Evaluation of a novel salaried medical officer position on service provision and performance at a rural health service: An exploratory mixed‐methods study

2021 ◽  
Author(s):  
Jaclyn L. Bishop ◽  
Sophie Ping
Keyword(s):  
Mixed Methods ◽  
Health Service ◽  
Rural Health ◽  
Service Provision ◽  
Medical Officer ◽  
Mixed Methods Study ◽  
Rural Health Service ◽  
And Performance

scholarly journals Radio back-up in rural health service

Nature ◽  
1978 ◽  
Vol 275 (5678) ◽  
pp. 264-264
Author(s):  
Zaka Imam
Keyword(s):  
Health Service ◽  
Rural Health ◽  
Rural Health Service

scholarly journals Drivers of ‘clinically unnecessary’ use of emergency and urgent care: the DEUCE mixed-methods study

2020 ◽  
Vol 8 (15) ◽  
pp. 1-256
Author(s):  
Alicia O’Cathain ◽  
Emma Knowles ◽  
Jaqui Long ◽  
Janice Connell ◽  
Lindsey Bishop-Edwards ◽  
...  
Keyword(s):  
General Practice ◽  
Mixed Methods ◽  
General Practitioner ◽  
Health Service ◽  
Health Services ◽  
Focus Groups ◽  
Emergency Departments ◽  
Help Seeking ◽  
Mixed Methods Study ◽  
Coping Capacity

Background There is widespread concern about the pressure on emergency and urgent services in the UK, particularly emergency ambulances, emergency departments and same-day general practitioner appointments. A mismatch between supply and demand has led to interest in what can be termed ‘clinically unnecessary’ use of services. This is defined by the research team in this study as ‘patients attending services with problems that are classified as suitable for treatment by a lower urgency service or self-care’. This is a challenging issue to consider because patients may face difficulties when deciding the best action to take, and different staff may make different judgements about what constitutes a legitimate reason for service use. Objectives To identify the drivers of ‘clinically unnecessary’ use of emergency ambulances, emergency departments and same-day general practitioner appointments from patient and population perspectives. Design This was a sequential mixed-methods study with three components: a realist review; qualitative interviews (n = 48) and focus groups (n = 3) with patients considered ‘clinically unnecessary’ users of these services, focusing on parents of young children, young adults and people in areas of social deprivation; and a population survey (n = 2906) to explore attitudes towards seeking care for unexpected, non-life-threatening health problems and to identify the characteristics of someone with a tendency for ‘clinically unnecessary’ help-seeking. Results From the results of the three study components, we found that multiple, interacting drivers influenced individuals’ decision-making. Drivers could be grouped into symptom related, patient related and health service related. Symptom-related drivers were anxiety or need for reassurance, which were caused by uncertainty about the meaning or seriousness of symptoms; concern about the impact of symptoms on daily activities/functioning; and a need for immediate relief of intolerable symptoms, particularly pain. Patient-related drivers were reduced coping capacity as a result of illness, stress or limited resources; fear of consequences when responsible for another person’s health, particularly a child; and the influence of social networks. Health service-related drivers were perceptions or previous experiences of services, particularly the attractions of emergency departments; a lack of timely access to an appropriate general practitioner appointment; and compliance with health service staff’s advice. Limitations Difficulty recruiting patients who had used the ambulance service to the interviews and focus groups meant that we were not able to add as much as we had anticipated to the limited evidence base regarding this service. Conclusions Patients use emergency ambulances, emergency departments and same-day general practitioner appointments when they may not need the level of clinical care provided by these services for a multitude of inter-related reasons that sometimes differ by population subgroup. Some of these reasons relate to health services, in terms of difficulty accessing general practice leading to use of emergency departments, and to population-learnt behaviour concerning the positive attributes of emergency departments, rather than to patient characteristics. Social circumstances, such as complex and stressful lives, influence help-seeking for all three services. Demand may be ‘clinically unnecessary’ but completely understandable when service accessibility and patients’ social circumstances are considered. Future work There is a need to evaluate interventions, including changing service configuration, strengthening general practice and addressing the stressors that have an impact on people’s coping capacity. Different subgroups may require different interventions. Study registration This study is registered as PROSPERO CRD42017056273. Funding This project was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme and will be published in full in Health Services and Delivery Research; Vol. 8, No. 15. See the NIHR Journals Library website for further project information.

