Questions related to Health Care Management
I'm doing a costing study of palliative care packages in low and middle income countries, and as a first step, we need to estimate the need for palliative care services by country.
Hemorrhagic Fever, such as Ebola, is included in the list of diseases/conditions that generate major needs for palliative care. Others include malignant neoplasm, heart failure, renal failure, COPD, dementia, HIV and etc. While death numbers for other diseases/conditions are available either through WHO or IHME, I can't find the death number for hemorrhagic fever by country (we are looking at Vietnam and India as two example countries). A lit search was not helpful as well.
Would anyone know where to find those data?
I am a dental hygienist in Riyadh- Suadi, Arabia, starting my master's research in healthcare administration. Can you help me to choose an easy, practical, and vital topic between these 5 topics?
- Health Care Management and Technology Adoption Or How Telemedicine Changes Healthcare Administration
- The Management of Patient’s Problems, who is really responsible?
- What is the various software that could be used for Hospital management regarding the cost-cutting?
- How to deal with the financial crisis in the healthcare system being a professional healthcare administrator?
- How can a good healthcare manager look after human resources data to find out the loops and holes for the improvements?
I've lost the link to a paper that showed healthcare managers need repeated evidence of improvement program effectiveness, if they are to support the program.
Has anyone seen / read similar literature? I'd be very grateful for the link.
Latin America and South Asia are now current hot spots for novel Corona virus. Centralized oxygen delivery system and ventilators are required in severe cases. Urban-rural disparity in health care management is not a new issue but during Corona crisis it seemed to be more prominent due to extreme inequity with poor healthcare facilities in rural areas.
In program which uses mixed indicator for admission and discharge, to estimate the over all coverage using SQEAC should I use both indicator or WHZ or MUAC?
The VAS is a commonly used tool in health outcome studies, when using it to assess importance of certain action or intervention, how we can interpret the results, for example on 1 to 10 line (where 1; the least and the 10; the highest), the average of importance was 4 out of 10, what does that mean? and if we want to identify the level of importance (very important, important, somewhat important, not important), where are the cut off point for each level? to say for example, one third of student view this intervention is very important.
Can we interpret the result as 1-5 is not important and 6 to 10 is important.
Complications related to viral hepatitis, alcohol-related and non-alcoholic liver disease, are the main reason for seeking gastroenterologists and hepatologists advice. In addition, hepatocellular carcinoma often arise on the ground of hepatitis, representing the fifth most common cancer in men and the ninth in women. In 2015, the World Health Organization estimated that 325 million people were living with chronic hepatitis infections (hepatitis B or C) worldwide and that globally, 1.34 million people died of viral in 2015.
In front of this global health problem, gastroenterologists, hepatologists and hepato-biliary-pancreatic (HBP) surgeons, are daily involved in the clinical routine in taking difficult clinical decisions. As Sir William Osler quoted: “medicine is a science of uncertainty and an art of probability” and no doctor returns home from a busy day at the hospital without the nagging feeling that some of his/her diagnoses may turn out to be wrong, or some treatments may not lead to the expected cure. Probability is a recurring theme in medical practice and the ability of dealing with risk and uncertainty can be elicited through a special kind of intelligence. In 2012, The UK psychologist Dylan Evans defined it as “risk-intelligence” that is "a special kind of intelligence for thinking about risk and uncertainty", at the core of which is the ability to estimate probabilities accurately.
Consequently, doctors are routinely asked to make predictions, and their predictions would lead to a consistent payoff when regarding a patient’s life. At the basis of “wise” medical decisions, physician’s experience surely plays a vital role. However, doctors can assume that their competency in a given area can be significantly higher than it really is. Such illusory superiority, is described as the Dunning – Kruger effect, a meta-cognitive bias leading to a discrepancy between the way people actually perform and the way they perceive their own performance level. The concept of “risk-intelligence” relies on the confidence that each subject has with their own knowledge, thus returning accurate probability estimates, and a “wise” doctor should be aware that he/she do not known, thus, returning high risk-intelligence.
