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BMC Health Services Research

Shi-Han Lei, Yan Zhang, Hao-Miao Li, Dai Su, Jing-Jing Chang, Xiao-Mei Hu, Qing Ye, Di Jiang, Ying-Chun Chen
BACKGROUND: The incidence of inappropriate admissions in China has become the shackle of its' service supply system. This research aims to assess the level of children's inappropriate admissions to county hospitals in rural China and identify the characteristics and determinants of children's inappropriate admissions. METHODS: A retrospective review was conducted on data of children aged 0-14 years. A total of 771 children medical records in four county hospitals was collected by stratified random sampling in Midwestern China and was evaluated through the Rural Appropriateness Evaluation Protocol...
February 18, 2019: BMC Health Services Research
Maria Strandås, Steen Wackerhausen, Terese Bondas
BACKGROUND: With its emphasis on cost-reduction and external management, New Public Management emerged as the dominant healthcare policy in many Western countries. The ability to provide comprehensive and customized patient-care is challenged by the formalized, task-oriented organization of home-care services. The aim of this study is to gain deeper understanding of how nurses and the patients they care for, relate to and deal with the organizational systems they are subjected to in Norwegian home care...
February 14, 2019: BMC Health Services Research
Shelley A Wilkinson, Maxine O'Brien, Sally McCray, Desley Harvey
BACKGROUND: Translating research into clinical practice is challenging for health services. Emerging approaches in implementation science recognise the need for a theory-driven approach to identify and overcome barriers to guideline adherence. However, many clinicians do not have the capacity, confidence, or expertise to realise change in their local settings. Recently, two regional sites participated in a facilitated implementation project of an evidence-based model of gestational diabetes mellitus (GDM) care in dietetics, supported by a team at a metropolitan centre...
February 14, 2019: BMC Health Services Research
Joanne Shaw, Suvena Sethi, Lisa Vaccaro, Lisa Beatty, Laura Kirsten, David Kissane, Brian Kelly, Geoff Mitchell, Kerry Sherman, Jane Turner
BACKGROUND: Collaborative care involves active engagement of primary care and hospital physicians in shared care of patients beyond usual discharge summaries. This enhances community-based care and reduces dependence on specialists and hospitals. The model, successfully implemented in chronic care management, may have utility for treatment of depression in cancer. The aim of this systematic review was to identify components, delivery and roles and responsibilities within collaborative interventions for depression in the context of cancer...
February 14, 2019: BMC Health Services Research
Mirjam Simoons, Henricus G Ruhé, Eric N van Roon, Robert A Schoevers, Richard Bruggeman, Daniëlle C Cath, Diny Muis, Johan Arends, Bennard Doornbos, Hans Mulder
BACKGROUND: At many outpatient departments for psychiatry worldwide, standardized monitoring of the safety of prescribed psychotropic drugs is not routinely performed in daily clinical practice. Therefore it is unclear to which extent the drugs used by psychiatric outpatients are prescribed effectively and safely. These issues warrant structured monitoring of medication use, (pre-existing) co-morbidities, effectiveness and side effects during psychiatric outpatient treatment. Improvement of monitoring practices provides an opportunity to ensure that somatic complications and adverse drug effects are detected and dealt with in a timely manner...
February 14, 2019: BMC Health Services Research
Edward J Miech, Nicholas A Rattray, Dawn M Bravata, Barbara J Homoya, Jennifer Myers, Teresa M Damush
BACKGROUND: Implementation of new programs within healthcare systems can be extraordinarily complex. Individuals within the same healthcare organization often have different perspectives on how implementation of a new program unfolds over time, and it is not always clear in the midst of implementation what issues are most important or how to address them. An implementation support team within the Veterans Health Administration (VHA) sought to develop an efficient method for eliciting an ongoing, detailed and nuanced account of implementation progress from multiple viewpoints that could support and inform active implementation of two new VHA programs...
February 14, 2019: BMC Health Services Research
Fiona Scorgie, Yasmin Mohamed, David Anderson, Suzanne M Crowe, Stanley Luchters, Matthew F Chersich
BACKGROUND: Accurate measurement of CD4 cell counts remains an important tenet of clinical care for people living with HIV. We assessed an instrument-free point-of-care CD4 test (VISITECT® CD4) based on a lateral flow principle, which gives visual results after 40 min. The test involves five steps and categorises CD4 counts as above or below 350 cells/μL. As one component of a performance evaluation of the test, this qualitative study explored the views of healthcare workers in a large women and children's hospital on the acceptability and feasibility of the test...
