Bmc Health Serv Res
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Bmc Health Serv Res · Jan 2008
A method to determine spatial access to specialized palliative care services using GIS.
Providing palliative care is a growing priority for health service administrators worldwide as the populations of many nations continue to age rapidly. In many countries, palliative care services are presently inadequate and this problem will be exacerbated in the coming years. The provision of palliative care, moreover, has been piecemeal in many jurisdictions and there is little distinction made at present between levels of service provision. There is a pressing need to determine which populations do not enjoy access to specialized palliative care services in particular. ⋯ Strategic location analysis methods must be developed and used to accurately locate future palliative services in order to provide spatial access to the greatest number of people, and to ensure that limited health resources are allocated wisely. Improved spatial access has the potential to reduce travel-times for patients, for palliative care workers making home visits, and for travelling practitioners. These methods are particularly useful for health service planners - and provide a means to rationalize their decision-making. Moreover, they are extendable to a number of health service allocation problems.
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Bmc Health Serv Res · Jan 2008
Towards integration of general practitioner posts and accident and emergency departments: a case study of two integrated emergency posts in the Netherlands.
Accident and emergency (A&E) departments and general practitioner (GP) posts are often used inappropriately, leading to overcrowding. In the Netherlands, increasingly more integrated emergency posts (IEPs) are being created, integrating the care provided by GP posts and A&E departments, in order to improve the provision of the emergency care. ⋯ IEPs could be a promising innovation to organize emergency care more efficiently; however, it might take time to convince professionals of the possible advantages. Studies involving more IEPs and longer follow-up times are needed to determine whether such integration should be stimulated.
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Bmc Health Serv Res · Jan 2008
A proposed approach in defining population-based rates of major injury from a trauma registry dataset: delineation of hospital catchment areas (I).
Determining population-based rates for major injury poses methodological challenges. We used hospital discharge data over a 10-year period (1996-2005) from a national trauma registry, the Trauma Audit and Research Network (TARN) Manchester, to construct valid numerators and denominators so that we can calculate population-based rates of major injury in the future. ⋯ Large national trauma registries, including TARN, hold suitable data for determining population-based injury rates. Patient postcodes from hospital discharge allow identification of denominator populations using a market area approach.
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To assess the development of and variation in lengths of stay in Dutch hospitals and to determine the potential reduction in hospital days if all Dutch hospitals would have an average length of stay equal to that of benchmark hospitals. ⋯ Hospitals in the Netherlands vary substantially in case mix adjusted length of stay. Benchmarking--using the method presented--shows the potential for efficiency improvement which can be realized by decreasing inputs (e.g. available beds for inpatient care). Future research should focus on the effect of length of stay reduction programs on outputs such as quality of care.
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Bmc Health Serv Res · Jan 2008
Urban women's socioeconomic status, health service needs and utilization in the four weeks after postpartum hospital discharge: findings of a Canadian cross-sectional survey.
Postpartum women who experience socioeconomic disadvantage are at higher risk for poor health outcomes than more advantaged postpartum women, and may benefit from access to community based postpartum health services. This study examined socioeconomically disadvantaged (SED) postpartum women's health, and health service needs and utilization patterns in the first four weeks post hospital discharge, and compared them to more socioeconomically advantaged (SEA) postpartum women's health, health service needs and utilization patterns. ⋯ Although SED women experienced poorer mental and overall health they reported similar health service needs and utilization patterns to more SEA women. The results can assist policy makers, health service planners and providers to develop and implement necessary and accessible services. Further research is needed to evaluate SED postpartum women's health service needs and barriers to service use.