To date, little is known about risk-intelligence and the Dunning – Kruger effect between doctors, and, especially, among hepatologists, a specialty strongly involved in important clinical decisions. With this aim we conducted a survey to test how risk-intelligence affects medical decision making in this particular clinical setting and whether the Dunning – Kruger bias can effectively affect these physicians.
If you are a gastroenterologist, hepatologist or HBP surgeon please help us in investigate this issue by completing the following survey:
Increasing unexpected healthcare utilisation in developed countries has led to several questions from the stakeholders, especially the health policy makers. Critics say unexpected healthcare utilisation cannot be prevented, while others say unscheduled utilisation can be avoided if adequate measures are put in place.
I believe, if the root cause of unexpected healthcare utilisation is known, there may be significant reduction to the high influx of patients to the health centres.
Question: In your opinion, what are the factors responsible for sudden utilisation of our health centres?
I have a group of subjects with XX disease enrolled in 2013-2016. After standard assessment, Patient received surgery or conservative treatment in terms of their own willing.
Recently I performed a telephone interview to inquiry their current functional outcome at the same time point.
My research question is:
1). Which treatment is more effective?
2). Is admission of year a predictor for functional outcome in terms of different treatment? (e.g. For surgery, is functional outcome going better as time goes by whereas for conservative treatment, is functional outcome going worse as time goes?)
3). For those patients who received conservative treatment, what factors may affect their functional outcomes?
Based on these questions, what may be your analytical method to deal with?
Organizational reforms and the shrinking of budgets going on in many countries surely have had an impact not only on nurses and clinicians but also on hospital administrators. Despite looking for recent studies on PubMed and google scholar, the only data I got access to (which explicitly states burnout is a thing among hospital admins) dates back to the 90's. Any help appreciated !
We (Bournemouth University) are conducting a project for 'Birthrights' on the human rights and dignity aspects of maternity care for disabled women. I should like to include (in the literature search) the paper you have mentioned as being in preparation if it is ready please?
Enabling Maternity Services to provide a normal birth for mothers with a disability: the views of practitioners.
We are hosting a consensus event at Bournemouth University on 26 May to discuss the study and the way forward for maternity services if you know of anyone who would be interested in attending? the link is on Eventbrite:
Thank you, Jilly Ireland
our research objectives is to find if the presence of appropriate healthcare services in schools and health personnel who provide it
we have collected our data contacting 40 random schools ( private,governmental) of all levels. asking about presence of healthcare equipments and the provider of care, number of incidence and how they managed it !
we thought of using chi-square test but the sample size is small , is there any other appropriate test we can use ?
Dear Research Scholars,
I need your advice regarding statistical technique.
I have collected data on Knowledge Management Practices such as knowledge perception (8 items) Knowledge gathering (11 items) knowledge creation (12 items) knowledge sharing (18 items) knowledge diffusion (13 items) and Knowledge retention (8 items) (all items are 70) from the Europe, Asia and GCC
(15 Countries have been involved with 200 responds). I would like to show variance between Europe vs Asia vs GCC so, which technique is very best for analysis?
Thank you in advance for your response and advice.
It is true that accounting information requires detailed analysis and specialized knowledge to interpret. This usually means a good understanding of the accounting model and accounting practices. However, this is true of most complex systems. For example, the lab reports you receive when visiting the doctor also require specialized knowledge to interpret, but I doubt you would describe them as “deceitful.” Why do the complexities of accounting imply deceit?
Does your facility have a protocol or guidelines that either limit admissions to inpatient floors during shift change so that oncoming nurses have adequate time to get report for patients they are going to take care of before settling a newly admitted patient? Mainly patients being admitted from the ER..
Will they use queuing theory for analysis?
Recently, in our hospital, a local investigator asked us for a study that sought to identify points of congestion in the flow of patients to the intensive care unit, that is, to identify waiting times in each of the intervening instances. Theory of queues proposed by Erlang. The distribution of contracting for the outputs did not behave like an exponential, do you think it is a mistake to use this distribution to hire the expenditures?