February 14, 2019: BMC Health Services Research
Matej Stuhec, Katja Gorenc, Erika Zelko
BACKGROUND: The population of developed countries is aging, leading to an increase in the use of medication in daily practice, which can lead to serious treatment costs and irrational polypharmacy. A collaborative care approach, such as providing medication review service provided by a clinical pharmacist (CP), is a possible way to reduce drug-related problems and irrational polypharmacy. The aim of this study was to determinate whether a CP's medication review service can improve the quality of drug prescribing in elderly patients treated with polypharmacy in primary care...
February 13, 2019: BMC Health Services Research
Robert Kaba Alhassan, Richard Tsikata, Richard Naatu Tizaawaw, Prince Asante Tannor, Perpetual Praba Quaw, Cecilia Aba Ata Awortwi, Martin Amogre Ayanore, Agani Afaya, Solomon Mohammed Salia, Japiong Milipaak, Prudence Portia Mwini-Nyaledzigbor
BACKGROUND: Data on nurses' adherence to standard protocol on nasogastric (NG) tube feeding remain scanty in Ghana even though patients in critical medical conditions are routinely managed using this procedure. This study explored self-rated adherence to standard protocols on NG tube feeding among professional and auxiliary nurses and the perceived barriers impeding compliance to these standard protocols. METHODS: This is a descriptive analytical cross-sectional study among professional (n = 89) and auxiliary (n = 24) nurses in a major referral hospital in one of the ten administrative regions in Ghana...
February 13, 2019: BMC Health Services Research
Lydia Nakiire, Ben Masiira, Christine Kihembo, Edson Katushabe, Nasan Natseri, Immaculate Nabukenya, Innocent Komakech, Issa Makumbi, Okot Charles, Francis Adatu, Miriam Nanyunja, Peter Nsubuga, Solomon Fisseha Woldetsadik, Patrick Tusiime, Ali Ahmed Yahaya, Ibrahima Socé Fall, Alemu Wondimagegnehu
BACKGROUND: The Integrated Disease Surveillance and Response (IDSR) strategy was adopted as the framework for implementation of International Health Regulation (2005) in the African region of World Health Organisation (WHO AFRO). While earlier studies documented gains in performance of core IDSR functions, Uganda still faces challenges due to infectious diseases. IDSR revitalisation programme aimed to improve prevention, early detection, and prompt response to disease outbreaks. However, little is known about health worker's perception of the revitalised IDSR training...
February 13, 2019: BMC Health Services Research
Sharon H Kim, Sallie J Weaver, Ting Yang, Michael A Rosen
BACKGROUND: Are creativity and compliance mutually exclusive? In clinical settings, this question is increasingly relevant. Hospitals and clinics seek the creative input of their employees to help solve persistent patient safety issues, such as the prevention of bloodstream infections, while simultaneously striving for greater adherence to evidence-based guidelines and protocols. Extant research provides few answers about how creativity works in such contexts. METHODS: Cross-sectional survey data were collected from employees in 24 different U...
February 12, 2019: BMC Health Services Research
Amy L Clarke, Julia Roscoe, Rebecca Appleton, Jeremy Dale, Veronica Nanton
BACKGROUND: Men surviving prostate cancer report a wide range of unmet needs. Holistic needs assessments (HNA) are designed to capture these, but are traditionally paper-based, generic, and only carried out in secondary care despite national initiatives advocating a "shared care" approach. We developed an online prostate cancer-specific HNA (sHNA) built into existing IT healthcare infrastructure to provide a platform for service integration. Barriers and facilitators to implementation and use of the sHNA were explored from both the patients and healthcare professionals (HCPs) perspectives...
February 12, 2019: BMC Health Services Research
Anna Häger Glenngård
BACKGROUND: The purpose of this study was to contribute to knowledge about what is regarded as an appropriate governance model in welfare markets in healthcare, from the perspective of government. The study draws on a framework about governance in healthcare systems as a continuous process of priority setting, monitoring and accountability. It relates to various dimensions of management controls; a view on management controls as a package with interdependence between different controls, a use of management controls as coercive or enabling, and implications of involving providers in the design of control systems...
