Designing Regional Health Systems in India: A Case Study of Himachal Pradesh

2015 ◽  
Author(s):  
Nachiket Mor
Keyword(s):  
Health Systems ◽  
Himachal Pradesh ◽  
Regional Health ◽  
Regional Health Systems

Embedding health literacy into health systems: a case study of a regional health service

2017 ◽  
Vol 41 (6) ◽  
pp. 621 ◽  
Author(s):  
Lucia Vellar ◽  
Fiorina Mastroianni ◽  
Kelly Lambert
Keyword(s):  
Health Literacy ◽  
Health Service ◽  
Health Services ◽  
Health Information ◽  
Health Systems ◽  
Health District ◽  
Local Health ◽  
Consumer Health ◽  
Regional Health

Objective The aim of the present study was to describe how one regional health service the Illawarra Shoalhaven Local Health District embedded health literacy principles into health systems over a 3-year period. Methods Using a case study approach, this article describes the development of key programs and the manner in which clinical incidents were used to create a health environment that allows consumers the right to equitably access quality health services and to participate in their own health care. Results The key outcomes demonstrating successful embedding of health literacy into health systems in this regional health service include the creation of a governance structure and web-based platform for developing and testing plain English consumer health information, a clearly defined process to engage with consumers, development of the health literacy ambassador training program and integrating health literacy into clinical quality improvement processes via a formal program with consumers to guide processes such as improvements to access and navigation around hospital sites. Conclusions The Illawarra Shoalhaven Local Health District has developed an evidence-based health literacy framework, guided by the core principles of universal precaution and organisational responsibility. Health literacy was also viewed as both an outcome and a process. The approach taken by the Illawarra Shoalhaven Local Health District to address poor health literacy in a coordinated way has been recognised by the Australian Commission on Safety and Quality in Health Care as an exemplar of a coordinated approach to embed health literacy into health systems. What is known about the topic? Poor health literacy is a significant national concern in Australia. The leadership, governance and consumer partnership culture of a health organisation can have considerable effects on an individual’s ability to access, understand and apply the health-related information and services available to them. Currently, only 40% of consumers in Australia have the health literacy skills needed to understand everyday health information to effectively access and use health services. What does this paper add? Addressing health literacy in a coordinated way has the potential to increase safety and quality of care. This paper outlines the practical and sustainable actions the Illawarra Shoalhaven Local Health District took to partner with consumers to address health literacy and to improve the health experience and health outcomes of consumers. Embedding health literacy into public health services requires a coordinated whole-of-organisation approach; it requires the integration of leadership and governance, revision of consumer health information and revision of consumer and staff processes to effect change and support the delivery of health-literate healthcare services. What are the implications for practitioners? Embedding health literacy into health systems promotes equitable, safe and quality healthcare. Practitioners in a health-literate environment adopt consumer-centred communication and care strategies, provide information in a way that is easy to understand and follow and involve consumers and their families in decisions regarding and management of the consumer’s care.

Data Transparency as a “Source of Truth” to Support Regional Health Systems Change

2017 ◽  
Vol 2 (1) ◽  
Author(s):  
Kristin M. Jenkins ◽  
Judy L. Bezanson ◽  
James R. Edgerton ◽  
W. Steves Ring ◽  
Baron L. Hamman ◽  
...  
Keyword(s):  
Health Systems ◽  
Systems Change ◽  
Regional Health ◽  
Data Transparency ◽  
Regional Health Systems

Abstract 182: The Impact of National and Regional Health Systems Arrangements on Hypertension Awareness, Treatment and Control: a Systematic Literature Review

2013 ◽  
Vol 6 (suppl_1) ◽  
Author(s):  
Jared Paty ◽  
Will Maimaris ◽  
Pablo Perel ◽  
Helena Legido-Quigley ◽  
Dina Balabanova ◽  
...  
Keyword(s):  
Health Insurance ◽  
Health Systems ◽  
Insurance Coverage ◽  
Regional Health ◽  
Cross Sectional ◽  
The Us ◽  
Cross Sectional Studies ◽  
Regional Health Systems ◽  
And Control ◽  
The Impact

Background: Around a billion people worldwide have hypertension (HT), a major risk factor for cardiovascular disease. A significant proportion of HT patients remain unaware, untreated, and are uncontrolled, despite the availability of inexpensive and effective medications. Weaknesses in health systems are thought to be a key contributor to the inadequacies in HT care and control globally. We performed a systematic literature review to summarize the effects of national or regional health systems arrangements on HT care and control. Methods: An existing health systems framework was adapted to illustrate the impact of health systems components on HT outcomes (awareness, treatment prescription, treatment adherence and HT control) and guide the conduct of the systematic review. Studies analyzing effects of health systems arrangements at the regional or national level on HT outcomes were included, and Medline, Embase, and Global Health were searched for eligible studies. Two authors independently assessed papers for inclusion, extracted data, and assessed risk of bias using a simple proforma. Pooling of results was deemed inappropriate considering substantial variation in study designs. Results: Fifty studies met our eligibility criteria; 1 randomized controlled trial, 11 cohort, 3 case-control, 30 cross-sectional, 3 ecological, and 2 qualitative studies. Forty-one studies (82%) were set in high income countries, 35 of which were in the US. Most studies examined factors relating to the effect of either health systems financing (35) or health systems governance and delivery (16). Longitudinal studies, supported by some but not all cross-sectional studies, consistently reported a significant association between health insurance coverage in the US and improved HT awareness, medication adherence, and control (10 of 21 studies). There was also a consistent significant association, in both longitudinal and cross-sectional studies, between reduced co-payments for medical care and improved HT outcomes (10 of 11 studies). Although lacking longitudinal studies, we found a significant association in 12 of 14 US studies between having a routine place or physician for HT care, and HT outcomes. Conclusions: A largely consistent association between health insurance status, medication copayments, and routine availability of HT care with HT outcomes was found. Implications for policy are mainly applicable to the US setting, where our findings suggest that expanding insurance coverage and increasing access to routine care may improve HT outcomes. Additionally, minimization of co-payments for medication and care may improve HT outcomes in the US and to a limited extent in other non-US settings. Future research efforts should primarily focus on obtaining high quality longitudinal data and reducing the information gap in low and middle income countries, which bear three quarters of the global HT burden.

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