In the UK we have a dedicated public health body that is split into regions.
Has anyone had any experience with setting up or evaluating new models of public health?
Is there any recent research (within the last three years) nationally or internationally looking at merging public health bodies within a larger region, what this looks like, and how effective it is in achieving its objectives?
I need to know if in addition to patient surveys there are other types of indicators
on the continuity of care.
I am looking at management approaches that improve the quality of care in hospitals in low- and middle-income countries. My particular interest is how to deal with the problem of vertical 'silos' and create decentralised teams that unite the efforts of clinical staff, administrative staff and supply chains in the service of patient care.
I will start by mentioning that clinical experience and intuition came before evidence based medicine. This being said I would like to point out to the fact that more and more of our patients are ( and will be ) nonagenarians and they may represent an age group with distinct bio-psycho-social characteristics. Should we define them as a distinct group ? Could you , dear colleagues indicate publications devoted to this subject ?
I need help with the scheduling in Anylogic.
I will describe the process
1. A patient comes in a clinic [newly created agent]
2. After his visit, he/she is given a future date for a following appointment (appointment 1)
3. He/she goes home [I created a zone – rectangular node – for this]
4. Day of the Appointment 1 arrives, he/she needs to go to the clinic [from home]
5. Point 2, 3, 4 repeat
My difficulty is that for the date and time for appointment 1 needs to be done dynamically (not predetermined). This means that the decision of the future appointment needs to happen at the end of the clinic visit, and it may be different for different patients.
How can I create such a schedule, attach it to each individual patient, and make sure that the patients come back at the clinic on the date of their appointment?
Much appreciated any help received.
I am looking into the required skills and competences of applied theatre practitioners in healthcare environments.
My research is to explore a way to decrease hospital social admissions. At the same time facilitating a safe discharge plan for the client. If you can give me different examples of hospital social admissions you've come across and just how each case was addressed.
We are trying to classify approaches in "humanitarian aid effectiveness" for a masters thesis (humanitarian aids in Afganistan in particular). We are interested in outcome (not output and not efficiency) oriented approaches. However, although humanitarian aids amounts to a huge sum on a global scale, we are having difficulty identifying a monitoring and evaluating system which is designed specific to the nature of humanitarian aids. We would be very happy to hear your recommendations about the literature and discuss issues which may arise.
Governments are cutting nursing posts and lowering down nursing education, below the European Directive 55. How can we stop this trend. What evidence do we have to convince politicians to invest in the nursing workforce?
Health Ministers, Education Ministers develop new roles in nursing, assistants to nurses, to make it all cheaper.
I am interested to know the caregivers needs to provide high quality care for patients with cancer. I am not looking for the psychological needs, but the knowledge and skills that we should equip the caregivers with, and the most common demands for the patients with cancer.
If you are aware about any instrument to measure these needs, this also will be highly appreciated.
Are there shifts being seen in recent occupational safety and health (OSH) research in comparison to traditional OSH research focuses of past decades? What are some of the causes for such shifts, and what are the emerging trends in the field?
Evidently, Accountability for reasonableness (A4R) is a widely accepted ethical framework that has been used internationally in previous studies for evaluating legitimacy and fairness in priority setting in hospitals. According to ‘accountability for reasonableness’, a fair priority setting process meets four conditions: relevance, publicity, appeals, and enforcement. Like A4R, is there a widely accepted conceptual framework that has been used in priori studies to evaluate effectiveness in budget management (the whole budgetary process from budget preparation to implementation, and monitoring and evaluation) in case of hospitals? Thank you.
Lipsky's book on Street-Level Bureaucracy is more general than the health-care sector, but applies to what I have seen in my field-study locations (public health clinics in South Africa). Sociology of Health and Illness has articles on nurse-doctor relationships (eg Allen 1997 on Negotiated Order). Social Science and Medicine has more relevant articles (eg Walker and Gilson 2004 use Lipsky). But forward-chaining from these turns up very little.
