their partners and society.