scholarly journals General Practitioners’ Attitudes toward Municipal Initiatives to Improve Antibiotic Prescribing—A Mixed-Methods Study

Antibiotics ◽  
2019 ◽  
Vol 8 (3) ◽  
pp. 120 ◽  
Author(s):  
Marthe Sunde ◽  
Marthe Marie Nygaard ◽  
Sigurd Høye
Keyword(s):  
General Practice ◽  
Quality Improvement ◽  
Mixed Methods ◽  
General Practitioners ◽  
Treatment Guidelines ◽  
National Level ◽  
Medical Officer ◽  
Mixed Methods Study ◽  
Antibiotic Prescribing ◽  
E Mail

Antimicrobial stewardship (AMS) interventions directed at general practitioners (GPs) contribute to an improved antibiotic prescribing. However, it is challenging to implement and maintain such interventions at a national level. Involving the municipalities’ Chief Medical Officer (MCMO) in quality improvement activities may simplify the implementation and maintenance, but may also be perceived challenging for the GPs. In the ENORM (Educational intervention in NORwegian Municipalities for antibiotic treatment in line with guidelines) study, MCMOs acted as facilitators of an AMS intervention for GPs. We explored GPs’ views on their own antibiotic prescribing, and their views on MCMO involvement in improving antibiotic prescribing in general practice. This is a mixed-methods study combining quantitative and qualitative data from two data sources: e-mail interviews with 15 GPs prior to the ENORM intervention, and online-form answers to closed and open-ended questions from 132 GPs participating in the ENORM intervention. The interviews and open-ended responses were analyzed using systematic text condensation. Many GPs admitted to occasionally prescribing antibiotics without medical indication, mainly due to pressure from patients. Too liberal treatment guidelines were also seen as a reason for overtreatment. The MCMO was considered a suitable and acceptable facilitator of quality improvement activities in general practice, and their involvement was regarded as unproblematic (scale 0 (very problematic) to 10 (not problematic at all): mean 8.2, median 10). GPs acknowledge the need and possibility to improve their own antibiotic prescribing, and in doing so, they welcome engagement from the municipality. MCMOs should be involved in quality improvement and AMS in general practice.

scholarly journals Has universal health insurance reduced socioeconomic inequalities in urban and rural health service use in Thailand?

2010 ◽  
Vol 16 (5) ◽  
pp. 1030-1037 ◽  
Author(s):  
Vasoontara Yiengprugsawan ◽  
Gordon A. Carmichael ◽  
Lynette L-Y Lim ◽  
Sam-ang Seubsman ◽  
Adrian C. Sleigh
Keyword(s):  
Health Insurance ◽  
Health Service ◽  
Rural Health ◽  
Service Use ◽  
Socioeconomic Inequalities ◽  
Health Service Use ◽  
Universal Health Insurance ◽  
Rural Health Service ◽  
Universal Health

scholarly journals Under Reporting of Abuse of Older Adults in the Canadian Prairie Provinces

SAGE Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. 215824402110532
Author(s):  
Kerstin Roger ◽  
Christine A. Walsh ◽  
Donna Goodridge ◽  
Stacey Miller ◽  
Marina Cewick ◽  
...  
Keyword(s):  
Older Adults ◽  
Content Analysis ◽  
Mixed Methods ◽  
Service Provision ◽  
Service Providers ◽  
Mixed Methods Study ◽  
Canadian Prairie ◽  
Prevention And Treatment ◽  
Reporting Recommendations ◽  
Prairie Provinces

This tri-provincial mixed methods study explores the reasons for under reporting abuse of older adults in the Prairie Provinces of Canada. Abuse of community-residing older adults, and specifically the reasons for not reporting such abuse, is poorly understood. This paper discusses the findings of the qualitative arm of the study that collected data through interviews with older adults having histories of abuse, their family members and service providers from related sectors. Content analysis was employed to identify three key themes: (1) recognizing and naming abuse; (2) barriers to disclosure; and (3) facilitators of reporting. Recommendations are made to improve awareness, education, and service provision in prevention and treatment of the abuse of community-residing older adults.

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