Academy of Management has articles on high- and low-status work. Org Sci, Adm Sci Q and Organization have articles that are generally too removed from the domain to be much use.
For a health care company, what are the various sourcing models that it can adopt in order to manage its tail spend?
Are there any such models? what are the top pharmaceutical companies doing currently to manage their spend?
Any expertise on these?
for testing customer experiences in Public and Private hospital care: I am in bit confusion with the validation to use the tool for the research in between the EXQ and other tools HCSQ, PubHosQual, CX, CXQ, PAD Model, PADPoM, EXQUAL, E-S- Qual etc. could you please suggest me how can i clear my understanding?
Are anyone aware of studies assessing patient satisfaction and quality of treatment in people with diabetes, comparing a standard structured out patient structure with pre-planned visits to an on-demand structure, where the patient demands all services?
We are developing a MOOC around this challenge to service delivery and want to hear from anyone who has evidence, service models, service user stories etc that could contribute to the MOOC material. we want to be as globally inclusive as possible so would welcome your input, especially if you want to contribute videos, presentations, podcasts and your research. please get in touch with us.
Menstrual health and hygiene has strong inferences on the health and wellbeing of a woman in general and of the overall society, in particular. The study of United Nations, 2013 revealed that globally menstrual women make up half (49.58%) of the population. Therefore, it is important to not overlook a phenomenon that a large percentage of the population experiences this on regular basis. The challenge of addressing the socio-cultural taboos, beliefs, and misconceptions about menstruation, is further compounded by the low knowledge levels, understanding and awareness of menstruation health. In 2010, Government of India has launched ‘MHS’ for the promotion of menstrual health and hygiene among adolescent girls in rural areas. Therefore, there is a great demand and need for accurate and relevant communication strategy which have been credited with advocacy, behaviour changes and social mobilizations to approach in combating this issue. In the words of Cohen (1963), the media “may not be successful in telling their readers what to think, but are stunningly successful in telling their readers what to think about”. Thus, this study is an attempt to examine the communication strategy and its efficacy to encompass good menstrual information, knowledge which influences individual or community decisions that enhancing, motivating and mobilizing them towards the use of good health practices and responds to care interferences.
The main objective of the study is to target and tailor menstrual health and hygiene messages to the rural women to find out the best communication strategy. The research will be based on the empirical study, where the researcher will examine the efficacy of the selected medium to be used for the diffusion of health related programme. The study will adopt quasi-experimental method wherein villages of Gaya district of Bihar will be selected through multistage sampling. The sample from the study subject will be selected by probability sampling. The data collection technique will be an interview schedule and focus group discussions of the study subjects. Communication strategies evaluations were reviewed to determine their impact on awareness, information seeking, knowledge, attitude and behaviour change towards the use of good health practices and responds to care interferences. Further the study will be helpful for government and non-government organizations for disseminating health awareness related information and practices.
Key Words: Menstrual Health, Communication Strategy, Gaya District, Empirical Study, Bihar
Particularly with reference to the NHS of UK, it can be said that the general physicians are required to be actively involved in patient care, especially in the case of hospital discharge and rehabilitation after trauma. But to what extent the pharmacist can be involved too? What powers, authorities, and skills can the pharmacist apply to relieve an ailing patient?
I am looking a variation in Medical test requesting practices by Primary care physicians. The tests I am looking at have clear guidelines, the data is normalised by demographics etc. Other variables like experience, special interests, QOF framework, patient pathways, resource allocation, easy of access etc have been factored in.
After all this one would still see 15 to 30 fold variation.
how does one go about defining " acceptable variation" in such a system where in a human being ( Doctor) is interacting with a patient. 2 sets of human factors influencing each other.
For example, I am a secondary care physician- and I am aware , in the last 10 patients I saw for a suspected condition - the number of tests I did vary from person to person.
Thoughts and comments please
I am in the process of conducting a meta-analysis and I am unsure about how to approach studies that have a high, or unclear risk of bias.