February 11, 2019: BMC Health Services Research
Devin Incerti, John Browne, Caroline Huber, Christine L Baker, Geoff Makinson, Amir Goren, Richard Willke, Warren Stevens
BACKGROUND: Although there has been growing attention to the measurement of unmet need, which is the overall epidemiological burden of disease, current measures ignore the burden that could be eliminated from technological advances or more effective use of current technologies. METHODS: We developed a conceptual framework and empirical tool that separates unmet need from met need and subcategorizes the causes of unmet need into suboptimal access to and ineffective use of current technologies and lack of current technologies...
February 11, 2019: BMC Health Services Research
Wenbin Liu, Lizheng Shi, Monika Sawhney, Xiaoli Gu, Yingyao Chen
BACKGROUND: Evidence-based decision on drug list or formulary has been applied worldwide. Although the importance of scientific evidence was emphasized, the decision-making procedures for including medicines into the national reimbursement drug list were often challenged by their process opacity and relying on subjective expert opinion. This study aimed to explore and assess the evidence for the effectiveness of anti-hypertensive medicines included on the Chinese National Reimbursement Drug List (NRDL), and to provide recommendations for further improvement...
February 11, 2019: BMC Health Services Research
Marte Rye, Oddgeir Friborg, Ingunn Skre
BACKGROUND: Gaining insight into factors influencing the adoption of evidence-based interventions (EBI) is essential to ensuring their sustainability in the mental healthcare setting. This article describes 1) differences between professional staff roles in attitudes towards EBI and 2) individual and organizational predictors of attitudes towards adopting EBI. METHODS: The participants were psychologists and psychiatric nurses (N = 792). Student t-tests were used to investigate group differences of global attitude scores on the Evidence-based Practice Attitude Scale-36 (EBPAS-36)...
February 8, 2019: BMC Health Services Research
Sarah Stegink, Alison M Elliott, Christopher Burton
BACKGROUND: Managing demand for urgent and unscheduled care is a major problem for health services globally. A particular issue is that some patients appear to make heavy use of services, including primary care out of hours. We hypothesised that greater variation (statistical complexity) in reasons for attending primary care out of hours services may be a useful marker of patients at high risk of ongoing heavy service use. METHODS: We analysed an anonymised dataset of contacts with the primary care out of hours care for Scotland in 2011...
February 8, 2019: BMC Health Services Research
Gavin George, Bruce Rhodes, Christine Laptiste
BACKGROUND: The continuous migration of Human Resources for Health (HRH) compromises the quality of health services in the developing supplying countries. The ability to increase earnings potentially serves as a strong motivator for HRH to migrate abroad. This study adds to limited available literature on HRH salaries within the Caribbean region and establishes the wage gap between selected Caribbean and popular destination countries. METHODS: Salaries are reported for registered nurses, medical doctors and specialists...
February 8, 2019: BMC Health Services Research
Natasha Noble, Christine Paul, Justin Walsh, Kylie Wyndham, Sue Wilson, Jessica Stewart
BACKGROUND: This cross-sectional study aimed to explore, among a sample of patients attending one of four Aboriginal Health Services (ACCHSs), the degree of concordance between self-report and medical records for whether screening for key healthcare items had ever been undertaken, or had been undertaken within the recommended timeframe. METHODS: Across the four ACCHSs, a convenience sample of 109 patients was recruited. Patients completed a self-report computer survey assessing when they last had preventive care items undertaken at the service...
February 8, 2019: BMC Health Services Research
Karen G Rentas, Laura Buckley, Dawn Wiest, Cortney A Bruno
BACKGROUND: A small percentage of patients relies extensively on hospital-based care and account for a disproportionately high share of health care spending in the United States. Evidence shows that behavioral health conditions are common among these individuals, but understanding of their behavioral health needs is limited. This study aimed to understand the behavioral health characteristics and needs of patients with high hospital utilization patterns in Camden, New Jersey. METHODS: The sample consisted of patients in a care management intervention for individuals with patterns of high hospital utilization who were referred for behavioral health assessments (N = 195)...
February 8, 2019: BMC Health Services Research
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