Department of Army Health Services Command CHAMPUS Catastrophic Case Limits Gateway Catchment Areas

1991 ◽  
Author(s):  
Scott A. Optenberg ◽  
Atanacio C. Guillen ◽  
William R. Cahill ◽  
Paul L. Frederick
Keyword(s):  
Health Services ◽  
Catchment Areas

Civilian perception of the role of the military in Nigeria’s 2014 Ebola outbreak and health-related responses in the North East region

2021 ◽  
pp. e001696
Author(s):  
Chris M A Kwaja ◽  
D J Olivieri ◽  
S Boland ◽  
P C Henwood ◽  
B Card ◽  
...  
Keyword(s):  
Human Rights ◽  
Health Services ◽  
North East ◽  
East Region ◽  
Catchment Areas ◽  
Key Informant ◽  
Military Relations ◽  
Epidemic Response ◽  
The Military

IntroductionCivilian–military relations play an important yet under-researched role in low-income and middle-income country epidemic response. One crucial component of civilian–military relations is defining the role of the military. This paper evaluates the role of Nigerian military during the 2014–2016 West African Ebola epidemic.MethodsFocus groups and key informant interviews were conducted throughout three states in North East region of Nigeria: Borno, Yobe and Adamawa. Participants were identified through mapping of stakeholder involvement in Nigerian epidemic response. English-translated transcripts of each key informant interview and focus group discussion were then coded and key themes were elucidated and analysed.ResultsMajor themes elucidated include developing inclusive coordination plans between civilian and military entities, facilitating human rights reporting mechanisms and distributing military resources more equitably across geographical catchment areas. The Nigerian Military served numerous functions: 37% (22/59) of respondents indicated ‘security/peace’ as the military’s primary function, while 42% (25/59) cited health services. Variations across geographic settings were also noted: 35% (7/20) of participants in Borno stated the military primarily provided transportation, while 73% (11/15) in Adamawa and 29% (7/24) in Yobe listed health services.ConclusionsRobust civilian–military relations require an appropriately defined role of the military and clear civilian–military communication. Important considerations to contextualise civilian–military relations include military cultural–linguistic understanding, human rights promotion, and community-based needs assessments; such foci can facilitate the military’s understanding of community norms and civilian cooperation with military aims. In turn, more robust civilian–military relations can promote overall epidemic response and reduce the global burden of disease.

Tele-health as a starting point for establishing primary healthcare in low-to-middle-income countries. (Preprint)

2020 ◽  
Author(s):  
Shahmeen Rasul ◽  
Luamar Dolfini ◽  
Syeda Anum Zahra ◽  
Tien Tran
Keyword(s):  
Health Services ◽  
Primary Healthcare ◽  
Digital Health ◽  
Low Cost ◽  
Evidence Base ◽  
Vital Role ◽  
Middle Income ◽  
Middle Income Countries ◽  
Starting Point ◽  
Catchment Areas

UNSTRUCTURED We read with great interest about challenges of digital health interventions in Pakistan.[1] This issue is pertinent, as even during a global pandemic, many more people might die from preventable conditions than from COVID-19 in Low-to-Middle-Income Countries (LMICs). This reiterates the need for establishing a viable primary healthcare (PHC) structure in LMICs, as opposed to avalanching funds from donor agencies. As a group of ethnic medical students training in London, we would like to share our unique perspective on healthcare in different economies. Hiring staff on a contracted salary, devising catchment areas and the running costs of practices are just a few of the major drawbacks to developing a PHC structure; changes must be made on an institutional level to implement a structure of this magnitude. On the contrary, tele-health services are currently operational in some LMICs (e.g. Aman Health in Pakistan) and can be a pragmatic solution for the time-being. PHC is innovating, and with time we have seen a rise in tele-health services such as NHS 111 in the UK. Most of the population in LMICs are able to access a phone calling service through feature phones and landlines, allowing access to local advisors and eliminating language barriers entirely. Tele-health is essentially used to direct patients to correct services, such as referrals to local specialists and hospitals. Using pre-existing services means this model can run at a low cost, and acts effectively as a ‘mediator’ between the general population and the appropriate service. By doing so, tele-health can play a vital role in preventing mortality down the line due to early intervention. Patients can also be given safety-netting advice if they have milder issues, which reduces unnecessary visits to doctors and alleviates burden on oversubscribed services. Furthermore, staffing for tele-health is made attainable by the use of software-based algorithms, as callers do not necessarily need a medical background. Achieving a sustainable PHC structure means money is saved on the treatment of preventable conditions. This can be used to incentivise governments, and points for further research include an evidence-base that a PHC structure is actually a wiser option for the economy in the long-term. However, this is ambitious. For now, tele-health services can serve as a realistic starting point.

Description and classification of mental health services: a European perspective

1998 ◽  
Vol 13 (7) ◽  
pp. 333-341 ◽  
Author(s):  
S Johnson ◽  
L Salvador-Carulla
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Service Use ◽  
Validity And Reliability ◽  
Programme Implementation ◽  
Services Research ◽  
Similar Treatment ◽  
Catchment Areas

SummaryWhilst steady progress has been made in the development and dissemination of valid and reliable instruments for evaluation of patient outcomes, progress in establishing standard methodologies for description and classification of mental health services has been limited. Valid and reliable methods of describing and classifying services are needed in mental health services research for purposes including; i) comparison of levels of provision between catchment areas and countries; ii) reaching an understanding of the relationship between socio-demographic indicators and service use; iii) investigation of the degree to which one service may be substituted for another; iv) evaluating programme implementation; and v) understanding why different outcomes are observed from apparently similar treatment programmes. Where programmes of research encompass different countries, the need for methods of comparing the local service contexts is particularly acute. In this paper, the various contributions which have been made to the somewhat fragmented body of research in this area are reviewed, and the problems which have hampered the development of satisfactory instruments are discussed. A set of criteria for satisfactory service measurement methodologies is proposed: these include development of standard nomenclature and operational definitions of service types; clear demonstration of validity and reliability; comprehensiveness; and applicability and similar interpretation in a range of countries.

A Communitarian Correction for Health Outcomes in New South Wales?

1996 ◽  
Vol 2 (2) ◽  
pp. 36 ◽  
Author(s):  
Chris Rissel
Keyword(s):  
Health Services ◽  
Health Outcomes ◽  
New South ◽  
Theoretical Perspective ◽  
New South Wales ◽  
State Level ◽  
Health Department ◽  
Australian Health ◽  
South Wales ◽  
Catchment Areas

For over a decade, there has been a growing focus on health outcomes in the Australian health care system at a national and state level. Designed to improve population health, health outcomes programs are an attempt to re-orient health services. In Australia, New South Wales (NSW) is probably the most advanced state in implementing a health outcomes approach. What is the role of communities in the model of health outcomes proposed by the NSW Health Department? A theoretical perspective of 'community' is presented, which is then used to analyse major policy documents and publications from the NSW Department of Health that advance a health outcomes approach. The interface between health services and communities is particularly important from the perspective of NSW Health Areas and Districts which must implement programs to improve the health outcomes of the communities in their catchment areas. The contribution to improved health outcomes that is possible by working with communities should not be lost in any re-orientation of health services.

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