Nursing errors commonly include failure to:
* collaborate with other healthcare team members
* clarify interdisciplinary orders
* ask for and offer assistance
* utilize evidence-based performance guidelines or bundles
* communicate information to patients and families
* limit overtime
* adequately staff patient care units with enough nurses to allow them to safely provide care.
Please describe what you can do to minimize these types of errors?
The health care industry seeks to protect, restore, and enhance health.it is important to adopt an approach to design, construction, and operations and maintenance that supports a healthy environment, both in their facilities and in their communities
A major trend for medical advice, given the growing trend of sick patients living longer, is to look for advice on the web from sources such as HEALTHPAD, etc, I am now intrigued by the comparative effectiveness of those sources of MEDICAL help.
I am wondering on serious research that would compare,let us say, 100 patients with a serious flu or stomach infection, and put them in a situation to consult an actual physician face to face and 3 or 5 web medical advice places and then compare the results of the advice .
My last book was on orgnizational culture in clinics and hospitals. Now I am asking what if the local culture is taken away (can it be done?) and we look for medical advice outside the brick and mortar locations.
Any advice of reserach on this topics is WELCOME.
I am fully aware that the results might be contradictory in many cases or fully wrong methodologies in others. But this is a topic of huge implications for every and all countries health systems.
Please advice with your views but more important with serious research citations on this techno-social topic. Probably one with major social implications.
MUCHAS GRACIAS AMIGOS
I have found some standards for quality as the Joint Commission standards, and also I have seen the standards on health of the ISO, I want to know if there is more and better, and if there is guidelines or standards for quality and planification in health.
A colleague of mine has requested assistance in attaining international evidence demonstrating how up-skilling paramedics improves quality/patient care and the economic value of doing so, to continue to strengthen the case for change at a strategic level.
I am "putting it out there" to call on the international pool of knowledge and information, that may not have been published, but undoubtedly exists. Even small individual case studies are as important as large scale projects to bring about and support change.
Thanks so much for your consideration and look forward to hearing all you have to offer.
Demand of transparency of health care systems has evolved over the last years. Some of the domains expected to conduct transparenly are pricing and quality of care . Likewise this concept is different for health care consumers, physicians and health care organizations administrative staff. My question refers to what should be the expectations of elderly people, elderly patients and their care givers in terms of transparency?
I am bachelor in nurse and I follow the orientation of management of care. Now, I do a master thesis, and need some recommendations for definition of the study object. My interest is research the issue of the quality of nurse care in populations with dementia in México City.
Beyond stratifying for health literacy, we are interested in controlling for an individual's total exposure to/encounters/interaction with healthcare delivery. This could be thought of as duration of exposure as well as intensity for unit time.
Is anyone aware of a validated method of measuring this?
I am searching for research literature and scholars working on Indic perspectives on end of life care. Can anyone who has been working or published in this area may kindly share their experience and published work? Thank you.
We at our institution have developed a protocol to deal with terror attacks . Now how can i confirm scientifically that my protocol has actually improved the outcome of the incident in term of mortality and morbidity owing to better patient disaster management plan ?
International studies just describe an event and then discuss the outcomes - no set protocols yet!!
In most of the societies, small reforms are done to improve the health status of the people, but sometimes results are not up to the mark. Can you suggest some measures to achieve set goals for health?
it has to do with the filed of "logistics" and the gaps in customers' expectations when it comes to health management
I would like to measure patient perception of service quality (or patient experience) in Emergency Department of hospitals.
Is there a valid questionnaire in this regard?
Dear friends, We are conducting a research on cost effective analysis of sexual and reproductive health service provision. We focus only on medical services in both static clinic and outreach. We would like to focus on indicators like "Cost per client", "Cost per service", "Number of clients per service provider per day", "Cost recovery ratio", etc. Could you please share your experiences?
Thank you in advance.
M. Suchira Suranga
I am working on a project to show how social media can be used to improve patient outcomes, specifically in community health centers.
