Bmc Health Serv Res
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Bmc Health Serv Res · Aug 2016
Using systems thinking to identify workforce enablers for a whole systems approach to urgent and emergency care delivery: a multiple case study.
Overcrowding in emergency departments is a global issue, which places pressure on the shrinking workforce and threatens the future of high quality, safe and effective care. Healthcare reforms aimed at tackling this crisis have focused primarily on structural changes, which alone do not deliver anticipated improvements in quality and performance. The purpose of this study was to identify workforce enablers for achieving whole systems urgent and emergency care delivery. ⋯ In this study, participants agreed that whole systems urgent and emergency care allows for the design and implementation of care delivery models that meet complexity of population healthcare needs, reduce duplication and waste and improve healthcare outcomes and patients' experiences. For this to be achieved emphasis needs to be placed on holistic changes in structures, processes and patterns of the urgent and emergency care system. Often overlooked, patterns that drive the thinking and behavior in the workplace directly impact on staff recruitment and retention and the overall effectiveness of the organization. These also need to be attended to for transformational change to be achieved and sustained. Research to refine and validate a single integrated career and competence framework and to develop standards for an integrated approach to workplace facilitation to grow the capacity of facilitators that can use the workplace as a resource for learning is needed.
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Bmc Health Serv Res · Aug 2016
Evidence of non-response bias in the Press-Ganey patient satisfaction survey.
Measures of patient satisfaction have gained prominence in recent years as changes to the American health care system have led to the incorporation of such metrics into reimbursement models. The response rate for widely-used outpatient satisfaction metrics and variables influencing the probability of survey nonresponse remain largely unknown. ⋯ The response rate to the Press-Ganey Medical Practice Survey of outpatient satisfaction is low in an orthopaedic outpatient population, and furthermore, is impacted by patient characteristics such as age, sex, insurance type, and type of orthopaedic subspecialist encountered. The findings of the present study should inform future non-response weighting procedures in this area. More research is needed to assess non-response bias-including follow-up studies of non-respondents-in order to more accurately measure of patient satisfaction.
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Bmc Health Serv Res · Aug 2016
Measuring the burden of preventable diabetic hospitalisations in the Mexican Institute of Social Security (IMSS).
The prevalence of diabetes among adults in Mexico has increased markedly from 6.7 % in 1994 to 14.7 % in 2015. Although the main diabetic complications can be prevented or delayed with timely and effective primary care, a high percentage of diabetic patients have developed them imposing an important preventable burden on Mexican society and on the health system. This paper estimates the financial and health burden caused by potentially preventable hospitalisations due to diabetic complications in hospitals operated by the largest social security institution in Latin America, the Mexican Institute of Social Security (IMSS), in the period 2007-2014. ⋯ Resources used for the hospital treatment of diabetic complications are then not available for other health care interventions. In order to prevent these hospitalisations more resources might need to be invested in primary care; the first step could be to consider the financial burden of these hospitalisations as a potential target for switching resources from hospital care to primary care services. However, more evidence of the effectiveness of different primary care interventions is needed to know how much of the burden could be prevented by better primary care.
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Bmc Health Serv Res · Jul 2016
Economic crisis, austerity and unmet healthcare needs: the case of Greece.
The programme for fiscal consolidation in Greece has led to income decrease and several changes in health policy. In this context, this study aims to assess how economic crisis affected unmet healthcare needs in Greece. ⋯ The adverse economic environment has significantly affected unmet health needs. Therefore health policy actions and social policy measures are essential in order to mitigate the negative impact on access to healthcare services and health status.
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Bmc Health Serv Res · Jul 2016
Emergency Department and Inpatient Healthcare utilization due to Hypertension.
Hypertension is one of the commonest chronic diseases, yet limited data are available for related health care utilization. Our study objective was to describe the emergency department (ED) and subsequent hospitalization related health care utilization and charges due to hypertension in the U.S. ⋯ Hypertension is associated with significant healthcare burden in the U.S. Future studies should assess strategies to reduce hypertension-associated cost and health care burden.