Often training in health care is assessed through evaluation of learning and evaluation index. what other ways and means can be used to evaluate impact and effectiveness of the training buildings?
I am working on my master's thesis and will be testing models that have facets of health as the outcome. Specifically, I am looking at:
- physical health (i.e., health problems, such as hypertension, pain, vision problems),
- functional health (i.e., how health problems impair or limit daily functioning, such as working, sleeping, seeing),
I'm thinking that these facets of health are formed by their indicators, rather than the indicators being reflective of the facet of health. But can an argument be made in favor of reflective?
Related, if I do treat these are formative, what are the implications for treating these latent variables as endogenous outcomes? I've read Diamantopoulos et al (2008) and I am not sure how, or if any recommendations for formative latent variables change if the latent variable is the outcome.
If it helps in any way, most of my indicators are categorical, but I also have a few continuous. I was planning on using robust weighted least squares as my estimator and conducting my analyses in Mplus.
Thank you in advance, and let me know if you need more details.
Failure to rescue is shorthand for failure to rescue (i.e., prevent a clinically important deterioration, such as death or permanent disability) from a complication of an underlying illness (e.g., cardiac arrest in a patient with acute myocardial infarction) or a complication of medical care. Failure to rescue rates used for both research purposes and as quality indicators are typically derived from hospital administrative databases. However, it is not clear how identify it, so what are the best indicators to measure it?
The ambiguity and variability in existing literature on the magnitude of socio-economic inequality in self-reported morbidities makes it difficult to set priorities in health policies.
I am currently involved in conducting cost effectiveness study of anti-epileptic drugs. We have collected QOLIE 10 scores from 451 patients using propsective observational method. I would like to receive references for mapping algorithm for calculating utility values from QOL scores of QOLIE 10.
Conventional cost function assumes that the hospitals is minimizing cost, or maximizing profit or patients.
However, this is likely not the case for public hospitals in developing countries, in absence of incentive to compete and to self-sustain.
1. So, what are public hospitals in developing countries maximizing / minimizing?
2. How should a cost function for these public hospitals look like?
3. Is there any literature discussing how should a cost function for public hospitals in developing countries be specified? How similar or different should it be from conventional cost function?
4. Studies from developing countries have used the conventional cost function such as Weaver & Deolalikar (2004) below. Is this correct?
I have tried to look for literature but to no avail.
Would be glad to have some discussion here.
Thank you very much in advanced.
There are a number of gold nuggets buried in the text, on medical education but also on the financing of the health care system.
Relatively little is known about the association between ageing and health care costs in middle- and low-income countries - whereas, in high income countries, available data does not yet point to a clear answer - with income elasticity and patient expectations, time to death, the type of service (inpatient or outpatient), and expensive technology, all possibly contributing more to increased spending than ageing populations.
See for example, Asia in the ageing century: Part III - Health care. www.cepar.edu.au/media/113850/asia_in_the_ageing_century_-_part_iii_-_healthcare.pdf
Any relevant and recent (last 5 years) analyses, published or in the grey literature, would be appreciated.
I am looking for journals and articles that focus on decentralization of healthcare systems, more so in Africa. For example from National level, to regional boundaries, to the local boundaries.
Health Literacy is defined as the ability to read and unerstand basic medical
and health information. According to several sources more than one third of the population in North America has no health / medical literacy. The outcomes are estimated at more than 100 bilion USD for the health care sector with additional
negative cosequences like : innability to understand inform concern documents,
innability to access and use adequate and proper health/medical info on the net
etc. The next generation should aquire this through school teaching programes
- What you dear fellows think about ?
A local health service has recently introduced a, add on service to assist GPs in offering better service to people with chronic mental illness, after four years, there is need to determine whether that service is having desired outcomes.
i intend to research of whether there are specific provisions for the poor and the vulnerable in the Nigerian National Health Bill 2014. They key questions include, are the provisions rights or privileges; who is eligible and who is to advocate for the poor? I would like read about other researchers critique of Health Bill in relation to equity and inequity in the Nigerian health system.